Not so long ago Dr. Michael Vallis enjoyed his trips to the grocery store.
“Maritimers, we’re pretty friendly people,” he said.
“I can still remember the first time I went into a grocery store when the lockdown started and all of a sudden I realized I used to be quite happy, I’d smile at people, I’d say hi to people.
“And the first time someone came down my aisle, I thought, ‘Get away from me.’ ”
As a health psychologist, Vallis knows all about the psychological effects of feeling threatened or fearful.
For example, if a diabetic’s blood sugar goes extremely low into hypoglycemia, they may suddenly have trouble walking and speaking.
“The psychological aspect is a very strong fear response,” Vallis said in a recent interview. “If you’ve ever had an episode of low glucose it can be terrifying.”
"The pandemic has really placed the mental health issues much more in the centre of the screen because of just the nature of the pandemic itself."
- Health psychologist Dr. Michael Vallis
The COVID-19 pandemic has added yet another layer to the psychological impact of disease, which in turn can lead to serious physical consequences.
For example, the rate of amputation among diabetics has risen during the pandemic because people are afraid to seek treatment even after warning signs such as numbness in the arms and legs arise.
“What’s happened with COVID is that people are concerned about going to the hospital,” said Vallis, who spoke at a virtual conference on diabetes this week organized by Diabetes Canada.
His topic was the need for all health-care providers - dieticians, pharmacists, nurses and doctors - to look outside the box when it comes to mental health issues related to diabetes.
“It’s really a timely presentation because COVID and the pandemic has really placed the mental health issues much more in the centre of the screen because of just the nature of the pandemic itself,” he said.
“This is an issue that diabetes providers have always been aware of - which is the psychological, emotional, relational aspects of diabetes - but the average diabetes provider is much more focused on the medical and the educational aspects.”
As a result, they may refer every mental health issue to psychologists. Vallis has worked in the diabetes field for many years and It’s often his role to help the care team become more comfortable in supporting a patient’s mental well-being.
As for concerns this might lead to people providing inappropriate care - given their training - Vallis said you don’t need to be a psychologist to deal with diabetes distress. It’s not a matter of treating an abnormal response, which is the purview of a psychological specialist.
“Diabetes distress is normal. It’s very, very common. We’ve discovered up to 50 per cent of people with Type 1 diabetes report distress and 40 per cent with Type 2.
“I would say that education and support is helpful and it’s not psychological intervention.”
Although dealing with any chronic disease entails stress, diabetics bear an unusually heavy psychological burden. They must adhere to a strict diet and their lives are governed by a medical regimen of glucose monitoring and daily self-injections of insulin.
Vallis listed off four different types of distress associated with diabetes, on top of the fear of low glucose and the knowledge that this disease will only get worse with time.
But even brief conversations with care providers - for example at the pharmacy - can go far in alleviating these stressors, Vallis said.
“Distress, psychological insulin resistance, fear of hypoglycemia, they can be dealt with by pharmacists in the context of their work.
“When you step back, it helps us to become comfortable with the idea that we have to understand the whole person.”