Dr. Diamond Talks Mental Health


// Image courtesy of Dr. Danielle Moskow Diamond

Alex Chou: Hi, Dr. Diamond. Thank you for joining me. If you don't mind, it'd be great if you could start by talking a little bit about your work and what inspired you to pursue this career.

Dr. Diamond: Yes. Well, thank you so much for inviting me to be here, Alex. So I'm currently a postdoctoral fellow in the Center for Anxiety and Traumatic Stress Disorders at Mass General Hospital, where I specialize in treating anxiety, OCD, and trauma in adults, with a particular interest in working with young adults.

I took an honors psychology course in high school and just fell in love with psychology and knew that I wanted to major in psych in undergrad. I went to Emory University undergrad, took Intro to Psychology and actually loved the neurobiology courses, so added on a double major of neuroscience and behavioral biology. And I toyed with the idea of med school for a little bit, but took some of those classes and shadowed a psychiatrist and kind of realized it wasn't exactly for me — I wanted to do more of the research, teaching, as well as treating patients with longer sessions. So I did a senior honors thesis and really loved that. And that propelled me into the Ph.D. world.

I worked for three years as a research coordinator, and then started at Boston University for my Ph.D. And for me, being able to wear so many hats and do all those things has been really awesome. I met you, Alex, when I was an instructor for BU’s AIM Program, which is a course for high school students who want to do an immersion course in college-level psychology courses. And so I've just loved having the opportunity to wear so many hats. And then, of course, my passion is doing the clinical work — working with patients — whether it's groups or individual work.

Alex Chou: I'd also love to hear a little bit more about your current research interests.

Dr. Diamond: Most of my research tends to focus on treatments for anxiety, as well as mindfulness and suicidality. As I mentioned, I love working with young adults. And so being able to research different treatments that will be most effective for young adults is a big passion of mine.

My lab at BU is focused on treatments for anxiety. I had the opportunity to do a lot of research involving treatments for anxiety, whether that was comparing medication with group therapy for generalized anxiety or a group study on positive aspect treatment for low mood. Now I'm doing some research related to mindfulness. And that was also what my dissertation was on — I developed a scale to be able to better predict where individuals focus their attention and the function of that focus, so that we can tailor mindfulness treatments for individuals, since I found that many of my patients with anxiety or trauma really struggled with more traditional meditation exercises. And so really being able to pinpoint, are there certain individuals perhaps with higher anxiety, sensitivity, who don't do as well closing their eyes and focusing on their breath, and perhaps would benefit more from grounding themselves in their environment and noticing different sights or smells or sounds around them?

Because that's really what mindfulness is, right? Meditation is a type of mindfulness. But mindfulness is really this idea of, how can we ground ourselves in the here and now, to be able to not ruminate about the past or worry about the future if we can truly be in the present moment. That's the antithesis of anxiety. So that research was really a passion of mine, being able to develop a new scale to better assess and then find particular treatments that work best for individuals.

Alex Chou: The American Psychological Association reported that in a study conducted during the 2020 to 2021 school year, more than 60 percent of students met the criteria for at least one mental health problem. Broadly speaking, are young adults more likely to face issues with mental health and other age groups? And if so, why might that be?

Dr. Diamond: I'm happy to talk about my research specifically. So my paper that I was referencing that was published in 2022 is in the Journal of American College Health called “Anxiety and suicidality in the college population.” I talked about how 75 percent of the onset of lifetime mental illness actually occurs by age 24, with the average age of anxiety onset from early adolescence to young adults, and over half of each birth cohort enrolls in college each year. So if we think about young adulthood being this really vulnerable time, and the significant proportion of individuals at this age that enroll in college, then college-age students definitely are at elevated risk for mental health challenges.

And in my paper, I reported on how about 35 percent of college students experienced moderate to severe anxiety, and 41 percent reported moderate to severe depression. And these results were from 2018, so I can only imagine they’re higher post-Covid, especially since yearly the rates continue to rise. And I think there are many reasons why college students are at this elevated risk for mental health challenges. I mean, one is just biologically, young adulthood being this vulnerable age — but for college students in particular, college students are exposed to unique stressors that place them at risk for mental health challenges, like student debt, or uncertainty about job opportunities, the rise of social media and all that comes with that academic pressures. There could be some sort of culture shock or separation from family unit, particular culture shock for first-generation students really adjusting to a very new atmosphere. So I think that there are a lot of reasons that college students are more at risk, which is even more reason for us to implement better programs. And whether it's prevention programs, or have treatment opportunities readily available for individuals who are facing this really new chapter in their life.

Alex Chou: What advice do you give for someone who may be going through a particularly tough time but doesn't know if the feelings or emotions associated with these low points would constitute a need for treatment? In other words, how would you differentiate mood disorders from, say, having a bad time?

Dr. Diamond: So really, the definition of any sort of emotional disorder is when these feelings for an individual are either distressing or greatly bothering the person, or if they're interfering in important ways, like interfering in their ability to function at school, or socially or in their relationships. So that's really what classifies something as a disorder — everyone experiences anxiety at points or sadness at points. And when it gets to that point of distress or impairment, that's when we'd recommend this type of treatment.

However, personally, I mean, I'm such a huge advocate for therapy, that I think anyone would benefit from treatment, right? I don't think you have to have an emotional disorder to attend therapy. Now, there's so many different types of treatment available. Of course, there's longer-term supportive therapy, if you wanted to find a therapist you really connected with and just wanted that non-judgmental support. People see therapists for months or years, even for more evidence-based CBT, which is the type of treatment that I tend to do. They're actually designed to be short-term. So typically, treatment is about 12 to 16 sessions. And it's really this idea to develop skills to then be able to carry forward and implement throughout your personal life.

