Behavioral Medicine


What does behavioral health mean?  A helpful way to understand this term is to think about why people go the doctor when they don't feel so good.  Common reasons for doctor visits include diabetes, high blood pressure, depression, chronic pain, weight gain, and complications from drinking, smoking, or using drugs.  


The term "behavioral health" was adapted in the 1970's and 1980's to differentiate between Freudian analysis and behavior-focused therapy.  This distinction helped clinicians to offer specific treatments for behavioral change, such as addictive behaviors.  Think of the behaviors you were taught as a kid, i.e., "Eat your vegetables; Stay away from sweets; Say 'No' to drugs!"  How have your lifestyle habits changed over the years?..


Today, behavioral health is incorporated into mental health to describe genetic, environmental, social, and psychological factors that influence behaviors associated with chronic illness.  A recent medical journal predicted that two in every five Americans will develop Type 2 diabetes in their lifetime.  While this is a scary statistic, we can use the following case example to explore how diabetes can be managed with behavioral health interventions.  


Case Example:

Ms. Smith is a 32 year-old woman who was recently diagnosed with Type 2 diabetes and depression.  She struggles to take her medication everyday and has a poor diet consisting mostly of processed food and sugary drinks.  The patient has a sedentary lifestyle and is 20 lbs. overweight.  She goes to the doctor for a check up and is told that her Type 2 diabetes can damage her kidneys, liver, heart and eyes if she doesn't take better care of herself.  At her follow up appointment a month later, Ms. Smith tells her doctor that she has not been able to make any changes to her lifestyle despite the risk factors. Her physician then offers a referral to a behavioral health specialist.  


Ms. Smith and the behavioral health specialist work together to establish a plan to prevent her illness from getting worse.  Her wellness plan includes a healthy, portion-controlled meal plan, a mood journal, yoga class, and cognitive-behavioral therapy-CBT.  Following 6 weeks of treatment, Ms. Smith reports fewer depressive symptoms and increased compliance with daily medication and her nutrition plan.  She has learned to be mindful of emotional eating tendencies and has lost 5 lbs.  Ms. Smith enjoys yoga class and has learned more about the mind/body connection.  She has also learned how to control negative thinking by keeping a daily journal.  The behavioral health specialist then consults with Ms. Smith's physician regarding her progress and treatment goals.  


Physical and mental health issues occur in tandem.  Routine medical care and behavioral health counseling are especially helpful to maintaining a healthy lifestyle that has positive effects on both your mind and your body.  Think about your lifestyle as a pattern of behaviors that helps you feel good most of the time or one that causes you to feel tired, angry, or 'blah' most of the time.  Making key changes in lifestyle behaviors can lead to a fuller, happier life.  Ask yourself, 'What behavioral changes could I make to feel more energized, vital, and enthusiastic about my life'?