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Struggling - mentally, physically, type 1diabetes, depression

B

-beckyb93-

Well-Known Member
Messages
101
Type of diabetes
Type 1
hi all,

I've not been on here for abit 3yrs, not entirely sure why but im struggling. Mentally. Physically. Diabetes wise. Depression wise. Work wise. My friend suggested a forum or blog so I thought id try.

Background. I'm 27 and a nurse. Diagosed type 1 Christmas 2000. I've had issues with hypos, hypers, diabulimia, dka three times. In 2008 I suffered massively with diabulimia, and resulted in becoming comatose in ITU in alder hay, where I had to he resuscitated 4 times. I've been bullied, been left out, been called, been alone.
Had bouts of low mood, anxiety and depression since I was 14. Diagnosed aged 16. Been self-harming since I was 15 (non for the last couple yrs) (go me).

Things are going well or should I say were going well.
My HbA1c was 7.1mmol/L back in January. My weight was 73.4kg. Both my lowest.
However since the whole covid situation, its all gone to pot.
My weights rose to 77.9kgs, my HbA1c is back up to 8.2. I feel terrible. I have hyper after hyper followed by rebound lows. Or lows followed by rebound highs. Some days I din6t want to test because I dread to see the result. I feel like I'm in a vicious circle that never ever ends.
I go to the gym 2-4times a week depending on my work schedule. I do 3-4 long days (12.5 hours (not including the commute by bus) I've worked the entire covid. I've even had the dreaded covid.

Alots happened recently. One of my freckles doubled in size and changed colour. I've been for a biopsy and I'm awaiting the results to find out if its benign or malignant.
My shoulders been playing up for years. And I've recently been for an MRI. Awaiting appt for those results too.

My diabetes is out of control. Up down up down. I feel no matter what I do it just does its own thing.
I eat reasonably. I've tried low cal and low carb and I just hypo hypo hypo. I do eat chocolate everyday. But only if my blood sugars are below 8. Anything above 8 and its no chocolate for me.
With my anxiety and depression I just feel I'm struggling so much right now.
I spend ages crying and worrying. I'm a nurse I should be able to handle this.
But with my weight increasing and me looking in the mirror I just see fat fat fat.
I've contemplated omitting my insulin to drop some weight but at the same time I know I'll jusy end up in dka again which obvs scares me.
I'm on complex therapy.
Novorapid x3/day
Levemir of a morning
Dapaglifloxin 10mg
Metformin MR 2g
Duloxetine (for my anxiety and depression)
My consultants also put me in victoza/liraglutide to try and help with my blood glucose and weight issues. Because I've tried dieting, I go to the gym regularly, I work long days always on my feet but since covid I've just put on weight, BMs have gone up, my moods horrid.

I shouldn't feel like this. I dint want to feel like this. I mean I've also had really good aspects to this god-awful yr. I've been to Jamaica (precovid)
Me and my partner bought a house and we moved in almost 2 months ago. I've got a job. A house. Food on the table.
But at the same time I spend countless hours thinking about omitting my insulin, cutting my fatty stomach off, self harming. And I shouldn't.

I know this doesn't replace processional or medical help but I don't know if talking to others who may understand or relate may help.

I've opened up to my partner about these things and he's great, until it comes to my depression becoming bad. He just freezes up, not sure what to say. I know he tries and he's trying.

Sorry for the huge post.
Thanks to anyone who reads and/or comments.
Becky
 
I'm no expert in any of those, but I can recognise someone needing a hug while we wait for the experts [[[[[hugs]]]]]]
 
Thank you.
I should be asleep getting rest before tomorrow's shift but im just lay here on this page with things in my mind. Will I hypo? Will I go high again? Why do I bother?

I feel temporarily the omitting insulin and cutting will help. But I know longterm it won't. Not in the slightest.

I should be happy. I've a lovely home. I've go an amazing partner who loves me so incredibly much. I've got a good family. Who I miss tremendously (I moved 97miles away to uni and for my career) I speak to my mum almost every other day if not more. My dad once a week. My beautiful niece, nephew and godson atleast fortnightly if not more.
But yet I still feel this way. Like why should I bother.
Omitting my insulin will help me loose some much needed weight. But I know its so dangerous and definitely shouldn't be done. I'm miserable. But I have so much going for me. My house my home with my fantastic partner, my carer, my close friends and family. But yet I feel so alone sometimes, a freak, a fat slob, a broken mess.
 
