Many people feel that the daily struggle of caring for diabetes is likened to a battle, they must arm themselves every day to fight the war. With no time off for R & R it’s not unusual to sooner or later develop battle fatigue or as we call it “burnout”. Do you often find yourself experiencing these type of feelings:
- Feeling overwhelmed and/or defeated.
- Feeling angry and frustrated and other strong negative feelings.
- Feeling as though diabetes is controlling your life.
- Knowing that you aren’t doing what you should to care for yourself but also feeling unmotivated or unwilling to act.
- Trying to tell yourself that complications will not happen to you, and yet knowing that they are a real possibility.
- Stopping your efforts, not thinking about care, and thinking that high numbers are the “norm” for you.
- Stopping all activities such as testing or doctor visits, anything that will supply feedback of the consequences of your lack of care.
- Feeling alone without support from friends and family who just don’t understand.
- Feeling ashamed because you feel that having diabetes was your fault and you deserve what you got.
These are some of the major signs of Burnout. Joan Williams Hoover is the author who first developed the concept of diabetes burnout. She stated ”few things generate burnout like the awful frustration of having followed instructions and done everything just right and still fail to get diabetes under control. Think how discouraging it must be to fail at something you really wanted, and then think about what it’s like to have diabetes and fail at something that you never wanted in the first place”
Given all of the work and daily decisions involved in diabetes self-care, not to mention the unexplained occurrences and frustrations, it’s not hard to fall victim to burnout. For some people the frustrations can lead to feelings of helplessness and depression. If not dealt with the depression can become even worse and effect every aspect of a person’s life. Then there are also the physical and psychological effects of uncontrolled diabetes. It’s a down hill spiral. There are ways to stop the spiral however, and steps you can take to not fall victim to the process again.
Let’s face it, you won’t get any medals for taking good care of yourself. Most people aren’t even aware of the work it requires, and the sacrifices too. When your efforts meet with constant failures and frustrations it seems so easy to just give up because of feeling that nothing you can do will help.
Complications are a very real threat with diabetes. I’ve heard some horror stories over the years that actually made me cry, such as people who had developed gastroparesis so severe that they were no longer able to eat solid food and had to have a feeding tube installed. Then there are the awful pains of neuropathy, kidney failure, blindness, amputations……….
The problem is that most of these conditions take years and even decades of poor care to develop. It’s very difficult for some people to concentrate on something decades in the future when the present moment is more real to them.
You must remember, however, that until quite recently (and even now) many people weren’t actually diagnosed until they had diabetes for 5 to 10 years. That’s a long time for damage to start to take root. Many people were diagnosed when they started having symptoms bad enough for them to finally seek doctor’s care, but for many, especially now when the criteria has been lowered, they feel fine and it comes as a complete shock!
Fear of complications might be enough for many people, but fear does not work for others. As I’ve said they might feel that they are fine and it couldn’t happen to them. Or they might be worried but unable to gain control and feel helpless. There are also people who perhaps unconsciously feel that these things are inevitable, perhaps they watched family members go through this. They feel that they are doomed and there’s nothing they can do to stop it. Unconscious thoughts and feeling are a big factor in not taking control. A person really needs to examine their thoughts to uncover some of these “hidden” thoughts and attitudes that could be undermining their motivation.
Let’s face it, I don’t know any perfect people, although many try to constantly tell me how perfect they are! 
I spoke of constant decision involved every day in diabetes self-care, and we face them many times each day. Most people live moment to moment, it’s also an “instant gratification” world. Think of the people in deep debt now because of things they had to have “now” instead of saving for. When we look at that delicious dessert bar do we think “oh, that would taste soooo good!” or do we think “I will not succumb to this temptation because it will cause me to have horrible complications 10 years from now”. Most of us have alternatives for temptations or plan for them, but we do on occasion give in to the temptations (lack of perfection boo hoo)from time to time. If you’re already suffering from the symptoms of burnout it’s much easier to give in again and again, until finally you give up altogether.
In my opinion the greatest obstacles to overcoming burnout are depression, feelings of helplessness, frustration and unconscious thoughts that hinder our efforts.
I’ll be addressing all of these factors more in upcoming posts. For now I’ll leave you with the thought that you are not alone, many of us have gone through this situation and have overcome the obstacles.
Hang in there!
Lizzy
Recommended Reading: “Diabetes Burnout” by William Polonsky, PhD, CDE
© EMO 6/12
Knowledge is Power
When I was diagnosed, close to 11 years ago, I was told “you are diabetic”, given a prescription for some medication, and told to wait for a nurse to come in and give me an insulin shot. When I picked up the prescription I was given a 10-page booklet telling me “All About How to Mange Diabetes”, and sent on my way. That was the extent of my “education”. 
