Q: Our teenage daughter was recently diagnosed with type 1 diabetes. Since then, we’ve noticed her outgoing personality shift to become much more shy and introverted. Are these kinds of behavior changes normal after diagnosis? What can we do to support her?
Maureen Monaghan, Ph.D., C.D.E., is a psychologist and behavioral scientist for adolescents and young adults with type 1 diabetes at Children’s National Hospital in Washington, D.C.
Disclaimer: The information in this article is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
A: When a child or teen is diagnosed with type 1 diabetes, there is no one way kids are expected to respond — and there is no right or wrong way either. Adjusting to diabetes is different for every teen. What you need to know as a parent is this: However your teen responds is normal.
With that said, teens often do feel worried or anxious right after diagnosis. They may be concerned that they won’t know how to handle their diabetes in their usual school and social settings, or they may struggle to adapt to the daily demands of diabetes and changes to their routines. Even the most outgoing of teens may withdraw from sleepovers, sports, and other usual activities as they figure these things out. If a teen experienced anxiety or depression in the past, these issues can resurface.
There is a whole year of “firsts” associated with type 1 diabetes — first Halloween with diabetes, first day back on the sports team, first time going out with friends for pizza. Some teens go into “survival mode” right after diagnosis and have a delayed emotional response to their diabetes. Parents may notice changes in their teens only after they hit certain milestones, sometimes months after diagnosis.
To understand what could be at the root of your daughter’s personality shifts, start asking more open-ended questions about how she’s feeling about diabetes and life in general. Really listen to the responses you get. Maybe it will come out that she’s feeling shy because she doesn’t know how to explain diabetes to her friends, so she’s started to avoid them. Once you understand what’s going on, you can help her make a plan — for example, helping her create an “elevator pitch” to communicate about diabetes with her peers.
In keeping the lines of communication open, avoid making assumptions. If your teen is not showing up at the nurse’s office for her pre-lunch injection, for example, don’t assume it’s a fear of needles or avoidance of her type 1 diabetes care driving this. It could come out that she has Spanish class right before lunch and missing the last 10 minutes of class is making her worry about keeping up.
Whatever is happening in her life, match your support to fit her needs. It could be that what she needs to hear in the moment is simply, “Yeah, I know it’s hard. Let’s figure this out together.”
Sometimes getting the help your teen needs involves reaching out to your diabetes care team. If you’re noticing issues such as persistent sadness or anger, fear of site changes, or marked mood swings, your care team can provide added support and resources to help your teen cope and adjust.
How Other Parents Deal
“I could tell that my son felt hesitant to share about his T1 with his friends, and it was making him feel isolated. So here’s what we did: We had a sleepover! He asked his closest buds over for the night, and over the course of the evening — we went bowling, out for burgers, and then watched movies at home before lights-out — his friends saw blood sugar checks, carb counts, and bolusing in real time. That night showed his friends that nothing had really changed. Jake just had a few extra things to do that they did not. They were curious and asked questions, but it was all so natural. For our son, that night was a game changer for helping him feel so much more comfortable talking about his T1.”
—Lora A., California, mom of 14-year-old Jacob