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Most diabetes treatment plans focus solely on glucose management, but I would like to introduce you to something new to add to your bag of tricks! It’s your autonomic nervous system. It’s free, it’s always running in the background, and it is mostly responsible for your mood and stress level. Have some diabetes stress or burnout? Keep reading…..
But first, a biology lesson. Your nervous system includes your brain, spinal cord, and the nerve cells that connect every part of your body. It is a superhighway of information conduction that tells your central processing system (your brain) what is happening in the world around you and in you. Then your brain does all sorts of magic – creating ideas and images, and sending signals throughout your body.
Your nervous system has 2 primary parts. Your somatic nervous system. This is the part you have control of and can move at will. Point a finger, raise your hand, or select a shirt to wear and it’s your somatic nervous system sending the signals. It’s useful, but a bit less magical! The other part is your autonomic nervous system (ANS) – it is where the action is!
Autonomic nervous system
Without your involvement, your ANS is breathing, digesting, regulating blood pressure, and keeping you alive. It’s also replaying programs it has learned from your life experiences. Riding a bike, typing, tying your shoe….. All those things you can mindlessly do without thinking about it.
Your ANS gets much more specific based on what is going on in your world. There are 3 basic states 1) “Fight or Flight” – your sympathetic nervous system(SNS), 2) “Mend and Befriend” your parasympathetic nervous system (PNS) and 3) Shutdown – a hyper-protective mode of your PNS.
Almost done – I promise the diabetes relevance is coming!
States of your Nervous System
Each state of your autonomic nervous system has a very necessary purpose.
- Fight or flight is for survival. It primes your body for action, gets hyper-focused on anything else that looks dangerous, increases heart rate and blood pressure, narrows your vision down to the specific threat, and makes you very reactive. No time to think! Also – it dumps glucose in your bloodstream to fuel up for predicted activity. All very good if you step on a Lego or encounter a wild bear. The SNS takes over before you realize what just happened. It utilizes a LOT of your body’s energy and is outward-focused. It is designed for very short bursts of activity when danger is present
- Mend and befriend is for repair, healing, digestion, growing, learning, creating, and connecting with others. It’s when you feel safe to let your guard down and just chillax! All your body’s resources (oxygen, immune system, nutrition, hydration, protein synthesis, etc) are turned inward to get your body in its best shape. You can hang out here forever! And it feels really nice. It is your body’s preferred and natural state.
- Shutdown is when your system is so overwhelmed physically or emotionally that it just can’t go on. Perhaps in situations of starvation, extreme illness, or deep depression. The body can’t spare any energy and is just trying to get by. This is for extreme survival situations.
How Does this Impact Diabetes?
Ok – here is the diabetes part (bad news first).
It’s easy to get stuck in fight or flight mode with diabetes. It can be very obvious threats such as hypoglycemia or DKA, but often is more about what goes on in your head. You see, the SNS believes whatever is going on in your brain is real and will kick into action. So worry, anxiety, feelings of failure, feeling judged, believing you are somehow damaged or unworthy, feeling isolated or unheard, or beating yourself up for any number of reasons (mmmm, maybe you want to be perfect?) will immediately and without your permission turn on fight or flight. Your thoughts alone will trigger it, even when no real danger is present.
Chemicals, hormones, and alarm signals flood your body with the news “All is not well! Battle stations everyone!!” There is nothing you can do when it gets activated. It just happens. You become reactive, you feel like everything and everyone is out to get you, you feel alone and like no one understands you, you are not open to input or new information and you put up BIG WALLS to keep you safe. And there is that extra glucose released – no fun.
Your brain is biased toward the threat and will look for other thoughts (true or not) to bolster its case. “They hate me! I am a failure! I can’t do this! I suck! I am alone!” It’s a vicious cycle that can land you in a very lonely and disconnected place. Perhaps even shut down if it goes on unchecked. PS – shutdown can show up as the dreaded word “non-compliance”. Makes sense right? It’s all too much and you stop dealing with things.
So this obviously paints a very bleak picture. I’ll add one more thorn before we get to the good part. Our medical system is predicated on teaching you the worst-case scenario, identifying all your problems, and reminding you that you fail a lot. It’s all done in the name of “Patient Education” and the system really believes just knowing this is enough to scare you into “behaving better”. How’s that working for ya???
Ok, time to switch gears, and here comes our parasympathetic nervous system to the rescue! It truly is the cavalry that helps us recover and navigate through the bad things. And remember it’s automatic too – it just happens. It’s like sleep, chilling with your friends, enjoying a lingering, lovely meal, watching a sunset, playing with babies/puppies – in general feeling safe and comfy. Walls are down, ears are open, shoulders relaxed, the heart is open, systems find balance, the mind is curious and creative, and you feel peaceful and safe.
Parasympathetic loveliness is soooooo necessary! So much so, that our bodies force us to sleep every day (and if we don’t we suffer). In our busy, modern, TikToking-Amazon-shopping-event-attending-sports-playing-neighbor-comparing-over-planned lives, we don’t get enough time in our PNS state. Period. We need time for maintenance, repair, healing, balancing, and restoration.
Add diabetes to the mix and you don’t even get to sleep all night every night. Not to mention thinking about being a pancreas every waking minute. We need MORE Parasympathetic time to boost immunity, replenish energy, repair tissue damage, decrease inflammation, balance endocrine function, and calm our minds. It is MISSION Critical! Tapping into this state helps us cope with the ups and downs of diabetes, lays the groundwork for healing, and is crucial for preventing complications. Yet, our culture believes this is non-productive time and frowns on this sort of “self-care”.
Switching to Parasympathetic
So hopefully, by now you are curious about how to get more of this super-beneficial state of your nervous system. But you may also be thinking, “Wait you said it’s all automatic and we can’t control it!! So now what??!!”
