Diabetes is challenging enough to manage at the best of times. But we are not in normal times. Covid-19 has turned our worlds upside down.

I am only just about managing my emotions regarding this world crisis and I don’t have a long term condition to grapple with on a daily basis.

I had to go into 14 days of quarantine, even before lockdown started. I was probably in a form of shock for most of that time although I didn’t realise at the time, to what extent.

So what can I, as a psychiatrist, who is also experiencing distress, offer you as my five top tips to help you navigate your way through this storm?

1) It is really important to accept that your emotions are normal.

It is normal to feel:

• Shock
• Denial
• Fear
• Anger
• Frustration
• Hopelessness
• and much more...

You may be worried about your loved ones and your own health. You might be worried about getting food or medication or getting access to healthcare for your diabetes as well as contracting Covid-19. 

It is normal to go through these stages of emotions. We all do it and most of us do move through the stages. And we can also go backwards and forwards between these emotions.

You might find you are feeling different from others in your family. That’s ok too. We are all different and cope differently at different times.

Every time I feel overwhelmed or angry or despondent, I try to think of the change curve (see below) and where I am on it. This helps me to remember that this is normal and that it will pass.

2) Only spend energy worrying about the things you have control over. 

Make a list of the things that you are worried about and write these in two columns:

a) all the things you have no control over

b) all the things you do have control over

Make a plan to deal with the things that stress you out in column b, the things you can control.

For example, you have no control over the government advice to self-isolate, or the fact that you may be in high rise block of flats with no garden. You probably can’t change that. However, you might be able to control how you spend your time whilst at home.

 I know it is much harder to stay connected with people who make us feel better at the moment. But we can still do this. Pick up the phone. Send a text. Start a conversation. One small step at a time if that is the way you need to do it. You can also try to minimise connection with some of the relationships that drain you or make you feel bad.

And you definitely do have control over your internal world. Your mind. So that brings me to my next top tip.

3) Try to practise mindfulness

Mindfulness is a meditation practice that helps you to concentrate on the here and now and to be in the present moment. In other words “yesterday has gone, so there is no use worrying about it” and “tomorrow isn’t here yet, so don’t worry about it”.

This is much easier said than done. But help is at hand.  At the moment, there are lots of free resources that can help you do this:

• Apps
• Audios
• Videos
• Reading material

Start with one or two minutes and build up. And don’t worry if you don’t get it straight away. Every second you can be mindful is a success.

4) Be kind to yourself

That means:

• Don’t beat yourself up if you end up comfort eating or your sugars are a bit higher than you would like. The more you do that, the more your stress hormones rise and these stress hormones actually make you more likely to want to reach for more comfort food. It is a really unhelpful cycle.
• Don’t beat yourself up if you haven’t managed to clean the house or use your isolation time more “productively”.

There are lots of self-compassion resources available for free and I really like this set of audio resources on compassion.

The Self-Compassion App is for you if you want to feel happier, calmer & more connected. Whether you get caught up in cycles of stress and anxiety, regularly give yourself a hard time or struggle to relax and enjoy the moment – this app can help.

Remember: you are adjusting, like the rest of us, to a huge shock.

5) Get help if these tips don’t help much

We know that many people will get through the process of adjustment, but a significant proportion will need more help and that is normal.

If you are finding that you can’t function, carry out your day to day duties or sleep properly, for more than two weeks, then you may be experiencing depression or anxiety that would benefit from more support. Some people may find that they are using drugs or alcohol more, in order to cope.

Some people may have more extreme symptoms for example, of post-traumatic stress disorder or psychosis or feeling suicidal.

If you are struggling, please seek support.

Contact your GP or health care professionals. Mental health services, self-referral talking therapies and GP surgeries are open and available to support you, even if it is over the phone. Diabetes UK also has a helpline.

Or if you would like to remain anonymous, Samaritans are available to call 24 hours a day, free on 116 123 from any phone.

Please don’t suffer alone.

Conclusion

Not all of my tips will apply to you or will be possible. But I hope you have found at least one thing that makes sense to you, that you can grab hold of and have a go at trying. I know it may sometimes feel like the challenge is too big. I have been there too. This is why I love the phrase “eat the elephant, one bite at a time”. What is stopping you from taking your first bite?