Diabetes: The Basics – Healthy Coping

Diabetes Self-Management- HEALTHY COPING- based on the ADCES7 Self-Care Behaviors   

Updated 2021 by Kim Ladd, RN, BS, CPHQ, CDCES  

Listen to Diabetes: The Basics—Healthy Coping Audio   Note: Audio not updated

Healthy coping means being able to manage the demands of everyday life, your diabetes self-care, and your relationships with others. It means maintaining a positive attitude, motivation and emotional balance while living with diabetes. Recognizing negative emotions and taking steps to reduce the detrimental impact they can have on your self-care is an important part of diabetes management. 

Emotional Adjustment and Diabetes 

For all people, whether they have diabetes or not, healthy emotional adjustment is an important part of having a good quality of life. If you have diabetes, it is even more important. To have good diabetes control, you must do many things every day —eat the right kinds of food at the right time, exercise properly, take the right amount of medication or insulin at the right time and check the blood glucose (sugar) at the right times. This is a lot! To manage it all, you’ll need a sense of emotional balance in your everyday life. 

When Do Emotional Adjustment Problems Happen? 

Adjustment to diabetes can be a problem at any time. But at certain times and in certain situations, you might be more likely to develop adjustment problems. These include: 

  1. When your diabetes is first diagnosed. 
  1. When your diabetes treatment changes, especially if it becomes more complex. 
  1. If you are treated badly by other people because of the diabetes or the diabetes treatments. 
  1. Any time there is a major change in other areas of your life, like moving, getting married, having children, changing jobs, or retiring. 
  1. If you get tired of doing all the things needed for good diabetes control. 
  1. If you work hard at control and you don’t get the results you hoped for. 
  1. If you find out that a diabetes complication has begun or has gotten worse. 
  1. If you are diagnosed with some other chronic illness or disability. 

Adjustment problems are very individual. They can show up in as many ways as there are people with diabetes. However, there are several adjustment problems that show up often in people with diabetes. These include: 

  1. Denial 
  1. Anxiety 
  1. Anger 
  1. Depression 
  1. Feeling guilty 
  1. Feeling overwhelmed 
  1. Eating disorders 
  1. Having problems relating to family members or other people close to you. 

People with diabetes tend to have these types of problems more often than most other people. Scientists think the reasons are partly physical and partly emotional. On the physical side, having diabetes may make your brain and nervous system more prone to having problems. On the emotional side, having diabetes and knowing you have a long-term chronic disease can put you under a lot of emotional stress and diabetes self-management itself can be a stress, since it can be difficult, boring, or frustrating. 

What Can You Do to Help Yourself Adjust? 

First, it’s important to admit to yourself that you do have a problem. This is the first step to taking positive action. 

Next, ask yourself how serious the problem is. If your emotional state is keeping you from taking good care of yourself, or if it’s making it hard for you to go about your usual daily life, then it’s a serious problem. Fortunately, most serious emotional problems can be treated effectively through counseling, medication, or both. It’s important that you get help from a mental health professional. It’s best if you can find one who is familiar with diabetes. Your doctor or diabetes educator should be able to help you find someone who can give you the help you need. 

If your problem is troubling, but not interfering with your diabetes care or daily life, you may get some relief by using self-help techniques. A few suggestions are: 

  1. Talk with other people who have diabetes. If you don’t know anyone you can talk to, try joining a support group or an online discussion group. 
  • Ask your local hospital if they have any diabetes support groups in your area or search online for diabetes support groups 
  1. Use stress management techniques
  1. Discuss with your doctor or diabetes educator how you can simplify your diabetes care, to give yourself a break. 
  1. Make a mental list of all the things you enjoy that are not affected by having diabetes. Then be sure to include at least one of these things in your life every day. 
  1. Read a book about adjusting to diabetes. These can give you many more ideas about things you can do to help yourself. A few good ones are: 
  • Diabetes Burnout: What to Do When You Can’t Take It Anymore, by William Polonsky 
  • Diabetes: Caring For Your Emotions As Well As Your Health, by Jerry Edelwich and Archie Brodsky 
  • The Mind-Body Diabetes Revolution, by Richard Surwit and Alisa Bauman 
  • 101 Tips for Coping With Diabetes, by Richard Rubin, Gary Arsham, Catherine Feste, David Marrero, and Stefan Rubin 
  • Stress-Free Diabetes, by Joseph Napora 

