WRITTEN BY: Beyond Type 1 Editorial Team
Editor’s Note: Get continuous updates about the coronavirus pandemic (COVID-19) here.
Like Type 1 diabetes, managing mental health is uniquely important in times of uncertainty like the world is facing now. Our team took the opportunity to ask questions and get clarity about the things we’re struggling with and thinking about. We had a roundtable discussion with clinical psychologist, certified diabetes educator and Beyond Type 1 Leadership Council Member Dr. Mark Heyman about best strategies for getting through this tough time and adjusting our mindset to understand this new normal. Here are some of the mental health concerns our team wanted help coping with:
Lala: I am struggling with a pretty high level of anxiety and every few days, that tips into a total meltdown – I’d love some tips and tricks for how to manage that… I’m also a little bit worried about this becoming habit.
Dr. Heyman: I want to say that having anxiety right now is totally normal. I think that the key thing here is managing it… With not being able to go out of our houses very much and with the fear about this pandemic, I would be surprised if anyone was not filled with anxiety and a little bit worried if that wasn’t the case. I want to normalize that.
Anxiety is really fear about the future, whether it’s a perceived threat in the future or a real threat. And so the best way to manage anxiety in this case? Find some routine so that you have predictability during your day. Getting up at the same time every day, taking a shower and getting dressed like you’re going to be going to work I think can be really, really helpful in giving you grounding for your day.
In terms of this anxiety becoming a pattern, I think that’s a reasonable concern. A way that you could address that is by recognizing when that tipping point might be coming and then changing the scene , doing something very intentional to change what you’re doing at that time because our brains are really smart and they get in habits easily and we get triggered into those habits… If those feelings of being tipped over into that kind of panic happen for you, change the scene. Go outside for a walk, do something to calm yourself down. Get away from work for a little while and go and do something to distract yourself and get your mind off of it. Being intentional about that is a really great tool to make that a habit.
And if you see it becoming a habit, the weird thing about habits is they can be broken. You have to be aware of them though and so being aware that it’s becoming a habit is an important part. Being intentional and being aware of what’s happening for you within your body, within your mind, can be a helpful step for you.
Todd: Is it normal to be overeating this much? I think because I’m stuck at home, I’m going through food way faster than expected. Do you have any advice for how to not just go back and forth to my kitchen every five or ten minutes?
It’s totally normal that you happen to be eating more, not necessarily because you’re at home, but because you’re stressed. Not being able to leave very much and having the change in your routine can be really stressful. Often times we use food as a comfort. That’s a totally normal response to a stressful situation.
Tips and tricks: don’t be so hard on yourself . This is expected. Certainly, you could try to stop and if you wanted to do that, that’s totally fine. But I wouldn’t beat yourself up too much over it if that’s happening for you. A couple of things that you can do are one: people find that it’s helpful to have food out of sight. If you have food on your counter, put it away. If you have a garage, put the food in your garage. Only have the things available that you want to eat that are there so if it’s out of sight, it’s just not going to be available to you. Also, I think that it can be helpful to have a regular eating schedule. Say to yourself: “I’m going to have breakfast, lunch, and dinner and maybe an afternoon snack.” Set those expectations for yourself at the beginning of the day because it’s much easier to follow a plan than to kind of have a free for all and be kind of going back and forth to the kitchen.
If you find yourself eating a lot, eating mindlessly, then try to eat more mindfully . And what that means is that let’s say you go to the kitchen and you say, “Okay, there’s a bag of chips on the counter.” Instead of taking a whole handful of chips or taking the whole bag of chips to your desk and just eating them, maybe take seven chips out of the bag. That’s a random number, but take seven chips out of the bag and then eat each chip mindfully. Pay attention to what it feels like in your hand, what it smells like, what it’s like to put it to your lips and chew it and to be very intentional about that. It’s slowing yourself down and helping you eat more slowly, not overeating, but also to really appreciate what it is that you’re eating and to experience that because there’s nothing worse than having a really great snack but scarfing it down and not really being able to enjoy it.
