How decision fatigue can be life-threatening for some Aussies


Decision fatigue is a psychological phenomenon that impacts our ability to make choices. But there are some Australians who are disproportionately affected and for them, it could be life-threatening.

When Brittany McEvoy was diagnosed with Type 1 diabetes four years ago, she was told by doctors repeatedly that it wouldn’t impact her day-to-day life that much: “Just be more aware of what you’re eating and always give yourself insulin,” they told her, but the then-20-year-old quickly realised how much more complicated that was.

“From waking up in the morning to going grocery shopping, meeting friends for coffee, adjusting to new workplaces, exercising, going on holidays, Christmas and family gatherings with food, I cannot think of any aspect of my life that was not impacted by diabetes,” she says.

“It took at least a year or two to really adjust to diabetes in my lifestyle given that all areas of my life were impacted, not in a big way, but just many tiny considerations were needed to learn how to survive with T1D.”

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Type 1 diabetes, with which around 130,000 Australians live, prevents the body from creating insulin, a hormone that regulates your body’s blood sugar levels by carrying glucose into the blood cells. When there’s no insulin to let the glucose into the cells, sugar builds up in the bloodstream and this can cause life-threatening complications.

Maintaining this delicate balance every few hours, just to survive, was “exhausting”. McEvoy would notice how angry and emotional she’d become due to having to juggle so many things: insulin, needles, test strips, finger prickers, lollies to stabilise her blood sugar levels.

“The simple task of going to the shops to get bread became a burden as I didn’t know if I was going to go low, so I had to bring all my diabetes gear with me ‘just in case’,” she says.

McEvoy was experiencing what’s known as decision fatigue; a psychological phenomenon that inhibits our ability to make good decisions. The more decisions you need to make in life, the worse you’re going to be at weighing the options.

While this condition doesn’t discriminate–it can affect those experiencing burnout or other mental health concerns–it disproportionately impacts those with Type 1 diabetes, as those living with this chronic condition must make around 180 extra decisions every day compared to the average person.

“The quality of your decision-making will deteriorate as the day goes on meaning that you may have a reduced capacity to make appropriate ‘judgement calls’ later in the day,” explains clinical psychologist Dr. Rosalyn Taylor.

“For people living with Type 1 diabetes, this can cause errors in decisions regarding insulin dosing and result in hypoglycemia or hyperglycemia which can directly impact their health.”

“I can see why people who have lived with diabetes much longer than I have become burnt out and begin to simply ‘ignore’ making as many decisions with their diabetes,” observes McEvoy.

“I know many of my close T1D friends have experienced periods where they don’t even inject insulin anymore because of how exhausting it is to keep on track and maintain good blood glucose control.”

New technology, such as smart insulin patches that automatically release the correct dose would take some of the pressure off in daily decision making, but as it’s in its early stages, it’s expensive and not a viable option for McEvoy. Instead, she’s made adjustments to her diet that help her keep on top of her insulin levels.

“I usually have the same breakfast every day because I know the right dose of insulin to have,” she says.

“However, eating the same foods most days isn’t the best quality of life for me, as well as it reduces how much diversity I consume in my diet.”

For those experiencing decision fatigue, whether they live or care for someone with diabetes or are suffering burnout, Dr. Taylor recommends a few strategies to reduce its impact.

Establish daily routines

Having a routine and effective habits helps to reduce the stress associated with decision making and will reduce decision fatigue.

Meal planning

Pre-planning meals in advance can help to reduce decision fatigue on a day-to-day basis. Having a frequent foods list with carbohydrate amounts on it to refer to can also assist with reducing the burden of calculating carb levels at every meal.

Self-care

Identifying early when decision fatigue is leading to burnout and ensuring you have regular self-care strategies in place. Things like time out for yourself, social connection, good sleep habits, giving yourself permission to take time for yourself. Self-care is not selfish, “you can’t pour from an empty cup”.

Make decisions earlier in the day

Decision fatigue increases as the day progresses, so try to make important decisions earlier in the day so that you are fresh and are thinking more clearly.



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