Diabetes and Massage Therapy: Yes, It Could Lower Your Blood Sugar

If your experience of modern medicine’s approach to diabetes was anything like mine, you were given two basic keys to managing your blood sugar shortly after your diagnosis (and neither were a pamphlet on diabetes and massage).

First, you were told that you’ll need to track your carbohydrate intake from now on. Along with that you were probably told that the expectation for adhering to any sort of diet plan is incredibly low. After all, you made it this far in your life without watching what you eat, so what are the odds you’re going to change now? 

The second key makes up for that though. It’s the promise of modern medicine. You just take a pill and go enjoy your burger and shake, no effort, no stress. After a while, you’ll up the dosage and maybe add another pill or two, or even insulin injections if those don’t work.

The likelihood of “reversing” diabetes or managing it purely through diet and lifestyle is slim. Again, the bar here is very low. Beyond a few informative packets you’ll likely toss on the way out of the office, no one really pushes you to make healthier diet choices or to find ways to maximize your physical activity like your actual health depends on it.

That’s why we have medicines.

By my reckoning the problem with this approach is twofold. First, there’s a lot we can accomplish with diet and exercise. I know because I’ve done it myself. When I was diagnosed, my blood sugars were in the 500s and my A1c mirrored it. I needed insulin and metformin to get it back down to normal. Through a years-long process of changing the way I eat and move, and much to the surprise of my doctor, I achieved remission. It’s unheard of, he assured me. And I’ve heard the same from my coaching colleagues in medical practice as well.

Even for all the focus I’ve put on my health since then, there was something in my diabetes management strategy that I missed until just last year when I experienced an uncharacteristic and alarming blood sugar spike for several months. It’s the second problem with the medicine-centered approach. It’s the key no one really talks about, not even the folks advocating for plant-based diets as a way to manage blood sugar.

I’m talking about the influence of stress on diabetes.

Diabetes and Massage Therapy

Stress relief is truly the bridge that connects diabetes and massage therapy. And that makes sense, right? I mean, if there’s anything we all associate with massage therapy, it’s relaxation. People book a massage after stressful events or as a means of managing peak stress levels.

From my perspective, both the massage industry and diabetes research suffer from a curious desire to make themselves more complicated though. It’s as if, to some degree, we’re afraid of giving our mindset enough power to influence the physical condition of our body. So, diabetes becomes this mysteriously unmanageable monster we can only ever treat with medication. And massage therapy becomes this practice we have to justify as medically necessary for some reason other than the simple reality of stress relief.

Mind and body are connected though. Where some cultures might divide them, holistically we can even think of them as one being. After all, what is a mind but the thoughts and feelings of a brain and nervous system, themselves part of a body?

Still, the need to make massage therapy “medical” (in the sense of being more than a relaxation technique) has produced some great research on diabetes. A systematic review of scientific literature on diabetes and massage published in 2001, noted that massage might influence insulin uptake at the injection site, lower or normalize blood glucose levels, and improve certain forms of diabetic neuropathy.

Of note, the paper’s authors write:

“Additionally, massage has been shown to decrease anxiety in a variety of patient populations, including people with diabetes. These stress-reducing benefits of massage have raised the possibility that massage may be of benefit to people with diabetes by inducing the relaxation response, thereby controlling the counter-regulatory stress hormones and permitting the body to use insulin more effectively.”

A 2019 systematic review covering the previous twenty years of research on diabetes and massage noted similar effects for diabetics, including “a decrease in blood glucose, hemoglobin A1c (HbA1c) levels while an improvement in neuropathic pain and diabetic foot ulcer.”

What This Means For Diabetics

The bottom line is that depending on what your symptoms are, how well your diabetes is managed, and what kind of massage you’re receiving, massage therapy could really help you with a lot of the medical concerns you have.

Beyond the coulds and cans and maybes though, I truly think we (as diabetics) can look at massage as something that helps us relax. And that’s good enough, no other medical work needed. Helping diabetics relax equals better body use of insulin. That in itself is phenomenal.

The cool thing about being as fixated on healthy eating and fitness as I have been since my diagnosis, is that I can rule out most of the usual suspects when I see my blood sugar levels spike. I know it’s not what I’m eating. And I know it’s not that I’m sitting around the house or office too much.

The thing no one prepared me for or talked to me about before I saw it though was that high levels of stress in your life can send your blood sugar high on up there too. For about a month, I was seeing numbers in the upper 200s, and even after restarting medication, there was little change. It was only after I got my stress back under control that I saw relief.

If we care about our health post-diagnosis, we can’t afford to dismiss the impact of chronic stress on our physical health. And with that in mind, making massage therapy a regular part of our lives is a great way to better manage our stress level and our long-term outcomes living with diabetes.

