Knowing when to ask for help and understanding why you need it is crucial to manage your mental health. Monique Marais expands on this.

Children find it easy to ask for help, irrespective of how challenging the task might be. Adults on the other hand view asking for help as a sign of weakness. Somewhere in the growing up phase, we lose our ability to freely ask for assistance, and by doing this, we isolate ourselves, placing more and more strain on ourselves to make it work. The reality, however, is that at some point, everyone needs help. Knowing when to ask for help and understanding why you need it is crucial to manage your mental health.

World Mental Health Day

On 10 October each year, we celebrate World Mental Health Day, which is a global initiative to raise awareness and support for mental health issues.

The World Health Organization advocate that “World Mental Health Day 2023 is an opportunity for people and communities to unite behind the theme ‘Mental health is a universal human right” to improve knowledge, raise awareness and drive actions that promote and protect everyone’s mental health as a universal human right.”

The stigma behind mental health issues makes it even harder for people to ask for help. We need to debunk the myths society has, so that everyone can freely ask for help without judgement.

What is mental health?

Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behaviour. If left untreated, mental health issues can overwhelm you and can lead to suicidal thoughts or an attempt to take your own life.

The American Psychological Association reports that from 2008 to 2018, a survey showed that 5.8% of Americans were not receiving the care they needed for their mental health.

Fear of asking

At some point, you need to let go of your fear of asking and take the assistance that is available or offered. This can be something small, such as sharing household chores, or something bigger, such as not taking the lead in a group project.

It can mean facing your fears and seeing a doctor, psychologist, or social worker to address your mental health concerns, to find a treatment regimen that works for you, so that you can lead your best life.

Three tips to assist with asking for help

Krista Rizzo, a life coach, shares three tips to assist you with asking for help:

1. Change your mindset – You do not have to do it alone; you are only one person, and it’s okay to ask for help. Learn to delegate; most people want to help.
2. Make time for yourself – Self-care is important for you to be effective; you can’t give from a cup that is empty.
3. Reassess your priorities – Take time to evaluate what is important and what you need to change to enable you to meet your goals and live your best life.

Dr Joan Rosenburg (PhD in Psychology) has the following view on asking for help, “It is appropriate to absorb what is good and to feel grateful for the appreciation and support of others. When others extend their assistance, wisdom, availability, time, talents, or enthusiasm to you, unquestionably, they are giving of themselves. Gracious receipt of their generosity not only meets whatever needs you may have, it also honours them. When you allow yourself to receive, you have reached that harmonious balance between independence and dependence.”

Help

H – Asking for help, gives you HOPE that things will work out, that you will achieve your goal instead of fail because you tried to do it alone.

E – Everyone needs help at some point in their lives, you are not alone.

L – Link with resources, know where your support lies and when to reach out.

P – Prioritise your mental health, ask for help when things are too much to deal with alone.

Asking for help is a significant and valuable skill, and it’s a sign of personal strength and emotional intelligence. Here are several reasons why asking for help is important and why it reflects strength:

• Fosters collaboration – It brings people together and can lead to better problem-solving and innovation.
• Shows self-awareness – You realise your own limitations, which is a crucial component to emotional intelligence.
• Promotes learning and growth – By asking for help, you gain new knowledge, skills, and insights which you can apply in the future.
• Strengthens relationships – You show trust and vulnerability when you ask someone for help.
• Relieves stress – Attempting to handle everything on your own can lead to stress and burnout.
• It creates a culture of reciprocity – When you ask for help, others are more likely to ask you for help when they need it.

Remember that you are only one person, you don’t need to do it all, and you don’t need to do it alone. You have unique qualities and attributes, you should share these qualities with others. Asking for help is therefore not a sign of weakness, but rather a display of strength, wisdom, and humility. It benefits not only you who is seeking assistance, but also the people you turn to for support. It creates a culture of collaboration and mutual growth, and it’s an essential component of personal and professional development.

Go out, be healthy, and know when to ask for HELP to live your best life.

References

1. Why Asking For Help Is A Strength (And Three Ways To Do So Effectively) (forbes.com)
2. What Makes It So Hard to Ask for Help? | Psychology Today
3. World Mental Health Day 2023 – Mental health is a universal human right (who.int)
4. Mental health – Wikipedia
5. Mental health in education – Wikipedia

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Daniel Sher, a clinical psychologist, educates us on males with diabetes and eating disorders, in hopes of breaking down stigmas and misconceptions.

When we talk about diabetes and eating disorders (EDs), a topic often left in the shadows is their impact on males (men).¹ Traditionally, research in this realm has focused on females (women); and for good reason. Research shows that females who have diabetes are disproportionately affected by disordered eating.

