(Warning: Very long and detailed but please read if you have the time. I very much need the help)
I'm 18 year old freshman at Temple University getting ready for my second semester and the college life has presented a few problems that I'd like to get some opinions and advice on.
This is my second draft of this post. The first was ridiculously long and rambling, so in order to save everybody some eye strain I will try to condense my current problem in a broken-up, list-like manner.
-I have had diabetes since I was 9 years old. Up until recently I lived a fairly normal and well-controlled life.
-Near the middle of my senior year I started to develop a now extreme anxiety about going low.
-This anxiety is highly irrational and affects all aspects of my life. I no longer feel comfortable doing anything that requires me to leave my dorm room.
-This includes all activities that are even remotely physical-shopping, walking around the city, exercise, dancing,acting on a stage, going to amusement parks,and(sex)
-Because I have pretty much ceased all physical activity I have gained a significant amount of weight (I was about 20 lbs overweight, now I'm 50.
-I have also ceased to participate in most sedentary activities as well, including going to concerts, theater productions, hanging out with friends, going to parties, going out to eat, driving, going to the movies, and traveling.
-Basically any activity where I am not alone, sitting, and can focus all of my attention to what my bloodsugar is causes me a lot of anxiety
-All these things I listed (with the exclusion of sex, which I do not allow myself to do because I am too scared I will go low) are things that I used to love to do
-I am also too scared to try new things. I joined my school's paranormal club the first semester because that has always been a dream of mine. However, I declined to go on any ghost hunts because I knew I would be too anxious all the time about my bloodsugar.
-No longer doing things for enjoyment plus gaining weight has led my self esteem to drop significantly and to me feeling worthless
-If I do end up leaving my room for class or in an attempt to go out into the city I have a constant urge to check my bloodsugar every ten minutes. If I do not check my blood sugar I will experience a "false low" that will not go away until I check
-I am too worried about going low while I sleep that most nights it is near impossible to fall asleep
-I have anxiety attacks if I am outside of my room for more than five minutes without at least 2 glucose bottles, even though I usually carry about 20+ in my backpack
-I check so often that I run out of strips way before it is time to renew my prescription so I must pay 100-200 dollars on strips from the store.
-I am so paranoid that my bloodsugar is constantly over 250. I always feel sick and tired because of this but I feel anxious if it is any lower than 200.
-Having such poor control makes me simultaneously freak out about the complications I will face in the future while freaking out about going low.
-I have told this to my endo. She is trying to get me a CGM even though my insurance won't cover it but is not particularly helpful otherwise.
Again, I apologize for all the text. I just felt as though this is the only way I can fully express all the issues I have been having. I am extremely depressed and miserable. My anxiety is out of control and dampening any chance at a normal life. My question to anyone reading is just to share any kind of advice or story they think could help. I have no idea how I developed these extreme anxieties. I'm not really sure how to remedy this problem but I'm desperate to improve my life. Do I have any chance at regaining happiness?
Thank you for your time
I'm sorry this is happening, have you had a life threatening low at some point in time that would trigger this kind of behavior ? I mean I have woken to uniformed men in my bedroom on more than a few occasions and that is what eventually prompted me to take better control. I have had D for going on 38 years and it is really only within the last year that I have finally gotten a handle on what is going on in my body and how foods, moods, exercise, stress, and anxiety effect my blood sugar. And yes to answer your question, you most definitely have a chance for regaining happiness. There is no simple answer though, I have gotten a Dexcom cgm and that for me has made a huge difference in my ability to control D, and not let it control me, but for you it may be a psychologist who can help you get past the fear of lows and help you get a better handle on the anxiety. There are no magic wands or pills just a lot of hard work. But I do hope you can find some balance and get past the anxiety and panic of being low. Life is too short to spend it worrying about low blood sugars. JMHO good luck, Clare
To answer your very last question, "Do I have any chance at regaining happiness?" my answer is Yes, Yes, Yes. And actually you've taken the first step towards doing just that by acknowledging that the problem has gotten so out of control and asking for help. I'm sure you'll get lots of good advice about specific aspects of your D management, even things specific to you like fears of lows, etc. But I want to come at it from a different tack. Your problems aren't so much in D management, though obviously you are not where you want or need to be with your D. Your problems are emotional, some of which is related to D some of which goes beyond it. My personal opinion is that you could benefit greatly from therapy. The ideal therapist for you would be a Type 1 who knows what you are going through. If you are near a larger city that might be a possibility. I would suggest contacting your local branch of JDRF and see if they can recommend someone. If you are unable to find a Therapist who is themself Type one then one who has experience dealing with people with D would help. Failing that, a good therapist who you feel a connection to and who is open to understanding how D impacts your emotions would work just fine.
