Stasis is the antithesis of life. Like a river in springtime, life flows constantly.
This philosophy – this process metaphysics – has been my personal philosophy for the past 5 years. It’s a worldview that I was first exposed to through two great traditions of the East: Taoism and Buddhism. Although I’m neither a Taoist nor a Buddhist, they’ve certainly influenced my own philosophy.
Initially, this change-centric conception of the world merely intrigued me. The novelty of it seduced me. In time, I began to reflect upon my life and knowledge of history. I discovered that, in the main, change is the law of life – both of people and of nations.
Life is the Great Teacher. Over the past 5 years, I’ve learned countless lessons. My awareness has expanded. The implications of change is now clearer to me.
What was once a philosophy learned mostly from books ( such as the Tao Te Ching) has become deeply personal. Life is the ground out of which our philosophies grow and receive their nourishment.
My recent experiences with type 1 diabetes has nourished my understanding.
What I have come to the realization of can be sumarized thusly: With new circumstances come new challenges.
Let me show you what I mean.
Back in December – prior to starting this diabetes blog – I was burnt out. On a brisk December night – in the first week of the month – I experienced a stubborn high. Everything I did was for naught.
I drank water like a fish. I did a correction with a syringe. I did everything that I’ve been taught to do over at the Joslin Center. My actions helped, but only a little. My blood glucose levels remained above 350 for 12 hours.
Did I mention that I was panicked?
This event made me realize that I was experiencing diabetes burnout, and I realized that I’d have to climb out of the deep, dark hole that I’d stumbled into. I procrastinated.
Just to be clear, at this point I did desire to liberate myself from my situation. The psychological barriers to me doing so were still too high. It would take another unpleasant event to spur me into taking serious action to rectify my situation.
It took another stubborn high to motivate me to take decisive action. I knew that I had to rise above the frustration and fear that I was experiencing. I coped with it (mainly) through writing. This d-blog played an essential part in that process of recovery.
Back then, managing my type 1 diabetes adequately was too difficult. Therein lied my problem. It’s the reverse today. Now that managing diabetes is no longer a psychological burden, T1D has become too easy to manage.
The ease with which I’m managing my diabetes isn’t bad, per se. The problem lies in how it impacts my attitude and actions.
There’s a very real possibility that, given my psychological makeup, I’ll become lax, and allow unskillful diabetes to creep back in.
I have reached the publishing deadline that I have set for myself. This post will come to an abrupt con…….
Self-complacency. Things are going well. My blood sugars have remained – with the exception of a few aberrations – at a satisfactory level. The one possible threat: me. If I allow arrogance through the door, it will cause mayhem. If I invite laxity inside, my hospitality will be the axe that fells me. Self-complacency = more hyperglycemia. Period.
To prevent myself from acting complacent, I need to remind myself that it’s my actions that are keeping my type 1 diabetes under control. Testing frequently, being comparatively physically active, etc. If I don’t do these things, my level of control will be diminished.
Openness is a particularly strong aspect of my personality. My appetite for knowledge knows no bounds. My imagination has been a close companion of mine from an early age. I need intellectual stimulation.
I have my parents to thank for this. Thanks to my dad – who’s a professor – I’ve become a well-spoken, independent-minded, and highly intelligent young man. Thanks to my mom – who exposed me to fine art and classical music from a tender age – I’ve come to have a deep appreciation for and/or interest in art, music, literature, architecture, etc. Despite being somewhat simplistic, this characterization of parental influences upon the development of my personality is, for the purposes of this post, adequately true.
In addition to being a prominent factor of my personality, openness to experience is a pertinent part of my self-identity. I, admittedly, take pride in it. Despite this pride, however, I’ve come to recognize that there’s a downside to it.
Upon defeating my unskilful diabetes management habits I was struck by discontent. Having been seized by such an uncomfortable feeling, I was compelled to introspect. New insight was the result.
