Your brain is complex and does many things automatically. One thing you do have control over, is your thoughts. However we all have automatic ways of thinking about our lives, who we are and the events that happen to us. Often people have a history of things in their lives, stories about things that have happened, which can lead to thinking this is the way things will always be. It is easy to get stuck in a thinking pattern. This includes things like thinking everything always goes wrong for you, or that because you had a couple of bad days, things will always be this way.

By challenging these thoughts and looking at what goes through your head you can challenge these thinking patterns. One of the most common thoughts is the "shoulds” of life. Lots of us respond to things that happen in our lives with "should have and should not haves". This includes things like telling yourself "I should have worked harder", "I should not have eaten that", "I should have acted sooner", "Ishould not have taken on that job" etc etc etc. In diabetes people might say they should have had more or less insulin, eaten more or less, noticed their blood glucose sooner and so on. What it is about is blaming yourself, rather than looking more objectively at the situation.

This way of thinking is unhelpful as it greatly increases your stress. What can help is to turn this around into things like " it would have been nice if I had thought about that earlier, but I made the best decision I could at the time and now I am moving forwards". In this way you are being much gentler on yourself , you will relax more and your stress will be lower and your self esteem higher, as a result.

Mindfulness

Mindfulness Meditation is a fantastic way to help you change your thinking. It can be helpful in management of your diabetes. It helps you to climb out of your head, put aside any worries and focus on the moment. Mindfulness is all about paying attention to the here and now. This involves bringing your focus to the present moment and being non judgmental about the current moment - you just are, you just see and smell and feel and hear and taste - everything in that moment. You notice it but you don't place any thoughts about it.

If you can learn not to judge what is happening in your head and just observe your thoughts - you become more relaxed and free to get on with life. It is as if you are watching your thoughts rather than being caught up in them, which can take you away from every day life and increase your stress.

Have a look at this website to find out more.

 Be gentle on yourself!

Lots of people with diabetes beat themselves up about their BGL results, but this just adds to stress levels. At the end of the day this is a number and it does not define who you are as a person.

What can help is to look at if diabetes &/or other problems in your life are overwhelming you - try to get perspective and balance.  See all the things that are happening in your life – try not to focus on just the problems.

Avoid the dangerous approaches to stress management

It is important to avoid the use of alcohol, drugs and over-eating as a way of managing stress. They don’t help! These activities give short term relief and long term pain and can become problems in themselves. Seek help if you feel such behaviours are problematic. Reach out to someone in your network who can offer support and involve your loved ones where you can, seeking their help and support in managing diabetes as well as other problems/stress in your life.

Remember you are not alone and build compassion

Realise you are not meant to be a hero! Talk about your problems and worries, write about them, blog or start a journal and get it out there! Asking for HELP is ok. It is also important to tune into your reactions and thoughts about other people. Your emotions in regards to others can lead to high stress – jealousy, hate and resentment all lead to high stress and unhappiness. Trying to let go of jealousy, anger and resentment and put yourself in other’s shoes – showing true compassion can help to reduce stress in your life.

 Meditation and deep relaxation

Deep relaxation and meditation are very helpful in reducing your current stress and anxiety and can have ongoing effects when you practice these regularly. Meditation is a way to bring your mind into a state of peace, quiet and tranquillity. It is about focus and calmness.

The word meditation, is derived from two Latin words : meditari (to think, to dwell upon, to exercise the mind) and mederi (to heal). Often a focus is used, such as a candle flame, a Mantra (repeated word or phrase) or the rhythm of your natural breath. During mediation it is normal for your mind to wander off again and again, but you learn to gently bring your mind back to concentrating on your breath or other focus.

Whatever you do with awareness, is meditation. Just watching your breath, listening to the birds, or noticing the sound of the waves. As long as these activities are free from any other distractions to your thinking and you can truly focus, it can be meditation. When you live with diabetes and the every day stress of life, meditation can be an effective way of calming your mind and giving you focus. It can help you to feel more peaceful and more able to keep managing on a day to day basis.

Traditionally, yoga describes meditation as having several stages. Now we often mean any one of these stages when we talk about meditation. Some people learn only concentration techniques, some relaxation and so on. There are many misconceptions concerning meditation. However all forms of meditating, where you are focusing and calming your mind, can have great benefits. Methods such as Mindfulness Meditation are being used by doctors and a range of health professionals in managing illness and disease, anxiety and depression.

