First things first
One of my fears before coming into treatment was that no one else in the clinic would be suffering from diabulimia and wouldn’t be able to understand my struggles. This was a perfectly rational fear because it is true that you come across less people in treatment without diabetes than with. However, the feelings behind what I was doing were exactly the same as people with other eating disorders. The trapping feeling of fear, the anxiety, the desperation and the anger were all common feelings amongst other clients, and in groups it didn’t matter so much about the actual behaviour, it was about the feelings which led up to it, and many clients could relate to this. Also, everyone in clinic has very different behaviours in their eating disorders. No two bulimics or anorexics will use behaviours in exactly the same way so there is always variation and the relating to others doesn’t come from the behaviour itself, it’s the feelings. There are some unique things to diabulimia, but things I didn’t feel comfortable talking about in group I took to my one to one therapist, and more often than not she suggested I bring it up in group because it was more relatable than I thought!
Starting the recovery process
The first thing which had to be addressed when I came into treatment was keeping my blood sugars under good control. I learnt that I couldn’t do therapeutic work without this, because high blood sugar would cloud my thought space. This was a matter of self-care, which I didn’t understand the meaning of until I started self-care group at Recover. Many-a-time I have heard the phrase ‘you just lack self-care with your diabetes’ spoken at me by healthcare professionals. For a long time the true meaning of this phrase didn’t ring true with me, mostly because I truly believed I was doing exactly what I wanted to. In my head, because I thought my eating disorder brought me happiness, dedicating myself to its behaviours felt like self-care, even though I knew it was dangerous. Because at first my motivation to control my blood sugars for myself was lacking, my main motivation came from my therapists. My nutritional therapist at Recover looked at my recordings of my blood sugar each week, which I colour coded green, orange and red, and we talked about individual readings – for instance how a high reading had happened.
Accepting myself as a human
But deep down I knew I had to find another way to feel motivated. Without a reason for me, my recovery felt unstable because I knew if the help was gone my motivation would also be gone. So with the help of my therapist and core group I started working on my core self. Having grown up in a vaguely religious environment with diabetes, I had spent my childhood debating about whether I believed in a God. More specifically, I believed that if he existed, this God must be punishing me. The only conclusion I could come to as a child was that this must be because I was a bad or unlucky person (this was all at a very sub-conscious level that I only retrieved from my brain through therapy!). Therapy taught me that this was simply false. Now I really believe that no one is born as a bad person or becomes one – everyone is just affected by the things going on around them and makes behaviour choices which are either constructive or destructive. This helped me to accept myself and feel less resentful towards being who I was and being in my diabetic body.
Finding my identity
As a child my diabetes was a huge part of my identity. I felt I was ‘the diabetic one’, which was not helped by no one else I knew having diabetes, and a feeling of being different from others. When I had tried to reject my diabetes as being a part of me, my identity became my eating disorder, and by the time I came to therapy I was in the position of not really knowing who I was underneath my illnesses. A big part of recovery was reconnecting with who I was, levitra online mainly through mindfulness. As I meditated in meditation group I discovered more about my feelings, first. How each feeling actually felt in my body helped me to become aware of them coming up in real life. I was discovering what feelings actually felt like and how I felt about different things in my life. It was hard to feel sad or angry, or other more negative emotions, but I could finally feel joy and gratitude and love for things and people. I was finally discovering what interested me and what I wanted in my life. And to do those things I had to look after my body so that it could support me to do them. I learnt that I was into writing, art and photography, and to be able to get my creativity out without distraction I had to have the clear headedness of good blood sugar.
Challenging old beliefs
I felt all-or-nothing about my complications as well. I felt that if I’d already spent so long with high blood sugars, was there really any point in making effort? Wasn’t I already going to have complications in the future? The fact that you can never take a day off from diabetes furthered this and I often found myself overwhelmed at the thought of my future with diabetes. Whenever I found my sugars better controlled I had a sinister voice at the back of my head telling me that there was no point because I’d be getting complications anyway. My first step was to share this with my therapist, who encouraged me to think about it more. The fact was the more I looked after myself, the less likely and the further away complications would be. The best thing I could do would be to look after my sugars now and accept that I couldn’t control what life could throw at me later down the line, but being in a good recovery if that happened would change how much the complication would affect my life. For example, as an unwell person if my foot was cut I would be more likely to leave it, but as a person in recovery I would accept that feet are a high risk and get it checked out. That would lead to less complications anyway because I’d be more on top of my treatment of them.
The biggest part of learning to live peacefully with well-controlled diabetes was facing the extent to which I hadn’t accepted it. I had to become aware of my feelings towards it in order for them to change. I did this through creative therapy at Recover clinic, where I would draw something to represent myself, something to represent my diabetes and look at how my subconscious creative self related the two. I also thought back to childhood memories of emotional memories associated with diabetes and noted how angry I felt for my child self. This helped me to start making a dedicated effort for that child who still exists in me: to look after her and reassure her.
