Pregnancy, diabetes, and mental health

Your care team is monitoring your blood sugar, your diet, your numbers. Every appointment is focused on the physical management of a diagnosis that arrived in the middle of one of the most vulnerable experiences of your life.

Nobody is asking how you're doing with it. That's the gap I work in.

The diagnosis changed something.

Whether you were diagnosed with gestational diabetes at your 24 week glucose test or you came into pregnancy already managing type 2 diabetes, the emotional weight of navigating a metabolic condition during pregnancy is significant and consistently ignored.

The fear about your baby's health. The grief for the pregnancy experience you expected. The exhaustion of constant monitoring on top of everything else pregnancy asks of your body. The shame that comes from a medical system that has historically used language around diabetes — failed tests, bad numbers, poor control — that lands somewhere in your body whether you mean it to or not.

All of that deserves support.

I have two offerings to share.

First, a free resource related to pregnancy, diabetes, and mental health (click the button below).

If you might be ready for more support, read on.

Who this is for

Gestational diabetes You got the diagnosis and something shifted. The excitement flattened. You're managing your numbers and your diet and showing up to every extra appointment and also quietly falling apart in ways nobody around you seems to notice. The grief, the fear about birth, the guilt about not feeling grateful enough — that's what I work on.

Type 2 diabetes in pregnancy You came into this pregnancy already carrying a diagnosis and everything that comes with it. The additional monitoring, the heightened risk, the weight of managing a chronic condition while also growing a baby. For women with type 2 diabetes, pregnancy can bring a particular kind of fear and hypervigilance that doesn't get enough clinical attention. You deserve support that understands both the medical context and the emotional one.

Postpartum diabetes adjustment The baby is here. For some women the gestational diabetes resolves and leaves behind a complicated relationship with food, with their body, and with the medical system that felt more like surveillance than care. For others the diagnosis becomes a permanent one and the postpartum period involves processing what that means going forward. Either way the emotional work doesn't end at delivery.

What therapy looks like

Individual therapy for diabetes in pregnancy and postpartum is focused, collaborative, and grounded in the specific experience of navigating a medical condition during one of the most psychologically significant periods of life.

We work on the grief and anger around the diagnosis. The anxiety about birth outcomes and your baby's health. The complicated relationship with food and your body that monitoring can create or intensify. The fear about what comes next — postpartum, future pregnancies, long term health. And the shame that the medical system often inadvertently instills and that you deserve to put down.

This is not generic talk therapy. It is perinatal mental health support with a specific clinical understanding of what diabetes in pregnancy actually involves and what it does to a person.

Frequently asked questions

Do I need a formal diagnosis of anxiety or depression to work with you? No. Many women I work with don't meet full diagnostic criteria for a mood or anxiety disorder but are significantly affected by their diabetes diagnosis. If the emotional weight of this is getting in the way of your pregnancy experience or your postpartum adjustment, that is enough.

My gestational diabetes resolved after delivery. Do I still need support? Sometimes the diagnosis resolves and the emotional residue doesn't. A complicated relationship with food, lingering fear about future pregnancies or long term health, or a postpartum period that felt harder than expected can all be connected to what happened during pregnancy even after the diagnosis is gone.

I have type 2 diabetes and I'm not currently pregnant. Can you still help? This page is specifically focused on the pregnancy and postpartum period. If you're planning a pregnancy and want to work through the emotional aspects of managing type 2 diabetes while pregnant, reach out and we can talk about whether this is the right fit.

I feel like I should just be grateful for a healthy baby. Is that normal? It is one of the most common things I hear. Gratitude and grief are not mutually exclusive. You are allowed to hold both. The guilt about not feeling grateful enough is often one of the heaviest parts of this experience and it is worth addressing directly.

How is this different from seeing any other therapist? Most therapists are not specifically trained in perinatal mental health and do not have a clinical understanding of the experience of diabetes in pregnancy. The specificity of this work matters. You shouldn't have to explain the emotional weight of a failed glucose test to a therapist who has never thought about what that language does to a person.

You've been managing the numbers. It's time someone helped you with everything else.

Virtual individual therapy for gestational diabetes and type 2 diabetes in pregnancy and postpartum, across PSYPACT states.

Dr. Lexie offers virtual therapy for gestational diabetes mental health, type 2 diabetes in pregnancy, perinatal anxiety, postpartum adjustment, and diabetes-related grief and shame across PSYPACT states including Illinois, Pennsylvania, Florida, Texas, Maryland, Washington, D.C., and New Jersey. She specializes in the emotional experience of high-risk pregnancy, maternal mental health, and the psychological impact of pregnancy-related medical diagnoses.