Individuals with diabetes may struggle with various symptoms caused by high or low blood sugar. High blood sugars tend to cause depressive feelings and mood swings, while low blood sugar may cause scattered thoughts while extreme lows can even cause hallucinations and delusional thinking.
It was November of 1989, my freshman year of college; I had just passed the clock in the center of campus when I felt weak. As my legs gave out, I tripped and fell. My blood sugar had dropped to 17mg/dL, and I didn’t have any glucose on me. Luckily, I had gotten some strength up and stumbled my way to the campus restaurant where I downed a glass of juice and recovered.
While working as a diabetes focused psychotherapist, I have listened to multiple stories involving delusions and hallucinations during extreme low blood sugar reactions. I have also experienced that state mind during my last low blood sugar that landed me in the hospital.
It was 1994 and my last year of undergrad, and I had just turned 21 years old. I was studying for an exam one afternoon in late October, and it was 3pm. The sun was glaring as it entered my bedroom. I remember looking at the clock. The clock read 11:00 pm and as I believed it was time for bed I went downstairs to the bathroom and brushed my teeth.
In reality, I froze at the bottom of the steps, and I spent five minutes staring at my roommate. Then I turned around, went back upstairs to my room and went to bed.
At 4pm, I awoke to demons in my room. They strapped me to a board of wood, carried me downstairs and out the front door. After they take me outside, I notice my roommate waving goodbye as I'm being put into a hearse. Just as I thought I was dead, I awoke in a cold hospital room, connected to a glucose IV.
These examples show how low blood sugars can impact us physically and change our perceptions of the world around us. High blood sugars can also affect us physically, psychologically and emotionally.
High Blood Sugars
For individuals with type I diabetes and some who have type 2, high blood sugar put them at physical risk due to ketones. As high blood sugar levels continue to increase above 250, the liver can start failing, causing ketones to seep into the bloodstream.
Ketones are a mild form of acid released from fats, to prevent starvation. When they release into the bloodstream, they build up til you become so saturated with acid that ketoacidosis occurs. Ketoacidosis is a toxic physical state that has a high mortality rate in people with type I diabetes, and some who have type 2.
High blood sugar levels in the bloodstream negatively impact cognitive functioning of the brain. The higher one's blood sugar goes, the more the brains ability to process information decreases. If blood sugar stays high for extended periods, then many issues occur, from destabilizing emotions as notes by symptoms of depression to poor judgment and decision-making. Everybody experiences different symptoms, but the outcome is usually the same making the relationship with oneself and others more difficult.
So What Now?
If you are having multiple reactions a day due to overly tight management, then set your target range higher. Getting an A1c of 7 is better in the long-run than the impact of daily multiple low blood sugars. Everyone's issues are unique. If you are struggling to manage your blood sugar levels, scheduling a session with a Certified Diabetes Educator (CDE) may help. Fear of low blood sugars may cause some people to keep their blood sugars high, in this case seeing a psychotherapist who specializes in phobias or diabetes could help.
Working toward better blood glucose management always helps.
If you are unsure of what is wrong, whether it's having trouble getting blood glucose under control, depression or anxiety, scheduling a session with a psychotherapist who focuses on diabetes care can help. As a practitioner who specializes in diabetes psychotherapy, I take a holistic approach addressing all areas, including how the condition impacts you physically, psychologically, and emotionally. I work clients to target various aspects of their lives with the goal of helping them to thrive and better manage a life with diabetes.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist, diabetes-coach, presenter, and writer. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.