At times, emotional adjustment can be hard work. It may take some time and real effort to find the emotional balance you need to live well with diabetes and for most people, taking the time and making the effort pays off. With healthy emotional adjustment to diabetes, you are well on your way to having a balanced, satisfying life. 

Diabetes and Stress 

Dealing with stress is an important skill for people who have diabetes. The combination of high stress and diabetes can lead to serious physical problems. Stress management is not just about learning ways to relax, but it also helps to control blood glucose levels. 

What Is Stress? 

Stress is a reaction to a change or problem. Many people feel anxious, tense, or under pressure when stressed. A physical change like having an injury or illness can cause stress. Stress can also come from strong emotions such as being upset, angry or worried. 

Stress is a part of everyone’s life. Most people have small stresses every day, like spilling a glass of water or misplacing their keys.  At times, we may experience large stresses, like the death of someone close or the loss of a job. Even good changes like buying a house or having a baby can cause stress. 

How Your Body Reacts to Stress 

When you feel stressed, your body releases hormones that speed up your heart, tense your muscles, and raise your blood pressure and blood glucose (sugar). This is called the “fight or flight” response. In old times this “flight or fight” response helped people to act quickly against a physical threat. For example, if a person encountered a wild animal, the stress response helped him/her fight it or run away. 

In modern times, most stresses in life are not physical threats. Instead, emotional stresses are more common, for example feeling misunderstood at work, worrying about money, or having an argument with a family member. Sometimes the “fight or flight” response can help you stay focused and alert so you can deal with stresses that last a short time, like taking an exam or giving a speech. But it won’t help you deal with most long-term stresses. 

The stress response can cause high blood glucose and high blood pressure in people who have diabetes. If these high levels last for a long time they can cause severe damage to the body. High stress can also make it hard for you to practice your diabetes self-care and keep your body healthy. When feeling stressed, some people overeat or do not eat enough. Others might stop exercising, use cigarettes or turn to alcohol or drugs to cope. All these behaviors can damage your health and make it more difficult to control your blood sugars. 

How You Can Cope with Stress 

You can never get rid of all stress. But you can learn to cope with stress in positive ways. You might try these 6 suggestions: 

  1. Learn relaxation techniques such as deep breathing, tai chi, yoga or meditation. To do these techniques properly and effectively, it is best to learn from someone who has experience teaching them. 
  1. Ask friends and family for support and accept it when it is offered. 
  1. Stay as healthy as possible. It takes some effort to eat right, exercise regularly, sleep enough, and take your medication as you should, but it is effort well spent. Neglecting your health will only cause more stress. 
  1. Take time to do something you enjoy. Watch a movie, listen to music, take a walk in a park, read a book, or visit with friends. 
  1. Join a support group, where you can talk to other people who have similar experiences. 
  1. If you are having money problems, speak with your doctor about low-cost choices for your medications. Also, major drug companies have programs to help people with low income get their products at lower cost. This will not solve your money problems but will help you take care of your health while you are working on your money problems. 

If you continue to have high stress after trying the above suggestions, you might consider getting advice from a mental health counselor. This is especially important if stress is interfering with your normal life responsibilities, or with your diabetes care. Learning to deal with the stress in your life will help you manage your diabetes and stay healthy. You can visit the American Diabetes Association Mental Health Provider Directory for help with locating a mental health provider that has demonstrated competence treating the mental health needs of people with diabetes. 

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