Diabetes blues: Beyond pills, injections, blood checks

Diabetes affects and is regulated by the brain. 

Learn more! Click here.

From Medical News Today (excerpt).

Lastpdated Fri 24 May 2019

By Adam Felman 

Reviewed by Deborah Weatherspoon, PhD, RN, CRNA

Diabetes affects much more than blood sugar. It can lead to sudden mood changes that may place an emotional strain on relationships and personal life.

For some people, the stress of living with diabetes can contribute to both changes in mood and concerns about potential complications. The physical effects of diabetes may also lead to nervousness, anxiety, and confusion.

Sometimes, friends and family may struggle to understand these mood swings, but learning about how diabetes can affect mood and providing support can help promote a stronger, healthier relationship.

In this article, we look at how diabetes might affect a person's mood and relationships.

We also spoke to Jenn Catterall, who lives with type 1 diabetes and manages the condition using an insulin pump, about her emotional experiences with diabetes.

Diabetes and mood swings

Diabetes often has a complex emotional impact.

Diabetes can affect a person's mood, causing rapid and severe changes.

The symptoms of low blood sugar levels that might contribute to mood swings include:

• confusion
• hunger
• co-ordination and decision-making difficulties
• aggression and irritability
• personality or behavior changes
• concentration difficulties

Signs that indicate a person may have high blood sugar levels include:

• difficulty thinking clearly and quickly
• feeling nervous
• feeling tired or having low energy

Changes in blood sugar level can affect a person's mood and mental status. When blood sugar returns to a normal range, these symptoms often resolve.

Fluctuations in blood glucose can result in rapid mood changes, including low mood and irritability. This is especially true during hypoglycemic episodes, during which blood sugar levels drop below 70 milligrams per deciliter (mg/dL).

However, when some people have low blood sugar, they experience a slightly euphoric feeling, in a similar way to being mildly drunk. Jenn reports the following with her own experiences:

Low blood sugars can be almost a nice experience, similar to being tipsy. When I was a teenager, my brother jokingly commented, "You're much nicer when your blood sugars are low!"

The body compounds this pleasant sensation by releasing adrenaline in an attempt to convert any available glycogen in the liver back into glucose to boost levels in the bloodstream."

This surge in adrenaline can lead to a fight-or-flight response. In Jenn's words, "Anything that might get in the way of a hypo recovery is now a danger, and your brain now focuses on keeping you conscious or alive."

This fight-or-flight state contributes to the feelings of irritability that might result from hypoglycemia in some people.

The speed of mood swings can vary, according to Jenn.

"The changes in mood, like the symptoms, can vary a lot in how suddenly I'll feel them, and they don't always parallel each other. However, we are talking a matter of minutes, up to maybe half an hour. It's not as sudden as an epileptic fit."

Hyperglycemic episodes, when glucose levels rise above 130 mg/dL when fasting and 180 mg/dL after meals, may also cause confusion in people with type 1 diabetes. This is less common in type 2 diabetes.

Diabetes affects and is regulated by the brain. 

Learn more! Click here.

Drug Abuse and LGBT Community: Social Anxiety on Steroids

People who identify as lesbian, gay, bisexual, or transgender (LGBT) often face social stigma, discrimination, and other challenges not encountered by people who identify as heterosexual. They also face a greater risk of harassment and violence. As a result of these and other stressors, sexual minorities are at increased risk for various behavioral health issues.

Many federally funded surveys have only recently started to ask about sexual orientation and gender identification in their data collections. Surveys thus far have found that sexual minorities have higher rates of substance misuse and substance use disorders (SUDs) than people who identify as heterosexual. Therefore, it is not yet possible to establish long-term trends about substance use and SUD prevalence in LGBT populations.

Substance Use and Misuse

Understand social anxiety and stress in the LGBT community.

According to 2015 data from the National Survey on Drug Use and Health, adults defined as "sexual minority" (in this survey, meaning lesbian, gay, or bisexual) were more than twice as likely as heterosexual adults (39.1 percent versus 17.1 percent) to have used any illicit drug in the past year. Nearly a third of sexual minority adults (30.7 percent) used marijuana in the past year, compared to 12.9 percent of heterosexual adults, and about 1 in 10 (10.4 percent) misused prescription pain relievers, compared to 4.5 percent of heterosexual adults.

A 2013 survey conducted by the U.S. Census Bureau found that a higher percentage of LGBT adults between 18 and 64 reported past-year binge drinking (five or more drinks on a single occasion) than heterosexual adults. LGBT people in treatment for SUDs initiated alcohol consumption earlier than their heterosexual counterparts.

Lesbian, gay, and bisexual (LGB) adolescents also reported higher rates of substance use compared to heterosexual adolescents. In one meta-analysis, LGB adolescents were 90 percent more likely to use substances than heterosexual adolescents, and the difference was particularly pronounced in some subpopulations; bisexual adolescents used substances at 3.4 times the rate of heterosexual adolescents, and lesbian and bisexual females used at four times the rate of their heterosexual counterparts.

