Dealing with stress

How your body reacts to stress

When you feel under pressure you may find that your blood glucose level begins to climb. When you are stressed your body releases a mixture of hormones, commonly known as the 'fight-or-flight hormones'. Their role is to get you ready to stand and fight or to run away by releasing lots of stored energy, making it available for your muscles to use.

A lot of the stress many people feel is mental stress, not physical stress - but your body does not seem to know the difference. So, although you are unlikely to be running away or getting into a fight, the mental stress will be making your fight-or-flight hormones pump glucose into your blood, even though you don't really need it.

Stress and diabetes

When you understand about the fight-or-flight hormones, it's clear that stress will tend to raise your blood glucose levels. This certainly seems to be true if you have Type 2 diabetes.

For Type 1 diabetes, however, the situation is not so clear-cut. For some people with Type 1 diabetes, their levels may go down, possibly due to a change in routine, or increased physical activity.

Keeping stress under control

Sometimes stress cannot be avoided, but although you may not be able to live a stress-free life, there are things you can do to help reduce its effects.

Here are a few suggestions:

• Identify what is causing your stress
  Take time to identify what is causing you concern. Then the trick is to accept that some things are beyond your control and then focus upon the things you can influence
• Exercise
  Taking more exercise can be an excellent way to reduce the effects of stress. Exercise can distract you from many problems; it also makes your body release hormones called endorphins which make you feel happy and contented
• Relaxation techniques
  There are many relaxation techniques available. Here is one technique to try. Sit down for five minutes, relax and take some deep steady breaths - in through your nose, hold it for a few seconds and then out through your mouth.

When you feel stressed

Understand how stress affects your diabetes. When you are doing your regular blood glucose tests, before each test give yourself a stress score on a scale between 1 and 5. Record your stress level next to your blood glucose result in your monitoring diary. Over time, if stress affects your blood glucose you will begin to see a pattern of disrupted levels and high stress scores.

Diabetes and depression

Having diabetes is not easy, and sometimes it seems very difficult. There's testing, clinic visits, insulin injections or tablets, watching what you eat and drink, collecting repeat prescriptions, visiting your GP. It can all get too much. This is sometimes called diabetes burnout.

Sometimes it goes beyond burnout. Everyone feels down sometimes, but in depression, these feelings become more frequent. Mild depression makes everything seem like a bigger effort and less rewarding when accomplished. Those at the other end of the scale can feel like giving up on life altogether.

Tackling diabetes burnout

If managing your diabetes is becoming too much then it’s important to discuss this with your nurse. With both of you looking at the situation there may be changes to the routine that could make a big difference. Maybe some of your goals are over ambitious; more realistic goals could help your diabetes become a lot easier to manage.

Tackling depression

The best thing you can do is talk your problems through with someone. This can be someone close to you, or sometimes a couple of people are better - friends or relatives.

Your diabetes nurse knows that depression is more common among people with diabetes. They may be able to recommend a trained therapist who can help. A support group may also be worth considering.

Your third option is your GP who can offer counselling or treatment for depression.

Keeping on top of things

There are a number of things that you can try to tackle feelings of feeling overwhelmed or mild depression

• Getting your emotions out in the open
• Physical exercise. Something as simple as going for a brisk walk can change someone's mood dramatically. And it's good for you too!
• Looking after yourself. Eating well can make you feel a lot better
• Ask for help. If you have a pattern of getting down, you may be able to recognise its beginnings and do something about it before it gets too bad
• Find things in life that you genuinely enjoy and look forward to doing