Roger Murray

One of the less-talked-about mental health conditions today is postpartum depression (PPD). A CDC study shows that about one 1 in 10 women in the US reports symptoms of depression after giving birth; in some states, it’s 1 in 5. But despite its prevalence, almost 60% of those women do not receive a clinical diagnosis. And if any group needs support, it’s new mothers, yet of those who do screen positive for the condition, less than 25% receive follow-up care, often because they don’t fully understand their symptoms or are worried about a perceived stigma around the condition. During the pandemic, PPD levels in new mothers have been higher than normal. It’s thought that this is due to the general stress that hit us all during this life-threatening global event, as well as necessary hospital covid-19 policies like quarantining, separating family members in the birthing area, and reducing skin-to-skin contact between mother and baby after birth. In general, postpartum depression can be a highly disruptive condition if not addressed – and often comes at a time when women are still trying to recover from the physical effects of childbirth – so it’s important to raise awareness of what it is, what causes it, who it affects, and ways to cope with it. What Is Postpartum Depression (PPD) & What Causes It Postpartum depression (sometimes called peripartum depression) is a serious mental health condition that involves the brain and affects behavior and physical health. Much more than the “baby blues”, PPD causes sad, flat, or empty feelings that don’t go away and often interfere with your day-to-day life. You might feel unconnected to your baby, as if you are not the baby’s mother, or as if you can’t love or care for the baby. These feelings can be mild to severe. Symptoms of postpartum depression are similar to symptoms for depression (see our symptom list here), but may also include these symptoms which can last for weeks or even months: Crying more often than usual Feelings of anger Withdrawing from loved ones Feeling numb or disconnected from your baby Worrying that you will hurt the baby Feeling guilty about not being a good mom It’s thought that normal pregnancy hormonal changes in estrogen and progesterone may trigger symptoms of postpartum depression. In the first 24 hours after childbirth, these hormones quickly drop back to normal pre-pregnancy levels, and scientists think this sudden change may lead to depression in some women. Levels of thyroid hormones may also drop after giving birth, and in some women, low levels of thyroid hormones can cause symptoms of depression. In addition, social and psychological factors play a large role in determining who develops PPD and who does not. For example, women with lower or poorer quality social support, and less stable domestic situations may be at increased risk of PPD. Also, a family or previous history of depression, having multiples like twins or triplets, being a teen mom, or experiencing a preterm birth and/or birth complications can also increase the risk of PPD. It’s also important to note that PPD can also occur in women with a healthy pregnancy and birth. Treatment Of Postpartum Depression The best way to know is to watch carefully for the symptoms described above, in yourself or your loved one who recently gave birth. If you notice any, the first step to getting treatment is to talk to your health care provider or mental health professional who can diagnose and prescribe a course of treatment. Like other types of depression, postpartum depression can be managed with talk therapy, medication, lifestyle changes, and a supportive environment, or a combination of all of these. Women who are nursing should discuss the risks and benefits of medication with their doctors. Tips For Coping With Postpartum Depression In the meantime, here are some tips to help you cope with postpartum depression (note, these do not replace treatment with a trained professional): Talk to your partner, friends, and family about your symptoms and your need for support. Don’t overdo it on housework and baby care once home from the hospital; balance these duties with your partner or a loved one or try to get outside help if that is not possible. Join a support group of new parents, many of which are now online, making them easier to attend - try looking here or here. Eat a healthy, balanced diet - again, ask for cooking help from friends and family, or consider a meal delivery service. Get physically active, as much as possible - even if just a 20 min walk around the block; researchers have found that those who engaged in at least 2 hours per week of moderate intensity exercise were less likely to report depression or anxiety symptoms after birth. Engage in mindfulness and relaxation, such as meditation or yoga. Consider Telebehavioral Health Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re a patient, 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 Centers for Disease Control US Department of Health and Human Services, OASH Postpartum Support International (PSI)

It’s estimated that 9% of people in the US will be diagnosed with PTSD in their lifetime; the numbers are much higher for veterans of military service: between 11 and 20% are diagnosed with this debilitating condition. And it’s no wonder - PTSD is a mental health disorder that occurs in response to experiencing or witnessing disturbing and distressing traumatic events - which is common to most vets who have seen combat. By way of detailed explanation, Matthew Friedman, MD, Ph.D., Vice-Chair for Research in the Department of Psychiatry at the Geisel School of Medicine at Dartmouth, says that PTSD is common, especially among recent veterans, because deployed military personnel “have at some point felt helpless to alter the course of potentially lethal events; been exposed to severe combat in which buddies were killed or injured; been exposed to uncontrollable and unpredictable life-threatening attacks such as roadside bombs; or experienced exposure to the consequences of combat, such as observing or handling remains of civilians, enemy soldiers, or US and allied personnel.” We can all agree that that’s a significant amount of trauma for an individual to experience. Thankfully there is hope for those who are seeking treatment for PTSD. Due to the many military veterans living with PTSD (and more diagnosed every year), scientists at government and educational institutions are constantly researching new ways to help those living with this mental health condition. Our goal is to shed light on some of the latest PTSD treatments that have been found to be effective. Traditional Treatment For PTSD: One Size Does Not Fit All A few months ago, we wrote about the science of PTSD; how experiencing trauma impacts different parts of the brain and ultimately changes it, causing the parts of the brain responsible for thinking and memory to stop functioning correctly. When this occurs, it’s hard to separate safe and “normal” events happening in the present from traumatic events that happened in the past. Because of this, PTSD can impact daily routines, making it difficult to do normal tasks, such as sleeping, eating, or concentrating. It can significantly impact work and relationships and left untreated, it can cause dependence on drugs or alcohol. Traditional treatment for PTSD has been a combination of medication and therapies, such as Cognitive Behavioral Therapy (CBT) and Cognitive Processing Therapy (CPT). These treatment methods are an attempt to help minimize, or even eliminate, the distressing symptoms that people with PTSD experience. However, a 2020 study published in the Journal of the American Medical Association found that a “one-size-fits-all” treatment prescription for PTSD does not work. It may be that traditional therapies work for one individual, but newer, innovative therapies work better for the next. The study concluded that it is vitally important that each patient is evaluated within the context of their unique set of PTSD causes and symptoms, and that their behavioral health professionals help them find the right combination of treatments that work for them, rather than use a one-size-fits-all approach. Further, it’s important for patients and medical professionals to keep trying different treatments until they find one that works - something that isn’t often done, as many sufferers give up after trying one or two treatment attempts. What Are The Latest PTSD Treatment Options For Veterans? Below are just some of the latest evidence-based treatments for PTSD. This list is by no means exhaustive. To keep up on treatment developments, watch the news or subscribe to military and scientific / health journals, some of which you can find here. Non-Traditional Approaches Like Meditation & Acupuncture Researchers have found that non-traditional treatments like yoga, meditation, acupuncture, acupressure, and doing repetitive, peaceful tasks such as sanding wood, knitting, crocheting, restoring cars, or tying fly-fishing flies can be very effective tools in managing trauma symptoms. Horseback riding or having a service or companion dog can also help some PTSD patients. Trauma-Focused Psychotherapy A 2021 study published in Biological Psychiatry showed that trauma-focused psychotherapy can significantly reduce the symptoms of PTSD. This treatment, used specifically for PTSD, involves techniques such as "in vivo exposure," which involves directly facing a feared object, situation, or activity in real life, and "imaginal exposure," which involves facing the trauma memory. A person who is afraid of crowds, for example, may be repeatedly exposed to large gatherings. After a while, the person recognizes there is no actual danger, so this process eventually promotes new learnings in the brain. Eye Movement Desensitization & Reprocessing (EMDR) You may have recently seen Prince Harry, on his mental health series The Me You Can’t See, undergoing this kind of therapy on camera in an attempt to show us (and de-stigmatize) how he is healing from childhood trauma and loss. EMDR works by having the individual with PTSD pay attention to a back-and-forth movement or sound (like following a moving finger, a flashing light, or a tone that beeps in one ear) while calling to mind the upsetting memory – until shifts occur in the way that the memory is experienced. A similar therapy is the Emotional Freedom Technique (EFT), also known as ‘tapping’. Stellate Ganglion Block (SGB) This treatment involves a shot of local anesthetic in either the stellate or C6 ganglions on the side of the neck, which numbs the nerves for 8 hours. When the numbness wears off, patients report immediate relief of PTSD symptoms. A recent study published in JAMA Psychiatry found that SGB therapy significantly reduced the severity of PTSD symptoms over a period of 8 weeks. Three Key Takeaways If you or a loved one have been diagnosed with PTSD, know that there are multiple proven treatment options available. Perhaps some of these newer therapies may work for you. And remember, it’s likely that your medical professional will recommend a combination of more than one therapy to reduce your symptoms. In summary, the three most important learnings to take away from this post are: One size does not fit all when it comes to treating PTSD; what works for one person may not work for the next. Mental health specialists must view each patient as unique, requiring highly individualized therapy combinations. The most effective PTSD treatment may actually be a combination of several therapies and medications; rather than just one. If at first you don’t succeed, try, try again: Keep trying different treatments until you find the ones that work. It may feel like a slow healing process, but persist and you’ll find the combination that’s right for you. Please note that any treatment must be done in conjunction with a trained mental health or medical specialist and not attempted outside of medical care. Sources American Psychiatric Association National Institutes of Health Journal of the American Medical Association

With the recent announcement that the U.S. will withdraw all its forces from Afghanistan by September 11th of this year, we thought it was a good time to look at the issues that veterans may face adjusting to life post-deployment. Over 2.2 million troops - men and women - have served in the conflicts in Iraq and Afghanistan since 2003. While many service members readjust to life after being deployed, many do not. An Assessment of Readjustment Needs of Veterans, Service Members and Families by the Institute of Medicine of the National Academies found that many service members returning from the conflicts in Iraq and Afghanistan “report that their experiences were rewarding, and they readjust to life off the battlefield with few difficulties. Up to 44%, however, return with complex health conditions and find that readjusting to life at home, reconnecting with family, finding work, or returning to school is an ongoing struggle...These military personnel often have more than one health condition. The most common overlapping disorders are PTSD, substance use disorders, depression, and symptoms attributed to mild TBI. Common Challenges Facing Soldiers Readjusting To Life At Home Soldiers face unique challenges when they separate from military service and return to civilian life. Even the most resilient find adjustment somewhat stressful; unfortunately these challenges are also associated with mental health disorders like PTSD, depression and anxiety. Post-Deployment Adjustment Challenges Include: Relating to civilians who do not know or understand what they’ve experienced in the field. Families may have created new routines during deployment. A returning vet may have never applied or interviewed for a civilian job, and needs to figure out how to translate their military skills into civilian terminology for a resume. Or if returning to a job, they may need to catch up, learn new skills, or adjust to a new position. No clear chain of command or hierarchy outside the military; they don’t know where to go for help. Learning how to buy clothing, groceries and other seemingly mundane civilian needs, and having to negotiate the overwhelming choices of civilian shopping outside the PX. Adjusting to subtle nuances in social conversations and workplace lingo that are unfamiliar. These are just a few of the logistical adjustments that returning soldiers must make, never mind the emotional adjustments they face, such as losing an immediate support group of fellow troops, recovering from the loss of friends who died overseas, feeling isolated and alone among people who don’t understand what they experienced, feeling challenged by a new civilian job, having to renegotiate family relationships, and dealing with good and bad memories of deployment. And this commonly (and understandably) leads to problems with mental health. Mental Health Issues Among Returning Veterans They call them “war’s invisible wounds.” While physical wounds are easy to identify, the psychological wounds of war are often not as easy to spot. Multiple studies have found a link between combat experiences and mental health issues related to military service. And it's not just soldiers who suffer - one study found that lengths of deployments are associated with more emotional difficulties and mental health problems among military children and spouses too. Below are three of the most common mental health issues associated with returning soldiers. Post-Traumatic Stress Disorder (PTSD) Traumatic war-time events such as military combat and violent accidents or deaths in the field involving themselves or unit members can have long-lasting negative effects such as trouble sleeping, anger, nightmares, feeling constantly jumpy, and alcohol and drug abuse. Many vets find that these symptoms are in fact Post-Traumatic Stress Disorder (PTSD). A JAMA Psychiatry study found the rate of PTSD to be 15 times higher in returning veterans than in civilians. Depression & Anxiety Overall, the rate of depression in returning vets is 5 times higher than for civilians.However, research has found that depression is currently one of the most prominent health conditions among female veterans, who experience higher rates of depression than their male counterparts. Women who have been exposed to combat during deployment or witnessed the injury of unit members and civilians in war zones are especially vulnerable to depression and anxiety — all of which makes readjustment that much harder. Over half of all female veterans have needed to access mental health treatment with a primary diagnosis of depression and/or anxiety disorder. Suicide Suicide is a particular concern that has emerged for veterans, who experience a 50% higher incidence than the general population. And like depression and anxiety, female veterans have an 80% higher incidence of suicide than male veterans. A recent study of active-duty soldiers and veterans found that 3% of men and 5.2% of women reported suicidal ideation in the previous year. And of those who reported suicidal ideation, 8.7% also reported a recent suicide attempt. This is a trend that must be stopped. Tips For Acclimating Upon Return These are just a few tips to help with the transition from deployment to civilian life: Allow yourself to feel all kinds of emotions. Give yourself permission to feel the way you feel, even if it’s uncomfortable. Go easy on yourself and give readjustment time to unfold. Talk about how you’re feeling with family and friends. Your loved ones may not know how to ask about your experience, but talking about your feelings can be an important part of the readjustment process. Try not to overbook yourself. You may have lots of things on the post-deployment to-do list, but give yourself time to ease back into your routine. And give yourself a break if it doesn’t all feel comfortable right away. Limit your use of alcohol. Drinking too much can confuse your thinking, cloud judgment, and exacerbate mental health disorders. Watch spending. It's very common to want to celebrate your return with a new car or electronics, but those bills can catch up quickly and cause extra stress at a time you don’t need it. Most importantly, know when to seek help. If you or a loved one are feeling signs of stress — either physical or emotional — seek expert help from a behavioral health specialist as soon as possible. (And if you or a loved one are suicidal, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1). Consider Telebehavioral Health Telemynd supports veterans and their families. 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 Institute of Medicine of the National Academies U.S. Department of Veterans Affairs American Psychological Association

