“I can’t do this anymore,” a 17-year-old woman named Lia posted here. “I can’t control [my glucose]… I know I am responsible for myself, but…I find it extremely hard to do everything…when it is needed. Please help me!”
Well, I’d like to help, so I have to ask you all. Do you ever feel that way? Most people with diabetes and other chronic illnesses sometimes do. I know with my multiple sclerosis, I work very hard with diet, exercise, and relaxation to keep my body as functional as possible. Sometimes it works and sometimes it doesn’t, and the days it doesn’t can be frustrating and scary. “Yesterday I could walk to the bathroom; today I can’t. What did I do wrong?” On those days, I feel like Lia; I want to give up.
With diabetes, there are even more opportunities to feel like a failure. As Diana M. Naranjo, PhD, and Korey K. Hood, PhD, wrote here,
When a person has diabetes, there are a lot of “things” that must be repeated over and over, such as checking blood glucose levels, administering insulin, and coordinating insulin with food and physical activity.
When things aren’t going well, it’s easy to react like one woman who said, “I feel like I do the same thing over and over again, but we’re not getting anywhere.”
So what do you do with those burned out feelings? How can we avoid them and recover from them? According to Drs. Naranjo and Hood, most important is to avoid trying for perfection. They write,
The problem with aiming for perfection is that so many things go into achieving optimal control, and you can’t control all of them…When you set out to have all perfect blood glucose levels or that perfect A1C level, you can set yourself up for feeling like a failure. Anything that falls short of perfect, even if it is the best you…can do at that time, may cause guilt and blame and diabetes burnout.
There is just no place for perfectionism in diabetes management (or in any area of life, actually). It just leads to beating yourself up and sapping your self-confidence. And then, why keep trying if you “just can’t do it,” as Lia said?
Naranjo and Hood advise “stop black-and-white thinking. Recognize the effort you are making to manage diabetes… Feelings of guilt and the subsequent blame you assign are not helpful; they can lead to feelings of resentment or wanting to give up.”
But perfectionism is hard to let go. In most cases, we learned it as young children. You have to please the adults in your life, or you’ll get in trouble. To please them you have to be perfect. It’s not easy to unlearn that lesson. If you are inclined to perfectionism, you might want to get some help.
Cognitive-behavioral therapists are good with this kind of thing. They can help you change harmful thoughts and self-defeating needs to be perfect. It’s also helpful to talk with others with diabetes. How do they deal with the emotions and stresses of the illness and self-management? How do they avoid falling into the perfection trap?
Related to perfectionism is overgeneralizing bad things. When I have a bad day, say a day when it’s hard to stand, that doesn’t have to mean I’m getting worse. I’m just having a bad day, probably for a reason. If I can figure it out, I can get some strength back.
Likewise, if your A1C goes up, or your neuropathy pain increases, or your sexual function is down, that may not mean you’re getting worse. Something just went wrong. Maybe it was something you could control, or maybe your meds need to change, or your diet, or something. Maybe it was out of your control, like an illness or a major stress, but it doesn’t mean you can’t get better again.
When life seems harder or less enjoyable, when it seems your life is getting smaller, that doesn’t have to be permanent either. It just means you’re going through a hard time.
Similarly, good glucose numbers don’t necessarily mean you are getting better. A new medicine might be helping keep numbers down, or life may be easier, or you may have learned some things, but you may just be going through a good patch.
The point is to take it day by day. As they say in AA, “one day at a time.” Or as Scott Coulter advised in his column, “live in the moment.” Trying to be perfect or judging yourself badly will weigh you down and produce burnout. Letting go of self-judgments, perfectionism, and black-and-white thinking will take a lot of negative feelings out of your equation.
What do you think? What would you tell Lia?