Did you know the brain can change? This means that you can build brain resilience to cope with the stress that leads to diabetes burnout. Daniel Sher explains how.
Harvard University’s research into the science of resilience tells us that we should think of life as a scale, or a see-saw. On one side, you have diabetes and all of the stress that this condition can bring. To stay resilient, you need to counter-balance the scale with a big dose of skills and protective factors, so that you can tip the scale in the right direction.
Strategies for building brain resilience
Reframe
Reframing involves changing problematic thinking patterns with more helpful ideas. This is one of the central tools used in therapy approaches like cognitive-behavioural therapy (CBT). The following are some examples of thinking patterns that arise in many of us:
“I’m a bad diabetic!”
“I never get anything right.”
“No matter what I do, I’m definitely going to develop complications.”
“My blood-glucose is always high!”
These thoughts, apart from being largely inaccurate, are also unhelpful to the extent that they put us at risk of burnout, depression and anxiety.
The first step to reframing is in noticing these thoughts. Next, ask yourself just how accurate they are, before exploring some possible alternatives, such as:
“I am trying my best.”
“Sometimes I fail, sometimes I succeed.”
“With the right support, I can avoid or minimise the risk of complications.”
“It really sucks that my levels are high right now, but I know what I need to do to bring my levels down.”
Thinking in this way becomes a learned skill. This is more than just positive thinking. Rather, you are training your brain to interpret situations in a more resilient way. The more you practice reframing, the more resilient your brain is likely to become and the lower your risk of burnout will become.
Work on your relationship with food
Whether you’re looking at a problematic relationship to food, a full-blown diagnosed eating disorder, or a combination between the two; eating problems make a person with diabetes exceptionally vulnerable to diabetes burnout. Why? You eat every day. If eating always causes stress, guilt, fear or frustration, those are a lot of difficult emotions to carry.
Take time to be conscious of the thoughts and feelings that come up around eating for you. You may want to journal about where these come from and how they affect you. Enlist the support of a dietitian who you like and trust. Experiment with mindful eating.
Re-moulding your relationship to food, though, can be incredibly tough, as often these associations get hardwired when you are in infancy (or even before). If you are concerned that you have an eating disorder or a food addiction, speak to a mental health professional about getting the right support.
Meditate
Mindfulness has been shown to help people to rewire brain-neural networks in a way that helps improve cognition and emotion regulation. Mindfulness is a really powerful tool to foster resilience and avoid burnout. Try to incorporate some mindfulness in your daily routine – even if you are only doing it for five minutes per day. Practicing this frequently helps to lower overall stress levels and makes it easier for you to cope with difficult emotions in the moment.
If you are interested in learning or deepening your mindfulness abilities, there are many resources, apps, videos and training courses available online. If you really want to up your game in this regard, see if you can find an in-person mindfulness training group or a therapist who practices Mindfulness-Based Stress Reduction.
Exercise
Often, you underestimate just how powerful exercise can be for mental health, resilience and limiting burnout. Research shows that exercise reduces anxiety, depression, cognitive difficulties, poor self-esteem and social withdrawal.
How? Exercises leads to an increase in blood-flow to the brain and a regulation of the stress-control system (the hypothalamic-pituitary adrenal axis), which is connected to parts of the brain responsible for important psychological functions such as:
- Mood and emotions;
- Memory and decision-making;
- Motivation;
- Fear and behavioural control.
All of these brain-based regions are central to diabetes burnout, and exercise can help nourish your brain in a way that helps limit your risk. Research has also shown that people with diabetes in particular stand to benefit from the mental health effects of exercise.
Schedule time for self-care
You know too well how busy life can get. As a person with diabetes, you often struggle to prioritise your own needs. Remember, though, that managing diabetes is, in and of itself, a full-time job. This exists on top of all the other responsibilities that you already carry.
For this reason: it’s so important to actively schedule and prioritise sufficient time for self-care. A moment in your week or day during which you can focus entirely on making yourself feel calm, comfortable or enlivened. Take some time to identify an activity that can provide you with this experience. A walk in the forest, knitting, an online game, listening to your favourite music or catching up with an old friend are all possible options.
Connect
Social connection is one of the most important tools that we have to regulate emotions and foster resilience. Connecting with your support system is also a very powerful way of treating diabetes distress. Whether it’s a spouse or partner, friends, family, a religious group or a member of your medical team: make sure that you are socialising frequently and in a way that helps you to refill your cup, so to speak. Also make sure that you have an established system that you can lean on as soon as you start to notice signs of distress creeping-in.
Reflect and develop insight
Developing resilience involves learning from past experience and developing personal insight. Take some time to reflect, discuss or journal about your past. When have you experienced burnout previously? What are your personal trigger points? How can you plan to limit the impact of these vulnerabilities going forward? Discussing these points with a therapist may be a good idea.
Takeaway message
Diabetes burnout makes the tough job of diabetes that much harder to cope with. However, burnout is not a mental disorder or a sign of weakness: it’s a normal reaction to the demands of diabetes. Burnout is not just a random nuisance. Often, it’s an important signal that something about your relationship to diabetes is imbalanced and unsustainable.
Burnout is your mind and body telling you that you need to take a break or re-think the way in which you are managing your life. It can be hard, though, to work out what you need while you are experiencing full-blown burnout, so be sure to lean on your medical team and support networks during these times.
References
Center on the Developing Child (2015). The Science of Resilience (InBrief). Retrieved from www.developingchild.harvard.edu.
Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2017). Exercise and mental health. Maturitas, 106, 48-56.
Sardar, M. A., Boghrabadi, V., Sohrabi, M., Aminzadeh, R., & Jalalian, M. (2014). The effects of aerobic exercise training on psychosocial aspects of men with type 2 diabetes mellitus. Global journal of health science, 6(2), 196.
Tang, Y. Y., Hölzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 16(4), 213-225.
MEET THE EXPERT
Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital in Cape Town where he works with Type 1 and Type 2 diabetes to help them thrive. (Valium) Visit danielshertherapy.com
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