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The holiday season is supposed to be filled with a lot of great feelings. Warmth and coziness from a hot beverage on a cold day. The excitement of watching someone open a gift you gave them — or opening a gift yourself! But holidays can also be filled with grief, loneliness, emptiness, or sadness that comes with the death or health decline of a loved one.
The holidays can magnify grief because of the (mis)perception that everyone around us is joyous. The truth is grief is a common experience. You’d be hard- pressed to find someone who hasn’t lost a loved one at some point in their life.
Despite grief experiences being common, T1D doesn’t take a break for anything. People live with T1D, which means people experience all the ups and downs, including grief, while managing T1D. When you’re dealing with T1D, the grief experienced by a loss — especially around the holidays — is compounded with additional stress, additional emotions, and additional challenges of having to continue to manage a complex illness to keep going from one day to the next.
One of the most difficult things about grief is —even though it’s a common experience — grief is different for each person. There is no way to predict the grieving process. Even experiencing the past loss of a loved one doesn’t provide much insight into how you’ll deal with your next loss.
There is no right way to grieve
What research does show is there is no right way to grieve. There are no set stages that everyone most go through to accept a loss. There are no set timelines for when things will get better — although, we do know that people who are bereaved usually learn to live with their loss over time. And there is no set of emotions or behaviors that one must exhibit that showcases ‘real’ grieving.
Grief does make daily life extra difficult. It may be harder to sleep. It may be harder to eat like you normally would — either having no appetite or eating too much. It may be harder to have the motivation to take care of yourself — like less motivation to shower, to go out, or to do anything at all.
Grief is not just about feelings
Grief is (partially) a physical process that involves the body’s stress response. Grief impacts the immune system by increasing inflammation and reducing resistance to other illnesses. Dealing with the stress of grief also wreaks havoc on many hormones and can make blood glucose (BG) unpredictable or difficult to manage.
A lot of this has to do with cortisol and its effect on blood glucose. Too much cortisol means insulin resistance that leads to high BGs— which can mean you might need some urgent fine-tuning to your insulin doses with support from your healthcare team.
But it’s not all about highs. Sometimes cortisol levels get exhausted by prolonged stress (yes, your endocrine system can get burnt out, too!). Eventually, when your cortisol is depleted, BG levels dip as your insulin resistance shifts and your insulin doses need a reduction.
What are you supposed to do about a physical process where its sole function is to make your daily diabetes life harder during an already difficult time?
Cut yourself some slack — especially if your BG isn’t cooperating
Sometimes in your life ‘good enough’ T1D management is good. Unless you find yourself experiencing dangerous lows or dangerous highs, you are likely doing enough to manage your T1D considering your other needs. Don’t beat yourself up for imperfect BGs during a really stressful period in your life.
Your BG readings will probably be wonky during this period of increased stress. Try to remember the biological processes you’re up against, accept that you’re doing your best, and – as long as you’re not putting yourself in any immediate danger – be okay with letting go at least a little bit.
Because adding more stress to yourself during this already difficult time is certainly something you don’t need.
Take care of yourself as much as you can.
Grief can make it difficult to engage in normal routines. It can be difficult to sleep or to eat. When you have T1D, not sleeping and not eating will also impact your BG and your health. It’s not easy to just not eat if you don’t feel like it or not worry about what you’re eating. Instead, try to simplify your routines.
Simplifying a routine will look a little different for different people. For example:
- If you have difficulty eating, try creating a schedule.
- If you find that your food intake is much more erratic (e.g., more food, different foods that you don’t normally eat) and it’s impacting your BG levels, try eating meals that you’re more familiar with and can predict their impact on your BG more easily.
- If you have difficulty sleeping, try different ways to practice good sleep hygiene and get in rest in whatever ways you can.
Look to others for support or whatever else you need
You can rely on others in your social circle for support. Maybe it’s your romantic partner, a close friend, or a family member who offers you a meal, a conversation, or just a distraction. All those things can be helpful.
You may not be up for socializing. It may be hard to see the people or go to the places that remind you of the person you lost. That’s okay, too. But you don’t have to stay isolated. You can find support in other ways.
Beyond your immediate social circle, there are many people in the T1D community who have experienced grief. You might find some of their experiences may provide you with comfort in knowing that you’re not alone in having to deal with so much at once. Sometimes just knowing that there are other people out there who really get it — even if they’re not in your day-to-day life — is especially comforting. For one person’s story, check out Andrea’s video over at She’s Diabetic.
Reach out to your providers or professionals to help
If you are struggling to keep your head above water with T1D as you’re grieving, your healthcare team can help. A little boost in basal insulin, for example, can have a big impact on how much work it takes to stay in (or near) your goal range and let you spend more time taking care of yourself in other ways.
Your healthcare team may have additional resources for you available in your area or even in your provider’s office. Your health care is about your whole health — and that includes your emotional and physical well-being as you’re grieving. So don’t hesitate to get professional recommendations for managing your T1D and managing your grief.
Remember you’re not alone in this.
This holiday season, if you’re grieving — whether that grief is fresh or refreshed from years past — I hope you’re able to remember that you are not alone in what you’re feeling. No one can quite understand exactly what you’ve lost, but there are people who understand that loss is hard. And there are people who understand that loss is even harder when managing T1D.
Need support right now?
Call 988 for the free Suicide & Crisis Prevention Hotline.
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