Great observation! We can’t just tell our brains to shift into parasympathetic, but there is a back door. I’ll call them Safety Cues. Just like how the brain gets input when there is danger and shifts into fight or flight, if the brain gets signals that “all is well”, it goes back to its favorite place – parasympathetic goodness – mend and befriend.
Using Safety Cues is our only trick to shift gears. Best news ever – Safety Cues are free and easy and never run out of supply!! The only catch, is you have to notice when you shift into fight or flight and use your Somatic Nervous System (that manual part) to evoke some Safety Cues.
These are some really good techniques that send messages to your body that it is safe. We can literally use our minds and body to change our internal biology! It always starts with a pause when you notice you are in flight/flight. Just stop and notice what is happening for you. Then, see what might help you feel safer in that moment. Give some of these Safety Cues a try:
- Polyvagal Breathing (my favorite): It stimulates multiple aspects of your vagus nerve which slows down heart rate, drops blood pressure, and calms the system. It’s the opposite of panting (like shallow breathing when we are scared). You simply breathe in for a count of 4 through your nose with a closed mouth. Notice the air flowing through the back of your nose, down the back of your throat, into your lungs, and expanding your abdomen. Then exhale slowly through your nose again, for a count of 8 – keep your mouth closed. Repeat 5-8 times. The key is slowing down the exhales. Just this breathing technique alone will move you towards or into parasympathetic.
- Melt your muscles You might notice that you get tensed up in Fight/Flight mode. So choosing to pause and melt your muscles helps to u ndo that and lets your brain know those muscles aren’t really needed. Focus on what is tight (shoulders, fists, thighs, jaw, forehead, butt, etc). Then take a deep breath into those areas and let those muscles go as you exhale. Just melt. Pay attention, you may feel some tingling, warmth, or soothing feelings. Do several breaths and melts until you notice the shift. Enjoy it, it will enhance the experience.
- Mental vacation. Think about a place where you feel safe and calm. Bookm ark it in your mind so you can easily access it when needed. When you notice yourself getting activated, pause and mentally “go there” with everyone one of your senses. What does that place look like, sound like, smell like, taste like, and most importantly, what does your body feel like in that place? Literally, try it on and allow that feeling of safety, comfort, and peace to wash over you, shifting you into parasympathetic.
- Get out of your head. When your thoughts are fueling your fear-based state, you can’t think your way out of it. You need to enlist the help of your body. Once again, pause and turn your awareness to your physical body. Notice what parts of your body are touching the chair. How do they feel? How do your clothes feel on your skin? What sights, smells, and tastes are present in this moment? Feel your feet on the floor, connecting you to the earth. Seek out the places where you feel stable. Especially notice these places and sensations that feel good! Get curious about what else is going on inside “You”, besides your thoughts.
- Physical Touch. Practice this ahead of time to know what feels good, and see how your body reacts to any of these options. Very simply we can use our own touch in a soothing way. Place your hands gently on different parts of your body like your cheeks, forehead, back of the neck, over your heart, or over your stomach. Notice what your hands sense touching that area and notice what that area senses from your hands. Feel the warmth, tingling, connection, and/or ease in the moment. Another option is a self-hug. Place your hands in opposite armpits and give a squeeze. It can be very comforting!
What’s the benefit?
Learning how to shift into a parasympathetic state has many benefits. Honestly, the hardest part is to remember to notice when your thoughts have set off the alarm bells! But if you can catch yourself and pause, then engage in a Safety Cue you will have less anxiety, you will be a better communicator, you will be less defensive, you will feel more heard and seen, you will be able to tell others what you really need, you become more proactive (moving towards what you want), you will be more creative, you will be more curious and your body will feel better. Maybe more!
Internally, your resources will be available to heal illness, balance endocrine functions, repair injuries, reduce inflammation, grow new tissues and so much more. Your body is a healing machine when it isn’t engaged in battle. Just look at any scars on your skin as a reminder. Your ANS made that skin knit back together and heal all on its own. And this healing happens everywhere in your body when your resources are available (not focused on finding danger).
Sounds too good to be true, right? The catch is, it takes practice. You have to do it. You have to pay attention. Disrupt the pattern. Intentionally do things to shift back into the state of “mend and befriend”. But the more you do it, the easier it becomes.
When to do it?
The easy answer is “often”! But especially when you notice you are down on yourself or your mind just won’t shut up. When someone triggers you (commenting on food, glucose readings, your efforts, etc.), I really like the Polyvagal breathing technique. It gives me back a sense of control and it makes it easier to not take everything personally. I always do this before a provider visit too. No matter how many years of living with diabetes, I still dread the feeling of judgment that tends to show up for me. If you are feeling stressed, defensive, or ready to fight, you won’t be able to listen, or communicate, and may misinterpret things during this time with your doc. Also if you need to have a difficult conversation, it’s always better to find your internal “Safe Place” before you begin.
You are more than your glucose level or your physical body. Your mind, emotions, spirit, and experiences are all inextricably linked within your physical self. They all must work together to create wellness. So use the tools God gave you to create a place where you feel safe, creative, curious, connected, and empowered. Use your mind’s intention, to engage your body, to shift the state of your nervous system so that your spirit can soar!
This is a gift you can give yourself and it will spread to those around you. You deserve this self-kindness and healing in our stressed-out world.
Lastly, I have a favor to ask. Share this blog with anyone you know in healthcare. There is no place where feelings of safety, comfort, and connection are more needed than in our fractured, disjointed, rushed medical system. And if your parasympathetic nervous system isn’t engaged when you are in the care of a medical professional, healing is nearly impossible. And that seems to be the accepted norm these days. Let’s change that!
Be well, my friends.
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