The Relationship Between Stress, Trauma, & Type 2 Diabetes
INTRODUCTIONChronic stress alters the eco-system of the body, mind, and spirit like oil pollutes water. Stress and trauma affect the metabolism of the individual and the community. The ability to find and absorb the nourishment of food as well as the nourishment of friendship. In response to chronic stress, people feel depressed, helpless, anxious, irritable, and then they blame themselves for feeling that way. These feelings often lead to self-medication with sugar and carbohydrates, drugs, alcohol, sex and other activities.
ALCOHOL RECOVERYWhen people are in recovery from alcohol abuse they often turn to sugar (after all, alcohol is sugar), carbohydrates, and coffee as part of the withdrawal and maintenance process. However, this also taxes the liver considerably and makes one vulnerable to the development of diabetes type 2. Thus, alcohol addiction may also be understood as a physiological addiction to sugar. Stress contributes to anxiety and depression and leads to self-medication with drugs, alcohol, carbohydrates, and sugar; in turn, these substances exacerbate stress and the cycle of self-medication continues until it is stopped.
THE STRESS RESPONSEThere are broadly 3 types of stress that exist along a spectrum: Eustress, stress, and traumatic stress. Eustress is a word coined by Dr. Hans Selye. Eustress refers to the stress that arises from a positive challenge, such as a new job, learning a new skill or (extreme) exercise. Whether stress has positive or negative effects in one’s life depends to a great degree on the individual perception of the stressor and its meaning to their life. In “normal stress,” for example, regular life events such as attending school, job changes, relocation, marriage, or partnerships combine with an individual’s sense of control and purpose, determining the level of perceived stress. The perception of an event, coupled with an individual sense of control, influence physical and emotional response to the stress. Yet, persistent multiple stressors may also lead to lowered immune response and increased susceptibility to infectious disease. Chronic stress also impairs the ability of the body to metabolize glucose.
TRAUMATIC STRESSStress becomes traumatic when stressors overwhelm the individual’s capacity to cope. The idea that every person has a “breaking point” is based on the observation that everyone has limits and when those boundaries are crossed traumatic response develops. Traumatic stress is by definition, an experience in which the survival of the whole being is at stake and it responds with the “fight, flight, or freeze” response. Hans Selye first defined the General Adaptation Syndrome (GAS) as a predictable response to stress after he observed rats that he exposed to toxic chemicals or frigid water develop gastrointestinal, cardiovascular, and respiratory illness as well as generalized depression and distress.
HOW DOES STRESS AND TRAUMA CONTRIBUTE TO DIABETES?Under chronic stress, hormones (glucocorticoids) such as cortisol are antagonists to the production of insulin. Thus excess stress leads to high cortisol and reduces the ability of insulin to not only produce, but also to be used by cells. Think of a hammer that keeps banging on a door to say “let me pound this nail in,” but the door is cement and won’t let the nail in. Excess stress turned the door from wood, which would accept the nail, into cement, which will not. In normal hormone cycles, cortisol is higher in the morning in order to energize the start of the day, and as the day progresses it lowers until it reaches its lowest ebb at midnight during sleep. However, under acute stress (and too many refined dietary carbohydrates), cortisol can remain elevated throughout the day and even shoot higher at night leading to insomnia and exhaustion the next day. There is no question that managing stress and cortisol levels improve blood glucose levels. There are other reasons that persistently high cortisol is dangerous to health. An elevated cortisol level often accompanies or drives Type A behavior: impatience, irritability and “workaholism.” Workaholism, or “addiction to stress,” commonly occurs as a stage of recovery following the more dangerous addictions, such as sugar, drugs, and alcohol that have been eliminated. This stage reveals the body’s physiological or biological addiction is still in process. Understanding how the body drives behavior and how behavior drives biology can help an individual understand the requirements for complete healing. Cortisol has been referred to as the “hormone of death” because it binds to nerve cells, called neuronal receptors, in the brain leading to increased calcium levels in the membranes. Too much calcium leads to cell death and this has been implicated in cognitive decline. Dementia is now called Diabetes Type 3. Over time the experience of chronic, relentless stress (family, financial, work, war, health or accidental stressors) can deplete cortisol, leading to fatigue and depression. This is like a car without gas in the tank and yet, even when filled with “gas” (energy), it won’t go very fast because there are holes in the tank. Diabetes often occurs at the end of this stream of events: Childhood stress > excess refined carbohydrates > adult stress > excess refined carbohydrates > fatigue > coffee > depression > diabetes > pain. With depleted cortisol, the individual feels tired in the morning, often wanting to sleep in, but feeling low energy will use stimulants like coffee and sugar to get energy. This is like taking that hammer to the gas tank with holes in it and saying: “get going!” It doesn’t work because it’s the wrong type of fuel. In this type of pattern, energy rises and falls throughout the day; the 10 am coffee break, the sleepiness after lunch, and a late afternoon coffee break. This reflects a complete reversal in normal circadian reflects the biological rhythm of depression and chronic pain. This is commonly associated with diabetes, fibromyalgia, and other chronic pain syndromes. This pattern tells us why, without the reduction of stress, prevention and control of diabetes is impossible. To reverse this pattern, one needs to withdraw from negative stimulants, like stress and coffee, feel just how exhausted one is, and slowly rebuild one’s health through nutrition, including stress modulating adaptogens, exercise, and stress reduction therapies.
