A Chronic Illness Is a Full-Time Job—and It’s Messing With My Mental Health

But I’ve also been stockpiling the emotional burden of my disease. “Diabetes is a job, and it involves work and effort,” says William Polonsky, Ph.D., a certified diabetes educator and president of the Behavioral Diabetes Institute. “The vast majority of managing diabetes isn’t what your doctor does; it’s the stuff that you do every day. There’s no pay, no vacation, and you have to do it forever.” Sometimes that means dealing with low blood sugar right in the middle of an important meeting, driving, or even having sex—not exactly times when you want to hit the “pause” button for a minor medical episode. Being “present” often requires me to be two places at once: doing whatever I’m doing, and simultaneously keeping an eye on my diabetes quietly ticking in the background.

With a chronic illness, even something as simple as going on a date has an added layer of complexity. I could usually make it through a couple of dinners without anyone noticing that I was checking my blood sugar (not just my phone) under the table, but if things got hot and heavy, there inevitably came the moment when I’d have to fess up and explain that I may have to stop midromp to check my blood sugar.

When I was in my teens and twenties, I tried to pretend my diabetes was a peripheral part of my life—I wasn’t ready to own the fact that I had a permanent, chronic illness that could result in very real complications like kidney failure, eye disease, neuropathy, or heart disease if I didn’t maintain well-controlled blood sugars. Unless I was with close friends or family, I often hid my blood glucose testing and insulin delivery.

But downplaying it, of course, didn’t change the fact that I do have diabetes. What I couldn’t quite bring myself to admit until recently was that I felt an intense loneliness attached to my disease. I hated the idea that my condition could slow me down or spoil the fun. While other people my age were eating whatever they wanted and partying their faces off, I knew that for every drink I had or handful of fries I ate, it could mean I’d be on a blood sugar roller coaster for hours afterward.

Now that I’m in my thirties and actively planning for a future with my partner, I’ve been forced to look at the emotional toll my diabetes has taken on me—and I’ve realized I’m just beginning to understand another layer of my already complex disease.

Learning to Carry the Mental Burden of Chronic Illness

The daily stress of maintaining healthy blood sugar levels might seem like a small thing to people who don’t experience it—even I tried to write it off as general “life” stuff for a long time, piling it alongside things all young adults deal with, like building a career, paying bills, and navigating relationships. But all the blood sugar math, and finger pricks, and stress over what’s on my plate really add up. Going for a run, eating at restaurants, getting dressed, traveling, driving—heck, even having my period—all involve additional checklists to ensure my glucose is in control and I can be comfortable. Plus, managing diabetes is expensive. It’s a lot to keep track of.

I’ve been lucky so far to have not developed any serious physical complications, but it’s become clear in the past few years that a large part of my emotional turmoil—acute anxiety, worry about money and safety, fear of making mistakes—is, and always has been, directly related to my diabetes.