Tag Archives: mental health

Piling Up

I’ve been getting to work early lately. These days, I’m usually at the office at 7:00 a.m. That involves rising around 4:30 or 4:45, getting showered and changed, getting breakfast, and right now, getting breakfast for The Great Spousal Unit too, before heading out the door around 6:15.

There are two reasons for the early mornings. To begin with, I want to get used to working this kind of shift, so when December gets here and it’s already dark at 5:00, I can be off and still get a little sunlight for an hour or so.

The other reason is because when I get off of work now, I’m usually going home and working on something additional. It may be a podcast episode (or, this week, a podcast glitch), it may be research for my Advisory Council duties, or other outside advocacy initiatives. It may involve blog post writing, or just things that need to be worked on around the house.

These days, I’m finding that things are really piling up, and I’m going at a pace that’s less than fully productive.

Even though it sounds like it, I’m not whining. I realize how fortunate I am to be involved as much as I am, and when I think of how I’ve fared at similar times of busyness in my past, I’m amazed that I’ve been able to keep from imploding completely this time.

But I’m 56 years old. That’s not ancient; as George Jones once said in a country song, “My body’s old but it ain’t impaired”. I’m still able to make an impact. However, I’m feeling like it may be less of an impact in some cases, because not everything is getting my undivided attention when I work on it. Is this how it is for everyone?

I’ve come to this realization due to a number of factors, and those signs mean I need to look down the road and plan some change. I’ve been missing or pushing back self-imposed deadlines for projects. Interviews I want to do are being put off until I have more time.

And I have that song going on in my head. I always have music playing in my head (if it’s not already playing in the room I’m in). Over the years, I’ve come to associate certain songs or certain artists with specific memories. That’s why the 1978 songs Hollywood Nights by Bob Seger, On Broadway by George Benson, and Blue Bayou by Linda Ronstadt, though very different songs, remind me of certain parts of my life back in high school.

Well there’s a song, one I’m not particularly fond of, and when it starts to go off on a never-ending loop in my head, I associate it with chaos in my life. And this week, it started running over and over again.

Perspective: A lot of my chaos is self-imposed. Looking at things reasonably, I think I’m handling life pretty well right now. But… I don’t know if you do this too… often, the more involved I am, the more perfect I expect things to be. And the more disappointed I am when they are not. It makes no sense, but that doesn’t keep me from feeling that way sometimes.

One of the other things that makes no sense is to expect to rid myself of all the chaos all at once. That’s not going to happen. Instead, it will be a gradual process, and once it’s over, I’ll (hopefully) be in a place that feels less busy, but just as satisfying and meaningful.
Here are the things I need to work on right now:

1. Change the tune. Play music… lots of music. Including music I don’t always listen to, like opera or zydeco. I need to push that never-ending loop out of my head.

2. Make a list of things I’m doing that I like, and things I don’t like right now. That may seem difficult. Surely, I wouldn’t be involved in something if I didn’t like it. But if I start listing everything, I’m sure I’ll identify the things that get my immediate attention versus things that don’t.

If I’m procrastinating on something, it goes into the Don’t Like pile. If I address something immediately because I’m worried about the fallout from not addressing it immediately, it will also go into the Don’t Like pile. The Don’t Like pile is the first place I’ll look to pare down what I’m committed to.

3. Fulfill my existing commitments. This may seem counter-intuitive, but if I say I’m going to do something, I need to do the best I can to come through for the people who’ve trusted me enough to accept my promises in the first place.

4. Be mindful about future promises. I still think it’s okay to say Yes to things, but I need to say Yes to things that fill my soul and make me happy, rather than things where I just hope the work will become worth it someday.

5. Breathe, and recognize that my life is not bad. Not, it could be worse, just that it’s not as bad as it sometimes seems to be. In fact, I’ve probably done some of that already, which has probably kept me from imploding. Also, I do have a couple of great things coming up that I’m very excited about. Both of those things indeed fill my soul and make me happy. So there’s that.

If you’ve actually gotten to this point, Thank You for letting me vent. I needed to get this down on paper, so to speak, and I’ll probably come back and refer to it again and again.

My life isn’t perfect right now, but it’s not terrible. I’m starting to understand the definition of the word meaningful. There will be changes coming up, though not right away and not all at once. But it’s all about body and mind. I’ve got to make new space for my mind to operate at full capacity again.

The Dog Days of January.

How about those dog days of… January?

In the grand American game of baseball, August is the month known as the dog days of summer. It’s when writers and broadcasters wax philosophically about needing to stay focused, stay the course, and stay on a winning trajectory. The season is long, say the pundits. In August, you’re already five months into the regular season, with still another month of the season to play in September. You can’t let down now. Bear down. This is when champions are made.

In real life, we often concentrate on May, as Mental Health Awareness Month, or on December, because we know that a lot of people feel left out or are feeling troubled during the holidays. But what about January?

