Burnout does everything it can to stop teenagers looking after diabetes, it pushes parents into a spiral of feeling nothing is good enough. It can make everyone dread coming to clinic as it encourages you to feel guilty if glucose levels aren’t ‘goodenough’. Don’t despair. There are ways to turn down the burn and get life back on track
Living with diabetes requires a lot of effort on the part of the young person who ‘has’ diabetes. They need to think abut what they eat, take the ‘right’ amount of insulin and manage exercise. This is relentless and exhausting. Young people who take on most of the responsibility for managing diabetes may notice they keep missing clinic, forget to take insulin or stop bothering to pay attention to what they are eating or what their blood sugar levels are. There might be more arguments at home as parents start to get worried and start relentlessly reminding what needs to be done. This usually has the effect of increasing the feeling of frustration. Young people tell me ’On the one hand I want to and on the other hand I don’t want to’ or ‘I know I should but I just can’t be bothered’. They can get more and more fed up and unhappy with the situation. ‘The harder I try the worse it gets’. Burnout likes to get kids labelled as difficult or noncompliant or ‘bad’.
Parents, siblings and families often get forgotten. They have to live with diabetes too. Parents of younger children usually need to take on most of the management – even when their child is at school. Parents of teenagers have to balance encouraging independence with worry about safety and ‘letting go’. Burnout makes them feel disillusioned and frustrated as if diabetes has taken over. It feels like there is no way to deal with the endless attention it demands. Burnout in parents has the opposite effect to young people. Rather than forgetting to do the things that need doing parents can’t stop thinking about them. Constant worrying about getting blood glucose readings ‘right’, constant testing 24 hours a day (especially in little ones) constantly reminding and checking and checking and checking. For most parents this is the normal state of affairs. But when they become completely exhausted and frustrated and distressed about ‘never getting it right’ then the flames of burnout has been ignited.
- Noticing burnout is giving you a hard time is the best place to start.
You might feel more stressed than usual, you might feel anxious or your mood might be a bit lower then usual. You might notice that you are feeling angry about things or getting into arguments. You might have lost interest in things that you used to enjoy doing.
Is this OK?
If the answer to this question is no then you’ve taken the first step towards getting your life back on track.
- Be kind to yourself and focus on the solutions rather than the problems.
No-one can be perfect all the time so if you have a day when you don’t get everything exactly right remind yourself that you can start again tomorrow. Write down what has gone well – even if it’s nothing to do with diabetes – even if it was only for a couple of minutes. Diabetes is just one small part of your life and you are not your diabetes. What have you managed to do? How come? What made this one small positive step possible? Was it something you did, or said or something someone else did or said. Keep track of these sparkling moments and forgive yourself for the things that don’t go so well. You are only human!
3 Ask for help
Don’t suffer in silence. Get some support. Family, friends (and coworkers) can only help if you let them know what you need them to do. Find someone you trust to let you take a few hours off. Get someone to share the jobs like night-time blood glucose checking. Get your diabetes team to put you in touch with another parent so you can swap a night of baby sitting with each other. Burnout loves making people feel like they are isolated so don’t let it win.
4 Negotiate a ‘diabetes holiday’
Teenagers that are exhausted trying to remember to take insulin and count carbs every day can take a short holiday and let an adult take care of things in the evenings for a few days or weeks. Work out what is helpful, such as counting carbohydrates together at a meal, or calculating insulin (injections or boluses). Work out what isn’t helpful, such as being asked constantly if a particular food is the “right” food to be eating or if you’ve done your blood glucose. Swap your pump for injections done by someone else for a short period of time (you must talk to your diabetes team if you are going to do this one). Be creative but give yourself permission to ‘take a break’ from the relentless nature of diabetes.
Parents can take a holiday too. Ask your partner or family member to take over for you for a few days. I know lots of parents often feel they are they only one managing things at home and have very little support. So ask another parent from the clinic for help – organise a sleep over so you can have a night off, go out for dinner, go to the pictures, go out for a coffee, have a massage or a manicure. It doesn’t have to be much. Give yourself permission not to be ‘on the job’ for as little as an hour. You can always repay the favour when they are feeling ‘singed’ by burnout themselves.
5 Keep things in balance
Who are you keeping diabetes under control for? Is it your clinical team or is it for you? Work out the pros and cons for you of not letting burnout win. You may want to have good glucose control to reduce the risks of diabetes complications or to stop your parents or partner or doctors nagging you. But try and remind yourself what matters to you and how to make the benefits of not letting burnout win relevant to your own hopes and dreams, hobbies and interests.
6 Use your diabetes team.
Don’t suffer in silence. You are not the only person living with diabetes who is feeling like this. Your diabetes team will help you think of practical ways to manage the effects of burnout. And if they don’t then think about changing teams! Ask to speak to a psychologist if the team has one. Look at what support groups are available in your area. Ask your diabetes team to help you start up a group if there isn’t one.
7 Use the power of your mind
Mindfulness can help understand, address and overcome the mental and emotional impact of having diabetes, including the emotional and psychological conditions that give rise to diabetes burnout. Try the free app ‘Stop, Breathe Think’. Teens may also enjoy reading “The Mindful Teen’ by Dzung Vo. If your team can’t offer a course then have a look on the internet for what might be available in your area.
8 Connect with others
Social media can be a force for good and bad so ask others which websites they find helpful. Check out blogs and websites for suggestions and advice. Do the stuff that works and ignore the stuff that doesn’t.
One website recommended to me by a young person who has recently got herself back on track is Beyond Type 1 . Parents might find the Children with diabetes website helpful . Talking online and meeting other young people who are also battling burnout as well as those who have successfully overcome it can help motivate you. Ask your diabetes team to organise aTree of Life workshop or a ‘social’ where you can meet other people so you don’t feel like you are the only one struggling.
I’d love to hear from you if you found any of these ideas helpful or if you have some ideas that have worked for you think I can learn from and share with others.