You started your day happy but, for no obvious reason, your mood’s been up and down since. A flash of irritability saw you snap at a friend. The comfort food binge meant to soothe your ragged nerves did the opposite. Now, drowning in a sea of guilt and misery, you wonder why your emotions seem to be on a perpetual roller-coaster. Such unpredictability can be very undermining.
It shakes your confidence and can disturb those around you. But mood swings go with the territory when you have diabetes – the challenge is to recognise them as a side effect and learn how best to manage them.
“While emotional peaks and troughs are a normal part of life, people with diabetes can be more prone to mood swings because of the stress and unending daily demands of managing their chronic health condition,” says Dr Lisa Engel, a health psychologist specialising in diabetes.
“In addition, both high and low blood glucose levels can have physical effects that profoundly impact on mood.”
So what’s driving your moody blues? Is it physical, emotional, or both? Identifying reasons for your mood swings is the key to predicting and preventing them.
Try these strategies to smooth your way.
Learn to let go
“Keeping yourself on too tight a rein with your diabetes care can cause you misery because you feel you’re missing out on the good things in life,” points out Dr Jennifer Conn, an endocrinologist specialising in diabetes at the Royal Melbourne Hospital. “Being too rigid in your management canalso lead to problematic behaviour, where some people get burnt out and throw in the towel, or go on an eating or drinking binge.”
Let your hair down: Ordering dessert or having a second helping of rice and curry occasionally won’t cause you long-term health damage. “Remember, it’s the way that you manage your diabetes most of the time that matters,” says Dr Conn.
Get a grip on your BGLs
Your emotional status quo and blood glucose levels (BGLs) are so intricately linked that both highs and lows in your blood sugars can slam dunk your mood.
“Low blood glucose levels, known as hypoglycaemia, activate the sympathetic nervous system, causing a biological stress response where your body tries to alert you to the falling blood glucose levels and releases adrenaline,” says Dr Conn. “This is why anxiety and stress are classic signs of a hypo, along with symptoms such as irritability and confusion. Meanwhile, high or elevated blood glucose levels can also cause irritability and fatigue as well as affect your brain function and clarity of thinking. This causes frustration if you then find it harder to concentrate or keep on top of things.”
Keep a check: If you have a sudden, unexplained emotional slump, a blood test will confirm whether your blood glucose level (BGL) is awry and needs correcting. A sugar hit may be all that’s needed to see you bounce back.
Adopt healthy habits: Aim to engage every day in some healthy habits to help stabilise your BGLs, including exercising, getting enough sleep, minimising alcohol intake, managing stress and following a diet that includes lots of vegetables, fruits, wholegrains and healthy protein.
See your specialist: If your BGLs are out of whack, some minor adjustments in treatment and simple lifestyle changes could be all that’s required to stabilise emotional swings.
Make over your medication: Unsettled mood can sometimes accompany the natural progression of diabetes – being irritable and volatile can be a sign in people with type 2 that they need to step up their medication or move on to insulin. Health issues, such as diabetes complications, can also have an emotional and physical impact, so seek your doctor’s advice.
See the big picture
Don’t allow one unexpectedly high BGL reading to drag you down.
“This can create a vicious circle, particularly when you have done everything you should to manage your diabetes well,” says Dr Christel Hendrieckx, clinical psychologist at the Australian Centre for Behavioural Research in Diabetes.
“If you’re constantly getting upset about fluctuating or high blood glucose levels, then you risk getting emotionally upset and this can increase your levels further.”
Take a long-term view: Make a distinction between the exceptions and how your diabetes management and BGLs normally are. This way, you are less likely to panic and suffer an emotional slump due to one or two unexpected hiccups in your readings or your health.
Divide your day: Evaluate half days or split your day into three time frames. You can then make an assessment at the end of each one about your BGLs within each time frame.
“This helps you realise the whole day wasn’t a write-off because you got one unexpected reading,” says Dr Hendrieckx.
Know your limits
Those people with diabetes who are naturally conscientious are likely to manage their condition more effectively, reveals research from
the Fremantle Diabetes Study carried out by The University of Western Australia.
