Diabetes Forecast

Journaling Can Benefit Your Overall Health Plan

Studies show that journaling can be an effective part of your health plan

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Julie Hurtado began keeping a journal when she was diagnosed with type 1 diabetes at age 11 for one simple reason: Journaling helped her cope. “It was such a powerful way for me to release and clear all the emotions—fear, anger, sometimes even denial—that swirled around me at the time,” says Hurtado, now 48.

Today, she credits her mood journal with helping her manage her diabetes. By journaling, she avoids letting negative emotions balloon into chronic stress, which can affect her blood glucose numbers. “When I write out my feelings, it prevents me from just rehashing them over and over in my mind,” she says. “It allows me to put the experience away and move on.”

The Write Way

Journaling has been recommended for years as a way to reduce stress, anxiety, and depression. But mood journals are unique. Unlike regular journals, which are usually meant for chronicling your day-to-day life, mood journals are a place to focus specifically on your feelings and emotions. They’ve become increasingly popular, as apps and online mood trackers have emerged on the Internet. But they are more than just a trend: Research shows they can be effective tools to help people manage chronic health conditions.

A study published in 2018 in the journal JIMR Mental Health looked at 70 adults with various medical symptoms who also experienced anxiety. Participants were asked to keep a web-based journal for 15 minutes a day, three days a week, for 12 weeks. Those who did so reported less stress and better moods. “We are often bothered or stressed out by experiences or challenges in our lives, and this can crowd out or displace positive experiences, thoughts, and reflection,” says study author Joshua Smyth, PhD, distinguished professor of biobehavioral health and medicine at Pennsylvania State University. Journaling allows you to refocus on more positive topics, such as good experiences or strong relationships, he says. That, in turn, can tamp down stress hormones that affect overall health.

A landmark study published in 1986 in the Journal of Abnormal Psychology found that people who wrote about past traumatic experiences had lower blood pressure and heart rates, as well as increases in T-cells, which help fight disease, compared with those who wrote about superficial things.

Feelings to the Fore

A mood journal gives you a place to release thoughts and feelings that you may not be acknowledging. “The problem with our emotions is not the emotions that we have but the fact that we don’t know how to express them,” explains James Gordon, MD, executive director of The Center for Mind–Body Medicine in Washington, D.C. This happened to Hurtado recently, when she couldn’t find blood glucose test strips at her local pharmacy. “I became increasingly anxious at the idea of having to run around town to find them,” she says. Over the next few hours, as she grappled with anxiety, her blood glucose level went up.

Not surprising. When unexpressed emotions build up, it takes a physiological toll. As levels of stress hormones such as epinephrine (adrenaline) rise, more glucose is released from the liver, says Emily Nosova, MD, an endocrinologist at Mount Sinai Hospital in New York City. But at the same time, cortisol levels rise, which causes body tissue (both muscle and fat) to be less sensitive to insulin. The result: more glucose in your bloodstream.

Lowered stress can lead to other health benefits. “When you feel better about yourself, you’re more likely to embrace and stick to healthy habits, such as getting enough sleep and doing regular physical exercise,” says Nosova. 

Writing down your thoughts may also help you break not-so-healthy patterns. Say, for instance, potato chips have become your go-to snack. Jot some notes about how you’re feeling and include what happened right before. “You may recognize that you got into an argument with someone and were so upset that you turned to comfort food,” says Aleksandra Drecun, PhD, an associate professor of psychology at Miramar College in San Diego. “Catching yourself at the time and actually writing down your feelings can give you the distance you need to make a different choice.”

Getting Started

It can be hard to put words to your deepest thoughts and emotions if you aren’t used to expressing them. A good way to begin? Explore experiences that you’re grateful for. “You can write about a time when someone went out of their way to do something helpful or positive for you, progress that you’ve made on a major goal, or a time when you assisted someone else,” says Smyth.

You may be writing about emotions that are embarrassing to you or upsetting, so it’s important that your journaling remains private. Use a password-protected personal computer or a diary or notebook that you keep under lock and key. “Many find the slower and more reflective pace of handwriting preferable, but select what you like,” says Smyth.

In the beginning, aim to write for only about five minutes each session, and focus on expressing your thoughts and feelings related to the topic rather than on writing style. “Remember that this writing is private and just for you, not for an audience,” says Smyth. At first, schedule these sessions at specific times of the day, several times a week, so you can develop a habit of journaling.

“Treat it as your own relaxation time, not as if it’s a chore,” says Nicole Bereolos, PhD, CDCES, a certified diabetes care and education specialist in Dallas. “It’s a way to wind down and to be good to both your body and mind.”

If you have writer’s block, ask yourself what emotion you’re feeling right now and what caused it, suggests Bereolos. How did you respond to the emotion? Was your behavior appropriate? What could you have done better? What might you do differently next time? Bereolos says these strategies are similar to what you’d do in cognitive behavior therapy, which helps you recognize negative thought processes and stop them.

If you can, end with gratitude. Finish each session by adding a few sentences on what you’re grateful for. Take that part of your journal and type it into your phone or stick it somewhere visible in your house so it’ll motivate you when you’re feeling upset or anxious.

Mood Tracking

Apps can give you structure and streamline the journaling process. With Daylio, you can label your mood—Rad, Good, Meh, Bad, or Awful—to help you get a clearer picture of when you’re happy or upset. Maybe you felt angry at yourself for eating a doughnut when you were stressed about work this afternoon but felt better after going for an after-dinner walk to lower your blood glucose. The app will prompt you to elaborate in the journal section.

Other apps include Moodpath, T2 Mood Tracker, and iMoodJournal. A major benefit of using an app is accessibility. When you’re super busy or on the go, it may be easier to make a quick entry on your smartphone than pull out a physical journal.

That said, the usefulness of apps may be limited. “Most people find that their moods and emotions are more complex than what they can express in an app,” says Bereolos.

Hurtado performs what she calls “write and rip.” When she feels upset or stressed, she scribbles her thoughts down on paper, then rips it up and burns it in her fireplace. “The intention is to release your emotions: anger, frustration, fear. But instead of keeping a journal, you destroy what you’ve written,” she says. “The act and ritual of writing and ripping helps release the negative emotions, which allows space for other, positive ones, like gratitude and hope, to enter.”



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