Holidays + Mental Stress + Diabetes = High Bloodsugars + Even Higher Stress: Solving the Equation
The holidays often foster high stress levels in people. As joyous as the holidays can be, they can also be really stressful at times. High bloodsugars often show up more prominently during the holidays. While changes in diet is one factor, it's not the only one.
"There is a myth out there that it's all about food as to why the blood sugar rises," says Dr. Richard Hellman (former president of the American Association of Clinical Endocrinologists), The truth is that other factors play a role, he explains, including stress.
Stress can wreak serious havoc on our minds, bodies, and diabetes management. Being mindful of our stress levels, especially during the holidays, is really important. Stress usually affects our bloodsugars for two main reasons. According to a recent report by the ADA:
People under stress may not take as good care of themselves as they normally would. They may eat and/or drink more, and exercise less. They may forget, or feel they don’t have time to check their glucose levels or plan good meals regularly.
- Stress hormones can alter bloodsugar levels directly (usually raising sugars).
Moreover, once activated, stress hormones (like epinephrine and cortisol) that are busy dealing with (real or perceived) short-term danger stay "on" for a long time, thereby contributing to unwanted high blood sugar levels.
"In diabetes, because of either an absolute lack of insulin, such as Type 1 diabetes, or a relative lack of insulin, such as Type 2, there isn't enough insulin to cope with these hormones, so blood sugar levels rise," says Richard Surwit, PhD, vice chairman of Psychiatry and Behavioral Sciences at Duke University Medical Center, and author of The Mind Body Diabetes Revolution.
More insulin is often needed during high-stress times to combat these effects. Plus, since insulin can function as a fat-storing hormone, the more insulin our body needs, the more fat our body can end up storing. Can you see the vicious cycle at work here?)
Why Mental Stress Matters
· The body can’t tell the difference between real or perceived threats. It doesn’t decipher between a mental stressor like the internal stress you experience when being yelled at by your boss or parents, and the imagined worry over the very real feeling that you may be yelled at by said parties in the future. You picture it clearly in your mind, and it feels real, ergo, it is real—to the body at least. This is where the flight-or-flight response kicks in.
· Science has proven that when the fight-or-flight response (which kicks in as a result of perceived stressors (whether real or imagined, physical or mental) is activated, many of our hormone levels rise. The cumulative effect of this often leads to high bloodsugar levels since these hormones launch into action and respond by making a lot of stored energy (like glucose and fat) available to cells, which are primed to help us escape the (perceived) danger.
· When your body no longer produces any insulin, or can’t properly use the insulin it still puts out, the body’s fight-or-flight response creates serious issues. Because the perfect amount of insulin is no longer produced or used properly, the body struggles to let this extra energy into the cells. When it can’t, much of that excess glucose piles up in the blood. Hence, hyperglycemia.
- People under stress may not take as good care of themselves as they normally would. They may eat and/or drink more, and exercise less. They may forget, or feel they don’t have time to check their glucose levels or plan good meals regularly.
· Several peer-reviewed studies (such as this one) have proven that mental stress usually raises bloodsugar in Type 2 diabetics. For Type 1 diabetics experiencing mental stress, however, levels often go up, but bloodsugars can also drop as a result (It is, in essence, a crapshoot). However, when it comes to physical stress (injury, infection, illness, etc.), higher bloodsugar levels are reported in people with both Type 1 and Type 2 diabetes.
[Side note: As a Type 1 diabetic, my own body has responded both ways, but more often than not, my bloodsugar levels rise--often quickly and quite dramatically--as a result of mental or physical and real or perceived stressors.]
Knowing how your body is likely to respond can help mediate the added stress that comes from also having to stress over wonky bloodsugar levels.
3 Tips to Help
1.) Keep it in Perspective!
Focusing on the simple things in life and breaking up tasks into even smaller, more easily accomplished mini-tasks—especially when feeling overwhelmed—keeps us feeling more productive, which makes us happier.
When we’re happy and enjoying life, stressful thoughts tend to take on less importance. Keep in mind, the majority of things that stress us out the most right now will likely be forgotten by next year.
Yet who among us can prevent all mental stressors? If you feel stress coming on, breathe. Take a few deep breaths in and out. Remember a happy or funny moment. Look at a picture of a baby laughing or someone you love. Stretch. Do yoga. Smile. Fake it if you have to. It still helps. Meditate for five minutes. Fake it if you have to. It still helps. Play. Take a breather. Laugh. It helps.
2.) Put yourself on “Priority Status!”
Pay closer attention to the ways mental stress affects you and your bloodsugar levels and diabetes management. Put it on priority status for a week. Doing so helps you spot patterns, and knowing your patterns can help you figure out how best to respond to stress. During this time, I test and record my bloodsugar more often I can compare levels before, after, and during times of mental stress. I jot down my bloodsugars, and include a note about what mental stress was going on in my mind and give it a number (stress level using a simple a 1-10 scale, for example).
3.) Plan Ahead!
Holidays or events that center around food and drink (and a lot of it at once like Halloween and Thanksgiving dinner) often create a lot of mental stress—especially when you’re pinch hitting for your pancreas.
On the one hand, you just want to feel normal and enjoy the day. On the other hand, you’re not exactly normal in the insulin-producing department, so such holidays must be planned for in advance.
Personally, my stress level rises just thinking about all the potentialities and all the work and minutiae required to pull it all off in the end. This year I want to enjoy the process, and the pre-holiday excitement. In looking for solutions, I found three that I trust will keep folks level-headed and enjoying themselves in the process. Like most things, they’re not so much secrets as common sense reminders. I’m talking about 1.) thinking ahead, 2.) having a system (to be organized), and 3.) starting early.
By thinking ahead and already having a system in place to negate the chaos, I create peace-of-mind--the antidote to mental chaos and stress. Simply being able to joyfully check a few things off my calendar and list of to-do’s prevents unnecessary (and unwanted) mental stress from accumulating.
A few to-do's I can already check-off my list are:
- ·Knowing where back-up supplies are (& how much I have)
- Having a solid back-up plan in place should pump, medications, insulin, or body malfunction
- Communicating above plan to loved ones
- Collecting/purchasing things early (like cards, Halloween candy, food and gifts, etc.)
- Asking for help (in advance)
- Trying out supplies, outfits, and decorations in advance
Having these few things done in advance helps me stay peaceful, knowing that I am right on track. That way, I have more time to play and enjoy this time of year, whether it's carving goofy faces on pumpkins and roasting the seeds, or watching Charlie Brown specials with loved ones by the fire.
Let us know: How does stress affect you and/or your loved ones? What tips do you have to help overcome some of the stress associated with the holidays, or simply everyday life with diabetes?