However, in males, especially those living with diabetes, these disorders manifest uniquely and require our attention. Understanding this intersection is crucial, not only for providing effective care but also for breaking down stigmas and misconceptions surrounding EDs in men.

What are eating disorders?

Eating disorders are complex psychiatric conditions involving dysfunctional relationships to food and the body. People with diabetes (Type 1 and Type 2) are at risk of developing eating disorders, such as:

• Bulimia (intentional purging or vomiting);
• Anorexia (severe under-eating and weight loss);
• Binge eating disorder (episodes of extreme overeating); and
• Diabulimia (skipping insulin in an attempt at losing weight).

Binge eating disorder and sugar addiction both involve an over reliance on high carbohydrate foods in an attempt to regulate distressing emotions. Both of these conditions are important drivers for Type 2 diabetes in particular.

Males vs. females: The different shades of EDs

The presentation and experiences of EDs can differ significantly between males and females. Men are less likely to be diagnosed due to social stigma and a lack of awareness, both by healthcare providers and the men themselves. In men, EDs often co-occur with an emphasis on body shape and muscularity, rather than just weight loss.

Why are people with diabetes vulnerable?

Several risk factors contribute to the development of EDs in males with diabetes. These include genetic predispositions, psychological vulnerabilities (such as anxiety and depression) and increasing societal pressures for a certain body type (namely, a “shredded” muscular physique with limited body-fat). Perfectionism may also be a risk factor and this complex combination of variables can lead to an unhealthy preoccupation with food and body image, particularly in those with Type 1 diabetes.

Picture the following hypothetical scenario: a young man with diabetes is constantly bombarded by social media images of idealised male physiques; ones that emphasise muscle and leanness. He navigates a world where every meal and snack requires careful consideration and balancing with insulin, a world where food is not just nourishment but a mathematical equation impacting his health.

In this environment, his diabetes management starts to morph into a tool for body sculpting, subtly shifting from health-focused to appearance-driven. The lines blur between diligent diabetes care and an emerging obsession with body image. This scenario reflects a reality for many, highlighting the nuanced ways in which societal norms and diabetes management can converge to create a fertile ground for disordered eating behaviours.

The risks of co-occurring diabetes and EDs

Overlooked eating disorder tendencies in people with diabetes can be extremely dangerous, putting a person at risk of:

• Poor glycaemic management with higher A1Cs and increased blood-glucose variability;
• Heightened risk of long-term complications;
• More frequent DKAs which can be acutely life-threatening; and
• Increased risk of mental health disorders.

Altered brain function

A particularly worrying aspect of disordered eating in diabulimia is the impact on brain function. Insulin plays a crucial role in regulating blood glucose levels. Restricting insulin leads to heightened blood-glucose levels and these fluctuations can damage the brain (especially if sustained over time).

At the same time, eating disorders can lead to nutritional deficiencies which affect serotonin (a brain-chemical that is implicated in depression). Conditions, such as anorexia, have also been associated with changes to the brain’s grey matter. The structural and chemical changes to the brain can further trigger cognitive and emotional difficulties. All of this can lead to a nasty vicious cycle, making the challenging job of managing diabetes that much tougher.

What sort of help is available?

Treating EDs requires balancing the psychological and physical aspects of the condition, meaning that multi-disciplinary collaboration is hugely important. When it comes to diabetes and EDs, dietitians play an absolutely invaluable role. Best results shine through when there is a team approach between the patient, family, endocrinologist, dietitian and psychologist. At times, an eating disorder diagnosis may mean that a short-term admission is indicated.

When to seek professional help?

Recognising when to seek help is a critical step. What are some warning signs to look out for? These include sudden changes in eating patterns, hoarding or stealing food, obsessive thoughts about food or body image and deliberately skipping insulin to lose weight.

All of these may indicate a dysfunctional relationship to food and it’s crucial for men with diabetes to understand that seeking help for an ED is a sign of strength, not weakness. Don’t be ashamed to flag your concerns with your doctor or a mental health professional.

References

Araia, E., Hendrieckx, C., Skinner, T., Pouwer, F., Speight, J., & King, R. M. (2017). Gender differences in disordered eating behaviours and body dissatisfaction among adolescents with type 1 diabetes: Results from diabetes MILES youth—Australia. International Journal of Eating Disorders, 50(10), 1183-1193. https://doi.org/10.1002/eat.22746

Araia, E., King, R. M., Pouwer, F., Speight, J., & Hendrieckx, C. (2020). Psychological correlates of disordered eating in youth with type 1 diabetes: Results from diabetes MILES Youth-Australia. Pediatric Diabetes, 21(4), 664-672.https://doi.org/10.1111/pedi.13001

Broadley, M. M., Zaremba, N., Andrew, B., Ismail, K., Treasure, J., White, M. J., & Stadler, M. (2020). 25 years of psychological research investigating disordered eating in people with diabetes: What have we learnt? Diabetic Medicine, 37(3), 401-408.