Those of us who deal with this condition are more prone to emotional issues than the general population but that doesn't mean we can't be helped as well as anyone else. I've seen people with many serious emotional/mental issues who are recovering and living happy lives. You can get there too!
Another issue aside from therapy is to find a group of other Type 1's. Though not every Type 1 feels as you do, we all understand what you deal with 24/7. Again, JDRF is a great source of information about such groups as is your local hospital based D program. Being around people who understand can be so healing!
Oh big hugs to you! Thats a lot of stress/worry/crap to deal with on top of college courses.
My suggestions would be this: first see if your college offers counseling (I didn't check where you are prior to responding - but my college had counselors on staff so it stands to reason that other colleges might do this too?) and if it doesn't then it wouldn't hurt to local a counselor near your college. I'm not a medical professional of any sort, but a lot of what you're worrying about seems to come down to stress and perception?
It also wouldn't hurt to see about having a meeting or two with a diabetes educator - I actually met with one just today because, like you, my blood sugar is running high and nothing I'm doing seems to help. Just meeting with her the first time I can see all kinds of things that I had been doing wrong or had just gotten lazy about. I have all the tools I need I just haven't been using them. Maybe meeting with a CDE yourself with help you feel like you're more in control of your diabetes.
Finally, if you feel like your endo isn't helping you then switch if you can. A CGM will only show you your blood sugar more often - it won't address the other issues that, IMO, are larger (meaning, the anxiety).
Oh my. I am so sorry. Recommendation: seek counseling. You are NOT crazy, lunatic or anything else. You are an anxiety ridden diabetic, as we all are or have been.
You need to step up and understand that it is what it is. You can't change that. So, you can freak out or give up the fear so you can live your life--fully. Please choose your life.
You go low, you go low. You will work hard to keep this from happening, but it will happen. When I get low I alwaystry to step up, smile and go on. I can wallow in apprehension, but what is the point? Does that change anything?
You need to step out, try things, take risks. You are 18 and have been diabetic half of your life. DO NOT LET THIS DISEASE TAKE OVER YOUR LIFE. Rule it.
I have been there, but it is all about you right now, Mega. You need to stop being afraid. Honestly, I am afraid a lot, but I cannot let me be ruled by fear. Look for help, as others have suggested. Please.
And let us know how you are doing. You are in my thoughts. NOW go watch a good Friday night movie and relax...
I thought about your dilemma some more.
- First, I want you to understand that counseling can really help. I hit a really low point around my 40th D anniversary. I had never had therapy or even considered it until a CDE recommended someone. Her specialty was chronic disease. She was a Type 1 and wore the same pump. It was the first time I had ever met another Type 1. She was great for me and really got me back on board. It really changed my world.
-Like AR, college was full of things I should not discuss. In 4 years, I had one episode where I got up, took insulin, went back to bed and woke up in emergency. It is the only time I have ever been transported. There were others, like the time I tried to toast a sponge for breakfast... But I survived, and I learned.
-And I agree with the CGM. It can take a lot of stress away. Its not perfect, but can really help.
re the post itself, this is one of the better long/ "help!" posts w/ the paragraphs and bullet points! It makes it much more readable!
