The Accelerating Excellence In Translational Science (AXIS)Charles Drew University of Medicine and Science

Dr. Curley L. Bonds

People with diabetes face challenges every day. The difficulties of managing potential risk of obesity, counting calories, keeping doctor’s appointments and attending to self-care cause stress. That stress might be building the foundation for another illness: depression.

Dr. Curley Bonds, Associate Professor at Charles Drew University and Health Sciences Clinical Professor at UCLA, is uncovering the link between depression and diabetes.“It is a two way street with diabetes and depression,” he said. “People that have genetic predisposition to diabetes can have depression. Diabetes affects all organs including the brain, through decreased blood flow and neuropathy (nerve damage).”

Dr. Bonds observed that the list of tasks that a diabetes patient needs to follow for proper selfcare falls off during depression. When each day becomes a struggle, the will to live is gone and treating diabetes isn’t worth the effort.

Dr. Curley Bonds is the chair of Psychiatry and Human Behavior at Charles Drew University and the Medical Director at Didi Hirsch Mental Health Services. He served as the Director of the Consultation and Evaluation Service for the UCLA Center for Health Sciences before coming to CDU in 2005.

Depression intrigued Dr. Bonds from a young age. He said having a close family member with the illness drew him to become a resident advisor in his dorm. In that position he enjoyed helping his fellow students through counseling. In medical school, studying the brain fascinated him. “It was something I enjoyed and had an affinity to,” said Dr. Bonds.

Dr. Bonds observed that psychiatry is an under populated specialty because it is not the first choice for many medical students. As a result, patients seeking care may have difficulty finding a provider. The problem is amplified in medically underserved communities.

“I think especially for minority communities there is a stigma associated with acknowledging that you have any type of mental health problem,” said Dr. Bonds.
“Whether it is depression or substance abuse.”

Depression affects between 20-25 percent of all people at some point in their life, Dr. Bonds said.

People who don’t have access to counseling or delay treatment of their depression because of a sense of shame tend to end up with more complex illnesses. By the time they get care, they may have already lost their jobs and alienated themselves from their friends and family.

“People think of depression as being a weakness, or some sort of spiritual failing,” he said. “They think if they pray hard enough or exercise they can treat it on their own.”

Depression complicates treatment for people with diabetes. “Depression is a cognitive illness,” explained Dr. Bonds. “So if a regimen is complex—involving different medications at different times of the day, before or after a meal—it can be hard to follow if you are not thinking clearly.”

Some drug-drug interactions can also complicate diabetes. Psychiatric medicines that cause weight gain or weight loss can also complicate diabetes. Drug-drug interactions between medicine for depression and medicines for diabetes add another layer of complexity.

Dr. Bonds works to address that problem. In a 2009 study, Bonds and a group of CDU researchers demonstrated that pharmacological treatment of depression improved systolic blood pressure and levels of blood glucose in subjects. With UCLA and the Didi Hirsch Mental Health Services, Dr. Bonds is part of a team developing a project to help people with mental illness make medical decisions.

“The goal is to develop a training program to support patients when they come into the doctor,” Dr. Bonds said. “It is helping consumers ask the right questions so they can arrive at the right answers.”

Dr. Bonds is also working with researchers to create an online resource to help patients with mental health problems with support from UCLA, CDU and Didi Hirsch.