According to the Department of Defense, 37% of active-duty military families have children, and like their active-duty parents, military kids make sacrifices in their own ways too. From coping with the challenges of a parent’s deployment to starting a new school to accommodate a recent move (known as a Permanent Change of Station or PCS), military kids commonly experience stressors that can impact their mental health. On average, military kids attend up to nine different schools before graduating high school due to relocations. What kind of impact do these frequent moves have on the mental health of military kids and their families? And what are some ways to cope with the stress? Military Kids Move Every Two to Four Years, On Average Military families typically make a PCS move every two to four years (this is over 3 times the civilian family average), which means that the kids are constantly adjusting to new schools and environments, making new friends, and leaving old ones behind. In some cases, PCS moves can occur quickly and unexpectedly, leaving little time for closure, for kids to fully process what is happening to them, or to say goodbye. Multiple studies have been conducted to measure the impact on mental health of PCS moves. The Journal of Adolescent Health published findings that military kids who move frequently were significantly more likely to have a mental health issue. In addition, it found that age was a powerful predictor of the impact on mental health, i.e., military kids aged 12-17 were four times as likely to need help from a mental health professional as military kids aged 6-11. This makes sense intuitively, as teens are already going through the changes and stresses of puberty. Add in the need to rebuild their social connections and form new friendships, and one can see why PCS moves impact teens harder. The stress of PCS moves affects parents too. Another study by the School Psychology Review found moving increases tension in the home in general. Kids reported feeling anger or resentment toward their parents and the military because of the disruption to their lives. Some kids reported telling their parents that they refused to move or would run away to avoid moving entirely. Ways The Disruption Of A PCS Move Causes Stress What is it about frequent moves that causes so much burden? First, change itself is stressful to us all, as numerous studies have found over the years. And when families make a PCS move, they must adjust to a new home, new school, address, neighborhood, friends, teachers, religious community, routines, and potentially new local culture and weather. That’s a lot of change! In addition: Students involved in sports who move later in the year can miss team tryouts, or the new school may not offer the same athletic programs. They may feel the loss of having to end close relationships with friends at a previous school. It’s more difficult to gain acceptance in a new school where cliques and social networks are already established. Because of potentially limited experience with military families, civilian school staff may have a knowledge gap that affects their effectiveness working with military students. Parents themselves are swamped with new jobs and to-do lists, and may not have the patience or time to consider a kid having trouble with the transition. If one parent is deployed or at risk of being deployed, kids may experience further stress from the constant fear for a parent’s safety. All can lead to considerable stress, as kids find they lack a feeling of connection to others in their new community. As a result, symptoms of depression and anxiety can appear, such as separation anxiety, excessive worry, sleep problems, and physical complaints such as headaches or stomach pain. Tips For Coping With The Stress Of A PCS Move PCS moves are not all doom and gloom. Research suggests that many kids develop strength and resilience from adapting to frequent military moves. And there are steps parents and schools can take to support them through the moves in order to reduce the impact on their mental health. Number one is simply to be aware of the potential mental health impacts and to watch for signs and symptoms of distress. Our previous release discussing different symptoms of mental health conditions is really helpful. Parents can read up on the impact of PCS moves, and educate themselves on ways to support kids during the transition. And as with all mental health issues, the earlier that symptoms are noticed for intervention and treatment to begin, the better the prognosis and outcomes. Experts Suggest These Tips For Coping With The Stress Of PCS Moves Keep up established routines and rituals as much as possible, and start new rituals in the new place that encourage parent-child bonding time. Talk about the move as much as possible and give kids the opportunity to vent their negative feelings (and help them find positive ones too). Parents are advised to let kids in on a little of their own misgivings about the move and to find ways to address them as a family. This provides more positive feelings of validation and control. Connect with other military children and families when possible. As well, in the military community itself, most installations have a resource officer or School Liaison Officer who may be able to suggest appropriate resources. Even in a civilian school where there are few military kids, school guidance counselors are the best place to start a conversation between the family and the new school, as they are the gatekeepers to community mental health resources. Even if the counselor does not have experience with military students, he or she may be able to suggest local resources with more expertise. Finally, although it may seem simple, making sure that kids get enough sleep, eat healthy foods, and get out and exercise will go a long way toward maintaining better mental health. And when kids do exhibit symptoms of transition distress, seek out a mental health professional as early as possible. Sources Military Spouse Journal of Adolescent Health School Psychology Review

Do you have trouble falling asleep or staying asleep? You may be one of the 50 million adults in the United States with a chronic sleep disorder. For healthy adults, the recommended amount of sleep is seven hours per night. But if you suffer from a sleep disorder, squeezing that many hours into a single night is a real challenge — but shouldn’t be ignored, because our body’s inability to rest could be linked to underlying mental health conditions. A lack of sleep only exacerbates mental health disorders like depression and anxiety, leading to a negative cycle between overwhelming feelings of hopelessness or stress, and restlessness. So, what are sleep disorders, how can we manage mental health symptoms, and what can we do to achieve better sleep? Common Sleep Disorders In general, sleep disorders are characterized as chronic sleep conditions that impact your quality of life or ability to function. These include trouble falling or staying asleep, falling asleep at the wrong times, and abnormal sleep behaviors. According to the International Classification of Sleep Disorders (ICSD-3), the official description is a “curtailed sleep pattern that has persisted for at least three months for most days of the week, along with complaints of sleepiness during the day”. The five most common are: Insomnia. Characterized by the inability to initiate or maintain sleep, it may also take the form of very early morning awakening. Often causes excessive daytime sleepiness, which results in functional impairment throughout the day. Narcolepsy. A neurological disorder that affects the brain’s ability to control sleep-wake cycles. People with narcolepsy may feel rested after waking, but then feel very sleepy throughout the day. They may fall asleep even in the middle of an activity. Restless Legs Syndrome (RLS). Characterized by an unpleasant “creeping” sensation, originating in the lower legs, but often associated with overall leg pain. This sensation is seemingly only relieved by moving your legs, walking, or kicking - which of course, prevents sleep. Sleep Apnea. People with sleep apnea often make periodic gasping or “snorting” noises while asleep, during which their sleep is momentarily interrupted. If you snore loudly and feel tired even after a full night's sleep, you may have sleep apnea. REM Sleep Behavior Disorder (sometimes called Parasomnia). Characterized by abnormal sleep behaviors which manifest in vivid, often frightening dreams associated with movement during REM sleep, people with this kind of sleep disorder appear to “act out their dreams”. Common symptoms include: movement such as kicking, punching, or jumping from the bed in response to action-filled or violent dreams; making noises, such as talking, laughing, or shouting; and being able to recall dreams if you awaken during an episode. The Link Between Sleep Disorders, Depression, & Anxiety Scientists have found that 75% of individuals with depression experience sleep disturbances. And unfortunately, the relationship is bi-directional - meaning that not only does depression exacerbate sleep disorders like insomnia, but having a sleep disorder first can actually help bring on depression (if a person is already predisposed). And like the proverbial chicken and egg, often it’s hard to know which came first. Researchers believe sleep problems may contribute to depression by way of abnormal changes in the functioning of the neurotransmitter serotonin, the key hormone that stabilizes our mood and provides feelings of well-being. They have found that not enough sleep impacts the way serotonin works, disrupting our circadian rhythms and increasing vulnerability to depression. Sleep problems are also a common symptom of anxiety disorders. If you’ve had anxiety, you know that feeling of your brain “racing”, making it almost impossible to sleep. And even after falling asleep, you may wake up with anxiety in the middle of the night. Sleep disruption like this can lead to sleep fragmentation, which reduces both the quantity and quality of sleep. Scientists say that individuals with anxiety disorders have high sleep reactivity - sleep reactivity being the degree to which stress disrupts sleep, manifesting as difficulty falling and staying asleep when a person is highly stressed. Compounding this is something called anticipatory anxiety, which is when individuals with anxiety know they’ll have problems falling asleep, and so their anxiety increases when they go to bed, causing sleeplessness, and ultimately a downward spiral of anxiety and lack of sleep. There’s a clear link between sleep disorders, depression, and anxiety. As a result, taking steps to sleep better can have a significantly beneficial effect on quality of life, so it’s important to seek professional help if you’re experiencing sleep problems or think you recognize any of the symptoms discussed above. And fortunately, once diagnosed, sleep disorders are treatable. Tips For Achieving Better Sleep Persistent problems sleeping increase the risk of relapse for those who’ve been treated for depression or anxiety, but practicing healthy sleep habits can reduce those feelings and can have a beneficial effect on your overall mood. Establish a sleep schedule. Creating a routine to sleep can help your brain get accustomed to getting the full amount of sleep. This means having a set wake-up time regardless of whether it is a weekday or weekend. Follow a routine each night. Building a consistent routine such as washing your face and brushing your teeth can reinforce in your mind that it is time for bed. Unplug from devices. Set a buffer to unwind without electronics that can cause mental stimulation. Making it harder to calm thoughts. The blue light emitted from these devices can also decrease melatonin production, taking longer for you to achieve REM. Don’t force it. If you’re still tossing and turning after 20-minutes, consider getting up and stretching, reading a book, or doing something that calms you using soft lights before returning to bed to try again. This will help build a healthier mental connection between being in bed and falling asleep. Diagnosis & Treatment In Conjunction With Mental Health Issues In order to diagnose a sleep disorder, a doctor or mental health professional will gather information about your symptoms, as well as medical and mental health history. They may also order tests, such as a daytime or overnight sleep study to determine a diagnosis. Because of the multifaceted relationship between mental health and sleep, it is common for treatment to include both cognitive behavioral therapy (CBT) and prescription medication. With proper treatment underlying causes of disruption can be addressed; allowing you to achieve better quality sleep. Consider Telebehavioral Health Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re a patient, 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 here & apply. Sources American Psychiatric Association Sleep Foundation Sleep Foundation National Institutes of Health (NIH)

