Living with diabetes is a challenge. Far from being “just a touch of sugar,” diabetes affects all aspects of your physical and emotional health. You may find yourself overwhelmed by the effort needed to manage not only your blood glucose, but also your feelings and behaviors surrounding the disease. And don’t forget the effects diabetes has on the significant people in your life. From fears for your health to financial concerns, diabetes has an impact on your family members and close friends. Fortunately, though, when members of a family work together to understand each other’s feelings, they can support each other through good times and bad.
Do you remember when you or a family member was newly diagnosed with diabetes? After recovering from the initial shock, perhaps you experienced the following reactions:
• Disbelief: “I don’t believe this. The lab must have made a mistake.”
• Denial: “If I don’t think about diabetes, I won’t have to deal with it.”
• Anger: “Why me? I don’t deserve this!”
• Guilt: “Maybe this wouldn’t have happened if I’d eaten better or exercised more.”
• Sense of loss: “I’ll never be able to enjoy life again.”
• Fear: “How am I going to take care of myself? Will I develop complications?”
• Loneliness: “No one can possibly understand what I am going through right now.”
It’s important to know that all of these reactions are normal. You may experience one, all, or none of them, and you may continue to experience them long after the initial diagnosis. Being able to recognize these emotions and accept that that’s how you feel right now is a big step toward eventually coming to accept your new reality with diabetes. It can also help to talk about your feelings with those members of your family or broader support system who can listen without judging or advice-giving.
Being “stressed out” seems to be the new norm. Stress occurs when people perceive that the demands placed on them – such as the demands of work, school, or relationships – exceed their ability to cope. Although some stress in life is considered beneficial – because it gives you the energy boost you need to study for exams or meet work deadlines – too much stress can negatively affect a person, physically and emotionally.
When you experience stress, your body behaves as though it were under attack. It prepares to take action with the “fight or flight” response. Certain hormone levels increase, with the result that stored glucose and fat are released to give cells the energy needed to escape from perceived danger. In a person with diabetes, this can lead to high blood glucose levels if the pancreas cannot respond to the release of stored glucose with a release of insulin (the hormone that lowers blood glucose).
Emotional stress can be short term, such as anxiety over an upcoming medical appointment, or longer term, such as dealing with a demanding teenager. Longer-term stress can lead to longer periods of elevated blood glucose.
In some cases, individuals with diabetes may find themselves neglecting their self care due to stress. They may drink more alcohol, forget to take their medicines, or make poor food choices simply because they are overwhelmed by the demands in their lives.
To find out if emotional stress is affecting your blood glucose control, try this: Each time you check your blood glucose level, rate how stressed you feel at that moment on a scale of 1 to 10, with 1 being an ideal, relaxing day and 10 being the worst day of your life. Then write your stress level next to your blood glucose level. After a week or two, look for a pattern. Do high glucose levels occur with high stress levels? If so, you might have an issue with stress and blood glucose control.
Physical stresses such as injury, illness, or surgery can also lead to elevated blood glucose levels in those with diabetes. That’s why it’s important to develop a sick-day plan with your diabetes care provider before you get sick. Likewise, if you are scheduled for surgery, chemotherapy, or any other medical intervention, speak to your doctor about the possible effects on your blood glucose levels and how to manage them.
Take a deep breath…and cope
Coping is the way you deal with emotional lows and stress. Everyone has their own coping style, but some styles or strategies are more helpful than others. Individuals with diabetes who take a problem-solving attitude or who try to find a way to put their problems into perspective usually have less of a blood glucose elevation in response to mental stress. On the other hand, those who use coping methods such as denial, avoidance, or anger, or who engage in “escape behaviors” such as excessive eating, smoking, drinking, or drug taking, often find that they have created more problems rather than fewer and that their behavior has had a negative effect on their diabetes.
How can you improve your coping style? First, recognize the fact that you are under stress, and try to identify and minimize the stresses you are facing. Oftentimes stress is a sign that something in your life needs to change, whether it’s a discouraging job situation or having too many irons in the fire. You may not be able to remove diabetes from your life, but you can learn to cope with its demands.
For some people, particularly those with Type 2 diabetes, relaxation therapy seems to help make the body more tolerant to stress hormones and their effects. The American Diabetes Association suggests several ways to relax:
Breathing exercises. Sit or lie down and uncross your legs and arms. Take in a deep breath. Then push out as much air as you can. Breathe in and out again, this time relaxing your muscles on purpose when breathing out. Spend 5 to 20 minutes doing this, at least once a day.
Progressive relaxation therapy. This approach involves learning to recognize when each specific muscle group in the body is tense by tensing then relaxing muscles in a systematic manner. You can learn this technique from a clinic, physical therapist, or video or audiotape.
Exercise. Another way to relax your body is through movement, such as gentle stretches and range-of-motion exercises (such as arm circles), or slow jogging. Moving to music adds to the fun, and exercise has the added benefit of burning calories and lowering blood glucose.
Replace bad thoughts with good ones. Change your outlook on life by keeping a gratitude journal, in which you list things you are grateful for every day, from a beautiful sunset to the happiness on your grandchild’s face. Every time you feel yourself thinking in a negative way, purposefully think of something for which you are grateful.
Seek out support
Family and friends can offer their support on your diabetes journey, and they’ll be most effective at supporting you if they understand your needs. One way to help the people you’re closest to understand you and your diabetes better is to invite them to come to medical appointments or diabetes classes with you. Include them in your new lifestyle choices of better eating and more physical activity. Invite them to join you in relaxation exercises or in a rewarding new activity or hobby. (Click here to read about how one family coped together.)
Try not to rely too much on any one person, though. Remember that your friends and family members are most likely facing stresses in their own lives, too. Be respectful of a person’s need to sometimes say no, and keep in mind that some people are more comfortable providing practical support, while others are better at listening and providing emotional support.
Diabetes support groups can help by introducing you to others who are in the same situation as you are; you may even learn some great tips on diabetes care and for coping with common problems. Ask your health-care team about diabetes support groups in your area. If you feel that your stress is so severe that you are often overwhelmed, depressed, or unable to take care of yourself, ask for a referral to a counselor or therapist. You may learn new ways of coping or changing your behavior. Above all, don’t go it alone. (Click here for more tips on coping with diabetes.)
As someone once said, “You don’t have to like diabetes, you just have to get along with it.” Involve your family, friends, and others to make your relationship with diabetes a healthier one.