Snapchat® and Instagram® stories that instantly delete. Throwaway Twitter® accounts where anything goes. And anonymous “confession” websites, like the DiabetiConfessions Tumblr®, where people with diabetes of all ages can, as the site describes, “rant and rave and let out everything.” Social media has become a favorite gathering place for teens to share real, uncensored information about the ups and downs of life with type 1 diabetes.

And it’s not necessarily a bad thing. “Having a place to talk about the experiences of T1D and connect with others who are experiencing similar things is an important outlet,” says Aimee Folger, LICSW, a child and adolescent therapist from Needham, Massachusetts, who specializes in type 1 diabetes and chronic medical conditions.

Chatting anonymously or posting to sites where texts and images self-delete after a number of hours often appeals to teens who feel especially constricted in their daily lives, notes Austin, Texas-based therapist Marie Wallace, MA, LPC, whose practice focuses on counseling adolescents and young adults. “When teens hear a lot of ‘you can’ts’ from their parents, teachers, or doctor, this can trigger a need to find someplace to talk about these things and get feedback from others.”

Just what might you hear from your teenager if you were a fly on the wall of a diabetes confessional?

What Teens Are Saying — and What You Can Do

Browse the archives of the DiabetiConfessions Tumblr and you’ll find secrets ranging from the lighthearted to the heartbreaking. The excerpts below are paraphrased but reflect real sentiments expressed on the site.

Confession: I frequently fake low blood sugar to get out of stuff I don’t want to do.

Lows must be addressed, so parents must confirm whether cases of hypoglycemia are real and if so, that they’re being treated with fast-acting sugar. But if you’re concerned that lately your teen seems to be turning down more invitations or skipping chores or assignments, and the reason is always diabetes, it may be time to intervene. Says Folger, “First figure out the things your teen is trying to get out of. Are they associated with diabetes, or are they typical teenage activities that he or she feels negative about, like homework? Parents can encourage their teen to find other ways to cope with things in their life that they perceive as negative, but also explore their relationship with diabetes — what else is diabetes besides an excuse for them to use?”

Confession: When I’m mad at my dad, I don’t eat or I don’t bolus, but I tell him that I did. I feel terrible later, but I keep doing it anyway.”

“Some of the biggest mental health challenges associated with diabetes are related to the individual feeling like he or she doesn’t have control. A teen who feels out of control in many aspects of his life may seek to control a situation — in this case, trying to win an argument with Dad — by ‘punishing’ the parent by having blood sugars that are out of control,” says Folger. Parents can aim to ward off this dangerous form of rebellion by helping their teen find other areas that he can have more choice in and by identifying healthy coping skills the teen can use when feeling frustrated. “It’s all about helping the child feel more in control and empowered in their life,” says Wallace.

Confession: “My friend celebrates her diaversary with her family every year. It’s like another birthday. Why don’t my parents do this? I feel stupid asking them to help me celebrate the worst day of their lives… when they found out their kid was damaged.”

To Folger’s ears, this confession isn’t so much about the diaversary itself as it is about the child’s own guilt about her diabetes, and how she feels her parents view her diagnosis. “Guilt can be a huge part of T1D, whether it’s related to making a mistake, like eating something ‘bad’ and miscalculating an insulin dose, or to children feeling like they’re a burden to their parents,” she finds.

Children may also mirror their parents’ own feelings of guilt. “Parents may struggle with bringing up a diaversary on their own, not knowing whether their child wants to be reminded of it, just as a teen may struggle to initiate the conversation with his or her parents.” Take stock of what emotions you’re modeling to your child about diabetes, and don’t be afraid to start conversations that might not have easy answers.

The Trouble With Anonymity

Make one of your conversations about internet use. While giving voice to one’s frustrations can be a first step towards finding solutions, venting on anonymous websites can have some significant downsides. “Anonymity can be dangerous when these sites become a place to voice unsafe thoughts,” says Folger. The people your teen is interacting with might not have the best advice, or could be completely wrong in their feedback.

Another downside to internet-only interactions with fellow teens is the quality of the connections. It can be reassuring for a teen to hear that others have also felt shame around food, for example. But what then? “Posting may help a teenager feel connected in the moment, but it doesn’t create a sustainable relationship,” says Folger. In other words, once the buzz of getting some comments on a post fades, teens may feel more isolated and confused than ever.

If it’s been a while since you’ve discussed healthy social media behavior together, check out different sites with your teen and talk about their features and how they can be a help or hindrance for diabetes care and general safety. You could also talk about feeling connected with others teens with type 1 and brainstorm ways to strengthen real-world connections. Instead of anonymous internet sites, find in-person events or support groups that give your teen the important opportunity to truly feel heard and understood.

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

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