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Relating the Five Stages of Grief to Diabetes

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Five Stages of Grief

Relating the Five Stages of Grief to Diabetes

February 25, 2008
By: Dan Weiman for Diabetes1
Diabetes is a chronic disease that can lead to serious health problems. While the physical ramifications of the disease are frequently discussed, the effect diabetes can have on mental health and well being is equally important to talk about. The American Diabetes Association estimates that 15 to 20 percent of people with diabetes suffer from depression. This is more than five times the percentage of people in the general population who are depressed.
The five stages of grief often apply to people who are going through a divorce, the loss of a loved one, or even facing their own end of life decisions. If you or a loved one was recently diagnosed with diabetes, you may experience the stages in your own unique way.
Stage 1: Denial – Many people diagnosed with diabetes initially struggle to believe their diagnosis or the diagnosis of their child. Katie Marschilok, a registered nurse, experienced deep shock when she found out her child had type 1 diabetes: “Some people get into denial that the disease won't change their lives.” The faster that recently-diagnosed people and their families can move past this idea, the more effective their treatment will be. Denial can hurt your mental health as well. By not confronting such a big issue head on, people with diabetes and their families must often cope with underlying depression.
Stage 2: Anger – For people with type 1 diabetes, anger can result from having to cope with a chronic disease that other people do not understand. Type 2 diabetics can experience this type of anger, but they also may feel angry at themselves. Michael Graham, a man with type 2 diabetes, describes his anger toward his own habits: “My initial reaction to my diabetes diagnosis was disbelief followed by annoyance with myself for neglecting my health and allowing diabetes to blossom.”
Stage 3: Bargaining – The bargaining stage can begin when active diabetes treatment is in full swing. Treatment regiments can be very strict and require fairly drastic changes in lifestyle. People with diabetes need to monitor their blood sugar and may need to take medication or follow a new diet. Scott Johnson, a diabetic blogger, described his experience with bargaining: “If I had to decide which stage I'm in right now, I would say it would be bargaining. You know, like I'll eat this or that just one more time, then I'll be ‘good.’ Even when I know the impact on my blood sugar will be not good.”
Stage 4: Depression – Clinical depression is a reality for 15 to 20 percent of people living with diabetes. Many more experience temporary depression when they first learn their diagnosis. Depression, aside from its major mental impact, can lead to lethargy which can impact other treatments for diabetes, especially exercise. Psychiatrist Patrick Lustman describes the connection: “Because of physiologic and behavioral interactions between diabetes and depression, each becomes more difficult to control, increasing the risks of cardiovascular disease, diabetic retinopathy causing blindness, neuropathy and other complications.”
Stage 5: Acceptance – Acceptance of diabetes is more complicated than merely acknowledging that you or a loved one has the disease. In order to stay healthy and undergo proper treatment, it’s important to fully understand that diabetes will have a major impact on your life. Once people living with diabetes make the necessary lifestyle adjustments, they can continue living a productive life taking the proper steps to ensure monitoring their health is a top priority.
There is no magic timeline for moving through the stages. Some people breeze through quickly while others may get stuck in some stages for quite a long time. Dealing with a diagnosis of diabetes for yourself or a loved one can be overwhelming. If you find activities you used to enjoy not as exciting or are feeling sad, angry, or upset, make an appointment to talk to someone. Your primary care doctor or Certified Diabetes Educator should be able to give you some recommendations. Some people also find it helpful to talk to other people who are facing similar challenges. Click here to share with others in the Diabetes1 community.
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