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Sunday, January 23, 2011

Diabetes and Marital Conflict

Depression due to the psychological stress that a diagnosis of diabetes brings is quite common. This manifests as a feeling of sadness, confusion and helplessness.

Anger against self and others due to the perceived ‘ill luck’ of developing diabetes and having to follow a particular dietary pattern is also manifested in some individuals with diabetes, while some others are thoroughly embarrassed about having to carry about their medications and blood sugar monitoring equipments and give themselves injections at very odd places.

All of these can definitely lead to stress and conflicts in relationships that individuals with diabetes are involved in. It is indubitable that the social and emotional support accruable from functional marital and other relationships goes a very long way in improving the rate of recovery from illnesses.

Individuals with chronic disorders like diabetes who have very supportive relationships are able to adapt better psychologically to the condition and engage in more healthy behaviours that will lead to an improvement in their clinical condition. The other side of the coin is that in which there is a great deleterious effect on health as a consequence of marital conflict with associated manifestation of unhealthy behavior and poor psychological adaptation by the individual who is ill.

The diagnosis of diabetes as does other chronic illnesses can lead to a dysfunction in family dynamics if not properly handled. Hence, as in all human relationships, thoughtful words and rational communication can help to ameliorate the physical and mental stress associated with the management of diabetes.

Science has clearly proven that hostility between couples does impair health while thoughtfulness between couples has potential health benefits. It has also been proven that stress, whatever the origin, not only raises the blood sugar level, but also impairs health generally. Individuals with poorly controlled diabetes will then do well to ask themselves; is my poor blood sugar control due to disharmony in my marriage or due to work and financial stress?

A study christened IDEATel that compared higher marital stress and diabetes outcomes concluded that higher marital stress leads to poor blood glucose control and higher depression while lower marital cohesion leads to higher blood pressure levels.

How else does marital conflict apart from increasing the level of stress hormones lead to poor blood glucose control? Certain unhelpful behaviours that may hamper blood glucose control have been identified in the spouses of individuals with diabetes. Principal among these is nagging about diet in individuals who are yet to comply with dietary advice. This constant criticism raises the stress level in the person with diabetes with consequent elevation of the blood sugar level. Others include poor communication and poor support.

Helpful behaviours include general relational support, reminders about medication and exercise, hospital visits and dietary support which include food purchase and preparation. Spousal support can thus lead to improved knowledge about diabetes, better blood sugar control and reduced stress level.

Individuals with diabetes should involve their spouses in the day to day management of their diabetes while spouses should not be overly worried to the point of distraction about the health status of their partner as it may be counter-productive. One must however sound a word of caution here that some individuals with diabetes, especially of the male gender sometimes carry their carefree attitude too far so as much as to cause an unnecessary death.

It is known that for many people with diabetes, the strain of living with it does not put any stress on their marital relationships, while it does in some others. For those that are currently having poor control due to marital strain and stress one cannot but ask, do you want your blood sugar to be under control? Then improve your marriage!

When you do fight, be careful with your words, if the words used are strong ones, they not only damage your health but your partner’s too. Family equilibrium should be maintained by avoiding recriminations and attributions of guilt especially in the area of diet.

Thank you Dr Olubiyi Adesina, Consultant Diabetologist/sunnewsonline.com

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