Severe mood swings with type 1 diabetes in adult woman

I've just moved in with a woman with T1 diabetes, who is also a single mother.  Unfortunately, for me the mood swings are becoming intolerable. About 1 or 2 days of the week, she is extremely happy and possitive. 3 to 4 days a week she is extremely down and will not engage in conversation or do any activity other than watch TV.  About 1 or 2 days in a week she is on a war-path slinging abuses and accusations of mistrust.  

What are the options? No support group exist in this region, but mental health care does exist. How do you convince someone to pursue help, especially someone that is tired of seeing doctors?

[JDRF-Team-sgg]

I am so sorry that your friend is having this emotional seesaw problem. I am hesitant to blame her mood swings entirely on diabetes, for many type 1 diabetics are even-tempered and happy people, but I DO want to tell you that many parents notice that their type 1 children are irritable or hyperactive or just "not themselves" when glucose levels are either high or low. So my first suggestion to you is to encourage her to try to even out the glucose levels. Even if this is not the real cause of her emotional issues, it may help her feel more in control and also may help alleviate depression or feelings of irritability. I, too, am a type 1 diabetic, and I have been very tightly controlled ever since the birth of my first child 26 years ago. I tightened up the control even more when some of the newer insulins came out and I was able to switch to an insulin regiment that very closely matches the digestion time of my meals so that my sugars no longer vary much from the normal range of 70-126. I find myself a much happier person now that my sugars are so normal, and I can attest first-hand how depression is one of the symptoms of low glucose levels. I cannot tell you how I react to high levels, for I don't really have them.

So my first point is that some of the problem may be due to glucose ups and downs. If you are able to converse with her at all, you may want to ask her what her levels usually run and you may want to encourage her to work hard to get them to normal as often as possible.

Now, all of that being said, depression is something that is fairly common among all people with chronic illnesses. We deal with chemical imbalances that can cause physical depression as well as the emotional drain of chronic illness. Many doctors believe that ALL type 1 diabetics should be treated for depression, so I think that it would be easy enough to get her doctor to make a recommendation that she be seen by a mental health care professional.

My bet is that she is aware that something is not right. My bet is that she would like to be happy and even-tempered. People usually do NOT enjoy being irritable, moody, or depressed. So my advice would be to try to find a time when she seems receptive to discussing this, and to gently encourage her to go first to her endocrinologist and to ask him for a referral to get help. Tell her about this posting, and that you asked this question because you care about her, and tell her how common it is for type 1 diabetics to need some help with the emotions. And tell her that her glucose numbers may have a huge effect on how she feels emotionally. She may not even be aware of this, for it is often not as apparent to the patient as it is to the observer that there is a difference in moods when they are OK vs. when the glucose levels are "off".

I am not a doctor, but I have been involved with the Juvenile Diabetes Research Foundation for several years, and I have seen case after case of people who need emotional help, so she is NOT alone, nor is she unusual. I do believe that help is going to be found in a combination of tightening up the glucose controls and also having her checked for chemical imbalances in the brain that cause depression. I believe that the incentive you are asking for is actually that she probably WANTS to feel better.

Being a single mother is a huge stress in and of itself, and I feel for her. Some of the mistrust and anger may not be due to any health issue at all, but may be the result of previous pain in a relationship. The cure for this is also counseling. I would suggest that she get the health issues as perfectly controlled as is possible (including any chemical depression) and then perhaps once health is ruled out as a possible cause, any pain in her past needs to be addressed by a counselor.

My last suggestion is that if you can get her to see a counselor, you might want to go with her the first time, and make sure you tell the counselor about the ups and downs. Bipolar disorder is characterized by ups and downs that are fairly regular patterns, and sometimes this is not diagnosed until it becomes severe. Perhaps she should be checked for it, for it is very treatable once a diagnosis is established.

If she cannot be motivated to do this for herself, she may be able to be nudged to do this for her child, for an upset mother cannot properly take care of her child. This might be the incentive that motivates her the best.

Kudos to you for caring for her enough to ask for help with this issue. I wish you the very best in getting her to seek help.

[Plaxibo]

Diabetes can change a person.  But what you describe sounds like Bipolar disorder.  I am not a doctor though.  There are a lot of treatments available for mood swings.  Get her to a psychiatrist and (s)he probably can send her to a support group.

I have had type one diabetes for 16 years and my parents tell me I am a hard person to predict.  I mean predict what my mood will be on any single day hehe.

Mark B.

[dcole]

Her blood sugar is anything but stable.  About once or twice a week, she goes hypo or hyper.  I'm not living in America and the medical situation in this country is a bit more primitive (accessible but primitive). She does moniter her blood regularly, and her diet is not so terribly bad, but still she goes out of balance easily.

Getting her to go so a professional is hard (a thing that is considered a bit taboo in this country).  We've had 6 months in a tense relationship because we bought a flat together. Before this I mostly just saw the "good and happy person."  After we moved in, it was impossible to hide the negative side.  

I read about comorbidity problems with bi-polar disorder.  She doesn't have the extreme highs assoiciated with mania, but sometimes the "happy times" seems to be a bit abnormally high. (These times are great, because everything is perfect and we can plan for the future, and we enjoy each others company).  Unfortunately, these times are become less and less.  

So that is the situation. Any further comments would be helpful.  

[JDRF Team SGG]

While moods can be affected by glucose highs or lows, I am truly hesitant to blame noticeable mood swings on diabetes alone. Your friend's situation does sound more like bipolar disorder than simple high or low glucose. If the main problem is the high or low reading, the mood should pretty much go away after the person's sugar is normalized. For instance, if I get hypoglycemic, I may feel depressed while low, but as soon as my sugars rise back to normal, the helpless feeling or depressed feeling goes away. From what you write, it does not sound as if her moods noticeably improve when the high or low is fixed.

As for how to get her to agree to see a doctor, no one can force an adult to get emotional help even if it is very obvious that it is needed. All you can do is to gently or firmly (depending on the person) encourage her to seek help. As far as any stigmas against getting medical help for emotional problems, this should be just between her and her doctor and if so, she needn't worry about how others will feel about her seeking emotional help. From what I have read about bipolar disorder (some members of my extended family suffer from this problem), it can be very difficult to live with someone with this disorder unless it is treated. Keep nudging her, and we hope she will listen to your suggestion that she seek professional help.

[gswank]

Having been a type 1 diabetic for 47 years I can attest to the fact that blood sugar variations can and does lead to massive mood swings, irritability, hyperactivity and depression. Even with the new insulins Type 1 is not easy to control as physical activitie burns carbs like crazy then inactivity doesnt, so your blood sugar is constantly changing. Stress also affects blood sugar levels. Excitement produces adrenilin which will cause you to burn energy, stress does just the opposite. The mood swings can be drastic. God Bless you all. Gene

[zberlin]

I've been dating a 30 yrs old woman with diabetes type 1.  I completely agree with you.  I've never been through such a roller coaster relationship in my entire life. Can one attribute it to diabetes?  I don't know but it's tiring to be the recipient of such emotional abuse

[zberlin]

my relationship with this woman finally ended not long ago.  I loved her dearly. I really wanted to marry and have a family with her.  I saw a beautiful and wonderful person deep deep deep deep deep deep deep inside.  I was tired of the emotional roller coaster. I tried my best to make things work.  But everything became impossible.  The abuse became unbearable. I don't deserve this!!! I completely shut down. We completely shut down

I am at peace.  Finally!!!!!

I wish Lisa the best and may she find the man willing to stand on one toe for 8 days for her.