-beckyb93- said:
... My diabetes is out of control. Up down up down. I feel no matter what I do it just does its own thing. I eat reasonably. I've tried low cal and low carb and I just hypo hypo hypo....
Click to expand...
You need to get back into the sense of being in control. It quickly switches the perspective from negative to positive. While your situation is complex, eating low carb is still the most powerful tool for stabilising blood glucose and getting in control. If eating low-carb caused hypos, you must still have been using too much insulin. Eating ketogenically is even better. The cause of high blood glucose (carbohydrate) and the cause of low blood glucose (insulin) are removed, making blood glucose very stable. At the same time, the body learns to use mostly fat for energy, which doesn't affect blood glucose at all.
 
I understand what your saying but low carb doesn't work for me.
Even with only 2 units I hypo. And I have no energy at all.
Because of my busy career and being on my feet and moving all day that also causes me to go hypo. Hence needing carbs.
If I don't have insulin my sugars rise dramatically and I develop ketone.
So I have to have insulin and carbs otherwise I'm either hypo or hyper with ketones. So I have to eat carbs with atleast 2 meals a day. Usually all 3 meals.
Thanks for your comment
 
-beckyb93- said:
... Omitting my insulin will help me loose some much needed weight. But I know its so dangerous and definitely shouldn't be done. ...
Click to expand...
Also be aware that it is not sustainable. Once omitting insulin is started, restarting it becomes really difficult. You daughter is similar to my daughters, except that it ended badly for her. Look for a sustainable strategy and work with a coach/counsellor to put it into action.
 
I'm sorry about your daughter. I can't imagine how hard that must have been.

I will tell you straight I won't be walking with a coach/counsellor. I feel much much much worse. I've tried several times in the past with different ones and I've left feeling even worse than before. Wanting to purge, and self harm and miss insulin even more.
 
-beckyb93- said:
... Even with only 2 units I hypo. And I have no energy at all. ...
Click to expand...
Could your basal and bolus dosage be out of balance? That also causes unpredictable blood glucose numbers. Testing basal over the full 24 hour cycle would help. It sounds like getting blood glucose stable enough to do the test could be challenging, though. The lack of energy when switching to low-carb is just temporary, while the body learns to use fat for energy. When the process is complete, you will have more energy than you have had for years.
 
MarkMunday said:
The lack of energy when switching to low-carb is just temporary, while the body learns to use fat for energy. When the process is complete, you will have more energy than you have had for years.
Click to expand...
Though do remember that low carb may just not suit some people or work for them
 
I am lowish carb most of the time, and it helps me stabilise my weight (abeit much higher than I'd like). But it's a real issue that you have to take glucose when you go hypo, which negates the low carb regime.

But I agree with @MarkMunday that @-beckyb93- needs to get her basal right. Things are much easier when you're on the right basal amount. But I can imagine that basal amounts might vary quite a bit with a demanding nursing job. In her position I'd consider asking my clinic for a cgm and a pump, so that basal levels can be changed according to activity levels. Pimp the cgm out so that it has alarms (miao miao if it's a libre) so that you can first avoid the hypos and second avoid the highs.

It's really difficult to manage weight loss or gain while you're cycling through hypos and rebound hypers, and it's also depressing. T1 is a demanding illness, but though most of have periods of not so stellar control (I've been much much worse than 8.2 and I make no promises that I will always maintain my current somewhat tenuous control) that doesn't mean that you can't pull back into better levels (and feel mentally better for taking back that control).

I made a decision (after an adolescence where I lost weight by having too little insulin because I didn't see a specialist for ages, and it was pre glucometer so could only suspect my levels were high ), that it was more important to have good diabetic control then achieve an ideal body shape or weight.

And 95% Lindt chocolate is fairly low carb, delicious and is hard to binge on

You are not alone, many many T1s have faced similar issues. Try to remember that things can get better.
 

Hi Becky,

I'm not going to try & understand your life. Your partner sounds great, your family unit are trying to be supportive as they can.
Yeah, I know.. But they don't quite (with the best intentions.) "get it.."

Do you have a CGM set up of some sort to assist in your working day.? (& everything else.)
When was the last time you checked out the "basics" with a basal check..?

It is however empathised that swinging BGs affect emotion. Take the issue there first.
 
Oh no 8.2 isn't my worst but I just feel I'm going back that way. And because my diabetes isn't great atm or recently I'm finding myself have depressive thoughts and episodes.

Yes I've checked my basal. No I'm not on the pump. I tried the medtronic couple of years ago and absolutely hated it. Being attached to it with the giving set 24/7 just made me so so depressed. I didnt want to get up or eat or move or shower. The constant visible reminder attached to me and getting caught made me so so depressed that I went back to MDI.
I have the freestyle libre at present.

Like I said low carb doesn't work for me. Especially in my high demanding job. Always on the go.
 
My experience with depression is that it doesn’t matter how many good things & support you have in life, it does not negate how bad you feel.

You are putting a lot of pressure on yourself and it’s just making you feel worse. Being a nurse doesn’t mean you should have perfect control, you may certainly understand the medical terminology easier that us non healthcare professionals but your not extra ‘failing’ because your nurse.

