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Women's Health

Mercy Women's Care at St. Anne
3404 W. Sylvania Avenue
Toledo, OH 43623

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Making a Stress Management Plan

separator It's just about impossible to live a life without stress. Everyday life comes with stressors-maintaining relationships, caring for children, getting stuck in traffic, working under tight deadlines, dealing with illness. These stressors cause a stress response, an actual chemical change, in your body. A rise in sugar levels is often one result of stress.

According to psychologist Dr. Jeff Penwarden, "Some degree of stress is useful. It can motivate us to pursue goals, learn and change. But prolonged stress that doesn't get relief can lead to system exhaustion and even organ failure."

Having diabetes itself can be a stressor, explains Penwarden. "There is some amount of drudgery at having to manage this disease day-to-day and week-to-week," he says. "One result of that particular stress can lead to fear that the condition may get worse, guilt over not taking care of yourself perfectly, anger and depression."

Signs of stress
Some signs that you may be stressed out include
  • Preoccupation
  • Sense of worthlessness
  • Excessive worrying
  • Anxiety
  • Irritability
  • Depressed mood
  • Thoughts of death

There can be physical symptoms as well, including fatigue, stomach distress, weight loss or gain and compulsive behavior, such as watching too much television, overeating and taking drugs or alcohol. People who are stressed out may also become argumentative, or they may withdraw.

Techniques for managing your stress
Stress is inevitable, but you can learn techniques that help you respond to it in ways that don't have such a negative impact on your life and your health. Penwarden recommends four steps that can get you on the road to improved stress management-and improved quality of life.

  1. Identify your stressors. If there are things on your list you can change, take steps to do so. That will help eliminate some of your stress, but probably not all.

  2. Identify any negative, self-defeating behaviors you might have. Overeating, watching too much television, etc. You may already know what they are, but taking the time to identify them as causes of stress in your life is an important step.

  3. Make an actual chart of your compulsive behaviors. Having this kind of visual tool can be an extremely useful way to help you monitor yourself. Penwarden is a strong advocate of this type of charting. "Charts help us stay on track and they help us stay honest with ourselves," he says. "Put these up where you can see them." He acknowledges that it takes a lot of commitment to stick with this practice. "Don't get discouraged if you stop your charting for a few days. Just pick it back up."

  4. Learn calming exercises and practices. "There are a lot of different ways to approach this," says Penwarden. "Concentrating on the breath, self-hypnosis, therapeutic massage if you can afford it, listening to relaxation tapes. Visualization can help too. Some people with diabetes find it helps to imagine small insulin keys unlocking the door to hungry cells. Or they imagine an alarm is waking up the pancreas."

It can help to take relaxation technique classes. Meditation appeals to many people, but it's a good idea to get some instruction. The same is true for any of these kinds of things. Qigong is a peaceful series of Chinese exercises that's actually fun to practice. It calms yours mind and body. T'ai chi is another relaxing exercise. Talk to a member of your healthcare team for advice about getting instruction in these kinds of activities. You can also look in the Yellow Pages and read community bulletin boards.

A change in attitude
Penwarden emphasizes the importance of making adjustments in your attitude to help you improve your response to stress. "Learn time management strategies," he says. "Learn to set a realistic schedule, and learn to say no. Set aside time for play and relaxation as well as work.

"Better communication with your partner is also important. There's so much stress that comes from problems in relationships. Learn to listen and suspend your need to respond right away. Avoid unsolicited advice. When you feel that it's important for your partner to listen to you, ask 'Are you open to hearing my opinion?' "

Imagine and dream
Penwarden also talks about the importance of developing a sense of fun. "Be playful, get lost in the things you love. Be willing to look foolish. Be curious.

"Seek social and spiritual connections as well," he continues. "View life as an adventure. And if you're having trouble making these things work for you, seek counseling."

Dr. Jeff Penwarden, Psychologist, April 2002
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