Another Time Warp Closes

When my best friend called me from the other side of the country to tell me she just found out she had gestational diabetes, I wasn’t surprised.

It wasn’t that her health history made it predictable.  She’s the healthiest person I know, works out regularly and consumes kale, quinoa, and kombucha like they’re actually enjoyable.  We became vegetarians in high school, and while I survived off of potato chips and cheese pizza she took vitamins and ate vegetables.  Years later she’s still a vegetarian and I’m (cough) not so much.

Maybe I knew something was wrong because we’ve been best friends since grade school and I have a sixth sense for what she was feeling.  Maybe her unusual silence in the days after I knew she was going in for testing was a giveaway. 

Either way I should’ve been prepared.  I understand what it’s like to get the news that you have diabetes; I don’t know what it’s like to hear it when you are carrying another human life inside you.  It seemed like an illness with an expiration date that was more complicated in many ways than regular diabetes, because she had to learn fast and in the middle of so many other weird things the body does during pregnancy.

I wanted to tell her that it’s not as bad as it sounds.  I wanted to reassure her that everything they tell you seems daunting at first, but it is entirely manageable.  I wanted to assuage the guilt in the back of her mind that it was somehow her fault.  I wanted to tell her it was not a tragedy but another challenge and that no matter what we would figure it out together.

But when she told me about the diagnosis and the tear-filled weekend that followed, all I could do was listen and offer encouragement.  I never got around to saying “me too.”

It seems like every time the opportunity to disclose comes up like this it’s like a time travel warp in a 90’s movie that will close forever if you don’t jump through in time.  Every moment after that window feels like it’s irrevocably too late. 

The next phone chat is the second best time to tell her, but even when we talk about her struggling with the new diet and routine of blood testing I offer my support but not expertise.  The calls after that, the text when she loses a relative, the days approaching her delivery date...with every new occasion it feels more and more awkward to say it, like it’s at the worst selfish and at best irrelevant.    

And with the passage of time, what you didn’t say becomes what you can’t.

But this is truly not a irreparable state, and I will tell her, because I know simple candor will cut through the awkwardness that accumulates each day I continue to hide it.  I have faith in the Chinese proverb, “The best time to plant a tree was 20 years ago.  The second best time is today” and the countless other adages that guide us past a view of the past as quicksand prohibiting progress and cementing mistakes.

Mental Health and Diabetes

As Mental Health Month comes to a close I wanted to share my thoughts on what mental health has to do with diabetes management.

In short: everything.

I believe it’s fair to say that the treatment of diabetes lends itself to behaviors that mimic or lead to the development of actual mental health disorders: eating disorders, anxiety, depression, you name it.  The personal responsibility for day-to-day management combined with the often-aired doom-and-gloom warnings of dire complications, significant cost of medications and supplies, lack of social understanding, and isolation is difficult to process into positivity.  Having diabetes can feel like walking an endless road full of deadly perils alone while armed only with a map written in Sanskrit.

The irony is that if you let all those things get to you, everything gets worse.  Ignoring the disease to save your sanity can be disastrous.  That’s why we need support to keep going. 

Maybe that comes from the online diabetes community, where we can be inspired by the encouraging voices and ambitious people living with diabetes.  Maybe it’s the annual conferences and workshops on diabetes that, among other benefits, showcase just a sampling of the sheer number of people involved with diabetes in some capacity.  Maybe it comes from friends or family members who listen when we vent on a bad day, gently ask us how it’s going when we’re quiet, and laugh, eat, and spend time with us with acceptance of who we are and whatever health conditions are a part of us.  Maybe it comes from local support groups that introduce us to other people with diabetes and their stories, where we can talk about our current challenges or topics not related to diabetes at all.

Finally, we can find that support from mental health professionals, because the truth is that the totality of the above options are sometimes not enough without the foresight to sort through and connect them.  It’s like a scatter plot graph of support—you get opinions and facts here and there, but it’s more helpful to understand the trends by drawing a line. People trained in mental health can help you sort through the mess of conflicting ideas, see the bigger picture, and find the back door to circular logic.  Those thoughts that accumulate in our heads like extra glucose in our veins—you’re not doing enough, you need to try harder, you're failing.  We’re in the trenches of diabetes management every hour of every day, and it’s eye-opening to get an outside view.

But even in the 21st century the relationship between mental and physical health still struggles for validation.  Research seems to recognize it more and more, but the stigma is still prevalent.  Perhaps a holistic approach to diabetes would mean people get the care they need to achieve better outcomes, saving health care money in the long run.

I wish that when people are diagnosed with diabetes they would be referred to a therapist as well as an endocrinologist.   I wish counseling was offered as readily as visits with nutritionists and diabetes educators when numbers aren’t where they should be.