STRESS, DIGESTION AND DEPRESSIONWith diabetes type 2 there is also a history of poor digestion. Improving digestion is important to managing stress and mood. Mood responds to blood sugar. When blood glucose is balanced, mood is also balanced and the emotional ups and downs of the day even out. Digestion and intestinal health are important to mood because many of the neurotransmitters that govern mood such as serotonin are made in the small intestine where food is digested. Neurotransmitters (NT) are brain chemicals that communicate information throughout our brain and body. They relay signals between neurons. They affect mood, sleep, concentration, weight, carbohydrate cravings, addictions and can contribute to depression, pain, anxiety, and insomnia when they are not in balance. Pharmaceutical-grade amino acids may be compounded according to the specific biochemical needs of the individual to provide the building blocks that support specific NT production. Minerals like Chromium and vanadium also help regulate blood glucose. I address a comprehensive nutritional strategy in my book: Preventing and Treating Diabetes Naturally, The Native Way. Stress and depression are exacerbated by poor liver and gallbladder function. Poor food quality, especially trans-fats and fried foods, leads to a liver and a gallbladder that are unable to process these fats leading to sluggishness and stones or gravel. In traditional Chinese medicine, a congested gallbladder is said to cause angry feelings. The symptoms of gallbladder problems include burping, flatulence, a feeling of heaviness after a meal, shoulder pain or pain under the ribs on the right side or in the back directly behind the diaphragm. Awakening with bloodshot eyes is another sign of gallbladder problems. Good liver and gallbladder function are essential to prevention and treatment of diabetes. Removal of the gallbladder solves nothing and exacerbates health problems. Removal decreases the body’s capacity to digest foods. The gallbladder is required to emulsify the essential fatty acids so important in keeping depression and stress low, regulating glucose balance, and maintaining artery health and low systemic inflammation. If the GB is not functioning well, then even something as nutritious as fish or fish oil capsules will be less effective because those nutrients are not being digested properly. When the gallbladder is removed these problems become worse. Removing a gallbladder is like throwing out the garbage can, instead of the garbage. Surgery should be avoided at all costs. For individuals who have had their GB removed, replacement supplements should include natural ox bile. Beets and beet tops, are rich in betaine, are an excellent food that assists gallbladder function.
SELF-CARE TIPWhen making changes it is easier to create a positive new habit, than it is to stop a negative habit. Often negative habits will drop away once the new habit is firmly in place. Understanding how physical illness can result from stress provides us with opportunities to reduce stress and thereby improve physical well being.
Leslie Korn is a Nutritional Therapy Practitioner who has specialized in Integrative Medicine for Mental Health and Chronic Illness since 1977. She completed her clinical and research training at Harvard Medical School and The Harvard School of Public Health and has worked with indigenous populations in the jungle of Mexico and the Pacific Northwest specializing in the prevention of diabetes type two and in tribal food and plant revitalization for over 35 years. She directs the Nutrients for Natives program at the Center for World Indigenous Studies. She is the author of 8 books including Nutrition Essentials for Mental Health, The Good Mood Kitchen, and the latest, Preventing and Treating Diabetes Type 2 Naturally. She will also be giving a keynote at the 2019 NTA conference, Roots. Check out Leslie’s newest book, Preventing and Treating Diabetes Type 2 Naturally, here.