Stress and Diabetes - Often Left out of the equation?

In my experience as a PWD  who helps  people diabetes on a daily basis I often question why stress isn't one of the priority discussions that should take place.

Health professionals  have their routine during diabetes visits that usually include: diet, blood glucose readings, BP, Wt, A1C, feet, kidney's, then the time is up and it's time for the next patient.

I propose stress and mental coping be added to this equation as part of the team's repertoire or interviewer's strategy in discussing diabetes during a visit.  You'd be amazed at the responses you get when you simply ask, "So, how are you feeling about your diabetes?"

I personally use a four legged approach to my discussions with PWD I am trying to help.  I call it my diabetic stool, so all the legs need to be stable for decent control. I discuss  Diet, Activity, Medication, and Stress.  If all these are in check the you tend to achieve fairly decent diabetes control.  This is my discussion strategy with PWD.  But the first question I ask is; "So, how are you feeling about your diabetes?" I know I am repeating myself, I heard once it's good for emphasis.

"Sorry about the image quality, it is word document that wouldn't paste"

After going through the above I flip it so the stress is on the top, to basically say, unless your stress and mental health is in check then all these other components are even harder to control, and you may indeed fall off your stool.  It is very visual and they usually ask to take it home with them as a visual reminder. 
Most folks have not been given a good explanation how stress may effect their diabetes.  They are  usually aware hat having a common cold or serious illness can effect control, but they don't realize that mental Health, Anxiety, and prolonged stress can seriously hamper diabetes control.

Why is this?  I suspect it is because where the mind goes the body will follow.  If you are mentally well you are going to physically take care of yourself.  But there is also the biology  to consider.

When you are experiencing stress, acutely, or prolonged, you are more resistant to insulin. Your body releases hormones that inhibit insulin from doing its job, that is, letting the glucose into the cells to be used appropriately for energy.  Some of the stress hormones are cortisol, and adrenaline. The body also starts producing more glucose from your liver, getting ready for the "Fight or Fight" response. This used to be handy thousands of years ago when extra sugar was needed to feed the muscles in case you needed to attack a woolly mammoth or flee from a saber tooth tiger, but not so good now. This extra glucose simply increases and floats around wreaking havoc and leading to complications if not corrected.

What I am getting at is patent's and PWD need to know that stress impacts there diabetes control just as much as food.  It needs to be brought up, discussed, dealt with.  But the problem is our health care system isn't designed for health care workers to spend an hour talking about how PWD are feeling about their chronic process they deal with 24/7/365, every second of every day. 

On a positive note, we as a system in Canada are moving toward Primary Health Care, where by Allied Health Professionals work with physicians to assist them in improving patient care.

I work in this area and as a result I spend an hour dealing with all aspects of an individuals chronic disease, including Stress and Diabetes.

Trev

Well guess what, we need to.

Peeling Back my Diabetic Brain

"My Diabetic Brain"

I was thinking about the movie Shrek when he makes reference to himself being complicated, with many layers like an onion, and donkey refuting this in a positive way, by saying more like a layered cake. 

My point is we are complicated, with many layers.

I,  at least feel like my brain is complicated lately.  Things that used to be clear, and simple are now questioned, judged, and not so clear. 

The cognitive behavior tricks or more respectfully stated "Techniques" do seem to work.  My wife notices a different "me" but what do I notice when I peel back the layers of my thoughts?

I'll tell you:

Those "ANTS"(For those who missed my previous post, ANTS = Automatic Negative Thoughts) are still pesky little buggers that are trying to penetrate my mind.  I am more watchful of them now, which may explain the changes on the outside. But it is still very trying to always keep on guard. It is like being on guard all the time with no one to replace you. A lot like having diabetes I guess. 24/7. 

As I am more aware, conscience, or whatever of my thoughts, it is apparent that these ANTs are plentiful.
More then I would have previously known if it weren't for the Jedi Training.

Now when an ANT makes its way into my stream of thoughts, I snatch the little bugger, stare at it, think about, and decide what to feel about it, and the result seems to be a more positive emotional response. Not as reactive, not like a run-away train. 

