Mindfulness-Based Cognitive Therapy and Diabetes Management

Conspectus Borealis Volume 5 Issue 1 5th Anniversary Issue Article 8 4-4-2020 Mindfulness-Based Cognitive Therapy and Diabetes Management Kerri H. Watkoske Northern Michigan University, Follow this and additional works at: https://commons.nmu.edu/conspectus_borealis Part of the Health Psychology Commons Recommended Citation Watkoske, Kerri H. (2020) "Mindfulness-Based Cognitive Therapy and Diabetes Management," Conspectus Borealis: Vol. 5 : Iss. 1 , Article 8. Available at: https://commons.nmu.edu/conspectus_borealis/vol5/iss1/8 This Article is brought to you for free and open access by the Journals and Peer-Reviewed Series at NMU Commons. It has been accepted for inclusion in Conspectus Borealis by an authorized administrator of NMU Commons. For more information, please contact Kevin McDonough. Running head: MBCT AND DIABETES 1 Mindfulness-Based Cognitive Therapy and Diabetes Management Kerri Hope Watkoske Northern Michigan University MBCT AND DIABETES 2 Mindfulness-Based Cognitive Therapy and Diabetes Management Over nine percent of the United States population has a chronic disease of type II Diabetes (Taylor, 2018). This substantial amount of people must manage their symptoms so the disorder does not get worse. Some symptoms of type II diabetes include, but are not limited to, fatigue/drowsiness, frequent urination, infection of the skin, intense itching and pain/cramps of legs, feet, and fingers (Taylor, 2018). These symptoms can progress with noncompliance to diabetes management problems. If the symptoms are not managed they can lead to amputations, kidney failure, liver failure, loss of eyesight, and even death (Taylor, 2018). Therefore, management programs are critical for the individual to maintain a longer, healthier life. However, diabetes frequently has comorbidities of both physical and mental health complications, hindering management. Comorbid physical health problems can be hypertension, kidney damage, obesity and cardiovascular disease (Fugger et al., 2019). For the mental health comorbidities, 40% of individuals who have diabetes suffer from anxiety symptoms and 20-40% have depressive symptoms (Son et al., 2014). These mental health comorbidities, which are the focus of this paper, lower self-care behaviors, have an adverse impact on insulin, and lead to poor management of other comorbid health problems (Son et al., 2014). Decreases in mental health can lead to mismanagement of diabetes symptoms. This can happen by an individual having decreased physical activity or by having inadequate drug compliance, which can make stress more prominent, leading to further problems. Diabetes Management Diabetes management programs often require serious life changes. Some common life changes for this group of individuals include, but are not limited to, losing weight, managing stress, changing diet, and exercise (Taylor, 2018). Because many lifestyle choices lead to the MBCT AND DIABETES 3 development of type II diabetes, management is difficult because individuals have to change their lifelong habits. Common changes individuals’ should make to their lifestyles include refraining from indulging in sugary food and drink and adopting an exercise routine. When insulin levels are not controlled, due to not following the recommended management plan, individuals are at higher risk for the development of depression (Fugger et al., 2019). This mental health complication can lead to added stress or non-compliance to the management program. When stress is increased, it elevates the levels of glucose in the system, which in turn worsens the symptoms of diabetes (Taylor, 2018). Stress management is addressed in diabetes management programs, but other mental health disorders frequently are not. Comorbid mental health disorders are depression and anxiety. These disorders can cause stress and noncompliance to diabetes management programs. Diabetes and mental health To begin, Fugger et al., (2019) noted that roughly 94,000 completed suicides happen worldwide each year within the diabetes population. This suggests the serious mental health problem that goes untreated in this population. This further supports the need for better mental health treatment to be implemented into diabetes management programs. Research also suggested that mental health complications have been overlooked in clinical practice for diabetes and many individuals remain untreated (Son et al., 2012). Because mental health disorders are common among this population, the absence of mental health treatment can aggravate diabetes symptoms reducing the quality of life. This group of individuals is more likely to participate in adverse health behaviors such as smoking, physical inactivity, and poor diet (Fugger et al., 2019). Additionally, as an example of how depression can advance symptoms of diabetes, high blood pressure and heart disease are common among individuals MBCT AND DIABETES 4 with advanced depression and comorbid diabetes (Fugger et al., 2019). Therefore, individuals suffer not only the common adverse health habits of depression that typically make diabetes symptoms worse, but also the comorbid physical health problems which advance their symptoms. Some treatment options for mental health comorbidities are antidepressant medication including, selective serotonin reuptake inhibitors (SSRIs). This drug not only has a positive effect on depression, but also on blood glucose control (Fugger et al., 2019). This treatment option limits the adverse side effects of depression to give the individual the push to jump back into proper diabetes management. The other positive side effect of SSRIs is that they lower blood glucose levels among some patients. This assists in keeping glucose levels low, which helps to reduce the adverse side effects of diabetes. The drawback of SSRIs is that there is poor drug adherence, with compliance rates varying from 38%-79% (Roohafza et al., 2016). Although SSRIs have promising results, many individuals do not benefit because they fail to take the drug. However, additional drawbacks of psychopharmacological treatment are the side effects of the drug. About 30-50% of diabetic patients do not respond to antidepressant drug treatment, or relapse back into depressive symptoms (Son et al., 2012). Another complication with antidepressants are that individuals are noncompliant in taking them or some people take the drugs but do not find symptom relief, leaving them with their depressive symptoms. This leaves a need for a more effective mental health therapy that has long term, lasting effects for diabetic patients. Mindfulness based Cognitive therapy (MBCT) MBCT AND DIABETES 5 An alternative therapy, Mindfulness-based cognitive therapy (MBCT), has been implemented into some diabetes treatment plans. Traditionally developed as a treatment plan for individuals who have recurring depression, this therapy has been adapted into many new contexts (Alsubaie et al., 201 (...truncated)