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9 Responses

  1. Bernard Farrell
    Bernard Farrell June 25, 2014 at 6:22 am | | Reply

    Great post Mike. Ginger Vieira’s book on Diabetes Burnout may be an effective way to reduce the distress for some folks.

  2. Mary Dexter
    Mary Dexter June 25, 2014 at 8:25 am | | Reply

    One thing healthcare teams can do is look at ways not to add to the distress. With time constraints and large caseloads, it may be tempting to say, “Why don’t you just…?” forgetting that as a diabetic I don’t just do anything. With every change, I need to ensure I don’t make things worse. I’m already micromanaging much more of my day than they are.

  3. Tim Steinert
    Tim Steinert June 25, 2014 at 8:50 am | | Reply

    Once again, another group of doctors who tell us “it’s not so bad, walk it off” in the guise of a study. I hate to be a divider, but the stresses of Type 1 and Type 2 can be widely different. It’s just the nature of the beast.

    Type 1 symptoms come upon you quickly, upsetting what to that moment had been a “normal” existence. Now, after a month and a half of wasting away–”good news, we found out what it is!” Bad news: you get to have it forever and now you have to inject yourself everyday or your life is going to suck. Never mind that, your life is going to suck.

    Our approach to dealing with that suckiness does not happen in a vacuum. If I generally pull away from people when I don’t feel well, Physically and emotionally– it’s going to be problematic and lead to depression. Not distress, depression.

  4. Dan
    Dan June 25, 2014 at 8:39 pm | | Reply

    “Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person’s ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state.”

    Now, are be just splitting hairs?

    How is this going to help?

    Here is an idea– a full proof way to end this depression that diabetes becomes: FIND A CURE!

    Now, I am not a dreamer. Something like SMART insulin will do it (where the insulin might manage blood sugar over a week).

    But what I am getting at is the more the disease is easier to manage, the better off we will be, and the less depression.

    However, at this point, pumps and long acting insulin (like lantus and levemir) has helped, but it is still a chore to manage the disease.

    Until we have a major breakthrough, these people can define and redefine all they want. The depression will remain.

  5. Benjol
    Benjol June 25, 2014 at 10:35 pm | | Reply

    Dan, I think that unwittingly, though rejecting the distinction, the rest of your post confirms it.

    The whole point is that what is being called ‘distress’ here has extrinsic causes: as you say, take away my diabetes, and I’ll stop being down. Whereas clinical depression is considered to be intrinsic: it’s the chemicals in your brain, and no amount of changes to your circumstances will make it go away.

    In reality it is probably more of a spectrum, and the difference may not always be clear cut (the initial clinical depression may have been triggered by an external event), but I think that the distinction is useful:

    - For someone with clinical depression, it can take away a bit of the associated guilt (‘Why don’t you just snap out of it?!’)

    - For those with ‘diabetes distress’, it means that there is a potential alternative to taking extra medication (mood-control drugs on top of your diabetes care). As you say, if the diabetes causes it, fixing the diabetes will fix your distress. But perhaps more realistically (short- to mid-term), re-thinking your diabetes could fix or alleviate your distress (even something so small as no longer thinking in terms of ‘good’ and ‘bad’ numbers).

  6. Depression, or Just ‘Diabetes Distress&rs...

    [...] Many of us with diabetes feel pretty darn down in the dumps on a regular basis.  [...]

  7. Lisa
    Lisa June 26, 2014 at 10:35 pm | | Reply

    Yikes, I usually tend to be depress all the time. I’d better minimize being depressed. Is that really true, that depressed people has bigger risk of dying compared to those who aren’t depressed? I want to check that questionnaire that Fisher created. Where can I see those, is that for free Mike? KUDOS, very great content. Thanks for posting this Mike.

  8. Gary
    Gary June 27, 2014 at 4:03 am | | Reply

    “the mass of men lead lives of quiet desperation.” And that was a long time ago.

    Plus, at that time, if you had diabetes, your life span was very short indeed.

    Don’t get me wrong. I hate diabetes. But lots of times, it’s what you make of it. I’ve found in life, everybody has something; some a lot easier, who have trouble coping, some a lot harder who seem to have less trouble coping with what they have to deal with.

    Coping is never easy, but it can be done, successfully and satisfyingly.

  9. Susan Whittier
    Susan Whittier June 28, 2014 at 8:50 am | | Reply

    That was a terricfic presentation Mike. I’m glad that people are finally hearing what Dr. Fisher is saying. In the early days I used to fend off telephone surveyors inquiring if I felt depressed with a scolding and a laugh. Slowly I realized that the younger MDs and any new MDs I met were looking at me as if I was automatically labelled depressed – a new approach to all diabetics.I actually thought life was going quite well at that point in time. I spent a lot of energy trying to convince the medical arena that no I was not depressed, but yes I was ‘distressed’ and I had reasons to be – most of them unresolved medical issues without ongoing support that created pauses in lifestyle that I was unwilling to accept. Once the issues were idenified as being just that – and not just ‘Diabetes’ – things would improve for a while.Burnout was never even on the horizon – and I’m still tredding water! The canoe is kind of holy now…As I age though the experienced MDs age as well – and retire. This once again presents the ‘oh it’s diabetes’ repsonses to new concerns – with no suggestion re resolution or prevention..The most recent example of why this keeps happening was a response to my concern re a brain MRI image that showed narrowing of a central artery -the response – ‘well diabetics have strokes’…. Distress? – you bet – and every time I give back an agitated response to similar situations – it’s now labelled as depression…I hope Dr.Fisher can rewrite that current attitude.

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