Diabetes is a complex condition, which presents substantial challenges for those living with it. Self-management is critical to healthy, independent and flexible day-to-day living, but this requires drive, motivation and changing one’s behaviour and routines. One’s emotional and psychological wellbeing is compromised when one fails and when the complications of diabetes take their toll on one’s physical health.
UNDERSTANDING THE IMPACT
Several factors affect the emotional and psychological wellbeing of a person with diabetes. These include the degree to which one accepts the diagnosis, adjusts to the demands of the self-care routine and copes with the progression of the condition – which potentially includes the development of diabetes-related complications.
Dealing with the diagnosis
Diabetes can have a significant impact on one’s life as regular medication, frequent medical appointments and lifestyles changes can all lead to different emotional responses. These can include depression, anxiety, eating disorders, phobias, adjustment disorders and problems in personal and sexual relationships.
There are also cultural issues that can influence a patient’s management of his or her condition. Problems may be caused by a lack of knowledge about diabetes and available treatment and support, religious convictions, fatalism (I.e. ‘It is God’s will’) and barriers to diet and exercise interventions. Furthermore, issues with one’s body image (I.e. weight and appearance) and what is culturally acceptable, are also factors.
The effect on attitude
Diabetes may have a psychological impact on a patient’s outlook on life and the way one views life going forward. For example, parental concern about the possibility of one’s children developing the condition and the development of diabetic complications coupled with the need to manage the condition in conjunction with the psychological demands of everyday life.
Troubles with treatment
Adherence to – and finding the motivation to follow – the prescribed treatment is another challenge. This is because whether or not one continues treatment, is determined by the extent to which one is able to match one’s behaviour with the health advice or recommendations. Effective recommendations are likely to be complex and vary from patient to patient. This is due to the need to balance the various components of treatment with each other and with life issues outside of the condition.
As adherence to treatment and diabetic control is monitored, one needs to remember that patients facing this challenge may feel demoralised or depressed if the outcomes are poor. Therefore, it is important that patients do not blame themselves for poor outcomes, as this could potentially undermine their motivation to comply with all aspects of treatment.
ILLNESS REPRESENTATION DIMENSIONS
Coming to terms with the diagnosis of a chronic illness is a process of adjusting and coping on an emotional and practical level. Where one encounters difficulties with adjustment, one may also experience distress. The meaning attached to the illness (the illness representation) can influence the adjustment process.
There are five broad cognitive illness representation dimensions that are thought to be:
- Identity (the label given to the illness and knowledge of its symptoms)
- Cause (beliefs about the cause of the illness)
- Timeline (the perceived duration and course of the illness)
- Consequences (the perceived short and long term effects of the illness)
- Control / Cure (beliefs about the degree of controllability / curability of the illness).
Some symptoms (hypoglycaemic symptoms such as irritability, loss of concentration / poor memory, shaking and sweating) of diabetes, may be misinterpreted as anxiety and contribute to the development of health anxiety and poor coping. (I.e The reverse may occur.)
A POSSIBLE INTERVENTION
Although coping with diabetes may be challenging, an intervention such as ‘neurofeedback’ can aid in managing emotional responses. For example, areas such as poor concentration, irritability, low motivation, over thinking, anxiety, stress, sleep problems, memory problems, depression and positive thinking can be worked on in sessions. Neurofeedback aims to have a calming and relaxing impact on the individual, which – in the long run – can positively assist a person in their daily life. ‘Brain training’ is another method which can support you in overcoming the challenges of diabetes.
For more information on our brain and mind training visit: www.eq-advantedge.co.za or phone 031 266 8563,