Tuesday, March 29, 2011

What's up with SAD?!

We are nearing the end of March and my view remains dark, cloudy and with a chance of flurries.  Obviously talking about the office window view, and not my mood, but there is a link.

I do believe it(the weather or season) is a barrier to staying upbeat, positive. I also believe it gives those ANTS the upper hand.

SAD, great acronym, as this is how a lot of people get during the long winter months. My self included.  Oh, I am referring to the depressive disorder called Seasonal Affective Disorder. I am certain this was a contributing factor in derailing my mind  earlier this month. When you combine multiple situational stressors and no sunlight, grey skies, it is a recipe for a bad day.

Definition By Mayo Clinic staff

Seasonal affective disorder (also called SAD) is a type of depression that occurs at the same time every year. If you're like most people with seasonal affective disorder, your symptoms start in the fall and may continue into the winter months, sapping your energy and making you feel moody. Less often, seasonal affective disorder causes depression in the spring or early summer.
Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own — you may have seasonal affective disorder. Treatment for seasonal affective disorder includes light therapy (phototherapy), psychotherapy and medications. Addressing the problem can help you keep your mood and motivation steady throughout the year.

Like the definition indicates, don't ignore it, but consider this as a cause to your "decreased mood" coupled with a long term chronic disease (I hate calling it a disease) like Diabetes this can throw you into a depression. 

I have never been formally diagnosed with SAD but I sure feel better with the sun peers through the clouds, and the days get longer and brighter.

I encourage, reaching out to a friend, talk to your family physician, they also sell full spectrum lights at most large chain pharmacies. Exercise , Meds what ever it takes.

Yours in Health!


Monday, March 21, 2011

How to Stop a Racing Mind

"Dump thoughts above"
We have all had this happen.  It is bedtime, we are tired, exhausted, we perform the bedtime ritual, lie down, pull up the covers, flip the pillow and then we........start to become aware of our thoughts.

Now this is not always a good thing.  We say, nope, thoughts, go away and come back later, but somehow our brain and thoughts have another plan, and they linger, and race, until finally we glance at the clock and its been 2 hrs and we are still wide awake.

Thoughts are hard to control. But when you want to sleep they can make us anxious, restless, and ultimately rob us of a good nights rest. 

This same thing happens to me. I know of all people, but seriously it does. Sometimes I can mentally wrangle them(thoughts) and sleep. But lately, I give myself a time limit. I say, okay, 20 minutes for my thoughts, and then I take action.

By Action I mean; I dump my thoughts onto a pad of paper, then go to bed thoughtless, no not clueless, thoughtless.  This,  I have discovered totally works!

For example  ideas that  I just had to get up and write down:  to-do-list for the next day cause it was driving me crazy, any thought that persists, dump it onto paper and go back to bed.

Just thought I'd dump those thoughts onto the blog for y'all!


Thursday, March 17, 2011

Why so many whys?


Simple question right, well not all the time.

Why when you're tired do your kids seem to behave at their worst?

Why when you have planned a special meal your meter reads high?

Why is it when you have no money your car breaks down?

Why is when you want peace chaos ensues?

Why can't the sun shine more?

Why is it we know what to do but don't?

Why is when I wake up and say, I am going to be a better parent, friend, partner,
worker, I end up yelling at my kids, ignoring a friends call, and not listening to my partner?

Why don't mini vans have sound proof partitions like limos?

Why does it seem that when things are going really well things suddenly change?

Why do we have to live with diabetes?

Why does anyone have to endure pain and suffering?

Why are there so many whys?

My only answer thus far as that we are all imperfect, fallible, vulnerable, emotional, ever evolving humans.

The positive in all this is we have free will and the human ability to self reflect, change, and wake up tomorrow and try again.


Wednesday, March 16, 2011

Stress and Diabetes - Often Left out of the equation?

In my experience as a PWD  who helps  people diabetes on a daily basis I often question why stress isn't one of the priority discussions that should take place.

Health professionals  have their routine during diabetes visits that usually include: diet, blood glucose readings, BP, Wt, A1C, feet, kidney's, then the time is up and it's time for the next patient.

