The Anxiety Factor

It’s amazing what a few SWAG-free days can uncover.

Since last Monday, I’ve been (almost) meticulously counting every single carbohydrate I eat. I’ve noticed what may be an overzealous dinnertime insulin-to-carbohydrate ratio. I’ve noticed recurring trends in the late morning and early evening. And I’ve noticed that the rises I used to pin on carbohydrate miscalculations are probably not carb-related at all.

It’s not artisan sandwich bread or exotic sushi rolls that are to blame — it’s my good friend anxiety.

I’ve always read about the ways that mood can influence blood sugar levels — and vice versa — but I never thought they’d be enough to influence my numbers (or CGM graphs) on a day-to-day basis. But yesterday, after several hours of uncomfortable meetings, the unrest I’d felt all afternoon was plain to see on my pump screen — and my meter. Sure enough, about 45 minutes after my first meeting had begun, the line on my CGM graph had taken a 95-degree turn north. Four hours and two meetings later, I was still hanging out in the low 200s.

The only other time I’ve really noticed this trend is on weekends, particularly Saturday mornings. It’s not unusual for me to begin the weekend in the low 70s. And even after my requisite bowl of cereal and string cheese stick, even after I’ve spent an hour watching DIY network in my pajamas, even after bolusing as modestly as possible — I’m still on the low side of normal. Contrast that to a typical weekday, when I can slink out of bed with a blood sugar in the high 50s, and depend on nothing more than the ritual panic of a Tuesday morning to send my numbers into the 100s before I’m even out of the shower. Make that the 200s if I can’t decide what to wear.

The more I think about it, the more pathetically fragile all this makes me feel. To be sure, I lead a pretty drama-free life. I have a great job working with great people. I don’t have kids to feed Pop Tarts to or cart to school in the mornings, and my commute to work is less than a mile long. All this anxiety is in my head — and subsequently, my liver, my bloodstream, and on the screen of my blood sugar meter.

The most frustrating (and anxiety-inducing) part of the whole equation is that there’s no bolus for the freak-outs. I can’t pull out my shiny new kitchen scale and weigh my angst or stress in grams or ounces. All I can do is bolus, re-check, and get on with life. And, hopefully, chill the hell out.

Image via the ever-hilarious Natalie Dee.

13 comments on “The Anxiety Factor

  1. Bob P says:

    I have a lot of anxiety, as well: some of it about specific things, some of it “just because”. I haven’t really tested for effects on BGs: it might be worth doing.

    Thanks for this post.

    • Shannon G says:

      This is so interesting. I never thought about it like that. I know I’ve always heard that stress and anxiety can cause highs, but I usually discard it for something else. I’ve been having morning highs that are awful since I started working days. Now I’m wondering if it’s not just trying to get myself moving for the day that’s causing me some stress and the spikes…something to think about! Thanks

  2. Erica says:

    I absolutely experience this too. Thank you for sharing and making me feel so much less alone. I think this is something that would be hard to measure and report in a scientific journal and therefore doctors don’t seem to really be aware of.

    I am somone who experiences weight gain under stress also, even if my food intake decreases.

    There is a book about stress called, “Why Zebras Don’t Get Ulcers,” by Robert Zapolsky. He talks about the effect of stress hormones on blood sugars.

    Thank you again for such an honest, helpful post.

  3. Kelly says:

    I see this ALL the time in Leah for school related stuff. Monday mornings, when she’s anxious about getting back at it, are crazy high… but by friday when she’s back in the swing of things, she’s usually ok. Piano recitals, field trips, things like that she gets anxious about and we see that graph soar. And like you said, nothing we can do but check and correct.

  4. Kaitake says:

    Stress affects my blood sugar faster than insulin, juice, or exercise! Coupled with the fact that stress also upsets my tummy, and it’s a recipe for disaster for me. Unfortunately it can send me both high and low 😦 but knowing about it is half the battle. My endo was testing me for all manner of strange things cos we couldn’t figure out what was causing BG fluctuations, turns out it plain ol’ garden variety stress’n’anxiety!

  5. Bec says:

    I get high BG’s from just from watching my football team every week! I get so anxious/excited/disgruntled they skyrocket. But it is easy to dismiss our emotions and what they can do our bodies. Great post.

  6. Jeff says:

    I can just imagine future versions of my pump’s bolus wizard.

