Dealing With Stress? Don't Turn to Drugs and Alcohol

Shelter in place is stressful; and going to work when there is risk of Covid is also stressful.  There is no way around it right now, our lives are stressful.  A little stress can be good.  Most of us perform better with some stress; but not too much. 
Too much stress can lead to anxiety issues, depression, fatigue, headaches and muscle tension, insomnia, stomach problems and weakened immune system.  People who experience too much stress for too long become prone to illnesses, mental and physical.
Too often the response is, I'll use alcohol, or I'll get stoned and just forget my problems.  These responses do not get rid of the problem, although admittedly you care about your problems less when you are stoned or high or drunk.  When you sober up, the problems are still there, and in addition you have the consequences of the substance.  These consequences can include substance use disorder, health conditions, O.D., family issues and trouble at school or work.
May I suggest some alternatives to substances for dealing with stress.  Regular exercise is the most important.  Exercise releases endorphins which produce a natural high without the negative consequences.  Other activities to deal with stress are playing video games, meditate, walking, talking with a friend, doing something creative, play music, relax, take a hot bath, favorite TV program or movie.
These items are taken from a pamphlet  provided by the Stay Safe Series, Primo Prevention. 2014.

Holiday Stress, Mindfulness and Holiday Tradition

Helpful Holiday Resources   The holidays can often be filled with stress and pressure, leading to fatigue and withdrawal. It may seem ironic that the holiday season, which is supposed to cheer us up and bring us together, ends up stressing us out. Why does this happen? Well, our brains are hard at work trying to help us survive the chaos of the busy season. So, we’ve put together some helpful holiday resources to help you manage and even enjoy the holidays! Be Mindful One way to break the cycle of stress is through mindfulness. Mindfulness is about being interested and paying attention to what is happening in our bodies and minds in any one moment. By being aware of our experiences, rather than distracting ourselves and pretending we are not facing anxiety, we can learn to address our feelings as they come up. We can train our brains to reduce anxiety that can disconnect us from our family and friends. We can even tap into the very process that drives behavior: our natural reward-based learning system. Here’s how: instead of fighting our brains, or forcing ourselves to try to not be anxious during the holidays, be mindful and really pay attention to what you are doing. Curiosity is a powerful tool for taming stress and anxiety. What happens when we get curious? We notice that the feelings of stress and anxiety are simply made up of body sensations—and that these sensations come and go. We notice what is happening in our experience from moment to moment – a deeper level of mindfulness. By substituting the behavior of distraction, worry, or comparison with curiosity, we’ve hacked our brain’s reward-based learning process. Curiosity feels good and is readily available – it’s just a matter of tapping into our own capacity and noticing the reward right in that moment. So, in preparation for the holidays, take a few moments every day to train your brain to be mindful. Whenever you notice that you’re beginning to get stressed or anxious, take a moment to be aware of what’s happening in your body and mind right in that moment. Be curious.   Credit: https://www.mindful.org/train-brain-tame-holiday-stress-anxiety/ (Judson Brewer)   Define Your Holiday Traditions Talk to older family members or friends – Ask relatives about past holidays and events. Reviving these memories could link generations together and revive forgotten traditions. Savor edible traditions – Food is an essential part to many holidays, and the sense of smell is powerfully connected to memory. The wonderful aromas of decadent desserts or delicious dishes evoke memories of special days. Ask family or friends to share their favorite recipes to keep the memories going. Recall family origins – Research the traditions and foods of your ancestors, and find ways to incorporate them into your own celebrations. Members of your family will gain a sense of their own unique heritage that can be preserved for future generations. Record new memories – Keep traditions alive and remembered by keeping a “holiday journal”. Immediately after the holidays, briefly note how you celebrated, who was there, what you ate, where you went, etc. and capture a few moments on camera – but be sure to enjoy the moment as well! Keep it simple – Traditions should be fun, and not overly time-consuming or expensive. This year, take a few moments to define your family’s traditions and make a special effort to preserve them. Your family and friends will thank you for it!

Magazine Article: Self-regulation and Stress Coping at the Foundation of Resilient Recovery