I realize now this is going to take a lot of practice, herbal tea, some meds, therapy, and more peeling of layers to deal with those nagging ants that are trapped in my layer brain. 

I know my post likely sounds pretty "out there" but these are my peeled back thoughts.  I am hoping soon to compare my brain to a layered cake. 

Trev

Mental Health Stigmas - Barrier to Seeking Help?

The stigma attached to mental health ailments is obvious in my opinion.  I call them Mental Health Ailments because it is no different then a broken arm.   I read recently that the medical profession equates Depression to the Common Cold. Intereseting....

I think it is important to mention the labels and stigmatization that is attached to coming forward with a mental issue.  Be it depression, feelings of suicide, ADD, ADHD, or any other illness that messes with our brains emotional regulation. 

Is the stigma society places on mental illness a barrier to seeking help? This is a question that I have pondered.

I have mentioned this slippery slope to falling off of the mental deep end. It didn't happen spontaneously, so why did I not seek help earlier. Answer....I didn't want to be labeled as a nut bar!  I didn't want to tarnish my professional reputation.  I told myself, I can handle it, I'm a man, men handle shit. They don't ask for help. Those were a sample of my rationalizations to not seeking help earlier on.

The most powerful barrier for me was the admission that I had a mental problem and the perceived judgement or stigma that I thought society would cast upon me.

This is a problem.  I know they  have mental awareness months. It just never appealed to me, until lately, for obvious reasons.

I have worked in the medical community for most of my adult life. I hear the judgments, thoughts and perceptions people have towards the mentally ill. It is revolting.  Your brain is an organ, and one of the most complex ones in the human body, so it makes sense that something can go haywire.

In terms of diabetes, I have said this before, it is often last on the agenda in the management of diabetes. It should be first, because where the brain goes, the body will follow.

So what do you think?  Does a stigma exist in society and if so does it impede the prompt pursuit of help from those in need?

Trev

Momentary Lapse of Reason - Now What?

Great Album from Pink Floyd by the way.

What now? Why did I fall so deep? These are questions for me to explore. I want the spring back in my step, the passion back, but I feel like I am trudging through thick mud.  Everything is an effort.  Like being stuck in quicksand, reaching for a branch to grab a hold of and pull my self out. 

I have blogged about diabetes and mental health on Three 2 Treat numerous times; a few posts come to mind: Mood and Diabetes - What Gives!,  a few of my later posts like, Throw in the Towel Already! and most recently a, Letter of Resignation.

Were these signs that maybe I was on a slippery slope to deterioarating mental health or extreme burnout? Who knows.  

My momentary lapse in rational thinking scared the living shit out of me. Hindsight is not entirely twenty twenty at this point in time. However, I am astutely aware of what I was capable of doing, and also what I would have lost.

I hope to learn from this experience. I hope to share this with all who are willing to read this. I am not writing this for simpathy; but to express my self, and hopefully avert a future episode for myself or for another overwhelmed soul dealing with a chronic disease like diabetes who feels like there are no other options.

As my friend said (my dear friend) there are always options. Just pause long enough, and they will surface and present themselves. Always. Time, is alway ticking, but this is a good thing, as time allows us to ponder options, and some options obviously have better outcomes then others.

So in my case, and I am sure I am not alone. There was a moment where my  thoughts weren't rationale, or a momentary lapse of reason.. 

A "moment" by my definition is a temporary period in time, that inevitably passes. Thank god, my momantary lapse of irationale thinking passed uneventfully, allowing me to move forward in time to the next moment.

 Hopefully it will be a moment of mental clarity, one that is future oriented, one filled with joy, love, success, and life.

But what saved my ass in this crisis?  Luck amd a perceptive friend. 

What now? 

My own insight into what transpired, I guess.  A willingnes to seek help.  I have seen my physician, I have booked counselling, I am not ashamed to seek help. Talking and sharing is good.

Yes, even if you are a man. See my humour is still present, however lame.

Next I will look into resources I should have accessed prior to this event.

Thanks for letting me share.

Trev

PS:  If you are feeling desperate reach out.  Seriously!