January 5, 2016

The Holidays

I have been a type one diabetic since the age of nine and I suffer from an eating disorder.

The holidays can be a stressful time for everybody. There are presents to buy and wrap, planning to do, decisions to be made over where to spend your time and with whom. When you add the burden of chronic illness, such as type one diabetes, into the mix it can become even more difficult. It may mean taking each hour or even each minute at a time, being patient – with others around you and with yourself.

The biggest misconception regarding any type of diabetes is that it is straightforward and easy to manage. It is very far from being that. Type one diabetes is an especially relentless and unforgiving condition. It will not give you a break.  Attempting to ignore it and fake ‘normality’ means it just becomes a more intrusive part of your life through the damaging results of self neglect. It is often assumed management just involves a few blood needle pricks and watching what you eat; the huge emotional impact involved in being a diabetic is usually unacknowledged. Yet a pro-active approach is required to keep yourself well everyday: a rigorous itinerary of blood glucose monitoring and insulin administration, carbohydrate counting, checks on eyes and the sensations in your hands and feet.

Blood sugar levels can also be further aggravated by heightened nerves which can be pushed to their peak when mental health difficulties such as anxiety and depression already exist. Often families and friends will not truly understand, and can display ignorance without meaning to hurt you, but then be very upsetting, and prompt feelings of guilt. The difference between type one and type two diabetes is also commonly overlooked, with the latter less flexible in terms of dietetic freedom.

“Should you be eating this?” “Surely you aren’t allowed that?” “Well my father had diabetes and he only eats sugar free sweets?” Remember you are the expert of your own disease and nobody has a right to relay unsolicited advice, even if entirely well meaning.

When you also suffer from depression and a tendency to neglect your own needs, the process of self care can be particularly trying. Recovery from anorexia, bulimia, or any kind of eating disturbance can require that you step back from food, especially within a treatment setting as a day or inpatient where professionals are likely to take over. As a type one diabetic the entire approach has to be different as you instead must become even more attentive and aware of what you are putting into your body. Avoiding the contents of food packages in terms of numbers and quantities is not an option if you don’t want to be left with erratic blood sugars – a consequence that can in turn feed directly back into your eating disorder and the pattern of self destruction.

Festivities at this time of year invariably focus on food and indulgence, which can be challenging when dealing with diabetes alone, let alone the double edged sword of diabetes and an eating disorder. Food is absolutely everywhere you turn, with meal suggestions, cooking advice and suggestions of what to buy and what you just can’t live without. You turn on the television and its Nigella or Jamie displaying their versions of the perfect feasts, and every other advert is one that tells you that you must have a particular type of meat, dessert or alcohol. Once January comes around you then have a deluge of nutrition, dieting and exercise advice to face. It is just exhausting.

Yet often it can be your own thoughts that will not leave you alone. “I shouldn’t enjoy food”. “I will get fat”, I will never be able to stop eating”. An eating disorder will rarely permit you let you healthily detach or relax. Just like type-one diabetes it will always keep you on your toes. Social events can also be demanding and it is normal to feel you want to retreat and isolate. Pushing yourself to engage and be present is so important.

Christmas and New Years Eve are supposed to be enjoyable. Not just for your loved ones, but for yourself too. Try to give yourself a break physically, watch your favourite Christmas films, play games, open presents, breathe; even when your head is doing back flips and jumping up and down. Many crisis phone lines are always open and friends can be a life-line. Lean on those who are willing to be there and don’t suffer through thinking you must keep up a pretence to placate others.

Balance is crucial. The aim is to not let the sum of your illnesses dictate and reduce the holidays to memories of disorder and sheer panic, yet also do not pressure yourself to a breaking point, where in particular your eating disorder will figuratively throw its toys out of the pram. Give and take and negotiate with that negative voice as much as you can. Our basic and instinctive thoughts tend to be the most unreliable in these situations. Try to be gentle with yourself; nothing needs to be perfect and that is entirely okay.

Most of all, never give up. Surviving what may have felt like an overwhelming continuation of days is an achievement. It doesn’t matter if you had to claw your way through and use every coping strategy in the book, it is still a victory. Next year may be easier and better. So ring in the New Year with hope, even if just a tiny glimmer stashed in your back pocket.