It’s Mental Health Awareness Month and there’s been a lot of great discussion about the intersection of diabetes and mental health. We know that living with diabetes can come with some serious emotional challenges, and often these are not talked about openly by patients or their health care providers. By talking honestly about these issues, not only do we raise awareness about them and but we may also prompt other people to seek help. This honesty is a big shift from the past when silence, because of lack of understanding and embarrassment, was the status quo. Now, it seems that people with diabetes are feeling more comfortable talking about and (some) health care providers are feeling much more comfortable listening to their patients talk about about mental health issues
As a diabetes psychologist, this spotlight on diabetes and mental health is extremely welcome. But it also reminds me of the enormous amount of work we have left to in tackling diabetes-related mental health issues. We have gotten really good at talking about and describing all the reasons living with diabetes is so challenging. We have names for things that for far too long had no name. Now we can describe conditions like diabetes burnout, diabetes-related distress, and diabulimia and by taking about groups of symptoms, rather than talking in vague gerneralities. Naming and describing these things has been a huge step forward. However, it’s critical that we recognize that this is only the first step, and there’s a lot more work to be done.
Defining and describing problems related to diabetes and mental health is not enough. In fact, having the ability to define and describe gives us a huge responsibility to develop effective and evidence-based treatments for these problems. I’ll be honest – there’s a lot we don’t know. We know that we need effective interventions for diabetes-realted behavioral health conditions, and at this point, we don’t have them. Until we do, people with diabetes are at a big disadvantage – and they deserve more.
Interventions to address diabetes and mental health challenges don’t necesarily have to involve a mental health professional in an office. As we tackle developing interventions, let’s think out of the box and creatively. But we also need to think about these things in a way that can be empirically supported, replicated and scalable. Is the answer peer support? Technology? Brief interventions by endocrinologists? Treatment by a psychologist? I think the answer is some combination of all of the above. But we need to get a handle on what that is, and sooner rather than later.
While we do have tons more work to do, if you are dealing with diabetes and mental health issues, please don’t get too discouraged. Even though we don’t have many evidence-based treatments, that doesn’t mean that seeking help is pointless. Many therapists, including myself, have successfully treated people with diabetes, and will keep on doing so seeing good results. But we can only get better at our work, which will let us train more people and be confident that everyone is providing treatment that we know is effective.
With diabetes and mental health, we’ve come a long way, and we still have a long way to go…