Self-regulation and Stress Coping at the Foundation of Resilient Recovery by Stephen Sideroff, Phd, Counselor: the Magazine for Addiction and Behavioral Health Professionals, October 2016.
I found this article very fascinating.  It is presented in two parts really.  The first is how childhood effects someone's vulnerability to addiction and relapse.  "High levels of early childhood stress alter and impair neural mechanisms of self-regulation and functioning."  He is mostly talking about attachment issues, and how impairment in attachment "impairs endorphin brain circuitry" which in turn makes it more difficult to self-soothe.  It is also partially why stress can lead to relapse in adults.  Substances become a substitute for self soothing.
The second part of the article deals with the model for self regulation as a way to teach individuals how to self-regulate rather than turning to drugs.  This is a nine-step process.  It focuses on three areas, relationships, balance and mastery and engagement with the world.  This concepts are presented as things to learn:
1. Relationship with Self.  Being able to have positive and loving self-talk is essential.  Much of the author's work involves relearning this internal script.
2. Relationship with Others.  Healthy relationships should have a ratio of at least twenty positives to one negative.  He suggests relationship with less than a five to one ratio may need to be discarded.
3. Relationship with Something Greater.  This of course is the core of 12-step programs.
4. Physical Balance and mastery.  Relaxation techniques should be a part of any recovery program.  Being able to be at peace with yourself is essential.
5. Mental or Cognitive Balance and Mastery.  The perspective of an addict is frequently flawed.  Maintaining a positive attitude is essential to recovery.
6. Emotional Balance and recovery. Emotional reactivity negatively impacts resilience.  A brain is easily high jacked by reactivity.  A four step guide: 1) Become aware of emotions and accept them. 2.)Sit with emotions and recognize what they are about and whom they involve. 3) Expressing emotions in the contest of acceptance.  It is ok to be sad or angry about past events.  however it is not always possible to change the past.  Sometime accepting reality is needed.  4) Let go.  Once a feeling has been expressed, it is important to let go, and not continue to expect the impossible.
7. Presence.  This is about our ability to be in the moment.  This also deals with how you project into the world, which is charisma.  This can involve a change of posture.
8. Flexibility.  Flexibility is the ability to adapt.  Awareness of patterns is essential to being able to confront them, and adapt other ways of coping.
9. Power: The Ability to Get Things Done.  This is having realistic expectations, and setting goals, but understanding new learning is a growth process.  Having more power leads to more freedom, and less dependence, and then increased confidence in one's self.

Diabetes Focus

These are some ideas I gleaned form the Diabetes Focus magazine, Spring 2016:
Sleep Balance:  By sleep balance they mean having the same sleep schedule every day, not waking later on weekends for example.  Those who have the same schedule tend to be healthier.  Those with a greater discrepancy in their sleep schedule have higher cholesterol levels, and greater insulin intolerance.
Stress: Diabetes distress is a real thing.  Managing diabetes can be stressful as you worry about diet, exercise, medical care etc.  Also there is at times a lack of support from those around you.  This can lead to diabetes distress.  It is good to talk to your doctor about stress and diabetes.
Testosterone: There is a correlation between testosterone level and insulin intolerance.  In may be a good idea to ask for blood test.
Singing:  Singing has been shown to improve mood and decrease tension.  Singing also can help with memory and social skills.  People who participate in choirs feel more confident and supported in social settings.
Feet (Socks and Shoes)  Who knew there are socks better for diabetics than other socks.  Fitted socks are best, synthetic materials will keep your feet dryer, padded styles can keep feet protected.  For more recommendations check out American Podiatric Medical Association.  Shoes should be replaced more often than you think, 300 to 500 miles, and more often if you are overweight.  Best to buy shoes later in the day as feet are larger later in the day (who knew?), and best to try them out.  If they don't feel comfortable in the store, they won't at home.  They should feel good without being "worn in."  They should have plenty of room for the toes, but not be so big they slip.  Finally, with your feet protected, we all should walk just a bit more.  For diabetics a pre and post walk check of feet is important to check for any blisters or damage.

Article Review: Feeling Awe May Be the Secret to Health and Happiness

 Feeling Awe May Be the Secret to Health and Happiness, by Paula Spencer Scott, Parade Magazine, October 9, 2016.

Awe as a healer?  But think about it, those who are awestruck have reduced stress, and consequently improved health.  "Awe is the feeling of being in the presence of something vast or beyond human scale, that transcends our current understanding of things." psychologist Dacher Kelmer.  
1. Awe helps us see things in new ways.  It prompts the stop and think reaction.  It sparks creativity.
2. Awe makes us nicer--and happier.
3. Awe alters our bodies.  Awe is linked to reduced levels of cytokines which is linked to depression.  Perhaps urban blight, and living away from nature can by bad on health.
Awe as a healer is pretty new in terms of health science.  But there is something to the idea of getting out in nature, and looking up to see the sky.  Music can also contribute to "awe" moments.  Museums, planetariums, national, state and local parks, all can play a part.

Breathing

I attended a safety training this week.  Two of the presentations including breathing exercises.  Also Employee Wellness was there with handouts, including those about breathing.  I share one of those which seems a very good method.  One of the presenters including gather up the negative with the breath in, and then throwing it away with the breath out; then gathering up the positive with the breath in, and letting it flow over you, or putting it into your heart, with the breath out.

