Diabetes Self-Management Blog

“It’s strange,” said Margaret, diagnosed with Type 1.5 (LADA) ten years ago. “Managing diabetes as a single Mom with two teenage daughters was tough. But now that they have gone to college, I’m doing worse. Lately, I hardly plan meals or check my glucose at all.”

I told Margaret I didn’t think her story was strange. I thought she was lonely, and loneliness can sap motivation for self-management, because it can seem as if nobody cares. Even without diabetes, people often find planning and cooking “meals for one” too much trouble. It’s easier to microwave a packaged dinner.

Lonely people also lack social support. Because she always worked long hours to support her family, Margaret has not been physically active. “I was on the swim team in high school,” she told me. “I really loved swimming, but after the girls’ father left, I was overwhelmed. I didn’t have enough time or energy to swim. I miss that.”

Some of her low energy was probably due to diabetes. But she also didn’t have anyone to help with the kids or to swim with, and she still doesn’t. Lack of support leads to lack of exercise.

Finally, loneliness can cause direct physical symptoms. According to studies in the book Lonely, by Emily White, loneliness can raise your blood pressure, cause depression, and weaken the immune system. We’re primates; we like to be together. Being alone is stressful.

I asked Margaret what life had been like with her daughters at home. “Oh,” she laughed. “I was always busy. Cooking, cleaning, working, looking out for the girls. I was tired! But somehow I usually found time to cook recipes from diabetes cookbooks. I really like Mexican food, and I learned dishes with cactus and chilis that were good for my sugars and tasted great.”

“Now that I’m alone,” she continued, “it just seems like too much work. I buy frozen dinners and look at the carb content on the package. But I don’t worry about it as much as I used to.”

I asked Margaret if she thought she was lonely. “Sometimes at night,” she said, “I wonder how I got so alone. I think what happened is, I put all my energy into my daughters and didn’t keep up with friends. Now my old friends have drifted away, and I don’t know where to find new ones.”

Being a housewife can be a set-up for loneliness. Children’s moving away is a common path to loneliness, as is divorce. Others commonly mentioned include moving to a new city, death of a loved one, or losing or changing jobs. Less mentioned but very common is chronic illness, including diabetes. Illness puts more demands on us, so that we withdraw from others to pay attention to our health. It may cause us to feel different from others or cause them to see us differently and back away.

I told Margaret the best thing she could do was find other people with whom she could connect. She agreed, but asked me, “How? I have acquaintances at work, but it’s not like having close friends or a lover.”

Margaret was pointing out that there are two categories of loneliness. Emily White’s book quotes psychologists who identify “social loneliness,” which is a lack of acquaintances and friends, and “emotional loneliness,” which is lack of an intimate companion. Some people, like Margaret, have both kinds, but they need to be approached differently.

Potential friends are all over the place. A good book called Consequential Strangers describes the many ways casual contacts — coworkers, the crowd at the local deli, people you ride the bus with, neighbors, people who share your hobbies — can provide social support.

A site called Succeed Socially points out that casual contacts can easily turn into friends. Examples could include: people at work or in your classes, friends of people you already know, someone who has shown an interest in being your friend, friends you’ve gradually lost contact with who you could call up again, and siblings or relatives close to your age. Family members of any age can take the edge off loneliness.

We can also meet new people at work, school or church, or through community activities and hobbies. Succeed Socially suggests that if you can make one friend, you can meet their whole group and become part of a new circle.

Online resources are also good ways to meet. You can search for groups who share your interests at www.meetup.com. You can find other friends with diabetes at TuDiabetes, Diabetes Friends, and many others. You also try a diabetes support group.

Finding intimate connection may be harder, but usually the best way is to meet people doing something you like doing anyway. Then you’ll have something in common. Web sites like www.match.com and www.craigslist.org work for a lot of people.

I encouraged Margaret not to wait too long, because according to experts like John Cacioppo, PhD, of The University of Chicago, loneliness can sap your self-confidence and make it harder to connect over time. After being alone for too long, it’s normal to avoid others, because social contact starts to seem slightly threatening. That’s how loneliness becomes chronic.

Perhaps readers have some other ideas. What would you tell Margaret? Does loneliness affect your self-management or your life, and what can you do about it?

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