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April 29, 2002

Other Social Issues

Question from Laredo, Texas, USA:

My wife will be 40 years old in a few months and has had type 1 diabetes since she was two. Her father was a family physician and her mother and father were very much in control of her diabetes all through her childhood. Hence, today, she is in relatively good health with no serious health effects. I say serious because she is overweight. That is really the only health issue she faces. Her eyes, feet, kidneys and all are still in very good shape. However, things are not all well here in our marriage and for this I am writing you, seeking your help and especially your advice. I would say my wife could be considered depressed, but, after a talk we had the other day, another issue arose. I will not tell you I know everything there is to know about diabetes -- I am far from that point in my life, but I feel I know quite a bit but I had never considered the issue she brought up. What is there that I can learn about the mental aspect of a chronic disease like this? All through our marriage (since its beginning), there has been a struggle as to who was in control of many aspects of our life together. I always have taken the attitude that it had something to do with me just not being sensitive enough to her needs and desires. Hence, I would make every effort to change the way I would react or do or say or whatever. In other words, I initiated the change in order to make the marriage work and to do away with the source of conflict over control. This issue can manifest itself in what I think are the silliest ways. The other night, my wife said something that I had never considered before. She is the baby in a family of five siblings, and to add to that, her parents really worked at controlling her diabetes. Any field trip involved her mom. Girl Scout camps always had her mom there. Her mom or dad were always around to tell her what she could or could not do. I think there might be some real pent up hostility and anger in this area. My efforts to make change in myself seem to work for a while but don't seem to be a permanent answer because some additional issue always arises in the same sense. What I mean to say is that it appears to me that if you get to the core of the problem, it is pent up hostility and anger on her part that very well might be at the root of the problem. Hence, all of the change I initiate will not solve the central issue. Do you see what I am trying so ineptly to say? I think she is genuinely angry deep down inside at her disease and at her parents for being so controlling of her earlier life (even though she has her good health today because of it). I wish my wife were writing this letter, but she is not. Perhaps this is a denial issue. I need some direction. I won't say that our marriage is in trouble, but I will say that for me it is at times very difficult to live with my wife. The medical and health and diet issues are no problem. It is the mental, emotional and intimacy issues that seem to cause so many problems, and I feel one of us needs to get more educated on these topics.


Your love for your wife is so evident in your e-mail to us. She is fortunate to have a spouse who really desires to learn about diabetes and provide optimal support. Diabetes can feel very isolating if one has to “go it alone” in terms of the basics of managing the condition and understanding the implications of poor management. So for your unwavering support, you deserve credit.

The stressors of living with a chronic condition such as diabetes are myriad. Despite the very best of care, diabetes does not go away, and this alone can eat at someone’s soul over time. It is not my personal belief that everyone with chronic illness is bitter or angry, but I do think it is normal to question one’s lot in life from time to time. Your wife may very well feel some unresolved anger around her disease and her early experiences with it. She may be afraid. She could simply be tired of it all.

Depression can go hand in hand with diabetes and other chronic conditions. Educate yourself on the classic symptoms of depression and have a candid conversation with your wife about this. There are really good treatments now for depression, and I am not in favor of folks suffering when help is available.

Lastly, I want you both to know that you have a huge resource network here to ask questions of and get support from. You are absolutely right in knowing that you can only really control yourself and your feelings. The feelings of others are not in our hands. At best, we can use compassion, clarity, and love in all of our interactions and hopefully wisdom will emerge.