My daughter is in pretty good control of her diabetes (hemoglobin A1c is 7.4%), but, sometimes she gets mildly depressed. She is an excellent student at school, but I think the stress of everything gets to her. She starts getting too hard on herself and then acts out, and after her tantrum, she feels bad. I feel that at times her lows and highs give her wrong messages about herself. I would like information on cognitive-behavioral therapy and diabetes.

It sounds like your child is in the midst of her teen years and might be experiencing some hormonal changes and moodiness associated with the turbulent teens. Her diabetes control sounds reasonably good, and her high grades should be encouraging for her, and you as well.

If your daughter is overly vigilant about her weight, her schoolwork, and other areas of her life it might be useful for her to be tested for obsessive compulsive disorder. Some of the things you mentioned are consistent with that diagnosis. A qualified mental health professional should be contacted to make such an assessment.

I really don’t see much in your letter to indicate a severe problem. Maybe I am missing something? Is she an overachiever? Does she have unreasonable expectations of herself? Is she balancing her self worth on what her blood sugars are?

CMB