This is what I’ve come to realize:
My struggles with managing my diabetes adequately engaged my intellect. Setting objectives and developing a general strategy on how I was going to accomplish them was intellectually stimulating;
In December, I felt as if this diabetes blog provided me with an adequate outfit for my creativity. Since mid-January, however, I’ve felt less creative. My writing has left me feeling less satisfied.
Looking back at other periods where I’ve felt discontent (there have been quite a few), I’ve observed this universal pattern:
I wasn’t engaged in studying anything that I found intellectually stimulating;
I lacked a creative outlet.
From my observations, I’ve concluded that being engaged intellectually and having a creative outlet at all times is essential for my happiness.
Even if my memory serves me wrong (a distinct possibility), this conclusion still makes sense due to my extremely high levels of openness.
Going forward, I’m going to make a conscious effort to make sure that I always have a source of intellectual stimulation and an outlet for my creativity.
How do I define success? By which standards do I judge my actions? I’m vexed.
Until recently, I wholeheartedly believed that I had overcome my perfectionistic tendencies. All too often, self-perception is self-deception.
For four long years I struggled valiantly to rid myself of perfectionism. Did I struggle in vain?
For four long years I struggled vainly to rid myself of perfectionism. Did my unskillful approach sabotage my valiant efforts?
My thought’s are a series of questions and question marks… Uncertainty abounds… Shards of glass encircle me.
Despite all of this, I feel at home. Peace. Serenity. Freedom. These three are my closest confidants.
Despite all of this, I don’t feel lost. Shock. Anxiety. Paralysis. These three know nothing of me.
Creative destruction. A certain self-perception has been destroyed. In its place, a blank piece of paper has appeared. Creativity can now blossom.
I thought I had overcome perfectionism. I had overcome perfectionism in the realm of thought alone, and my judgement was clouded.
My thinking was wishful, but clarity’s been restored.
While pondering a post that I’d written recently, I realized that my perfectionism had merely changed forms.
By objective standards, the lapse in adequate diabetes management that I wrote about in the aforementioned post was insignificant. The problem was subjective. It was due to my interpretation of events, and my projections of the future.
I interpreted this incident as being problematic because it disrupted the story I told myself about my recovery from diabetes burnout. It shattered the myth of a perfect recovery.
In my myth, I was perfectly strong and, therefore, able to effortlessly overcome any obstacle. I didn’t expect myself to stumble so early in the story. When I did stumble, frustration struck me.
I’m grateful for how things transpired…
Going forward, I need to be more realistic. I need to make a less inflated estimation of my own strength. I need to account for setbacks… I still need to reconcile with my fallibility.
Creative destruction. An old story has been destroyed. In its place, I can create a new, more realistic one.
A month ago I was testing 2-3 time a day. On most days, my numbers remained above 200 all day, and I’d often see at least 1 number over 300. Numbers in the 400s – which had formerly been rare – happened almost every week.
Fast forward to this month. I’ve been testing 6-10 times a day. On most days, my numbers remain above 200 for most of the days, but I’m starting to see due some decent numbers. Numbers in the 400s – which been all too common a month ago – are now non-existent. Improvements have been made.
Being a pessimist, I’m adept at seeing the negative aspects of any situation. In my present situation, I could easily choose to focus on the fact that my blood sugars still remain, on average, higher than what I’d like to see.
Although I could choose to see my present situation through tinted glasses, I have decided not to. To interpret my situation in a negative manner would do me no good.
It’s essential that I keep things in perspective. Although my blood glucose readings are important, they’re not what’s most important to me. Of far greater significance to me is the fact that I’m testing my blood sugar frequently.
My current blood glucose readings are irrelevant to me, so long as I’m in the habit of frequently testing my blood sugar. Although, by itself, it won’t have a major impact on the extent to which I have my diabetes under control, it will form a firm foundation for me as I continue to recover from diabetes burnout.
Diabetes burnout struck me like a tornado. Where skillful diabetes habits had once stood, there remained nothing. A once-magnificent city had been replaced by a vast field of rubble.
