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Type 1, Self-Harmer, Insulin is a weapon

A

Andrew0306uk

Member
Messages
16
Type of diabetes
Type 1
Treatment type
Insulin
I got diagnosed with T1 after an overdose in 2013 but wasn’t under a Diabetic Consultant/Dietician until being hospitalised by Diabetic Ketoacidosis (DKA) in Feb 2019.

I’ve been diagnosed with Emotionally Unstable Personality Disorder since 2008 and one of my traits is a need to self-harm.

In July 2018 I somehow started a body dysmorphic episode and attached insulin usage to the cause of my being fat, which resulted in me stopping my Novomix 30 injections. My glucose levels sat at 30+ each day and the weight dropped off me (I was severely malnourished) and it resulted in my blood gasses being elevated causing the DKA.

I knew the risks of mismanaging my insulin but my self-harm needs drove the actions. I needed immediate/short-term damage but it didn’t happen, so I settled for long-term damage, and got the DKA.

Even since the DKA and my insulin regime changed from Novomix 30 to Tresiba + NovoRapid, my need to use the insulin dosages as a weapon haven’t gone. I have periods of increasing the background insulin by 300%+, or refusing the background insulin, and/or refusing the Rapid before meals, and/or increasing the dosages by silly amounts.

At the moment I am struggling to remove the need to self-harm with my insulin and I am looking for advice

I now have a Diabetic Consultant/Dietician but they just seem to panic when I mention the mental health issues dealing to my insulin, and my Mental Health worker has no clue as it’s relating to my diabetes. Both teams just say talk to the other team.

Has anyone else had issues with using insulin as a weapon against themselves?
 
Hi @Andrew0306uk , and welcome to the forum!

I'm sorry I can't offer any useful advice either. Sounds like you have a very hard combination of conditions to manage. One of them is hard enough but this particular combination must be a nightmare for you, and for your consultants as well.
Still, there are psychologists or psychiatrists specialised in diabetes. Sadly, I wouldn't know how to find them, as I'm not very knowledgeable in the health care systems outside my own country.

Have a big hug, and I have my fingers crossed you'll find a way to deal with both problems. Good luck!
 
There are a few people here who have had issues with withholding insulin.
Diabetes and high sugars can affect mental health badly.
I hope your teams can talk to each other and work out how to best support you.
 
Hello and welcome to the forum @Andrew0306uk

There are links between mental health and type 1 management in fact the 2 are fairly intricately linked - Abbott Libre are running a webinar next week I believe which may be of interest on mental health and type 1 which may be of interest, check their website.

Are you getting any mental health support from your team ?

The NHS are becoming more proactive so cognitive behavioural therapy may help but you would need to push your team if your not already being supported with this.
 

I’m having the Libre fitted next month for a 2 week trial so hopefully my partner will be able to monitor my levels easier, but checking is only part of the daily battle

I’ve been under the Mental Health Services since 2011 and had various therapies including group work and MBT. CBT is no longer offered.
 
Hello @Andrew0306uk

Here's the link for the webinar: https://app.livestorm.co/freestyle-uk-ire/diabetes-and-mental-health

I understand that mental health is complex, and apart from managing my own depression I have little experience in what you are experiencing, but my attitude to insulin is simply that it's a tool to help me live and function each day, it sounds like insulin has become the pinnacle of your mental anxiety, I see it as a means to which I cannot exist without it. I left the house after forgetting to attach my pump after showering, only realising about 10 mins into my car journey, the anxiety and stress I felt at forgetting to re-attach it made me feel quite ill, despite knowing I would be ok, however I am absolutely fixated on control and staying within range as much as I can, I appreciate we are possibly on opposite ends of the spectrum here, but I couldn't cope with not being in control of it. I have a child and my main motivator and focus is to keep as well as I can to avoid complications so I can see her grow up and not become a burden to her, so for me having this focus keeps me very firmly on the straight and narrow. Could you do this for your partner ?
 

Thanks for the link. I’ve registered for the webinar

We have 7 kids, and whilst most of the time they are my safety factor and reason to live, I also have deep periods where I feel such a burden on my family that they become the reason I want to end it all to end that burden. I understand that these are transient feelings/thoughts, but they still occur, often.

My anxiety is heightened when I’m not in control but I can’t seem to get my head around controlling my eating/diabetes. Not having the freedom to eat what I want, when I want and not being able to eat without having to check/inject just seems like such a restriction on my life and the needs of the diabetes controlling me and not me controlling the diabetes. I comfort eat. I distract eat. I eat ‘dangerous’ foods to quieten my need to ‘do something I shouldn’t’

Thank you for discussing this with me
 
Hello @Andrew0306uk It might we worth your while contacting Diabetics with Eating Disorders, they have a facebook page: https://www.facebook.com/Diabeticsw...DWMAqV9w2xuvq9vRJdDukAAdK6QN3F6ldoOukahJYM221

Please remember you are not a burden to your family, these are transient thoughts as you say, when you have them do acknowledge these thoughts as this will help you deal with them, remind yourself at times like this that your life is important to your family and without you they will be bereft so remember how vital it is to be there for them. If you need acknowledgement then talk to them about your feelings, I have very open conversations with my daughter, which I personally feel are necessary as she's often with me when I hypo so I rely on her patience and understanding whilst I recover, but we do talk about the importance of support and compassion in our family.