Diabetes and Stress

I picked up a Web MD magazine when I was in Walgreens, and found two articles on diabetes and stress.  The first, they studied people who were stressed and found their brain areas governing self control were turned down or turned off, so they ate more sweets and junk food.  The stressed the people by having them hold one hand in ice water for three minutes.  This is a known stress producing stimulus.  Then they presented them, as well as a control group, to a buffet with junk food.  MRI scans showed less activity in the self-control portion of the brain among those who were stressed compared to those not stressed.   Those who had the ice water bath were more likely to give into temptation as well.
The second article, written by Gina Shaw, tells that stress and diabetes and wreak havoc on your hormonal system.  Stress also makes one less likely to take care of their self.  Diabetes, for the most part, is a self-care illness.  You monitor you carbohydrate and calorie intake, you exercise or not.  It is all a person choice.  When there is lots of stress, it is less likely someone will take care of their self.
Stress relievers:  Breathe; deep breathing from your diaphragm will help send oxygen to your muscles and reduce stress, set yourself up for success.  Having healthy snacks available is good, but also a way to monitor your exercise and remind you to be active.  Then finally, having an understanding of your stress signals, so you know when to be on the alert and when to take action.
I have just gone through a period where by diabetes was not under control.  This was after I b urned myself.  It makes me wonder if the two things are related.  I had numbers over 300--a few not good outliers,  but have finally gotten my fasting blood sugar below 200, averaging about 175.  Some readings have been as low as 140, which is unheard of for me.  However, the doctor threatened me with insulin.  I don't want to go there so I have no choice but to watch my intake, and get plenty of exercise.

**Self Care is Vital

An article in the Bay Area Parent magazine has me thinking about self care.  This was also part of the training I attended this week.  What are you doing to take care of yourself.  We all work hard, but what do we do at work, and after work to take care of yourself.
At the training some things mentioned were exercise, having a pet such as a dog or cat to pet and reflecting to improve.
The article by Cindy Kaplan gives some specific ideas.  The article is geared towards parents of children with special needs, but we all need to take care of ourselves.  These are some thoughts I have about the article:
1. Remove yourself from the situation, lie down on the ground.  Lying down gives you a different perspective,  this could be similar to remembering our place in the world and is a technique to do this.
2. Put on some classical music.  Music can bring down the stress or tension in a situation, if the music is conducive to do this.  Hard rock with the steady third beat harder, and rap music with lyrics that excite and arouse won't do this.  But classical music will.  If classical music isn't your think, easy listening will also bring emotional levels down.
3. Stop outside and look at the sky.  Again this is a grounding strategy to remember the wonder of things and our place in the universe.
4. Give yourself permission to table a discussion.  This is a hard one for me sometimes, but I have taught time out as a way to not avoid, but discuss things at a better time.  In our training it was emphasized that being able to say, lets hold that for a moment and look at it in more detail, are good strategies for reflecting.
5. Light a candle.  A change of mood, and the process of doing something can bring stress levels down.
6. Express yourself creatively.  How often can we put things into paper through art or  writing.  Dance and music also give a chance at creation.
7.  Breathe.  take time to focus on breathing, and allow yourself to breathe deeply.  This is a good way to soothe over stressful situations.  You can breathe pains and stress away.  Recently when I burnt myself, when I remembered to breathe the pain was much less.
A few self care techniques should be in everyone's repertoire.  Also you should frequently ask yourself, What am I doing to take care of myself?

**Article: Holiday Stress

The article below is taken from the Santa Clara County Wellness website.  As we enter the Holiday season it seems appropriate to share it.

Surveys taken on the average American indicate that more than 8 in 10 Americans expect their season to be stressful.

Many factors contribute to the stress. We often operate on a busy schedule that gets even busier during the holiday season. More travel, more expenses, more things on your to do list; but coping isn’t beyond your reach.

There are things you can do to make this busy time of year easier.

1. Set a budget – Track your spending and keep to it. The holiday season is about family and friends not excess spending or overwhelming debt.
2. Set your priorities - You can't do it all. It's ok to say "no" so you can focus more energy on the people and activities that are important to you.
3. Have realistic expectations - Keep things as simple as possible so you can enjoy this special time of the year. Focus on the experiences with your loved ones and not on the perfect decor, table setting or holiday dinner!
4. Make memories with your loved ones. They will remember the love, support and cheer long after they’ve forgotten about a purchased gift. Try alternative gifts, maybe a family photograph, a homemade treat or special one-on-one time with that best friend where you do something fun together.  
5. Try volunteering or giving to those less fortunate. You might find personal gratification that lasts beyond the holidays.
6. Rest and relax -  Take time off from having a hectic holiday party season. Instead, allow yourself to kick up your feet, take a meditation class, go to a museum, or work on craft projects.
7. Maintain your daily routine. Keep sleep hours, physical activity minutes and eating times as normal as possible. Stepping too far out of your routine sets you and/or family members up to be more frazzled and stressed by the hectic season.   
8. Seek out help if you do feel blue or anxious. Talk to someone that you trust. 