“That doesn’t mean that a hyper-vigilant approach makes for better self-care,” says Dr Hendrieckx. “If a person with diabetes is highly motivated and organised and checking their blood glucose levels 12 times a day that may help them feel in control. But on the flipside, they may not feel relaxed. This, in turn, could be completely counter-productive if the stress increases their levels.”
Appreciate your best: Just try to content yourself with giving diabetes management your best shot. While it does need constant care, striving for perfection at all times is really an impossible burden, and is liable to overwhelm you with guilt, frustration and self-criticism.
“While gold standards like the healthiest range for your HbA1c result are useful to know, make your diabetes care more about your personal best,” suggests Dr Engel. “Look back as well as ahead so that you can appreciate how far you’ve come.”
Is it your job, your body image, concerns about your finances, your partner or your health? Mood swings can be a chicken-or-egg situation with diabetes, both caused by and impacting on your condition. This can sometimes make it hard for you to pinpoint which one is responsible when you’re feeling low.
“Making the connection between your mood and other lifestyle factors is very important, particularly as your mood can be harder to control than your food intake, yet it can have an equally huge impact on your blood glucose levels,” says Dr Engel.
Keep a mood diary: Write down your moods alongside any lifestyle issues such as sleep, food and stress. You’ll find this will help you spot any patterns around things that are sparking off your low mood. When a trigger becomes obvious, you can then do something about it – whether that’s going for relationship counselling, talking to your human resources manager about mistreatment at work or seeing a specialist to ensure you’re getting the best management for a worsening health issue. Addressing it and getting help to find ways to resolve the problem more effectively means it has less impact on your mood.
Be a detective: When you’re feeling low, ask yourself if you’d feel the same about the things that are upsetting you
if you didn’t have diabetes.
“This can help you put things into perspective, as well as recognise whether you need counselling or attitude changes towards your disease to cope with it more effectively,” says Dr Hendrieckx.
Challenge your stress reflexes
Being stressed is unhelpful for your diabetes as well as your emotional state. It releases stress hormones that increase your BGLs and also distracts you from managing your diabetes.
This means you may be more likely to get a takeaway that’s high in carbs, skip the gym or sit up too late because you’re worrying and can’t drop off to sleep.
“The way you respond to stress can often become a habit that doesn’t serve you. It actually makes the stress seem more overwhelming, which leads to a chronic low mood,” says Dr Engel. “Simply changing those habitual responses to difficult situations can boost your mood by helping you feel more in control.”
Avoid a victim approach: Remind yourself that most adults have to watch what they eat and exercise regularly, not just people with diabetes.
Give up grumbling: It may be your knee-jerk response to even the smallest irritation, but whingeing can profoundly alter your body chemistry, behaviour, stress levels and general health.
Look on the bright side: Okay, so you missed the bus on the way to work. But wasn’t it lovely sitting in the morning sun? And didn’t your colleague already have a coffee waiting when you got to your desk?
“Although you may not have control over aspects of your diabetes, you do have control over what you tell yourself,” says Dr Engel. “So when problems arise, ask yourself what else you could choose to think, feel and say about the situation. For example, if you get a high blood glucose reading, be in the moment. Say to yourself, ‘This is a number – it is only good or bad if I attach too much emotion to this one reading, and I’m not going to do that’.”
As this new way of thinking becomes a habit, your worries will start to lose their grip on your life, leaving your mind free to focus on the things that bring you more happiness, comfort and enjoyment.
Take a reality check: Realise that you are not centre stage in everyone’s lives. That hypo you had yesterday morning at work isn’t even registering anymore in the minds of the few people who witnessed it, even though embarrassment has you going over it repeatedly. “Don’t second-guess what other people are thinking about your condition or you risk believing your thoughts are the truth when other people are not even thinking about you or your diabetes at all,” says Dr Hendrieckx. “If you feel embarrassed after a hypo or because someone walked in on you when you were administering your insulin, seek that person out and clarify the issues about your diabetes with them so you can put your concerns to rest.”
This will help to ensure that an incident like a hypo doesn’t leave you feeling so ashamed or embarrassed that it puts you in a low mood for days. It will allow you to let go of your worries and move on.