Coming Home to the Body on the Path of Teshuvah

Just over ten years ago, I experienced an intense mental setback that resulted in me withdrawing from the university I attended in order to care for myself. I remember that September because it struck me that it was the first head of the school year at that point in my life where the future was a completely clean slate for me. There were no classes assigned to me. No new semester. No job prospects or work schedule to follow. It was for both better and worse, the freest time in my life at that point.

And there within me still, a war was taking place. The logical side of me was free-falling into complete oblivion. My crisis had overridden every expectation, hierarchy, and process that side of my mind depended on for ordered perception of the world. Was I succeeding at life (breaking myself so free)? Or had I completely fallen apart beyond repair? The desire-driven side of me countered with its own newfound strength. The emptiness existed for me to fill with something new. Now was the opportunity to set things right, to reset, and to start over on my own terms.

In some ways I think I am still getting the two sides of my head to work together. Neither extreme has proved capable of governing my life for too long. Life is best in balance.

There was so much that I learned about myself though during those early post-crisis years. It was, in the greatest sense, a transformative reorientation of what I am accomplishing with this lifetime.

What’s Teshuvah Got to Do With It?

Unrealized by me at the time, Judaism offers us a lot of great traditions around this same process and, coincidentally, during the same time of year. From the month of Elul (Virgo) through Tishrei (Libra), we’re invited to right our wrongs, re-balance the cosmic scales, and set our life back in the good orderly direction it ought to be following. This process is called teshuvah, which means “return.”

For some people, it might be helpful to think of that process as a return from sin to somewhere more familiar. In Judaism, sin is where we miss the mark. So, another helpful way to think of it might be that we’re centering ourselves behind the bow again, returning to aim again at our target.

Where do we aim? Some students of A Course in Miracles like to find the answer by breaking down the word atonement into its constituent parts: at-one-ment. We’re aiming towards oneness–within ourselves, in relation to one another, in relation to creation, and in relation to G-d.

For Kabbalists, teshuvah is literally the return of the letter Hey. In the sin of our separation from G-d, the very name of G-d has fractured, and our practice of teshuvah returns us to a state of perfect awe where everything is again aligned. That last Hey in G-d’s name represents the sefirah of Malkuth, essentially our perception of G-d’s presence in the physical universe, but also the very physical acts of repentance.

Teshuvah asks of us to stop missing the mark, to feel the emotional longing that occurs when we err, to verbally acknowledge our work, and to enact a plan to make changes, knowing that the real test will be the next opportunity we have to make the same mistake again. In the process of teshuvah we learn the sanctity G-d has embedded in these acts.

The Talmud actually tells us that atonement was one of the first things G-d created (even before creation itself). It’s that central to the mechanics of our universe. Like the seasonal cycles that return us to this process every year, our lifetime is set on this cycle of learning, processing, and growing. That’s the irony to Rabbi Eliezer’s instruction in the Talmud to “Repent one day before your death.”

The nature of this experience we call life is to explore and grow. We are always repenting and evolving. Life is teshuvah. Not even the tzaddikim can do one without the other.

Coming Home to the Body

This season, I am reflecting on G-d’s creation of mankind. The Bible teaches us that life is sacred. The human body is even created in the image of G-d. Our physical self-care and self-actualization is a holy obligation, and a central part of that work is learning to decline the things we ought not accept into ourselves. Likewise, we are intended to be fruitful, and the body is designed with a million ways to realize that intention even when parenting is not part of our individual futures.

For me, a gulf has emerged between this sacredness of creation and the society in which we are living. To some degree, this is something I picked up on intuitively during the years around that mental setback I mentioned before, yet I lacked the clarity and direction to disentangle it all at the time.

Today, many aspects of the gulf are quite clear.

  • We are living through an actual plague whose outcome is connected to the ways we nourish and move our bodies. We respond with stay-at-home orders and free doughnuts.
  • Rather than avoiding drug-dealers, we have become so desensitized to the fatalities and compounding malpractice of modern medicine that to even question what ethics guide them is to set yourself apart from the crowd, and in some areas, society itself.
  • We have created a society where dangerous chemical toxins are in nearly everything and where the hormonal alteration of the natural body is laughed off, ignored, or even celebrated.
  • We have created a society where “truth” is a function of politics, singular relative to power, and closed to debate except for the courageous willing to face down what amounts to social exile.

This is not the way we are meant to live. It’s not the way we ought to respect our bodies. It’s not the way we ought to respect our minds and the different perspectives we each bring to life together. We are meant to be as one, and also to be the many who are as one. We are meant to engage critically with life, society, and each other, yet to also act as one body together. The tefillin which Jewish men wrap around their arms and foreheads each morning mirror the paradox of this simultaneous oneness and plurality.

