Stress. Only six letters long, yet this word is so incredibly powerful. Stress has the ability to influence so much of our lives, relationships, moods, and health. For people with diabetes, stress can be particularly damaging. However, understanding what stress is, how it affects your body, and how to overcome it can begin to take its power away.
Stress is the result of your daily demands outweighing your available resources. At any given minute you have a set number of resources, which can be tangible, like money or food, or intangible, like time or patience. As long as you have enough resources to meet the demands that are placed on you, life is good. For example, your bills (demands) come in and you have plenty of money (resources) in your bank account. No problem – your demands are easily met by your resources and you have no stress. However, if the demands that are placed on you are greater than your resources, you feel it. For example, let’s say you are working against a deadline that is fast approaching. You may feel that the work you still have to do (demands) is much greater than the time left to do it (resources). This is when you experience that familiar feeling called stress.
Our bodies are made of many intricate systems that keep us breathing, thinking and moving. We also have a built-in response system to help us deal with dangerous and stressful situations, called the “fight or flight response.” Whenever we are faced with some sort of danger, our bodies immediately start preparing to fight the danger or run away from (flee) it. This was incredibly helpful when we were living in caves. Let’s say you are leaving your cave for a morning of hunting and gathering and came upon a tiger. This triggers an immediate and well-coordinated response. Your brain realizes this is not a good situation and releases stress hormones, like adrenaline and cortisol. Those hormones signal the release of glucose into the bloodstream. Glucose is fuel; it provides the energy for your muscles to fight off the tiger or to outrun it. You use up the glucose getting out of danger and your body goes back to a normal state. This system is great, for centuries it has allowed us to always be ready to deal with threats. It was so important that our bodies have maintained this system through the years.
We Seldom Face Tigers Now
The problem with this system is that today we don’t really happen upon many tigers. Our stressors are more often encountered while we are sitting still — paying bills, sitting in traffic, working at a desk, or having a difficult conversation. But our bodies don’t have the ability to differentiate between stress that requires action and stress that requires other types of resources. They still identify a threat, a stressor, and go into action, dumping enough stress hormones and glucose into our systems to fight off a tiger, which obviously is a little overkill for when you are only balancing a checkbook. Now we don’t have the opportunity to use up the glucose, so it just hangs out in our bloodstream until the pancreas can release enough insulin to clear it out.
If you have diabetes, your pancreas doesn’t produce enough insulin or your body doesn’t use the insulin effectively, so the glucose hangs out in blood even longer, resulting in hyperglycemia. This is one reason why you might have a high sugar reading even though you think you are doing everything right.
It’s true that while you are doing your best to make healthy food choices, your body can be sabotaging your efforts by dumping glucose into your bloodstream so that you can deal with your stressors. However, we can’t blame all of our high sugars on this (perhaps antiquated) fight or flight response. Our behaviors can be just as problematic. When we are faced with many demands and our resources are low, we start to conserve them wherever we can. When our time resource is low, fast food seems like the best way to conserve as much time as possible. Also, crossing things like our evening walk off of our to-do list seems like a good way to conserve time. When we are feeling particularly bad, we reach for comfort food, the treats that we associate with happy memories and less stressful times. This might be ice cream, cookies, potato chips, or macaroni and cheese, foods that further inhibit our body’s ability to clear out the glucose. This is the stress double-whamy. The body’s fight or flight system is increasing the glucose in our blood and our behaviors are increasing (or not helping to decrease) our glucose levels.
How We Can Counteract Stress
Well, all this is very stressful, isn’t it? Luckily there are things that you can do to counteract stress and its glucose-raising side effects. The first is going to the source — identifying the demands on your life. Often we just feel weighed down and stressed out, and it’s surprisingly hard to figure out why we feel that way. Once we track down the stress-causing demands, you can deal with them. Sometimes we can lessen or eliminate the demands. If your bills are a demand that causes stress, maybe there are ways to reduce them –- give up cable, skip the Starbucks a couple times a week, etc. Other times it is easier to focus on the resources that the demands are drawing on. If you are already feeling stressed by the time you get to work in the morning, it might be because you feel rushed from the time you wake up. If time is a resource you are short on, finding more time, perhaps by setting your alarm 15 minutes earlier in the morning, might be enough to meet those morning demands.
If you have trouble finding straightforward ways to reduce demands or increase resources, there are extremely effective indirect ways to reduce stress. If you are a physically minded person you might find that exercise is a great stress-reducer. Going for a walk, even just around the block or to your mailbox, has many benefits. It might put some (literal and figurative) distance between you and the stressor, burn up some of that extra glucose in your bloodstream, and make you healthier in general, which means less stress. Taking slow, deep breaths is something that can be done anywhere, in any situation. The process of slowing your breathing, actually stops the fight or flight response, and encourages your entire body to slow down and start to return to baseline.
Some physical relaxation techniques, such as progressive muscle relaxation (PMR), have actually been shown to reduce glucose levels in people with diabetes. To try PMR, start with your hands. Make really tight fists, as tight as you can, hold it for a couple seconds, and then release. Then move on to your arms, tensing the muscles like you are showing off your biceps, as tight as you can, hold it, and release. Continue to move through your body until you have tensed and relaxed all of the muscle groups. The feeling of tense muscles actually helps you to find the tension in your body and makes it easier to relax those muscles. It also helps to take your mind off of the stressors floating around in your head and bring your focus to your body.
Clearing Your Mind Helps
If these techniques don’t appeal to you, you may want to try a more cognitive route. Many people find it helps to journal or write about your stress. There is no right or wrong way to do this –- it can be in the form of a diary-type book, letters to a friend, or perhaps a blog about your life experiences. You may also want to try a technique that has withstood the test of time –- meditation. Clearing your mind of stressors, focusing on your breath or mantra, for just a couple of minutes can have a huge impact on the rest of your day. Researchers have found that another technique, called “guided imagery” can reduce stress and reduce glucose levels. You are probably very familiar with this type of stress relief, but you might call it “daydreaming.” Basically, it allows you to go to your “happy place” no matter where you are. To get the most out of this technique, close your eyes and really concentrate on being in your happy place. Imagine the sights, sounds, feelings, smells, and tastes that you experience when you are there. Just a couple of minutes in this imagined stress-free setting can change your outlook on the real world. Another technique is to dust off those rose-colored glasses. Try to find something positive in a stressful situation or try to see the best in others. A similar technique is keeping track of things for which you are grateful.
If you feel like you need more help or want more detail about some of these stress management techniques, there are people who can help you. Therapists are trained in ways to help you to reduce stress or change the way you think, and sometimes it’s just nice to have someone who listens to you. There are also websites that offer formal stress management training or access to relaxation exercises.
No one likes the feeling of stress, and it’s no secret that it can wear on you mentally and physically. These are all reasons to make stress management an important part of your diabetes management program. Remember that different things work for different people, so keep trying out techniques until you find one or more that works for you, and then practice them as often as possible.
Cathy Bykowski is a clinical psychology doctoral candidate at the University of South Florida. She has been researching stress for many years. Her current doctoral dissertation examines the psychological and physiological effects for adults with type 2 diabetes.