In North America and Europe, January is the first full month of winter. The sun is low in the sky, and there aren’t many hours of sunlight each day. We’re going to work in the dark and coming home in the dark. The temperature dips. Even when we’re off of work, we tend to stay home, where at least it’s warm.

Where we can easily be forgotten. It’s where we can easily fall prey to inaction and eating poorly and every other factor that makes us care less for our diabetes and our overall well-being. And before we know it, we feel like crap.

It even happens to people like me, who generally have an upbeat outlook on things. I generally don’t let things get me down. I mean, what do I have to feel down about anyway?

Yet, I have to admit, when I looked in the mirror last week, my look reminded me of the dog days, winter edition.

Unlike baseball, when this happens to us the fix is more than just staying the course, bearing down, playing like a champion. It involves a number of things. If you’re not exactly feeling spectacular right now, I hope you might find a few of these helpful:
Find time for sunshine. Weatherwise, it’s been nothing but gray in my city lately. I’ve been working a lot. When I’m off, I have things to do, appointments to keep. What I needed was a chance to stop and breathe, and feel the sunshine. Change my viewpoint.

So over the weekend, I went to the local conservatory. Not exactly out in the sun, but it’s warm, and every room is a greenhouse. It is not over exaggeration to say that sometimes, just fifteen minutes in a quiet corner there can change my whole outlook on life. It’s just what I needed.

Activity activates. This is where that endorphin thing comes in. Even if you’re only taking a walk, being active can give you a sense of purpose, a sense that you’re fighting back. I don’t know if it helps cure more serious illnesses, but in my case, being more active this time of year really perks me up.

Writing and Reading. If you think of writing as self-expression, you begin to understand why the term “Get something off my chest” carries so much sway. Writing helps me do that, whether it’s here or in a forum that no one else can see.

And we’re not the only ones writing great things. If we can’t find the motivation to inspire ourselves, there’s nothing that says we can’t find inspiration elsewhere. Sometimes, it’s where we least expect to find it. But we won’t find it if we don’t look.

Help someone else. We’re likely not the only ones we know feeling a little down this time of year. Even if you don’t know someone who needs a pick me up, there are plenty of others who need mentoring… need a meal… need something warm to wear out in the cold. Often, doing something for others results in something that helps us too.
One additional thing I should mention is that it’s important to give yourself the time for all these things. Often, just the act of granting yourself time to think or explore again is just what we need.

I don’t want anyone to think that these are cure-alls for more serious forms of depression or anxiety. There are many cases where care from a professional, or even a prescription might help your day have a little more sunshine too. Like time, granting yourself permission to seek help may be the greatest gift you can give yourself.

Wherever you are, whatever you’re feeling, and however your life unfolds, I hope that you can find the happiness and peace you deserve. No matter what happens, I support you… no conditions.
We’ll be discussing the January Blues and what each of us does and can do about them on Twitter Wednesday night at 9:00 p.m. ET(US). Follow @DiabetesSocMed, @StephenSType1, and the #DSMA hashtag and join the conversation!

Be kind. Be supportive.

Do you ever feel like you’ll never be able to catch up? Like, you’re in that dream where you can’t possibly run faster, but you can’t run fast enough?

I think we all experience that sort of thing from time to time. Some people live for that kind of existence… if they’re not struggling to keep up, they think there must be something wrong. Others get overstressed the minute they schedule one meeting to start exactly when the previous meeting is set to end.

Gee… we all react differently to stress. Not exactly a scoop of a story, from my point of view. How we react to stress tells us exactly nothing.

Honestly, we do all react differently to stress, including the fact that some of us don’t even recognize it as stress at all. I think just like diabetes, we all react to stress differently, and we all manage it differently.

And that’s okay. If we had one exact strategy for dealing with the stressors in our lives, you know we’d all be working on it. But most people handle stress with a mixture of dread and resolve, and sometimes it works, and sometimes it doesn’t. There’s no use complaining about the things that get us worked up.

But… and this is a big But… sometimes the stress is too much. Sometimes we can’t just work our way through it. If that’s the case, we need help and we should be okay with seeking it.

Likewise, when someone else is having a tough time of it, instead of just complaining more, instead of judging someone experiencing difficulty dealing with their stress, we should be actively supporting that someone. Helping them feel not alone, maybe reminding them that you’ve been there too, and giving them the space they need to feel like they’re not being manipulated by life like they’re a little marionette.

In the end, it’s not a perfect appointment book or a perfectly clean home or anything else that makes us feel good as much as people do. Let’s remember to be kind this holiday season, but also be supportive. You and your friends and loved ones are well worth the effort.

#DSMA Recap: Diabetes/Depressive/Depression

I don’t do this often anymore, but I wanted to touch on last night’s #DSMA Twitter chat. The chat was all about diabetes and depression, how we recognize it, how we treat it, and what kind of resources we lean on when we’re in need.

I learned a lot.