Another belief was that I felt that my body was ‘broken’ because of my diabetes, and found it hard to foster love for it. My view on this only started to change when a new idea was introduced to me in spiritual group, talking about gratitude. I had very little gratitude for my body, and felt anger rising when we talked about this topic. I expressed how I felt like my body had let me down and in a calm, loving response, the therapist responded that with the amount of damage I had done to my body through my eating disorder, my body had done very well to keep me alive. It sounds dramatic, and something I would definitely have not believed at my sickest, but there were many times where my blood sugar was dangerously high and my body could easily have gone into a coma instead of keeping me awake and able to get help. The point stayed with me for a long time and through appreciating the things my body does do for me I began to feel the desire to look after it.
Practically, one of the most important things I did was make my diabetes easier to manage. I bought a make up bag to keep all of my diabetes things in one place, which made a simple but huge difference. I got a calendar to write in all my healthcare appointments and dates when I’d have to renew prescriptions. I bought a pill box for medication and nutritional supplements (unrelated to diabetes but still health related). I stock-bought glucose tablets so that I always had a supply. All these things helped me because I didn’t have that worry in the back of my head that I might not be able to find something, or might run out of medication. I made an expanding list of all the foods I usually ate and their carbohydrates, so I wouldn’t have to rely on looking at packets where my eyes often wondered to the calorie content. I also made sure I wrote down all my blood sugars, and with a therapist came up with the idea of making my own. This was when I was discovering my creative side and the idea of a home made personal record book instead of a clinical one helped me feel more connected.
Diabetes does affect your life and a big message I found myself thinking was ‘just get on with it’. I wanted diabetes to take a back seat so much that I refused to accept when I needed to adjust my life for it. After going into recovery and experiencing controlled blood sugars I soon found that if I was reading a book and my blood sugar started to go high or low, it would take two or three reads of a sentence to take anything in. This surprised me because I started to wonder how I’d been able to function like this, let alone study! Nowadays I am studying and before I am set to do work I take a blood sugar. If it is high or low I sort it out as a priority. Treating diabetes as an absolute priority was a new idea to me in recovery, and came to me through a therapy group which looked at Maslow’s hierarchy of needs. It teaches that without the physiological needs being met (breathing, food, water etc), any needs higher on the pyramid such as love, esteem, self-actualisation, e.t.c. simply can’t be met properly. This taught me that when my diabetes is poorly controlled, I can’t dedicate myself to anything else, including my family, friends, successful employment or study.
I used to be very reluctant to tell employers or people at university about my diabetes because I didn’t want them to over react or treat me differently. When I came into recovery I made a point of making sure everyone I worked for was aware. That way I could just say the word and be allowed to take a ten-minute break to sort things out. I have found all my employers to be very accepting of that and if they weren’t I would be aware that I actually have rights in this area as well. In terms of exam arrangements, back at school I would haphazardly take in a bottle of Lucozade and hope for the best. When I started university in September I made a point of having a talk with the disability advisors at my uni, and we came up with ways that could help me. As it stands I am allowed to take all my equipment into the exam, take breaks to test my blood sugar if I need to, and I am given extra time. If my blood sugar is high one morning and I know I won’t be able to focus during a lecture or seminar, I am excused. This works really well for me because it allows me to really look after myself while getting the most I can out of my life and studies.
The other thing I found difficult about my diabetes was health appointments. I found it hard to book them, turn up at them or get the most use out of them. I felt I was only going to see my blood sugar average (Hba1c). When I started engaging with my diabetes team I started getting a lot more out of my appointments. They could tell I was trying hard and they were very encouraging. I addressed my deep-rooted fear of blood tests and hospitals with my therapist at recover and began to look for meaning in the appointments. I found myself having questions which came up, and making sure I was on top of who I needed to see and when. I was lucky enough to get onto a DAFNE course which I went to and made the most of, and my motivation went even higher as I met others with diabetes and started to feel like I was really worth being cared about. This also extended to booking health appointments about other things. Of course as a diabetic I find myself having to be at the doctors or pharmacy more than the average person, and I used to ignore problems in the hope that they’d go away. Now I find it is much more effective to face the symptom and take it to a doctor before I get carried away with imagining what it could be.
How I feel now
I didn’t choose to have diabetes, and it does require a lot of self-care every day. Sometimes I still feel angry or sad because it does cause some inconvenience. But ultimately my diabetes gives me more opportunity for self-care and looking after myself, and that is something I’m grateful for because I love the feeling of being looked after by the person who knows how to do it best (myself). Granted, it’s every day, which can be a little overwhelming. But recovery is about figuring out what you need in this moment. It doesn’t matter what’s happened in the past, or what could happen, it’s about what you need right now. So I take it not even day-by-day but moment-by-moment and it allows me to accept it in a much healthier way into my life.