Diabetes and depression have a strong relationship that has been described as bidirectional by several studies. The most recent study followed over 65,000 women ages 50 to 75 for 10 years. The study concluded that participants who had depressive symptoms were at a higher risk for a diabetes diagnosis and those with a diabetes diagnosis where at a higher risk for a depression diagnosis. Regardless of how the two diagnosis' manifest, depression can significantly impact one's motivation and desire to make healthy choices. This is understandable. If you are depressed then you are not interested in exercising and eating healthy. You are not interested in putting forth effort to count carbohydrates or eat a salad rather than a meatball sub. So how do you cope with the heavy lethargic dark low feelings of depression and overcome the impulsive decisions that can have detrimental effects on your body?
Opposite Action (OA) is a skill that originates from Dialectical Behavioral Therapy (DBT). Its effectiveness is rooted in its simplicity. The concept of OA is to recognize those times when you are on the threshold of making an unhealthy decision such as eating a large piece of cake, and challenging that impulse with another action that is opposite. OA is not about fighting the unhealthy urge or impulse, OA is about challenging the unhealthy impulse with a healthy action. It is important to engage fully in the opposite action with your entire body. Remember, it is action. It is not thinking about what is opposite. The more you engage your body in the opposite action the more likely the unhealthy impulse will shift in to an emotional experience that is pleasurable and healthy. And OA takes practice.
So what is the opposite of eating a large piece of cake? The answer is unique to you and the situation you find yourself in. One time it may involve eating a sliver of cake, and another time it may involve leaving the situation and going for a brisk walk. On the other hand, if you do eat the large piece of cake there may be some temporary relief but the depression will deepen, often fueled by guilt or shame. But a series of opposite actions over the course of a day can have a positive effect on how you feel about yourself as a person living with diabetes. It puts you in control of diabetes rather than diabetes being in control of you.
Another example is getting out of bed in the morning. Often when you are feeling depressed It can be a challenge to start your day and get out of bed. OA in this situation is getting out of bed and if there is an impulse to isolate and stay cooped up in your house, then get out and do something.
OA has been helping people with severe mental illness for decades with depression and other emotional experiences such as anxiety and anger. It can be a valuable tool you can add you're your coping kit when you are challenged by the daily grind of having diabetes, putting you in control.
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