Turning off stress
Luckily, the body has a built-in mechanism for turning off the fight-or-flight response. Known as the relaxation response, it reverses the physiological changes brought on by stress. Heart rate, blood pressure, breathing rate, glucose mobilization, and muscle tension all decrease. While the stress response usually occurs involuntarily, people can learn to call up the relaxation response at will. This is what relaxation techniques such as meditation and imagery exercises are intended to do. So learning such techniques should help improve diabetes control, right? Surprisingly, the answer to that question is a resounding maybe.
“I think the jury is still out about the effectiveness of relaxation techniques for this purpose,” says James Lane, PhD, an associate research professor of psychiatry at Duke University. The results of published studies to date have been mixed, and many of these studies have been too small to draw definitive conclusions in any case. Lane thinks another explanation for the lackluster results may be the absence of a good selection process for those taking part in the studies. “You would expect that relaxation training would be more beneficial to people who report feeling anxious or who say their glucose control is related to stress,” he says. Yet most researchers have disregarded these issues when picking study participants.
One study that backs up the view that relaxation may help some people more than others was led by Angele McGrady, PhD, a psychiatry professor at the Medical College of Ohio. Her small study included 18 people with Type 1 diabetes. Half were assigned to get relaxation training that involved the use of biofeedback, a form of therapy in which a person is taught to gain control of a physiological process with the aid of feedback from an instrument. In this case, people were hooked up to instruments that measured muscle tension and finger temperature. They then were taught to decrease the tension and increase the temperature, two signs of greater relaxation, by breathing deeply and listening to a relaxation tape. The other half of the participants got no such treatment. The researchers didn’t find any difference in blood glucose levels between the two groups overall. However, they did find that people with high scores on tests of stress, depression, and anxiety were more likely to have smaller changes in blood glucose as a result of the relaxation training.
Taking it easy
The bottom line: Relaxation techniques may help with blood glucose control very little or a lot, depending on your psychological makeup and your body’s sensitivity to stress. Whatever the case, however, they probably won’t hurt, and they may leave you feeling less tense and more at peace. While you can certainly take a class in meditation or go to a therapist who teaches imagery exercises, you also can try such techniques on your own at home. McGrady offers this caveat, however: “If you have frequent, long-lasting feelings of anxiety or depression, you should seek professional help.” Based on her study, you may not be able to focus on your relaxation practice until you get these problems under better control. What’s more, while deep relaxation usually leads to feelings of enhanced well-being and calmness, occasionally it can bring up disturbing emotions, such as fears, sadness, or despair.
Following are some simple techniques for getting the best of stress. You may find that one method is more effective or feels more natural than another. The best technique for you is the one that works. For more detailed instruction, see the books listed in “Relaxation Resources,” or ask your health-care provider to refer you to a good stress-reduction program in your area.