Living with a complex, chronic health condition like type 1 diabetes (T1D) is complicated, expensive, and burdensome. Most people live long, happy, healthy, and satisfying lives with T1D, yet there is a large body of evidence that mental health concerns and behavioral challenges are common, and interfere with self-management, quality of life, and health. At the same time, there are not enough professionals who have knowledge of the complex interplays between diabetes and psychosocial factors to meet the needs of the large and growing population of people with T1D, and their families.
To help address this gap, the Type 1 Diabetes Mental Health Workbook was created to provide a concise, practical resource for mental health clinicians and therapists to use in their care of young people with T1D. The workbook is divided into eight sections:
Overview of T1D
Language and communication about T1D
Challenges associated with a new T1D diagnosis
Approaches to addressing T1D self-management challenges
Emotions associated with T1D
Mood concerns and T1D
T1D-related worries and anxiety
Additional considerations
Chapter 7: T1D-Related Worries and Anxiety Available to Purchase
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Published:2023
"T1D-Related Worries and Anxiety", Type 1 Diabetes Mental Health Workbook: A Practical Resource for Providing Behavioral and Mental Health Support to Young People with Type 1 Diabetes, and Their Families
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One-third of children with T1D experience anxiety related to specific aspects of living with T1D, including social anxiety, fear of hypoglycemia, anxiety related to uptake of new technology, and needle anxiety or avoidance.
Rates of social anxiety may be higher in young people with T1D compared with their peers without T1D. Social anxiety in young people with T1D is often specifically related to social aspects of T1D, includ-ing others learning or knowing that the person has T1D, completing T1D-related tasks in front of other people or in public places, answering questions or talking about T1D, experiencing judgment about T1D, managing or communicating about T1D in dating situations, or having symptoms of hypoglycemia or hyperglycemia in front of other people. Social anxiety disorder, in which youth experience anxiety in a wide range of social situations and diabetes-specific social anxiety may or may not co-occur.
It may be necessary to distinguish among clinically elevated of anxiety, developmentally appropriate concerns about privacy, and secrecy. Privacy involves a preference to complete T1D-related tasks without an audience or avoid attention from others, whereas secrecy involves actively hiding T1D and its man-agement from others, which may negatively affect daily T1D self-management and well-being. Youth may prefer privacy but be willing to complete T1D self-management tasks in the presence of others when necessary. To avoid the development of anxiety, young people with T1D may need to practice completing T1D-related tasks in the presence of others. People who experience high anxiety or who engage in secrecy likely delay or avoid engaging in T1D self-management tasks and may benefit from intervention to address concerns and behaviors that interfere with optimal T1D management. Treating T1D-specific social anxiety is important to minimize suboptimal T1D outcomes and improve quality of life. Treatment for social anxiety disorder and T1D-specific social anxiety both respond best to cognitive behavioral therapy with exposure and response prevention.