Meditation usually has three stages: one, Concentration, two, Contemplation, and three, Meditation (the state reached when the meditator is no longer aware of meditating). For health purposes, it is enough to reach a state where your mind is quiet and steady, uour breathing is calm and steady, and you are feeling a sense of deep peace. With regular practice, you can get to this state and it will be very beneficial.

You can purchase many tapes and CD´s , books, videos and DVD´s to teach you how to meditate in way that suits you. Many people find breathing techniques one of the easiest ways to meditate.

Here are some helpful links to breathing techniques; meditation and relaxation

Dr Gillian Ross	Open Ground
Holistic Online	Reachout
Altmedicine	Free Meditations
Better Health
Beyond Blue	Panic Attacks
Cyh Health Topics

 Relaxation techniques often can help people with stress, anxiety, depression and sleep problems. Several relaxation techniques are listed below

Progressive Relaxation

This technique is often most useful when you use a guided tape or CD, or you can tape these instructions yourself by reading them slowly and leaving a short pause after each one. Then you have your own guided relaxation!

•  Lie on your back, on a firm surface - bed or floor.
• If you can not lie, you can do it in a chair, but it is more effective lying down.
• Do not cross your ankles and keep your fingers open and your arms and hands loose.
• Close your eyes.
• Take a deep breath and hold it, tighten your whole body, as tight as you can, squeeze every part, hold it…. And blow out the breath and let your body go soft.
• Do this again, take a deep breath, hold it, tighten your whole body, as tight as you can as if you are squeezing the last drop of water out of your body….. and breathe out and let go.
• Now feel your feet. Sense their weight. They feel heavy, very heavy. Consciously relax them and sink into the bed or floor. Start with your toes and progress to your ankles.
• Feel your knees. Sense their weight. They feel heavy, very heavy. Consciously relax them and feel them sink into the bed or floor.
• Feel you upper legs and thighs. Feel their weight. They feel heavy, very heavy. Consciously relax them and feel them sink into the bed or floor.
• Feel your abdomen and chest. Sense your breathing. Consciously will them to relax. Deepen your breathing slightly and feel your abdomen and chest sink into the bed or floor.
• Feel your buttocks. Sense their weight. They feel heavy, very heavy. Consciously relax them and feel them sink into the bed. Whole body sinking into the bed, or floor.
• Feel your hands. Sense their weight. They feel heavy, very heavy, whole body heavy, sinking into the floor, or bed. Consciously relax them and feel them sink into the bed. Your hands are heavy.
• Feel your upper arms. Sense their weight. They feel heavy, very heavy. Consciously relax them and feel them sink into the bed or floor.
• Feel your shoulders. Sense their weight. They feel heavy, very heavy. Consciously relax them and feel them sink into the bed or floor.
• Feel your neck. Sense its weight. It feels heavy, very heavy. Consciously relax it and feel it sink into the bed or floor. Turn your head from side to side, relaxing it, feeling it heavy, sinking into the floor, or bed.
• Feel your head and skull. Sense its weight. It feels heavy, very heavy. Consciously relax it and feel it sink into the bed or floor.
• Feel your mouth and jaw. Consciously relax them. Pay particular attention to your jaw muscles and unclench them if you need to. Feel your mouth and jaw relax and sink into the bed. Take a deep breath, you might feel like yawning, have a big yawn and relax your face and mouth and jaw.
• Feel your eyes. Sense if there is tension in your eyes. Sense if you are forcibly closing your eyelids. Consciously relax your eyelids and feel the tension slide off the eyes.
• Feel your face and cheeks. Consciously relax them and feel the tension slide off into the bed or floor, whole body heavy.
• Mentally scan your body. If you find any place that is still tense, then consciously tighten and then relax that place and let it sink into the bed or floor.

Toe Tensing

This one may seem like a bit of a contradiction to the previous one, but by alternately tensing and relaxing your toes, you actually draw tension from the rest of the body. Try it!

