Let's Talk Health: Living With Multiple Health Conditions and Ideas For Managing It All

"What Is the Best Approach For Someone Living With Multiple Health and Mental Health Conditions?"
Often times serious and ongoing health and mental health conditions occur together and impact one another, as in the case of type 2 diabetes and major depression. What is the best approach when multiple complex diagnoses are present? A recent online article shared recommendations presented at the Obesity Medical Association Spring Conference by Nowreen Haq, MD. 

Dr. Nowreen Haq acknowledges that there isn’t a clear answer since everyone’s situation is different. Dr. Haq is quoted as offering various steps to treatment for individuals living with diabetes, obesity, and major depression. The treatment focus may begin with specific changes in lifestyle habits and medication review/adjustment. Lifestyle habits can be thought of as steps in taking care of oneself. Dr Haq states that psychotherapy, specifically cognitive behavioral therapy, has been shown to improve A1c levels (a lab test that measures the 3-month average of blood glucose levels). 

The information reviewed by Dr. Haq appears consistent with current medical practice. Which of her suggestions cause you difficulty? What are the barriers to getting the results you want to see? 

I think that these three issues- obesity, diabetes, and depression- influence one another such that visible and sustained improvements in one health condition will positively impact the other health conditions. As a health psychologist, I would determine my treatment priorities based upon:

• The urgency of the patient’s medical condition (for example, very poor management of diabetes may make it necessary to figure out how to make improvements here first);
• Where patient is motivated to work and where they are likely to experience success;
• Impact of emotional/psychological state upon health and health-related behaviors. 

Ask Questions (During Appointment or via Email/Patient Portal) !
Some patients are confused or surprised when their medical doctor refers them to talk to a psychologist. Some feel misunderstood or stigmatized. If this has happened to you, ask your doctor his/her reason for the recommendation (remember that whole "no such thing as a stupid question" while in school as a child?). Chronic disease can be burdensome and difficult to manage. The field of medicine values team-based approaches to disease management. Unfortunately, this well-coordinated care may not happen as the norm due to time, effort, cost, and not knowing available psychologist specialists to refer to.  
This is my approach to working with patients who are seeking help in managing multiple conditions:              - Talking with the medical doctor and clarifying diagnosis and medical treatment plan;
      - Working with the medical doctor/patient on improved disease management;
      - Increasing motivation for the recommended lifestyle habits;
      - Providing tools for the patient to develop hope, change negative thoughts to positive ones, and              make progress towards their goals with my help.
      - Talk about their worries, stress, and life circumstances.
      - Psychotherapy provides patients with emotional support, feedback, and coping skills training so
        that desired changes can happen. 

I hope that this post helps to demystify what happens in therapy for patients who are new to therapy, have no prior experience with psychological conditions, or are concerned that seeking help will be a sign of weakness or challenge their drive to remain "strong." Therapy is a private experience in which you play an active part in determining the focus of treatment and the pacing. 

Thank you for reading ! and <3 Be Well !! 

​I have some availability for new telehealth patients. For more information or to request a free 15 minute consultation regarding therapy with me, visit my contact page.