Managing diabetes can often feel like a full-time job. And much like any job, there are certainly days where you want to pack it all, run away and ignore it entirely. However, we don’t often jack-in our job because we know the consequences would probably be pretty negative. With diabetes, the consequences of ignoring, self-sabotaging or neglecting, can potentially be life-threatening. This knowledge alone can sometimes make tough diabetes days even harder because there really feels like there is not much choice.
There is sometimes the assumption that because you have a condition - that you have possibly lived with for a long time, or that you manage well enough most of the time - you are somehow exempt from being able to still have really rubbish, down-in-the-dumps, frustrated, angry, upsetting and generally pants days when it comes to your condition. These days, and these difficult and tricky thoughts and feelings about your diabetes, is completely normal and completely valid. You can have and ‘be’ both – you can be a person with diabetes AND you can be a person who has days when they really struggle with their diabetes.
Much like the example of work at the top of this article, the days when we want to put our career in the bin and become an international gin taster (personal fantasy), are the days when things have gone wrong. This may be an accumulation of annoying things that just don’t seem to go right, or it may be a single incident of something that gone wrong or a bit sideways. Either way, this can often ramp up our more tricky emotions, sending us into a headspace of anxiety, anger, jealousy, fear, sadness, guilt, failure and I-am-totally-done-with-this-ness. Again, this is completely normal, valid, and most certainly happens when managing diabetes. Everyone who is managing their diabetes has had at least one of these days. For some, it may be a really bad week rather than a day, or it may be a really tough month rather than week. I plan on using the rest of this article to try and outline a few ways that may help you step out of this bad-day headspace.
We often speak to ourselves in a much more harsh and critical way than we would ever dream of speaking to anybody else. If you are finding that you are being hard on yourself e.g., “you’re failing”, “you’re useless”, “everyone else is doing so much better than you”; stop a second. Imagine your best friend or dearest loved one is sitting opposite you. If possible, say these thoughts about yourself out loud, as if you were saying it to them. As if they had diabetes and they were having a tough time. Tell them they are useless, failing and not as good as other people. You might find this upsetting because it is not very nice to hear (even when you are pretending to tell somebody else). Why is it okay to talk to yourself that way? Also, does it help or make the bad day better when you are cruel to yourself? Often it does not.
We are sometimes critical with ourselves in the belief it will ‘kick us up the bum’ into making changes. Sometimes this works, but often we end up making ourselves feel even worse, especially if change is tricky (which it certainly can be with diabetes). Often, you are probably doing your best in a tough situation and that is GOOD ENOUGH. I would invite you on a bad day, to pause and check in with a) how loud that critical voice is, b) is it helping at all? And c) if it is not helping or making you worse, can you speak to yourself in a different way – a way that you would to a friend or loved one that is having a tough time? “You are doing your best – this is hard, don’t forget”, “Wow today is tough, I’m sorry you’re having a rubbish time” or “I think you handle this amazingly considering it’s a full-time job – it’s no wonder you sometimes need a break!”.
This links with the section above. We sometimes believe thoughts are facts (especially critical thoughts we have about ourselves). I am useless, I am failing, I am doing everything wrong. These thoughts get absorbed into us so that we feel like we become them. However, thoughts are thoughts, NOT facts.
According to recent research1, we have around 6,200 thoughts a day. Many of these thoughts will come and go, barely registering e.g., “what type of cereal will I have”? “I need more toothpaste”, “this article is long”. Some thoughts are more sticky and get ‘caught’. Often these thoughts are emotive and personal; and the most sticky are often those that have a negative impact on us. We take these thoughts and shine a big spotlight on them, dissecting them and turning them over and over again. These thoughts then become our primary focus, we think about them so much that we believe they must be truthful and factual. “I AM useless because I can’t control my blood sugars today”. Although this thought feels painful and upsetting, it is still a thought, the same as “I need toothpaste”. It can be helpful to try and put these sticky thoughts/”facts” back in their place. Dr Russ Harris (Psychologist) calls this ‘thought defusion’ and there are many different ways of trying to de-fuse from your thoughts. Give the activity below a go.
