I wanted to write about diabetes, mental health disorders and the implications of the two together. There has always been a strong link between chronic medical conditions and the effects it has on the patients’ mental health, diabetes is no different. There are different types of diabetes, type 2 which is often but not always related to being overweight, and type 1 which is an autoimmune condition usually found in children although also diagnosed in adults. No matter what type you have, there is a very serious threat of some pretty horrible complications.
It has been reported by charity Depression Alliance in their report Twice as likely, that depression is “at least twice as common in people with diabetes as the general population and between 30%-50% of cases go undetected…85% of people with diabetes have no access to psychological support”. Suffering from depression is very understandable when you have the threat of complications such as kidneys disease, losing your sight, heart disease, losing limps. It is a 24/7 disease, with multiple insulin injections and pricking your fingers often more than 6 times a day to check blood sugar levels, there is never a day off, with no cure. I have had personal experience of depression and anxiety problems with diabetes; I look at this from both a personal and professional manner. I have also been one of those who ‘s battle with mental health problems went undetected, although I did raise the anxiety issue with my diabetes team but sadly they did not believe it was linked due to me having had the medical condition for so long, it was later found that it was linked. This is something that is found regularly and something I am campaigning to get changes for. Diabetes teams do not look at the emotional and psychological side of living with the condition; there is very little provision of it within diabetes care. Sadly those not doing so means many people are battling these mental health problems alone, which in turn affects their control. I have heard of plenty of young people who without getting the correct help have stopped looking after their diabetes which can have devastating effects. Added to that being prescribed insulin medication that does keep you alive but has very often been used to commit suicide (sadly there is no figures on this as it has not been studied in depth yet, as far as I’m aware), ensuring psychological support can make a huge difference for those who live with this chronic condition.
There are other mental health factors to link in to this, anxiety is a big one, people being scared of the future, being scared of needles but having to inject themselves multiply times a day. Separation anxiety is common in young people with diabetes, those who were diagnosed with diabetes as a young child who have had their parent’s involvement throughout. Being separated from those parents, for a school trip, a sleep over, often causes great anxiety being away from those who know what to do if something goes wrong with the young person’s diabetes. There is also an increasing case of an eating disorder called Diabulimia. This is where people with diabetes manipulate or completely stop using their insulin in a way to lose weight. Sadly doing so does give rapid weight loss, due to high blood sugars, those who do this risk those serious complications I’ve already mentioned, as well as regular hospital admissions caused by having such high blood sugars that ketones build up in their body and the individual goes into diabetic ketoacidosis, a life threatening complication of diabetes.
Some diabetes teams are beginning to include psychologists are part of the team, however these forward thinking proactive teams often find huge difficulties with receiving funding for the psychologists and psychological support for their patients. Some teams still do not even talk about this side in their patient’s appointments; this is partly due to not having much time per patient and partly due to not knowing how to respond when a patient opens up about depression or other mental health conditions. There is also still the view of diabetes being just about the blood sugars and insulin, the view that patients will not feel down or struggle with the condition. There is a lot of work to do to try to support these patients, to try to get diabetes teams to look at this side and to get the funding for the appropriate support. Hopefully with help these changes will come sooner rather than later and those people struggling will get easier access to the care they need. Living with diabetes can have serious implications on the patients mental health, wellbeing and diabetes control. Taking a more serious view on this side of the condition can greatly improve the lives of those living with the condition.
Join & share your views, experiences, and insights @MHChat every Wednesday 8:00 PM GMT / 3:00 PM EST / 12:00 noon PST. This Wednesday (30 January 2013), we’ll talk about “Mental Health Diagnosis & its effects & implications” and look forward to seeing you there @MHChat.