I propose stress and mental coping be added to this equation as part of the team's repertoire or interviewer's strategy in discussing diabetes during a visit.  You'd be amazed at the responses you get when you simply ask, "So, how are you feeling about your diabetes?"

I personally use a four legged approach to my discussions with PWD I am trying to help.  I call it my diabetic stool, so all the legs need to be stable for decent control. I discuss  Diet, Activity, Medication, and Stress.  If all these are in check the you tend to achieve fairly decent diabetes control.  This is my discussion strategy with PWD.  But the first question I ask is; "So, how are you feeling about your diabetes?" I know I am repeating myself, I heard once it's good for emphasis.

"Sorry about the image quality, it is word document that wouldn't paste"

After going through the above I flip it so the stress is on the top, to basically say, unless your stress and mental health is in check then all these other components are even harder to control, and you may indeed fall off your stool.  It is very visual and they usually ask to take it home with them as a visual reminder. 
Most folks have not been given a good explanation how stress may effect their diabetes.  They are  usually aware hat having a common cold or serious illness can effect control, but they don't realize that mental Health, Anxiety, and prolonged stress can seriously hamper diabetes control.

Why is this?  I suspect it is because where the mind goes the body will follow.  If you are mentally well you are going to physically take care of yourself.  But there is also the biology  to consider.

When you are experiencing stress, acutely, or prolonged, you are more resistant to insulin. Your body releases hormones that inhibit insulin from doing its job, that is, letting the glucose into the cells to be used appropriately for energy.  Some of the stress hormones are cortisol, and adrenaline. The body also starts producing more glucose from your liver, getting ready for the "Fight or Fight" response. This used to be handy thousands of years ago when extra sugar was needed to feed the muscles in case you needed to attack a woolly mammoth or flee from a saber tooth tiger, but not so good now. This extra glucose simply increases and floats around wreaking havoc and leading to complications if not corrected.

What I am getting at is patent's and PWD need to know that stress impacts there diabetes control just as much as food.  It needs to be brought up, discussed, dealt with.  But the problem is our health care system isn't designed for health care workers to spend an hour talking about how PWD are feeling about their chronic process they deal with 24/7/365, every second of every day. 

On a positive note, we as a system in Canada are moving toward Primary Health Care, where by Allied Health Professionals work with physicians to assist them in improving patient care.

I work in this area and as a result I spend an hour dealing with all aspects of an individuals chronic disease, including Stress and Diabetes.


Well guess what, we need to.

Monday, March 14, 2011

Peeling Back my Diabetic Brain

"My Diabetic Brain"
I was thinking about the movie Shrek when he makes reference to himself being complicated, with many layers like an onion, and donkey refuting this in a positive way, by saying more like a layered cake. 

My point is we are complicated, with many layers.

I,  at least feel like my brain is complicated lately.  Things that used to be clear, and simple are now questioned, judged, and not so clear. 

The cognitive behavior tricks or more respectfully stated "Techniques" do seem to work.  My wife notices a different "me" but what do I notice when I peel back the layers of my thoughts?

I'll tell you:

Those "ANTS"(For those who missed my previous post, ANTS = Automatic Negative Thoughts) are still pesky little buggers that are trying to penetrate my mind.  I am more watchful of them now, which may explain the changes on the outside. But it is still very trying to always keep on guard. It is like being on guard all the time with no one to replace you. A lot like having diabetes I guess. 24/7. 

As I am more aware, conscience, or whatever of my thoughts, it is apparent that these ANTs are plentiful.
More then I would have previously known if it weren't for the Jedi Training.

Now when an ANT makes its way into my stream of thoughts, I snatch the little bugger, stare at it, think about, and decide what to feel about it, and the result seems to be a more positive emotional response. Not as reactive, not like a run-away train. 

I realize now this is going to take a lot of practice, herbal tea, some meds, therapy, and more peeling of layers to deal with those nagging ants that are trapped in my layer brain. 

I know my post likely sounds pretty "out there" but these are my peeled back thoughts.  I am hoping soon to compare my brain to a layered cake. 


Saturday, March 12, 2011

Exercise is better then Drugs!

"Me doing it!"
Okay, I am not suggesting we all stop taking our medication but I worked out today for the first time in like 2 months. Amazing! Totally amazing!!!

