Managing Stress

Whether you have diabetes or not, stress is a fact of life. Add the 24/7 responsibilities of managing diabetes, and it's clear that understanding how to manage the emotional side of diabetes is crucial. In fact, coping with stress can actually help improve long-term blood sugar control.¹

To effectively manage stress, you'll want to learn how to identify stressors in your life, protect yourself from feeling overwhelmed, know how to solve problems, and maintain a positive perspective.

How Stress Affects Blood Sugar

Physical and emotional stress can come at you from any direction - bills piling up, the flu, or an argument with someone you care about. When you're stressed, your body steps up, triggering hormones that make more stored energy available to your cells.² This means more glucose entering your bloodstream² - great news if you need that energy to run away from a fire or bear. Not great news if it builds up in your blood.

For most people with diabetes, stress leads to high blood sugar. For some, stress can lead to lows.² What's more, stress can affect the way you care for yourself, further complicating the picture. For example, when you're stressed, you may not feel like you have time to test your blood sugar or plan healthy meals. You may drink more alcohol or skip exercising. Any changes like these can also make blood sugar levels unpredictable.²

Where Does the Stress Come From?

You know what's stressful about your life outside of diabetes. But diabetes itself can also be a source of stress. Self-care is an overwhelming responsibility. So what types of diabetes-related stress do you identify with?

Fear. Let's face it - a diabetes diagnosis can be scary. And people love to tell stories about terrible things that happened to people decades ago. Remember that diabetes has come a long way in recent years, so talk to your doctor about your real odds of developing complications.³ Then take steps to minimize your risk. After all, you're in charge.

Anger. Why you? Why diabetes? No one can answer that. But it's no surprise that diabetes can make a person feel threatened and angry. That may be a sign that you haven't accepted having diabetes.⁴ You'll probably never like having diabetes, but once you accept it, you can start taking control.⁴

Burnout or Depression. Diabetes is demanding and sometimes very frustrating. Burnout is common.⁵ And people with diabetes are more likely to experience depression than people who don't have diabetes.⁶ As the stress of daily self-care builds, a person may feel a sadness that won' t go away. It may be accompanied by changes in sleep patterns or appetite, loss of energy, trouble concentrating, or other signs.⁶ The first step is to talk to your doctor, because there is help.⁶

Outside Sources. Who hasn't had a run-in with the food police? Sometimes, they're the people closest to you, and sometimes they're those you hardly know. However well meaning, the uninformed may be. Since you can control only your own actions, you have three choices. You can get angry and annoyed, educate them, or smile politely and wait for them to go away. There isn't much value in getting angry, so choose option B or C, keeping in mind that on some level, they think they're trying to help. A heart-to-heart may show them that they're actually causing you stress.

Putting Stress in Its Place

To take charge of stress, try these suggestions.

Log your stress. Before you test your blood sugar, rate your stress level on a scale from 1 to 10. Write that number down, then write down your test result. After a week or two, you may see a pattern between high stress and out-of-range blood sugar levels.²

Identify sources of stress in your life. Start with what's bothering you most, and be as specific as possible. Think about work, home, and diabetes management, and write down everything that comes to mind. Perhaps it's something many people experience, such as frequently high blood sugar results. Knowing what's stressing you is the first step in combating it.

Practice positive thoughts. It's easy to get down on yourself when things aren't going according to plan. But making an effort to replace negative thoughts with positive ones can change your outlook and help things brighten up.² Think about things that make you happy or proud instead.

Learn to relax. Breathing deeply for five to 20 minutes in a quiet space can help calm your mind.² Make time for friends. Or take up a new hobby. Adding good things to your life leaves less room for what's not-so-good.

Get help. Talk to friends, family members, or other people with diabetes. Support groups help many people get through the stressful times in their lives.⁵ If you have any signs of depression, talk to a member of your healthcare team right away. They can rule out physical problems which can sometimes look like depression, and get you the help you need.⁶

Acknowledge your efforts. Focus on what a great job you're doing every day - not just on what goes wrong.⁵ Set achievable goals and keep moving toward them. Then give yourself a huge pat on the back when you get there.

¹ American Diabetes Association. "Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes." Diabetes Care. Volume 25, Number 1, January 2002. Accessed February 9, 2007. Available at: http://care.diabetesjournals.org/cgi/reprint/25/1/30?maxtoshow=&HITS=10 &hits=10&RESULTFORMAT=&fulltext=stress+management&searchid=1 &FIRSTINDEX=0&sortspec=relevance&volume=25&resourcetype=HWCIT

² American Diabetes Association. "Stress." Accessed February 9, 2007. Available at: http://www.diabetes.org/type-1-diabetes/stress.jsp

³ Behavioral Diabetes Institute. "The emotional side of diabetes: 10 things you need to know." Accessed February 9, 2007. Available at: http://www.behavioraldiabetes.org/downloads/Diabetes-10-things-brochure.pdf

⁴ American Diabetes Association. "Anger." Accessed February 9, 2007. Available at: http://www.diabetes.org/type-2-diabetes/anger.jsp

⁵ Joslin Diabetes Center. "I Feel Burnt-Out by Diabetes Care. Any Suggestions About How to Get Back on Track?" Accessed February 9, 2007. Available at: http://www.joslin.org/managing_your_diabetes_596.asp

⁶ American Diabetes Association. "Depression." Accessed February 9, 2007. Available at: http://www.diabetes.org/type-2-diabetes/depression.jsp