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Psychosocial

Overcoming Burnout

If you have never felt burned out from dealing with your diabetes, it means that you have never tried to control it. Burnout comes with the territory.

It’s the territory of being primarily responsible for controlling your health. Diabetes is one condition where you can’t just go into denial and turn over that responsibility to your doctor.

You constantly have to get your exercise, eat the right food, check your blood glucose level, and take your pills or insulin at the right time. You never get a vacation or even a day off. Generally, no one is going to remind any adult to do this, and if they did, you would probably consider it nagging.

It’s especially frustrating when you do all the right things and still fail to get your diabetes under control. What’s the use of trying?

Unless you just received your diabetes diagnosis, there will be times where all this is simply too much. I’m no exception.

It’s been a dozen years since a doctor asked me, “Did anyone ever tell you before that you have diabetes?” I tried to learn everything I could about diabetes and put that knowledge to work for me. But some days it is just too much and I slack off.

Not long ago I slacked off on my exercise, until painful arthritis in a knee made me get back on the trail and treadmill. It was easy to figure out why I would do that for my arthritis. A difference between diabetes and arthritis is that the benefits of exercise for arthritis are more immediate.

A special problem in controlling diabetes is that the benefits are long term, and it is all but impossible to see day to day results. In the short term uncontrolled blood glucose probably will just leave you tired. In the long term the consequences can take a wide variety of unpredictable forms that we don’t enjoy thinking about.

Even though these consequences can be serious, it is after all in the long term that they happen to us. Even if that term is just a year from now, it is a trade off between instant gratification – like watching a TV show rather than working out or eating another cookie – and deferring the pain of those consequences.

Why worry? After all, as the brilliant economist John Maynard Keynes said, “In the long run we are all dead.” That famous quote may have lead to more damage to the human race than all the wisdom in his magnum opus, the General Theory of Employment, Interest and Money.

Kenyes didn’t have diabetes, but if he did, he might have appreciated that by controlling it we will have a longer and happier run.

Just as the bad consequences of uncontrolled diabetes are inevitable, so too is diabetes burnout. Like the rider who is scared after being thrown from the horse, you need to get back on the horse of your diabetes control as soon as you realize that you’ve fallen. Burnout is inevitable, so any guilt from your fall is both baseless and counterproductive.

It might help to change your routine a bit with some variety to make your efforts at control more interesting or less boring.

A few days ago Elsa wrote me for the first time. “I need help,” she wrote. “I am at a point in my life that if I regularly checked my blood and exercised, I could still turn things around – but I don’t know why I don’t care. I get scared when I see the doc, and then after several weeks I go back to my old habits.”

Elsa’s story is a sad one, but she beautifully captures the diabetes dilemma. My best advice to her – and to you – is to read Diabetes Burnout: What To Do When You Can’t Take It Anymore, by William H. Polonsky and published by the American Diabetes Association. The other outstanding resource is Psyching Out Diabetes : A Positive Approach to Your Negative Emotions by Richard L. Rubin and my old friends June Biermann and Barbara Toohey and published by McGraw-Hill.

Of course you will get burned out! It’s what you do next that counts.

This article is based on an earlier version of my article published by HealthCentral.

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