HEALTH FOCUS: Managing chronic conditions with good mental health presented by Greenville Health System

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By Leon Buffaloe, M.D.

Greenville Health System recently hosted its 10th annual Minority Health Summit while focusing on two important topics: diabetes and mental health.

2016 Minority Health Summit

2016 Minority Health Summit

More than 2,000 people attended the event, which included performances by Akintunde, a Dove Award winning comedian from Columbia, and American Idol winner Candice Glover. The event also included presentations and panel discussions with GHS providers, including an internist, psychiatrist, podiatrist and a dietitian.

Candice Glover

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2016 MHS Physician Panel Discussion

Talking about mental health while addressing chronic health conditions, including diabetes, hypertension and heart disease is important. Too often, we overlook the link between the two.

I’m an internist, and I learned how depression impacts patients diagnosed with chronic diseases while I was a resident.

I once had a patient visit me in an outpatient clinic. The patient’s chronic diseases were unstable. The blood glucose levels were all over the place. The blood pressure readings were dangerously high. It was clear after reading lab work that prescription medication was not being taken. I simply thought the patient was being noncompliant with the prescribed regimen.

Then, I stepped out of the room to discuss these findings with my attending physician. He asked if the patient seemed depressed. I thought about it for a moment and realized the patient’s mood did seem solemn.

I returned to the exam room and asked questions to screen for depression. Many of the responses indicated that the patient was depressed. I followed up with my attending, and he instantly told me to deal with the depression, because, if I did not, the patient was not going to hear any suggestions I had concerning the chronic conditions.

That visit did not end with me prescribing a pill. It was more of a counseling session that involved me learning what was going on in the patient’s life. I learned she lost a job and felt her spouse had lost interest. Our visit became therapeutic, and I was able to convince the patient to prioritize her health. The patient agreed to resume following our prescription regimen.

Four weeks later, the patient returned for a follow-up visit, and her blood glucose and blood pressure readings were under control. She was still out of work and concerned about the marriage, but the patient had a more positive outlook after talking during our last visit.

I am not saying that all patients suffering with mental health illnesses can just talk them out and feel better. Many will improve with medication and counseling. However, it is important to note that poorly controlled diabetes is not just a result of poor self-management or not following the right drug regimen or eating too many sweets.

If you know that you have lost motivation in caring for your health, talk with your primary care doctor about treatment options. Most internists and family medicine physicians are comfortable treating some mental health illnesses, or they will refer you to a psychologist or psychiatrist.

Good mental health can definitely improve the management and outcome of chronic diseases.

Leon Buffaloe, M.D. , is an internist with GHS Family & Internal Medicine-Simpsonville.

Buffaloe, Leon MD (12-2-14) Labcoat








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