I think this is kind of par for the course. If some overeating is happening and it’s not a big problem for you, it’s not impacting your blood sugars, you’re not beating yourself up over it, I would give yourself some slack and let it be because you know this is going to end at some point. And when that happens, we can get back to normal.
T’ara: I’ve had diabetes for almost three years and during this pandemic, I’ve been feeling really anxious about bringing up the worst case scenario to my family members which is death. We’re trying to prepare for emergencies, but we haven’t necessarily talked about what happens if I pass away or another family member passes away, so I would love some ways to approach this topic with my family.
It’s a really scary conversation to have and probably scary for you, but also scary for them. It’s definitely an important conversation for you to have. I would be honest with them about your feelings. I would say, “This is really hard for me to talk about, but I think it’s important that we have this conversation.” And I think by laying your feelings on the table and letting them know how you’re feeling, it’ll make it a little bit easier to move on.
If you’re vulnerable and you say, “This is a tough topic, but I think that we should have a conversation about what happens if something awful happens and I’m really uncomfortable talking about this, but I think it’s an important one,” it makes everyone kind of feel like they’re on the same page. It’s much easier to have a conversation if everyone knows that everybody else is having a hard time because these are never easy conversations to have and I’m really glad that you’re thinking about having one. Because I think it will serve you well now. But also once we get through this, I hope it will serve you well in those conversations in the future with your family and friends and loved ones.
I think vulnerability, I think we have the wrong impression about it. With diabetes and with other tough conversations, by being vulnerable , you’re actually providing people with a model that they can use. Because as I told someone before, I would be worried if you weren’t anxious about the situation or anxious about talking to your family about these tough kinds of things. And that’s normal but we want a normalize that because if we normalize it, then no one has to feel like they have to have to be the tough one and be the strong one. Because at this point, it’s really hard for any of us to be the tough and strong one because we’re all really scared. And then if we pretend like we are then we’re not being authentic to ourselves and what our needs are.
Jordan: How I can cope with this new concept of time and struggling with the anxiety of not knowing what’s going to come of this situation?
I want to give you a couple of pieces of advice around that. The first thing is finding ways to structure your day… Making your days a little bit more predictable and structured can be helpful in giving you a sense of security to the extent that that’s possible right now. The second thing I would suggest that you do is be very mindful. If you know me at all, you know that I’m a big fan of mindfulness. What can happen here is that your thoughts can just kind of get away from you. And so you’re kind of in this big unknown and then your thoughts have lots of places that they can go and they can oftentimes go to some really scary and dark places. Being present in the moment, even if that moment is scary, it can be a lot easier than being lost in your head and that can give you a sense of grounding and a sense of security. The third thing is take advantage of this time for yourself . As scary as that is, find something new to do. So if you want to learn to draw or learn to play the guitar or learn to whatever it is that you want to do, take advantage of it and hopefully find some joy.
Mindfulness is a practice. And for those of you who are familiar with mindfulness, it really means being in the present moment for whatever’s happening for you without judging it… There are some great apps out there that you can download. My favorite is Headspace. There’s also Calm and a couple of other ones that have some really great resources that you can use to practice mindfulness. You can do a five or ten-minute practice every morning. And then as you’re going through your day, when your mind wanders away from where you are right now, those types of practices can help bring you back. Because the goal here is not to not have your mind wander – your mind is going to wander. You’re going to go off into places but to be aware when that happens and you bring yourself back.
If you’re stuck at home and you feel like you need some support, don’t let being at home be a barrier to that. I think that the vast majority of mental health professionals right now are seeing people over Zoom or over a lot of the other telemedicine systems. Please know that that support is there for you if you need it. Whether that’s diabetes specific-support or mental health support in general, look for somebody in your area, look for somebody in your state who provides these types of services and use them if you feel it would be helpful.