When and How to Add a Therapist to Your Diabetes Care Team

Mark Heyman, PhD, CDE, the founder and director of the Center for Diabetes and Mental Health in Solana Beach, California, was diagnosed with type 1 diabetes at age 21. While he himself has never gone through any major mental health challenges, he sees it all the time in his practice, when people lose motivation to deal with the disease, or develop an intense fear of hypoglycemia (low blood sugar), or struggle with disordered eating habits related to their diabetes management…..CONTINUE READING

Diabetes, whether it’s type 2 or type 1, Dr. Heyman says, “takes a lot of work on an everyday basis, and there are no breaks or vacations.”

That’s borne out in a review of research that showed people with diabetes are 1.4 to 3 times as likely to have depression as people who do not have diabetes. And a study published in February 2015 in the Journal of Psychosomatic Research that examined data from the 2012 Canadian Community Health Survey found that people with diabetes were more likely to have experienced a combination of major depression and generalized anxiety than people without diabetes; further, depression and anxiety were found to be related to greater functional impairment caused by diabetes.

Having both diabetes and depression can also pose physical health risks, suggests a review of nine studies published in October 2019 in Diabetes Research and Clinical Practice. In their analysis, which involved about 346,000 people, researchers found an association between those comorbidities and a nearly 48 percent increased risk of death from heart disease, a nearly 37 percent increased risk for coronary heart disease, and about a 33 percent increased risk for stroke.

When to Consider Adding a Therapist to Your Diabetes Support Team

Given the prevalence of these challenges, when should you seek help and add a therapist to your diabetes support team?

Sometimes the answer is: immediately. “It can’t hurt to meet with someone at diagnosis,” says Deborah Butler, CDE, a licensed independent clinical social worker at the Joslin Diabetes Center in Boston.

That way, you can talk with an expert about how the diagnosis is affecting you, and about strategies for coping with some of the challenges of the disease. Therapists and psychologists can also counsel family members on how best to help, such as by being careful not to police the patient’s food choices, but instead support them and suggest healthy choices, like going for a walk, Butler says. In addition, if you meet with someone at the outset, you’ll be familiar with the team you can go to when you need a mental health checkup.

As time goes on, consider seeking help if you experience symptoms of depression or anxiety for more than two weeks, says Anna Simos, CDE, who manages the diabetes education and prevention program at Stanford Health Care in California. She notes that you should look out for the following symptoms:

• Feeling resentful for having to perform routine tasks of diabetes self-care
• Skipping insulin or medication
• Feeling resentful about the disease or hopeless about your future
• Experiencing increased anxiety about diabetes-related complications
• Sleeping more during the day or skipping sleep during the night
• Isolating yourself from your social network
• Binge eating or undereating
• Growing frustrated with individuals in your life who are trying to help with your care

Tips for Finding Help for Your Mental Health

If you do want a mental health checkup, what should you do? Experts offer the following tips.

Seek out a therapist or psychologist who has experience treating diabetes. Heyman noted that the American Diabetes Association has a list of mental-health professionals who have demonstrated competence in treating people with diabetes. You can also explore online therapy options such as Talkspace, which is free to download from the App Store or Google Play.

Ask family and friends for support. “Social support is an invaluable resource,” Simos says. Family and friends can encourage you to take care of your mental health and well-being, despite any initial nervousness you may feel about taking that step.

Connect with other people who have diabetes. If you connect with others who have diabetes, you can discuss similar issues you face and commiserate together, Simos says.

In addition to the bounty of diabetes blogs, there’s a growing online community — called the Diabetes Online Community (DOC) — that can help you feel supported in your diabetes journey. Research suggests it can offer both mental and physical benefits. For instance, a review published in May 2019 in the Journal of Diabetes Science and Technology, which analyzed 47 articles, found that people in a DOC reported having a higher quality of life than those in the general population managing diabetes. Being part of this online community also may help you stick to your diet, exercise, medication, or insulin regimen, among other perks, according to a study published in July 2018 in Future Science OA.

Ultimately, know that asking for help isn’t a sign of weakness. Think of it as another thing to add to your diabetes management toolbox. “Diabetes is a disease that never goes away,” Butler says. “There’s never a break, so the more help, the better.”

Additional reporting by Melinda Carstensen.

For more on building your diabetes healthcare team, check out the Diabetes Daily article “5 Doctors You Should Be Seeing Annually”!…..CONTINUE READING