    BG: 104 (of course)
    Carbs: 30
    Cray cray: 5 of 10

  7. Lorraine says:

    That is so awesome that you have been able to isolate this. I bet you can develop a freak out bolus! Or even a freakout basal rate. Have I lost my mind, because I’m so not joking?

  8. Fiona says:

    I love Lorraine’s comment! Timely post, I had a stressful workday on Monday due to a poltergeist in my laptop. That 90 degree angle climb made for one ugly ass graph although it did help me to pinpoint the exact time of the incident, just by consulting my Dexcom!. I could have used a “homicidal techno-rage” bolus/basal.

  9. Renata says:

    If you have to find a silver lining, at least you know what it is. Why can’t you bolus for stress, especially if you are seeing the trend.

  10. Karen says:

    Oh yes, anxiety, stress, nerves – they all send my blood sugar sailing too. I don’t think you should see it as making you pathetically fragile though. Nope, instead it makes you sensitive – after all, who wants to be a cold, unfeeling robot??

  11. Melissa E says:

    I have the same issues with anxiety, heaven forbid I try to control my numbers when speaking in front of a crowd. That anxiety high seems to stay around a lot longer too! Thanks for stopping by my blog! The hens and their funny antics are pretty good for stress relief!

  12. Bijanca says:

    I don’t know if anyone is still following this but I really wanted to respond to why a person must consider before correcting for stress.

    I’m new to this (diagnosed Jan 2010) but the first thing I had to learn was to control my stress levels. With an amazing husband, 4 heroic kids of my own, the cat, dog, house, job, community work with troubled youth and teens in inner city areas, and the countless playmates and parents coming through our home and life… I was the poster girl for stress. I never stopped. Was always the one running to the next meeting, having the next get-together for the families, taking the community kids to the local pool, zoo, football games, baseball, cheerleading, you name it. And then it all stopped…
    (As I am Canadian you guys may wish to do the math but our 5.5 is roughly your 99 I believe. I passed out at the kids school. Thank god. at least I was with ppl that knew me. I went in with a 56. Was told I had the flu 6 weeks before and thought carbs were the way to go right? Bananas, ginger ale, crackers, etc.)
    Then nothing… no kids…no calls… no work… nothing… I was hospitalized for 1 week of absolutely no contact while they informed my husband of my new friend… And his…DT1 . And that was it. And my husband held me. And I cried… I think the best cry I have ever had. And it was great. Because I wasn’t dead. And because I can do this. If meaning that I got to spend one more day with my family I would do it. And on my journey I went. I learned new things, and met new ppl. No chance of a little pill… I was to stick myself now with this needle… everyday??? everyday… Damn. And I have to eat too?? crap… I’ve never liked food much. Always made me sick… now I know why! But I was alive. and there is no food on this planet worth getting me back there! We all fall off and need to be honest when we do and fix it.
    And then there is stress.
    Because stress can fluctuate so quickly from none to extreme (it is not unusual for my phone to ring with a crisis at 3 am), and from extreme to nothing (once some issue is solved) it is very unsafe to try and correct when you are high from a stress factor.
    If your issue becomes resolved rather quickly your stress levels will drop. You will crash as quickly as you rose. Then you will have to eat against the insulin you took. B-A-D. This sucks.
    This crash will also happen to me if I have had a relatively normal BG, but busy day and I relax with my husband after the kids go to bed. I can be at an 11 at 8:55 pm and a 3.4 at 9:15 because the kids have moved to their domains with necessary bed rituals completed, and my husband and I have settled in together.
    Realistically, when discussing this with my drs, family, and nurses, we post my target between 7-9.
    Assess stressful issue to be a 1, 2, or 3
    Add this to your target medium (in my case 8.5)
    At extreme times in the past 1 1/2 years I have been as high as 30 when factoring in this pattern and have almost been bang on. But only if I am honest with what is stressing me.
    It also, however, will generally cause you to personify the issue because you may not be thinking clearly. Always check your BG if your unsure how your body may be dealing with stress. I deal with more uncontrolled numbers from stress than from my food by far!!
    Stressed? Control what you can, let others make their choices, and talk to someone. It always helps to have a friend.
    Luckily, I have my family. And now you! Thanks!
    Thank you for giving me a place to relate again.

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