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LWD 107.00

Scott Coulter

March 7, 2013

I was reading an article the other day that suggested the link between diabetes and depression might be even stronger than had been previously thought. It found, among other things, that the correlation worked both ways — that not only did having diabetes lead to a greater risk of depression (something that shouldn’t be all that surprising), but that having depression led to a greater risk for diabetes. This was true even when accounting for diabetes risk factors such as body-mass index (a measure of a person’s weight in relation to his height).

One of the people involved in the research proposed that this might even suggest a biological link, though this was pure speculation since no genetic identifiers were found and no biological testing was done in the study. Nevertheless, reading this reminded me again that diabetes is not only a chronic medical condition, it is a chronic mental health condition. It’s easy to forget this sometimes, particularly when the bulk of the literature on this disease is focused so heavily on the medical aspect of it. When mental health is talked about, it’s usually an aside or brought up as a kind of corollary to the physical management issues — stress management so that your blood glucose doesn’t spiral out of control, depression management so that you keep up your diabetes management strategies.

So I thought today I would give my take on the mental health condition I’ll call “LWD” (Living with Diabetes). I’m even going to give it a (fictitious) DSM (Diagnostic and Statistical Manual of Mental Disorders) code: 107.00. LWD 107.00 affects a staggering 1 in 10 adults in the United States. It is a chronic mental health condition signified by high levels of ongoing stress, intermittent feelings of anger and depression, and a risk of fatigue or burnout.

The DSM would go on to describe more of the problems associated with the condition, and so I’m going to depart a little here stylistically. As a therapist, I’ve always taken a slightly less “deficit-model” view of mental health disorders, focusing as much on the strengths each diagnosis carries as much as the deficits. As such, my description of LWD 107.00 might continue like this:

People with LWD 107.00 have high levels of resilience in comparison to the general population, often able to continue in the face of ongoing challenges for extraordinary lengths of time. This skill can sometimes backfire for people with LWD, however, as they can have a tendency to continue “suffering quietly” well past the point where some kind of counseling might have been in order (ahem… I’m talking to myself right here!).

People with LWD 107.00 tend to carry high levels of stress, which can be problematic. Because people with LWD 107.00 face such a proportionally higher level of chronic stress, it is common for people with LWD 107.00 to ignore such stress until it reaches a point of crisis. Stress-reduction exercises are highly recommended for people with LWD 107.00 to avoid this kind of build-up.

People with LWD 107.00 are often excellent communicators, counselors, and meditators, thanks to their ongoing efforts to monitor their own 24-hour-a-day physical symptoms. As counselors, people with LWD 107.00 tend to be highly empathic people, in part because of their personal experiences with pain and sadness. This allows them to develop tremendous capacities to be of service to others who might be experiencing these feelings. This capacity can backfire for people with LWD 107.00, as well, leading them to ignore their own feelings entirely in order to attend to everyone else. People with LWD 107.00 should be reminded to give themselves time each day to process their own levels of anger, stress, sadness, and fatigue in order that these feelings are managed and not allowed to build to problematic levels.

The overall prognosis for people with LWD 107.00 is well above average. While the risk for depression and chronic stress is certainly a concern, the natural resilience of people with LWD 107.00 is a tremendous asset in helping them overcome the potential risks. People with LWD 107.00 should be encouraged to explore their feelings consistently. They should be encouraged to avoid the habit of dismissing their feelings of anger, sadness, fatigue, and burnout, as these feelings have the potential to build up, leading to serious consequences. Finally, people with LWD 107.00 should be reminded often of their strengths, which are many.



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