Managing Stress and Emotional Well-Being Prior to the session, make sure that you have tested your AV equipment and have all of your handouts ready. Welcome the participants as they enter the room. If you are using a virtual platform, be sure to welcome those participants as well. Provide the logistical details for the session ─ the length of the session, and when and how to ask questions. Be sure to include some interactive elements during the session to maintain participant interest. Be sure to monitor the time and keep the session moving. Start the session on time.

Discussion Topics Coping with emotions Managing stress “Welcome. Today we’re going to talk about healthy strategies to cope with emotions as an important part of managing diabetes. We’ll also talk about how to manage stress so that it does not cause further health problems.”

Common Emotions A person who has just learned that he or she has diabetes may have a range of emotions (worry, fear, sadness, anger, denial) and can feel overwhelmed. At times, managing diabetes can be difficult and individuals may have a health setback. When this happens, people may feel angry or depressed. Changes in blood sugar can affect mood and cause irritability. Other issues like family, financial, or work problems can also cause strong emotions. “It is normal for people with a chronic disease to experience a range of emotions ─ from happy to sad. Because how we deal with our emotions can influence how well we manage diabetes, it is important to understand our emotions and develop strategies to cope with them.” Read the slide.

Challenges Emotions such as fear, anxiety, grief and anger are normal, but they can be challenges to making healthy lifestyle changes and managing diabetes. Expressing these emotions is a healthy step toward dealing with them so that you can move on to a positive course of action. Read the slide. “ Expressing emotions is a healthy step to coping with them in positive ways.”

Coping With Emotions Coping is how a person deals with their emotions when facing a challenge. Positive coping strategies can help a person deal with emotions in a way that helps manage the situation while taking care of their health. Read the slide. “While it’s normal to go through a range of emotions, they can become a problem if a person uses unhealthy coping strategies to deal with them. Unhealthy strategies can include eating too much, not paying attention to personal hygiene, avoiding family and friends, and not following health team recommendations.”

Coping With Emotions People can develop healthy coping strategies by adjusting how they think, feel and act. Family members can provide support. “People with diabetes and their loved ones can learn healthy ways to cope with the roller coaster of emotions that living with the illness can cause.“ Read the slide.

Healthy Coping Strategies Finding healthy ways to cope with the emotional aspects of diabetes means Considering how your thoughts impact your emotions. Thinking about what is causing you to feel the way you do. Planning healthy coping strategies to deal with emotions. “Life with diabetes ─ as a person with the disease or as the loved one of someone with diabetes – will have its ups and downs. While you cannot always control what upsets you, you can control how you cope with your emotions. Finding healthy ways to cope is about addressing your thoughts, feelings, and actions when faced with an emotionally stressful or upsetting situation.” Read the slide.

Healthy Coping Strategies Ideas for healthy coping Find specific healthy actions you can take. Try your healthy coping strategies and keep track of how well they work. Note strategies that work well, and think about how you might use them in other situations. Think about strategies that did not work so well and what you could do differently for better results. Read the slide.

Healthy Coping Strategy Examples Attending a support group. Talking with family members or friends. Asking for help. Taking control of the current challenge or problem. Finding a positive outlet such as physical activity, a craft, or a club. Meditating and or praying. Keeping a journal or diary. “What other examples of healthy coping strategies can you think of? (Hand out the “Healthy Coping Strategies” worksheet.) Sometimes keeping a “feelings diary” can help. Write down the circumstances surrounding the current challenge and your feelings. See if there is a pattern. This may help you cope with the next challenge.”

Depression People with diabetes are twice as likely to have depression as people without diabetes. Depression is a serious issue because it can make it harder to stick with diabetes management routines, which could lead to complications. Poor blood sugar management, medications and other physical problems can lead to symptoms of depression. Read the slide.

Signs of Depression Feelings of helplessness. Feelings of hopelessness. Loss of interest in daily activities. Appetite or weight changes. Sleep changes. Anger or irritability. Loss of energy or interest in things you enjoy. Self-hatred. Reckless behavior. Read the slide. “Everyone has times when they feel sad. But depression is a serious mental illness that affects your quality of life. It is important for you to be aware of the signs and symptoms of depression and talk to your health care team about how you feel. Remember, depression can be treated if you get help.”

Managing Stress Stress is a physical or mental reaction to an event or experience. Stress is a normal part of life. Stress can make it harder to think clearly, make decisions and deal with things. Learning to identify the signs of stress is part of the process of learning to manage stress. Read the slide. “When people with diabetes have trouble coping with stress, it might cause them to stop managing their condition or to use unhealthy behaviors to cope. It is the way in which a person manages stress that is important. A person can make choices that are not healthy and add to the stress. Or they can make choices that help them take care of their health and cope with situations.”

Managing Stress Some people experience stress as a feeling (for example, anger, frustration, panic, overwhelming sadness). Other people have a physical reaction (for example, sweating, skin breakouts, clenched teeth, racing heart). Many people may have both ─ for example, overwhelming sadness that leads to crying. Read the slide. “What are some other reactions that you have which are a signal that you are stressing out?”

Healthy Stress Management Healthy things that you can do to deal with stress include Being physically active. Writing in a diary or journal. Talking with others in a support group. Sharing your emotions with your family. Praying and or meditating. Read the slide. “There are positive actions that you can take to calm your reactions and to increase your decision-making ability. We are going to do a couple of activities to help us better understand and manage stress.” (Do Stressful Activity 1 and or 2.

Healthy Stress Management People can manage stress by Removing or reducing the source of stress. Changing how they respond to stress. Talking with a friend or family member. Talking with a mental health counselor. Read the slide. “The challenge here is identifying what is really causing the stress and understanding the difference between the source of the stress and your reaction to it. You cannot always remove the things that cause you stress, but you can change how you respond to them.”

What You Can Do Follow these steps when you start to feel overwhelmed or out of control of your emotions Stop before you say or do anything. Breathe. Take a few deep breaths, meditate, pray, sit quietly, or count to five. Think about how the way you react will affect your health and the people around you. “Sometimes the ways we respond to stress can actually make the situation worse. When you feel overwhelmed by a situation or stressed out, follow these steps (read the slide).”

Control Your Diabetes Every Day Manage your diabetes ABCs (A1C, blood pressure, cholesterol, and stop smoking). Take your medicines. Eat a healthy diet and be more physically active. Use healthy coping and stress management strategies. Learn about managing your diabetes by visiting www.cdc.gov/diabetes/ndep. “Managing diabetes can be stressful and overwhelming. Following the steps on this slide help to improve your health with diabetes and can actually help you feel less stress and more hope. Learning to live with diabetes is not easy, but you can do it!”

Learning About Diabetes Learn How to Manage Your Diabetes Ask your doctor for a referral to a diabetes self-management education program recognized or accredited by the American Diabetes Association or the American Association of Diabetes Educators. Read the slide.

For more information, call 1-800-CDC-INFO (1-800-232-4636) www.diabetesatwork.org “Thank you for participating. Our next session is (provide the date of the next session).” For more information, call 1-800-CDC-INFO (1-800-232-4636) TTY 1-888-232-6348, or visit www.cdc.gov/info To order resources, visit www.cdc.gov/diabetes/ndep