September 15, 2000
Other Social Issues
Question from New Hampshire, USA:
I am a 27 year old health who has had type 1 for 15 years. Since I am a health professional, I see all the complications associated with diabetes. For the last five years, I have been in good control with A1cs between 5-7%. I am on a pump and attribute my intensive control to this. It’s great, and I wish most people with diabetes would go on one, if they had the self-efficacy to do so!
My question is regarding the complications of diabetes. I seem to worry constantly that I am going to develop retinopathy, then nephropathy, and then coronary artery disease. I do not have any complications as of yet, but I know soon they will be here. My pubertal years were typical, uncontrolled diabetes with A1cs in the 9-16% range! Thank God I saw the light.
Is worrying about my future is normal? Am I depressed? Is it normal to constantly think about slowly dying? I really feel that, even though my diabetes is under good control, my “quality of life” is not good.
How should I overcome this? Read up on death and dying books? Start taking some form of a SSRI [antidepressant medication]? When I talk to fellow CDE’s, they usually tell me that the “typical person with diabetes” they come in contact with doesn’t have the normal A1cs, do not exercise regularly, do not follow a healthy diet. I do it all. They remind me that I am not in that category. You’d think that I would “feel great”, but I don’t. I worry a lot more than people (my husband, friends, family) think. I don’t want them to think that I am a total hypochondriac, but I am afraid.
Answer:
I believe that the last line of your post says it all — “I am afraid”.
Of course you are! You are a trained health professional and are keenly aware of the consequences of diabetes left uncontrolled. Having said that, I commend you on all you have done to take back control of things. You cannot undo the past; you can only decide day to day about the future. I am sure you know this.
Being paralyzed by fear is another matter entirely. I don’t sense that this is true of you. You seem to be actively engaged in doing what you know is best for you. You do not list any of the hallmarks of depression or anything that would make me think an SSRI would benefit you. You do sound very anxious. A free floating anxiety is different from a state of chronic panic. I think you need someone you trust to share these fears with. It is normal to need to discuss what you fear. Discussion can lessen and even eliminate some fears.
My gut feeling is find a good listener and sort out the concrete fears from the abstract ones. Then, do the next thing. Fear never gets anyone anything they want. Not really.
CMB
