We’ve all been there, we get a little depressed or anxious and then, while in that mindset, we make choices like skipping our usual morning walk, having an extra handful (or two) of potato chips, and staying up late to scroll our phones or watch some mindless TV. The truth is, mental health conditions, no matter how minor, impact our ability to engage in self-care. For someone living with diabetes they don’t get too much time off from monitoring thier self-care. So even a short rut where they’re choosing foods that may not be the most nourishing, not sleeping well, or getting in enough physical activity can exacerbate factors related to healthy blood sugar management. 

How do we ensure effective treatment of both the mental health fatigue and the cardiometabolic health concerns? 

Effective treatment needs to start with an acknowledgement that the two are closely intertwined. You can’t treat one without the other and with the prevalence of depression in people with diabetes being 2-3x higher than in people without diabetes, it is clear that in order to move the needle on outcomes and improve quality of life for people who are suffering, a holistic approach needs to be taken.  The fatigue of caring for a condition like depression or diabetes can be improved when patients learn important coping tools and skills that help them build resilience to manage the daily demands of both conditions. 

From subclinical to severe mental illness, how does the spectrum of mental health affect cardiometabolic conditions? 

For those with diabetes, subclinical and clinical mental health challenges often present itself as something called diabetes distress. Diabetes distress is basically when someone with diabetes has an emotional state where they’re overwhelmed by feelings of grief, shame, or mental exhaustion which impacts their ability to care for themselves and their disease. Certainly, more severe mental health conditions can impact a person’s ability to cope with the daily demand of managing a chronic condition like diabetes. But the whole spectrum of mental health conditions needs to be considered because even subclinical mental health challenges can have an impact on diabetes outcomes. 

What is the biggest concern related to the mental health of people living with cardiometabolic conditions such as diabetes? 

I work with a lot of people who Vida treats for both mental health conditions and cardiometabolic conditions — the biggest concern for me is usually that stigma will get in the way of someone receiving the mental health care they need. Untreated mental health conditions can lead to significantly poorer outcomes and greater risks of complications. When both untreated depression and diabetes coexist, health outcomes are worsened for both. This can mean lasting complications like damage to kidneys, eyes, nerves, and can sometimes lead to amputations and other costly complications. One of the biggest concerns to be aware of is that depression is frequently missed, undiagnosed, or when diagnosed, patients often don’t receive the care they need.

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This article was written by Vida's Sr. Director, Cardiometabolic and Prescribing Gretchen Zimmermann. To learn more, visit vida.com or watch Vida’s session from the Going Digital: Behavioral Health Tech 2022 summit.