My take: A budget is easier talked about than actually done.  Setting priorities is a little easier to.  I love to write things down and then make check marks.  Realistic expectations comes down to accepting yourself as your are and others as they are, rather than comparing to some idealistic illusion.  Making memories is important.  It is not about how much money you can spend.  Volunteering and giving to others is a great way to make the holiday season memorable.  Resting and relaxing is something I don't do enough of during the holidays.  I do try to maintain my daily routine.  

**Pamphlet: Tobacco and Stress

Many people who smoke or use tobacco, do so because of the stress reduction.  However much of this is a false benefit.  For many, the nicotine addiction causes the stress, so of course using nicotine relieves this temporarily, however the long term effect is just the opposite.  Sometimes the stress reduction is related to the activities you might do with smoking, such as taking a break from work.
The exciting part about this pamphlet is the list of alternative suggestion to reduce stress.

I really like the idea of playing with your pet.  You can relax without the cigarette.  Stress reduction can become a life style which includes reading, enjoying music, gardening, meditation, exercise, eating well, getting plenty of rest, and talking over your problems with someone.

**Stress and Diabetes

I came across an article about stress and diabetes from everyday health.

http://www.everydayhealth.com/health-report/type-2-diabetes-lifestyle/stress-management-helps-type-2-diabetes.aspx?pos=2&xid=nl_EverydayHealthManagingDiabetes_20130702
It says that if we stress too much, it can raise the blood sugar of someone with diabetes.  This is because the reaction of our body to stress is to release sugar into the blood stream in preparation for a flight or fight response.  For someone who processes sugar normally, this is good, however for someone with diabetes like myself it can lead to increased sugar levels.
I wonder if this contributes to my high blood sugars at times.  I can go very well with my sugar numbers, especially if I have set routine, like on regular work days.  However when I am not at work, weekends and vacations, my numbers  rise.  There is something to be said for routine.
Another contributing factor to increased sugar from stress is forgetting to take your blood sugars, medications or eating sensibly.  I don't know if it is stress, but this describes me on the weekends when I am away from routine. 
These ideas are presented as ways to combat stress:

• Exercise more. Increasing the amount of exercise you get is a great way to burn off stress. Exercise can also help you reach or maintain a healthy weight and control your blood sugar. "If you can, you might want to bump up your exercise to about 60 minutes a day," Garcia-Banigan advises.
• Eat well. Maintaining good nutrition when you’re stressed helps control blood sugar levels. "You need to make sure to get the right nutrition so you have the energy to deal with stress," Garcia-Banigan says.
• Improve your coping style. Try replacing negative thoughts with positive thoughts, reducing the stress triggers you can, and being good to yourself. "Learn to manage your time well and make yourself a priority," Garcia-Banigan says.
• Learn stress reduction techniques. Breathing exercises, meditation, and progressive relaxation are all techniques that people have found to be helpful for stress management. Practice stress-relieving activities that work for you.
• Get support. Having a chronic condition like type 2 diabetes is stressful in itself. Talk to friends and loved ones about your feelings. Ask your diabetes caregivers about stress management assistance, and consider joining a diabetes support group where you can share feelings, ideas, and advice. 

In my case, the first two suggestions are very important.  I do not  as well one weekend.  There is food around all do, and I grouse with the luxury of being able to do so.  The second issue is exercise.  I do not.  I sit on my butt and don't do much of anything, while weekdays I walk to get to work, and get my exercise in that way.  I should be engaged in positive activity on the weekend, but usually I am not.
Of the other ideas, using meditation and relaxation techniques sounds appealing.  Prayer is a great relaxation tool, with the added benefit of communicating with He who gives life.
This article is beneficial to me.

**Can Lifestyle Change Reverse Heart Disease

http://www.everydayhealth.com/news/dr-dean-ornish-turn-back-clock-heart-disease/?pos=1&xid=nl_EverydayHealthHealthyLiving_20140506
This is a very good article from Everyday Health which presents the work and theories of Dr Dean Ornish on reversing heart disease through lifestyle changes.  He does say his program is not a cure, but it can reverse the normal progression of heart disease getting worse and worse and make it so things actually get better.  These changes include "supervised exercise, stress management through yoga and meditation, emotional support, and nutrition counseling."  He contends to say the "it is all in our genes" is not accurate, because genes give us predispositions only, not a death sentence.  Within that realm of genes, there is much that the individual can do with life choices.  He also talks about the roles of depression and loneliness in health.  His model has a large community oriented component.  He has also written books on these topics, such as "Dr. Ornish's Program for Reversing Heart Disease", "Weigh Less" and "Heart and Survival."
These concepts I find very interesting, and am always interested in how to be healthier.