Have you ever been told not to think about something, or not to look at something? Inevitably, you will only think about or look at that forbidden something.
That’s what it’s like when reading about stress. The word itself just induces stress. That is the great paradox of wanting to take care of stress while not stressing. As Dr Rowan Hillson explains in Diabetes: The Complete Guide:
“[…] it was not considered kind to talk about tissue damage in detail. But to fail to do so seems to me […] to take away their opportunity for working towards reducing the risk of their diabetes causing long-term problems. The down-side of giving such detailed information is that it provokes anxiety. However, a small trace of anxiety is what keeps one following health rules.”
It is good to be aware, but we also don’t want you to stress. So, take our hand as we thoughtfully guide you through this sensitive subject to address stress and diabetes. Enjoy a sprinkling of calm-inducing gifs along the way.
Common Anxieties and the Diabetes Distress Scale
Be aware that having stress or anxiety is common and perfectly normal. It’s also helpful to know that you are not alone in feeling anxious about diabetes issues in particular. Diabetes is not easy; there is no shame in feeling anxious about it.
The Diabetes Distress Scale (DDS) was developed specifically to assess those common anxieties, and to open up conversation between a person with diabetes and their healthcare professional. The Diabetes Distress Scale is based around 17 statements, in which the person with diabetes rates their response from “Not a Problem” to “A very Serious Problem”. Find an example of the Diabetes Distress Scale here.
This DDS example includes the statements: “Feeling angry, scared and/or depressed when I think about living with diabetes” and “Feeling that I will end up with serious long-term complications, no matter what I do”.
Some of these feelings may be identified as hypo anxiety and a fear of long-term complications – two of some of the common anxieties that those with diabetes can face.
Hypo anxiety is the fear of experiencing hypoglycemia. A hypo can be resolved in a straight-forward manner, and is a common experience for those with diabetes. Yet, that doesn’t make a hypo any less of an unpleasant experience. It is an experience that a person might wish to avoid.
A person with hypo anxiety may go out of their way – in a way that negatively impacts their life – to avoid having hypos in unpleasant settings, such as avoiding public situations, avoiding driving, or eating more than needed.
There are certain ways to address the problem, such as learning warning signs for hypos. But, most importantly, a person with such anxieties – whether hypo related or otherwise – can talk to a healthcare professional about these feelings.
They may advise techniques such as cognitive behavioural therapy (CBT), or speaking with a therapist. Access to mental healthcare is not always a given. However, you can still talk with friends or family about anxieties.
Likewise, a person who experiences anxiety surrounding fears of long-term complications can also speak to a healthcare professional, friends, or family. Those with diabetes are often told of future complications which they should avoid by managing their diabetes. It is not uncommon, then, to have anxieties about the future.
An important tip is remembering to put those feelings into perspective. Diabetes research has come a long way. Even in the early days, one of the first insulin patients, Elizabeth Hughes Gossett, lived into her 70s!
So, don’t forget that you’re not alone in dealing with stress and diabetes. If speaking with a mental healthcare professional is not an option, then speak with friends, family, and the diabetes community. As a community, we should be there for each other; many others with diabetes will be experiencing similar anxieties.
See some suggestions for online diabetes communities on our blog post about goals for diabetes self-management, and check out Hedia’s Facebook page for our monthly suggestions for diabetes-related content.
Stress and Diabetes: Effects on the body
You’re not alone in your anxieties, and you’re not alone in the way that your body responds to stress. It may not seem calming to read about the impact of stress on the body. But understanding how stress works will eliminate any undue worries you may have. Face stress by knowing about it.
The two important aspects of stress are the hormone adrenaline and – you guessed it – glucose. In a nutshell, stress results in adrenaline telling your body to release glucose. And, of course, too much glucose isn’t ideal for those with diabetes.
Additionally, cortisol (“stress hormone”) levels rise, which results in muscle and fat being less receptive to insulin. This makes blood glucose levels even harder to manage.
Stress is the so-called fight-or-flight response. A situation in which you may be fearful or anxious causes the body to prepare by releasing extra energy to either physically fight the problem or run away from it. But modern anxieties rarely come from physical threats. So, you simply end up with unused glucose in the body.
While stress is normal, prolonged stress places strain on the body that is detrimental. An example would be high blood pressure, which those with diabetes already need to be cautious of.
So, now you know. Now you can relax, assured that you know what happens with stress. Read on for tips on how to maximise that relaxation.
