Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist, presenter, author and founder of DiabeticTalks and Diabetes-Focused Psychotherapy. He recently wrote about how people living with diabetes often reach periods of struggle with the tiring and ongoing nature of diabetes. This has recently been known as “diabetes burnout.”

Healthcare providers who are not aware of diabetes burnout may think that a diabetes patient is simply being “non-compliant” in their care. Those providers and patients themselves need to understand that diabetes burnout needs to be dealt with in a healthy way or else problems can arise like depression, a lowered self-esteem, and poor diabetes management.

LeBow says it is common for people with diabetes burnout to have previously been doing well with their diabetes management and he recommends healthcare practioners help patients to get through their burnout and learn to avoid it if possible.

What are the Symptoms of Diabetes Burnout?

Diabetes burnout symptoms include “general feelings of exhaustion, guilt, resentment, shame and isolation” and these feelings last for long periods of time. They can make it very difficult for a person to keep up with diabetes management and perhaps even their general wellness and communication with others. It may look like depression but it isn’t the same.

“Some common burnout behaviors are struggling to check blood glucose levels, not addressing low or high levels and not eating or taking insulin at mealtimes. Patients may have stopped caring about managing their disease. Behaviors may also include isolating from friends and avoiding doctor appointments and other diabetes supports.” “In the face of diabetes management tasks, patients may experience a general feeling of paralysis or anxiety, anger, sadness or despair. They may begin to neglect relationships, hygiene and other activities of daily living.”

Why do People with Diabetes Develop Diabetes Burnout?

Ginger Vieira, author of Dealing with Diabetes Burnout wrote for Glu, “Diabetes burnout can be whatever it means to you. It can mean your fingers hurt from constant finger pricks. It could mean you’re tired of dealing with the scar tissue of insulin pump infusion sites. It could mean you’re feeling incredibly stressed out every time you have to contemplate the carbohydrate counts in your lunch or feeling painfully guilty every time you eat something a “diabetic shouldn’t eat” but feel too frustrated to choose differently.”

People living with diabetes (including caretakers) have to make many diabetes and health related decisions every day. They also continue making decisions everyone else is making about family, school, work and life in general. Making so many decisions can exhaust a person and even diminish their ability to continue making good decisions.

Psychologist Roy F. Baumeister was the first to call this “decision fatigue”. Basically, our willpower throughout the day which we assert when avoiding donuts for breakfast or choosing to walk at lunch or speaking kindly while mad at a coworker is not an unlimited resource. A large study showed how by the end of the day, people tend to demonstrate weakened decision making skills, especially after a day full of decision making. People with diabetes may be at high risk for decision fatigue because of the consistent need to monitor and make decisions regarding the interplay between diabetes and food, medication, physical activity, pain, and social situations.

Dealing with Diabetes Burnout

Though it may at times be unavoidable, diabetes burnout may be prevented writes Eliot LeBow, “Good diabetes management goes beyond the physical to include taking care of patients’ emotional health.”

He recommends that healthcare providers encourage patients to find support such as a diabetes educator, a psychotherapist and support groups to “help reduce feelings of isolation and loneliness.”

Ginger Vieira says that people with diabetes should feel entitled to feelings of burnout because diabetes is simply, hard work. People with diabetes can receive validation knowing that feelings of burnout are part of being a human while doing the work of a crucial automated process in the body.

To begin managing diabetes burnout one must acknowledge that it exists, understand that it is normal, and then seek the kinds of help needed in one’s individual situation.

How Healthcare Providers Can Help Patients

LeBow provides some ideas for healthcare providers insisting that the patient-provider relationship “can open the door for help or close it.”

Patients with diabetes visiting their healthcare providers are often nervous and fearful of blame and shame coming their way on top of already present feelings of negativity surrounding their diabetes management. If healthcare providers can help patients focus on positive aspects and on ways to improve their management, patients will feel more empowered to speak up for help and to communicate what their struggles are.

LeBow who himself has been living with type 1 diabetes since 1977, says that “referral to a psychotherapist specializing in cognitive behavior therapy, client-centered therapy or motivational interviewing is ideal, as these approaches tend to work well with people who live with diabetes.”

Further reading on diabetes burnout:

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