I promised, well announced on my blog The Diabetic Caveman that I would proceed with an exercise regime starting soon, which happened to be today.

I had to post about it.  After 40 minutes of moderate intensity circuit training and a bout of cool down cardio my mood instantly improved. I felt calmer, I felt that my thoughts were clearer and more positive which according to the cognitive behavior Jedi Mind Tricks  this leads to a more positive mood.

I willed my ass to the basement even though I did not want to at all. I dragged my sorry ass down stairs to the man cave and did it anyways.

I have not felt this clear, and positive in a very long time. I knew it had to be done, I knew the hormones that are released with activity which include, endorphins, testosterone, serotonin would directly improve my mood.

It is taking that first step that is the most difficult.  I took the first step, and tomorrow is another day and I know I will have to struggle with my mind, and will myself to repeat what I did today.


Friday, March 11, 2011

Giant Punching Bag - Good for Mood

"Truly a thing of beauty"
Who would have thought.  Please observe the beakon of hope to your right.

I am told to exercise, as this increases mood.  Okay, I already know this. But unfortunately the problem with depression is energy levels plummet, and to me, exercise is really difficult to get motivated about.

I wandered down into my man cave last evening. I scanned the area, noticed the treadmill, chin bar, free weights, then I noticed my banana bag.

Now, what the hell is a Banana Bag, no it's not a giant yellow banana.  It is my beacon of hope, my salvation, my stress reliever, my coping strategy to improve my mood and physical well being.  It truly is a think of beauty.

You can punch, kick, knee, hug, elbow, yell at, do what ever you want and it won't get angry with you.  I have been missing Mr Banana for a while now.  My rib is almost mended, and I can't wait to lay a serious ass kicking to it!  Strangely enough he always forgives me.

Something to look forward to.  Just what I need.

Now I have Jedi Powers (see previous blog) and Mr Banana Bag, Damn things are looking up!


Thursday, March 10, 2011

Jedi Mind Tricks to Battle ANTS?

"No Match For a Jedi!"
Yes - Apparently there are Mind Tricks available to fight the "ANTS"

I know, once again you are asking yourself, what in the hell is this guy talking about?

Well I had my first counselling session today. That's right, I am officially being counselled. Kind of like having my own personal adviser, like being president, or a king. 

She did some scales, or tools on me and said, you are definitely ranked as being off the charts in terms of being depressed.  I said, " I figured as much, now what?" 

She said it seems, "You are having a lot of negative thoughts and self talk". I replied, "Yup"

Then she said time is running short and she reiterated or validated what I was talking to her about, if you are wondering just read the last couple of posts. Then she told me she would email me some coping techniques called "Cognitive Behaviour Therapy" I said "sounds cool"

The conversation was concluded with a followup apt in 1 weeks time, and a safety plan in case I loose my marbles and desire to live again.  Apparently once you feel better you are actually more vulnerable to acting on your suicidal ideations. For the record, I am slowly seeing the rays of light.

I thought about "ANTS" no not the little irritating black bugs that march away with your picnic food, but the "Automatic Negative Thoughts" that can flood the brain when your guard is down.  Then I thought about the "Jedi Mind Tricks" or "Cognitive Behaviour Therapy"  Which is being emailed by my counsellor. But I am too impatient.  So I found the following on the net regarding "CBT

Here is an article written by By Dr Greg Mulhauser that decribes the basis for CBT titiled "An Introduction to Cognitive Therapy & Cognitive Behavior Approaches".  He states:

"Cognitive therapy (or cognitive behavioural therapy) helps the client to uncover and alter distortions of thought or perceptions which may be causing or prolonging psychological distress."

The following diagram taken from Dr Mulhauser's Article below sums up the usual process our brain follows:

I remember reading a book, a very long time ago called, "How to Keep People From Pushing Your Buttons"

It basically followed the same premise, we are stimulated by our environment, we think certain things, and then these thoughts are followed by emotions. Like if you are cut off while driving, you think "What an A-hole" or "Maybe he's in a rush" both thoughts will likely lead to two very different emotional responses, one likely in anger the other likely in understanding. 