Obsessive-Compulsive Disorder (OCD) may be one of the most misunderstood mental health conditions. It’s estimated that 1 in 100 people in the US lives with OCD, so it’s more common than you think, however, the way it’s often portrayed in the media may not be entirely accurate (think Monica Geller in Friends or Adrian Monk in Monk). In this article, we explain exactly what OCD is and take a look at common stereotypes in an effort to set the record straight. What is Obsessive-Compulsive Disorder? OCD can impact anyone, regardless of age or gender. It can emerge any time from preschool to adulthood, but most commonly appears between the ages of 12 and 20. OCD is a disorder in which people have recurring, unwanted thoughts, ideas, or sensations (obsessions) that compels them to do something repetitively (compulsions). The repetitious behaviors, such as hand washing, checking things, or cleaning, can significantly interfere with a person’s daily life. The key here is that the behaviors / compulsions are a direct result of the recurring, unwanted thoughts and anxiety. They do not occur without each other. Or to put it another way, many people without OCD have stressful thoughts or repetitive behaviors. However, these thoughts and behaviors are usually not linked, and do not typically disrupt your life. A diagnosis of OCD requires the presence of obsessions and/or compulsions that are time-consuming (more than one hour a day), cause significant distress, and impair work or social function. Contrary to popular belief, OCD is not just about hand-washing and being neat. While there are similarities across cases, individual manifestations of the disorder tend to mirror anxieties based on an individual’s life experiences. Surprisingly, people with OCD usually recognize that their thoughts and obsessive impulses are not reasonable. However, the distress caused by these intrusive thoughts can’t be dismissed by logic or rationale. Typical Obsessive Thoughts May Include (But Are Not Limited To): Recurring thoughts about germs; of being contaminated by others or their environment Extreme concern with order, symmetry, or precision Recurring, intrusive thoughts of certain sounds, images, words, or numbers Fear of misplacing or discarding something important, or forgetting to do something important Fear or recurring thoughts of existential crises or death Fear of blurting out obscenities or insults, or of hitting something (loss of control) The compulsions that are linked to or follow repetitive behaviors or activities that a person performs in response to an obsession. In the person’s mind, these behaviors prevent or reduce the distress related to the obsession, and that’s why they do them. Typical Compulsions May Include (But Are Not Limited To): Excessive hand washing, showering, or brushing teeth Repeatedly checking locks, switches, or making sure appliances are turned off Constantly seeking approval or reassurance Repeated cleaning of household objects Ordering or arranging things in a particular way Counting and recounting currency Repeated counting to a certain number OCD-related conditions include hoarding disorder (HD), body dysmorphic disorder (BDD), as well as hair-pulling and skin-picking disorders. Causes Of OCD The exact cause of Obsessive-Compulsive Disorder is unknown, but scientists believe that several areas of the brain may not respond normally to serotonin, a chemical nerve cells use to communicate with one another. In other words, neural miscommunication could be the root cause. Genetics, something we discussed in our previous article, plays a part - if you, your parent, or a sibling, have OCD, there's a 20-45% chance another family member also has it. Like other anxiety disorders, childhood trauma and environmental factors may cause onset OCD symptoms. Myths About OCD So what are the misconceptions about OCD? And where did they come from? As is often the case, OCD myths can stem from pop culture and entertainment. For example, if you saw Leonardo DiCaprio in 2004’s The Aviator, you know the true story of the reclusive billionaire industrialist, filmmaker, and pilot Howard Hughes, whose desire for extreme control over cleanliness and order in his home seemed truly unfathomable. Or if you watched USA Network’s Monk, you saw a brilliant former city detective frequently battling with his OCD tendencies. The problem with these portrayals is that they may not be accurate, and the disorder and its obsessions and compulsions are often treated as a gimmick to a serious condition. Viewers are encouraged to laugh when in reality, it can cause fear and shame to those who live with it. Three Common Myths About OCD, & Why They Don’t Reflect Reality Myth 1: OCD is only about cleanliness and being tidy. A fixation on keeping things clean is just one of the common compulsions of OCD, but not the only one. And not everyone with OCD has this particular compulsion. Triggers related to cleanliness and symptoms related to washing make up only a small part of the range of OCD triggers and symptoms. People can also have obsessions related to a wide variety of things, including losing control, hurting others and themselves, or losing things. Myth 2: OCD isn’t treatable and will never go away. Many people don’t seek treatment because they’re embarrassed; they believe they are alone in their experience and that their symptoms are unique to only them. This can be one reason why it goes untreated. But research proves it can be treated through therapy and prescription medication. It will likely never go away completely but symptoms can be managed so that they stop impacting daily life. In fact, it’s considered one of the most “highly manageable” mental health disorders. Myth 3: We’re all “a little bit OCD'' sometimes. Untrue and in fact, it is an inappropriate expression to use by those who do not have OCD and are unfamiliar with how devastating untreated symptoms can be. Stigma is a systemic problem faced across a variety of mental health disorders, which is why it is so important to realize that words and actions can trivialize those living with it. People with OCD cannot simply “turn it off.” Research has shown their brains are wired differently - results show higher levels of extreme worry and fear that can entirely overwhelm you. Treatment For OCD There are no tests for OCD, however, trained mental health specialists can diagnose it by asking a series of questions that try to get at the three signs of OCD: having obsessive thoughts, exhibiting compulsive behaviors, and whether they get in the way of normal activities. With proper treatment by qualified mental health specialists, people with OCD can lead full and productive lives. Many respond positively to a type of therapy called Exposure and Response Prevention (ERP) therapy, designed specifically to treat OCD. Cognitive-behavioral therapy (CBT) is another effective therapy. These therapies are often prescribed in combination with medication. Finally, many individuals report that support groups provide a safe, understanding place for those with OCD to feel less alone. Consider Telebehavioral Health Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re a patient, 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 here & apply. Sources American Psychiatric Association National Alliance for Mental Illness International OCD Foundation

Most of us know that a good night’s sleep is important to good health. It’s critical to maintaining brain cognition, concentration, and productivity. Sleep also improves immune function, staves off serious conditions like diabetes and stroke, and maintains our ability to deal with the challenges of everyday life. A new study has also found that many of us could be coping with concussion-like symptoms such as confusion, low energy, and memory loss due to a lack of sleep and compounded stress. Participants Included Cadets From U.S. Military Academies & College Athletes The research published in the January issue of Journal Sports Medicine was conducted by the Concussion Assessment, Research and Education (CARE) Consortium, a founding alliance between the NCAA and U.S. Department of Defense. Participants included cadets within U.S. military service academies – who undergo rigorous training and are required to participate in athletics – and students who competed in NCAA sports at 26 U.S. colleges. Study Results Researchers found between 11% and 17% of healthy college or military academy athletes with no history of recent concussion were reporting multiple symptoms – such as memory loss, low energy, and dizziness – that met the criteria for post-concussion syndrome (also known as PCS). The study found lack of sleep, pre-existing mental health conditions, and stress were the most common predictors for these concussion-like symptoms. Furthermore, between 50% and 75% of the athletes surveyed had at least one concussion symptom, with the most common being fatigue, low energy, or drowsiness. Women who participated in the study reported more symptoms than men: among cadets, 17.8% of men and 27.6% of women experienced concussion-like symptoms, and among NCAA athletes, 11.4% of men and 20% of women. The study concluded that a history of depression or ADHD were key contributing factors for NCAA athletes who experienced PCS-like symptoms. "The numbers were high, and were consistent with previous research in this area, but it is quite shocking," said lead researcher Jaclyn Caccese, assistant professor at The Ohio State University School of Health and Rehabilitation Sciences. "These are elite athletes who are physically fit, and they are experiencing that many symptoms commonly reported following concussion. So looking across the general population, they'd probably experience even more." What Are Typical Symptoms? A concussion can affect your memory, judgment, reflexes, speech, energy level, balance, and muscle coordination. Individuals who have had a recent concussion or are experiencing PCS-like conditions may act confused or dazed. Other symptoms can include: Headaches Nausea or vomiting Memory loss Ringing ears Difficulty concentrating Sensitivity to light Loss of smell or taste Fatigue and drowsiness A key takeaway related to those who have not had a recent concussion may be experiencing identical symptoms due to lack of sleep and/or the burden of stress being carried. What Do Experts Recommend? The research was originally designed to gather additional information regarding the effects and recovery of concussion for student-athletes at colleges and military service academies. Concussions are a known problem in sports, particularly contact sports such as football. Scientists who performed the research stated the results have implications for how we treat concussions in college athletes as well as how the general population manages sleep and stress. For example, they suggest athletes recovering from concussions be assessed and treated on a highly individualized basis. In addition, knowing athletes' medical history and baseline symptoms can help clinicians predict which pre-existing factors contribute to concussion recovery times, and ultimately improve treatment and recovery. For those of us who’re not college athletes, self-awareness and recognizing when our sleep cycle is being disrupted or how stress has been negatively impacting our daily lives is essential. Place greater emphasis on addressing the issues as they arise or develop healthier mechanisms for coping with the guidance of a mental health therapist. Difficulty sleeping or stress related to underlying mental health disorders such as anxiety or depression should always be diagnosed by a qualified and licensed behavioral health specialist. Consider Telebehavioral Health Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re someone seeking mental health services, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider wanting to join our network, apply online. Sources Journal Sports Medicine, 01.11.21: Factors Associated with Symptom Reporting in U.S. Service Academy Cadets and NCAA Student-Athletes without Concussion: Findings from the CARE Consortium Concussion Legacy Foundation: What is Post-Concussion Syndrome

Mental health disorders affect more than 25% of the population in any given year, and for a while now, scientists have understood that these disorders arise from a combination of genetic influence and environmental factors. Even early physicians made clinical observations noting the tendency of mental illnesses to run in families. Recently, several new studies have confirmed that psychiatric disorders do indeed have genetic roots. But how much can genetics be a contributing component to your mental health? Which disorders are you more susceptible to and which have no genetic correlation? What The Current Science Says About The Role Genes Play In Mental Health Advances in genomic research have identified hundreds of genetic variations that contribute to a range of psychiatric disorders. Recent studies published in science and medical journals such as Molecular Psychiatry, The American Journal of Psychiatry, and Cell, have confirmed that most major psychiatric disorders have a familial and heritable component. What they found was that no individual gene contributes much to the risk of a disorder; instead, hundreds of genes each have a small effect. The way it works is this: your genes are made up of segments of DNA; and any alteration in the DNA sequence produces a gene variant, which can then increase the risk for a disorder. Specifically, scientists found that the genetic causes of different mental health disorders can range from 20% to 45% for anxiety disorders, obsessive-compulsive disorder, and major depressive disorder; from 50% to 60% for alcohol dependence and anorexia; and from 75% and up for autism spectrum disorder, ADHD, schizophrenia, and bipolar disorder. These studies should not be inferred as an absolute that any one individual will develop a disorder. People with no family history of mental illness can be diagnosed with mental health disorders too. And even for those at higher genetic risk, environmental factors such as poverty, childhood trauma, exposure to certain toxins, substance abuse and others, also play a significant role in whether or not someone develops a disorder, or the severity of the illness. One Example: Bipolar Disorder According to the National Institutes of Health (NIH), irregularities in many genes may combine to increase a person’s chance of bipolar disorder (a disorder associated with episodes of mood swings ranging from depressive lows to manic highs). More specifically, scientists can now predict the chances for getting the illness in this way: there is a one in 100 chance of developing bipolar disorder if you are in the general population; however if one of your parents has it, the chances go to 10 in 100; and if one of your siblings has it, the chances go to 13 in 100. Remember, just having a genetic predisposition to Bipolar Disorder is not enough to trigger its development. Environmental factors must be present also. It’s also important to note that just because someone has a greater chance of the illness, doesn’t mean they will ever develop it. Why Research The Genetics Of Mental Health? Beyond identifying genetic risk variants, a major benefit of this research and its findings is the ability to provide new clues about the biological pathways that contribute to mental illness. Learning how mental health disorders are related at a biological level may inform how we classify and diagnose them in the future. As well, the findings may help develop new treatments that benefit multiple conditions. While we’ve got a good start, scientists all agree that much more research into the genetics of mental health is needed. Until then, it is still recommended during initial sessions with behavioral health specialists to share your family history of mental health in order to better recognize and treat underlying conditions. If you recognize potential symptoms of a disorder, it is important to receive a proper evaluation from a qualified behavioral health specialist, most mental health disorders can be managed through a combination of therapy and/or prescription medication.. Consider Telebehavioral Health Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, apply online. Sources Massachusetts General Hospital: Largest study of its kind reveals that many psychiatric disorders arise from common genes The Journal Nature: The hidden links between mental disorders American Journal of Psychiatry: Psychiatric Genetics Begins to Find Its Footing

We focus so often on the treatment of ADHD (attention deficit hyperactivity disorder) in children, that tend to overlook the fact that just as many adults are living with the condition; experts suggest even more remain undiagnosed. While some children outgrow their ADHD symptoms, up to 70% will continue being treated into adulthood. ADHD in adults follows a slightly different pattern than in children, as symptoms tend to evolve and may become more subtle over time. For example, adults with ADHD tend to have more problems with memory and attention rather than with hyperactivity. Adult Symptoms Of ADHD & The Impact On Daily Life In order for an adult to be diagnosed with ADHD, the must meet the following criteria in accordance to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV): six or more symptoms of inattention that have lasted at least six months, or six or more symptoms of hyperactivity and impulsivity that have persisted at least six months. Specific Symptoms Of ADHD In Adults May Include: Forgetting names and dates Missing deadlines and leaving projects unfinished Chronically late for work or important events Becoming easily distracted and disorganized Low frustration tolerance Putting off boring tasks in favor of more enjoyable activities Trouble multitasking Executive function deficits Excessive activity or restlessness Extreme emotionality and rejection sensitivity Generalized anxiety and mood disorders Blurting out inappropriate or hurtful thoughts The effects of adult ADHD are an overall inability to remain focused to follow through with responsibilities and an overwhelming accumulation of incomplete tasks — impacting careers and relationships over time. Adults With ADHD Often Remain Undiagnosed There is an abundance of materials focused on the general education of signs to look for in children with ADHD, but not nearly as much on awareness for similar symptoms and diagnosis in adults. That’s why some experts believe up to 75% of adults who have ADHD don’t know they have it. Without knowledge or outreach for treatment, day to day life can be much more challenging and lead to false feelings of inferiority. In fact, studies show that substance abuse as well as other compulsive bad habits impact a far higher percentage of adults with undiagnosed ADHD than the general population. So What Can Be Done? We need to better inform the public and broaden the conversation surrounding ADHD to include the adult population and eliminate common misconceptions & stereotypes that surround ADHD as “only a childhood condition affecting hyperactive kids”. If you are able to recognize these symptoms in yourself or someone you know, consider checking in with a mental health specialist who can conduct a clinical assessment to diagnose ADHD. Neuropsychological tests are often used for diagnosis. These can include timed, computer-based tests to measure attention and problem-solving skills. Neuropsych testing is not essential to making a diagnosis, but it can help shed light on how ADHD can be affects your daily life. It can also uncover potential coexisting conditions. Once Diagnosed, Adult ADHD Is Highly Treatable Getting the right diagnosis and proper treatment can be life-changing. Adults with ADHD don’t outgrow the condition, but most learn to manage it to great success. Standard treatments for ADHD in adults usually involve a combination of medication, education, skills training and psychological counseling. As with most treatments, it may take some time to determine what works best for each person, so stick with it. Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To Licensed Behavioral Health Professionals? Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! Sources Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): Diagnosis of ADHD in Adults American Family Physician: Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults Harvard Medical School - Harvard Health Letter: Recognizing and managing ADHD in adults

Last week, we wrote about how a good social support system of friends can help strengthen our mental health. Friends benefit us by providing a sense of belonging, keeping us motivated, and supporting us through challenging times, among other things. So in this article, we thought it would be a good idea to demonstrate specific ways that friends and family members can support those struggling with mental health issues, as well as to highlight support resources in the community beyond friends and family. How To Support Friends Or Family With Mental Illness First, know that there is no ‘one size fits all’ way to support someone with a behavioral health issue. How you provide support depends on their issues and needs, as well as your relationship with them. But at the top of the list is knowing the warning signs of mental health problems; in fact, you may be able to spot these before someone recognizes them in themselves. For example, if someone withdraws from social interaction, or has unusual problems functioning at school or work, or has dramatic changes in sleep and appetite, it may be a good idea to encourage them to see a medical professional to rule out specific mental health issues. The following are additional ways to offer support: Offer to be available for support. They may not even realize you are ready to be there for them, so make sure that they know they are not alone. Reassure them that you care about them – even if they don’t always feel like talking or being with you, it can be a comfort just to know that you care. Ask what you can do to help. You can leave this open-ended (“I want to know how I can best support you.”) or suggest specific tasks that might be helpful (“Can I drive you to your appointment?”). Don't try to diagnose or second guess their feelings. Try not to make assumptions about what is wrong or jump in too quickly with your own diagnosis or solutions. Listen patiently. Allow the person to talk openly with you without hearing dismissal of their thoughts or feelings. If they choose to share personal information with you, don’t share it with others. (However, if you hear talk of suicide, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1) Stay calm and low-key. It’s possible that the person you care for may have very challenging and complex behavior. Talk about suggestions for wellbeing. For example, ways of de-stressing or practicing self-care like exercising, eating a healthy diet, and getting a good night’s sleep. Experts advise that in supporting a friend with mental health issues, you don’t need to be available 24/7. Nor should you put yourself in danger to watch over your friend, or stay in a relationship that’s not working for you. At the end of the day, you aren’t responsible for another person’s mental health, so take care of yourself while you are taking care of them. Finding Local & National Support Mental Health Resources Beyond the support of family and friends, there are also community resources for mental health, and even resources at the national level – all of which can provide helpful information and services. To find help at a local level, reach out to medical professionals, and also check your local library, place of worship, or community center to learn about nearby resources. The National Association of State Mental Health Program Directors lists the names and contact information of public officials who head up each state’s mental health program. Also consider joining a virtual or in-person support group to connect with people who are facing similar mental health diagnoses or are caring for someone with similar issues. The National Alliance on Mental Illness (NAMI) has an online resource that can direct you to local support groups, as does the Depression and Bipolar Support Alliance. At the national level, we have a Mental Health Crisis Resource Center to locate not-for-profit organizations and government entities provide high-quality information and resources for various types of behavioral health issues. Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To Licensed Behavioral Health Professionals? Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! Sources American Psychiatric Association: Helping a Loved One Cope with a Mental Illness Psychology Today: How to Help a Loved One with Mental Illness National Alliance on Mental illness (NAMI): Community Support Builds Better Lives

It may seem obvious that having supportive friends makes us feel better, but did you know scientists have proven a link between our friendships and mental health? In one study, people who lacked social support were more likely to suffer from mental health disorders such like anxiety and depression. In another study, the presence of social support systems correlated to faster remission of major depressive symptoms. As the saying goes, friendship - defined as affection, emotional attachment, intimacy, and trust between two people - is “having someone who understands your past, believes in your future, and accepts you just the way you are.” But why is this? How can something as simple as having friends have such a positive psychological impact on us? Five Mental Health Benefits Of Friendship Humans are social animals by nature. The power of true friendship can be invaluable, but at times, we need a little extra help. If you are living with a mental health condition such as depression or anxiety, you know how comforting it can feel to just talk with someone. Good friendships also have additional benefits, such as increased feelings of belonging, increased levels of happiness, as well as improved self-worth and confidence. Here are five benefits of friendships that can help our mental health. Improve Our Mood. Friends can boost our mood by being there for us, whether it’s virtually or socially distanced. There is a simple pleasure in being in the company of other people we like, and it can be a relief to talk to someone else about how you’re feeling. Friends can also provide a distraction: a good laugh with friends releases endorphins (the feel-good hormones) into our bodies. Perhaps even better, research suggests maintaining strong friendships can help you cope with stress more effectively and help lower your chances of facing some types of stress in the first place. Provide A Sense Of Belonging. We all want to know that we matter to others — and that our life has purpose. Knowing you have a supportive network of friends can help you feel more secure in your life. Even when your friends are in different places, you still have those connections to trusted individuals who always have your back. And when you care for others, you take on the responsibility of offering compassion and emotional support, which can make you a stronger, better person too. Avoid Feelings Of Loneliness. Loneliness and social isolation can affect mental and physical well-being. A chat with friends can reduce the stress of feeling alone and provide us with a much-needed distraction. And even when you can’t get together in person, simply knowing you share a strong connection with friends can help you feel less alone. Keep Us Motivated. If you want to create positive change in your life, friends can help you maintain your resolve to practice healthier habits. They’ll cheer you on and might also support your choices by making changes with you. This encouragement can boost your self-confidence, increasing your chances of success. And friends can also help us make changes for the better by providing good examples. Support Us Through Challenges. A good friend can help cheer us up and offer support when we need it most. Knowing that support is available can improve feelings of security and help to protect against compounded stress. In fact, research suggests that if you have strong friendships, you’ll probably find it easier to handle the challenges that life throws at you. This study also found that while family support also helps boost immediate resilience, good friendships are an even better predictor of greater resilience throughout life. Talking To Friends About Mental Health Issues So there are many positive impacts of having good friends. No matter what you’re going through, healthy and close friendships encourage better mental health and well-being. But sometimes it can feel hard to talk to them about mental health issues. If you decide to tell your friends about your mental health condition, don’t be frustrated if they don’t understand right away. Answer questions they may have and remember that they are trying to understand your experience in their own way. If they are still unable to grasp it, be thankful for your time with them and the effort taken to try and comprehend what you’re experiencing. If you are the friend or relative, consider doing some more research to learn about the condition, and remember to check in on your friend regularly, your support can make a huge difference. Getting Together Safely During The Pandemic Recently the CDC has amended its guidelines for casual get-togethers with friends. While most of the time, we must continue to socially distance and wear masks, we may now “visit with other fully vaccinated people or those who have a low risk of serious infection indoors without wearing masks or staying 6 feet apart.” Read more about CDC guidelines here. Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To Licensed Behavioral Health Professionals? Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! Sources National Alliance on Mental Health (NAMI): Friendship and Mental Health PLOS One: Social network structure is predictive of health and wellness NIH: The correlation of social support with mental health: A meta-analysis

It’s estimated that almost half of all Americans will experience a mental health issue at some point in their lives. We’ve discussed some of these issues in previous posts - Generalized Anxiety Disorder, Major Depressive Disorder, PTSD, Bipolar Disorder to name a few. Although research shows that 76% of Americans believe behavioral health is just as important as physical health, and 56% want to access a mental healthcare provider, there are many barriers. This article discusses those hurdles, as well as possible solutions to getting every individual the care they deserve. Reasons For Not Being Able To Access Behavioral Health Services Lack of access to behavioral health providers does not come as a surprise to most Americans. 74% of us do not believe such services are accessible for everyone, and almost half of us (47%) believe options are limited. This is a situation that must be addressed, as without readily accessed mental health services, there can be a significant impact on jobs, relationships, and overall physical health on the individual level. And these individual impacts ultimately affect the economy as a whole. There are a multitude of reasons for not being able to access behavioral healthcare. Shortage Of Providers. There are mental health professional shortage areas in every state, according to a study by the Kaiser Family Foundation. This same study showed that nearly 40% of Americans live in regions with a shortage of mental health providers, leading to limited or delayed access to services. Regional shortages cause long wait times (38% of those trying to get help waited longer than a week for care), and some people simply give up rather than wait. Unfortunately, one of the main issues resulting from the behavioral healthcare shortage is that 60% of mental healthcare visits are through a primary care provider and not the specialty care that is necessary to truly address mental health. Transportation To Facilities. Related to the above is the fact that not all individuals have reliable transportation to healthcare - whether that is because of the distance they have to travel to seek help or the fact that they have their own mobility issues. This issue often impacts low-income communities, disabled individuals, and those who live in rural areas. 46% of patients report that they or someone they know has had to travel more than an hour to access care in a timely manner. Lack Of Awareness Or Understanding Of Where Or How To Get Help. While most Americans do try to find care, research shows that 29% who wanted treatment for themselves or loved ones did not seek it because they didn’t know where to go. Leading to a greater need for visibility and education to help identify behavioral health issues and understanding the right type of care to seek for treatment. Stigma. Several weeks ago, we wrote about the stigma around behavioral health that causes people to avoid or delay seeking treatment due to their perception that they may be treated differently, or that seeking treatment may impact their jobs or social status. In fact, research shows that nearly one-third of Americans worry about others judging them when they told them they sought mental health services. And a study specific to older adults found that the most commonly reported barrier to treatment for that age group was the personal belief that "I should not need help". How Virtual Behavioral Health Care Can Help So how do we address this problem? The issues are complex and will likely require further study and changes to public policy and education. But virtual behavioral health care (also called telebehavioral health) may be one of the solutions. Virtual care expands access to providers, eliminates the problem of transportation or mobility, reduces wait times, and eases concerns about the stigma since visits take place in the privacy and convenience of patients’ homes. The CDC recently concluded that “telehealth… can improve health care access outcomes, particularly for chronic disease treatment and vulnerable groups.” Another published, peer-reviewed study found 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.” And the good news is that 45% of Americans who have not already tried virtual behavioral health services said they would be open to the idea of trying it to address a current or future mental health need. Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To A Licensed Mental Health Professional? Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! Sources UnitedHealthcare National Council for Behavioral Health NIH

Anxiety is a common disorder - an estimated 31.1% of U.S. adults experience anxiety at some time in their lives. In our previous post, we defined Anxiety Disorders as “6 months or more of chronic, exaggerated worry and tension that is unfounded, or much more severe than the normal, everyday worry most people experience”. This can manifest in symptoms such as feeling restless, irritable, or on edge’, having a hard time concentrating, feeling tired all the time, and experiencing headaches stomaches, or other muscle aches. Women Are Diagnosed With Anxiety Disorders At 2X The Rate Of Men Multiple studies have found that women are twice as likely as men to be diagnosed with an Anxiety Disorder — and this holds true for adult women as well as girls under 18. In addition, women diagnosed with one type of Anxiety Disorder are more likely than men to be diagnosed with an additional Anxiety Disorder. Researchers have also found differences in the way women experience anxiety: Women report more body-based symptoms - specifically, women who have panic attacks report more shortness of breath and faintness. Panic Disorder, a type of Anxiety Disorder, appears to be more chronic in women. Women report a greater number of worries and more separation anxiety than men. Women tend to deal with their anxiety by avoidance, while men more often turn to substance abuse. Multiple Theories As To Why Women Are Diagnosed More Than Men Some researchers theorize that women’s monthly cycle can affect anxiety levels, or that female hormones may contribute to a more quickly activated, longer-acting fight-or-flight response, or that the hormone testosterone — more abundant in males — may help ease anxiety symptoms for men. Other studies revealed women are more likely to experience physical and mental abuse (as children and as adults) than men, and abuse is commonly linked to the development of anxiety disorders. Digging Deeper Into The Anxiety Gender Gap However, one of the biggest differences researchers found is that women are more likely than men to seek help when they experience symptoms of anxiety, and therefore get diagnosed. So the question becomes: are women actually experiencing anxiety more often, or are they more likely to discuss their symptoms with a health professional than men ? In other words, is there a societal influence on the levels of Anxiety Disorder diagnoses between genders? In his book, Invisible Men: Men's Inner Lives and the Consequences of Silence, author and professor of psychology at Clark University, Michael Addis postulates that "when men struggle with fear, and depression, it can tend to come out more as anger and aggression. And men in our culture are more encouraged to use, let's say, strategies such as substance use... to suppress those emotions...They are more encouraged to talk to their friend and to bottle it up, and to perhaps kind of withdraw and become passive” rather than reporting symptoms to a medical professional. In fact, a recent study looked at whether male leaders within organizations are penalized by asking for help, and found that in fact, sometimes men “may face backlash when they don’t adhere to masculine gender stereotypes — when they show vulnerability, act nicer, display empathy, or express sadness.” Unfortunately, this may play out by by impeding mens access to treatment, and therefore their overall mental health. Ultimately, whether in men or women, early recognition of anxiety symptoms is important so that treatment can start. A combination of cognitive behavioral therapy, medication and lifestyle changes (more physical activity, improved eating and sleeping habits) has been shown to be effective in reducing most symptoms of anxiety. Considering A Career In Telebehavioral Health Or Want To Access Virtual Care With A Licensed Professional? Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! Sources National Center for Biotechnology Information - National Institutes of Health: Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness Journal of Brain and Behavior: A systematic review of reviews on the prevalence of anxiety disorders in adult populations NPR: Understanding How Anxiety Might Be Different For Men