See this video below, which is a great example:
1) Write down the sticky thought e.g. ‘I am useless’
2) Now write below the same thing but put “I am having the thought that…” in front of it e.g. “I am having the thought that I am useless”
3) On the next line, now write “I am noticing that…” then what you put above e.g. “I am noticing that I am having the thought that I am useless”
4) Read line number 1 and then line number 3. Do they feel different when you read them? How? Often people find the latter sentence “I am noticing” etc. a lot less harsh and painful.
Thought defusion helps to put thoughts back to where they belong – not as a fact but simply as yet another one of those 6,200 thoughts you have every day. When we can do this, we can stop shining the spotlight on these thoughts – hold them ‘less tightly’. And hopefully, this will help you to feel less affected by them so you can free up some headspace to do other things that are important to you.
Sometimes it can help to try and figure out if there has been a certain trigger or reason why you are having such a bad day. It may not be possible, it may just be a bad day, or there may be so many little things that have added up, it is impossible to untangle them all. However, thinking of the factors that have led to today’s ‘bad day’ can sometimes help you be more compassionate with yourself as to why you are struggling. It can also help you figure out some solutions on how to change things.
For example, “Why do I feel so short-tempered and easily upset about my diabetes today?” Firstly, go back to basics: Sleep, food, pain/discomfort, too hot/too cold, water intake etc. Have any of these been disrupted? What else from a physiological point of view could be going on? New medication, new diet, are you unwell/sick, for women – where are you in your menstrual cycle? Then next level: has something or someone upset me? Has something happened in the last few days that isn’t necessarily about diabetes but has caused me to feel wobbly? Is there something I need emotionally that I don’t have right now e.g., company, friendship, compassion?
Sometimes you may go through such a list, starting with basics and getting more complex, and it may provide some reasoning as to why you are feeling this way. “Why do I feel so short-tempered and easily upset about my diabetes today? Oh, I only got 4 hours sleep, I don’t think I’ve had enough water, I’ve got a headache, I had a really hectic week at work, my friend let me down last night, I really need a hug”. There are some things here that may naturally make you feel better e.g., catching up on sleep, getting enough of the right food and water intake, taking a painkiller etc. Also, that in my example, I might need to call a friend, or get somebody round to give me a hug and look after me, or distract me with movies and chatter. It’ not necessarily going to work every time but particularly going back to those basics can really highlight that there are good reasons why you might be feeling crummy and its not just ‘you’.
If it is possible, literally making some distance from the ‘bad day’. When I say distance, I think about the idea of maybe popping all the negative thoughts, frustrations, upset and anger; on a shelf, just for a bit. These feelings are unlikely to disappear just by doing this, but it can help to take a break. Like taking off a really heavy backpack. You’ll probably have to pick it up again later but at least you would have had a rest and feel a bit stronger to manage it. Perhaps, getting outside, doing something physical or it may be changing your activity – choosing a film you love or a really engrossing series, or turning on the radio and baking something good. It could be calling your friend or your family, going for a wander around town or playing fetch with the dog. Sometimes it’s good to give yourself the permission to take a break and try to come back to things a bit more refreshed. Of course, this is easier said than done sometimes, but even a small break is better than none.
This is a mantra I personally use a lot. If you are having a bad day and perhaps the things above are too hard to try or just not clicking this time, it can sometimes be helpful and a relief to know that tomorrow will be different. I cannot promise you it will be better or worse. But it will be different. You will never have the exact same day that you have had today (unless you are Bill Murray). Sometimes that in itself can be a comfort and a useful mantra to hold on to. “Today is tough, I feel pretty rubbish and I am struggling; but tomorrow will be different and I will have a different day”.
I hope you have found some of these pointers helpful. As always, these are just a few ideas and not all of them will be helpful for all people. Explore what works for you. If the bad days are becoming more frequent and feel more intense, it may be a sign that you need further support. I would encourage you to seek this out, whether from your doctor or diabetes health team, or mental health support such as counsellors and therapists.
Written by Dr Sophie Augarde