“Several mental health problems, such as depression and anxiety, are common among those living with diabetes,” Gonzalez said. “Care team members with specialized mental health expertise are more likely to play a significant role in addressing these issues in ways that maximize the effectiveness of diabetes treatments.”
I read this quote in a recent article from Reuters Health and it reminded me of the powerful point the American Diabetes Association made when it announced a directory of mental health professionals trained to help people with diabetes. My mental health and my physical health have always felt inextricably linked, and when one is out of balance, the other shortly follows.
For example, when I was in college, a personal family event turned my diabetes upside down. I had just finished my sophomore year of college when my parents decided to divorce, and a lot of family stress resulted. While my mother and father were making sense of their new normal, I had a hard time grappling with the fallout, and I turned my back on any semblance of responsibility as it pertained to my diabetes.
(That whole paragraph is a nice way of saying that emotionally, everyone went bananas and I stopped caring at all about diabetes. I didn’t check my blood sugar. I took my insulin as necsessary, but not as needed. I indulged in a lot of the vice-ish offerings that college had to offer. My diabetes went off the rails. My A1C was the highest it has ever been. And I did. Not. Care.)
The thing that saved me from really making a mess of myself was a simple referral. I was still going to my endocrinology appointments, and when my endo saw that my A1C had jumped two and a half full points since our last visit (and that I was either on the verge of tears or actively crying throughout the entire appointment), she put her hand on my shoulder and kindly said that talking with the on-staff psychologist was important.
I’d never seen a mental health professional until that point in my life, and I’ll admit that I bucked up against the idea of having my feelings and emotions as the focus of a doctor’s visit. The stigma of seeing a psychologist made me feel “unstable” instead of in control. But the woman they paired me with was very maternal, and brilliant, very well-versed in handling young adults on the slippery slide of chaos, and made it clear that all the … stuff swirling around my family, while distracting and difficult, didn’t mean that my health and safety weren’t paramount. She let me talk. She listened. And we spent several visits helping shift my diabetes care back into the priority range. It was not easy, but it was necessary.
If my endo had not stepped in and recommended a mental health consult, I’m not sure how far down that slope I would have slipped. Since those visits back in college, I’ve seen several psychologists (twice more related to diabetes, once related to postpartum anxiety), and every time it becomes clearer and clearer how the line between “diabetes health” and “mental health” is the equator between my health hemispheres. My whole world isn’t intact without my mental health as monitored and carefully maintained as my physical health.
For years, A1C results ruled the roost for people with diabetes. Diabetes control, or lackthereof, was measured by your average blood glucose during the course of a three month period. But that lab work isn’t the only indicator of “health.” Yes, it is absolutely important to have well-managed blood sugars, but it’s just as important to address and maintain mental health.
Seeing mental health integrated as an accessible and instrumental part of managing diabetes is a really terrific step forward. Movements like these help remove stigma, encourage access, and help improve lives, and I’m all for it.