February 16, 2014

Diabetes and Stress

Stress is complex and for many people difficult to deal with, manage, and it then takes a toll on health and mental health. The sad part is many people do not recognize stress and how to deal with it. There can be positive stress and negative stress. Yes, I wrote positive stress.

Consider this – buying a house, birth of a child, planning a wedding – these are considered positive stress. These are a few of the negative – being stuck in traffic, death of a family member, and job stress. There are more causes of negative stress and all make your body behave as if it were under attack. Some sources of stress can be physical, like injury or illness, and stress can be mental, like problems in your marriage, job, health, and finances.

As stress builds, your body prepares to take action. Authorities call this the fight-or-flight response. How people react to this depends on the situation. Some people become combative and others find a way to walk away from the cause of the stress.  For those of us with diabetes, the fight-or-flight energy does not happen as easily because even if the hormones are present, the glucose and fat energy often in not available to prime the body for avoiding danger. Insulin is not always present to let the needed energy into the cells, and this causes glucose levels to rise in the blood.

When dealing with long-term stress, like surgery requiring several months of recovery, stress hormones designed for helping with short-term danger stay on for a long time. This in turn can cause long-term high blood glucose levels. For mental stress, whether short or long-term, the body pumps out hormones for no purpose. Neither fighting nor fleeing can help when the enemy is your own mind. In people with type 2 diabetes, mental stress often raises blood glucose levels. Stress hormones may also affect blood glucose levels directly.

To find out how mental stress affects your blood glucose management, before using your meter, write down a number rating of your mental stress level on a scale of 1 to 10. Then record your blood glucose level next to it. Then in a week or two, look for a pattern. Look for trends by graphing the data to make then stand out. Then ask yourself if high stress levels often occur with high blood glucose levels, and do low stress levels go with low blood glucose levels? If these are true, stress is affecting your blood glucose management.

The above should let you know that you need to make changes. You need to minimize stress or eliminate stress in your life. Some suggestions to help:

  1. Find a new route to work, leave earlier, or use mass transit if available.
  2. Have a talk with your boss, apply for a transfer if available, and change jobs if necessary or possible.
  3. Find a way to patch up a relationship.
  4. Start an exercise program.
  5. Take dance lessons or join a dance club.
  6. Learn a new craft or hobby.
  7. Volunteer at a hospital or charity.
  8. Obtain financial counseling.
  9. Find new ways to cope with situation causing stress.

For some people, the art of learning to relax can help. Relaxation therapy does work, but requires dedication. This tends to work for people with type 2 diabetes more than for people with type 1 diabetes. Some people with type 2 diabetes may be more sensitive to some stress hormones and relaxation therapy can help reduce this sensitivity.

Some to the different relaxation therapies include:

  1. Breathing exercises – sit or lie down and uncross your legs and arms. Take a deep breath followed by exhaling as much air as possible. Breathe in and out again, but this time relax your muscles as much as possible. Keep this up for about 10 to 20 minutes at a time and do this at least once a day.
  2. Progressive relaxation therapy – this is a technique, which you can learn in a clinic or from an audio tape. It involves tensing your muscles and then relaxing them.
  3. Exercise – This involves relaxing your body by moving it through a wide range of motion. Use circling, stretching, and shaking parts of your body. Remember the activity you did as a child – put your right foot out, put your right foot in, shake your right food and move it all about. They repeat for the different parts. Adding music may also help.
  4. Replace bad thoughts with good thoughts – Every time you have a bad thought, purposefully thing of something that makes you happy. Some people use a memorized poem, a prayer, or a quote and use it to replace a bad thought.

Some people will use a combination of the above; however, any method you use will take practice to learn relaxation. Practice, practice, and more practice.

Dealing with diabetes-related stress may be one source of stress that just does not go away. One suggestion is finding a diabetes support group and participating in it. Yes, that means the secrecy is gone and for some this stress nags at them, but letting others in the support group in will often make this stress disappear. You can learn other people's hints or aids for coping with problems. Making friends in a support group may lighten the burden of diabetes related stresses.

Some find dealing directly with diabetes care issues are helpful. What creates stress for you? Is it taking your medication when you should, pricking you finger to check your blood glucose level, exercising, or finding the right meal plan that is best for you?

If none of the above work and you need help, ask a member of your diabetes team for a referral. There is no need to suffer if the stress is severe enough that you feel overwhelmed. Yes, I am saying counseling or psychotherapy might help. Talking may help you come to grips with your problems and relieve the stresses. You may learn new methods of coping or changing you behavior. Stress needs to be conquered.

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