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Dealing With Diabetes & Depression

Rates of depression are significantly higher for patients with diabetes, especially those who are elderly, when compared with people without diabetes. About 20% to 30% of patients with diabetes suffer from clinically relevant depressive disorders. “Depression can worsen glycemic control in those with diabetes,” says Jason C. Baker, MD. Research suggests depression is associated with a higher risk of developing diabetes complications and adverse outcomes. Conversely, improving depressive symptoms has been shown to lead to better glycemic control. “Depression can result in reduced physical activity and a greater need for medical care and prescriptions, which in turn can increase healthcare costs and worsen quality of life,” Dr. Baker says. “In order to improve the management of patients with these two conditions, it’s imperative that healthcare providers be aware of this link and its consequences.” He adds that effective pharmacologic and non-pharmacologic treatments are available and may be of benefit in some situations. Routine Screening The stress of managing diabetes on a daily basis and the effects of the disease on the brain may contribute to depression, according to Dr. Baker. “There are multiple factors that may be at play, but one of the most important things clinicians can do is screen patients with diabetes for depression,” he says. “Oftentimes, physicians focus solely on the chief complaint or on A1C, blood pressure, and cholesterol numbers. We need to take a more holistic approach and be vigilant about seeking out depression or other mental health problems. This should become a routine part of all diabetes care.” Dr. Baker says that it can be challenging to address depression when managing patients with...
Mental Healthcare: Time to End the Stigma

Mental Healthcare: Time to End the Stigma

It was with great sadness that we all saw the tragic news of Robin Williams’ suicide. For years, mental health has been a taboo topic. While the passing of this great actor is horrifying, we are only aware of it because of his stardom. How many others have met a tragic fate like his, but we just do not hear about it because they are ordinary people? It affects all ages, all races, and socioeconomic statuses. It is not a phenomena located to the U.S. but all across the globe. True that many people have trouble gaining access to mental healthcare sources, often for insurance coverage reasons or lack of available providers. But more often, help isn’t pursued because of the stigma attached to mental health diagnoses. All too often patients are embarrassed to admit they have a mental health problem. Yet, diseases such as anxiety and depression are very prevalent in our society. These conditions are chronic medical problems, just like diabetes and hypertension. But patients are often made to feel that these diseases are just in their head and that they can just “get over it.” This does not just happen in our general society, but when they seek medical help as well. Patients do not understand that even physical pain can be an underlying sign of depression. And many feel that their healthcare providers brush it off as “just depression.” So, rather than face these stigmas and embarrassments, many choose to deny or hide their illnesses. They are left untreated, which allows tragedies like suicide to occur. How can mental healthcare stigmas be ended? 1. More...
Is There A Mental Healthcare Crisis In The U.S.?

Is There A Mental Healthcare Crisis In The U.S.?

We are all shocked when we see news stories of multiple people being killed by someone who seems to have gone off the deep end. While these events are extremely rare, it is a true tragedy to have them happen at all. It is often found that the guilty parties were suffering from some mental illness. These are the extremes of mental illness. However, milder forms of mental illness, such as anxiety and depression are very prevalent in the U.S. The unfortunate reality is that for many of these patients, they just cannot get mental healthcare even if they want access to it. How big is the problem? According to a survey of physicians on Sermo, the number one social network exclusively for physicians, approximately 84% of the doctors polled believe there is a mental healthcare crisis in this country. Often times, the primary care physician is left to care for these patients whom they may not feel comfortable taking care of, just because they cannot get an appointment for the patient with a psychiatrist. I often times have a patient who I believe needs to see a psychiatrist but is unable to get an appointment for up to 6 months. If a patient is having a mental healthcare urgency, they usually end up in the ER for lack of access to outpatient healthcare. But, psychiatrists are not to blame. This is rather due to a broken system that is in need of major reforms. Why is there a mental healthcare access crisis in the U.S.? 1. In the 1960’s, psychiatric hospitals closed their doors, making inpatient services very...
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