On the topic of burnout

Type 1 and LADA
1

hello everyone,
This is in league with the live Chat with Dr. Polonsky of the Behavioral Diabetes Institute a few days ago..

burnouts going to happen, and a healthy approach to help ease burnout is to take a safe "diabetes vacation" Safe meaning, being prepared for it :+) This is also in -line with the Live-chat coming up with Ginger Veira on the topic of burn-out.

i feel like burnout for me can sometimes happen on a weekly basis. Just getting emotionally tired from it. Sometimes I don't feel burned out for months, other times its a few days.

I'm curious what is your experience?

2

I haven't had a diabetic burnout yet I guess because I am so newly diagnosed even though I had the symptoms of diabetes long before I was diagnosed. I think I do suffer from burnout from a culumination of stress, work, multiple health issues, and lack of rest.

I think lack of rest is my biggest issue. If I could just decompress for a little while I would be o.k. but I'm on a constant treadmill/rollercoaster of doctors, medications, and "life issues" that I miss the chance to just relax. I think that is where the "diabetes vacation" needs to come into play.

If I could "calm" my RA down then my diabetes would be o.k. but RA is affect by stress, lack of rest, work, life, medications, food, etc, etc. which in turn upsets my diabetes. It's a vicious cycle. To the put I want to scream "Calgon take me away!" I know...I'm dating myself. :-)

3

Yeah, I deal with burnout too, sometimes quite frequently depending on what else is going on in my life.

So, it turns out, from a lot of neurobiological research, that willpower is physical. It is like a muscle--if you use it a lot, it gets tired and gives out. Using it consistently over time can make it stronger, but there will still be a limit beyond which your willpower is exhausted and needs time to replenish itself.

I remember one experiment where they measured actual calories burned in the test subjects when performing a task requiring willpower, and it resulted in an actual measurable calorie burn followed by an actual measurable decrease in blood sugar levels to match. Something like 4% more calories than normally burned by one's brain, which is a lot considering your brain usually uses something like half of your daily total calories.

So yeah, diabetes can be "managed" and you "get to live a normal life" (sort of) when your life is normal. But if you are facing a lot of stress, or situations requiring a lot of willpower, it's going to get exhausted and you will be burnt out and not have the resources left to deal with blood sugars and testing and insulin dosing.

4

this is a FANTASTIC dialogue, and i'm so happy you opened it up in response to my posting!!

Last summer, i had this massive "opening" (realization) about how much my diabetes has effected my life. I, in a way, suddenly realized I have a chronic illness ((though I had it since I was 2))

anyway--- in a rapid amount of research, something I found very fascinating was the link between willpower, the pancreas, and how its described in the chakra-system:

Courtesy of wikipedia, a "chakra" is:
"In Hindu and tantric/yogic traditions and other belief systems chakras are energy points or knots in the subtle body. They are located at the physical counterparts of the major plexuses of arteries, veins and nerves. Chakras are part of the subtle body, not the physical body, and as such are the meeting points of the subtle (non-physical) energy channels, called nadiis. Nadiis are channels in the subtle body through which the life force (prana), or vital energy moves. Various scriptural texts and teachings present a different number of chakras. There are many chakras in the subtle human body according to the tantric texts, but there are 7 chakras that are considered to be the most important ones."

here's an excellent evidence-based study on various "energy therapies" for better management:
http://spectrum.diabetesjournals.org/content/14/3/149.full

so, the thing about the whole concept of chakras, is basically how anything physical is also emotional / energetic. The chakras are in a way these marker-points for the mind-body connection.

According to the chakra system, each chakra-point is linked to a series of organs.
The pancreas is connected to the third chakra.

The third-chakra (also called the "solar plexus or the manipura chakra) has to do with willpower.

"The gift of this chakra is sensing your personal power, being confident, responsible, and reliable. The third chakra is the centre of your self-esteem, your willpower, self-discipline, as well as warmth in your personality.

The energy of this chakra allows you to transform inertia into action and movement. It allows you to meet challenges and mover forward in your life.

The main challenge for the third chakra is to use your personal power in a balanced manner. What does that mean? It means consciously harnessing the energy of the solar plexus chakra. It means being proactive rather then reactive or inactive."

Now, i'm not proposing that meditation and yoga are going to cure anyone of diabetes. BUT, what I think is 100% spot on, is that will-power is the ability to respond effectively and efficiently to an outside force that has effected you. It is the ability to act in response.

Diabetes- all kinds-- is a problem of energy conversion. Willpower is effective "will" conversion.


So, the physical issues that diabetes brings on in converting energy, manifests as willpower issues in behavior, energy, emotion, psychology.

are you following me?

Also, thinking of my own history, my biggest life struggle- to this day- is self worth. Is finding myself worthy of my own life and care. I've gone to hell and back with a deep-seated insecurity. And i do believe now, that this broken sense of self came from the wound that type 1 diabetes brought into my life as a very young child.

