Managing type 1 diabetes involves more than tracking blood sugar or taking insulin. It’s a lifelong condition that needs ongoing care through shifting demands. Whether you are diagnosed with type 1 diabetes or are a caretaker for someone with this condition, it requires your attention every day, for much of the day. At the Type 1 Diabetes Experience (T1DE) program at The Ohio State University Wexner Medical Center in Columbus, Ohio, we know the type 1 diabetes community is under-supported, with often misunderstood needs. T1DE is a clinic to address these behavioral health needs, aiming to improve care beyond medical treatment to include emotional and behavioral support, helping you focus on your goals and connections.
What is the Type 1 Diabetes Experience?
The Type 1 Diabetes Experience (T1DE, or “tide”) is a clinic at the Ohio State Wexner Medical Center focused on helping people address and manage the mental health challenges that often occur alongside a type 1 diabetes (T1D) diagnosis and the changes in daily life that follow. Whether you are newly diagnosed or have been managing T1D for years, the program can provide support for the physical, mental and behavioral challenges that are distinct to your condition.
The clinic is directed by Aaron Breedlove, PhD, assistant professor of psychiatry and behavioral health in The Ohio State University College of Medicine, who specializes in health psychology. Providers who work in health psychology help people build connections between behavioral choices and health choices, leading to illness prevention and better overall health. Through the clinic, Dr. Breedlove provides individual and group therapy, and he supports caregivers of people with T1D.
The mental health effects of type 1 diabetes
Learn how daily management of type 1 diabetes can increase the risk of anxiety, depression and burnout.
How does type 1 diabetes affect mental health?
Type 1 diabetes requires consistent monitoring, with research showing that people with T1D make 150 to 200 decisions daily about their condition. It’s not surprising that it can cause strong emotional and behavioral responses. People with T1D can feel like they have a job they didn’t apply for because they can spend hours each day thinking about their condition, monitoring blood glucose levels, and planning meals and activities. Some ways T1D can take a mental toll include:
- Because there is no apparent cause and often little to no warning before the onset of symptoms, people can feel angry or confused.
- Denial is a common reaction after diagnosis, which can lead to missed or inconsistent doctor appointments, medication and blood sugar monitoring.
- Checking blood sugar and having fear of low (hypoglycemia) or high (hyperglycemia) blood sugar can cause increased anxiety.
- People with T1D are up to three times more likely than the general population to develop depression, in part because of the daily maintenance and feelings of social isolation.
When to seek mental health care with type 1 diabetes
Psychologist Aaron Breedlove, PhD, of the Ohio State Wexner Medical Center, explains the differences between how type 1 diabetes and type 2 diabetes affects a person's mental health.
How does mental health affect type 1 diabetes?
Mental health and T1D are closely connected and influence each other in both directions. It can affect your emotional well-being, and in turn, your mental health can impact how you manage your diabetes. This is why it’s essential to care for both your physical and mental health.
Mental health challenges like anxiety or depression can make it harder to follow a diabetes care plan. You may find it more difficult to attend medical appointments, take insulin as prescribed, eat regularly, exercise or monitor your blood glucose levels.
Some people with T1D develop disordered eating behaviors. This can happen when someone has anxiety when taking insulin, believes it causes weight gain, or associates it with negative outcomes — leading to skipped doses or irregular eating patterns. Also, people with type 1 diabetes have to eat when they aren't hungry to raise their blood sugar, which complicates their relationship with food.
To complicate matters, the symptoms of anxiety — such as sweating, shaking, rapid heartbeat, and nervousness — can mimic the symptoms of low blood sugar. For someone with both anxiety and T1D, this overlap can be confusing and distressing. In some cases, fear of experiencing low blood sugar can heighten anxiety even more and lead to overcorrection or avoidance of insulin.
Mindfulness for type 1 diabetes help
Psychologist Aaron Breedlove, PhD, of the Ohio State Wexner Medical Center, explains the differences between how type 1 diabetes and type 2 diabetes affects a person's mental health.
What services are offered through T1DE?
Individual therapy
The clinic provides individual mental health support for T1D. These are private, one-on-one sessions between you and Dr. Breedlove, who uses acceptance and commitment therapy (ACT), a mindfulness-based approach.
ACT focuses on helping people with chronic illnesses live fuller, more meaningful lives by changing how they relate to their symptoms, emotions and thoughts — without trying to eliminate the illness itself.
Group therapy
Dr. Breedlove also leads therapy sessions for groups of people with T1D. Being in a group allows you to interact with other people who understand your experience personally. Confidentiality is stressed in all sessions so that participants feel safe. Participants are urged to only share what they are comfortable divulging to the group.
Caregiver support group
The clinic also offers separate support groups for caregivers of people with T1D, who also experience stress, fear and possible burnout while caring for a family member or friend.
Who is a candidate for T1DE?
You might be a candidate for the clinic if:
- You have T1D and are over the age of 18
- You are a caregiver for someone with T1D
The support groups for diagnosed individuals and caretakers are free and open to anyone, regardless of whether your loved one is cared for at Ohio State or in the clinic. One-on-one therapy sessions are available by appointment with Dr. Breedlove. Any adult with a T1D diagnosis is welcome, no matter your age of onset or experience with the illness.
What are the benefits of the T1DE clinic?
Mental health care that specifically addresses the challenges you face with T1D has several benefits, including:
Better self-care: People who receive therapy or other behavioral-health care alongside their diabetes care are more likely to manage their condition through medication, doctor visits, exercise, diet and glucose monitoring.
Skills building: You’ll gain mental and behavioral skills that will consistently help you overcome the behaviors that limit or prevent you from managing diabetes. With mindfulness-based therapy techniques, you’ll learn to work toward goals and values even when it’s challenging.
Cyclical benefits: When you care for your mental health, your diabetes management improves and vice versa. Creating and nurturing this relationship between the two can create a perpetual cycle for your overall health and well-being.
Why choose Ohio State for type 1 diabetes behavioral health care?
Psychologist Aaron Breedlove, PhD, of the Ohio State Wexner Medical Center, explains why you should choose Ohio State for type 1 diabetes behavioral health care.
Why choose Ohio State type 1 diabetes mental health support?
People with T1D have historically been underserved in mental health care. Despite the well-documented emotional and psychological challenges that often accompany diabetes — including distress, burnout, anxiety, depression and eating concerns — mental health services that address these issues in a condition-specific context remain limited.
Most mental health providers are not trained to understand the unique demands of living with T1D. The T1DE clinic at Ohio State stands apart because it focuses on all aspects of the type 1 diabetes experience. The program not only focuses on the diagnosed person but also families and caregivers in support groups. Dr. Breedlove also conducts research into the connections between mental health and T1D, helping push this area of health psychology forward.