I spent a long time sort of guessing how much insulin to take but always tested what I figured would be a reasonable amount. Most of the times I passed out from hypos seemed to be the day after wild benders, as I'd wake up early take some insulin and fall back asleep and wake up at the ER.
I have always worked to be happy because I'm sort of that way but it looks like the whole BG thing is a huge problem. I suspect that it may be that the goals aren't quite tight enough? I was really lucky when I got my pump as my doc's calculations turned out to be what I needed in terms of insulin and stuff fell into place. After 20 years of *waoooah* craziness all the time.
Re college, my concern would be that sometimes freshman courses you can sort of get by going to class a few times, for tests, etc. but that after that,as things get more specialized, the profs may sort of expect some participation? I suspect it'd be really hard to keep up with things sitting in your dorm room.
I think that a CGM might be very helpful and that the doc may want to press for it for you, although I dunno if they do that. It taught me a lot about how to play around with insulin. Before I started pumping, I sort of used insulin like something I'd buy in the parking lot at a Grateful Dead concert "oh, dude, I'd better shoot up..." but, once I got thinking more about "balance", I was able to figure a lot more out and get things to work. I hope that you can figure out a way to do that too.
I'm so sorry you're going through this! I think Zoe's suggestion that you find a type I therapist is a great idea, but if you can't find one, definitely a therapist of some sort. If there's no type I in Philly, maybe someone that deals with eating disorders would be close -- anxiety about weight and anxiety about lows is different, but maybe close enough... I kinda wonder if there might be some kind of anti-anxiety med that could help you out. It sounds like it's so debilitating for you. Did it just come up after you started school? Could it be related to leaving home?
Are you afraid of any low at all or only afraid of a serious low that you can't handle yourself?
I haven't had the exact anxiety you're talking about, but I have really let my anxiety about complications mess things up for me recently. I sat down to study for the california bar in september and when I looked at the white pages of the book these floaters just jumped out at me. I realized at that moment that I had been seeing floaters for maybe as long as weeks, but I would always find some way to not see them (they show up a lot more if you're looking at a plain light background). It took me around two months to get up the nerve to see my opthalmologist and the whole time I was completely convinced that it was the beginning of the end. I had horrible images of my husband and kids having to take care of me, blind and limbless (bc if my eyes were going probably the rest of me...). And every time I tried to sit down and study, my heart would start racing and I just couldn't do it. In the end it turned out that the floaters were just a normal age-related thing that had nothing to do with diabetes. I was pretty thrilled to find that out, but it was too late for me to prepare for the next bar exam. Now my hubby is pretty p***ed at me for not studying and we are so broke since I can't work till I pass it. And I keep wondering if I'm the only diabetic who's had this sort of trouble, but I guess not... And you aren't alone either.
Is your family of help when you call? It really pays to get treated for anxiety and its complications first. Lay it out for family, that this has to be dealt with because you don't want to jeopardize your career by pseudo-study and bad health due to high blood sugars: you want to be normal and happy.
When you're dealing with a cascade of problems, the cascade is not treated by trying to stem it here n there and meanwhile do studying. It's like a waterfall! You can't study well in a waterfall! It takes your breath away.
In the absence of family help, ask a friend in your dorm to go with you to the school's health center to get to a psychiatrist for evaluation and therapy potentials. You'll be happy once you've chosen that path.
And my best personal wishes for your tackling this front-on!
It's not unusual to experience anxiety in your first year at school....especially if you are away from home. The new environment and new challenges can take awhile to adjust to.
I agree with the others about getting help - sooner rather than later. It will help you adjust to your new environment and help you become productive again. You might be able to get help at the student health center. THere is a counseling center at Temple :
They may not have an expert on diabetes issues on staff, but they can certainly help you with anxiety. It is a very common issue among students. Do not be afraid or ashamed to seek help.
Another thing to think about is that since you have been running high for an extended period, your body may give you the symptoms of a low when you are actually at levels abnormally high, but lower than your average. This will go away when you slowly bring your averages down to more safe and normal levels. Remember that normal levels in a human being are 70-130 or so.... a real low is below this. When you are running as high as you describe, you might start to get symptoms of a low when you are in the mid to high 100's for example, even though these levels are abnormally high. Slowly bringing down your average will shift your body's setpoint to a more normal level.