A few months ago, we wrote about Post-Traumatic Stress Disorder, commonly known as PTSD, a mental health disorder that occurs after experiencing or witnessing a traumatic event such as a natural disaster, accident, assault, terroristic act, or military combat. Common symptoms of PTSD involve re-experiencing the trauma (e.g., nightmares, flashbacks, or emotional flooding), attempts to avoid reminders of the event, hyperarousal (e.g., feeling constantly on edge), and distressing thoughts or emotional reactions. In order to be diagnosed with PTSD, symptoms need to last for at least two weeks and interfere with daily functioning. It’s estimated that almost 4% of the general US population is affected by PTSD — a number that rises to 55% of those who are serving or have served in the military. For those experiencing, living with, or treating someone with PTSD, it may be helpful to learn how trauma affects specific parts of the brain in order to better understand the symptoms and treatment options. PTSD Is Unique Among Psychiatric Diagnoses First, it's important to note that PTSD is unique among psychiatric diagnoses because of the significance placed on the cause of the condition (i.e., the trauma itself - more on that below), rather than merely the condition. In fact, with the advent of DSM-5, PTSD is no longer classified as a type of Anxiety Disorder but its own designation: Trauma and Stressor-Related Disorders — which acknowledges that its onset is preceded by “exposure to a traumatic or otherwise catastrophic, adverse environmental event”. Start By Understanding How Trauma Affects The Brain Over the past several decades, research using neuroimaging has enabled scientists to see that PTSD causes distinct biological changes in the brain; and in fact, functioning is impaired in areas responsible for threat detection and response, and emotion regulation — which accounts for most outward PTSD symptoms. Not everybody with PTSD has exactly the same symptoms or same brain changes, but there are definite “typical” observable patterns that can be seen and treated. To put it simply, when trauma first occurs, our “reptilian brain” takes over — that part of the brain known as the brain stem which is responsible for the most vital functions of life (breathing, blood pressure, heart rate, etc.). The brain stem kicks in the “fight or flight" response and all nonessential body and mind functions are shut down so that we can focus only on what we need to survive. Then, when the threat ceases, the parasympathetic nervous system steps in again and resumes those higher functions that were recently shut down. However, for some trauma survivors, after effects remain, which we now know is PTSD. In these people, the brain’s “threat and alarm system” becomes overly sensitive and triggers easily, which in turn causes the parts of the brain responsible for thinking and memory to stop functioning correctly. When this occurs, it’s hard to separate safe and “normal” events happening in the present from dangerous events that happened in the past. PTSD Impacts Three Parts Of The Brain Significantly, Causing Disruption To Normal Life Research shows PTSD mostly impacts three parts of the brain: the amygdala, the hippocampus, and the prefrontal cortex (PFC). Here’s how these three parts of the brain work (or don’t work) together to cause symptoms of PTSD: Amygdala: a collection of nuclei located deep within the temporal lobe (the lobe of the brain closest to the ear). The amygdala is designed to detect threats in the environment and activate the “fight or flight” response, and then activate the sympathetic nervous system to help deal with the threat. Those with PTSD tend to have an overactive amygdala, causing irrational thoughts and primal reactions. For example, a harmless loud noise could instantly trigger panic. Prefrontal Cortex: covers the front part of the frontal lobe located just behind the forehead. The PFC is designed to regulate attention and awareness, make decisions about the best response to a situation, determine the meaning and emotional significance of events, regulate emotions, and inhibit dysfunctional reactions. In those with PTSD, the PFC is underactive, meaning that regulation of emotion and dysfunctional reactions does not occur when it should. An overactive amygdala combined with an underactive prefrontal cortex creates a perfect storm, causing those with PTSD to feel anxious around anything even slightly related to the original trauma, and/or have strong physical reactions to situations that shouldn’t provoke a fear reaction. Hippocampus: a complex brain structure also located deep in the temporal lobe. The hippocampus regulates the storage and retrieval of memories, as well as differentiating between past and present experiences. After a trauma, the hippocampus works to remember the event accurately and make sense of it. But because trauma is typically overwhelming, all the information doesn't get coded correctly, meaning that someone with PTSD may have trouble remembering important details of the event and/or find themselves overthinking a lot about what happened because the hippocampus is working so hard to try to make sense of it. Consequences Of PTSD Brain Dysfunction On Quality Of Life Understanding how the after-effects of trauma impact the brain so significantly helps explain why PTSD causes such serious disruption in daily functioning. PTSD often affects the ability to have healthy, satisfying relationships or tolerate uncertainty and rejections without excess distress. It causes sleep disturbances, negative mood, anxiety, and attention/concentration difficulties that often interfere with academic or career success. Other Disruptive Symptoms Of PTSD Include: Extreme startle response Heart Palpitations Shaking Nightmares Hypervigilance Hyperarousal Reactive Anger Impulsivity Increased Fear Decreased Positive Emotions Self-Blame Detachment From Others PTSD also often occurs with other related mental and physical health conditions, such as depression, substance use, and memory problems. PTSD Is Treatable The good news is that PTSD is treatable by trained behavioral health professionals. Treatment may include a combination of medications and behavioral therapies which have been proven effective on those with PTSD. And it goes without saying that each PTSD treatment and management plan should be tailored to meet an individual's specific needs since everyone is impacted differently. The important thing to take away is that PTSD is real, it is explained by highly-studied changes in the brain, and that millions suffer from it. Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To Licensed Behavioral Health Professionals Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! Sources National Center for Biotechnology Information - National Institutes of Health (NCBI - NIH): Traumatic stress: effects on the brain American Psychiatric Association: What is PTSD? US Dept. of Veterans Affairs: PTSD History and Overview

Research shows that over half of the people who need mental health care in the United States go untreated. A variety of reasons can contribute to this, including lack of mental health professionals, access in a given geographic region, or even limited insurance coverage. More often than not however, the common barrier to overcome involves our own stigmatization of what seeking mental health services means about us. Study after study reveals that many people avoid or delay seeking treatment due to their perception that they may be treated differently, or that seeking treatment may impact their jobs or social status. Despite Progress, Studies Show Many Still Have A Negative View Of Mental Illness According to the American Psychiatric Association, “a review of studies on stigma shows that while the public may accept the medical or genetic nature of a mental health disorder and the need for treatment, many people still have a negative view of those with mental illness”. Another study concluded "there is no country, society or culture where people with mental illness have the same societal ranking as those without mental illness." These views and perceptions cause public and self-stigma around mental health issues: Self-Stigma is internalized negative attitudes people with mental illness may have about their own condition. Public Stigma is negative or discriminatory attitudes that may be held by others about mental illness. Media Stereotypes Contribute To The Stigma The media has been guilty of exploiting both types by sensationalizing mental health disorders in an effort to amplify character personality traits or storytelling. A study revealed how entertainment and news media dramatize, distort, or over-simplify mental illness. The portrayals are often overly dramatic, distorted, and over-simplified characterizations that emphasize danger and unpredictability, or describe people with mental illness as ‘helpless’ with little chance of recovery. We can all probably think of a news story, movie, or series that distorted characterizations. The popular Netflix series “Behind Her Eyes”, based on a novel of the same name, is a good example of a simplistic and negative portrayal of stereotypical (and not inherently true) characteristics related to mental illness and trauma, which propels the notion of hopelessness and acts as a deterrent by someone wanting to seek help with their symptoms but because don’t want to “be like the characters” . Fortunately, people are starting to recognize the media’s role in stigmatization and are proposing steps to address it. More on that below. What Are The Harmful Effects Of Stigma Around Mental Health Issues? As you can imagine, the most harmful effect of stigma is a reluctance to seek help for mental illness or maintaining a regular treatment plan. Other negative impacts include: Worsening Of Mental Health Conditions Reduced Hope Lower Self-Esteem Self-Sabotage Impaired Recovery Social Isolation Difficulties At Work And In Relationships How Do We Address The Stigma Around Mental Health Issues? The good news is that many influential organizations and institutions are aware of the problem and are working hard to develop ways to address it. The two approaches that look to have the greatest impact are: Educating the public broadly to alter stereotypical stigmatizing beliefs and attitudes. Enhancing individual skills for coping with self-stigma through improvements in self-esteem, self-empowerment, and improved help-seeking behavior. On the public side, experts have suggested and are already making in-roads in implementing required mental health issues training for journalists, including expert input from psychiatrists in movie or TV productions (and including disclaimers or further information at opening or closing credits), using non-individualized descriptions of mental illness (i.e., “a person with an addiction”, rather than “an addicted person”), and using mental-health terminology with more precision, fairness, and expertise. On the individual side, the National Alliance on Mental Illness (NAMI) has come up with some tips to guide conversations with those who may be feeling stigmatized, and to improve our own potentially-stigmatized thinking about our mental health issues: Don’t Underestimate The Unfortunate Power Of Self-Stigma. Assume that your family member, friend, or patient is experiencing self-stigma, given its prevalence. Try to identify and understand its potential consequences. We often don’t want to admit that stigma impacts us as much as it does. Consider if you have made stigmatizing comments, even if unintentionally, and be prepared to recognize this behavior. Use Facts & Resources To Prove That Common Stigma Examples Are False. Talk about common examples of stigma to show your familiarity and experience with them. You may also note common emotional reactions triggered by stigma, for example, sadness and anger. Be Aware That Although It May Not Seem Reasonable For Them To Believe Stereotypes To Be True, They May Still Be Feeling Them. Be cautious about delegitimizing, diminishing, or dismissing emotions by saying things like, “you shouldn’t feel that way” or “why do you feel that way?” This may provoke an emotionally defensive response. When Someone Is Willing To Discuss Their Self-Stigma, Simply Listen. Empathize and validate their emotions. Engaging with peers, including conversations about stigma, can help normalize the feelings associated with self-stigma and allow for a “collaborative” resistance to stigma. Increased Availability Of Telebehavioral Health Services Can Also Help Alleviate The Stigma Around Mental Health The recent increased availability of telebehavioral health services has also been shown to help decrease self-stigma in accessing treatment for mental health issues. Since people don’t have to leave their house to access mental health professionals, no one is aware they’re receiving treatment. For those who worry about being treated differently because of their mental illness, this extra level of privacy has had significant positive effects. Virtual behavioral health services obviously also increase access for those with mobility issues or who live in areas that don’t have enough mental health providers. Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To Licensed Professionals? Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment online or call our live support for assistance in scheduling care today! Sources Mental Health America (MHA): Access to Care 2020 National Alliance on Mental Health (NAMI): The Many Impacts of Self-Stigma American Psychiatric Association: Stigma and Discrimination Around Mental Health

Last week we talked about how to spot the warning signs of mental health issues in children and adolescents. This week, we’ll address how to go about finding the mental health professional that can best help. One in six children in the U.S. between six and seventeen years old have a treatable mental health issue such as Depression, Anxiety, or Attention-Deficit/Hyperactivity Disorder (ADHD), so understand that you are not alone - there are many parents and caregivers looking for help for a child or adolescent in their lives. But where to start? There are a bewildering array of specialists who can help. To help you sift through the wide-range of information out there, we’ve provided a list of the different types of professionals who can diagnose and treat your child, as well as questions to ask those providers during your search. Getting Started For most parents and caregivers, consulting your family or child’s physician can be a good first step. The benefit to starting with someone who knows your child is that they may be able to confirm or recognize when behavior is beyond the typical range. They can also conduct medical testing to rule out possible non-psychiatric causes for the symptoms you’ve noticed. The disadvantage is that family physicians or pediatricians may have limited experience in diagnosing psychiatric and developmental disorders; or may not have the proper time to allocate for lengthy assessments often required for accurate diagnosis. Best practices in diagnosing children and adolescents include using rating scales to get an objective take on symptoms, as well as collecting information from multiple sources, including the child, caregivers, teachers, or other adults in their lives. Other types of mental health professionals may be better able to assess and treat your child. Understanding The Different Types Of Mental Health Professionals Most professionals who diagnose and treat mental health issues in children and adolescents have at least a master's degree or more advanced education, training and credentials. Below you'll find some of the most common types of providers. Child & Adolescent Psychiatrist: A medical doctor with specialized training in general psychiatry, psychiatric diagnosis and treatment in young people; able to diagnose the full range of psychiatric disorders recognized in the Diagnostic and Statistical Manual (DSM); fully qualified if they have completed national examinations that make them board-certified in child and adolescent psychiatry as well as general psychiatry; can prescribe medication. Psychopharmacologist: A medical doctor who specializes in the use of medications in order to affect feelings, cognition, and behavior. Although they specialize in the use of medications, they should know when other kinds of therapy should be integrated with medication into the treatment plan and be able to refer patients to other professionals for that therapy. Child Psychologist: Trained to diagnose and treat psychiatric disorders, but are not medical doctors so cannot prescribe medication; have a doctoral level degree and may hold either a PhD or a PsyD; often work together with psychiatrists to provide care to patients who benefit from a combination of medication and cognitive behavioral therapy; can coordinate necessary evaluations and assessments. Neuropsychologist: Psychologists who specialize in the functioning of the brain and how it relates to behavior and cognitive ability; have completed post-doctoral training in neuropsychology with either a PhD or a PsyD. They perform neuropsychological assessments, which measure a child’s strengths and weaknesses over a broad range of cognitive tasks, and provide results in a report which forms the basis for developing a treatment plan. Pediatric Psychiatric Nurse Practitioner: Has either a master’s or a doctorate, and can prescribe medication depending on the state; has training in treating and monitoring children and adolescents with psychiatric disorders; may work as part of a team in a pediatricians’ office, or practice independently. School Psychologist: Trained in psychology and education and may receive a Specialist in School Psychology (SSP) degree; can identify learning and behavior problems, and evaluate students for special education services. Social Worker: A licensed clinical social worker (LCSW) has a master’s degree in social work and is licensed by state agencies; required to have significant supervised training; does not prescribe medication, but may work with the family and treating physician or psychiatrist to coordinate care. Questions To Ask Prospective Mental Health Specialists It's especially important to look for a child or adolescent mental health professional who has the right background and experience to treat the specific issues your child is exhibiting. Arming yourself with the knowledge to be able to ask the right questions and know what to look for in a professional will help you feel more confident that you are getting a specialist that's right for your child. Ask the following questions when meeting with prospective treatment providers: Tell me about your professional training? Are you licensed, or board-certified, and if so, in what discipline? How much experience do you have diagnosing children whose behaviors are similar to my child? How do you arrive at a diagnosis? What evidence do you use? Do you provide the treatments you recommend, or do you refer to others? How will you involve the family in the treatment? Will you be in contact with my child’s teacher or guidance counselor? How long do children usually stay in treatment with you? What are your thoughts about medication? Can I speak with a parent whose child has worked with you? Looking For A Qualified Mental Health Specialist For Your Child Or Adolescent? Telemynd is a nationally delegated telebehavioral health provider. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists – all the specialists discussed above – who can evaluate, diagnose and provide treatment for mental health issues in children and adolescents from the convenience of home. Find your current insurance provider to request an appointment today. Sources National Institute of Mental Health (NIMH): Children and Mental Health American Academy of Child and Adolescent Psychiatry: Family Resources

According to the CDC, it’s estimated that one in six children in the U.S. between the ages of 6 and 17 has a treatable mental health issue such as Depression, Anxiety or Attention Deficit/Hyperactivity Disorder (ADHD). Mental health disorders in children and adolescents are generally defined as delays or disruptions in developing age-appropriate thinking, behaviors, and social skills. These issues can contribute to difficulty in school and in relationships with friends or family. The earlier a diagnosis is determined, a treatment plan can be started. Studies have shown that early treatment can help prevent more severe, or lasting problems. However, that’s sometimes easier said than done, as it can be hard to discern indicators of underlying mental health issues in children and teens from typical childhood “growing pains”. This article will help you learn what symptoms to watch for. Common Mental Health Issues In Children & Adolescents The most common behavioral health disorders experienced by children and adolescents fall into the following categories: Anxiety disorders Depression and other mood disorders Obsessive-compulsive disorder Attention-deficit/hyperactivity disorder (ADHD) Autism spectrum disorders Eating disorders Schizophrenia and related psychotic disorders (but to a much lesser degree) Compounding the complexity of identifying common issues is the fact that it’s very common for children and adolescents to have symptoms that cut across multiple disorders. For example, more than 25% of children with ADHD also have Anxiety, and another 25% meet the criteria for Depression and other Mood Disorders. Additionally, even though children can experience the same mental health issues as adults, their symptoms may be different. Mental Health Issues In Children May Be Hard To Identify; Therefore Initial Evaluations Should Be Done By Clinicians Who Specialize In This Age Group Evaluation of children and adolescents with mental health symptoms is typically more complex than that of adults. According to the National Institutes of Mental Health (NIMH), evaluation differs in the following ways: Developmental context is critical when evaluating children; for example, behaviors that are normal at a young age may indicate a serious mental disorder at an older age. Children exist in the context of a family system, and that system has a significant impact on their symptoms and behaviors; for example, children living in a family with domestic violence or substance abuse may superficially appear to have one or more mental health issues. In these cases, clinicians rely on direct observation, corroborated by observations of others, such as other relatives and teachers, to determine whether to make a true mental health diagnosis or not. Developmental and behavioral problems, like poor academic progress, or delays in speech and language can sometimes be difficult to distinguish from those that are in actuality due to a mental health disorder. In these cases, it's not unusual for formal developmental and neuropsychological testing to be recommended as part of the evaluation process. Watch For These Warning Signs Of Mental Health Issues In Children & Adolescents So how do you know if a symptom is just part of being a kid, or should be treated as a mental health symptom? How do you know when to request a formal evaluation for potential mental health issues? According to the National Institutes of Mental Health (NIMH), children and adolescents may benefit from an evaluation (and ultimately treatment) if they have more than one of these symptoms: Have frequent tantrums or are intensely irritable much of the time Talk about fears or worries frequently Complain about frequent stomach or headaches with no known medical cause Are in constant motion and cannot sit still Sleep too much or too little, have frequent nightmares, or seem sleepy during the day Are spending more and more time alone, are not interested in playing with other children or have difficulty making friends Struggle academically or have experienced a recent decline in grades Repeat actions or check things many times out of fear that something bad may happen. Have lost interest in things that they used to enjoy Fear gaining weight, or diet or exercise excessively Engage in self-harm behaviors (e.g., cutting or burning) Smoke, drink alcohol, or use drugs Engage in risky or destructive behavior alone or with friends Have thoughts of suicide Have sudden periods of highly elevated energy and activity, and require much less sleep than usual Say that they think someone is trying to control their mind or that they hear things that other people cannot hear Have You Noticed Any Of These Warning Signs In A Child Or Adolescent In Your Life? Telemynd is a nationally delegated telebehavioral health provider for Tricare members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who can evaluate, diagnose and provide treatment for mental health issues in children and adolescents from the convenience of home. Click here to find your current insurance provider to request an appointment today! Sources CDC: Data and Statistics on Children’s Mental Health Merck Diagnostic Manuals: Overview of Mental Disorders in Children and Adolescents

The Covid-19 pandemic has led to a dramatic increase in the use of virtual mental health services, (also known as telemedicine or telebehavioral health). The lockdowns and fear of infection have left patients in need of more care, yet with little choice but to move away from in-person care, and clinicians to quickly figure out how to adapt to new technology to order to offer it. The CDC has urged greater adoption of telemedicine, saying it “can facilitate public health mitigation strategies during the pandemic by increasing social distancing. These services can be a safer option for clinicians and patients by reducing potential infectious exposures.” Among the benefits, many clinicians are finding that telemedicine has allowed them to make behavioral health access available to more patients than ever before – which has positive implications for addressing the well-known shortage of mental health services in the US (which we wrote about in last week’s blog). Studies Show Patients Prefer Virtual Visits With Their Clinicians How well does telebehavioral health work? And are patients receptive to it? A resounding ‘yes’ say multiple studies done over the past few years. Overall, most show virtual mental health care to be as effective as in-person care in treating disorders such as Depression, Anxiety, and PTSD. For example, a 2016 meta-analysis of 452 studies of telepsychiatry found high patient satisfaction and quality equal to in-person care. A 2020 Veterans Administration study found telemedicine was as effective as in-person office-based care for treating Depression and PTSD in veterans and military personnel. And in another recent study on telebehavioral health, Accenture reported that 46% of patients “would choose to receive mental health appointments virtually.” What Are The Benefits To Telemedicine When Treating Mental Health Issues? Obviously, telemedicine isn’t appropriate in some cases – for instance in most emergency situations we recommend patients seek immediate help. But for many others, the convenience and accessibility make Telemedicine a preferred care solution. Benefits for patients and clinicians alike include: Improves affordability of care. Enables screening and evaluations to be done virtually, saving time, and getting patients quicker access to care. Offers more access for those with chronic conditions and medication management needs. Expands access for patients who have difficulty accessing care (e.g., those who live in rural areas, older adults, or those with limited mobility). Allows access to residents in long-term care facilities or other specialized residential facilities. Enables access to mental health specialists and specialized treatment centers that normally are geographically distant from some patients. Provides more personal care: patients receiving care from the comfort of their own homes feel more relaxed and open to new ways of thinking. Helps remove the “stigma” of mental health: patients can seek care from their homes rather than having to drive to an office where they may feel more “out in the open” or “exposed”. In addition, telemedicine has these further benefits to clinicians: Clinicians don’t need the overhead of a brick & mortar practice. Enables greater flexibility in scheduling and a better work-life balance. Removes the need to commute. For those clinicians who want to and are able to travel, they can see patients from virtually anywhere within the country. With Telemedicine, Clinicians Can Be Better At What They Do With all its benefits, study after study reveals that telemedicine is now a fundamental component of our healthcare environment. The American Journal of Managed Care says it predicts that telemedicine will continue to gain adoption and become a staple of modern-day patient care, even post-pandemic. And given that, telemedicine with an easy-to-use, award-winning EHR platform like Telemynd is a great way to expand your practice geographically and demographically - allowing you to reach new populations of patients you may not have had access to before. And With Telemynd, Clinicians Build A Practice On Their Terms Telemynd clinicians say things like “...plenty of referrals to choose from so my caseload was full within two months. Gentle entry into telehealth with user-friendly EHR”, and “...work-life balance… family and community atmosphere even though I am states away”, and “...feeling like you did something worthwhile that day”. If you’re a mental health professional and are looking for a way to expand your career or practice, Telemynd is a nationally delegated telebehavioral health provider offering a better way to see patients and deliver care through our secure cloud-based solution. Check out more recent reviews from your peers, and consider joining our network with access to millions seeking telebehavioral health! Sources Centers for Disease Control (CDC): Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic Harvard Business Review: Digital Tools Are Revolutionizing Mental Health Care in the U.S. American Journal of Managed Care (AJMC): Patient and Clinician Experiences With Telehealth for Patient Follow-up Care

Thinking about a career in mental health? Good! You are needed! An estimated 31% of U.S. adults experience an Anxiety Disorder at some time in their lives, and almost 20% will experience Major Depressive Order. Mental health disorders are not at all uncommon, yet over 89 million Americans are not able to find or get the treatment they need from mental health professionals because there just aren’t enough. This article provides an introduction to the types of jobs available in the field, the traits needed, and general schooling and licensure requirements. “Making A Difference” Is The Biggest Reason Many Chose This Career Path Clinicians already in the field say that their desire to help people better their lives is the biggest reason why they chose a mental health career. They agree that personality traits like compassion, empathy, patience, caregiving, and good communication are typical of those in the field. And while those traits may seem obvious, there are other less obvious traits necessary for a successful career in mental health: Flexibility - The field is ever-evolving, clients’ needs change, and your own daily work schedule may need to adapt to your patients’ schedules - ‘nine to five’ is not typical in this field. Confidence - You’ll be helping clients to reconsider and relearn their thinking patterns, so you’ll need to be aware of your own issues, challenges and expectations before treating others. Tech-Savvy - Not only is the field itself making more and more use of technology to solve privacy, productivity, and access issues, but you’ll need to understand your clients’ technology habits as it may impact their mental health. Life-Long Learner - The requirements for licensure and accreditation are typically ongoing annual coursework in updated theory and treatment, so a natural curiosity and openness to new ideas is an important trait for anyone considering the field. Multiple Types Of Professionals Can Choose A Career In Mental Health — Each Has Its Own Schooling & Licensing Requirements If you feel these traits describe you, you’ll have multiple paths to choose from as you think about what kind of mental health professional you want to become. Professional job titles and specialties can vary by state, but the list below is a general overview of the most common, along with schooling and licensure requirements. Regardless of job title, as a mental health professional, you may work in an inpatient facility (hospitals and psychiatric facilities) or an outpatient facility (community mental health clinics, schools, private practice) depending on what patient population you want to serve. You may even choose to see and treat patients virtually as the technology to do so has matured and the pandemic has created the need for remote patient visits. Psychiatrist - licensed medical doctor who has completed psychiatric training; can diagnose mental health conditions, prescribe and monitor medications, and provide therapy; MD plus completion of a residency in psychiatry required; need to be a licensed physician in the state where they practice; may also be designated as a Board Certified Psychiatrist. Psychiatric Nurse Practitioner (NP) - can provide assessment, diagnosis, and therapy for mental health conditions; qualified to prescribe medications depending on the state; requirements also vary by state as to the amount of supervision by a licensed psychiatrist; requires M.S. or Ph.D. in nursing with a specialty in psychiatry; must be a licensed nurse in the state where they are practicing. Psychologist - trained to evaluate patients’ mental health using clinical interviews, psychological evaluations, and testing; can make diagnoses and provide individual or group therapy but not prescribe medicine; need a Ph.D. in clinical psychology or other specialties such as counseling or education; licensed by licensure boards in each state. Counselor, Therapist - trained to assess mental health and use therapeutic techniques based on specific training programs; requires master’s degree (M.S. or M.A.) in a mental health-related field such as psychology, counseling psychology, marriage or family therapy, among others; licensure varies by specialty and state but examples include LPC (Licensed Professional Counselor) or LMFT (Licensed Marriage and Family Therapist). Clinical Social Worker - trained to evaluate mental health and use therapeutic techniques based on specific training programs; are also trained in case management and advocacy services; master’s degree in social work (MSW) required; licensure examples include LICSW (Licensed Independent Social Worker) and LCSW (Licensed Clinical Social Worker). Social Worker - provide case management, inpatient discharge planning services, and other placement services; requires B.A. or B.S. degree in social work. Job Growth Outlook For Careers In Mental Health: Excellent The field is experiencing growth, so if you’ve been thinking about jumping in, now is the time. In fact, employment for all professionals in the field of mental health is expected to increase 22% through 2028, according to the Bureau of Labor Statistics. If you’re considering a career in mental health, take a look at the types of jobs available with Telemynd - to get an overview of the number and range of choices in this field. Already a mental health professional and seeking a way to expand your career or practice? Telemynd is a nationally delegated telebehavioral health provider offering a safe and convenient way to see patients or meet with providers using our secure cloud-based solution. Check out recent reviews from your peers, and consider joining our network with access to millions seeking virtual behavioral health! Sources Substance Abuse and Mental Health Services Administration (SAMSA): Behavioral Health Workforce Report National Alliance on Mental Illness (NAMI): Types of Mental Health Professionals

No one would argue that it's been a tough year for all of us. We’ve never experienced a global pandemic to this extent in our lifetime. In addition to medical fears and loss associated with the COVID-19 virus itself, health experts say Americans are experiencing Anxiety and Depression made worse by pandemic-related stressors, including job loss, evictions, remote learning, travel restrictions and limits on gatherings with family or friends. As well, the length of time the pandemic has gone on is causing many of us to have increased feelings of emotional exhaustion and hopelessness. Survey Confirms Symptoms Of Anxiety & Depression Are Up A Census Bureau - CDC survey conducted over the past Summer and Fall found that expanded symptoms of Depression and Anxiety have been seen in all 50 states. The survey concluded that 1 in 4 of us reported feeling anxious more than half of the previous week, and 1 in 5 of us reported feelings of depression during the same time period. Results also showed the volume of calls to help lines have increased significantly compared to previous years, driven by COVID-19-related concerns. The Study Further Found That The Increased Stress, Anxiety & Depressed Feelings May Be Causing: Heightened fear and worry about health, finances, jobs, and loss of support services Changes in sleep or eating patterns, as well as difficulty sleeping or concentrating Worsening of chronic health problems Increased muscle tension and pain Increased use of tobacco, and/or alcohol and other substances What Can You Do To Relieve Stressful Feelings During The Pandemic? Focus on things you can control rather than the constant barrage of negative information coming at you through the media, colleagues, family, and friends. When you move the center of control from something outside yourself to inside yourself, you can help reduce anxiety. Try the following: Limit news and media consumption, including social media. When we constantly check our newsfeed and see bad news, it activates our sympathetic nervous system, and can send us into fight-or-flight mode. Doing this hour after hour can exacerbate mental health issues. Experts recommend limiting news and social media checks to once or twice a day, turning off news alerts, getting your information from one or two credible news sources, and only posting positive messages and comments on social media. Keep your routine, even if it feels disrupted. Experts say establishing and keeping consistent daily and weekly routines is a way for people to feel there is some certainty during the pandemic. Even if you work from home now, try to get up at the same time as before the pandemic and keep as much of your normal morning routine as possible - go for a walk or run, eat a healthy breakfast, and drink that cup of coffee or tea. Keep up regularly-scheduled medical and therapy appointments (most can be done online now). If you used to grocery shop once a week for example, but now are isolating at home, try using an online grocery delivery service, but do your online shopping at the same day/time you used to go out to the store. Make social connections by checking in with loved ones regularly. While social distancing and limits on gatherings are essential to slow the spread of the virus, you can still check-in with family and friends by phone, Zoom or Facetime, text or email. You might even consider taking live cooking or craft classes online (or whatever aligns with your hobbies) - you’ll connect with the teacher as well as the other students while in the class. Science shows there’s a clear connection between mental health and social contact, so make formal time in your schedule to for social activities, as it's one of the things that can easily fall off your to-do list. For most people, the stressful and depressed feelings will resolve on their own over time, but for some, they may not. Health experts recommend you seek professional help if you find yourself overwhelmed by continuing or increasing symptoms like exhaustion, fatigue, guilt, irritability, sleep problems, intrusive thoughts, and a reduced capacity to experience pleasure. Are You Noticing Signs Of Increased Anxiety Or Depression During The Pandemic? You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who provide treatment for depression from the convenience of your home. Click here to find your current insurance provider and request an appointment today! Sources CDC: Mental Health and Coping with Stress During the Pandemic The Lancet: The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders CDC - Census Bureau: Anxiety and Depression Household Pulse Survey

Have you made your goals for the New Year? Make sure self-care is on the list! Looking after yourself (self-care) is critical to your physical, emotional, and mental well-being. Most often we read about practical self-care practices that keep us healthy, like balanced eating and good sleeping habits. But it's also important to identify and make time to do things that really nurture you, like connecting with friends and family, doing hobbies, or just sitting still with a good cup of tea. Living With Depression Can Make Self-Care More Difficult However, when you live with Depression (sometimes called Major Depressive Disorder), the idea of self-care may feel like adding another burden to your already heavy load. And here’s why. Depression is a clinical mood disorder that affects how you feel, think, and behave and can lead to a variety of other problems if left untreated. It’s defined by the medical community as “feelings of sadness intense enough to interfere with functioning and/or a decreased interest or pleasure in activities”. You can find the symptoms of Depression here. And it’s not uncommon - Depression affects an estimated one in 15 adults in any given year, and one in six people will experience it at some time in their life. Often, Depression leaves you feeling like your physical and emotional self is “running on empty”, and so you’re drained of the ability to look after yourself. Self-care takes a back seat. And to complicate things, when you start to feel better, you may even ditch certain self-care habits - thinking you don’t need them anymore. It’s common when people start to improve, to get relaxed about therapy and treatment plans, and before you know it, you’ve suffered a relapse. Scientists say there's a neurobiological reason for this. The frontal lobe region of our brain is responsible for executive function—a set of skills that involves judgment and reasoning. The issue is that Depression is associated with dysfunction of the frontal lobes, so it's no surprise that people with depression find it hard to judge whether they need self-care or not. Skipping Self-Care Is A Slippery Slope To Relapse But There Are Ways To Prevent it As a whole, the best thing you can do to stave off a relapse is to stick to your treatment plan and create a healthy environment with basic self-care goals. Try not to think of self-care as a big, burdensome project, but rather a series of small choices that add up to a healthier lifestyle. And set realistic goals for yourself - don’t aim so high that your goals are unattainable or you may end up disappointed. Here Are 5 Attainable Self-Care Goals To Try In The New Year That Can Help Manage Depression: Stay tuned to your body. Mental illness doesn’t impact our brains alone; it’s physical, too. Depression can decrease energy, make you feel exhausted, and experience body aches or headaches. Start by noticing how you feel – both physically and emotionally – on a daily basis. Watch for physical symptoms that may provide clues as to what is happening in your brain. Noticing symptoms early can help you practice better self-care and potentially stave off a full-blown episode. Attend your therapy sessions consistently. Even if you’re tempted to skip a session or two, trust the process and attend them all. Consider discussing your reluctance with your therapist. He or she may be able to spot some faulty reasoning on your part. Or, if indeed you are better and changes are warranted, you and your therapist can make those necessary adjustments together. Take your meds as prescribed. Missing a dose can interfere with the medication’s effectiveness, and symptoms may return. Always talk to your behavioral health provider about stopping or changing doses. And remember, alcohol or drugs can also interrupt the efficacy of prescription medications, so avoid them. Learn deep-breathing or meditation and practice it every day. Scientists say this is one of the most effective self-care methods. Even though it seems unnatural at first, taking a series of deep breaths can help slow down racing or irrational thoughts. The act of slowly and deliberately inhaling and exhaling increases circulation releases endorphins, and relaxes muscles. And do this throughout the day - even just for 30 seconds - not just when you start to feel anxious or depressed. It will make a big difference in the way you feel. It’s the little things. Finally, self-care doesn’t have to mean fancy spas, big vacations, or running a marathon. Taking better care of yourself can happen at home. Making time regularly to take a walk, read a book, play with an animal, chat with good friends on the phone, watch a movie, or practice a hobby can help you cope with Depression more effectively. If you’re lonely, volunteering can be a great way to meet people and feel better about yourself - and again, it doesn’t have to be a big time commitment - maybe it’s just one or two hours every couple of weeks. Do You Recognize Any Of These Signs Of Depression? You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who provide treatment for depression from the convenience of your home. Click here to find your current insurance provider and request an appointment today! Sources CDC: Mental Health and Coping with Stress During the Pandemic CDC: Taking Care of Your Emotional Health NIH | National Institutes of Mental Health: Self-care for anxiety and depression: a comparison of evidence from Cochrane reviews and practice to inform decision-making and priority-setting NIH | National Center for Complementary and Integrative Health: Meditation in Depth

Holiday songs, the media, friends and co-workers urge us to be merry during the holiday season. However, that’s not always easy to do! As much as we love the holidays, they are invariably a stressful time of year. According to the American Psychological Association, 61% of us describe our anxiety as elevated during the holiday season. What causes this extra anxiety? Many things. The additional financial demands of the season, travel, interpersonal family dynamics, balancing work, shopping, cooking and decorating, too many social events, memories of past holidays, as well as unrealistic expectations can contribute to creating the perfect storm of emotions. Even in normal times, many living with Generalized Anxiety Disorder – a chronic state of anxiety and stress which can make a person feel constantly worried even when there is little to no reason to. The stress can become debilitating and can lead to a loss of perspective on the current situation. GAD is treatable by a behavioral health specialist but nonetheless requires those who live with it to take extra care of themselves with a balance of healthy diet and exercise. The added psychological pressure of the holidays can present a special challenge for those struggling with GAD. You may feel like crawling under a comforter and sleeping until the new year! It’s important to recognize key signs that things are becoming overwhelming and to know some coping skills to reduce the anxiety as it happens. 6 Signs You Are Experiencing Extra Anxiety During The Holidays Key signs to look for are changes in mood or behavior that differ from your norm. Be On The Lookout For: Erratic or unusual behavior, irritability or impulsivity. Physical symptoms of anxiety, such as a rapid heartbeat, shortness of breath, shaking, dizziness, sweating, an upset stomach, or a dry mouth. Social withdrawal as some individuals try to avoid situations that will bring on feelings of anxiety or panic. You may also lose interest in activities you used to enjoy. Changes in appetite and weight – either up or down. Insomnia, extra exhaustion and other sleep disturbances. Panic attacks that cause faintness, trouble breathing, pounding heartbeat, or nausea. How To Cope With Holiday Anxiety Below are some practical tips you can do to decrease stress during the holidays. We also recommend creating an Anxiety Action Plan containing helpful coping mechanisms beforehand, so that if you start seeing some of the early anxiety indicators listed above, you can put it into place. Prioritize your health. Make sure you are eating healthy foods, staying physically active, and getting enough sleep. Think twice about overindulging in alcohol—as it can worsen anxiety symptoms. Plan ahead. Think about your triggers and try to head them off. For example, if you're worried about money, put together a budget before the holidays. If holiday shopping causes stress, try to do it early, and avoid the stores by shopping online. If social situations make you uncomfortable, accept just a few invitations in advance and ask a good friend to attend with you. Use a calendar to plan specific days for shopping, baking, or gift-wrapping. Stick to a routine as much as possible. Wake up at the same time, try to eat at the same time every day, take your regular walk, and journal if you normally do that. Don’t schedule a new hair style or make drastic changes to your environment during the holidays! Schedule worry time. Yes, you read that right. Instead of worrying all the time, schedule a dedicated time –maybe even once a day – to do nothing but worry for a few minutes. Write the worries down if possible and even brainstorm solutions. This way, constant worrying won’t burn you out. Make time for self-care. Schedule time in your day to relax with yoga or meditation, drink a cup of coffee or tea, listen to a podcast, play with the dog, or even take a quick nap. Choose something that relaxes your body and calms your mind. Ask for support. Let your friends and family know that you might need extra support. It’s always ok to ask for help. Some experts even suggest practicing a secret signal with someone you trust who can help you during events if you become overwhelmed or anxious. And don’t forget to reach out to a behavioral health professional for additional help and resources. In general, experts advise lowering your expectations during the holiday season, try to keep things as simple as possible, and remember that you're not alone – many others are experiencing holiday anxiety like you. Do You Recognize Any Of These Signs Of Anxiety? You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who provide treatment for anxiety from the convenience of your home. Click here to find your current insurance provider and request an appointment today! Sources National Alliance on Mental Illness (NAMI): Mental Health and the Holiday Blues Harvard Women’s’ Health Watch: A Holiday Advisory for Your Emotions Harvard Mahoney Neuroscience Institute: Holiday stress and the brain U.S. Army Health: Handling stress and anxiety during the winter holidays

