Fear and Diabetes…

So I missed Halloween with this post, which is a shame because it’s such a great tie-in. Nevertheless, I wanted to write this week about diabetes and fear. This came up for me recently when I woke up with severely low blood sugar, and realized how close that put me to NOT waking up! In my follow-up I have adjusted DOWN my long-acting insulin, as it seemed to be pushing my blood sugar down overnight. But the whole thing reminded me of the plot to A Nightmare on Elm Street (which was being shown at least once every day SOMEWHERE on cable during the weeks surrounding Halloween), where you’re safe until you fall asleep. Once you’re asleep, Freddy’s comin’ for ya. It’s a great plot for a horror movie, actually. But it’s not much fun to feel that way in real life.

And while this particular episode seemed to tie DIRECTLY into the movie’s plotline, diabetes has always been something that seems to be “waiting in the bushes” for our moments of weakness. And that’s an exhausting thing to live with! It’s exhausting to have this feeling of being “always on” with this disease. It’s exhausting to never get a moment away from it. And it’s exhausting to have that knowledge always with you that it COULD sneak up on you if you drop the ball at any point!

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Diabetes inspires a fear of the “unknown,” and in some ways that’s really the most profound fear we know. Think about those horror films again — the fear builds when nothing is happening. The fear builds when the POSSIBILITY of something is lurking, but it hasn’t happened yet. When it actually happens, that’s the moment the tension RESOLVES in a strange way. The deep, psychological, down-to-the-core fear is inspired by this feeling of “dread,” this feeling of anticipation for the worst, and the knowledge that one cannot rest for even a split second for fear of being taken down. That’s certainly what I felt each evening going to bed after that low blood sugar! I was at the mercy of my blood sugar, at the mercy of hearing the alarm at 4:30 AM so I could monitor and make sure my adjustments were working. And in the broader sense, we are ALWAYS hoping to hold off complications, those shadowy monsters waiting just around the bend.

OK, so that’s life with diabetes. We’ve all experienced it. But now that I’ve painted a thoroughly depressing picture for all of us, let’s think about how we should respond to fear. To start with, I think it’s important to make a clear distinction between fear and pain. Pain is directly experienced. It is unpleasant, it is painful. But it is a direct experience, not something conjured up in our imaginations. Fear, on the other hand, is always about anticipating what might happen in the future. And that’s true even if the fear we have is inspired by something in our past — because the fear is that it will happen AGAIN. Fear is tied to predicting, and living in, the future.

Knowing this distinction can help us a great deal. Just identifying it doesn’t change anything, but understanding this points us in the right direction. The more we can live in the moment and avoid projecting into the future (and I mean good OR bad projections here), the less power fear has to work with. And if we manage to live entirely in the moment, fear has no ground in which to take hold. Now, easier said than done, of course. I was caught up in plenty of fear last week, but I can say that understanding helped me come out of that fear much more quickly than if I had not known the way out. It helped me use the tools I have at my disposal to reground myself in the moment — meditation, playing music, talking with my wife, riding my bike, all the stuff that brings me back to now.

But what about pain? If I’m making a distinction between fear and pain, and suggesting we avoid fear, what does that mean for pain? Here, the answer is counterintuitive. I think the real answer to successfully dealing with pain is to fully experience the pain. That’s not easy, but in my years as a therapist, I saw so many people whose lives were in shambles because of the great lengths they were going to simply to avoid feeling the pain in their lives. And inevitably, the measures they were going to in order to avoid that pain simply prolonged the issues and generated more dysfunction, pain, and isolation. Remember, pain is directly experienced. It is what it is — there is no changing it, no altering of it. Pain is factual. And therefore whatever psychological ploys we use to avoid it, we STILL experience it. But if we can manage to just experience it without layering counterproductive thought on top of it, we can avoid the dysfunction that can REALLY take us down.

Let me end with some good wishes. The holidays are around the corner, Thanksgiving is only a week or so away. Whatever condition each of your lives are in, whatever pain each of us is experiencing, whatever fears are lurking in the dark corners of our minds, let’s enjoy our blessings. Whether they are many or few, let’s take a breath and enjoy these moments together.