In the immediate aftermath of the storm, I was left in a state of shock. After gaining an appreciation of what had transpired, my shock turned to self-pity and despair. Being stuck in the position I was in felt like an injustice, and the magnitude of the task at hand inspired nothing but despair.
These days are now behind me. Having freed myself from self-pity and despair, I was able to focus on the process of rebuilding.
This process started in December of 2013, and has continued into the new year. Although a noticeable amount of rubble has been removed thus far, a significant amount remains.
I’m starting the process slowly by continuing to test my blood sugar more frequently. When I’m ready to move on to another task, I will focus on being more physically active again. For now, however, I still need to focus most of my attention on the first task.
Despite the large quantity of work that has yet to be done, the outlook is optimistic. Things will be restored to their former glory.
As I continue reestablishing skillful diabetes management habits, I need to pace myself.
I’d experienced diabetes burnout from September until the middle of December, during which I formed numerous unskillful habits. For instance, I was only testing twice a day, I didn’t change my pump site as often as I should, etc. Given the plethora of bad habits I had formed, I’m basically starting from square one.
Given the magnitude of the task at hand, it’s essential that I focus on one or two habits at a time; otherwise, I risk overwhelming myself. I risk burning myself out all over again.
Although the road to adequate diabetes management is long, I’m certain that, so long as I pace myself, I’ll reach my destination.
The wisdom of properly pacing oneself extends to other areas of life as well. I’m currently trying to pace myself in these other areas as well. This blog is one example of where I can implement it.
Therefore, I’m going to lower my posting frequency. For the rest of January I plan on posting twice a week – on Monday and on either Thursday or Friday.
I want to write about diabetes burnout – in particular, my most recent bout with it. I want to find a way to incorporate the posts I made on tumblr a month ago, when my burnout was at its peak. As I attempt to achieve these goals, I’m continually falling short. I’ve hit a brick wall – and keep hitting it over and over again. Writers block has reared it’s ugly head.
After writing and re-writing this post repeatedly, I’ve decided to give writers block the finger, and write about writers block. I ain’t gonna let writers block slow me down…
If you can’t tell already, this post is essentially going to be a free write until I’m able to magically transition to the topic I had initially planned on writing about.
As a writer, beginnings are my archnemesis. I need to find my groove; after I’ve done so, it’s takeoff! If I don’t, my writing’s a train wreck.
Perhaps it’s because I try too hard. Rather than putting my trust in my own abilities, I try to force myself to write rather than allowing myself to write. Perhaps having a preplanned subject matter adds extra pressure. Perhaps, like a guitar player, I simply have to relax my mind and body, and then just write.
The part of this post that is actually about diabetes begins after this sentence.
Now my groove is coming back to me and, of course, now I’m starting to feel low…
I’m actually 123 (a nice number for more than one reason).
That unpleasant interruption brings us to today’s topic: the psychological challenges of overcoming diabetes burnout.
When your blood sugar is high all of the time, you adapt to it. Chronic hyperglycemia is miserable to live with, but I get accustomed to living miserably. It also tends to make me feel depressed after awhile, which means I…lack of motivation.
In other words, chronic hyperglycemia eliminates possible motivations to improve my blood sugars, while also making it more difficult to feel motivated in general.
To complicate matters further, I know that, as I improve my blood sugars, I will both experience more lows and start to feel low when I’m not. Psychologically, there is little difference between the two. Both of them make me feel the same, and this feeling isn’t one I desire.
Do you remember how I mentioned wanting to incorporate something I wrote on tumblr into this post? Well…I’m about to do just that.
Here’s something I wrote while I was experiencing burnout:
The first sentence is the part of that post that’s relevant to this one.
Pulling yourself out of diabetes burnout involves making a decision between two shitty options. It’s not as black and white as it may seem.
If you’re stuck in a negative mindset, this taints your judgement. Both of them can appear to be equally bad if this is your mindset.
All of these things make diabetes burnout an incredibly difficult hole to climb out of.
