Editor's Note: This article was originally written by patient expert Kim Benjet.
I've talked to many, many parents of diabetic children and I'm always amazed at the parents' laser like focus on the diabetes care and the subjugation of their own personal needs in their efforts to keep their child healthy. Diabetes magnifies parental sacrifice by calling for less sleep, more intense relationships through the incredible task of "playing the pancreas" by monitoring blood sugar and delivering insulin 24 hours a day, every day.
Little is written about what happens to the parent in all of this. Most parents I know don't want to be narcissistic and complain of their own sacrifices and challenges. They see the real challenge as the child's. The child has the disease, not the parent.
I beg to differ.
Yes, the child has the disease and feels the high and low blood sugars and all the other assaults of diabetes. But look into the parents' sleep deprived eyes and you'll see they feel it to - all the time. The tears are just behind the eyes in so, so many parents I know. These are parents who have lived with diabetes for weeks and parents who have successfully managed it for years. The tears are still right there.
Shortly after Josh was diagnosed our nurse practitioner said to me, "Josh has diabetes, but the disease is yours". I quickly learned what she meant. It was my husband's and my job to "play pancreas", to make Josh's body work effectively so the disease didn't get in the way of his childhood.
The developmental parenting challenge I now struggle with is that I have to slowly hand over the diabetes management to Josh and help him to be responsible for his care. But I don't want him to have to deal with diabetes --- I want to fix it --- but I cannot. And, that is the source of much pain to me and many other parents. In some parents that pain eclipses sorrow and grief and moves to diagnosable and treatable depression.
When should parents seek help for themselves? When does sorrow become crippling?
A truly depressed parent cannot effectively manage their child's diabetes - that alone should be motivation to seek treatment and help.
While perusing the The Health Central Depression site, I found some interesting facts that may pertain to some parents of children with diabetes. Here's some information from the THCN Depression site.
Sleep: "Sleep abnormalities are an integral part of depressive disorders, with more than 90% of depressed patients experiencing insomnia. Although stress and depression are major causes of insomnia, insomnia may also increase the activity of the hormones and pathways in the brain that can produce emotional problems. Even modest alterations in waking and sleeping patterns can have significant effects on a person's mood. Persistent insomnia may even predict the future development of emotional disorders. Some experts think that some psychiatric disorders can be prevented by early recognition and treatment of insomnia." When the 3 a.m. blood sugar check is the norm and the parent can't fall back to sleep the effects of sleep abnormalities must be considered.
Depression and Family: Here's a statistic that might motivate some parents to seek treatment. "Depression in family members increases the risk for depression in other family members. Studies report that depression for even 1 - 2 months in a mother increases the risk for depression in her children. The more severe the maternal depression, the higher the risk for depression in the children. In a perpetuating cycle, being depressed as a child increases the risk for depression during adulthood. In such cases, genetic or environmental factors or both may be responsible. Spouses of partners with depression are themselves at higher risk for depression."
Medical Disorders and Depression: Also "severe or chronic medical disorders that feel out of a person's control can lead to depression".
See Expert Deborah Gray's post on MyDepressionConnection.com,"Talking to Someone with Depression - What to Say and What to Offer." Her tips might fit for some parents of children with diabetes. Finally, the ADA has some clear definitions and tips for identifying and dealing with grief and depression reactions in kids with diabetes. Many parents would be wise to ask themselves the questions related to grief and depression as well. See http://www.diabetes.org/for-parents-and-kids/living-with-diabetes/grief.jsp and http://www.diabetes.org/for-parents-and-kids/living-with-diabetes/reactions.jsp.
I implore parents to not be afraid to seek help for YOUR emotional reactions around diabetes. Sorrow and grief are all normal for a time. Untreated depression is not normal. Depression it is treatable and it is essential that you seek treatment. If you see yourself in the National Institute of Mental Health's list of depressive symptoms, it's time to seek help. If the blogs on the THCN Depression page resonate with you, it may be time to talk to a professional.
- Persistent sad, anxious or "empty" feelings
- Feelings of hopelessness and/or pessimism
- Feelings of guilt, worthlessness and/or helplessness
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details and making decisions
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating, or appetite loss
- Thoughts of suicide, suicide attempts
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment