Roger Murray

Recent research shows that 42% of U.S. adults are reporting anxiety and depression symptoms - up 11% over previous years. While that is alarming news, many of us are able to reach out to a qualified professional to seek help for mental health conditions if we need it. However, the reality is that the gap between individuals who need mental health care and those who receive it is sizable and grows bigger every year. Certain communities - for example, those who live in rural areas, certain ethnic communities, and even those within the military community - are often unable to find and receive the care they need. As far back as 1999, the Report of the Surgeon General on Mental Health found that “despite the existence of effective treatments, disparities lie in the availability, accessibility and quality of mental health services for minorities, and those living in some rural and urban areas.” In this article, we look at underserved communities, the reasons why they are underserved, and what can be done about the problem. Communities that are often underserved Ethnic minority communities. Studies show that ethnic minority populations are as much at risk for mental health issues as the population as a whole, but receive substantially less treatment. For example, for individuals diagnosed with depression, 69% of Asian-Americans, 64% of Latinos, and 59% of African-Americans do not access mental health treatment, compared with 40% of the general population. Rural communities. Studies have shown that 20% of residents of nonmetropolitan counties in the US have a diagnosable mental health disorder but have significantly less access to care than those who live in metropolitan areas. In this case, the gap is most often due to a chronic shortage of local mental health professionals and facilities. Underserved urban communities. The CDC says that individuals living below the poverty level in urban communities were nearly 2.5 times more likely to have depression than those at or above the poverty level. And recent research finds that that depression may be linked to characteristics of the neighborhoods in which they live - poor-quality housing, few resources, and unsafe conditions impose stress, which can lead to depression. Yet, these individuals are less likely to be able to access the quality mental health care they need. Veterans. Thousands of returning military personnel struggle with mental health conditions, including PTSD, depression, and substance use disorders. But studies show that only 50% of returning vets receive the mental health treatment that they need. Some of the barriers have included long wait times and mental health stigmas. Older adults. Studies show that up to 20 percent of adults aged 65 and over have a mental health condition, yet this population also struggles to get the help it needs - most often due to inability (lack of transportation) to get to treatment, or inability to navigate complex medical insurance systems. What are the barriers to accessing mental health care? There are many reasons why certain communities aren’t getting the mental health care they need. These include: Lack of local availability and resources. Underserved city neighborhoods and rural areas often lack the resources needed to maintain necessary community services, and private treatment facilities tend to locate in areas where they can guarantee a steady income stream - which may not be the case in these areas. Hence the chronic lack of mental health facilities and providers. Transportation issues, including difficulty finding childcare or taking time off work. Cultural stigmas about mental health. Even when resources are available, cultural stigmas about the nature of mental health prevent many individuals in some communities from seeking proper care when needed. Racial/Ethnic implicit bias. Unfortunately, multiple studies found levels of implicit bias between patient-provider interactions and health outcomes. Concluding that a more rigorous examination should be conducted as it may be contributing to health disparities for people of color. Language barriers and an insufficient number of providers who speak languages other than English. Lack of adequate health insurance coverage. Despite the reduction in the number of uninsured Americans since the ACA was implemented, there are still 28 million lacking any type of health insurance. As well, even for those with insurance, high deductibles and co-pays sometimes make care difficult to afford. What can be done to address behavioral health access issues? Interest from academics, practitioners, communities, patients, and families to address the gap in mental health care is growing - and that’s promising. Here are some of the ways we can address the problem (note that none of these will change the problem overnight - all of these suggestions need additional research and validation): Expanding outreach efforts outside of clinic walls with mobile clinics and technologies like digital and virtual treatment. Technology for telebehavioral health services has shown to help break down barriers, remove stigmas, and increase access Creating local marketing and communication campaigns designed to reduce mental health stigma and educate communities about treatment options. Inviting feedback from individuals about their mental health needs and obstacles to care, in order to better understand the issues. Encouraging mental health organizations to include underserved community members on staff or boards of directors. Contacting legislators—both local and federal—to support efforts to improve access to and the quality of mental health services in local areas. Improving payment options Whether you have personally experienced the challenges associated with mental health care access, or whether you’re advocating for a better mental health system, all of us can help make a difference. If you need help with mental health issues, consider contacting a qualified mental health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Journal Administration and Policy in Mental Health American Psychological Association National Alliance on Mental Health (NAMI) Journal of the American Academy of Child & Adolescent Psychiatry

New year; new resolutions, right? Let this be the year we try to better understand issues surrounding mental health - for ourselves and for our friends and loved ones who may be dealing with them. In this spirit, we’ve curated 10 books that may be helpful to both clinicians and individuals who want to learn more about mental health issues such as depression, anxiety, bipolar disease, PTSD, OCD, postpartum depression, and more. We broke them into two categories for ease of organization. The factors we considered when choosing which books to feature included: positive reader reviews, consistently high ratings, and author qualifications. All of these books are available at amazon and other online retailers, as well as in independent bookstores. Which books would you add to the list? Books about and/or authored by people living with mental health disorders A Beautiful Mind: The Life of Mathematical Genius and Nobel Laureate John Nash by Sylvia Nasar This iconic and Pulitzer Prize-nominated story of mathematical genius John Forbes Nash, whose brilliant career was cut short by schizophrenia, was published in 1997 but remains a classic, especially after it was turned into an award-winning movie starring Russell Crowe. Nash was eventually honored with a Nobel Prize in Economics, but struggled with schizophrenia his whole life. The book describes his mental health journey and its effects on his family, friends and career. Hello I Want to Die Please Fix Me: Depression in the First Person by Anna Mehler Paperny After hitting a breaking point in her early 20s, journalist Anna Paperny decided to do what she does best - use her investigative skills to find out everything she could about her own debilitating condition - depression. And thanks to that quest for knowledge, readers benefit from her concise descriptions of everything from types of therapy available to the effects of medication to the stigma around mental illness. Includes interviews with leading medical experts in the US and Canada. Everything Here Is Beautiful by Mira T. Lee One sister starts hearing voices while the other struggles to find a way to support and protect her in this book about how mental illness impacts friends, family, and caregivers. The book chronicles bipolar disease from the caregivers’ perspective - how one must always walk a bittersweet tightrope between helping and protecting, and backing off to provide independence. The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought by David Adam The author is a noted scientist and editor at The Journal Nature, and has lived with Obsessive-Compulsive Disorder (OCD) for 20 years. This multiple award-winning book is an exploration of both his mind and the history of the condition that makes his mind a hectic place. He explains what it's like to be plagued by intrusive and obsessive thoughts and compulsions, like hoarding and his multiple but necessary home rituals, and provides research into the history of OCD diagnosis and treatment. Down Came the Rain: My Journey Through Postpartum Depression by Brooke Shields When actor Brooke Shields welcomed her daughter Rowan Francis into the world, something unexpected followed – debilitating postpartum depression. She assumed she’d bounce back in a few days - but things only got worse. This honest memoir offers a first-person perspective on the devastating condition faced by millions of women after giving birth. Shields talks candidly about her struggles and offers hope for recovery by describing her own. Irritable Hearts: A PTSD Love Story by Mac McClelland Human rights journalist Mac McClelland spent 2010 reporting on Haiti’s earthquake but when she returned home to California, she was surprised by the lasting effects of the trauma she’d witnessed - nightmares, anxiety, insomnia, crying jags and more. After a diagnosis of PTSD, and in an attempt to help herself heal, she began investigating PTSD, its symptoms and treatment, and how she experienced it in her own mind. Books written to help those living with mental health disorders Permission to Come Home: Reclaiming Mental Health as Asian-Americans by Dr. Jenny Wang The author is the founder of the Asian, Pacific Islander, and South Asian American (APISAA) Therapist Directory and created this comprehensive resource especially for Asian-Americans, immigrants, and other minorities who may be experiencing behavioral health issues, to provide resources for improving self-care and mental health - a community she feels is underserved for various reasons. It Didn't Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle by Mark Wolynn Research has recently shown that the roots of mental health disorders may not just reside in our own current life experiences or in the chemical imbalances inside our brains, but in the lives of our parents, grandparents, and even further back. The author is a leading expert in the field and in this book, he looks at how trauma experienced by relatives may be passed down to the next generation and how to address those issues. Black Pain: It Just Looks Like We're Not Hurting by Terri Williams When successful business executive and mental health advocate Terri Williams was diagnosed with depression, she found that the topic was still taboo especially in the Black community. In this book, she discusses the emotional pain of depression and how it uniquely affects the Black experience, encouraging readers to seek help without feeling ashamed. She reminds readers that they are brave for facing emotional difficulties head-on and finding solutions with the help of others. This Too Shall Pass: Stories of Change, Crisis and Hopeful Beginnings by Julia Samuel This may be a useful resource for clinicians. In it, psychotherapist Julia Samuel uses hours of conversations with patients to show how individuals act and adapt differently in the face of hardship. Backed by research, her analysis of the stories she shares explains how mental health is different for everybody, yet evidence-based treatment and coping skills work across multiple populations. If you need help with behavioral health issues, consider contacting a qualified mental health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

You may have heard the term mentioned in the context of ways to address behavioral health issues. Cognitive Behavioral Therapy (also known as CBT) is a form of talk therapy that has been found to be effective for multiple mental health conditions including depression, anxiety, alcohol and drug abuse, and eating disorders. Considered a ‘problem-solving strategy’, CBT seeks to change dysfunctional (and often unhelpful) thoughts and behaviors by questioning, identifying and then reframing them. In this article, we look into how and why CBT works. How does Cognitive Behavioral Therapy work? CBT was built on the idea that our thoughts and perceptions influence our behavior. Researchers have found that when we feel distressed, our thoughts and feelings may distort our perception of reality - so CBT aims to identify and name those thoughts, to assess whether they are an accurate depiction of reality, and then if they are not, to come up with individualized strategies to challenge and overcome them. CBT was founded by psychiatrist Aaron Beck at the University of Pennsylvania in the 1960s who wanted to offer his patients a treatment option to the prevailing Freudian psychoanalysis style of the time which dealt primarily with patients' past (childhood) experiences. Beck wanted to develop a type of therapy that was shorter-term and goal-oriented, but also scientifically-validated. Cognitive Behavioral Therapy focuses on current problems and helping patients find ways to help themselves. This does not mean that it completely ignores the influence of the past, but it deals primarily with identifying and changing distressing thought and behavior patterns of the present. For example, CBT may have patients address questions like: What are you thinking right now? What were you thinking when you began to feel anxious? Can we find harmful patterns that emerge when you begin to feel anxious? The goal is to understand what happens in our minds when we are distressed and to change how we respond. In this way, we develop a greater sense of confidence in our own abilities to deal with challenging thoughts and feelings. What does CBT look like in practice? Research has shown that CBT is appropriate for all ages, including children, adolescents, and adults. It can be effective in a relatively brief period of time, generally, 5 to 20 sessions, though there is no set time frame. Research also indicates that CBT can be delivered effectively online, in addition to in-person therapy sessions. In practice, therapists and patients collaborate together to develop an understanding of the problem and to come up with a treatment strategy. Through exercises in-session as well as outside homework exercises, patients learn how to develop coping skills to change their own thinking, problematic emotions, and behavior. Therapy sessions may involve role-playing to prepare for potentially problematic interactions with others, as well as learning ways to calm one’s mind and body in times of stress. Multiple research studies confirm the benefits of CBT Research has shown that CBT can address conditions such as major depressive disorder, anxiety disorders, substance abuse, post-traumatic stress disorder, anger issues, eating disorders, obsessive-compulsive disorders, and others. Studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. If you are interested in exploring Cognitive Behavioral Therapy, consider contacting a qualified mental health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand how to recognize and treat multiple disorders like anxiety and depression, and many are certified in Cognitive Behavioral Therapy. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources American Psychological Association National Institutes of Health (NIH) Journal, Frontiers in Psychology

70% of US households have at least one pet and most of us view our companion animals as valued members of our families. We love them, we share our homes, our food, and our lives with them. And it turns out that they give back - in spades. Not only do our companion animals love us back and provide friendship, joy, and fun - but it turns out that they can help reduce stress and anxiety too. And by the way, a pet doesn’t have to be a cat or dog - rabbits, guinea pigs, birds, even reptiles can also provide stress relief. In this article, we’ll discuss the science of this human-animal bond, and explain why it's so beneficial. Multiple research studies confirm the benefits of companion animals The human-animal bond is defined as “the mutually beneficial relationship between people and other animals that is influenced by behaviors that are essential to the well-being of both.” Studies show an increase in oxytocin levels in the brains of both humans and animals when they interact positively with each other, and it may be that this explains the neuroscience of the bond. Taking this a step further, research has found that “pets are able to provide unique emotional support as a result of their ability to respond to their owners in an intuitive way, especially in times of crisis and stress.” Another study showed that the presence of a companion animal “buffers against the negative consequences of stress.” Yet another study on military veterans showed significant findings for the “benefits of animal companionship for veterans with PTSD, including effects on reducing feelings of loneliness, depression, worry and irritability, and increased feelings of calmness.” How do companion animals help reduce stress? One of the reasons for these beneficial effects is that companion animals fulfill the basic human need for touch. Intuitively, we know that patting or hugging an animal - a form of sensory stress relief - can calm and soothe us. And, animals tend to live in the moment — they don’t worry about what happened in the past or what might happen in the future. Therefore, they can help us become more mindful and to appreciate the present moment with less worry. In addition, companion animals help us in the following ways: Increase exercise and play. Taking a dog for a walk or hike - or even playing with a cat in the house - are fun and rewarding ways to fit daily activity into your schedule. In fact, studies have shown that dog owners are far more likely to meet their daily exercise requirements. And the more exercise and activity you get, the less stress you’ll feel. Keep us connected. Pets can be a great way to feel part of a community of “dog people” or “cat people”, for example, and can help spark conversations and meet new people in pet stores, clubs, or training classes. Staying social and feeling connected is a great way to reduce stress. Provide a sense of security and calm. The presence of a companion animal at home can help provide a sense of security, ease separation anxiety in kids, and make us feel important - therefore helping to maintain a positive self-image. Add structure and routine to the day. Most pets require a regular feeding, cleaning, and exercise schedule. Having a consistent routine keeps our pets balanced and calm—and works the same way for us, too. Having a pet to care for makes us get out of bed in the morning, no matter how bad the day may seem. Animals in therapy Companion animals can be a valuable complement to regular therapy for individuals dealing with anxiety or depression. A study published in Frontiers in Psychology concluded that animal-assisted intervention may prove a good complementary option for trauma and other mental health issues. This study found that ‘therapy animals’: can act as a comforting reminder that all is calm and safe, act as a base for mindful experiences in the present, and elicit positive emotions and warmth. To this end, you can find many successful therapy animal programs which visit hospitals, retirement homes, hospice centers, nursing homes, and schools. If this is something you might be interested in, a behavioral health specialist is a good place to start to find out more about these programs and to learn if a companion animal might provide stress relief for you. If you or a loved one are experiencing symptoms of stress or anxiety, consider consulting a behavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand how to recognize and treat stress and anxiety, and can help explore animal-assisted interventions. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Journal Animals BMC Psychiatry NIH News in Health Frontiers in Psychology

Caroline Kocot, MS, BSW, describes her equine (horse) therapy work with veterans and their families as “incredibly rewarding.” Caroline, who has a degree in social work from Indiana University, is currently a Provider Relations Coordinator with Telemynd, routinely meeting with new providers interested in joining Telemynd’s extensive behavioral health network. Before Telemynd, Caroline worked with innovative therapeutic programs like Bradford Woods Outdoor Center and Battle Buddies, employing therapy techniques like equine therapy - a type of recreational therapy (also called therapeutic recreation). Evidence-based programs like these use outdoor activities - in this case, games and exercises with horses - to help veterans transition back to civilian life while living with the effects of PTSD, Traumatic Brain Injury, or other combat-related disabilities. Caroline says she enjoyed it so much that she continues to spend her weekends at the programs as often as she can. Caroline spoke with us recently about her experiences working with veterans and about how therapists use the connection between people and horses to enhance physical or emotional healing. Veterans face unique challenges when they separate from military service and return to civilian life Even the most resilient of our veterans can find re-adjustment stressful, and unfortunately, these challenges are also often associated with mental health issues like PTSD, depression, and anxiety. And it's not just soldiers who suffer - studies have found that lengths of deployments are associated with emotional difficulties among military children and spouses too - which is why the programs that Caroline works with involve the families of veterans too. Traumatic military events such as combat, accidents, or deaths in the field involving themselves or colleagues can have long-lasting negative effects on vets - such as trouble sleeping, anger, nightmares, and alcohol and drug abuse - all symptoms of PTSD. A JAMA Psychiatry study found the rate of PTSD to be 15 times higher in returning veterans than in civilians. The same study found the rate of depression in returning vets to be 5 times higher than for civilians. Worse still, almost 10% of veterans reported a recent suicide attempt in the last year. These are behavioral health trends that must be addressed. What is recreational therapy, and how does it help veterans? The National Council for Therapeutic Recreation defines recreational therapy as “treatment services and recreation activities using techniques including arts and crafts, animals, sports, movement, drama, music, and community outings. Recreational therapists are specially trained therapists who treat and help maintain the mental and emotional well-being of their clients by seeking to reduce depression, stress, and anxiety, build confidence, and socialize effectively.” Recreational therapy offers an innovative approach to managing mental health issues such as behavior management, anger management, coping and adjustment, stress management, and substance abuse. This type of therapy engages individuals and their families to collaborate and cooperate - in activities that may feel like play - in order to accomplish their goals. Caroline’s work with individuals and horses included activities like walks and (easy) obstacle courses with horses, grooming horses, and even finger painting on the sides of horses (she says the horses love this, as it feels like being groomed). She says, “...but it's more than play. This is evidence-based therapy, and it's working.” Research shows that as a result of participating in recreational therapy, individuals develop a better sense of self-control and competency - which may be missing from their lives. Riding and caring for horses appears to improve self-esteem and anxiety. Other benefits may include: Promoting general well-being and health Enhancing mood and lessening psychological stress levels Improving teamwork, trust, communication, and social interaction with others Enhancing resilience and helping to overcome negative past experiences Diminishing the focus from disability toward ability, increasing independence, and restoring quality of life Lessons learned from working with veterans and recreational therapy Caroline says her experience has taught her that there is a multitude of approaches to addressing behavioral health issues with which many veterans live and that recreational therapy may be the right fit for many. However, she stresses that it's really important to stay the course and not give up if one therapeutic approach does not work. She says, “there are resources and help out there; keep asking for it, and don’t give up if one method doesn't seem to work. As the old adage says, “try, try again”.” If you or a veteran you know are experiencing symptoms of PTSD, depression, or anxiety, consider consulting a behavioral health professional There are recreational and equine therapy programs located across the U.S. Many involve outdoor activities like the programs Caroline works with. A behavioral health professional is a good place to start to find out more about recreational therapy, local programs, and if this kind of therapy is the right fit for you. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the issues facing veterans and their families and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

Parental burnout is real. In fact, it's a diagnosable mental health condition. And the pandemic has made it worse. A survey called “Stress in the Time of Covid-19,” conducted by the Harris Poll with the American Psychological Association, found that 46% of parents with children under 18 said their stress level was very high. Whether it's working longer hours, coordinating working from home with child care, adjusting to new sets of rules, making sure school-aged kids do homework assignments and get to sports practice on time, or just worrying about keeping them safe in the pandemic (and thankfully, the CDC has recently approved vaccines for kids aged 5 and over), there’s a lot on the minds of parents these days. In this article, we look at the research behind parental burnout and ways to mitigate it. What are the symptoms of parental burnout? Parental burnout is a distinct psychological phenomenon separate from parents feeling generally stressed and tired (and the latter is pretty normal). Parents typically don’t burn out overnight - it's a longer process - although those feelings of irritability and exhaustion may be early warning signs of something bigger. The World Health Organization recently recognized parental burnout syndrome in its International Classification of Diseases as an occupational condition linked to symptoms such as fatigue, changing sleep habits, and substance use. To receive an official diagnosis of parental burnout, you need the following four specific symptoms: You feel so exhausted you can’t get out of bed in the morning You become emotionally detached from your children; you might even have trouble showing them how much you love them You take no pleasure or joy in parenting, and have become less productive in the process These feelings are a marked change in behavior for you The science behind parental burnout Much of the recent understanding of parental burnout came from a peer-reviewed, published study done at a Belgian university in 2018. Scientists there found that burnout is much more common than previously understood and that it is associated with four primary factors: exhaustion in the parenting role, contrast with previous parental self, feelings of being fed up with the parenting role, and emotional distancing from children. Primary researcher Isabelle Roskam, PhD, concluded that, “...Parental burnout can be very damaging. As regards to the parents themselves, it can give rise to suicidal and escape ideations, which are much more frequent in parental burnout than in job burnout or even depression. This finding is not surprising considering that one cannot resign from one’s parenting role or be put on sick leave from one’s children.” A follow-on study done at the same university and published in Frontiers in Psychology, found that although mothers with parental burnout syndrome seem to share some of the same characteristics as postpartum depression, parental burnout differs in that it occurs in mothers with children over 18 months old, and the depressive feelings are not generalized, but experienced specifically in relation to one’s parenting role and tasks. Ways to address parental burnout The first thing to do if you are feeling symptoms of parental burnout is to talk to a qualified behavioral health professional. This condition is real, so take it seriously. They can help diagnose your condition and come up with a treatment plan that may include some combination of therapy and medication. In addition, experts suggest the following: Try to reduce perfectionism. Ask yourself “do I actually have to do everything I think I have to do at this moment?” Set up a structure or framework for each day (although it can be flexible). Experts suggest talking with family members and prioritizing by dividing activities into 3 categories: absolute non-negotiables, things you want to see happen, and things you would like to see happen. In this way, everyone’s expectations are on the same page. Look for the positives - even if it feels as if you are forcing yourself at first. Gratitude has been scientifically linked to improved mood. One way to feel more effective might be to keep a journal in which you write down one thing you did well as a parent every day. Schedule time for fun and relaxation - for you and for your family. It's easier said than done, but engaging in activities, guilt-free, that are good for you, not just good for your kids, will make a big difference. Take a walk outside, call a friend, make time for the gym, or promise yourself one episode of a favorite show at least once a week. If you or someone you know are experiencing symptoms of parental burnout, consider consulting a behavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand parental burnout and have experience treating it. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources New York Times American Psychological Association Journal of Affective Science Frontiers in Psychology

As the pandemic nears the 21-month mark, we’re hearing from more and more COVID-19 survivors that the virus’ impact can last beyond the first few weeks of symptoms. For some patients, COVID-19 has a long-term, far-reaching effect on their daily lives, impacting them physically, cognitively, and even emotionally - this is what’s being called “long-haul COVID”, “post-acute COVID” or just “long COVID”. Research shows that about 10% of those who’ve had COVID-19 get long COVID. The odds go up to 22% for those 70 or older. Experts don’t yet know exactly why people get long COVID, although many now believe that it’s not caused by just one thing; that there are multiple diseases happening. One thing we do know are its symptoms. People with long COVID may experience joint pain, headache, stomach cramps, a pins-and-needles feeling, heart palpitations, and more. One study found that even after 100 days, patients still reported fatigue, shortness of breath, loss of memory, concentration difficulties, and sleep disorders. Long COVID also appears to impact mental health - studies show that about 1/3 of those who experience long COVID also develop a mental health issue - primarily depression or anxiety disorders. In this article, we discuss what the latest research says about long COVID’s impact on mental health and what can be done to address it. Multiple explanations exist for the link between long COVID and mental health Scientists now know that in general, COVID-19 isn't just a respiratory illness, but a disease that affects many critical organs, including the brain. COVID-19 patients often experience neurological complications, such as confusion, delirium, and other cognitive impairments - which may help explain some of the psychological effects of the disease. In addition, patients living with long COVID may be unable to exercise, socialize, or work - or otherwise live their lives as before. They may be battling feelings of hopelessness and fear that COVID could affect the rest of their lives. All of this can have a significant impact on emotional well-being. Some patients may have spent long periods of time in the hospital and/or in the ICU, which can be deeply stressful or even traumatizing. Echoing this, researchers at University College London interviewed Long COVID patients and found five “themes” which influenced their mental well-being, including: the availability (or lack of availability) of care and understanding from others, perceived lack of treatment options, disruption to ordinary living caused by their symptoms, the lack of clarity about the outcome of their illness, and the changes it caused to their identity How can we address the mental health impacts of long COVID? As with most mental health disorders, the first place to turn is to a qualified mental health professional. The American Psychological Association reports that many existing psychological and behavioral therapies — like talk therapy, cognitive-behavioral therapy (CBT), group therapy, and peer support, for example — seem to be effective treatments for aspects of long COVID’s psychological symptoms. Family members and friends should be validating and supportive when Long COVID patients report psychological symptoms. The University College London research mentioned above found that, as expected, people who felt supported and cared for by their social network and by health professionals were less anxious or depressed than those who did not. Interestingly, treating the mental health symptoms of long COVID can also help alleviate some of the physical symptoms, as long COVID has a bidirectional association with physical and mental health. In other words, the ‘mind-body relationship’ may be driving some symptoms, and so addressing them on multiple fronts can be highly effective in reducing their impact. If you or a loved one are experiencing symptoms of long COVID or showing signs of anxiety or depression, consider consulting a behavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between COVID-19 and mental health. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Journal of Infection NPR The Lancet Psychiatry The American Psychological Association (APA)

Do you find yourself having trouble thinking about big decisions like whether to switch jobs, start or end a relationship, or move to a new city? Or even more basic daily decisions like where to go on vacation, or how to organize your day? If so, you’re not alone - and stress may be having an impact on your decision-making ability. The American Psychological Association (APA) in concert with The Harris Poll just released the results of their 2021 Stress in America survey. This online survey was conducted in August among adults who reside in all parts of the U.S., and reveals that the uncertainty associated with life during the pandemic has caused day-to-day stress to feel overwhelming for the majority of us. Further, this stress has made daily tasks and decision-making more difficult, particularly for younger adults and parents. This post looks at the startling results of this survey and includes suggestions for dealing with everyday stress. 61% say the pandemic has made them rethink how they are living their lives Major sources of stress, according to the survey, include: Work (66%) Money / finances (61%) The economy (59%) Family responsibility (57%) Personal health (52%) The top 2 sources of stress (work and money) are up More than one-third of survey respondents said it has been more stressful to make both day-to-day and major life decisions compared with before the pandemic. Younger adults were more likely to feel both kinds of decisions are more stressful now (daily decisions: 40% of Gen Z adults, 46% of millennials, and 39% of Gen Xers vs. 24% of boomers, and 14% of older adults; major decisions: 50% of Gen Z adults and 45% of millennials vs. 33% of Gen Xers, 24% of boomers, and 6% of older adults). Over 60% of all respondents say they have begun to question how they are living their lives and whether they are making the right decisions about it - and increased stress plays a big part of this: 63% say that uncertainty about what the next few months will hold causes them even more stress, and 49% say that the pandemic has made planning for their future virtually impossible. Parents are citing significantly more stress over the past 18 months ‘Decision-making fatigue’ seems to have had a disproportionate impact on parents, given the big changes to schedules and everyday routines during the pandemic. Many say they are struggling to manage households divided by vaccination status, with one set of rules for vaccinated adults and kids over 12, and another for the younger, unvaccinated kids (although this should resolve soon as the FDA recently authorized a COVID-19 vaccine for 5- to 11-year-olds). According to the survey, parents with children under 18 were more likely than those without children to say that both day-to-day decisions and major life decisions are more stressful than pre-pandemic (daily: 47% vs. 30%; major: 44% vs. 31%), with 54% of those with younger children under 5 reporting that day-to-day decisions have become more stressful. The real science behind our inability to make decisions when feeling stressed Multiple research studies have found that stress has a broad impact on the brain regions involved in decision-making processes. One study found that not only is the methodology of our decision-making altered under stress, but also our ability to make reliable cost-benefit evaluations necessary for bigger life decisions. Stress can cause us to focus too much on potential rewards and too little on potential risks; or put another way, stress biases our decisions toward comfortable (but potentially negative) habits rather than on goals. This obviously becomes problematic when weighing life-changing decisions, such as changing careers or having a baby, for example. Suggestions for coping with everyday stress It’s not all bad news. The survey did find that U.S. adults maintain an overall positive outlook. 70% said they were confident that everything will work out after the pandemic, and 77% said that overall they are faring ok. What to do if you are feeling more stressed than usual these days? Experts suggest things like: Building in regular exercise to your routine - even a brisk, 20 min walk can work wonders to relieve stress Eating a balanced diet and limiting alcohol Getting enough sleep Connecting with supportive friends and family (and the key here is ‘supportive’) Making time for hobbies and fun Spending quality time with a pet Trying meditation, journaling, or yoga if you don’t already practice these Feeling prolonged stress or anxiety? Consider Telemynd Request an appointment online or call our care team for assistance in scheduling a session today. Our mental health professionals understand the link between current stresses and mental health. If you’re a behavioral health provider looking to join our team, see all the benefits and learn how to apply here. Sources American Psychological Association Journal of Neuroscience Research The Decision Lab

No question, stress is affecting us at work. A 2020 survey by Mental Health America found that over 80% of respondents felt emotionally drained from work and 71% said their workplace significantly affects their mental health. Another study by the Anxiety and Depression Association of America found that over 50% of employees say stress and anxiety impacts their workplace quality and performance. The main culprits of all this workplace stress? Deadlines (55%), interpersonal work relationships (53%), staff management (50%), and dealing with unexpected issues and problems (49%) - not to mention the pandemic. These statistics seem unsustainable. Some employers recognize this issue and are in the process of creating company policies to address it. In this article, we look at the status of mental health in the workplace, and what both employers and workers can do to address the problem. The COVID-19 pandemic has had a negative impact on mental health A 2020 CDC survey found that 1 in 4 of us reported feeling anxious more than half of the previous week, and 1 in 5 reported feelings of depression during the same time period - driven by COVID-19-related concerns such as illness, remote learning, travel restrictions, the switch to remote work, child care issues, and limits on gatherings with family or friends, and more. A recent McKinsey study found that 9 out of 10 employers say they know that COVID-19 is having an impact on their employees by creating unprecedented anxiety and depression, and 70% say they’re taking action - yet the same study found that almost half of workers anticipate that going back to the office will have somewhat or significantly negative impacts on their mental health. Mental health issues in the workplace can impact both employees and employers Stress, anxiety and other mental health issues on the job can impact: Job performance and productivity Physical capability Cognitive functioning Communication with coworkers Engagement with one’s work Mental health issues in the workplace are also associated with higher rates of disability and unemployment. All of these issues are damaging to employers as well as workers. What can employers do to address the mental health crisis? If you’ve a manager, you’ve probably read about the success of interventions and programs such as the following list - which all start by acknowledging the importance of good mental health at all levels of your organization, and talking openly about the problem. In addition, employers can: Provide managers with training to help them recognize the signs and symptoms of stress in team members and encourage them to seek help from qualified mental health professionals Make mental health self-assessment tools available to employees Distribute materials (such as brochures or videos) about the signs and symptoms of mental health issues and ways to get help Provide free or subsidized access to coaching, counseling, or stress management programs What can workers do to address mental health issues in the workplace? It can benefit all of us to be on the lookout for warning signs that we might need to make changes at work or get professional help. Experts suggest that each of us can: Watch out for warning signs. For example, if you start to notice you’re losing interest in your job or your productivity drops, or you start dreading work each day, or you feel so anxious that you have trouble thinking about everything that you’re supposed to do, it’s an indication that something is not right. Consider setting boundaries. Would it help to have a more flexible work schedule, or set limits as to when and how often you respond to work messages? Or do you need something bigger like a short-term disability leave (usually decided with a mental health professional)? Get support. If you find you need help, seek out a trusted friend or family member, peer group, or qualified mental health professional - someone or somewhere you can feel seen, heard and validated. A mental health professional will work with you to determine what mental health condition you are experiencing and come up with a plan to address it. Note that it's illegal for an employer to discriminate against you if you have a mental health condition. And according to the U.S. Equal Employment Opportunity Commission, if you have a qualifying condition like major depression for example, you may have a right to a reasonable accommodation that would help you do your job. Talk to a qualified mental health professional about this first. If you identify with any of these signs of workplace-related stress or anxiety, consider consulting a behavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between the stresses of college life and mental health. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Harvard Business Review Centers for Disease Control (CDC) McKinsey & Company McKinsey & Company

This Fall, over 3 million students started college in the US - some attending classes in-person for the first time in over a year. Do you know a loved one who went away to college this year? We know that teens have a lot on their minds anyway, and while some issues are not new, electronic media has amplified some of the struggles that young people face. On top of that, starting college means learning new systems, places, and faces, as well as potentially facing more academic competition than ever before. Not to mention, the stress of separating from family and living alone - potentially for the first time. So just how does the transition to college impact the mental health of this population? It turns out …significantly. Read on for the research behind the headlines, as well as warning signs to watch out for. What the research shows about college students and mental health In the context of the stressors mentioned above, many college students experience the first onset of mental health and substance use problems or an exacerbation of existing symptoms. One study found that 60% of all college students suffer from at least one mental health problem. And according to recent surveys from the American College Health Association, 60% of respondents felt ‘overwhelming’ anxiety, while 40% experienced depression. A 2019 Penn State University study found that demand for campus mental health services spiked by over 30% in one year. The COVID-19 pandemic seems to have made things worse. Measures such as lockdowns, social distancing, and stay-at-home orders introduced negative impacts on the higher education ecosystem. A 2021 study found that 71% of college students indicated increased stress and anxiety due to COVID-19. This study found that contributing stressors included: fear and worry about their own health and the health of their loved ones (91%) difficulty in concentrating (89%) disruptions to sleeping patterns (86%) decreased social interactions due to physical distancing (86%) increased concerns about academic performance (82%) Access to behavioral healthcare is key - but not always a given Studies have shown a link between poor academic performance, and anxiety and depression among college students, so it's critical for students to have easy access to help. A study looking at mental health and academic success found that symptoms of depression or anxiety are a significant predictor of a lower GPA, and a higher probability of dropping out. The problem is that many colleges and universities are not staffed with enough specialists to handle the volume of students that need help. As well, some students are uncomfortable admitting they need help, think that high stress is “a normal part of student life”, or do not know where to find help. One study found that among students with mental health issues, fewer than half received treatment when they needed it. How to spot symptoms of depression or anxiety in college students Recognizing signs of depression may seem difficult - but is critical. After all, everyone has “off days” when they feel overwhelmed with the stresses of college. However, when those days become weeks, and/or getting out of bed every day for class becomes a struggle, take notice. Here are signs of anxiety or depression to look for in college students: not enjoying activities you once loved feeling hopeless no longer attending classes or social outings experiencing extreme anger or sadness reacting negatively or with apathy to most things talking about death or suicide suddenly turning to drugs or alcohol to suppress feelings family history of depression or anxiety If you or a college student you love shows any of these signs, avoid telling them to "cheer up" or "snap out of it." Many people experiencing mental health issues are aware of their condition, and telling them to “get over it” is not helpful. Instead, encourage them to seek help. If there isn’t help available on campus, consider virtual therapy. Online platforms like Telemynd provide access to mental health specialists from the privacy of a dorm room or home. If you recognize any of these signs of anxiety or depression, consider consulting a behavioral health professional Request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between the stresses of college life and mental health. If you’re a behavioral health provider looking to join Telemynd, see all the benefits and apply here. Sources Journal of Affective Disorders Forbes Journal Medical Research

We spend an average of 2.5 hours per day on social media in the US. And that’s up 31% from 2015. According to the Pew Research Center, 70% of adults and 81% of teens in the U.S. use social media daily. And of course, we all post our best - the best vacation pics, the best party pics, the best outfit pics - it's a recipe for unrealistic comparison on a daily basis. Why do we do it? To boost self-esteem and feel a sense of belonging in our social circles, we post with the hope of receiving positive feedback. But there’s a downside - research shows that time spent on social media has an adverse effect on mental health. The effort spent to achieve and maintain the ideal body so that we look “as good as” others we see on social media, can trigger significant anxiety and depression. In this article, we dig into the research and share suggestions to mitigate the negative impact of social media. What the science says about social media and mental health Facebook, Instagram, Pinterest, Twitter, YouTube, Snapchat, and more recently TikTok (whose use is up 800% in the US since 2018) - all provide an easy means to post, view, and compare ourselves to others, 24/7. Filters that provide the ability to airbrush photos, whiten teeth, and more, are easy to find and use. Now, it’s not only celebrities who look perfect—it’s everyone. In fact, plastic surgeons have seen an uptick in requests in recent years from patients who want to look like their (unrealistic) filtered Snapchat or Instagram photos. Logically, we know this can’t be healthy behavior. And the science backs this up. Research has linked social media use to decreased sleep, increased anxiety and depression, and significant body dysmorphia - which often leads to eating disorders. One study, published by the Public Library of Open Science (PLoS One), found the prevalence of depression and anxiety to be over 48%, for those of all ages and genders who looked at social media frequently. Another study, published in Computers and Human Behavior, found that individuals who used social media over 2 hours per day reported significantly higher body image concerns and internalizing symptoms than peers reporting no use of social media. A 2018 British study tied social media use to decreased or disrupted sleep, which can be associated with depression, memory loss, and poor work or academic performance. One study, published by the Public Library of Open Science (PLoS One), found the prevalence of depression and anxiety to be over 48%, for those of all ages and genders who looked at social media frequently. Another study, published in Computers and Human Behavior, found that individuals who used social media over 2 hours per day reported significantly higher body image concerns and internalizing symptoms than peers reporting no use of social media. A 2018 British study tied social media use to decreased or disrupted sleep, which can be associated with depression, memory loss, and poor work or academic performance. How social media’s ‘ideal body image’ portrayal impacts different communities Some communities are impacted more than others - for various reasons they are more likely to feel pressure to look good on social media and/or more vulnerable to the effects of constant comparison. For example, studies have found that social media use has been linked to higher rates of depression in teens, which in turn has lead to a higher suicide rate among the age group. When there’s a ‘filter’ applied to the digital images, it can be hard for teens to tell what’s real and what isn’t, which comes at an already difficult time for them physically and emotionally. A Pew Research study of teens, technology, and friendships revealed a range of social media-induced stressors: Feeling pressure to post attractive content about yourself Feeling pressure to get comments and likes on your posts Seeing people post about events to which you weren’t invited Having someone post things about you that you cannot change or control Another community adversely affected by the need to achieve a perfect body for social media is the LGBTQ community. For example, research published out of Dalhousie University found that social demands placed on gay men, based on social media images, to achieve a perfect body, have serious mental health consequences. The men in this study talked about how “constantly thinking about food and body ideals often lead to losing themselves in feelings of inadequacy, anxiety, low self-esteem, and depression.” The National Eating Disorder Association similarly found that those who identify as LGBTQ+ experience unique stressors that may contribute to the development of eating disorders - these stressors include the inability to meet body image ideals within LGBTQ+ cultural contexts that are promoted in social media. Women in general, and young black women in particular, are also at greater risk for developing mental health issues due to unrealistic body image portrayals on social media. One study found that celebrity culture, as portrayed on social media, perpetuates the ideology that young black women can only achieve beauty through changes in skin color, extended artificial weaves, and a thin body frame. Another study out of Yale University School of Medicine found that as black teen girls navigate social media, “they are aware that they are seen as less desirable than their white teen counterparts.” Of course, all of this leads to significant mental health issues. How to mitigate the negatives effects of social media Can anything be done to mitigate the downsides of social media? While the biggest changes need to come at a societal level, it turns out that there are some tactics that individuals and families can take - starting with something as simple as monitoring social media use. In an article from Harvard’s McLean Hospital, psychologist Jacqueline Sperling, Ph.D., says “it’s probably unrealistic for most social media users to quit completely. However, they can monitor their behavior to see how their use impacts them.” She adds, “if someone notices that they feel less happy after using social media, they might consider changing how they use the sites, such as viewing them for less time and doing other activities that they enjoy instead.” Experts also suggest the following options: Find and follow body-positive accounts and influencers, or join support groups - this can help shift our mindset about the ideal body image set by society. Take an ethical stand and refuse to read, or view media, or buy advertised products that do not promote a healthy and diverse body image. Use your own social media accounts to become an advocate for positive body image. Give a shout-out to retailers, advertisers, or celebrities who promote natural looks, healthy body size, and diverse body shapes. Consult with a behavioral health specialist if you or someone you love is finding it hard to disconnect from social media overuse. If you recognize some of these signs for anxiety or depression, consider consulting a behavioral health professional Request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between social media and mental health. Seeking a meaningful career in behavioral health? Consider joining our national team of providers making a real impact on the lives of thousands, learn more about the benefits here.

The COVID-19 pandemic has created a ‘new work normal’ for many of us. While around 7% of Americans worked from home regularly before the pandemic, now 33-50% regularly work from home. Working remotely seems great on the surface, as we get to avoid lengthy morning routines (especially if you’re also getting other family members ready for the day), long commutes, and common office distractions, like the cubemate who talks loudly on the phone. However, many of us have found that when those lines of separation between work, family time, and relaxation are blurred, it can actually lead to more stress. Why is this? Mental health professionals say that things like lack of social contact with others, overworking, and loss of good sleep and eating habits - all of which can happen when we work from home - contribute to a more stressful work experience. They advise that in order to work smarter, and to reduce the chances of mental health issues like anxiety and depression, we should adopt a set of boundaries and routines when working remotely. Tips to maintain a healthy work-life balance while working from home The most important tip is to separate “work” and “life”. This means both dedicating a physical space to do your work that isn’t your bedroom, and separating your work and home activities throughout the day. For example, it can be tempting to use the time between meetings to do the dishes or the laundry, but this can ultimately lead to burnout. Other tips include: Establishing a routine. Routines and schedules help us feel a sense of control - so when work routines are significantly altered, it can feel like we don’t know where to begin or how to be productive. Creating a new schedule can be a good way to regain that sense of control. Start with a robust morning routine – take a shower, meditate, get dressed, etc. - before logging on for the day. And just like before the pandemic, it pays to remain flexible, as sometimes routines can change. Taking regular breaks. In a normal in-office workday, you probably would have stopped to chat with a coworker, gotten up to refill your coffee or tea, or left the office for lunch. When you’re working from home it can be more difficult to find those break times. So try to schedule breaks on your calendar and hold yourself accountable to those times. During a break, you could go for a quick walk, play with your dog, or meditate if you are so inclined. By regularly removing yourself from the work environment for 10 or 15 minutes, you’ll feel refreshed and productive instead of feeling exhausted and unable to focus. Keeping a consistent sleep schedule. Even if you don’t have a meeting until 10am, get up on time anyway. Resist the urge to binge-watch Netflix late at night. The same wake and bedtimes are critical to self-care because they contribute to better overall sleep quality. Otherwise, you may find yourself feeling groggy during the day, or with fluctuations in energy. (And if that happens, it's much more productive to go outside and take a brief, brisk walk instead of taking a nap.) Eating healthy food. Stay hydrated throughout the day by filling up a water bottle and keeping it next to you at your desk. Resist the urge to snack all day long - it's so easy to keep running to the fridge - especially if you are stressed. But if you're particularly challenged by this, consider making your lunch in advance, just as you would have for the office. And be sure to have lots of healthy snacks and less junk food in the house. Having a clock-out time. It’s very easy when you work from home to keep working into the evening - to “just answer an email or two to get caught up”. But that can lead to burnout over time. To be as effective as possible at your job, know when to start and to quit for the day. Set your ‘do not disturb’ notifications between 5pm and 8am for example. Resist the urge to check email in the evening and on weekends. Turn off the sound on your phone or laptop so you don't hear the email and message notifications as they come in. Making an appointment for “you time”. Self-care isn’t just about long baths and glasses of wine. It means prioritizing the things that you love - whether that’s reading, hiking, visiting with friends, or whatever makes you feel happy and relaxed. It's about finding healthy ways to comfort yourself, setting priorities, staying connected, and creating structure. In this way, you build a stronger foundation for yourself and your career. If you or someone you love shows signs of too much stress or anxiety, consider consulting a behavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Wall Street Journal The National Sleep Foundation Griffis, Hailley

Back-to-school can be a time of heightened stress and excitement for kids in normal years, but this year, add in increased health worries and new routines associated with the covid-19 pandemic, and the level of ‘back-to-school anxiety’ is higher than ever. In fact, at Telemynd, we’ve recently seen an uptick in requests for mental health visits for kids and adolescents. So, with families in mind, this article will look at the reasons why back-to-school may cause extra anxiety this year and some actionable ways to address it. The number of mental health issues in young people has increased in the pandemic A recent study published in the Journal of the American Medical Association (Pediatrics) found that the number of young people struggling with mental health issues has likely doubled compared to pre-pandemic levels. The study found that 1 in 4 kids are experiencing elevated symptoms of depression and 1 in 5 have higher levels of anxiety. A CDC study found that in 2020, emergency room mental health visits increased 31% for kids ages 12 to 17, and 24% for ages 5 to 11, compared to the same period the prior year. And it's no wonder. For many young people, the pandemic has increased worries about sickness, family finances, separation from friends, disruption in routine – even coping with grief from loss. A year of remote learning, although necessary for safety, may have taken an emotional toll on many – some may have fallen behind in their studies, or suffered from lack of academic support. Back-to-school transitions will be harder this year Most mental health specialists agree that, in general, kids are realizing that the world is not as safe as we all thought it was – and that increases anxiety. Dr. Jennifer Louie, a clinical psychologist at the Child Mind Institute, says, “There’s just anxiety in the air, and I think kids feel that. They are wondering: Are we sure it’s safe to go back (to school)? And are other people safe? And is it safe to touch this?” To be sure, some kids have enjoyed homeschooling and spending more time with family. But for those who are predisposed to anxiety, depression, or other mental health issues, transitioning back to classroom learning this Fall may be harder than ever. How to help kids deal with back-to-school anxiety For parents and caretakers, it may feel complicated – on the one hand you want to reassure them that it’s safe to go back to school in-person, while also encouraging them to be cautious, and preparing them to be flexible if rules or situations change. Here are 5 ways to address additional back-to-school anxiety: Emphasize safety measures. Talk about how schools have done months of planning to minimize risk and keep everyone safe — and how kids can do their part by following the rules. It's fine to explain that we can never be 100% sure everyone will stay healthy, but that there are measures in place to try to ensure best possible outcomes if people get sick. Validate their feelings. Validate any worries by acknowledging that, like any new activity, going back to school can be hard, but with time, it will get easier. For younger kids, praise ‘brave’ behaviors, e.g., “I love how willing you were to take the bus this morning.” Make sure they know they aren’t alone - that teachers and administrators are watching out for them and that you’ll deal with any safety and health issues together. Have a routine. Making sure that your child has a predictable school morning routine can help everyone feel more secure. Try to do things at the same time, the same way every day. And practice problem-solving if issues come up; for example, if they worry they can’t find their way around school, help them think through who to ask for help. Make sure they get enough sleep and good nutrition. The shift from summer to school-year wake-up times can be challenging for a lot of kids, but lack of sleep can make them more vulnerable to anxiety. To deal with this, consider leaving TV, phone, or laptop outside the bedroom at night. And have lots of healthy snacks and lunch material in the house to ward-off unhealthy eating (which also contributes to stress). Observe your child's behavior. Watch for signs of depression or anxiety, for example, becoming more withdrawn, angry, or having trouble concentrating. Also watch for physical changes like abdominal or other physical pain - which also can be warning signs. Be sure to regularly and directly ask them how they're feeling. It is also not uncommon for kids who struggle with anxiety and depression to “hold it together” during the school day and have a “meltdown” when they arrive home to release some of the pent up feelings they have kept inside while in school. It is important for parents to be prepared for this type of response and to create space for their child to decompress when they arrive home before trying to engage them about their day. Understanding “why” your child may be acting in a way that is unlike them is the first step in recognizing the signs that they may be struggling with a mental health issue. When to seek additional help If you see any of the warning signs mentioned above (and see more here), or if a young person’s worries about school start to interfere with their ability and willingness to attend school or participate in normal activities, like sports, or socializing with peers, consider consulting a licensed behavioral health professional. In some cases, kids may be resisting going back to school because last year’s learning at home “felt” easier than going to school (e.g., kids with a lot of social anxiety, or those with learning disorders may have had an easier time when they could work at their own pace). Mental health professionals can sort out real anxiety and depression symptoms, and provide recommendations to help. If a young person in your life is showing signs of heightened back-to-school anxiety, consider contacting a mental health professional With the right mental health support, kids can adjust to school this Fall, make new friends, learn new things, and thrive. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Harvard Medical School Centers for Disease Control (CDC) Behavior Analysis in Practice JAMA Pediatrics

There’s a lot to be stressed about these days - whether it’s news headlines, endless to-do lists, or worry about money and bills. But for some, stress and worry can be so prevalent that it starts to interfere with our ability to function. In this case, we might consult a clinical professional and try talk therapy or medication. In addition, there’s another technique that has gained popularity in recent years to deal effectively with anxiety and depression, called EFT (Emotional Freedom Technique), also known as "tapping." EFT Tapping is a research-based intervention that combines cognitive behavior therapy (CBT) techniques, such as awareness building and reframing of interpretation, with the stimulation of acupressure points on the face and body by literally tapping on them. In our continuing series on treatment modalities, we’ve provided an overview of EFT Tapping here: how it works, some of the research behind it, and who can benefit from it. What is EFT Tapping? EFT Tapping helps tune in to the negative patterns we form around anxious thoughts or troubling memories, by physically tapping with our fingers on identified acupressure points while at the same time focusing on those thoughts and emotions. According to experts, focusing on a negative thought while simultaneously tapping on acupressure points sends a calming signal to the brain, allowing us to acknowledge the stress while calming the body. Think of it as having similar (but noninvasive) effects as acupuncture. EFT Tapping is facilitated by an experienced, certified EFT practitioner in a therapy session, with the ultimate goal of shifting limiting thought processes, resolving past traumas, and promoting healing around emotional issues that may be holding us back. How does EFT Tapping work? EFT Tapping can rewire the brain. From research, it is understood that tapping on specific pressure points can result in a calming effect on the amygdala (the stress center of the brain) and the hippocampus (the memory center), both of which play a role in the unconscious process we use to determine if something is a threat or not, and therefore whether our “fight or flight” response should kick in. Indeed, studies at Harvard Medical School have shown that by stimulating the body’s acupressure points you can significantly reduce activity in the amygdala. Therefore, EFT Tapping works to effectively rewire the brain; to interrupt and change neural pathways so that you want to do the things that are going to improve your life and make you feel better. Research shows EFT Tapping is effective in treating multiple mental health disorders Multiple studies have been done to determine the effectiveness of EFT Tapping for different mental health issues. Here are just a few: Reducing cortisol levels. One study measured changes in cortisol (the primary stress hormone) levels and other psychological distress symptoms after a single hour-long intervention of EFT Tapping and found it reduced those distress symptoms by 24%. Decreasing anxiety. Another study looked at the length of time needed before different therapeutic interventions took effect in patients with anxiety, and found that only three EFT Tapping sessions were needed before study participants’ anxiety was reduced. That same study showed that after a year, those reductions in anxiety were maintained by 78% of participants. Treating depression. In a study exploring EFT Tapping for depression, researchers found that a weighted mean reduction in depression symptoms was 41% after using EFT. Reducing symptoms of PTSD. Another study using EFT Tapping to treat PTSD in veterans found that 60% of participants no longer met clinical PTSD criteria after three EFT Tapping sessions and 86% no longer met the criteria after six sessions. Other studies have shown the effectiveness of EFT Tapping even beyond reducing anxiety, depression, and PTSD symptoms. For example, it can help minimize food cravings and aid in weight loss, or reduce fears around events like public speaking, test-taking, and even childbirth. If you or a loved one are living with mental health issues such as Anxiety, Depression, or PTSD, consider EFT Tapping Like other treatment modalities, therapists can be trained and certified in EFT Tapping. Certification requires a specific number of hours in the classroom and in clinical practice. Many behavioral health specialists offer EFT Tapping therapy; look for one that is experienced and certified. Many of Telemynd’s clinicians specialize in EFT tapping. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Journal of Evidence-Based Integrated Medicine EFT International Journal of Nervous & Mental Disease Journal of Nervous & Mental Disease Explore: The Journal of Science & Healing

Dialectical behavior therapy (DBT) is an evidence-based cognitive-behavioral treatment that provides individuals with tools to help reduce negative behaviors and regulate intense emotions. Although it was originally created to treat borderline personality disorder (BPD), it has been effectively adapted to treat other mental health conditions, such as depression, bipolar disorder, and eating disorders. Its objective is to help people understand and accept difficult and often contradictory feelings, and then learn the skills to manage them. Read our overview to learn how it works, who can benefit from DBT, and what treatment looks like. What is Dialectical Behavior Therapy (DBT)? DBT is a comprehensive treatment that includes many aspects of other cognitive-behavioral approaches, such as exposure, problem-solving, and stimulus control, as well as cognitive restructuring. In plainer terms, DBT focuses on helping individuals to change unhelpful ways of thinking and behaving while at the same time focusing on self-acceptance. DBT teaches four sets of behavioral skills: mindfulness, distress tolerance, improved interpersonal skills, and emotion regulation, so that individuals have the tools to make positive and healthy changes in their lives. The key to DBT is the term, dialectical. Here, dialectical means learning to understand how two seemingly opposing perspectives can both be true. In this way, DBT promotes balance and avoidance of “black and white”, “all-or-nothing” styles of thinking. For example, accepting yourself and changing your behavior might feel contradictory, but DBT teaches that it's possible to achieve both goals together. At the heart of DBT are acceptance and change. Who can benefit from DBT? DBT has been adapted to treat those with mental health issues such as eating disorders, suicidal and self-harming behavior, bipolar disorder, treatment-resistant depression, and substance use issues. The thinking is that since these disorders are often associated with unhealthy attempts to control intense, negative emotions, DBT’s emotion-regulation approach can help. Indeed, multiple research studies have shown that DBT can be effective in treating substance use issues, and decreasing suicide ideation, hopelessness, anger, and depression, and also that the effects of DBT treatment can last for sustained periods of time. What does DBT treatment look like? Although highly effective, DBT can take many therapy sessions and multiple months (sometimes over a year) of treatment in order to see change. It typically involves weekly one-on-one therapy sessions, weekly group skills training sessions, homework, and regular therapist check-ins (often by phone or video). According to the research, DBT treatment consists of four stages which go in order, with each phase having specific goals, such as: Treating issues related to past trauma Reducing therapy-interfering or quality-of-life-interfering behaviors, such as suicidal ideation or self-harming Developing renewed self-esteem and improving day-to-day behavioral skills Developing the capacity for optimum life experience and for finding a higher purpose. Please note, if you or a loved one have thoughts of suicide, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1. If you or a loved one are living with disorders such as depression, an eating disorder, or other self-harming behaviors, consider DBT DBT treatment requires fairly extensive training in order for behavioral health specialists to offer it to clients. Some get trained in DBT in graduate school or postdoctoral work, and others can get DBT-certified with supervised, on-the-job training. A qualified mental health professional will first assess your symptoms, treatment history, and your goals, and from there, figure out which type of therapy treatment is best for you. Because each illness responds differently to treatment techniques, you’ll want to go with what’s been shown most effective for your diagnosis and symptoms. Many of Telemynd’s clinicians are DBT-certified. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Indian Journal of Psychological Medicine BMC Psychiatry Borderline Personality Disorder and Emotion Dysregulation

EMDR (Eye Movement Desensitization and Reprocessing) therapy has been around since the 1980s, and recent stories featuring several well-known media personalities have credited the technique with helping them heal from past trauma. In the news or out, EMDR is an evidence-based, extensively researched therapeutic modality that is commonly used by behavioral health specialists to help support clients’ recovery from past trauma. EMDR has proven particularly effective for those living with PTSD, and as the date draws nearer for US troops to pull out from Afghanistan, we’re focused on sharing vital resources and techniques that can help military families and their loved ones cope with the transition. What Is EMDR? In plain language, EMDR is an individual therapy technique aimed at helping people process trauma during therapy in a more detached way than talking about the event (which can be emotionally intense and often lead them to shut down). It had been thought that emotional pain from past trauma required a long time to heal. But studies have shown that our minds can mend from psychological trauma in a similar way that our bodies recover from physical trauma - and often in as little as 6 to 8 weeks, depending on the individual and their engagement in the program. In fact, one of the important benefits of EMDR is that by using this therapy, people can experience progress that normally can take years. In one study, 77% of combat veterans were free of PTSD symptoms in only 12 therapy sessions. EMDR works in eight phases. The clinician first learns about the client’s history, while also helping them to create a sense of safety and awareness in the body. Key traumatic memories are identified and reprocessed. After the clinician has determined which memory to target first, they ask the client to hold different aspects of that memory in their mind while using their eyes to track the therapist’s hand as it moves back and forth. As this happens, internal associations arise and the client starts processing the memory and associated disruptive feelings. Once the memories are reprocessed in this way, the brain develops new neural pathways free from the associated negative emotion so that the traumatic memories do not cause the same repeated “fight, flight or freeze” survival response. As the psychologist who originated EMDR, Dr. Francine Shapiro said, “unlike straight talk therapy, the insights clients gain in EMDR therapy result not so much from clinician’s interpretation, but from the client’s own accelerated intellectual and emotional processes.” The EMDR International Association has a more specific description of the eight phases here. How Does EMDR Help Veterans Recover From PTSD? It’s estimated that almost 4% of the general US population is affected by PTSD — a number that rises to 55% of those who have served in the military. A few months ago, we wrote about PTSD and how it negatively impacts the lives of those suffering from it. For example, remembering and reliving the initial trauma may cause problems at work or at home – triggering an out-of-perspective or inappropriate emotional response to everyday experiences. Individuals who have PTSD avoidance symptoms may do things like avoiding driving a car or visiting certain locations. Others may feel stressed and angry all the time and isolated from friends and family. Left untreated, PTSD can cause adverse impacts on relationships and work, and even dependence on drugs or alcohol. EMDR therapy has been recognized as effective for PTSD in the treatment guidelines of the US Department of Veterans Affairs (VA) and the World Health Organization (WHO). EMDR treatment options for veterans range from intensive daily therapy sessions to weekly sessions. In multiple research studies, both frequencies were found to be equally effective, with a substantial decrease in PTSD symptoms ranging between 36% and 95%, depending on the framework of the study. As well, studies show that EMDR therapy can produce stable long-term effects for PTSD sufferers. But how exactly does EMDR therapy reduce the symptoms of PTSD? As we wrote a few months ago in How Trauma Changes the Brain, stress responses are a protective part of our natural instincts. But in those diagnosed with PTSD, the distress from the trauma remains in the memory, and those upsetting thoughts and emotions can create an overwhelming feeling of being “back in that moment” - even if you are sitting safely at home. EMDR therapy is thought to help improve the way the mind processes these memories, which can sometimes be too difficult to do by just talking about them. EMDR allows guided self-healing to happen in a natural way that has long-term benefits. Moving your eyes in a rhythmic back-and-forth motion in EMDR therapy, while recalling the trauma, causes shifts in the way that you experience that memory, and information from the past is allowed to finally process. Essentially, the experience is still remembered, but the protective need for the fight, flight, or freeze response related to the original event is resolved. In effect, EMDR is helping to ‘retrain the brain’. If You Or A Loved One Has Been Diagnosed With PTSD, Consider EMDR Therapy Many behavioral health therapists offer EMDR therapy. Look for therapists who are EMDR-certified. Among other requirements, EMDR certification requires 20 hours of training and 20 hours of clinical practice, 50 EMDR therapy sessions, and adherence to EMDR International Association policies. Telemynd supports veterans and their families, and many of our clinicians are EMDR-certified. Through our national partnership with TRICARE, we’re able to offer you and your beneficiaries access to licensed therapists or psychiatrists from the convenience and privacy of your own home. Request an appointment online or call our live support for assistance in scheduling care today! Sources EMDR International Association Journal of EMDR Practice and Research Journal of EMDR Practice and Research Brainline.org

