What is stress
Stress is defined as an imbalance between a demand and one’s capability to respond to the demand. This can occur due to any reason, for example – challenges with work, family, finances; if the demands are not met there is an important (perceived) consequence.
If you perceive that the demand made on you physically or emotionally outweighs your resources to deal with it then you may experience anxiety, distress, which can manifest into physically symptoms like tension in the muscles, sweating, increased heart rate, fatigue, even headaches, upset stomach, nausea, sexual dysfunction, diarrhea or constipation.
These are just short-term effects of stress, if stress is not treated, it can inflict long term illnesses to the body, even increase one’s risk of developing Type 2 diabetes.
Stress Production – How it works
There’s a part of your nervous system called the autonomic nervous system that automatically controls the organs in your body: it controls the heart, blood vessels, kidneys, pupils, digestive glands, liver, stomach, bladder, sweat glands, lungs, intestine, genitals and even salivary glands.
This is the part of your nervous system that is in charge of responding to perceived threats to your body. When you are stressed, your body suppresses all your unnecessary body processes in order to provide energy for you to fight or run. Basically, it acts as though a lion is chasing you, and yet you could just be seated quietly in your house!
Your sympathetic nervous system (part of the autonomic nervous system) is activated by two hormones, adrenaline and glucocorticoids (cortisol).
At this point your body’s muscle and skeletal system become tense and filled with energy. Your liver and skeletal muscle cells release glucose and fats from the body stores into the blood. Your breathing becomes hard and fast as your heart and lung action accelerates in the effort to distribute blood to the essential organs of your body in readiness for fight or flight.
For some of you, it is accompanied with panic or anxiety.
Your heart rate and blood pressure increase as the cortisol hormone suppresses the functioning of your immune system. Most life circumstances won’t afford us a fight or flight option, and so we must learn better strategies for managing stress. These strategies are especially important when dealing with emotional stress.
Effects on Stress on Blood Sugar/ Blood Pressure
As discussed earlier, the stress response works to support the flight or fight response i.e. ensuring the body has enough energy to either run away from the stressor or deal with the stressor head on. The physiological and behavioural mechanisms that accompany the stress response can affect blood sugar and blood pressure control in different ways:
- Hormones associated with stress
During the stress response, our bodies release adrenaline and cortisol hormones into the blood stream. The effect of this is the activation of enhanced breakdown of carbohydrates and lipids from their stores in the body as well increased blood supply (elevating blood pressure) to deliver these nutrients (glucose, fatty acids..) and oxygen to the muscles to support either fighting the stressor or running away from it. This leads to a rise in blood sugar. For those without diabetes, the stress-induced blood sugar rise is followed by an increase in insulin secretion, so the blood sugar rise is modest and temporary. For those of us with diabetes, however, stress can cause a significant and prolonged increase in the blood sugar level leading to poorly managed blood glucose levels if it happens consistently.
- How long you are stressed for
Evidence shows that chronic stress (prolonged periods of high cortisol levels in the blood) coupled with the associated changes in health behaviour can contribute to the development of visceral obesity (fat accumulating around the waist) and the metabolic syndrome (hypertension, dyslipidaemia, glucose intolerance, insulin resistance, and obesity) both of which not only significantly increases the risk of cardiovascular disease and type 2 diabetes but also increases the risk developing diabetes-related complications.
- Behavioural Changes linked to stress
In addition to the physiological impact that stress has on blood glucose control, research has shown that stress interferes with the ability to self-manage diabetes. Doing everyday self-care tasks, such as monitoring glucose frequently, being physically active, following a meal plan, and correctly preparing or remembering to take insulin or oral medications at the right time, is difficult during times of stress. Moreover, diabetes self-management tasks themselves may become a source of stress. Experiences of stress may lead to other unhealthy behaviours, such as smoking, which in turn are linked to poor blood glucose control but also to a greater risk of developing diabetes complications.
The behavioural mechanisms through which stressful experiences might affect diabetes control are varied and often complex and may differ from one person to the next due to various reasons such as social support, ability to cope, and other psychosocial variables. Learning to prevent and control the negative responses to stress is helpful, particularly if the causes are relatively permanent.
Stress Management
It is almost impossible to exhaust all the strategies that are available for managing stress. However, we can highlight just two:
- Changing Stress producing situations
Time management, Goal setting and organizational techniques may reduce small stressors that often compound until a crescendo is reached.
Diabetes-specific approaches that may help individuals cope better with diabetes include setting specific, realistic self-management goals. Many individuals set global vague goals that may serve to worsen stress such as “Lose weight,” “Take better care of my diabetes,” and “Improve my glycemic control.”
Realistic, measurable, and achievable goals specifically stating the measurement criteria that indicate success are more helpful as motivators. Examples of realistic, measurable goals are, “I will walk 20 minutes each day on Monday, Wednesday, Friday, and Saturday at 5:00 p.m.;” and “I will lose 4kg over the next 9 weeks by following my meal plan and increasing my walking to 30 minutes, 5 days per week.”
Evaluation does not necessarily have to focus on whether a goal is met, but rather on how successful one’s effort has been in trying to achieve it.
2.Changing the physiological response to stress
Stress in itself is not harmful, but our perception and reaction to the stress makes all the difference. It might cause physiological changes in the body that can either be for better or for worse. Getting a hold of how we respond to stress can be done by engaging in behaviours that not only help us maintain our sanity in stressful situations but also elicit hormones such as serotonin, oxytocin and dopamine that can lower the circulating levels of cortisol, the stress hormone. Some of these practices include:
- Different relaxation techniques – with/out tapes; deep muscle relaxation; head to toe relaxation; Breath focused relaxation;
- Meditation
- Hot relaxing baths, you can throw in scented candles
- Distractions and involvement in pleasurable activities such as active participation in a hobby (even a sedentary one like snakes and ladders) or exercise program can help combat stress. Typically passive activities, such as watching television, may not help alleviate stress, although attending a concert, theatre performance, or movie with friends can have beneficial effects as a distraction.
- Social support – Having 2 or 3 people that you can easily talk to about different stressful situations in your life
- Getting enough sleep – Aim for 7-8 hours, minimum of 6 hours; More than 9 hours of sleep may lead to worsening of the stress response
- Positive work-life balance
Whatever works best for you as far as stress management is concerned, use that!!! As long as it is healthy and sustainable.
