Chronic disease and psychotherapy. Diabetes melitus as a defense to life changes and mourning

Background

Anxiety disorders and depression are common clinical psychiatric manifestations when Diabetes is diagnosed and for a short adjustment period at the beginning of treatment.

Materials and methods

Our clinical material was consisted of: seven diabetic female patients aged 19–32, diagnosed around the age of 16 and had a moderate adjustment to the treatment. A sudden severe dismissal of doctor treatment suggestion had been observed to the extent of serious pathological problems to be presented hence a psychological support was advised.

The treatment consisted of once a week individual psychoanalytic psychotherapy at the AHEPA Psychotherapy Unit and the duration was 14–32 months.

Results

It was found that important changes of the patient's lives which were felt to be welcomed and happily accepted (marriage, pregnancy, success in studies) were the trigger of the emotional disturbance hidden under the non-compliance to the existing treatment for their condition.

Discussion

Fear of hypoglycaemia, helplessness, hopelessness, anger and sadness around the chronicity of their disease came up at the beginning of the therapy. Denial, repression, projection and regression were permanent and the basic conflict was around femininity issues and the patient's maternal role along side with separation anxieties and difficulties in mourning.