By Stacy Ogbeide, PsyD, ABPP, CSOWM
DPC Education Center Advisory Council Member

Stress Management—a topic those living with heart disease and chronic kidney disease have heard before but now in 2020, takes a whole new meaning. We are in the COVID-19 pandemic—unprecedented times—that are impacting people physically, financially, socially, spiritually, and emotionally. Maybe your healthcare has been disrupted; treatment disrupted; work, social, and family life disrupted. Your current stress management options are no longer working, or you don’t have access to your typical stress management options, which is beginning to take a toll on you. Don’t lose heart—I’d like to share a few thoughts and ideas about how to manage your stress levels during these uncharted times.

  1. The stress response is real and can impact patients with heart disease and chronic kidney disease.
    First and foremost—acknowledge what you are going through. Searching for a “stress-free” life is unfortunately, probably not going to happen. Life is difficult. And with difficulty comes stress! Some of us like to push through stressful times, ignoring what is going on around us and not giving ourselves time to manage the stress we are experiencing. That approach can work for a short time but eventually, it can take a toll on your health, well-being, as well as your family and social relationships. Once you acknowledge that increased stress is present in your life, then you can figure out what you’d like to do about it. The social worker at your dialysis center is a great resource for managing stress.
  2. Try something different—relaxation skills work!
    You may have heard about different relaxation skills such as diaphragmatic breathing, progressive muscle relaxation, guided imagery or even mindful meditation. If you are currently using any one of these skills—great! If not, why not try something new? Any one of these relaxation approaches is great to counteract the stress response and the impact of the stress response on your body. It would only take a few minutes out of your day each day, and practice makes permanent. So, go on and try something new. Who knows—you might like it!
  3. Thoughts, Emotions, and Behaviors: A Domino Effect
    It’s true—how we think does impact how we feel and what we do—especially in times of increased stress. Have you ever thought to yourself, “I worked really hard today, and I’m going to have a cheat day and eat whatever I want!” And then, you may start to feel guilty about what you ate due to having heart disease or chronic kidney disease? And then you might think, “Oh well, I’ll just have another bite…” And the cycle continues. Learning to recognize your thought patterns and how they impact your emotions and behavior patterns will not only impact the course of your health condition, but also give you another tool for managing stressful times. Finding what your “hot” thoughts (thoughts that trigger unhelpful emotions and behaviors; example: “My health will never get better”) can be a helpful tool because then, you can learn what a useful “cool” thought (thoughts that trigger a helpful emotion and behavior: “I had a hard day today, and that doesn’t mean my health won’t get better”) can be to reduce the impact of the stress on your overall health.
  4. Last but not least: Self-compassion!
    Dr. Kristen Neff has a fantastic definition of self-compassion: “Self-compassion involves acting the same way towards yourself when you are having a difficult time, fail, or notice something you don’t like about yourself. Instead of just ignoring your pain with a “stiff upper lip” mentality, you stop to tell yourself “this is really difficult right now,” how can I comfort and care for myself in this moment?”
    Another concrete way to engage in self-compassion is to ask yourself this question: “What would I tell a loved one who is going through the same situation that I am?” or “How would I treat a loved one who is going through the same situation that I am?” Recognizing that you are having a difficult time or in a difficult season is important. Engaging in self-compassion and using any one of the stress management approaches mentioned above (or something else that improves your health and is of value or important to you!) is a great way to show yourself some compassion during stressful times.

Are you a health care/behavioral health professional interested in learning more about stress management for patients with heart disease or chronic kidney disease? If so, check out:

Stacy Ogbeide, PsyD, ABPP, CSOWM is a Board Certified Clinical Health Psychologist and Board Certified Specialist in Obesity and Weight Management. Her website is