Reading your situation to me feels like a life in chaos, I recognise the feeling & the stress of working during the pandemic is no doubt not helping.

The one thing I’ve accepted is that sometimes I just need to completely stop & focus on the issue that is causing me the most distress, even if it feels like I’m too busy & I’ll fall behind if I slow down.

Is it possible for you to take a week or two off work & just focus on your diabetes control? Can you spend your days off on whatever you do to relax? I read a lot & sometimes just need to take an entire week off & do ‘nothing’ except read, take care of my kids & keep on top of my carb intake, insulin & BG.

Just an idea, it may not appeal to you but it might give you the space to test your basal & carb to insulin ratios, then that’s one issue under control & you can focus on fighting your other issues.
 
levemir doesn’t last a whole day. If you are injecting once a day now, can you try twice a day (split into 2)?

I am sorry you are having a difficult time, hope you will find a way out of your struggle.
 
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Hi there. I've also suffered from bulimia (did not suss out the insulin stopping thing but did make myself sick and hated myself for doing it). At the time I was trying hard to keep afloat with a degree, boyfriend etc.
I certainly had no concern for high blood sugars other than they made me feel like a failure too along with weight fluctuations and the feeling that I wasn't quite living my life the way I was supposed to!
Your post does sound as if you are overwhelmed and floundering about what to do next and how to get out of the vicious circle. It also sounds as if it has been made a whole lot worse by isolation though I am glad you've told your partner and us lot. That is a start. If you were advising a mate what would you tell them to do?
What I did was admit I had an issue and needed some time off to put solutions in place. The longer is goes on the harder it is to unpick the habits you've got into to cope with whatever feelings triggered all of this. Your choice is to carry on 'coping' as you are now with the risk that you crash or just live unhappily or you take a risk by talking to someone and possibly go through a difficult process in which you cede a little control of your coping mechanisms but a good counsellor should always give you the choice about how far and how fast you go. The fact that you talk so firmly about not seeing a counsellor or trying low carb are perhaps indicators of a need to be in control when you sound like you really don't feel in control at all. Please be open to the possibility that you can change this with help.
As for the diabetes that does put some urgency on things but you also know there is a great chance you can turn things around without any complications.
I hate celebs taking about mental health issues but was interesting to see Freddie Flintooff taking about Bulimia and the issues around getting help he is still wrestling with 20 years on!
 
I've had several bad issues with low carb and with counsellors which is why I won't.

I have isolated at all. I've worked the entire lockdown. I never got a "letter" to self isolate.

I take levemir twice a day. Morning and evening.
Its like one day my regime is working and the next its not.
Usually my bms are about 5 or lower now. Today just checked and they are 12.9.
Its just all too much
 
Sorry I did not mean isolated as in shielded. You've been working all the way through and you are away from family hence overwhelmed and isolated. I can't know how it is to be you but you did sound as if you want to scream but can't! Your Bgs are better than mine btw. 13.7 in spite of no breakfast and an early work shift..
 

Yours could be because you've not had breakfast and insulin your liver has released some glucose for energy for the body.
I do feel like I want to scream. I just feel like crying and giving up. I'm trying to stay strong and carry on. But all I want to do it curl up and cry and cry. I feel like just having some big fat cake to help me feel better (short term only) then I'll regret it and want to cry more. I dont want to inject but I know I need to.
I feel like self harming. Just to get some release. But again I know that'll be temporary
 
-beckyb93- said:
Usually my bms are about 5 or lower now. Today just checked and they are 12.9.
Click to expand...
That's pretty good if you ask me. Though I'd love to stay in range 100% of the time, I currently average 1 day per 3 months, and I'm happy with that. It's easy to get discouraged when you read about the folk on here who have non diabetic hba1cs and never stray above a bg of 8, but most/many of us just have to muddle along. You don't have to be perfect, you just have to manage your diabetes well enough so that you control it without having it dominate your life and make you feel depressed. You'll have some bad days (or months, or years), but it's your overall levels that matter. It's never too late to tighten your control, and you don't have to have perfect diabetic control to be happy.

Having said that, just how bad is your hypo situation? I honestly find hypos the worst part of T1 and I would urge you to work hard to avoid them. (As a long term T1, I get hypo unaware if I have too many, so I am very happy to now have a cgm that warns me before I go hypo.) It's really easy to have a rebound high after a hypo, followed by another hypo when you correct. Last time I had a bad hospital inducing hypo (2 years ago) my diabetic specialist advised me to aim for a bg of 6 to 12 for a while to regain my awareness. If you've got a libre you could look at getting a miao miao transmitter so as to warn you when you are going low (or high), and pretty well avoid hypos altogether.

Good luck, sending lots of virtual hugs to you.
 
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