What I have been describing is, of course, an extreme example. What I’m describing is a case where diabetes burnout and chronic hyperglycemia fed into each other.
It probably would have made more sense for me to organize the last three paragraphs into bullet points but what has been done has been done.
In conclusion, I don’t like writing conclusions, therefore this post will abruptly end here
Diabetes burnout feels like being mugged. It comes up behind you, seemingly out of nowhere, and robs you of any positive (or neutral) feelings towards diabetes that you may have had. In its aftermath, you are left feeling vulnerable and discouraged… temporarily stunned and immobile… And, although there’s nothing wrong with these feelings (in fact, something’s probably wrong with you if you don’t feel them), there come’s a time when you must get up and take action, despite how you’re feeling. You must report the crime to the police, and put your trust in them. You must accept that you’ve done all that you can, for now.
I was recently mugged. It seemingly came out of nowhere. My most recent A1C was the best it had been in 9 years, I was testing as often as I needed to, and I was exercising almost every day. Things were looking up! I was proud. The days (years) of not paying close attention to my type 1 diabetes were behind me…so I thought.
Something happened. My attention became lax, and, gradually, all my progress became unraveled. What once came naturally had turned into a disgusting chore. All of this happened right under my nose.
That’s the thing about diabetes burnout: it seemingly hits you out of nowhere, and it takes time to register what has just happened to you. Although it might be obvious to an outsider that all is not going well for us in dealing with diabetes, it isn’t immediately clear to us. Awareness comes in time. We’re not often immediately cognizant of diabetes burnout. It appears gradually; once it appears, our awareness of it is also gradual.
During my most recent encounter with diabetes burnout, it took me a good month to become aware that I had fallen. Until then, life seemingly went on as it had before.
Self-awareness slowly established itself. Initially, I was only aware that I wasn’t feeling as well as I had when I was testing more, exercising, etc. Then I put two and two together. Being aware of this, however, wasn’t enough lift me out of diabetes burnout.
Then things took a turn for the worse. I ended up – somehow – in the unenviable position of having to live my life while almost constantly being over 200. Numbers in the upper 300s, and even the 400s, had become a regular occurrence. Although, by then, I was painfully aware of my burnout, that awareness wasn’t enough to lift my out of the whole I’d fallen into and spur me to action. If anything, in the short term, my awareness only succeeded at torturing me.
At this point I knew that I had fallen into a deep hole. I was painfully aware that my ever-present hyperglycemia was slowly killing me. None of this helped. It only fueled the flames of negativity that hyperglycemia had started. It only succeeded at increasing my feelings of dread. I dreaded all of the habits I’d have to reestablish. I dreaded the thought of having to experience more hypoglycemia. My self-awareness still left me stuck in inaction. However, there are no eternal nights; this mental state did not remain for long.
What helped me begin the process of lifting myself up out of the hole I had fallen into? Honest self-expression. I didn’t let my pride get in the way of me expressing how I felt on tumblr. I didn’t let fear over what other people might think dictate what I published. I allowed my mask of strength to fall off, and showed my vulnerability by expressing my feelings of disgust, disappointment, and despair. Unlike in the past, I did’t let these feelings fester in me. By being willing to “stare into the abyss,” and express what stared back at me, I opened up the opportunity to take the necessary actions to restore myself to full health.
Where I stand now, I’m taking things one step at a time. Through my experiences of dealing with diabetes burnout, I’ve been taught the dangers of being over zealous. By rushing to improve things too quickly, we often set ourselves up for failure. Life with diabetes is all about balance. I have yet to find the proper balance, but I have faith that I eventually will, so long as I persevere.
I am doing what I can do, rather than focusing on what is out of my control. I can’t always control what my numbers will be, but I do have the power to get into the habit of doing the things that are necessary to get back on track. In short, my focus will be on the concrete actions that are needed to be healthier, rather than the abstract goal of “better health.” If I stick to this approach, I shall return to my former glory in no time 😉