The Grimace That Passes For a Smile..
I worked in mental health and general healthcare as a healthcare assistant. It was one of the most physically and mentally demanding jobs I’ve had — and I did it while managing Type 1 diabetes, which added a layer of complexity that I absorbed entirely alone.
On the bad days — and there were many — I’d put a smile on. Or something that passed for one. A grimace of professionalism that said “I’m fine, I’m coping, I’m present” when what was actually happening underneath was something else entirely.
I felt like shit. The blood sugars would be doing something difficult. The cognitive fog would be present. The emotional weight of managing the condition through a demanding shift — without anyone around me having any idea what that actually involved — was significant.
And if I’d tried to explain? Nobody would have got it. I knew that. So I didn’t try. I just kept smiling. And I felt truly, completely alone.
What The Perfomance Costs
Performing wellness you don’t have is exhausting in a specific and often underestimated way.
It’s not just the energy of the performance itself — though that’s real. It’s the compounding effect of the isolation it creates. Every time you smile through something you’re not okay with, you widen the gap between what’s visible and what’s real. And that gap, maintained over time, becomes a kind of prison. The people around you are responding to a version of you that doesn’t exist. You’re receiving care and concern — or not receiving it, because you’ve signalled you don’t need it — based on a fiction.
And underneath the performance, the real experience accumulates without acknowledgement. Without witness. Without the relief that even a single honest exchange can provide.
The smile doesn’t just mask the difficulty. It extends it.
Why T1Ds Smile Through It
The reasons are understandable and consistent.
Nobody would understand anyway. The gap between what T1D actually involves and what most people around you can comprehend is real enough that the explanation feels like more effort than the silence. Particularly in professional environments where you need to function.
You don’t want to be the problem. The person whose health is making things complicated for others. The one whose condition requires accommodation and consideration and management of other people’s responses.
You’ve been doing it so long it’s become automatic. The performance has become the default. Smiling through is just what you do.
And sometimes — honestly — you’re so tired from managing the condition that you don’t have the energy for the vulnerability that honest disclosure requires.
What Telling The Truth Actually Does
I’m not suggesting you owe anyone an explanation of your T1D in every context. You don’t. Your medical history is yours.
But the habitual performance of wellness you don’t have — the sustained smile through genuine difficulty — has a cost that compounds over time. And finding at least one person, one context, one space where you don’t have to perform it does something that nothing else quite replicates.
It lets the real experience be witnessed. And being witnessed — even briefly, even imperfectly — reduces the isolation that the performance was creating.
It doesn’t have to be a dramatic disclosure. It can be as simple as: “Today was hard.” Said to one person who you trust to receive it. Without explanation, without justification, without the full story.
The truth, in that small form, is a kind of freedom. Not because it fixes anything. Because it means you’re no longer alone with it.
Before I go…
Guess what? You’re allowed to be pissed off.—Anger isn’t a weakness. It’s a signal. You’re angry because: You followed the rules and still didn’t “win.
”You’re exhausted from managing a condition that gaslights you daily. You feel invisible while the world celebrates “progress” and you’re just trying not to pass out after lunch.
It’s not a tantrum. It’s data. It’s your body saying: “This isn’t working for me.” So, what now?—Translating Rage into Strategy Instead of suppressing your anger (and giving yourself heartburn on top of high blood sugar), channel it. Here’s how:
1. Name the emotion.
Loudly. Say it. Write it. Swear about it. Try: “I’m sick of smiling, my body feels like it’s sabotaging me. ”Owning the anger defuses its shame.
2. Ask: What’s the real trigger?
Was it the number?The exhaustion?The dietitian’s blank smile when you mentioned being burnt out?Pinpoint it. That’s where your real work starts.
3. Do one small act of rebellion.
Skip the spinach smoothie. Blast music. Cancel that guilt-ridden walk and nap instead. You’re not lazy. You’re choosing self-preservation.
You’re Not Broken. You’re Burned Out. Here’s the twist: You don’t need more discipline. You need support that sees the emotional labour diabetes demands. And no, you won’t get that from a pamphlet that says “eat whole grains and smile.
But you can find it inside a community that gets the rage, the tears, and the WTF mornings. I built one. And it’s not made of sunshine and denial.
Quick Action for Today Ask yourself: What does “being strong” even mean to me? Then, burn the version someone else sold you.—Still sick of smiling? Good. You’re Alive. That anger? It means you care. It means you’re still in the fight.
And it means your story isn’t over. So let’s stop pretending we’re fine when we’re not. And let’s start redefining strength as showing up messy, loud, and completely human.
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Talk soon,
Pete 🙂
