March 1st marked Self Injury Awareness Day worldwide. Diabetes is a difficult disease to live with that affects us emotionally and psychologically as much as it does physically.
I’ve written before about the link between diabetes and mental health (particularly depression and anxiety), and Clare has written about burnout in diabetes but this time we thought it’d be important to dig down into one specific aspect of mental health, self harm.
For this post, we’ve invited a person with diabetes to write a guest blog, and they’ve done so anonymously.
Googling for any sort of link between diabetes and self harm tends to only yield results about insulin omission (diabulimia with or without the intention to lose weight). Many bloggers have written about this (as usual, Ninjabetic nails it), so I won’t repeat what she’s said, as I don’t have any experience in this area.
I can only speak about what I know, and regrettably, this is something I know about. We all know the old adage, Your Diabetes May Vary, and this applies particularly here. Having diabetes is stressful, life is stressful, and we all cope with it in different ways. Some people overeat, some people drink, some people take drugs, some people do all of the above, and some people do none of the above. And some people self harm.
As a girl, it’s pretty much impossible to make it through your teens without knowing someone who has cut themselves. Finding out more about it, you’ll read that people do it in moments of high tension when the emotions of a situation become too much. And some people find relief from it. This is where it gets complicated. As a person with diabetes, you’re constantly breaking your skin, drawing blood, inflicting pain on yourself. And by some strange logic, I felt that, if people are doing something like that to relieve emotional pain, and I do that every day, then maybe it might help me too. And so almost out of curiosity, I tried it. It is something I have sporadically done now, for several years, always in times of high emotional distress.
Eventually, and that’s with a VERY long inbetween, I decided to seek some help. Which for many people is a challenge in itself. I like to think I can be quite open about my diabetes, yet, opening up can be so, so difficult. I have a long history with my GP and diabetes team and yet, I found it hard to talk about the specific difficulties I was having. One of the recurring things I see on Twitter is people not wanting to disappoint their team (this, I guess, is a negative side of them praising you when you’re doing well). But I can’t stress enough, they are there to support and care for you in all ways, or at least signpost you to get help you need. Having said this, I actually bypassed them and self-referred to the Improving Access to Psychological Therapies (IAPT). This is available to anyone, and, even if you don’t end up taking up any of their services (such as Cognitive Behavioural Therapy or onward referrals), it can help to talk to someone who doesn’t know you about what’s getting you down.
We chatted a bit about non-harmful ways to get the same feelings of release, such as snapping an elastic band on your wrist, or holding ice in the palm of your hand. I am yet to try these, as my episodes tend to come on very quickly without warning, but I am keeping them in mind. There are loads of organisations out there which provide different kinds of support (Mind, SelfHarmUK, LifeSigns). Try and make sure any self harm specific social networking you do doesn’t end up triggering you.
As an aside: remember that us D folk are slow to heal and more prone to infection. So look after yourself, make sure you keep any wounds clean, and do not be ashamed to seek help if things start to look manky. Your doctor is there for you, not there to judge you.
Tips from the outside- how can I help my friend if I think they might be self-harming?
There is such a stigma around self harm, and you don’t get far in a conversation about it without someone calling it ‘attention seeking’ behaviour. This is such a damaging sentiment, and I can’t stress that enough. As a bystander, friend or relative, by adopting this attitude you risk completely alienating the person you are trying to be there for.
From my point of view, being asked about cuts and scars makes me feel pushed into a corner. It can unearth feelings of guilt about doing it, and secondary feelings of guilt from lying about what happened. How injuries happen isn’t something we like to talk about, so please, let it lie. We are probably feeling crap enough about it as it is.
Don’t panic. Yes, it’s scary, and yes it’s not nice to hear. But self harm is rarely a sign of suicidal intention. It’s a sign that we are struggling with a lot of feelings, but not that we are planning to end it all. Yes, suicide is more common in people who self harm, but this is probably due to a general skew towards mental illness within this group of people.
Don’t judge. Just be there. Try and find out how you can help them. Sometimes, the help you give them might be backing away and giving them some space. Make sure they are well supported before you do that. But keep in mind, they may be feeling overwhelmed, so you could even be part of the problem. Give them space to process what took them to that crappy headspace in the first place.