Spiritual Check-In: How often do you:- Pray or meditate?
- Set aside time to spend in nature?
- Reflect on and count your blessings?
- Tell people you love how important
they are to you? - Spend time helping those less fortu-
nate than yourself? - Find the opportunity to participate in
a cause that you believe in? - Act in a way that matches your own
values and moral beliefs?
Take inventory of the things you do well
and be sure to praise yourself. Then focus
on items that need improvement. No reason
to stress out by making several changes at
once—start with one thing at a time. Plan
a date night, take a couple days off work, or
make a grocery list of things you’ll need for
a healthy dinner. Successful small changes
over time eventually make a big impact.
Healthy ways to deal
Breathing Exercises: Doing breathing exer-
cises can be helpful in unwinding as well
as dealing with short-term stress. Effective
breathing is different than regular breath-
ing because it helps slow down your nervous
system. To do it, you breathe in through
your nose. If your stomach gets puffy, youknow you are doing it right. After counting
to four and filling your belly with air while
breathing through your nose, hold it for
four seconds. After another four seconds
of holding your breath, blow it out. For the
most effective results, blow out through
your mouth as if you were blowing up a
balloon—don’t push it all out at once.
Hobbies: Hobbies that engage your
body and mind (going for a hike, crafting,
sewing, etc.) have been shown to improve
overall happiness and health. You know
how you’ve been thinking about hiking
local trails in your area or finally taking
that bike out from the back of the garage?Go for it. Not only will the activity be good
for your diabetes management (because
exercise can lower blood glucose levels),
but also it will help to deal with the stress
of managing a lifelong illness.
Support Network: Sometimes you just
need to vent. So call a close friend or go
on a walk with the family and let it all out.
This same individual or group can also
encourage the healthy changes you make
to manage your diabetes. Make sure to
have a mental list of people on your “sup-
port team” who you can call to chat or
depend on for emotional support if you
feel overwhelmed.Counseling
Sometimes we need a little more help
outside our natural support system. And
that’s OK. A therapist or counselor can be
useful in helping you identify your existing
coping skills and learning new ones. Talk
to your endocrinologist or primary-care
provider to learn more about the benefits
of counseling from a mental health pro-
fessional. They can refer you to a mental
health professional in your area who has
knowledge of diabetes and the training
necessary to offer counseling.Conclusion
Make a personal commitment to your
mental fitness. Start with a mental health
check-in and make plans to be your best
you. Seek help when you need it. And,
above all, make yourself a priority—you
owe it to your health. Katy Walker is a licensed clinical social worker and
licensed diabetes educator. Laura Hieronymus is a
doctor of nursing practice, master licensed diabetes
educator, and the associate director of education
and quality services. They are at the Barnstable
Brown Diabetes Center at University of Kentucky
in Lexington, Kentucky.REFERRAL TO A
MENTAL HEALTH
PROFESSIONAL
Your diabetes care provider
may recommend a mental
health care professional
if you have:
Diabetes distress despite
individualized diabetes
education;
Depressive symptoms;
Disruptive eating patterns;
Weight loss due to skipping
your diabetes medication;
Anxiety and/or fear of
hypoglycemia (low blood
glucose);
Serious mental illness;
Repeated diabetic
ketoacidosis (DKA);
Cognitive impairment;
Inability to perform diabetes
self-care;
and you are before or after
bariatric or metabolic surgery.Adapted from: The American
Diabetes Association Standards of
Medical Care (2019). 5. Lifestyle
Management [Table 5.2]. Diabetes
Shu Care 2019;42(Suppl. 1):S55.
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