Diabetes and mental health: Ways to cope with diabetes burnout and anxiety

The content in this article should not be taken as medical advice. Please consult your healthcare provider regarding your individual health needs. 
Everyone experiences stress in their lives, be it pressures related to work, parenting, balancing our budgets, personal relationships or just the hectic pace of modern life. But for those with diabetes, the daily grind of acting as a human pancreas can wear on the mind and create even more stress, anxiety, depression or diabetes burnout.
Sometimes, mental health challenges related to diabetes call for professional support and advice. And who better to tackle this topic than Dr. Mark Heyman, a psychologist who’s lived with Type 1 diabetes for more than 20 years.
The Diabetes Psychologist
The founder of The Diabetes Psychologist in San Diego, Heyman has practiced for 11 years and wrote “Diabetes Sucks and You Can Handle It.” He has also managed his T1D with Dexcom CGM since 2013. To call him experienced and empathetic would be an understatement.
“Because I have diabetes myself and live it day to day personally and professionally, people really appreciate that,” Heyman said. “The fact that I have diabetes really opens a sense of trust and authority for me with patients.”
Heyman’s lifelong passion for helping others achieve their full potential led him to a career in psychology. After his diabetes diagnosis at 21, he struggled to adjust to living with the condition and couldn’t find the mental health resources he needed. He noticed others with diabetes struggling to believe they could still meet their full potential, do what they wanted and become the person they're meant to be. 
“From that realization, I decided to become the resource I always wanted to have,” Heyman said. “The word ‘can't’ is prevalent with diabetes – I can't do this because I have diabetes, I can't eat that, I can't you name it. And it really bothers me that people have that perception. I want to break down those barriers for people and help them see they can do whatever they want to, and I want to give them the skills and tools to empower them to do that. It’s something I love, and it’s really at the heart of what I do.”
That means helping people with diabetes develop the coping skills they need to handle the stress, anxiety and depression that can sometimes arise from a new diabetes diagnosis or ongoing diabetes management. There is no magic wand, Heyman cautions. 
“We can't make your anxiety about diabetes completely disappear,” he said. “But what we can do is teach you the skills you need to be able to experience anxiety, diabetes burnout or any of the things you're experiencing, but not let them get in the way of your life. And we can help you to carry them in a way that will help you to do whatever you want to do without being unrealistic about what success looks like.” 
Identify the stressors, then use these tips to cope with diabetes burnout 
First, know that diabetes fatigue is common. Nearly everyone living with diabetes finds it stressful at times. You are not alone, and you likely will experience diabetes burnout
Identifying stressors and their causes is not only important for long-term health, but it’s also the first constructive step toward finding solutions to overcome them. Heyman said he sees some common causes of stress and anxiety for people with diabetes, and he offers a few tips to cope. 
The five common stressors:
  1. The work - Diabetes is a condition that you must manage all the time, and there are no days off. The constant stress of all that work with no time off can wear on your mental health.
  2. The unpredictability – After all the work you put in, sometimes the output is not what you want it to be. It can cause frustration when you do the same thing every day, yet you get different results. It can also create a sense of helplessness and feelings of being out of control. 
  3. The anxiety – First, you might be anxious about what happens at every moment. For example, obsessing about your glucose levels going low might make you anxious about how safe you are or make you ruminate about what might happen if you do things outside your comfort zone that could cause glucose level fluctuations. You might also develop anxiety about the future and worry what will happen to your long-term health if your glucose levels stay too high (hyperglycemia).
  4. The adjustment to new things – After a diabetes diagnosis, there’s an adjustment to a new way of life, new treatments, using a CGM or AID, and a “mourning” for how life was before. Prior, you didn’t need to take insulin or closely watch diet. But after diagnosis, it becomes vital. You can clearly remember what life was like before diabetes, and you might feel a tension between the memory of life before and the memory of life after, which can be incredibly challenging.
  5. The feeling of isolation – You might sometimes feel as if no one else can truly understand your experiences with diabetes. That can make you feel lonely. And when people try to help you, they often don't know how to help, don't give good advice or don’t give good support, and that's stressful.
“In the end, there's going to be some level of stress and frustration living with diabetes just because that’s the nature of the beast,” he said. “The questions I like to ask are: ‘How do you tolerate that stress? How do you deal with that anxiety?’ And dealing with it – I don't mean make it go away, because that's not possible and you're setting yourself up for failure if you believe that's going to be the case. But how do we help you learn the skills you need to be able to tolerate that anxiety? Because if you can tolerate it, then suddenly it's not going to get in your way. It may be a bump in the road, but it's not going to be a big barrier.” 
Thankfully, there are solutions.  
Three ways to cope: with diabetes burnout and anxiety
  1. Mindfulness – Learn to question and hold thoughts lightly around the meaning you put on things. Ask yourself or a loved one if your response to worry is healthy or if it’s getting in your way. Put simply, be aware of your thoughts and your anxiety. Be honest with yourself, really evaluate those thoughts, challenge them and then take committed action. 
“I like to use dating as a metaphor,” Heyman said. “Remember being interested in someone and debating how to reach out and how to ask them out? You put yourself through anxiety and self-doubt as you work up the courage. No matter the result, you realize it’s worth going through that stress because it’s the only way to get relationships. The same thing must be true in our lives with diabetes. You must think about what things are really important to you in your life, and what are you willing to do to have them? Likewise, why is doing the work for your mental health and being able to tolerate the anxiety and the stress worth it to you? Addressing these things is challenging. But if you have a reason why it's so important to you, you can use that as the leverage you need to get to the place where you want to be, even though it's going to be hard no matter how you cut it.”
2. Normalize the experience of living with diabetes – In other words, understanding deeply and learning to accept that the experience is completely normal. 
“Normal doesn't mean fun and it doesn't mean we want them to be this way forever, but to know that what's happening for them is not unusual or out of the ordinary,” Heyman said. “I think one of the biggest challenges is that people think their experience is completely different than anybody else with diabetes. But if we can normalize the experience, it takes the charge out of their experience. Once we normalize that experience, then we can give them skills and tools, and they're more open to those skills and tools, as opposed to being wrapped in their head that what they're experiencing is completely outside the realm of what’s normal.”
3. Recognize what can be controlled with diabetes and what cannot – There are things you have influence over, and there are other things you have no influence over when it comes to diabetes and its management. Focus on what you can control – control the controllable. 
“You have control over your behavior, you can choose when to check your glucose levels, when to take insulin, when and what to eat,” Heyman said. “And then when you do those things, you have influence over what your glucose levels are going to be but not perfect control. If your glucose level is high right now, you can bring it down over time. If it's low, you can bring it up, but you can't bring it up to a certain number necessarily. You can bring it up to a certain range within reason.” 
You can lean on technology to help gain more control
With Dexcom G7, you can see your accurate1 glucose levels in real-time without fingersticks†, and that can translate to increased confidence as you navigate diabetes management. 
†Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings. 
While life with diabetes can have moments of anxiety, burnout, and even depression, there are resources that offer mental health help for people with diabetes, such as the CDC, the American Diabetes Association or your healthcare provider. Not everyone with diabetes will need professional mental health help, but resources like these can be a great help for those moments when diabetes feels overwhelming. 
If you are living with diabetes and not using CGM, talk to your doctor about Dexcom G7. We can help you get started with a free benefits check. Click the button below to send us some basic information. 
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1 Garg SK, et al. Accuracy and Safety of Dexcom G7 Continuous Glucose Monitoring in Adults with Diabetes. Diabetes Technol Ther, 2022.
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