Manage the emotional, behavioral and pragmatics of life
by an Anonymous Parent and Dr. Carol Francis
Section: Juvenile Diabetes or Diabetes Type II in Children
Topics: Management of the Psychological Factors of Childhood Diabetes
My eight year old son loves mood rings—those heat sensitive, color changing rings that turn black if you are cold and supposedly nervous or upset or turn a beautiful shade of purple if you are tranquil and blue if you are in Nirvana---Awe!
My twelve year old is the son with Juvenile Diabetes and quite frankly I wish sometimes that we had a mood ring that would indicate when his blood sugar was about to make him miserably depressed or lethargic. Even more disconcerting is when is blood sugar spikes and so does his anger: irrational rageful moments when no reasoning in the world can get through. Twenty minutes pass and finally, his angry rampage will actually have lowered his blood sugar it seems and my son is back. My reasonable, affectionate and logically kindhearted son returns hardly remembering his cruel words or illogical aggressive gestures.
Before my oldest son was diagnosed with Diabetes, Type I, these moments were very puzzling to say the least. As a parent who adores her children and truly enjoys each moment I have with my sons, these moments of anger or depression seemed so incongruent with his personality and his knowing that he is much loved and supported.
Now that he has been diagnosed, these events of emotional extremes are easily traced to moderate or very high spikes or very sudden lows in his blood sugar. In all the training I have had through our excellent support hospital and the caring and thorough nurses, doctors and teachers, the mood swings associated with Diabetes, Type I in children has never been addressed.
Dr. Francis: Talking with parents on-line, in my office and in support-groups, the effect of high and low blood sugar swings on their otherwise reasonable, loving and usually quite cooperative children is quite frequently discussed.
I am a Clinical Psychologist and one of my specialties is children. I have been working with children, their parents and teachers for over 30 years. Depression, anger, cooperation, ADHD/ADD and academic complications are the most frequent reasons parents seek my assistance. Within the last 15 years, I have noticed a big change in how doctors and parents have become more alert to the impact of foods, sleep, and exercise upon their child’s moods, school performances and helpfulness. Now, as Juvenile Diabetes is more frequently and more easily diagnosed, we can now understand this and other disorders and their impact on a child’s personality, emotionality and behaviors as well.
As parents of children with diabetes, we are not only managing their insulin, blood tests, diet and exercise in order to save their lives and maintain the quality of their physical well-being. We are also managing their diabetes so that their personality and relationships will not be severely impacted by their emotional instability.
We as parents cannot afford to become confused or be personally offended when our diabetic children become irrationally angry, bursting in tears or agitated with worries. We need to harness ourselves during those 20-40 minutes of outbursts and figure out how to manage the moments when no logic, no words and no emotional comfort will have the desired calming impact. When we are able to manage our reactions to our children’s emotional and behavioral reactions to their blood sugar swings, we become more available to assist our children through their mood swings so that all the wonderful moments that will follow will not be destroyed or made worse by our poor reactions to their very difficult emotional outbursts.
No parent who does not manage Juvenile Diabetes can truly appreciate how very difficult it is to passage through these intense, irrational, extreme moments of anger or depression. But rest assured those of us that have wonderful children who are coping with all the management issues associated with diabetes know what you are going through.
Here is some advice for managing the moments so that once your child’s blood sugar returns to normal, so too can your relationship and your household.
First, never take the moment personally. Do not concern yourself with the words, accusations, attacks, or blames that might pour forth during those 20-40 minutes. Please remember that when these blood sugar highs and lows occur, your child’s brain and therefore his/her personality is entirely bathed in chemicals that will trigger the most primitive, emotional and aggressive portions of his/her brain.
Second, manage your child’s words and behaviors in a manner that keeps your other children, you and your spouse at a safe distance especially if impulse controls are temporarily too low to prevent physical aggression from occurring.
Third, make sure your child having the outburst is safe both from himself/herself and from your own personal inclination to get angry in a self-protective or defensive manner. Remember, you are human too and when someone is anger at you in an unfair manner or in an excessive manner, you may also have a brain bath of chemicals that propel you into a fight or flight pattern. Therefore, remind yourself to remain calm and disengaged from the emotional provocations that your child is hurling at you and also disengage from the emotional reactions that are being stirred up inside of you.
Fourth, do not try to discuss the issues that your son or daughter is bringing up during these crazy emotional moments. Rather, reassure them that you love them and that you will discuss everything when they are calm. Later, when all is calm, let your child know that when they have these extreme moments that you know they cannot discuss or solve the issue with you right then. Remind them that you will discuss or solve those issues as soon as everyone returns to normal.
Fifth, as a parent you are primarily a teacher. You will need to help them learn to manage their own emotional outbursts due to high or low blood sugar. Your child will likely enter into relationships with their co-workers, friends, spouse and children and need to know how to manage these moments so that their relationships in their future are not permanently harmed by these extreme moods. So, as their teacher, when your child is in a reasonable state of mind, teach them how to isolate themselves, giving themselves time-outs when they are angry for example. Next, you can teach them how to discharge these emotions without causing any harm; they can hit pillows, exercise, go for a run or twirl in circles—anything constructively physical--as alternate ways to discharge their energies at those times.
Sixth, as their teacher-parent, you want them to develop a consciousness or a conscience about never letting it be okay to physically or verbally hurt others. You want to teach them that in these moments, when their emotional brain-centers are triggering wildly, they have other portions of their brain policing them and stopping them from hurting others. They need to have ingrained in them that they cannot direct their angry actions toward anyone. Teach them to talk about their angers when they are calm and in a problem-solving frame of mind. Also, you want them to be aware these moments are short-lived and need to be passed through with minimal damage created so there are no regrets for anyone.
Seventh, remember that you do not want to do or say anything during this time that you may regret as well. Remember that you need to manage these moments for everyone’s emotional and physical safety. Do not say or do anything that will actually aggravate the moments and make things worse then they have to become.
Do not choose these short-lived moments as the time to teach a lesson or to drive home a point or to tell them anything that they actually would be pained to remember later. They can not think clearly during these moments anyway, so save your breath and efforts. When you can later discuss with them how to manage these moments, avoid describing their behaviors or words as truly fundamental parts of their personality. For example, you might be tempted to say, “You are such an angry child!” “You are out of control so much!” “You need to be severely punished for not stopping when I told you to.” “You are so mean!” “You are so unreasonable.” These moments are not who they are typically so help them realize that their self-definition is not based on these brain-glitch moments.
Keep to the plan of teaching constructively and with solutions in mind. Do not teach with accusations, shameful descriptions, blame or demeaning pronouncements—you will harm your child’s self-perception and actually reduce their ability to skillfully cope with these moments.
On the other hand, do not coddle your child and let him/her feel that they are not responsible for their words and actions. Instead, practice how they can manage their extreme moments in a manner that works for them. This gives them the tools to be responsible even when they are crazed by the chemical brain-baths associated with extreme spikes in blood sugar.
There are many other ideas that parents of children with Juvenile Diabetes need to share about how we manage the emotional, behavioral and pragmatics of life. Don’t feel embarrassed; seek solutions to your dilemmas and worries—that is what good parenting truly is!
Finally, enjoy your days with your children. These days are short lived anyway—not because they are diabetic but because they will grow-up very soon and create lives of their own. Hopefully, they will always remember that YOU HAD THEIR BACKS AND STILL DO!
For more help, information and support-group opportunities regarding Parenting Children With Diabetes, please contact Dr. Carol A. Francis at 310-543-1824.