Fears about COVID-19 can take an emotional toll, especially if you are living in an area with a higher number of coronavirus positive cases. But you're not powerless. The Diabetes Health team shares some tips to help you get through this stressful time.May you live in interesting timesThe irony of this saying is definitely not lost on anyone. The world as a whole has fallen victim to the COVID-19 virus. It's a frightening time. Neighbourhoods, cities and even countries are in the midst of a lockdown hoping to flatten the curve of this worldwide pandemic. Worldwide, people are living in areas that have already been affected by coronavirus or are bracing for the worst to occur. The uncertainty of the past few months has raised questions not just about physical health and well-being but mental health as well. Mental health is more than just the absence of mental disorders or disabilities.The World Health Organization constitution states that- Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Mental health is a state of well-being in which an individual realises his or her abilities, can cope with the normal stresses of life, can work productively and can contribute to his or her community..How stress affects DiabetesStress can be physical or mental. It can complicate Diabetes by distracting you from proper care or affecting blood sugar levels directly. Learning to relax and making lifestyle changes can help reduce mental stress.In people who have Diabetes, the fight-or-flight response does not work well. Insulin is not always able to let the extra energy into the cells, so glucose piles up in the blood.Stressful situations trigger the fight-or-flight response wherein the body either prepares to face the stressful situation or escape it entirely.Chronic stress can completely upset your emotional equilibrium, as well as your physical health. Chronic stress can do real harm to your body, and cause emotional and physical problems, including digestive problems, chest pain, high blood pressure, anxiety, irritability, depression, muscle tension and fatigue..For people with Diabetes, stress plays a direct role in worsening your health parameters as it raises blood sugar levels and blood pressure levels, activates our fat cells, contributes to insulin resistance and impairs glucose tolerance. Not only does stress hamper your mental well-being but it also wreaks havoc with your physical well-being. Many sources of stress are long- term threats. For example, it can take many months to recover from surgery. Stress hormones that are designed to deal with short-term danger stay turned on for a long time. As a result, long-term stress can cause long-term high blood sugar levels.Effective stress management is crucial for continued mental and physical well-being.Dealing with Diabetes-related stressSome sources of stress are never going to go away, no matter what you do. Having Diabetes is one of those. Still, there are ways to reduce the stress of living with Diabetes. Support groups can help. Meeting other people who experienced similar feelings can help you feel less alone. Making friends in a support group can lighten the burden of Diabetes-related stress..Dealing directly with Diabetes care issues can also help. Think about the aspects of life with Diabetes that are the most stressful for you. It might be taking your medication, or checking your blood sugar levels regularly, or exercising or eating as you should. If you need help with any of these issues, speak with your doctor..4 A's of stress managementThe four A's are:.AvoidIt is important to avoid unnecessary stress. If the non-stop news cycle makes you anxious, turn off the TV. It is important to remain updated but you could refer to official websites about the information on Covid-19. Social media also may not be a source of reliable information, especially about Covid-19. It is best to check news related to the coronavirus only once a day..AlterIf you can't avoid a stressful situation, try to alter it by changing how you communicate and function in your daily life. Voicing your feeling, instead of bottling them up, is more useful.AdaptRegain your sense of control by adapting your expectations and attitude to the stress inducing event. Your brain is capable of rewiring itself and trying to learn from the experience so you can handle the stressor differently next time..AcceptAccepting your stress can help lift the weight off your shoulders and could be the first step to asking for help.Identify your feelingsEffective stress management helps you break the hold stress has on your life and regain control..The first step to tackle stress is to identify your emotions. People often feel things that they are unable to explain. Psychological and emotional signs like anger, irritability, restlessness, feeling overwhelmed, unmotivated or unfocused, irregular sleeping patterns and poor memory or concentration are signs which indicate stress.The resulting anxiety can be debilitating. It is important to identify what is making you anxious. One way to do is by starting a stress journal. A stress journal can help you identify situations and events which cause you stress. When you feel stressed, keep track of it in your journal. Keeping a daily log will help you identify patterns and common themes. Note down:.What caused your stress (guess if you're unsure)How you felt, both physically and emotionallyHow you acted in responseWhat you did to make yourself feel betterGet some Stress gets amplified when you don't get enough sleep. It's especially important now to get the recommended amount of sleep to help you stay focused on work and on managing the stress the current outbreak can bring. Sleep plays an important role in keeping fit and prevents many health conditions. Disturbed sleep and daytime sleepiness may affect metabolism and may lead to weight gain, irritability, forgetfulness and depression. In rare cases, people may also talk or