As you have read in previous blogs, hypertension or high blood pressure can contribute to diabetes complications. One factor that can cause hypertension is stress. Yes, stress is a fact of life, such as paying bills, taking care of children and/or your elderly parents, plus managing your diabetes. How we perceive the situation is the critical factor for understanding what the stress is and how we can cope with the situation.
The experience of stress is highly individualized. What constitutes overwhelming stress for one person may not be perceived as stress by another. If the demands of the life situations are threatening and we do not have the skills to react to the situation effectively, we then label the situation as a threat. This then leads to feeling overstressed and we react with a stress response or 'fight and flight' response. This can result in our physical and emotional responses becoming heightened so that we can deal with the stressor. How our bodies react to the stress can be very harmful.
Hypertension or high blood pressure is one way our bodies react to overstressful situations. Hypertension can occasionally cause headaches, vision problems, dizziness, or shortness of breath, but most people with hypertension have no symptoms. Hypertension is usually discovered at a regular medical checkup.
When our bodies are experiencing hypertension, it may be a sign that we may be experiencing an incredible amount of stress and need to learn new coping strategies.
One coping strategy used is called the Mindfulness Based Stress Reduction (MBSR) program by Dr. Jon Kabat-Zinn. MBSR helps us become consciously aware of how our body and mind work together. It helps us become aware of our options in stressful situations and be mindful of the relevance and effectiveness of our responses when we feel this way. We may be able to exert considerable control over our experience of the stress. Its premise is to help us learn how to focus on the moment we are in and to then control our thoughts and feelings from taking over our lives and affecting our behaviours.
The program incorporates mindfulness meditation, and yoga in assisting us to relax, slow our thoughts and become consciously aware of these thoughts. You can learn the techniques of MBSR by taking an 8-week program, which can be very helpful, or by attending individual therapy sessions with a therapist who specializes in MBSR. Definitely you can learn and implement the MBSR techniques on their own, by reading Dr. Kabat-Zinn’s book and listening to his CD. The program incorporates an 8- week training program.
Key components of MBSR:
- Helps to keep a person in the present moment
- This helps to control thoughts and prevent looking into the past or future, which can cause a person to become more anxious and be unable to cope with the stressor
- One thing to remember is that no one knows what is going to happen in the next minute, hour or the next day. To realize this, can help control thoughts and premonitions.
- Focusing on a meditation, such as deep slow breathing or moment of the body through yoga movements, helps a person relax and take a break from thinking about the stressful situation. This enables a refocus on the problem. Most people inform me that once they do these steps they see the stressor in a different light and are able to solve the problem in a less stressful state.
- Studies on these techniques have shown that the mind is a factor in stress and stress-related disorders, and meditation has been shown to positively affect a range of autonomic physiological processes. These include lowering blood pressure and reducing overall arousal and emotional reactivity.
For example, one of my patients with type 1 diabetes was explaining her relationship with her mother. As she was explaining the stressful situation, her thoughts projected into the future. She was speaking faster and she stated her heart felt like it was beating at an accelerated pace.
I instructed her to take deep slow breaths, in through the nose and then out through the mouth. Once she had relaxed by breathing, I asked her if anything she described in the future could occur. She explained the thoughts were her fears of 'what ifs'. She stated that she felt calmer and realized that these ‘ifs’ caused her to become anxious and unable to deal with any stressful situation. Since this session and practicing MBSR techniques through the use of CD, she has become more aware of how her mind works and how her body responds to her thoughts. By breathing slowly, she feels less anxious, and she has found that this has lowered her blood pressure as well.
Remember: there are healthy and unhealthy ways of coping with stress. If you have not experienced a lot of validation or support in your life, you may be especially vulnerable to unhealthy coping strategies such as eating problems or other addictive behaviours. Before removing these strategies, which have helped you get through some rough times, you will need to ensure that you have some healthy strategies to fill the gap, such as MBSR. Often professional support is needed to guide you through this process.
Here are suggested resources on MBSR:
Kabat-Zinn, Jon. Full Catastrophe Living Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness.New York: Bantam Dell, 2005.
Due to the high level of MBSR support available in Toronto, please see this website for a directory and wealth of MBSR therapists and group-based programs. To learn more about Mindfulness for Diabetes Management click here.