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Psychological Aspects of Diabetes

It is beyond the scope of this book to describe all the complexities and possible manifestations of the psychological aspects of diabetes and so the following is an overview of factors that are generally well known and recognized. As can be readily appreciated, diabetes impinges on everyday life to an even greater extent than most other chronic diseases. Managing the condition makes certain demands upon daily life and these change with time and are affected by normal life events. This means that diabetes may not only have a psychological/emotional impact at the time of diagnosis but also ongoing, long-lasting effects which can all too easily be overlooked. Diabetes clinical care staff are well aware of the psychological effects of diabetes and are trained both to help directly and to recognize more complex conditions that require referral to a specialist.

The way in which a person comes to terms with diabetes, both at the time of diagnosis and in the longer term, depends upon an enormous range of different factors which include the following:

personality and temperament - general outlook on life
general health beliefs as well as specific ones concerning diabetes (e.g. does the person believe that he or she can positively influence/alter health outcomes through his or her actions?)
type of diabetes and method of treatment required
presence or absence of diabetic complications
presence or absence of other diseases, conditions or disabilities
presence or absence of existing psychological problems or illness
religious/philosophical beliefs
level of family and social support
age - children, young people and the elderly may experience particular difficulties
occupation (is diabetes likely to affect the person's present or future employment/career prospects?)
ambitions (does diabetes prevent the person from achieving cherished goals in life, e.g. in sport, or does the person believe that it may do so in the future?).

These are just some of the factors that influence people's responses to diabetes, both at the time of diagnosis and as time progresses. Reaction to the diagnosis may be one of relief, especially if adverse symptoms have been experienced that are readily corrected with the instigation of treatment. In contrast, others may deny the diagnosis or become angry and depressed, especially if they have only negative beliefs about diabetes. Parents of a newly diagnosed child often feel totally misplaced guilt. Sometimes people pass through a series of stages, similar to the process of grieving, before they are able to come to terms with the diagnosis. These may include denial, anger, bargaining, sorrow, and finally acceptance.