So apparently, these Jedi Mind Tricks will assist me in dealing with my ANTS, as these little buggers are apparently directly effecting my emotional outlook on life. Too bad it wasn't as simple as using a spray can of raid.

Man, I am liking this personal adviser thing, too bad it's only temporary.


Wednesday, March 9, 2011

Mental Health Stigmas - Barrier to Seeking Help?

The stigma attached to mental health ailments is obvious in my opinion.  I call them Mental Health Ailments because it is no different then a broken arm.   I read recently that the medical profession equates Depression to the Common Cold. Intereseting....

I think it is important to mention the labels and stigmatization that is attached to coming forward with a mental issue.  Be it depression, feelings of suicide, ADD, ADHD, or any other illness that messes with our brains emotional regulation. 

Is the stigma society places on mental illness a barrier to seeking help? This is a question that I have pondered.

I have mentioned this slippery slope to falling off of the mental deep end. It didn't happen spontaneously, so why did I not seek help earlier. Answer....I didn't want to be labeled as a nut bar!  I didn't want to tarnish my professional reputation.  I told myself, I can handle it, I'm a man, men handle shit. They don't ask for help. Those were a sample of my rationalizations to not seeking help earlier on.

The most powerful barrier for me was the admission that I had a mental problem and the perceived judgement or stigma that I thought society would cast upon me.

This is a problem.  I know they  have mental awareness months. It just never appealed to me, until lately, for obvious reasons.

I have worked in the medical community for most of my adult life. I hear the judgments, thoughts and perceptions people have towards the mentally ill. It is revolting.  Your brain is an organ, and one of the most complex ones in the human body, so it makes sense that something can go haywire.

In terms of diabetes, I have said this before, it is often last on the agenda in the management of diabetes. It should be first, because where the brain goes, the body will follow.

So what do you think?  Does a stigma exist in society and if so does it impede the prompt pursuit of help from those in need?


Tuesday, March 8, 2011

Momentary Lapse of Reason - Now What?

Great Album from Pink Floyd by the way.

What now? Why did I fall so deep? These are questions for me to explore. I want the spring back in my step, the passion back, but I feel like I am trudging through thick mud.  Everything is an effort.  Like being stuck in quicksand, reaching for a branch to grab a hold of and pull my self out. 

I have blogged about diabetes and mental health on Three 2 Treat numerous times; a few posts come to mind: Mood and Diabetes - What Gives!,  a few of my later posts like, Throw in the Towel Already! and most recently a, Letter of Resignation.

Were these signs that maybe I was on a slippery slope to deterioarating mental health or extreme burnout? Who knows.  

My momentary lapse in rational thinking scared the living shit out of me. Hindsight is not entirely twenty twenty at this point in time. However, I am astutely aware of what I was capable of doing, and also what I would have lost.

I hope to learn from this experience. I hope to share this with all who are willing to read this. I am not writing this for simpathy; but to express my self, and hopefully avert a future episode for myself or for another overwhelmed soul dealing with a chronic disease like diabetes who feels like there are no other options.

As my friend said (my dear friend) there are always options. Just pause long enough, and they will surface and present themselves. Always. Time, is alway ticking, but this is a good thing, as time allows us to ponder options, and some options obviously have better outcomes then others.

So in my case, and I am sure I am not alone. There was a moment where my  thoughts weren't rationale, or a momentary lapse of reason.. 

A "moment" by my definition is a temporary period in time, that inevitably passes. Thank god, my momantary lapse of irationale thinking passed uneventfully, allowing me to move forward in time to the next moment.

 Hopefully it will be a moment of mental clarity, one that is future oriented, one filled with joy, love, success, and life.

But what saved my ass in this crisis?  Luck amd a perceptive friend. 

What now? 

My own insight into what transpired, I guess.  A willingnes to seek help.  I have seen my physician, I have booked counselling, I am not ashamed to seek help. Talking and sharing is good.

Yes, even if you are a man. See my humour is still present, however lame.

Next I will look into resources I should have accessed prior to this event.

Thanks for letting me share.


PS:  If you are feeling desperate reach out.  Seriously!

Monday, March 7, 2011

Suicidal Ideation Prompts Blog - Read all about it!

