I was diagnosed with insulin dependent diabetes one month before starting high school. Upon my diagnosis, I thought about all the things I knew about diabetes, which basically amounted to what I had read about one of the characters from the book series “The Baby Sitter’s Club.” I knew my life would be different- giving injections, pricking my fingers, and having a really strict diet. One thing I didn’t expect, however, was the role diabetes would play in my interactions and relationships with others.
During my graduate studies in human communication, I studied the different variables affecting our associations with others. I was drawn towards researching the effects of chronic illnesses (such as diabetes) on relationships. Chronic illness can change every aspect of a person’s life, including social experiences and personal identity. I, of course, began to think about myself and how living with diabetes might have changed me and my relationships.
I have always been incredibly open about my diabetes, and find myself frequently explaining facts about diabetes, but I’ve never given diabetes the driver’s seat in my life. If anything, I probably underestimate the part it plays. I have never had anyone reject me as a friend, dump me as a romantic partner, or treat me like slacker coworker because of my diabetes, so I never considered the role that diabetes might play in my relationships. But living with diabetes does require some adaptation and planning. I thought about how having diabetes affects me, and then about how it might influence the people I love.
For example, although I felt great about my relationship with my mother and the way my adolescent life with diabetes had gone, when I asked my mother about it, she admitted that she didn’t. She was so afraid of “nagging” that she didn’t ask me much about what was going on with my body, and felt worried and left out.
I was surprised. My mom was angelic in helping me in my health care and I didn’t feel like she’d left me on my own. I’ll never forget the day I was released from the hospital after my diagnosis. We walked into our house, and neither of us knew what to do. We just looked at each other, and wondered out loud what on earth I should have for lunch. That meal of a sandwich, grapes, and carrots was the most carefully planned feast possible, and I enjoyed every bite of it. As the months passed and we both got into the routine of diabetes, my autonomy grew. I was fairly independent but still felt like my mom was there for me if I needed her My mom, it turns out, felt left out and worried. She knew I needed to take care of myself, but still needed reassurance that I was healthy and happy. Sadly, I wasn’t good at giving reassurances.
It doesn’t take an expert in personal relationships to know that successful and fulfilling relationships (family, friend, romantic) occur when both parties are comfortable with how things are working. One of the most common struggles in personal relationships is balancing needs that seem to contradict one another. For example, in the relationship with your romantic significant other, you want to feel close and connected while simultaneously maintaining some sense of individuality. In the example with my mother, what we should have worked out was how I could be independent while she could still have enough information to be comfortable.
These types of contradictions are at the heart of “relational dialectics” theory, which seeks to explain and define patterns of communication in interpersonal relationships (Baxter & Montgomery, 1996). When speaking about relational dialectics and relationships where there is chronic illness, one of the most common areas of concern is the contradiction of “Openness and Closedness,” the need to be open and share information versus the need to be exclusive and private.
With me, in the relationships with my family members, friends, and co-workers, I struggle with how much to tell. I want to explain things about my diabetes (i.e., why I am suddenly eating packets of table sugar, or why I am incredibly irritable or grumpy) because I want people to understand me. I don’t, however, want to talk about my health all the time. I also don’t want to be judged by my blood sugar levels or have people tell me what to do.
From the side of the relational partner of someone who has diabetes, the struggle is with knowing the diabetic has to take care of herself, but also wanting to be able to help and support. Usually the biggest issue for relational partners is not only the fear of being a “nag,” but also seeing their loved one in pain or hurting themselves (i.e., not taking injections or checking blood sugar levels).
Case in point: A few months after I got married, my husband timidly asked, “Have you checked your sugar level lately?” He asked because I was being a jerk driver, which is out of my normal range of behavior, and he had been trying to figure out how to delicately ask how I was feeling. (My mom and my husband have since discussed at length my various moods according to different glucose levels… They claim I turn into the Wicked Witch of the West when high, or get really stoic when low?)
I was so used to handling diabetes matters myself that I’d never thought about telling my husband about my blood sugar levels. I also didn’t really know the extent of my grumpiness, and subsequently didn’t think of how what I was feeling would impact anyone else.
These days I try to be a little more sensitive and have my relationship radar up, although I constantly find myself in opportunities where I can do better. I have to ask myself the chain of questions again… How does diabetes affect me? How does diabetes affect the people I love? What do I need, and what do my relational partners need? What do I tell? What do I keep to myself? Is it okay for me to ask for help in handling an emotional issue related to my health? How do I ask my friends and family if they are satisfied with our relationship? Will they really tell me if they feel like I talk about my health too much?
I don’t have easy or quick answers to these questions. Every person and every relationship is different. How you choose to handle things in one relationship might not be satisfactory in another. For all parties in the relationship, however, I do offer this advice: be aware! First think of how you are affected by diabetes, and how others might be affected. Be mindful of what is working and what is not. If you are the relational partner that is worried about the other’s health, say something. If you are the relational partner that needs more encouragement, speak up! Write a letter, send a text, or put your arm around your friend, spouse, parent, or child, and have a conversation. In reference to diabetes, what could make the relationship better? What needs to be shared? How can you both be better supporters of one another?
Satisfying relationships can provide comfort, protection, understanding, love, fun, pleasure, and happiness. Having healthy relationships is good for the soul and spirit, but also good for your body. Research has shown that people in satisfying relationships typically have better physical health, generally including a more resilient immune system, less drug and alcohol abuse, better sleeping patterns, lower blood pressure, stronger cardiovascular health, and increased capabilities for handling stress.
Having a positive foundation of support in your relationships is a crucial component of taking care of your health. I am far from perfect in the balancing act that is life with diabetes, but although I may wobble I know I won’t ever fall, thanks to the relationships I have with my amazing friends and family.
Baxter, L. A. & Montgomery, B. M. (1996) Relating: Dialogues and dialectics Guilford Press, New York, ISBN 1-57230-099-X