walk while sleeping and grind their teeth..Tips for better sleep.Go to bed and wake up at the same time every day, including weekends, to avoid confusing your body.Turn off your tablet and phone before bedtime or use a blue-light filter with your device. Blue light can stimulate your system and keep you awake.Relax a bit before heading to bed. Have a nightly ritual that gets you in the state of mind to fall asleep.Skip caffeine and alcohol. These can stand in the way of a good night's sleep.Exercise daily but not within two to three hours of bedtime..Eat healthyEat well and drink plenty of fluids. Foods can help manage stress in several ways. Comfort foods can boost levels of serotonin, a calming brain chemical. Foods can also cut levels of cortisol and adrenaline – stress hormones that take a toll on the body over time. A healthy diet can help counter the impact of stress by shoring up the immune system and lowering blood pressure. Foods like tea, orange, spinach, pistachios, avocadoes, almonds, good carbs from whole grains, brown rice and vegetables, chickpeas, dark chocolate, berries and fruits like cherries and grapes, dark green vegetables, peas, beans, soya, lentils, paneer, eggs, walnuts, olive oil, avocado, flax seeds, oily fish like sardine, tuna, mackerel and salmon, cod liver oil are beneficial to build immunity. Speak with your dietician to understand how you can include these in your daily diet..Tips to reduce stressMaintain a routine as best you can – Even if you're stuck at home, try to stick to your regular sleep, school and meal or work schedule. This can help you maintain a sense of normalcy.The 4-7-8 breathing method – Place the tip of your tongue against the roof of your mouth and keep it there the whole time. Part your lips slightly and exhale with a whooshing sound through your mouth. Close your lips and inhale silently through your nose. Count to 4 in your Hold your breath for 7 seconds. Exhale with a whoosh sound for 8 seconds.Exercise every day – The lockdown has made it increasingly difficult to exercise outdoors or in your gym. But it is important to keep up with your exercise routine indoors. Routine exercise can help improve the way your body uses oxygen and helps you cope with stressful situations.Keep in touch – Social contact with friends and family is an extremely effective way to relieve stress. Reach out to family members, friends and colleagues regularly via phone, text or other virtual platforms. Make sure that you are checking on those that are Check-in regularly with your parents, grandparents and your children. Use video calling app to connect with your friends and family. Reconnect with friends.Set aside leisure time – Include relaxation in your daily schedule. Don't allow other obligations to encroach during this time. This is your time to take a break from all responsibilities and recharge your batteries. This could include anything that brings you joy.Keep your sense of humour – This includes the ability to laugh at yourself. The act of laughing helps your body fight stress in several ways. Watching a comedy series on TV or reading a humorous book can help you relax.Disconnect – While it's important to stay informed of the latest news and developments, the evolving nature of the news can get overwhelming. This is particularly important for our children and elderly. Whenever possible, disconnect physically and mentally from the 24/7 news cycle. Play with puzzles, a board game, tackle a project, reorganize something, see a movie, learn a new skill or start a new book that is unrelated to coronavirus coverage.Speak with your children – It is important to discuss with your children in an age-appropriate language about the coronavirus epidemic and the resulting lockdown. Provide facts about what has happened, explain what is going on now and give them clear information about how to reduce their risk of being infected by the disease. Ensuring that your child follows a daily routine is of paramount importance. Children should understand that it is normal to feel sad, stressed, confused, scared or angry during a crisis. Help them understand that they can alleviate those feeling by discussing them with people they trust.Music therapy – This makes use of guided imagery and other established techniques to play an important role in reducing stress. Listening to music can have a tremendously relaxing effect on our minds and bodies, especially slow, quiet classical music. This type of music can have a beneficial effect on our physiological functions, slowing the pulse and heart rate, lowering blood pressure, and decreasing the levels of stress hormones. Music, in short, can act as a powerful stress management tool in our lives. The British Academy of Sound Therapy in collaboration with the Manchester band Marconi Union created the world's most relaxing song called Weightless. The song starts at 60 beats per minute and steadily slows down to 50; all the while your heart rate gradually matches the slowing beat. The intervals between notes produce a sense of relief, and unsystematic chimes prompt deeper relaxation. Finally, low sounds and hums reminiscent of religious chants put you in a calm state of mind.Avoid tobacco, alcohol and other drugs – Use of tobacco or alcohol or other drugs to cope with emotions or boredom can worsen physical, mental health and reduce immunity. Just as you can recognise your mental health problems, be sensitive to such problems in your near and dear ones, which may include:Changes in sleep patternsDifficulty in sleeping and concentratingWorsening of health problemsIncreased use of alcohol, tobacco or drugs.If you feel overwhelmed, talk to a health worker or counsellor. Have a plan, where to go to and how to seek help for physical and mental health needs if required. The National Institute of Mental Health and Neuro-Sciences (NIMHANS) has also launched a toll-free number – 08046110007 for people seeking help.