Wow! You’ve got a lot of good info on this website. I’ve just been reading everything under the Stress & Burnout tab.
I haven’t been self-testing my blood sugar for about 6 months. My latest lab test, in December, was 91 (fasting) and 6.2 (A1c). Those aren’t horrible numbers, but they could be better. And I’ve been having a very hard time eating balanced meals. No incentive to cook, so I end up mostly eating bits of things. Plus, I think I’m overindulging in nuts, and I’m afraid that may be causing me to gain weight, a problem I’ve never had before. And I’m not exercising much at all. I need to climb back on the wagon but it’s so hard to feel any motivation when you feel soooo burnt out.
Hi CB, I recognize you from ADA.
This is what I mean when I talk about the long-haul. We all go through this from time to time, it pays to shake things up now and then. I can cook when I want to, I just haven’t wanted to for a while so I end up eating strange things that don’t have to be cooked. The suggestions here are good ones, such as try different things to shake the monotony. Also, and I found this helpful, make sure you have satisfaction in what you do eat. I made a big pot of turkey chili last night. I really like it but haven’t made it for a long time because I’m off cooking (or burning in the current situation). It was soooo good! I’d eat it even if it wasn’t low-spike. So shaking up your menu and trying different things can help to get you out of the slump. Give it a try.
Lizzy
Hi Lizzy. I just found your site and could say yes to most if not all to the above. I’m 47 with type2 for about 17 yrs. Ive maintained good control and not so good. As life throws me curves, so does my control. Im looking forward to reading more as I bounce back through one of lifes little bumps in the road. Thanks for being here.
Hi Aaron,
I know it’s hard day after day. One thing I’ve found helpful is to have a “cheat” meal one day a week of whatever I want, I lock the meter away. I also try to vary what I eat a lot, the same old thing does get really old and makes you want things you know you shouldn’t have.
Keep on keeping on,
Lizzy
“Knowing that you aren’t doing what you should to care for yourself but also feeling unmotivated or unwilling to act.”
This is the one I struggle with. I struggled more with it when I was on Metformin. It was almost like…hey I’m at a point where I have to be on meds, what does it matter how hard I try?
With a LOT of research and good blogs like yours, as well as having a Dr (temporarily) who is watching my numbers VERY closely, I have found that it is worth trying. I’m sure I will have burnout again, but at least I know what working at it means for me. I also know now what works for me and I can work with my GP/PCP much closer to ensure that my numbers stay where they should be, hopefully being able to continue on without meds for a (good long) while.
Taking meds is in no way a failure, if you need them you need them.
The important thing is to maintain good numbers, with or without medication to help. BTW metformin doesn’t help produce insulin and diet is still very important while taking it.
Lizzy
Can you explain what Metformin does? I always thought it was a form of insulin. Thanks. Marlene
No Marlene,
Metformin is not insulin nor does it stimulate insulin production. It’s main effect is on the operation of the liver. Here’s the link that explains it:http://lizzysdlounge.com/2012/03/14/all-about-metformin/.
Lizzy
Lizzy, I have had 2 strong reactions to the above info. First of all, I am so thankful to have found you and to hear from others like myself. I had no idea of how far in the dark I was until I joined the ADA community forum.
My second reaction. I am in shock at the state of Ignorance regarding the medical community. Why was I not given the information that I am discovering on your website Lizzy? For so many years I was so in the dark. I am angry and upset. Why wasn’t there a packet of information given to me years ago telling me the kinds of things that you have posted Lizzy?
How many times did I say thanks to my Doctors for their helping me understand my diabetes? ” Here you go Alan. Just watch your diet, take your insulin, oh, by the way we have to increase yur insulin but don’t worry, you will be fine.”
I’m sorry Lizzy, I didn’t mean to spill all of my negativity. Alan
I understand Alan, I was pretty much left in the dark myself. Luckily for me I was already a medical researcher and knew where to look and understand the situation. That’s why I’ve been on the message board all of these years and decided to start my own blog.
I really don’t know what the answer is, I suppose that time is a factor in it. There’s also the fact that a majority of people just don’t want to make the changes necessary and are in denial. I don’t think they fully realize that this is a disease that can cause much harm, and without care even death. It’s like the future is too far away to worry about today.
The education situation is getting better these days, it still has a long way to go but at least it’s getting better. I’ve also noticed that since the diagnosis criteria was lowered more and more people are being diagnosed at lower levels, which will make their control a lot easier.
Yesterday’s gone Alan, at least you did find the help. That’s a plus.
Lizzy
I am so grateful for this blog. I finally understand how to assess my BG highs and lows against the std deviation. Many thanks. Marlene
Hi Marlene,
Glad you found information to help you in your BG control!
Those big roller-coaster swings can make you feel worn out.
Lizzy