It was from seeing patients that Fisher first got the hint that this diabetes-specific emotional state exists. "We were really struck by the number of folks reporting high levels of stress and depressive symptoms who weren't even close to reaching major depressive disorder," he says. So if they weren't clinically depressed, he wondered, what were they dealing with? The answer was that they were experiencing unique emotional issues directly related to the burdens and worries of living with a chronic disease. They had diabetes distress