Diabetes and Mental Health

Having diabetes can cause stress. Think about the times you’ve experienced stress in relationship to your diabetes. Between checking blood glucose levels, monitoring food intake, taking your medication and making healthy choices, the sheer thought can become overwhelming. Stress affects the “fight or flight” hormones in your body. When you have diabetes, the stress hormones, adrenaline, cortisol, and norepinephrine, can contribute to high blood glucose levels. Additionally, feeling this type of stress may make it harder for you to take care of yourself. Some stress is unavoidable, but you can learn to handle stress so it doesn’t get the best of you.

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Ongoing stress can also leave you more vulnerable to developing negative coping strategies (such as denial) and increases the likelihood of mental health issues. Individuals with diabetes are 50 percent more likely to suffer from depression or anxiety and are also at higher risk for other mental health issues such as posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). Like staying healthy with diabetes, staying mentally fit is another important step for your overall well-being.

Risks for negative coping

To integrate mental fitness into your regular diabetes routine, you should have a basic knowledge of mental health issues and be aware of your own risk factors to be prepared to address those risks. Risk factors include:

• being easily annoyed;
• becoming tearful more often;
• thoughts you’d be better off dead;
• feeling overwhelmed, even by simple tasks;
• changes in weight or appetite;
• trouble sleeping;
• unexplained nausea;
• aches and pains;
• loss of interest in sex;
• feeling unsteady or weak;
• lightheadedness;
• feelings of guilt;
• anxious thoughts (often takes the form of “what if _____ happens?”); and
• worrying something horrible will happen.

It is important to keep in mind that we all have these feelings some times. They are only an issue if you recognize that you have several of these feelings on a consistent basis for more than two consecutive weeks.

Although everyone should be mindful of his or her own mental well-being, if you have a life-long illness such as diabetes, you need to stay in touch with your thoughts. If you have a history of depression or anxiety, symptoms may occur more often or be more severe. Additionally, you may be more likely to experience negative coping if you don’t have a support system for your diabetes health. But these are all things you can manage…just like your diabetes.

Mental health check-in

Everyone should do “self check-ins” as a part of his or her regular routine. The check can be used to make sure you are still on the right track to living your best life. More importantly, it can point you in the right direction if something just feels “off” when there is no obvious explanation. Many different aspects add up to a person’s overall well-being. Although physical health should certainly be included, your emotional, social and spiritual health is just as important. Take a look at these health questions and then ask yourself: is this something that I already do well or something I could focus more on to reach a healthier me?

Physical check-in

How often do you: Make a point to eat healthy meals? Get at least 30 minutes of exercise five times a week? Attend regular medical and dental appointments? Check your blood glucose levels? Take your diabetes medication(s) as prescribed? Make time to participate in physical activities that you enjoy (such as hiking or swimming)? Sleep at least seven to eight hours a night? Take time to appreciate your body and feel good about the way you look?

Emotional check-in

How often do you: Say “no” when someone asks you to do something that you prefer not to do? Spend time doing an activity or hobby that you enjoy? Take time away from your work or other obligations? Learn something new just because you find it interesting? Find a reason to laugh? Express your feelings to people you care about?

Social check-in

How often do you: Spend time with people that you enjoy being around? Take time to call friends and family that you don’t see as often as you’d like? Have interesting conversations? Get to be physically intimate with your significant other? Spend time alone with your significant other? Meet new people?

Spiritual check-in

How often do you: Pray or meditate? Set aside time to spend in nature? Reflect on and count your blessings? Tell people you love how important they are to you? Spend time helping those less fortunate than yourself? Find the opportunity to participate in a cause that you believe in? Act in a way that matches your own values and moral beliefs?

Take inventory of the things you do well and praise yourself. Then focus on items that need improvement. No reason to stress out by making several changes at once — just start with one thing at a time. Plan a date night, take a couple days off work or make a grocery list of things you’ll need for a healthy dinner. Small changes over time eventually make a big impact.

Healthy ways to deal

Breathing exercises

Doing breathing exercises can be helpful for unwinding as well as dealing with short-term stress. Effective breathing is different than regular breathing because it helps slow down your nervous system. To do it, you breathe in through your nose. If your stomach gets puffy you know you are doing it right. After counting to four and filling your belly with air while breathing through your nose, hold it for four seconds. After another four seconds of holding your breath, blow it out. For the most effective results, blow out through your mouth as if you were blowing up a balloon — don’t push it all out at once.

Hobbies

Hobbies that engage your body and mind (going for a hike, crafting, sewing, etc.) have been shown to improve overall happiness and health. You know how you’ve been thinking about hiking local trails in your area or finally taking that bike out from the back of the garage? Go for it. Not only will the activity be good for your diabetes management (because exercise can lower blood glucose levels), but it will help you deal with the stress of managing a life-long illness.

Support network

Sometimes, you just need to vent. So call a close friend or go on a walk with the family and let it all out. This same group can also encourage the healthy changes you make to manage your diabetes. So make sure to have a mental list of people on your “support team” who you can call just to chat or depend on for emotional support when you feeling overwhelmed.

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The four “A”s of stress relief

• Avoid situations that stress you out by taking control of your environment
• Alter your perception and consider changes that improve your situation
• Accept the things that you cannot change and focus on the positive
• Adapt your standards and expectations to make situations less stressful
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Counseling

Sometimes we need just a little more help outside our natural support system. And that’s OK. A therapist or counselor can be useful in helping you identify your existing coping skills and learning new ones. Talk to your endocrinologist or primary-care provider to learn more about the benefits of counseling from a mental health professional. They can refer you to a mental health professional in your area who has knowledge of diabetes and the training necessary to offer counseling.

Conclusion

Make today the day you commit to your mental fitness. Start with a mental health check-in, and make plans to be your best you. Seek help when you need it. And above all, make yourself a priority — you owe it to your health.

Want to learn more about maintaining emotional health with diabetes? Read “Reducing Diabetes Stress: Alternative Treatements” and “Relaxation Techniques for Stressful Times.”

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