Substance Use Disorders and Comorbidities

LGBT persons also have a greater likelihood than non-LGBT persons of experiencing a substance use disorder (SUD) in their lifetime, and they often enter treatment with more severe SUDs. Some common SUD treatment modalities have been shown to be effective for gay or bisexual men including motivational interviewing, social support therapy, contingency management, and cognitive-behavioral therapy (CBT).

Addiction treatment programs offering specialized groups for gay and bisexual men showed better outcomes for those clients compared to gay and bisexual men in non-specialized programs; but in one study, only 7.4 percent of programs offered specialized services for LGBT patients. Research is currently limited on rates of SUD among transgender populations, although research shows that transgender individuals are more likely to seek SUD treatment than the non-transgender population. Current research suggests that treatment should address unique factors in these patients' lives that may include homophobia/transphobia, family problems, violence, and social isolation.

Sexual minorities with SUDs are more likely to have additional (comorbid or co-occurring) psychiatric disorders. For example, gay and bisexual men and lesbian and bisexual women report greater odds of frequent mental distress and depression than their heterosexual counterparts. Transgender children and adolescents have higher levels of depression, suicidality, self-harm, and eating disorders than their non-transgender counterparts.Thus it is particularly important that LGBT people in SUD treatment be screened for other psychiatric problems (as well as vice versa) and all identifiable conditions should be treated concurrently.

LGBT people are also at increased risks for human immunodeficiency virus (HIV) due to both intravenous drug use and risky sexual behaviors. HIV infection is particularly prevalent among gay and bisexual men (men who have sex with men, or MSM) and transgender women who have sex with men. SUD treatment can also help prevent HIV transmission among those at high risk. For example, addiction treatment is associated not only with reduced drug use but also with less risky sexual behavior among MSM, and those with HIV report improvements in viral load.

Source: National Institute on Drug Abuse

How to call your congressman when you have social anxiety

Many people have social anxiety and the idea of call a representative to fight Trump is daunting. We talk about depression, stress, and trauma in our new book, Healing the Brain. Click for your copy. And learn about small steps to make difference.

“How to call your reps when you have social anxiety”

There’s a LOT going on in the U.S. right now. Many people’s rights and safety are at risk. You’ve probably heard that one of the most effective ways to advocate for issues you care about, or stand up against dangerous policies and appointments, is to call your local representatives.
If you want to help but have social anxiety and find phone calls very intimidating, you may be thinking, “How do I do this?!” (An oversized telephone handset hovers ominously over the narrator with its cord spiraling around her body. She looks up at it with great concern.)
Here’s a step-by-step:

1. Block off time on your calendar. Each call only takes a minute or so, but you might want to block off more time for your first call, so you can prepare your words & nerves. Don’t rush yourself! Scheduling is super important, otherwise you will perpetually delay calling.
2. At the scheduled time, go sit somewhere quiet.
3. Find out who represents you. Some places to look: House (http://www.house.gov/representatives/find/) and Senate (http://www.senate.gov/senators/contact/).
4. Write out exactly what you plan to say. It only needs to be a few lines, and there are lots of templates online that you can use. e.g. “Hello! I am constituent from city (zip code) and I am calling to urge Some Name to publicly…” If they have already released a statement, don’t use that as an excuse to avoid calling. I know it’s hard, but call anyway. Thank them and ask them to keep pushing.
5. Take a deep breath. You can do this.
6. Do this: dial. (This is the hardest part.)
7. Read from your script. At this point, you’ll likely be sent to voicemail or to an actual person. The person will most likely be friendly and probably won’t have much time to talk, so you shouldn’t have to deviate much from your script. It’s a quick conversation.
8. That’s it! Say “Thank you” and hang up.

You did it! If you’re thinking “Hey, that wasn’t so bad…”, call more people! And follow up with them next week, or even tomorrow, to make sure they keep these issues top of mind.
It is okay if your voice shakes. It is okay if you feel awkward.They get a lot of calls, so they don’t have time to judge you by how well you delivered your message.
Is is also okay if you can’t call.
This week, my best friend told me, “Do something that is uncomfortable but not harmful to your mental health.” For me, calling was enough outside my comfort zone to be stressful & scary, but not so far away as to use up all my energy. That might not be the case for you, and that’s okay. Do not beat yourself up about it. There are lots of ways to take action without picking up a phone:

• Write to government officials
• Create art that challenges and art that inspires
• Donate, if you’re financially able, to organizations that fight injustice
• Listen to immigrants, people of color, women, trans and non-binary people, people of all faiths and sexual orientations, and people with disabilities. Support their work. Amplify their voices.
• Keep it up. 
  
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