Its only as an adult that I am finally looking at this wound, and healing its pain.

""The wound is the place where the light enters you."
-Rumi

would love to hear your thoughts and responses to all of this.

5

:+) hey what is RA?

6

RA is Rheumatoid Arthritis.

7

mm. i thought as much but didn't want to assume..

the whole rest conversation is so important.

you know, disease takes space. in order for us to live healthfully with disease, we need to have room to care for it.

but we live in such a compressed society :/

8

I've always tried to go by two rules: 1) You don't have to like it; you just have to do it.
2) There are no barriers, only challenges.

As a diabetic, I'm probably more obsessive, more careful, more observant of daily events, and I learned I can use those characteristics to my advantage.

It's funny, but with my T1D metabolism, I rarely feel tired or sleepy unless it's an indication of a hypo or a hyper. But, I do feel drained sometimes.

When that's the case, I take a break by not cutting off from my care, but going to one of my hobbies and wrapping myself up in it is the way I deal with "burnout." And if I can, taking some annual leave. For all the attention the T1D demands, the pumps and glucometers make it easier to carry around and to have flexibility in life.

9

I've never really looked into the chakra stuff, but at the very least that is some coincidence. Wow.

Those are very interesting points. I hadn't really thought about it that way.

I think for me, I think of willpower as a budget, or a bank account. I have to balance the income and expenditure. There are times when there are extraordinary expenses--like last year, when I lost my job and my daughter had a number of health issues going on and I was dealing with a stalker, and none of that could be put off, so my diabetes care was not great. Major burnout. But in general, I try to be careful about what willpower-demanding activities I let into my life, so that I know I'll have enough to deal with what needs to be dealt with. I'm not sure if that matches up with what you're talking about, though.

I know exactly what you mean about the self-worth thing, though. Why spend a lot of time and energy preserving yourself when you don't really care about yourself to begin with? It is a struggle I try hard to work through myself, some days with more success than others. :)

10

What is your definition of "burn out"?

For me the cute images Polansky wrote of were very cute, but went absolutely nowhere with them. So Im compelled to ask, what are we calling burn out exactly?

11

Don't go the route which Gopi Krishna described opening his chakra's -wg-

12

IMO burnout is when you dream of your honeymoon (that temporary time frame where you still produced insulin and had hope that maybe your diabetes dx was wrong). It takes a long time to accept that diabetes is part of your life and an even longer time to manage it well enough that the doctors get off your back. I agree that burnout can be exasperated by other factors; stress, love life, family, work...but ultimately the only person who can help you, is you. That is the most challenging for me to accept, that I'm in charge, and when I mess up or relax I immediately experience the consequence.

13

Can I borrow your "white coats" -wg- ??? Mine have always been, and likely shall always be "chuckle-heads".

While I respect your perspective, I would like to point out, no matter how "tightly" we micro-manage this stuff, how OCD that vigilance guarantees little or nothing. Meaning if we don't have the gene(s), no matter how badly we screw up, it is not likely we will get many complications. Nor does being OCD about "control" guarantee the outcome either.

Its rarely an either/or outcome. And sometimes regardless of out efforts stuff happens...

14

lol what?

15

i think thats a great question, how do we define burnout. and is it a "we" definition, meaning-- should we have a common definition we can all adhere to.

((i actually haven't yet read Ginger's book, or actually any books on the topic, so im not following/continuing already established thought/dialogue about it yet.))

What do you mean by cute images-- what were you referencing? I don't know if i remember them. Regarding taking a diabetes vacation, or?

I've come to a place where I got sick and tired of the blood sugar rollercoasters, and I've decided to stabilize my "fuel" source (food) as much as possible in order to stabilize my energy and blood sugar.

this led me to the ketogenic / high fat way of eating, and its making a huge difference.

However, even with excellent balance -- (personally i refuse to use the word control and think its completely the wrong way to think about a living ecosystem- including our own bodies)-- I still feel bizarre energy ... depletions? I don't know. There is a disease present in my body even with wonderful bg numbers.

thats the part that is the constant soreness, and thats the part that takes a lot of emotional resilience and a supportive partner, support network, friends, family, community, etc.

16

i agree with you, Stuart... its just not that linear. I think the use of the word "control" comes from the fact that we want to feel and believe we are in control.

but we all know we aren't. we can try to create circumstances for success, hope for the best, and live our lives as fully as we possibly can while we have them :+)

17

Hello Marina:

I'm not a huge fan of the Great White Shark (sic. diabetes) we all swim with. Your question is a great one, and I intimately wish I had a better answer. What I have now seems a grim smile and a low expectation of bliss and joy, rainbows and kittens in my diabetes future(s).

I want to drink the *@(#@(@#(&@&#@ Kool-Aid, I truly do. Is this "burn out" certain you think? Or is severe skepticism all right, and a very different creature, IYV?

