How Type 1 Diabetes Affects My Mental Health

It rolled in. Like a steam train.

Depression, that is. I don’t remember exactly when I first felt a change in my mood and behaviors. I cannot put a pin on a timeline of my life. It must have been after July 2013, at some point in between then and now my life has been a series of ups and downs. I became aware of my mental health after being diagnosed with type 1 diabetes.

I was 17, I was growing up, changing, becoming who I wanted to be.

Thinking back over the last four years, type 1 diabetes is the predominant contributor to my steadily declining mental health. Combine health issues with three years of mentally and physically exhausting years of studies, I think I can see where it all began. It started around an unexpected diabetes related hospitalization, I threw up during one of my exams and was disqualified. Meaning I had to start from the beginning despite all my hard work. This affected me massively, I felt like a failure. I felt like I was being punished for having diabetes, yet I persisted. I restarted the course, passed and got into my first choice university, despite being severely mentally ill.

For those of you who don’t know, type 1 diabetes is an auto-immune disease with no known cure. Bit of a bummer, isn’t it? It occurs when the insulin producing cells in a person’s body have been destroyed and no longer produce insulin. In short, my pancreas refuses to do its job correctly. Therefore, I self-administrate injections five times a day (or whenever I eat) to stay alive. Sounds simple? Do not be fooled.

When I’m talking to people about this disease, I don’t refer to it as a disease. It doesn’t feel like that despite the fact it can kill me. This disease is a full-time job. No days off, no sick days nor no holiday exceptions. It’s there every day. Every second, every minute, every hour. It’s a part of me. It’s my life. Diabetes is not only on my mind though, but my loved ones around me too. It can make me feel like a burden, especially when my family are deciding where to go to eat. “Make sure Brianna can eat something,” they constantly worry. They ask me questions about my health. Unfortunately, it makes me angry because trying to explain to someone what diabetes is and what it means to have it is no easy feat. Especially to someone who doesn’t have it themselves, which is why I tend to write personal pieces on it, in hope that people begin to understand what it endures.

It is the meticulous monitoring and planning that wrecks havoc with my state of mind. My days are often planned around my food intake and the factors that may change my blood sugar reading. Food is not the only factor to consider when planning my day. Exercise affects it. I like to run and it can be a frustrating task to work out how the activity may affect my sugars. The weather. Stress. Amount of sleep. Menstruation. Illness. A hot bath.

So many factors to think about. Imagine everything you do affecting your body. Time consuming? Only a little.

I wake up and the first thing on my mind isn’t my shopping list or impending bills. The first thing on my mind is “what are my blood sugar levels?” From the second I wake up to the moment I sleep, it’s on my mind. It never leaves. I can’t switch it off.

The worst thing isn’t the injections, the bruises or the blood. It’s the way a number on a screen can affect my mood. I credit my self-worth on a number. If the reading is good, I feel fantastic and successful, almost like a good diabetic. If the number is bad, I feel guilty, angry and worried. I’ve felt guilty for enjoying a high carbohydrate cheesy pizza with my friends. I’ve felt guilt for eating a doughnut. (Although, what contributes to a number being “bad” is mostly psychological. My bad might not be your bad.)

In a restaurant recently, I ordered a virgin strawberry daiquiri, blissfully unaware of the sugar content until my mum mentioned it. A quick Google search told me the sugar content. Sometimes I let diabetes win, I let it get me down and restrict me from eating like everyone else, experiencing life like everyone else. But that one time with the cocktail, I thought, “screw it.” I’m allowed to enjoy something sweet and sugary every now and again. My body might not agree with me, but why should I restrict myself for a number on the screen? However, the “screw it” attitude can be a disaster. It can lead to neglect of my condition which can lead to severe health complications including blindness, nerve damage and kidney problems.

Diabetes is a balancing act. It’s knowing when enough is enough.

There is no such thing as a “good diabetic” or “the perfect diabetic.” No matter what I do every day, no matter how many times I check my blood sugars and do all the right things, it’s the hardest thing to control and manage. No matter how accurate my carbohydrate calculation is, my body might not react in the way I expect it to. I have no idea how my body will react under any circumstance. I have good days where my body and sugar readings seem to be cooperating. I have bad days when I want to quit, give up, eat whatever and whenever I want with no fear of the consequences. I’m fighting my thoughts daily on what to do, how to respond to my disease and the way it makes me feel.

It’s impossible to manage, yet every diabetic puts a huge amount of stress on themselves to have the tightest control of their condition. The need for control has a role in affecting mental health. Losing control over my blood sugars makes me believe I’m losing control over my life. I’ve lost control numerous times, I’ve experienced burnout. It doesn’t help that I strive for perfection in all aspects of my life. One bad reading on my monitor can make me feel useless and not good enough.

Type 1 diabetes centers on control. Like being on a strict army regime. It’s tough and demanding. There are endless doctors’ appointments that come with the condition. Regular health checks-up, retinal screenings and blood tests. There’s remembering to put in prescriptions at the right time to avoid running out of supplies. There’s painful injections, fear of complications and sleepless nights.

People living with diabetes are two to three times more likely to have depression than the general population. It is a condition that is emotionally and physically exhausting. Sometimes I wake up ready to give up. The injections, the finger pricking, the weighing out of food. The amount of times I’ve cried because I’m tired of dealing with it every day. I’ve felt intense anger for eating something high carb and facing the consequences of a high blood sugar reading. I experience a lot of anxiety surrounding the condition. I worry what people think when I’m injecting in public. I worry I’ll experience a low blood sugar in my sleep and pass away. (It’s a possibility – a rare one, but it happens.) I worry what the doctors and specialists will say.

Mental health has many spectrums. It’s not just depression and anxiety. Diabetes can lead to eating disorders. It causes the patient to fixate on their food consumption. How much they are eating, the nutritional value of it. It plays on your mind 24/7.

Studies have said young girls with type 1 diabetes are more likely to experience an eating disorder. It’s not a surprise when there’s such a heavy focus on food. For young people, which is when the condition shows its first symptoms, their bodies are changing and body image can be affected. Diet culture affects teenagers worldwide, so when you have a condition that relies on you to watch what you eat, it becomes a bigger problem.

Diabulimia (although not a formal diagnosis) is when a patient will deliberately administrate less insulin than they require aiding weight loss. The lack of insulin in the patient’s body will induce hyperglycemia which over a long period of time has dangerous affects, resulting in the body breaking down its muscle and fat to gain energy.

I’ve been there, I’ve struggled with disordered eating because of diabetes. Prior to being diagnosed I was extremely ill. One of the symptoms of diabetes is weight loss. I lost weight very quickly. I had family members commenting on me looking “anorexic.” This weight loss was infectious. Looking in the mirror and seeing how much my body changed made me want to stay that way, I feared gaining weight and I ate small amounts. I ate very little because it helped manage my blood sugars. It was a form of control. I beat up my body because I wanted to be in control of my condition. I didn’t want to fail. Fortunately, I noticed before the side effects were permanent. I started eating more, I got my period back and I gained weight.

The disease is forever. Not the ideal forever you could have dreamed of. The disease is here to stay until a cure is discovered. Type 1 diabetes is a rollercoaster of emotions.

Include commitments, employment, a social life and education to the world of diabetes – no wonder patients are more likely to experience mental health problems. Every day is a battle.