First, some facts. According to a study published three years ago by the U.S. Centers for Disease Control and Prevention, one in ten American adults report depression. The first paragraph of the web page devoted to it tells the story:
”Depression can adversely affect the course and outcome of common chronic conditions, such as arthritis, asthma, cardiovascular disease, cancer, diabetes, and obesity.”

The Depression and Bipolar Support Alliance cites a statistic that says that 8 ½ percent to 27 percent of people living with diabetes also experience depression.

An article published on diaTribe earlier this year takes it a bit further, noting that:
“Diabetes distress is much more common than clinical depression and affects up to 39% of people with type 1, and 35% of people with type 2.”

So depression, or diabetes distress, actually, is a common occurrence among people living with and affected by diabetes. At the same time, there’s a lot of hand-wringing over why we don’t know more about it, and why don’t we reach out more often to those who are feeling this way, and how do we solve this problem?

I’m obviously not an expert, though I can claim to be one of those people who have suffered diabetes distress off and on throughout my 23 years living with Type 1. My biggest problem was that when these moments occurred, I didn’t know where to turn or who to reach out to. And I have to admit to worrying about who to reach out to, because I didn’t want to be seen as a crazy nut, or have my symptoms advertised to the world. I was lucky enough to get through these times with a minimum of help and family and friends who helped me find perspective.

But as in many things, I think the solution begins with ourselves.

We need to make it okay, normal, to recognize the need for good mental health. We need to stress that seeking help when we need it is a normal thing, and it’s a vital part of managing our diabetes. We need to be willing to state this over and over again to people inside and outside of our community. We need to affirm the notion that relying on the resources we need to help us feel better makes us strong, not weak.

And when we see someone who is suffering, we need to hold their hand, look them in the eye, and if we can, help them find their soul and their dignity. This diaTribe post has some great pointers, and links to a number of resources that can help you begin coping right now:


If that doesn’t do it for you, and you still feel you need help, please reach out to me and I’ll try to point you in the right direction. Know that if you are living with diabetes and depression, you are not alone. You will never be alone.

I support you… no conditions.

Better, not best.

For many people, living with diabetes means also living with depression and other mental health issues. That’s why this story in the New York Times this weekend caught my eye. It doesn’t have to do with diabetes and depression, but rather with what mental health care looks like today and what it will look like later in the year. Or next year. Or maybe later. What I read in the story is a prime example of one of my biggest frustrations with medical care of any kind. The two hallmarks of managed care in America: Confusion and Delay.

The story describes improvements (hopefully) in access to care for addiction and mental health for patients. Under the Patient Protection and Affordable Care Act, mental health care must be included in all insurance plans. No more leaving it out. And under recent updates to a separate law, the Mental Health Parity and Addiction Equity Act of 2008, plans are not allowed to charge more for co-pays or deductibles for mental health coverage than they charge for physical care. In addition, insurance plans will be required to show consistency when determining whether coverage for physical or mental care is medically necessary. They won’t be allowed to make getting prior approval for in-patient mental health treatment more difficult than the approval needed for admission to an acute care hospital. I like the idea of consistency in the law, and the recognition that care for mental hygiene should be considered on an equal footing with physical care.

What I don’t like is this: According to the NY Times story,

“The new parity rules apply to most health plans and are effective beginning July 1, although many plans will not have to comply until January of next year.”

The rules apply to most plans? What plans? Why not all plans? The piece mentions that some insurers have implemented the equity requirements into their plans already. For those who haven’t, why wait until July 1? What’s the deal with exempting some plans from compliance with the law until next year?

I’ve seen now several provisions of the PPACA and other laws over the last few years get delayed. It seems like it’s almost a given that the most contentious parts of these legislative efforts will always be delayed for one reason or another. Some of the reasoning for those decisions have to do with timing, and how fast insurers can react to change. I get that. But if we’re going to concede that point, we must also recognize that part of the reason for staggering compliance with the equity rules goes back to those ideas of Confusion and Delay. The more confusing insurers make things, and the more they delay, in their thinking, the more money they’ll save. Even when it’s been proven that early access to care of any kind almost always results in better outcomes, helps avoid complications in many cases, and often results in cost savings too.

So, I would ask of insurers: What are you afraid of? If someone needs coverage so they can see their psychiatrist or therapist, or to check into a treatment center for depression today, they need that coverage. Today. At some point, you will be covering that in tune with how you cover a broken arm anyway. Do you want to take a chance that someone could be irreperably harmed by denial of coverage, or by the constraints of cost? Are you okay with, can you visualize, someone being lost just so you can keep your plan the way it is for another six or eleven months? I can’t. I couldn’t live with myself knowing that.

So, insurer, if you can somehow turn off that fear, whatever it is, residing in your backbone somewhere, or if you can ignore it, you can begin the process of going from a bottleneck to being a conduit leading to positive outcomes, for people who are unquestionably worth it.

Stepping off of my soapbox now… How do you feel about this?

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