1. Spencer Nance PSY 328/01 March 11, 2015 Dr. Gordon Cappelletty

2. Diabetes & Heart Disease Two major health problems Affect individuals physically and psychologically Medical challenges Long term lifestyle changes (Stuckey et al, 2014)

3. Diabetes: Initial Diagnosis 8,596 study participants with Type I or II diabetes 46% reported negative psychosocial well-being Difficult diagnosis period Difficulty in managing symptoms and coping with complications Feelings of sadness, anxiety, helplessness, and depression Daily balancing act with medications, diet, and exercise (Stuckey et al, 2014)

4. Diabetes: Life-long Commitment Long term commitments to disease can be exhausting Multitude of lifestyle changes Feelings of deprivation and isolation Frustrations associated with everyday required tasks can cause non-compliance Emotional trauma from diagnosis can lead to depression (Stuckey et al, 2014)

5. Diabetes: Fear & Acceptance Acceptance more difficult with unexpected diagnosis Daily stress in living with diabetes, which can lead to unhealthy behaviors Fears over potential complications associated with disease Fears over physical requirements associated with disease (Stuckey et al, 2014)

6. Diabetes- Coping Need for adaptive coping skills Conquering obstacles Supportive family and friends Take one day at a time (Stuckey et al, 2014)

7. Video: Diabetes & Depression https://www.youtube.com/watch?v=pm4aZ0vJiBw (Engel, 2010)

8. Cardiovascular Disease: Early Crucial Period Prone to adverse psychological issues Individuals who survive a heart attack are 3 times more likely to have depression within first 6 months Post-myocardial infarction depression- risk factor for further heart attacks and death (Vogele, Christ & Spaderna, 201 2)

9. Cardiovascular Disease: Study Worries over perceived threats after having a heart attack Fears of having another cardiac event Fears over limitations in work or other activities Feelings of inadequacy and self-doubt Fears over interpersonal relationships (Vogele et al, 2012)

10. Negative vs. Positive Coping Individuals who dwell on traumatic past cardiac events are at an increased risk for adverse psychological issues Lack of coping skills can lead to depressed mood, pessimism, and family conflicts Individuals who feel in control of disease process report less symptoms of stress, anxiety, and depression Cardiac rehabilitation programs can be beneficial in managing psychological symptoms (Vogele et al, 2012)

11. Study on Patient Outlooks Patients who have an optimistic outlook and seek rehabilitation after heart attack are at a decreased risk of developing adverse psychological issues Patients with pessimistic outlook after heart attack are at an increased risk of adverse psychological issues and will have more difficulty in overcoming depression (Vogele et al, 2012)

12. Interventions Rehabilitative programs offer support during recovery period Psychological interventions and counseling should be started upon diagnosis First 2 weeks after diagnosis is most crucial time for risk of depression (Vogele et al, 2012)

13. Video: Heart Attacks & Depression https://www.youtube.com/watch?v=RND_o8-fbks (Baylor Health Care System, 2010)

14. Conclusion Diabetes and cardiovascular disease- devastating diagnosis for the patient Both cause life-long physical and psychological challenges Both require long-term lifestyle changes, which can be stressful and difficult Ongoing monitoring and support for adverse psychological issues are crucial (Vogele et al, 2012)

15. References Baylor Health Care System (2010). Heart attacks and depression [Video file] Retrieved February 28, 2015 from https://www.youtube.com/ watch?v=RND_08-fbks Engel (2010). Diabetes and depression [Video file] Retrieved February 28,2015 from https://www.youtube.com/watch/v=pm4aZovJiBw Stuckey, H.L., Mullan-Jensen, C.B., Reach, G., Kovacs-Burns, K., Piana, N., Vallis, M., Wens, J., Willaing, I., Skovlund, S.E., & Peyrot, M. (2014). Personal accounts of the negative and adaptive psychosocial experiences of people with diabetes in the second diabetes attitudes, wishes and needs (DAWN2) study. Diabetes Care, DOI: 10.2337/dc13-25361935-5548. Vogele, C., Christ, O., & Spaderna, H. (2012). Cardiac threat appraisal and depression after first myocardial infarction. Frontiers in Psychology, DOI 10.3389/fpsyg.2012.00365.