18

I believe, regardless of diabetes, if you work out a good plan for how to live your life (whether it involves chakras or moments of clarity or some 7 step program or activating moon stones or insert intangible life plan here) you should try it, refine it, collect data as you learn and stick to it. You see what you want to see and you hear what you want to hear. Believe something hard enough and it is real. Belief is a powerful thing. For some things in life the placebo can be as effective as the real thing, except for insulin :)

In terms of "willpower" and burnout, I personally don't see what choice I have. Diabetes frustrates me sometimes and I spend a lot of time during the day thinking about diabetes. It prevents my thoughts from focusing on other things in my life that may change me in certain ways. However I have been DKA, I have read stories of what happens to people that don't control their diabetes, I have seen how it affects peoples' lives and their loved ones. My decision concerning what I believe about controlling my condition, more than any other possible options I have, is that there are no other paths I could take. This is the only option. If I am upset about that path, well too bad because you are on a train and you can't get off. You have a ticket and turning it down means you get thrown into the ditch at 60mph. Its that simple and it doesn't have to be any more difficult.

I think psychologically you need to control how you perceive diabetes is affecting your daily life. In the long run, if you manage your perceptions from day to day you will feel better. For me, that is a low-carb/high protein diet, exercising, tracking data, analyzing that data, applying changes based from analysis and slowly crossing the gap between where I am and my goals. I dont associate tracking blood sugar data with "control" per se, if that makes sense. I control the data and how the data comes in, but that is not controlling "me" its just controlling some part of me; like moisturizing my skin, brushing my teeth or exercising to stay fit. More importantly, I perceive high/low blood sugars as just data points to help me manage my condition and this data should not affect my self-esteem. The same way as experiencing more acne means I need to wash my face better, not be upset because I did not control my acne this week.

19

This is the only option. If I am upset about that path, well too bad because you are on a train and you can't get off. You have a ticket and turning it down means you get thrown into the ditch at 60mph. Its that simple and it doesn't have to be any more difficult.

i think thats really spot on, and i know it took me a long time to learn to surrender to my disease, and all that it means. surrender not in the "losing" way, but precisely in the way you write of it.

For me, that is a low-carb/high protein diet, exercising, tracking data, analyzing that data, applying changes based from analysis and slowly crossing the gap between where I am and my goals.

what you write of is a healthy understanding of what it means to be successful-- in diabetes management, and every day life. Taking full responsibility or the circumstances life presents you. the sad truth is that many of us are not taught this. thats why you see all these "10 habits of highly successful people" articles all over the place. thats why there's a lot of pain in the world.

i;ve also come to the lowcarb / high fat decision for the same reason. I'm viewing food as fuel- what do i need to eat to make my engine run as optimally as I/it can?

More importantly, I perceive high/low blood sugars as just data points to help me manage my condition and this data should not affect my self-esteem.

again, thats a beautiful and healthy attitude.

I hope you don't find my question rude-- did you grow up in a safe and supportive, emotionally healthy family? and if not, what experiences led you to this place?

i stand in agreement with you, but i know for how long and how much pain i had to burn through in order to get here.

20

I did have a good family that always pushed me to do well academically and paid for me to do extracurricular activities, sports and volunteer work. In college, I spent all my "free" credits on philosophy courses. My favorite past-time was to track ideas concerning human identity, existentialism and theory of the mind across the broader range of topics philosophy covers, but I havent kept up on that. I have an avid scientific approach to understanding the world but recognize the difficulties associated with understanding the world through your inherently limited perceptive abilities. Thus, you see what you want to see and hear what you want to hear (http://www.youtube.com/watch?v=TPqvHRvA8w0). I spend a living working as a software development project manager and spend a whole lot of time analyzing financial data.

That being said I have entertained a lot of crazy beliefs concerning how you should perceive yourself in the world and get through the fact you control your own existence. The best advice I got was from some old dude talking to me about some action I was having trouble taking, saying, "That sounds like a bunch of ■■■■■■■■ to me! You just do it!" I realized, he was right. It can be complex but it can also be as simple as you want it to be. There doesn't have to be a bunch of baggage with it, that's just some gunk your mind does that you can stop it from doing.

Ultimately I take a reductionist approach to things. If you want to get good at football, you're going to have to run 10 miles a day, hit people with your head and be in physical pain most of the time. If you want to do some back-country camping you gotta make snares, chop wood, ■■■■ in the woods and hide from bears. If you want to be a full-time writer, you're going to get a lot of criticism, make a lot of ■■■■ work for a long time and maybe live out of a van for a while. If you want to manage diabetes, you manage your diet, track data and make adjustments. Once you start getting it right you can start safely training for that marathon in a couple months.

I like living. I'd like to do it for a while. People say life is hard, but most of that is just your point of view. Some people don't really get to do it at all.