Doyle, E. A., Quinn, S. M., Ambrosino, J. M., Weyman, K., Tamborlane, W. V., & Jastreboff, A. M. (2017). Disordered eating behaviours in emerging adults with type 1 diabetes: A common problem for both men and women. Journal of Pediatric Health Care, 31(3), 327-333.https://doi.org/10.1016/j.pedhc.2016.10.004

Dziewa, M., Bańka, B., Herbet, M., & Piątkowska-Chmiel, I. (2023). Eating disorders and diabetes: Facing the dual challenge. Nutrients, 15(18), 3955.https://doi.org/10.3390/nu15183955

Russell-Jones, D., & Khan, R. (2007). Insulin-associated weight gain in diabetes—causes, effects and coping strategies. Diabetes, Obesity and Metabolism, 9(6), 799-812. https://doi.org/10.1111/j.1463-1326.2006.00686.x

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We learn about five common myths about diabetes and how they are debunked.

With millions affected worldwide, diabetes remains one of the leading health concerns of our era. However, alongside genuine information, a great deal of misconceptions surrounds this condition.

Over the past decade, South Africa has seen diabetes cases double, reaching 4.2 million, which equates to one in nine adults. Shockingly, 45% remain undiagnosed. As per the International Diabetes Federation’s latest data, it’s now the leading cause of death among South African women and the second highest for both genders.

Understanding diabetes

Diabetes is a complex condition arising from multiple causes. At its core, it’s characterised by the body’s inability to produce or effectively use insulin, a hormone essential for regulating blood sugar.

Type 1 diabetes, often diagnosed in childhood, is an autoimmune condition where the body attacks insulin-producing cells. Its exact cause is unclear but is believed to involve genetic, environmental, and possibly viral factors.

Type 2 diabetes is more common in adults and is caused by insulin resistance and insufficient insulin production. It’s linked to genetics, obesity, poor diet, sedentary lifestyle, and age.

Gestational diabetes affects pregnant women and may increase the risk of Type 2 later in life.

Signs and symptoms

The warning signs of diabetes can be so mild that they go unnoticed. Some common symptoms include:

Increased thirst and urination: High blood glucose levels cause the kidneys to work harder to filter and absorb excess sugar, leading to frequent urination. This can result in dehydration and a consequent increase in thirst.

Unexplained weight loss: Despite eating more, rapid weight loss can occur as the body uses muscle and fat for energy because it can’t use sugar effectively.

Hunger: Fluctuating blood glucose can increase appetite, even after meals.

Fatigue: Insufficient glucose in the cells can cause tiredness and lack of energy.

Blurred vision: High blood glucose levels can lead to fluid being pulled from the eyes’ lenses, affecting the ability to focus.

Slow healing: Sores, cuts, and bruises may take longer.

Tingling or numbness: High blood glucose can cause diabetic neuropathy, leading to tingling or numbness in the extremities, especially feet and hands.

Darkened skin patches: Areas of darkened skin, called acanthosis nigricans, can appear, particularly in the neck and armpits.

Debunking the myths

         Myth: Overeating sugar causes diabetes.

Reality: The causes of diabetes are multi-factorial. While consuming too much sugar, especially in drinks that contain added sucrose and fructose, such as sodas, is linked to an increased risk of Type 2 diabetes, eating moderate amounts of sugar in isolation does not trigger diabetes.

Myth: Only overweight individuals get diabetes.

Reality: While obesity is a significant risk factor for Type 2 diabetes, accounting for 80 – 85% of the risk, many overweight people never develop the condition. Conversely, a fair number of those with average weight can become diabetic. Factors like family history, age, and ethnicity also influence risk.

Myth: People with diabetes should avoid all carbohydrates.

Reality: Carbohydrates are essential to a healthy diet, even for those with diabetes. The key is to opt for complex carbohydrates like whole grains, vegetables, and fruits, which have a lower glycemic index and are processed more slowly by the body.

Myth: Diabetes is not a severe disease.

Reality: If not managed well, diabetes can lead to chronic health complications such as heart disease, stroke, kidney damage, and vision problems. Effective control of blood glucose levels and regular check-ups are paramount to prevent complications.

Myth: Once you start insulin, your condition has worsened.

Reality: Insulin is a standard treatment for people with Type 1 diabetes and can be prescribed for Type 2 diabetes if other methods don’t control blood glucose adequately. It’s a crucial step in the treatment process, not an indication of disease progression.

*This article is attributed to Affinity Health. 

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