1. Lie on your back, close your eyes.
2. Sense your toes.
3. Now pull all 10 toes back toward your face. Count to 10 slowly.
4. Now relax your toes.
5. Count to 10 slowly.
6. Now repeat the above cycle 10 times.
7. Now repeat the above cycle 10 times.

By concentrating on your breathing, deep breathing allows the rest of your body to relax itself. Deep breathing is a great way to relax the body and get everything into synchronicity.

Lie on your back.

1. Slowly relax your body. You can use the progressive relaxation technique we described above.
2. Begin to inhale slowly through your nose if possible. Fill the lower part of your chest first, then the middle and top part of your chest and lungs. Be sure to do this slowly, over 8-10 seconds.
3. Hold your breath for a second or two.
4. Then quietly and easily relax and let the air out.
5. Wait a few seconds and repeat this cycle.
6. If you find yourself getting dizzy, then you are overdoing it. Slow down.
7. You can also imagine yourself in a peaceful situation such as on a warm, gentle ocean. Imagine that you rise on the gentle swells of the water as you inhale and sink down into the waves as you exhale.
8. You can continue this breathing technique for as long as you like until you fall asleep if you like.

Guided Imagery

In this technique, the goal is to visualize yourself in a peaceful setting.

1. Lie on your back with your eyes closed.
2. Imagine yourself in a favourite, peaceful place. The place may be on a sunny beach with the ocean breezes caressing you, swinging in a hammock in the mountains or in your own backyard. Any place that you find peaceful and relaxing is OK.
3. Imagine you are there. See and feel your surroundings, hear the peaceful sounds, smell the flowers or the barbecue, feel the warmth of the sun and any other sensations that you find. Relax and enjoy it.
4. You can return to this place any night you need to. As you use this place more and more you will find it easier to fall asleep as this imagery becomes a sleep conditioner. You can practice this after any of the other relaxation techniques. So once you are fully relaxed, you go to your favourite place and enjoy it!

Diaphragmatic Breathing Technique (belly breathing)

This type of breathing is very useful for relaxation and meditation activities and in particular for use in dealing with Anxiety and in lowering your overall stress. It can help to steady your blood glucose levels if you practice this regularly when relaxing or meditating. Using breath in this way can be a useful way to meditate.

When overcoming high levels of anxiety it is important to learn how to use correct breathing. Many people who live with high levels of anxiety breathe through their chests. This is shallow breathing and it disturbs the balance of oxygen and carbon dioxide necessary to be in a relaxed state. This type of breathing will make anxiety symptoms worse. It is hard to feel relaxed when we breathe like this.

The best way to breathe in managing anxiety is a technique called Diaphragmatic breathing or stomach breathing. This type of breathing uses the diaphragm muscle (a strong dome shaped muscle) located under our ribs and above our stomach. When we breathe in, we push the muscle down, and our tummy moves forward. When we breathe out, the diaphragmatic muscle moves back to resting position and our tummy moves back in. There is little or no upper chest movement during this type of breathing.

Diaphragmatic Breathing Exercise

First you need to tune in and become aware of your breathing.

Place one hand on your upper chest and one on your stomach. Take a breath and let your stomach swell forwards as you breathe in, and fall back gently as you breathe out.

Try to get a steady rhythm going, take the same depth of breath each time.

Your hand on your chest should have little or no movement. Try and take the same depth of breath each time you breathe in. When you feel comfortable with this technique, try to slow your breathing rate down by putting a short pause after you have breathed out and before you breathe in again.

At first, it may feel as though you are not getting enough air in, but with regular practice this slower rate will soon start to feel comfortable.

It is often helpful to develop a cycle where you count to three when you breathe in, pause, and then count to three when you breathe out (or 2, or 4, or 6 - whatever is comfortable for you).

This also helps you to concentrate and focus on your breathing without any other thoughts coming into your mind. If you find other thoughts entering your mind, (which they usually will at first) just let them go and bring your attention back to counting and breathing.

If you practice this technique regularly, say for ten minutes twice a day, and any other time you are aware of your breathing, you will begin to strengthen the Diaphragmatic Muscle and it will start to work normally in this way and help you to have a nice relaxed feeling.

Anytime in which you are experiencing anxiety, try and remember to breathe in the manner describe above, and your anxiety level will decrease.