Control and type 1 management can become an issue, I do low carb but I still have a night off every once in a while, so I can eat the ice cream/chocolate/cake without guilt, as long as I get my BG stable before bedtime so it doesn't knock into the following day that's my personal goal, but I don't feel guilt when I do this. This way I don't feel so restricted with it all.

More than happy to chat, don't feel so alone though, it's something alot us can understand
 
I can relate to a significant degree on this.

Self-harm with me was all about the lancets for me at school. In adult life, I've slowly dealt. Having a partner you love show you in the expression on their face how much it pains them gives another way of looking at things. It helps a bit, I've found. Would I want to hurt those so close to me through hurting myself?

The other thing to help deal with self-harm urges is to rather than cut at my arms, to imagine a tree growing out of the same spot.

Seeing hurt as ground for growth, for new strength.

These are little important things that can perhaps help.

The most useful thing for me was therapy. The hurt comes out through self-harm, the question is where that hurt is buried? What is triggering it to awaken?

I did something a bit odd, which was to do psychotherapy on myself. I read a book on EMDR therapy and self-applied it. You're "not meant to" but I did. I went back in time to as close to the source of the hurt as I could and re-evaluated why I felt so bad about myself.

A psychotherapist is trained to do this and if psychotherapy is something you wish to consider, it could be useful.

Have you looked into (or had) therapy for Emotionally Unstable Personality Disorder?

Dialectical Behavioural Therapy is one of the areas of therapy and that one is interesting as the researcher who developed it had EUPD.

Personally, I don't look at EUPD as a personality disorder. Many people with EUPD have extraordinary gifts for compassion and empathy. Each shadow has its light and all that.

We're not alone in this. What you're feeling, the hurt is valid. Don't feel guilty for feeling hurt. The other big help I got was a book on Self-Compassion by Kristen Neff. She encouraged me (through her writing) to connect my experience with that of others. To have emotions and feelings is human. She encourages people to treat their own selves as they their own best friends. To be compassionate and understanding of one's self. That was really valuable to read.

Take care Andrew, I'm not on here a lot but I pop in every now and again to see if I connect with a thread.

Look after yourself.

Ed
 
So sorry to hear of your distress and hope you can find peer support at least. There are diabulimia documentaries which may still be available on You Tube /i player.
When I had an eating disorder with type 1, my type 1 did at least get me further up the queue for psychological health. I never abused insulin because I hadn't made the connection about the weight thing yet I had binge and vomit episodes and generally ran high bgs which my consultants had no idea about until I asked for help with my disordered thinking and bad habits.
I now find that having a pump to quietly drip in the stuff and eating low carb makes the diabetes run along in the background far easier but I think getting some cognitive behavioural therapy to bed in new behaviours and challenge your negative thoughts about yourself would help and may be more readily available than other therapies.
Please take some hope that you don't have to always feel like this.
 
Thanks for the replies. Having a bit of a wobble at the moment. Will read and reply as soon as I can
 
Wow.

Ok. There's so much to unpack here and I am not any kind of therapist.

I'd just like to chip in with "I can see how ins. dosing could be used as a self harm means."
 
Ellenor2000 said:
Wow.

Ok. There's so much to unpack here and I am not any kind of therapist.

I'd just like to chip in with "I can see how ins. dosing could be used as a self harm means."
Click to expand...

So much to unpack and that’s only about 1 pocket full ....

But for now I’ll just tap the pocket and carry on with each day
 

Thank you

Next time I see my diabetic nurse/consultant I might ask them if they feel having a pump would be beneficial for my situation
 
Andrew0306uk said:
Thank you

Next time I see my diabetic nurse/consultant I might ask them if they feel having a pump would be beneficial for my situation
Click to expand...
Pumping involves a fair bit of mental health evaluation (at least in my area it does) so the process might be helpful all round.
 
If you can not get your medical teams to exchange information perhaps going to a support organisation that specialises in self harm may be a helpful.
A good support group will help you realise your triggers and give you displacement activities. If you join a forum make sure its moderated and is a charity or professionally run. There are a few now.
https://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm
There are adults who self harm who lead 'normal' lives, perhaps only close family know. I think you have mad a huge step admitting you self harm and want to do something about it.
I think the idea of a pump is a good one to try. I find it hard to understand how the mental health team do not wish to become involved, there are so many people who have mental health issues who are also diabetic, the only reason I can think of is they want to keep your mental health history 'secret'.In the old days mental health notes used to be kept seperate from general notes and even now the RMN's tell RN's as little as possible.
 
Spoke to my Mental Health Worker today. She had no clue about Diabulimia.
 
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