A few years back, a parent came to me in crisis. The parent’s fifteen-year-old daughter, Kristen, was struggling to care for herself, and didn’t seem to care. Kirsten was failing school, on the verge of being held back, not checking her blood sugar or taking her insulin consistently, and contemplating suicide. Kristen had Oppositional Defiant Disorder, a psychological condition marked by extreme unwillingness to follow the rules or listen to authority figures.
Oppositional Defiant Disorder reared its head in several areas of Kristen’s life. Any time an adult would ask her to do something, she’d refuse—regardless of the cost to herself or her health. Since her blood sugar levels were constantly low in school, the nurse recommended that Kristen checks her level before class. Kristen informed me that even though she knew it was a good idea to check her blood sugar, she wouldn’t do it because the nurse had asked her to.
To avoid following directions, Kirsten became a skillful manipulator. She would blame the school staff for her behavior, knowing that her mother would take her side. At home, Kirsten would use her diabetes as an excuse to not do her homework, or would stay in bed faking high blood sugars to avoid school. It wasn’t until Kristen’s mother caught her faking low blood sugar that she brought her to me.
But Kristen wasn’t just shirking responsibility—she was dangerously apathetic. As with other ODD patients, Kristen was aware of the negative consequences of her behavior, but still, couldn’t bring herself to follow directions. In our sessions, Kristen expressed every intention of doing her work going to school, and taking care of herself. Once a parent, teacher or doctor told her to do those things, it was as if someone had flipped a switch. Kristen would go to her room and spend the rest of the night doing nothing at all.
If you have a family member with Oppositional Defiant Disorder in conjunction with diabetes, you know how confusing, frustrating and terrifying it can be. ODD is not well understood, and children suffering from it are often mislabeled as selfish or bratty. Kristen is actually a very smart girl. She wants and knows how to take care of her diabetes. It’s her depression and Oppositional Defiant Disorder that keep getting in her way.
If you are raising a child with ODD and diabetes, here are some things to remember:
- While it may feel like your kid is trying to hurt you, children with ODD aren’t actively trying to hurt or punish their parents.
- No one can control anyone else’s behavior—not actually. You can’t control your child’s personality any more than you can control my character traits.
- Your child is struggling with intense emotions. ODD is often associated with depression and low self-worth. While you may feel as though they are pushing you away, it’s important not to lose your patience.
- Although he or she may not want to, it’s important that your child goes to therapy.
- Acting in your child’s best interest will not always make you popular with them. However, approximately two-thirds of children with ODD experience behavioral improvements within three years of diagnosis.
Do you have a child with Oppositional Defiant Disorder and diabetes? Share your experiences in the comments section.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.