This blog, is different from the others (Three 2 Treat & The Diabetic Caveman) that I author.

This blog will be solely devoted to diabetes and mental health. My current struggles with D, my struggles with my 2 type 1 kids, and hopefully some research and good techniques to manage the "Mind Game" that accompanies living with diabetes. 

I guess what prompted this new blog was a recent experience that is actually very fresh in my mind.  So raw I am dealing with it in my heart and soul as I type this, which will hopefully make it more real.

If you have had the chance to read my other blogs,  you will know my style is open, candid and real. Feel free to let me know if you feel I am straying from my blog writing principals.

I have had diabetes for 28 years, and for the most part  have successfully managed it. Nevertheless, it has  taken its toll on me mentally.

Last week it (Diabetes) finally beat me, at the mental game. I call it a game because it is, see my post on Three 2 Treat called, "A Diabetes Mind Game"  Well let's just say I felt like I was defeated and in check mate(which in chess means game over, no other moves, the end)  Ready to topple over my king in the game of life.

In my 38 years of being on this earth, this is the lowest I have ever felt. I have always been able to see a glimmer of light. Not this day.  I woke up, went to work, and didn't take my insulin. That's right, I did not take any insulin. For those with Type 1 DM you know this is not a good way to start the day. I picked my children up, dropped them off, and said my goodbye, I will always love you no matter what statements. WTF!  Who does that......

Now, a glimpse into my mind. Why was I in check mate. I had lost all desire to care. I was tired, so very tired, of diabetes, life, commitments, bills, debt, basically tired of living.  I decided my plan was to go into (DKA) Diabetic Ketoacidosis and slip away.  I know in retrospect it is an easy way out. But a way to never think about diabetes ever again.  So what happened?

Well, I posted a comment titled "Life Sucks!"on facebook.  Then went about my work day(pretending diabetes didn't exist). It is amazing how you can act normal, despite what you are truly feeling on the inside.

Later in the day, cramps started to set in, my brain got foggier, and I knew I was on my path to DKA, according to the plan.  I was thirsty but did not drink.  I wanted to be dehydrated, it would expedite the process and end result..

Then I received a call from my friend, who happened to be a very talented social worker. He said, "Hey buddy, wanna grab a burger after work today". I immediately started crying, it was like the flood gates busted, I was now swearing at him under my breath for making me cry at work. He made me promise to meet him, and I did.

I arrived at the restaurant before him.  Starting to feel abdominal cramps, and physically sick. I ordered a double burger, bacon, loaded, with onion rings, and a large coke.  I had know idea what my glucose was and didn't care.  Ryan arrived, sat down, and my phone rang. I answered it, "Hello, this is officer ------ may I speak to Trevor?" I replied,  "This is him, may I help you sir?"  He sated he wanted to talk to me as there was a concern about my safety.

I told him my location,  and informed him that  I had my friend here and handed Ryan the phone. Ryan told the Police officer that he would ensure I took my insulin and if not he would call the officer back.  Being a health care professional I knew that if I did not comply,  the police would apprehend me and lock me in a psych ward for the night or longer. Wow, was I fucked up.  I didn't care either way.  I also had to promise to make an apt with my physician ASAP. So what happened?

 I spent the night with Ryan. The next day I went home to my wife. I seen my physician. I am booked to see a counsellor to hopefully figure out what got me to this desperate state. Still not sure if I need to go to the hospital.  I know I want to live. I know there are options. I know my wife and children need me, and love me.  Like I said before what the hell is wrong with my brain!? 

Life can get pretty messed up.  Our minds are amazing things, our emotions are amazing things too, however, sometimes, emotions confuse the mind, self talk no longer works, and emotions are so overwhelming  that poor and often life threatening decisions and/or  actions are set into effect.

I used to hate facebook, but I fear what the outcome what have been if Ryan hadn't been perceptive to my post and called me. I'd either be dead, seriously ill, or locked up in a mental hospital.

But....Here I am. At work on Monday,  contemplating the last five days. Playing a serious game of mental chess with diabetes, who is relentless in his ability to take me down again.  I say the Mind-Game isn't over yet.  Let's reset the Chess Board and hopefully I can be more strategic this time around.