And, you know, outside of therapy, of course, there's always things you can do. Of course, for individuals who are meeting criteria for having emotional disorders, there's medication, there's — for individuals who want to kind of practice — other sorts of treatments. There's things like exercise or engaging in mindfulness practices, like meditation or grounding techniques. Of course, making sure you're sleeping well and eating well and doing things in line with your values. So making sure you spend time with friends and family, if that's important to you, or self care.

Alex Chou: The [Harvard] Crimson has reported that the University Health Services Department has actually faced an increasing demand for mental health counseling. What large-scale programs would you propose that the University could implement? Or that any academic institution could implement?

Dr. Diamond: I've spent a lot of time thinking about this, because I do think there's such a need, and there is space for this. I know in the beginning of college — does Harvard have those programs where, online, you do trainings related to alcohol use, or sexual abuse — like that kind of prevention training? I think some sort of mental health training could or should be required at the start of college — being able to understand warning signs in yourself or others.

Unfortunately, suicide is quite common, or at least on the rise in college campuses. And I think that having this type of required course for students to fill out before starting would be extremely beneficial to recognize warning signs in oneself or others related to anxiety, depression, suicidal ideation. So that's one thought I've had, and it could be the type of thing where every six months you engage in this course.

I also know of other programs — when I was in college, I volunteered at Penn for this organization called Reflect that was started by Jared Fenton. And it was a program that was started because therapy is obviously wonderful. And people can feel alone when they go to treatment and don't talk with their peers about their struggles.

And so this is a program that began that's now on many college campuses, for students to come together monthly and talk about mental health challenges. And to really have this open, vulnerable space to feel heard and to feel like you're not alone in your struggles. And so I think programs like that are really wonderful to destigmatize mental health challenges.

Alex Chou: In order to contextualize this, just out of curiosity, is the rising need for mental health services reflected in the greater Boston area as well?

Dr. Diamond: Yes, Unfortunately, mental illness is at higher proportions in cities, which I'm not exactly sure why, but that's what the research shows. So definitely in Boston there's a need. I mean, Boston is such a wonderful place for mental health resources. We have McLean Hospital, we have — there's so many amazing private practices — Mass General's psych department is incredible, as well as, there's so many college campuses here. And so I think making sure students know that they can utilize counseling centers, as well as BU’s Center for Anxiety & Related Disorders. So there's a lot of resources here, which is amazing.

Of course, one of the biggest challenges with mental health treatment is it can often be difficult to afford, right? So trying to find a provider that's in-network is not always the easiest, or a provider that doesn't have a long wait list. So this is something I also think about a lot — often times the really great best resources are a little bit more difficult to attain. And so trying to figure that out, how can we match people's needs, which there clearly are needs?

Alex Chou: Following nationwide trends of turning healthcare services to a virtual format, Harvard has partnered with TimelyCare, which is an online mental health coaching platform to alleviate the demand for student mental health services. How might mental health services differ between in-person and telehealth formats for those receiving treatment?

Dr. Diamond: That's a really good question,a nd definitely a lot of the research is looking into this. From what I've read, the initial research actually showed that there's not a huge difference between in-person and telehealth, which I was surprised by. I trained during a very weird time where I started my training in person and then towards the beginning of my Ph.D. program, Covid hit, and so very quickly, the bulk of my training experience was virtual. And, of course, this was nothing that I expected or that any of us expected.

So I've had some in-person opportunities and a lot of telehealth opportunities. And there's definitely a difference, at least for me, being in a room with a client and being able to see their full body, kind of noticing if they're shaking, or you pick up on certain symptoms that you just don't pick up on over Zoom. However, there are a lot of pros to telehealth as well, and I think that's the reason most clients want telehealth services, one just being, it's a huge time-saver. Therapy often is available in the middle of the workday. And so for people to be able to take a call during their lunch break and not have to account for driving in and leaving, I definitely recognize that that's huge.

And I think we've been able to provide more access. You have to see a provider in the state that you live in. So it used to be the case, the bulk of our clients at Mass General lived in the Boston area. But now I can see anyone in Massachusetts, and you know, I've even had patients who come in from other states and drive over the border. And I think that access is really beneficial. So there's pros and cons.

I also think it depends on the client's presentation. For some individuals, actually being home is really beneficial. So for instance, if I had a client with OCD, and we wanted to do at-home exposures, being able to see them in their bedroom and do things that interfere with their day-to-day, in the actual environment, is huge, and something we didn't used to be able to do. But then there are some clients that perhaps would benefit more from being in person, and I could kind of see their full expression.

Alex Chou: I wanted to provide a space for you to share any closing thoughts you might have. What is one thing you wish everybody knew about mental health or mental health care, or a call to action you might have for listeners?

Dr. Diamond: I just want to keep working towards reducing the stigma, particularly in young adults. So just know there's nothing wrong about seeking therapy, and again, you don't have to have a mental illness to benefit from treatment. If you're thinking about it, just give it a go. If you can get into your college mental health clinic, or if you have treatment options available, there's no harm.

I think for me, because I'm an advocate for suicide prevention, checking in on your friends. One important statistic that I always like to bring up is, you're never going to put the thought of suicide in someone's head. So if you're worried about someone, ask: Ask if they're okay, ask if they've had thoughts. It will not make it worse, it could save someone's life. So I think continuing to check in on your friends and become aware of symptoms in yourself and others is really, really important.

And yeah, I definitely hope that schools continue to prioritize mental health and consider some of these options, like implementing trainings, making it very clear and known what the options are for students who want to seek out mental health services. And feel free to reach out if you have any questions. I'm happy to answer questions. I have an active Twitter account, @dmoskowdiamond if you're interested in following me, or on LinkedIn. But just know that you're not alone and that there's always treatment available.

// Alex Chou ’26 is a staff writer for WHRB News.