How to Deal with Shame in Type 2 Diabetes
Shame is an experience that many people with type 2 diabetes encounter. If you struggle with shame, you are not alone. Unfortunately, shame often results in individuals avoiding self-care behaviors or visits with their healthcare providers and, consequently, missing or delaying opportunities to screen for complications. There is also a significant mental and emotional burden to shame as well.
Dealing with shame by understanding where it comes from
Shame from judgement and stereotypes
A big part of the experience of shame involves the social side of diabetes and the fear of being judged by others. What will other people think? What will they say? Will they look at me differently? Here we see an association with cultural myths, misconceptions, and stereotypes that are still tied to type 2 diabetes, as well as the way our culture talks about diabetes. This includes the idea that lifestyle is the only factor related to the development of type 2 diabetes and that many people associate it with being overweight.
The truth about stereotypes
When we look at ideas like these we can see that, as with most stereotypes, there are elements of truth but they are not consistent across the board. And, these ideas impose blame and feeling like “it’s my fault.” We know that lifestyle factors and obesity are significant risk factors for developing type 2 diabetes. But we tend to bulk all lifestyle behaviors (eating habits, physical activity levels, etc.) into the category of “choice.” In reality, it’s not as cut and dry as a choice.
Some lifestyle factors are not a choice
It’s helpful to remember that there are both modifiable and nonmodifiable behaviors, meaning, there are a lot of things that influence your ability to eat right and be active. A lot of times, they can be socio-economic and environmental challenges. Examples of some of these may include geography, having no transportation, living in rural or urban areas with little options for healthy food (i.e. food desert), working night shift, etc. Some of these so-called “lifestyle factors” may not necessarily be a choice by a product of your environment.
There's also the genetic factor
Then there is also a genetic component here that is necessary for the development of diabetes. This is why some individuals who eat poorly don’t gain weight or why others who are overweight don’t have diabetes. Furthermore, consider that in India, while there are lower rates of overweight and obesity, there is a higher prevalence of diabetes.1
Shame from being a burden to loved ones
Sometimes individuals feel shame because they believe that they will become a burden to their loved ones. Or, they believe that developing serious complications are a guarantee when you have diabetes. This too is not necessarily true. Most often, when people automatically associate diabetes with complications, burdens, and disability, it stems from experience. Usually, they have a family member or friend with diabetes who had that experience. Early detection and intervention are critical for getting a handle on diabetes and avoiding or delaying complications.
Shame from self-blame
Then there is the element of being judged by yourself (AKA self-blame). As with lots of things, when diagnosed with diabetes you will naturally want to know the reason why this has occurred. This can bring about a sense of failure and blaming yourself as if you have somehow failed to manage your health or allowed this to happen to you. This line of thinking produces feelings that you have “brought this on myself” and extreme guilt.
Tips for dealing with shame
When dealing with shame, here are a few things to remember:
Blaming doesn’t help
It’s not your fault and blaming yourself doesn’t do any good. In fact, it only makes things worse. Dealing with the burden of shame, failure, and guilt puts you in a negative headspace, making it more challenging to create and sustain healthy lifestyle behaviors. Of course, letting go of these feelings isn’t always easy. Many people find that journaling and/or use of a “surrender box” is helpful (a surrender box involves writing a letter declaring your release of this emotion). And don’t be afraid to get support from a professional when needed.
You are not alone
Those words, “You are not alone” can be quite powerful. And it’s true. Let that sink in. Others have experienced these same emotions, the struggle of diagnosis and making changes, and living with diabetes. In fact, millions of Americans have diabetes! It helps to connect with others who have diabetes and understand what you are going through. Diabetes support groups and online communities are an excellent resource for this.
It’s no one else’s business
Okay, so it’s obviously your doctor’s business…and, it is important for healthy coping and safety that you do not hide diabetes from your spouse or perhaps an immediate family member. However, it is no one else’s business that you have diabetes. You are in no way obligated to reveal to the world that you have diabetes. Of course, you will encounter some tricky situations on occasion, such as how to handle turning down sweets when necessary, but you will learn how to navigate these with time and support.
Diabetes does not define or control you
Experiencing some shame is not uncommon, but allowing yourself to continue to experience shame and become consumed with this means that you are allowing diabetes to control you, rather than you controlling diabetes. You are so much more than a diabetes diagnosis. And, you are still the same person. Continue to engage in the things that bring you joy.
You can lead a normal and productive life with diabetes
A diabetes diagnosis does not automatically mean that you are now destined for complications. Taking control of your diabetes by doing your best to manage it will help you to avoid or delay complications. Sure, managing diabetes is not easy, and some days are harder than others. But, diabetes self-management practices do not have to be consuming. Start small, little changes add up quickly. Get help from a diabetes professional when needed. You will likely need the most support and education during the first year or so following your diagnosis.
Do you live with any sleep disorders (eg. insomnia, sleep apnea, RLS) in addition to your diabetes?