I see an opportunity for teshuvah here, an opportunity to return behind the bow and to aim again towards something better. When I first started Free to Live Healthy, I intended it primarily as a journal to chart my own way along this path, reclaiming my health and life from a society that does not live up to Biblical values. For me, alignment within the body is alignment with Torah is alignment with G-d….

Today I can see how this blog itself is part of the teshuvah in my journey. I have got to come home again. Come home to the body, to scripture, to oneness, and to G-d. I know there are so many of us out there–my work has already brought so many of us together. My hope in writing here is to make the way a little clearer for those as lost as I have been before, and to show one path that might take others a bit further along the way we are each returning home to this body G-d has created.

Years ago I learned a beautifully simple meditation from the Plum Village teachers, and it seems fitting to close with it here:

“Breathing in, I am aware of the body.

Breathing out, I am arriving at home.”

5 Questions to Ask Before Coming Off Antidepressants

Choosing to come off of antidepressants is a deeply personal choice which unfortunately can often be misunderstood or stigmatized by both health professionals and our everyday social circles.

More than that, the choice to make any alteration to our brain chemistry is a fairly consequential decision in our lives. It may impact our emotional and physical states, relationships, career, and other areas of our life.

While being under the prescribing doctor’s care is almost always a good idea when making changes to prescribed drugs, these five questions may help you to develop a more holistic plan for coming off antidepressants if that is the choice you make.

What are you going to do when you have your next anxiety attack?

Depending on where you are in your mental health journey this question may seem moot. The truth about some antidepressants is that we feel like we don’t need them when they’re working best. Another way to look at that truth though is to consider that it applies to every coping strategy. When something works, we stop thinking about it. (Even when it does more harm than good, as may be the case with our antidepressants).

Consider how addicts view their drug of choice or how over-eaters view food. The strategy for dealing with an unwanted experience becomes so reflexive we eventually act on muscle memory more than conscious decision-making.

Coming off antidepressants shocks that whole process. Suddenly the coping strategy we’ve grown to depend on isn’t available anymore, and we’re once again facing the same beast that sent us seeking that strategy to begin with.

So what’s the next strategy? Try to imagine yourself in different potentially triggering situations, and then brainstorm your way through them. Going to yoga class might work at establishing a long-term healthier baseline, but it’s not realistic when hyperventilating in the bathroom at work. Give yourself a tool belt with as many different options as you can imagine.

How are you going to manage withdrawal symptoms?

This might be shocking news if you’ve never looked into coming off antidepressants, but the withdrawal period (sometimes lasting weeks or months) can be awful. By my reckoning, there are two components to withdrawal. First, there’s the new feedback we get from the body as it adjusts to life beyond a chemically induced altered state. Some people report the sensation of “brain zaps,” episodes of dizziness, mood swings, and more.

Second, there’s the potential intensity of reacclimatizing to our original symptoms. While you might have experienced anxiety or depression while taking antidepressants, without them, you’re experiencing the un-numbed version. It might be more intense than you’ve been used to for a while, or even worse than before.

How will you plan for, track, and address these experiences?

How do you know if you need to stop?

So here’s an uncomfortable part of coming off antidepressants. Sometimes you have to stop, restart the drugs you don’t want to be on, and wait to try again later. It happens to the best of us, and it’s no reflection on your character or strength as an individual if it happens to you too. People using any drugs for any reason often go through cycles of coming off of them. In this sense, antidepressants are no different than other drugs just because they’re prescribed or legal.

What experiences are your absolute limit in this process? What lines will you draw to protect your long-term health as you begin withdrawal?

What support systems will you engage while coming off antidepressants?

Building on the last question, who will help you through this journey? What professionals and more intimate connections do you need to engage? The obvious answer is that coming off antidepressants should be under the care whatever doctor prescribed them in the first place. But the less obvious answer is that lovers, family members, and friends are probably going to see you more than that doctor.

Who can you trust to give you objective external feedback about your emotional or physical state while withdrawing? What groups or communities might be able to help you feel safer and supported during this process?

What does long-term mental wellness look like for you?

Not a lot of doctors seem to want to ask this question. And that may be an important piece to why so many of us seek health beyond what conventional doctors offer.

Long-term mental wellness is more than just applying a prescription to a set of symptoms, or slapping a diagnosis over it all. How do you want to feel? How do you not want to feel?

Your vision for long-term mental wellness might include mitigation of certain symptoms or experiences, but it could also include aspects like finding time or a medium for creative expression, not being on medications for the rest of your life, eating healthier, sleeping better, or feeling more confident in yourself.

Write or sketch all this out.

Coming off antidepressants isn’t a choice in league with picking out a shirt for tomorrow. You’re making a life-altering decision here. Be certain you’re making the choice you want to move forward with, and that it fits into your vision for your long-term sense of self.

No one else can answer that question for you. Truthfully, no one else may even ask.