I believe it is safe to say that Covid-19 has caused widespread disruption to life as we knew it. School, work, travel, relationships - all shaken up during the pandemic - and with it, our mental health. Some of the latest research has found that 25% of US adults are experiencing significantly more anxiety this year than in the past, and 20% are experiencing more symptoms of depression now than in the past. The research also shows that the volume of calls to helplines has increased significantly over the past year. The disruptions to everyday life have increased the need for behavioral health care – which has put an even greater demand on what was an already limited supply of mental health providers. Here at Telemynd, we’ve found that providing mental health care virtually, also known as telebehavioral health, has proved to be an effective way to make sure everyone seeking quality care has access. In fact, we believe that if there’s a silver lining to the pandemic, it’s that the adoption of telemedicine by the industry and consumers alike, has been accelerated by at least 5 years. Every indication points to telebehavioral health being here to stay, and if you’re a provider, there may be no need to return to your brick and mortar office. Research Supports Overall Satisfaction & Effectiveness For Patients & Providers One study published in JIMR Formative Research suggests that more than half of people using telehealth want to keep receiving that care virtually post-pandemic. Another study found that 78% of patients who use telebehavioral health are very or extremely satisfied with their telehealth experiences, and 75% are more likely to continue to use it after the pandemic. In addition, in a recent survey of employers who offer healthcare benefits, 90% report that their focus on telemedicine increased during the pandemic, and 52% say virtual medicine will continue to be an important priority within their organization’s health care activities following the pandemic. It’s clear that the demand is there for telebehavioral health - but is it effective? The answer is a resounding ‘yes’. A published literature review found without question that “behavioral health virtual visits deliver the same outcomes as in-person visits for many conditions, and meet the same standards of care set by the National Committee for Quality Association.” Our Own Data Shows Record Growth Levels Beyond The Pandemic At Telemynd, we’re seeing strong indications from payors and patients that telemedicine is their preferred method for the delivery of behavioral health care services. Between third quarter 2020 and second quarter 2021 we experienced 4X growth in new patients seeking mental health services, an upward trend we continued to see as we move through 2021 at a record-setting 61% increase in demand. Both clinicians and patients have demonstrated their ability to quickly adapt to telemedicine with no sign of slowing down, even in a post-pandemic world. Telebehavioral Health Benefits — For Patients & Clinicians Many challenges have been addressed through the implementation of telebehavioral health, including: Minimal wait to connect with a quality mental health professional Expanded access for patients who may live in a rural area, have limited mobility, or reside in long-term care facilities Saving time with virtual screenings and evaluations Better treatment for chronic conditions and medication management Personalized care from home, which promotes willingness to share in settings they’re already comfortable in Eliminating the stigma often associated with seeking mental health services and providing additional patient privacy For clinicians, telebehavioral health has many benefits as well, such as: Removing the overhead and upkeep of a physical location More flexibility to schedule clients at a pace and level that supports your needs Added freedom to travel while seeing patients anywhere in the country Simple and reliable weekly income direct deposited with complete remittance reports from our finance team All of these benefits lead to a true work-life balance. Telebehavioral health is a win-win for clinicians and their patients! Telebehavioral Health Allows Clinicians To Be Better At What They Do With all the benefits and studies showing adoption and effectiveness, telebehavioral health can now be considered a fundamental component of our healthcare environment – in other words, it’s here to stay. Telemynd helps each provider who joins to expand their practice and eliminate the administrative burden. Giving reliable income and the ability to focus on what matters most — delivering quality mental health care to patients. Sources Futurity Willis Towers Watson American Psychological Association Journal of Internal Medicine

Much has been written about returning military personnel and Traumatic Brain Injury (TBI) because it’s important to raise awareness of this issue as so many of our men and women who have served overseas live with the lingering effects of serious head injuries. And depending on what part of the brain is injured, TBI is often correlated with mental health problems. In fact, studies show that when people without any prior mental health issues or history of mental illness suffer a TBI, their risk for depression and other mental health issues increases significantly – up to two to five times higher than the general population. In this post, we review the link between TBI and mental health, how to look out for symptoms, and treat them if they develop. What Is Traumatic Brain Injury & Why Do So Many Military Personnel Get Them? The TBI Centers of Excellence (part of the Office of the Secretary of Defense) reports nearly 450,000 TBIs among U.S. service members from all branches between 2000 and 2020 - that’s a significant number of our service men and women living with the repercussions of a serious head injury. The CDC defines a TBI as a disruption in the normal function of the brain that is caused by a bump, blow, or jolt to the head, or a penetrating object. Military service members are especially at risk from explosions experienced during combat or training exercises, and in fact, currently, approximately 80% of new military TBI cases occur in non-deployed settings, most often sustained during training activities. TBIs have persistent, and sometimes progressive, long-term debilitating physical and emotional effects. Typical physical symptoms include headaches, seizures, weakness, numbness and loss of coordination, to name just a few. A TBI may also trigger cognitive symptoms including confusion, frequent mood changes, memory loss, executive dysfunction, behavioral changes and difficulty reasoning or learning. The Link Between TBI & Mental Health Disorders Scientists have found that living with a TBI may also lead to mental health disorders, including Major Depressive Disorder (most common), PTSD (second most common), Anxiety Disorder, Panic Disorder, and to a lesser extent, Bipolar Disorder and Schizophrenia – all most likely caused by damage to brain tissue during the original head injury. Following Is More Detail About The Two Most Common Mental Health Disorders Associated With TBI Major Depressive Disorder — The prevalence of depression within the first year after brain injury is 33%–42%, and within the first 7 years is 61%. Depression may slow the pace of cognitive recovery, impact social functioning, and lower overall health-related quality of life. In addition, people recovering from TBI who also have depression are 3 times less likely to stay on their prescribed medication. They also report more severe physical symptoms (like headache, blurred vision, and dizziness) compared to non-depressed TBI patients. Depression after TBI may result in part from direct or secondary injury to brain tissue, and it also may result in part from the TBI patient’s frustration with the pace of recovery and loss of “normal” routine and ability to participate in activities of daily life. PTSD — Studies show that military personnel who suffer a TBI are almost twice as likely to have developed PTSD one year later than those with no TBI. One of the problems in diagnosing PTSD in these situations though, is that post-acute symptoms following TBI overlap somewhat with those associated with PTSD itself. Fortunately, clinicians with solid experience treating PTSD are more apt to be able to tell the difference. Scientists believe that PTSD may develop following TBI due to several factors: unconscious or conscious “encoding” in the brain of sensory factors (the sights and smells) associated with the event that caused the TBI, reconstruction of the trauma memory from secondary sources (for example, other people who were there), and memory of circumstances surrounding the event that also may be emotionally traumatic (like seeing others hurt). Looking at this issue from another perspective, researchers have also found that veterans seeking help from the VA for mental health issues, were found to have undiagnosed TBI in 45% of the cases studied. In other words, symptoms of depression and other mental health disorders were the tip-off that something was significantly wrong medically; in this case, the patients had suffered a TBI at some point in their military service that had not been diagnosed or treated. Watch For Symptoms Of Mental Health Disorders If You Have Been Diagnosed With A TBI Making progress in rehabilitation from a TBI can be especially challenging when it’s complicated by an undiagnosed mental health disorder. That’s why it’s so important for people with TBI to be screened for mental health disorders too, and for loved ones and clinicians to watch for signs of mental health problems after TBI. If you see general symptoms such as the following, consult with a qualified mental health provider (and when in doubt, go ahead and get checked out): Feeling especially sad or down Excessive fears or worries, or extreme feelings of guilt Extreme mood changes Withdrawal from friends and activities Detachment from reality, paranoia, or hallucinations Inability to cope with daily problems Problems with alcohol or drug use Excessive anger, hostility, or violence Suicidal thinking Mental Health Disorders Associated With TBI Are Treatable For people with a TBI who are also diagnosed with a mental health disorder, it’s important that treatment for that disorder be integrated into the overall TBI rehabilitation treatment plan as prescribed by a qualified mental health provider. Treatment may include a combination of medications and therapies such as Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing therapy (EMDR) — treatment options similar to those recommended for people who are not dealing with a TBI. So, the good news is that mental health disorders associated with TBI are treatable, but it’s critical to be on the lookout for symptoms so they’re not missed. Sources Journal of Neuropsychiatric Disease and Treatment Centers for Disease Control Journal of Neuropsychiatry