In
my last article, “Recognizing & Approaching Depression”,
I promised to provide suggestions you could make to patients struggling
with depression. I will do that in my next article. For now however,
I’d like to answer an email sent to Diabetes in Control from someone
I regard as sad, but not depressed.
Ann writes: “I was diagnosed with diabetes at the end of January
2004. My highest reading on the glucose tolerance test was 213. My bs
reading are really good and the A1C was at 5.6 about 2 weeks ago. I
feel a lot better, think clearer, find myself smiling, wake up with
energy and go to bed with energy since I've been on a meal plan. Life
is so much better. I'm so very thankful for this.
My problem is I either cry on the way to the grocery store or get really
depressed while shopping. Today my mind focused on the can't and the
loss that comes with improved eating. Can't buy lean cuisine or another
quick fix meal because of the sodium, & or fat. Can't have this
and can't have that etc. Last week I was able to focus on the cans once
I began shopping. I'm normally an upbeat person and would like to shop
again w/o getting depressed and crying. Just when does this end and
when will I be able to move forward?”
Dear Ann: Though it certainly would be nice to know, I don’t
think you’re asking for an exact time period after which your
sadness will disappear. Permit me to interpret your question a bit.
I suspect what you’re asking is how to stop feeling so sad and,
more subtly, why you should be feeling so badly about being so good.
You know the loss but you also know the gain created by healthy eating.
Why doesn’t the bad feeling go away? Why is the loss so strong
that, at least when you shop, it overruns the upbeat you, the you that
focussed on the “cans” just the week before?
I don’t know any more about you than what’s in your email.
Factors such as other physical conditions, other medications, your age,
support system, general stress level, quality of relationships and spiritual
status will all have some influence on your ability to be the upbeat
person you normally are. Obviously, your ability to continue to stay
with your healthy meal plan will also play an enormous role in keeping
you stable, both physically and emotionally. Though you’re off
to a great start, only time will tell us how well you will stay with
a healthy lifestyle.
Assuming that none of the above are serious influences on your mood,
let’s take a look at some answers to my interpretation of your
questions:
1) You’re In Mourning: You’ve had several losses at one
time and, like after a death, the mourning process can be powerful and
is somewhat predictable. In January you lost the ability to think of
yourself as healthy or perhaps “normal.” You were given
a label. It pretty clearly sounds like Type 2 and since 90% of newly
diagnosed Type 2 have weight as a factor and probably have Syndrome
X, chances are health was a concern before your official diagnosis.
That said, officially getting the word is an impactful moment and a
form of loss.
You’ve lost the freedom to let your impulses govern your food
choices. Indeed, you’ve lost choice.
You may be angry with yourself or fate for this loss, something we also
experience in mourning death.
As you described, you’ve lost convenience and perhaps pleasure
from the taste of now forbidden foods. These losses are real but are
often discounted when people point out to themselves that since this
convenience and pleasure isn’t good for them, thus they shouldn’t
want them anymore. We do want convenience and pleasure and there’s
no point in pretending otherwise. We have feelings about death and the
person who died that are also often illogical and not socially acceptable,
sometimes to ourselves.
Denial is a common response in mourning. I think, on a deep level,
you’re still processing your new diagnosis. I regard that as normal
and to be expected. Of course you “know” you have diabetes
and there are times that information is well integrated. There are other
times, like on the way to the market when your attention is directed
towards food, that the denial emerges. For illustration, ask yourself
if you feel the same sense of “can’t” in regard to
anything to which you are allergic. You are likely to be aware of restrictions
re allergies but the emotional response will be much less intense.
The “normal” mourning process waxes and wanes. People are
initially pained, many things trigger the pain via association and over
time the triggers are fewer and the responses less painful.
2) You’ve done very well. You have moved forward. Not forward
in the sense of no longer feeling the
“can’ts”, forward in having an A1c of 5.6, of feeling
as good as you do and of going shopping last week and being “can”
focussed. Perhaps doing well is part of a deeper wish/expectation /fantasy
that after being diagnosed you would do what should be done and then
things would be OK again, back to “normal.” Restricting
your choices in the supermarket shatters that fantasy.
3) Restriction of choice and loss of things we like are universal and
common experiences. However, the exact history of these things in each
person’s life is different. It’s always uncomfortable but
for some the pain can run deep. If your life contains particularly painful
experience around restriction and loss, your present response is going
to be enhanced.
4) Life outside of food effects life with food. If you’re having
a day in which life is filled with joy and promise, chances are the
supermarket will be filled with “can”. If the reverse is
true, you are much more likely to see “can’t”.
There are other possibilities but space and time also produce restrictions.
Let me offer a few suggestions:
A) Get into the feeling of “can” before you leave for the
market. Don’t wait to see how you’ll feel.
B) Aggressively seek new recipes and new forms of foods. The mistake
commonly made is to eliminate the foods that are now bad for you, leaving
a list that quickly feels boring and restrictive.
C) Try to stay on the edges of the market. The less you make eye contact
with foods that aren’t good for you, the easier it will be. Each
time you have to say “NO” to yourself is a little blow you
must absorb.
D) You’re allergic to white foods.
E) Really pay attention to the pleasure you’ve created. Keep it
in mind while you shop.
I hope this has been helpful. Let me know how you’re doing.
Len
Print This Article