Tips for Diabetes and Stress Management
1) Burn it off
Exercise is always important. You may even be fed up with hearing about the importance of exercise. But, as Dr Nick Cavill says – and as quoted by the NHS’s page on exercise – “If exercise were a pill, it would be one of the most cost-effective drugs ever invented”.
Exercise helps in all areas. With stress in particular, exercise will help get rid of that extra energy which the fight-or-flight stress provides.
Of course, there should be a balance. Too much exercise will have a toll on the body. The World Health Organization recommends 30 minutes of moderate-intensity activity five days a week. So, if you’re stressed, even just a walk will burn off that energy.
2) Ingest to de-stress
Much like exercise, you will already know that eating and drinking well is beneficial. But did you know that certain foods or drinks can increase or decrease stress?
Alcohol may seem like a de-stresser because it lowers inhibitions. But habitual drinking will increase stress in the long-term. According to drinkaware.co.uk, alcohol is a depressant, and affects the chemicals in the brain. After long-term drinking, serotonin – the chemical that regulates mood – will be negatively influenced.
Certain foodstuffs can also increase cortisol – that stress hormone, remember? This includes coffee and sugar. So, maybe think twice about whether you need another triple venti soy milk caramel macchiato.
Additionally, being prone to stress eating will make both stress and diabetes as a whole harder to manage. So, next time you have a craving for chocolate, opt for dark chocolate (which will usually have less sugar than other kinds) because it reduces cortisol.
Other cortisol-reducing food includes food with prebiotics – such as bananas, pears, garlic, and leek – and probiotics – such as yoghurt, mozzarella, and miso.
3) Let it out
Your anxieties shouldn’t have to sit within you: let go of them. Again, speaking to a mental healthcare professional is a good shout, especially if you have particular problems that you want to address.
Be open to talking with family and friends, too. It’s relieving to talk about your problems with people who care for you. It is comforting to have that familiarity. Or, perhaps you don’t have a particular problem that you need to address – then talk to your friends anyway. It’s healthy to simply chat and hang out. If you have friends with diabetes who understand your situation, then that’s an added benefit.
You can also let your anxieties out by writing down your thoughts on a piece of paper. Then, throw the paper away, as a symbolic way of moving on from your stress. Alternatively, let it out more abstractly: sing, paint, dance!
This is any kind of action that focuses on your present state of being: taking time to simply be aware of your body. This often includes relaxing breathing techniques – taking slow and long breaths while standing or sitting in a comfortable position.
There are a plethora of mindfulness techniques out there, but yoga is a fairly all-encompassing one. It consists of breathing, meditation, and ensuring the body releases tension through various poses.
One easy mindfulness technique for de-stressing is tensing the individual muscles in your body and then relaxing. This achieves a sense of relaxation throughout the whole body. If you are unfamiliar with it, mindfulness doesn’t need to seem “peculiar” – you can just take a moment in your day to be calm.
5) Relaxing through action
Even when resting, our minds can still be racing. But certain actions that don’t require much mental forethought can help take your mind elsewhere.
You can let your mind wander while your hands are occupied. Examples of this are journalling, mindfulness colouring, knitting, or even doing the dishes!
6) Less screen, more sleep
A lack of sleep causes stress, and stress causes a lack of sleep. It’s the circle of stress.
Break the circle by turning your environment into a sleep-haven. Most importantly, curb your screen time: the blue light from laptops and phones affects your body’s production of melatonin, the hormone that deals with sleep.
Put away the phone before bed, and try a different activity to unwind, like reading. Get yourself in the mood for sleep by dimming lights, reducing noise, and making sure your bed is both tidy and comfortable.
7) Know your stress
We all have different thresholds for stress. Pay attention to how much is too much; don’t overload yourself. Sometimes, it’s ok to say no to events and plans. Find your balance.
Plus, if you discover what your triggers are, you can plan in advance how to combat your stress when it does come. Alternatively, you can attempt to avoid those triggers altogether once you have identified them.
That paradox again – by saying don’t stress, does that actually make you any less stressed? But, we hope that by this point, you don’t need to stress about stress itself.
Now you know what your body does. Ultimately, it’s just chemicals. That might not make the experience any less real, but at least you know it’s the body’s natural response. You also now have our tips on diabetes and stress management for practical solutions.
Finally, talking to people and talking about diabetes will help a great deal, especially for the psychological aspect of stress. Every person with diabetes will have some of the same anxieties: it’s normal.
So, genuinely – don’t stress.
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