As you slowly improve your control, you will feel more alert and happier, you'll want to do things more, etc. And then moving more will help with control and it will get easier and easier. Sitting in your room actually makes BG harder to control as you don't get any help disposing of glucose from exercise...then you need more insulin, etc and it sets up a whole negative feedback.
Hi Meg, when I first started college, I felt the same anxieties about going low. First, has anything bad happened to you as a result of a low? Second, as a way to slowly increase your 'involvement' and become less anxious, I would try to focus on your triumphs. What have you accomplished. First, putting diabetes aside, you have been accepted to college and are living (or trying to live) on a dorm. That is a huge accomplishment. Second, you are reaching out for help...this is an important action for those of us with the D. Many times it can be difficult to ask for help and I am glad that you did. What I would recommend is keeping a journal/diary of your accomplishments, even if they are small, so that you can gain confidence in yourself. Some days when I first started college, I made a goal to just get up and dressed in clothes. A goal for you might be to walk to the bench outside your dorm. Like I said, these are very small goals, but by meeting these goals, you might be able to build on them. For instance, after 3 weeks of walking to the bench, maybe you could arrange to meet a friend at the bench and walk to a dining common with your friend. This is something that might work for you. Also, for BG control, try to make the goal that, even if it is for a short period of time, you are going to try to remin in control or get in better control (even if better is going from 250 to 225mg/dl) for just 1 hour or 2 hours. By starting small, you might feel like you are more in control. Also, with a fear about going low, keep in mind that YOU can control your diabetes, YOU can temp your basal, YOU can take gluco tabs, YOU can munch on a snack. So, to answer your question, you can regain happiness by taking small steps and feeling confient. Please keep us updated, I wish you the best! :)
Freshman year is a challenge for many students in the best of circumstances. I agree with other replies that therapy and a cgm would help to get you back on track. I am a T1 and faculty member at a college in NY. I also have been involved with getting Freshmen connected with faculty advisors. You might inquire at your counseling center at Temple if there are any T1 faculty members who might be willing to be your advisor. Once you get the professional support you need from a therapist, CDE, and hopefully a CGM (is it included in your college medical insurance plan?), you might benefit from a faculty member who can be a more frequent contact for moral support- your cheerleader in your recovery. T1 faculty are out there. You may have to ask more than one person to find them though. I can be a virtual cheerleader for you now. You can do it!!!
I started out very similarly to you. I am terrified of lows, and it does not help that I have some hypo-unawareness and don't start to feel them until I am below 40. I also experience "false-lows" and sick feelings that I attribute to bloodsugar changes. Every time I feel weird, I need to take a test and end up testing sometimes every hour each day. I asked my endo to prescribe more strips per day for me, which helps so I don't run out.
When I first began to fear lows, I didn't even notice it myself. My average BS crept up. First I spent a lot of my day in the 200s..a few years later I spent more of my day in the 300s. For the last year I have rarely gone a day without hitting <400. I'm telling you this because this can spiral out of control very quickly! I am now at the point where my hands are starting to tingle and ache from neuropathy. There are days my eyesight is so blurry I can barely focus, and driving is sometimes impossible. And I am very very tired. I started to think to myself, the highs are what's going to get me in the end, not the lows. I've made a big mistake in not realizing that until now. But I am still scared of the lows more!
In March, I am going to receive a service dog who has been trained to smell low bloodsugars and signal to me before my BS goes too low. I know this is going to help me tremendously with my anxiety over lows! Maybe you should consider one? There is a group here on Tu about them.
I have tried the Dexcom and if you can get it, I would do that as well! It was not helpful to me because constantly knowing my number and seeing the trending arrows pointing up and down made me even more anxious and I started to ignore it just to get through the day :) But I still recommend it to anyone thinking about it because it is pretty amazing when you can get it to work for you.