Bipolar Disorder, formerly called Manic Depression, is a mental illness associated with dramatic shifts in mood, energy, and the ability to think clearly. Individuals with Bipolar Disorder experience repeated and significant mood swings, or ‘episodes’, that can make them feel very high (manic) or very low (depressive). These moods differ from the typical ups-and-downs most people experience. The condition affects men and women equally, impacting approximately 2.8% of the U.S. population. The average age of onset is 25, but it can also occur in teens. With a good treatment plan including therapy, medications, and a healthy lifestyle, individuals can manage their symptoms effectively. Definition of Bipolar Disorder There are three types of Bipolar Disorder, according to NIH | National Institutes of Mental Health: Bipolar I Disorder: when people experience one or more episodes of mania. Most people diagnosed with Bipolar I have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with Bipolar I, manic episodes must last at least seven days or be so severe that hospitalization is required. Bipolar II Disorder: when depressive episodes shift back and forth with hypomanic episodes, but never a “full” manic episode. Cyclothymic Disorder: a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. They may have brief periods of normal mood, but these periods last less than eight weeks. In addition, some individuals experience symptoms of Bipolar Disorder that do not exactly match the three categories listed above, and are referred to as “other specified and unspecified Bipolar Disorders”. Symptoms of Bipolar Disorder According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), symptoms of Bipolar Disorder break down into manic and depressive symptoms, depending on what kind of episode is happening. During an episode, the symptoms listed below may last every day for most of the day, and episodes may last for several days or weeks. It can sometimes be more difficult to identify symptoms of Bipolar Disorder in teens than in adults since moodiness is common in teens anyway. If you or a loved one are experiencing any symptoms, be sure to check with a behavioral health professional who can rule out Bipolar Disorder or make an official diagnosis. Causes And Risk Factors Of Bipolar Disorder Most scientists agree that there is no single cause of Bipolar Disorder and it’s likely that multiple factors contribute to an individual’s chance of having the illness. Factors that may increase the risk of developing Bipolar Disorder, or act as a trigger for the first episode include: Having a first-degree relative, such as a parent or sibling, with the disorder Periods of high stress, such as the death of a loved one or other traumatic event Drug or alcohol abuse Treatment For Bipolar Disorder Bipolar Disorder is very treatable. Medication or a combination of therapy and medication are used to manage the disorder over time. Since people respond to treatment in different ways, those with Bipolar Disorder may need to try different combinations of medications and therapy before finding the plan that works for them. Bipolar Disorder doesn't get better on its own. If you or a loved one have any of the symptoms of depressive or manic episodes listed above, see a behavioral health professional. Treatment can help keep your symptoms under control. Do you or a loved one have symptoms of Bipolar Disorder? Telemynd is a nationally delegated telebehavioral health provider for Tricare members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who can diagnose and provide treatment for Bipolar Disorder from the convenience of your home. Click here to find your current insurance provider to request an appointment today! Sources American Psychiatric Association: What Are Bipolar Disorders? National Alliance on Mental Illness (NAMI): Bipolar Disorder NIH | National Institutes of Mental Health: What Is Bipolar Disorder?

Everybody can have trouble sitting still or paying attention now and then. However, for some people, it’s so difficult that it interferes with school, work, and social life. These individuals may have ADHD (short for Attention-Deficit / Hyperactivity Disorder), one of the most common neurodevelopmental disorders of childhood – and for many, it lasts well into adulthood. Approximately 9% of children and 5% of adults have been diagnosed with ADHD, and professionals believe there are likely more who are undiagnosed. Fortunately, our society has become more cognizant of ADHD symptoms, so there’s a better chance of catching it early and getting treatment. Definition of ADHD ADHD is defined as a “persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development”. Scientists first documented children exhibiting inattentiveness, impulsivity, and hyperactivity in 1902. Since that time, the disorder has had many names. Previously known as simply ADD, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), renamed the disorder Attention-Deficit / Hyperactivity Disorder, which better reflects the importance of the inattention part of the disorder as well as the other characteristics of hyperactivity and impulsivity. Symptoms and Diagnosis of ADHD The DSM-5 criteria for ADHD are lengthy, and are slightly different for children vs. adults. To be diagnosed with Inattention, 6 or more of the symptoms below must be present for children up to 16 years old, while 5 or more symptoms must be present for those 17 years and older. Symptoms must be present for at least 6 months, and be disruptive and inappropriate for developmental level: Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities. Often has trouble holding attention on tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked). Often has trouble organizing tasks and activities. Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework). Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones). Is often easily distracted Is often forgetful in daily activities. To be diagnosed with Hyperactivity and Impulsivity, 6 or more of the symptoms below must be present for children up to 16 years old, while 5 or more symptoms must be present for those 17 years and older. Symptoms must be present for at least 6 months, and be disruptive and inappropriate for developmental level: Often fidgets with or taps hands or feet, or squirms in seat. Often leaves seat in situations when remaining seated is expected. Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless). Often unable to play or take part in leisure activities quietly. Is often “on the go” acting as if “driven by a motor”. Often talks excessively. Often blurts out an answer before a question has been completed. Often has trouble waiting their turn. Often interrupts or intrudes on others (e.g., butts into conversations or games) In addition, the following conditions must be met: Several inattentive or hyperactive-impulsive symptoms were present before age 12 years. Several symptoms are present in two or more settings, (such as at home, school or work; with friends or relatives; in other activities). There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning. The symptoms are not better explained by another mental disorder (such as anxiety disorder, dissociative disorder, or a personality disorder). Causes And Risk Factors Scientists are not sure what causes ADHD, although many studies suggest that genetics plays a big role. In addition, researchers are looking into possible environmental factors such as lead paint, and are also studying how brain injuries, nutrition, and social environment might contribute to ADHD. Scientists do know that the risk of ADHD can increase with the following factors: Close relative, such as a parent or sibling, has ADHD or other mental health disorder Alcohol or drugs during pregnancy Premature birth How Does ADHD Impact Daily Life? Children with ADHD often experience delays in independent functioning and may seem to behave younger than their peers. They may also have mild delays in language, motor skills, or social development that are not part of ADHD, but often co-occur. Kids with ADHD tend to have low frustration tolerance, difficulty controlling their emotions, and often experience mood swings. Ultimately, they’re at risk for potential problems in adolescence if the ADHD is not diagnosed and treated, such as academic failure or delays, difficulties with peers, risky behavior, or substance abuse. Early identification and treatment by a behavioral health provider is extremely important. Many adults who have ADHD don’t know it. They may feel that it’s difficult to get organized, stick to a project or job, or remember to keep appointments. Daily tasks such as getting up in the morning, getting ready for work, arriving on time, and being productive on the job can be especially challenging for adults with undiagnosed ADHD. Adults with ADHD have difficulties with attention, focus, executive function, and working memory. If you feel you or your loved one have any of these symptoms, check in with a behavioral health provider who can diagnose and treat you – individuals with ADHD can be very successful in life with the right help! Treatment for ADHD ADHD can be treated with a combination of support, therapy, and medication. Speak with a behavioral health professional to learn how best to approach treatment that is right for you or your loved one. They will assess current symptoms and history to determine the best treatment plan. For example, certain kinds of therapy can help individuals with ADHD become more aware of their deficits in attention or focus and can provide skills for improving organization and efficiency in daily tasks. Therapy may also address feelings of low self-esteem, and help control impulsive and risky behaviors. Do you or a loved one have symptoms of ADHD? You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who can diagnose and provide treatment for ADHD from the convenience of your home. Click here to find your current insurance provider and request an appointment today! Sources Centers for Disease Control (CDC): What is ADHD? Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): ADHD NIH | National Institutes of Mental Health: What is ADHD?

It's normal to have upsetting memories, to feel stressed, or even to have trouble sleeping after experiencing a traumatic event. But most people start to feel better after a few weeks or months. If you still have intense, disturbing thoughts and feelings related to that experience long after the traumatic event, you may have Post-Traumatic Stress Disorder, commonly known as PTSD. Definition of PTSD PTSD is a mental health disorder that occurs after experiencing or witnessing an upsetting traumatic event such as a natural disaster, accident, sexual assault, terroristic act, deployment into a combat zone, or being threatened with death or serious injury. Individuals who have been diagnosed with PTSD may relive the event through flashbacks or nightmares; feel continual sadness, fear, or anger; or an overarching detachment toward those they previously held closest. Strong negative reactions to sensory cues that remind them of the event is another common effect; seemingly “ordinary” loud noises or even an accidental touch could cause a trigger. PTSD affects 3.6% of the U.S. adult population. About 37% of those diagnosed with PTSD are classified as having severe symptoms. If you or a loved one are in the military, the statistics are even higher: 11-20 out of every 100 veterans who served in the wars in Afghanistan and Iraq have PTSD in a given year. PTSD often occurs with other related conditions, such as Depression, substance abuse, memory problems, and other mental health problems. Know that PTSD is not a weakness. Anyone who experiences trauma is susceptible to developing it. We don’t yet know why some experience stronger PTSD symptoms while others are able to seemingly move past the events, but research continues to be conducted for improved treatment. Symptoms of PTSD According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), in order to be diagnosed with PTSD, an individual must have all of the following for at least one month: At least one re-experiencing symptom (e.g., flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating, bad dreams, or frightening thoughts) At least one avoidance symptom (e.g., staying away from places, events, or objects that are reminders of the traumatic experience, or avoiding thoughts or feelings related to the traumatic event) At least two arousal and reactivity symptoms (e.g., being easily startled, feeling tense or “on edge”, having difficulty sleeping, having angry outbursts) At least two cognition and mood symptoms (e.g., trouble remembering the key features of the traumatic event, negative thoughts about oneself or the world, distorted feelings like guilt or blame, or loss of interest in enjoyable activities) Many individuals develop symptoms within three months of the trauma, but symptoms can appear later and often persist for months or years. It’s best to speak with a behavioral health professional to get a clear diagnosis and to find how best to approach a treatment plan that’s right for you. Causes And Risk Factors Anyone can develop PTSD at any age after a triggering event, but multiple risk factors play a part in determining whether an individual will develop PTSD after a traumatic event or not, including: Childhood trauma (related or unrelated to the triggering trauma) Feeling horror, helplessness, or extreme fear during and after the event Having little or no social support after the event Dealing with additional stress after the event, such as loss of a loved one, job or home, or medical injury A history of mental illness or substance abuse Scientists believe that our “fight-or-flight” instincts – which can be life-saving during a crisis – when extended past the event, can leave us with ongoing, unhelpful symptoms. How Does PTSD Impact Daily Life? PTSD can impact our day-to-day routines in many ways, making it difficult to do daily tasks, such as sleeping, eating, or concentrating. It can impact relationships, and our outlook on life. 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 avoidance symptoms may do things like avoiding driving or riding in a car. Other individuals may feel stressed and angry all the time or isolated from friends and family. Left untreated, PTSD can cause dependence on drugs or alcohol or avoidance of activities that once made us happy. Treatment for PTSD It’s important to know that it’s never too late to get help for PTSD! While it cannot be cured, PTSD is treatable and mitigated in several ways. Treatment typically combines therapy, medication, and self-management strategies, such as self-soothing and mindfulness. Service animals, particularly dogs, often help with reducing symptoms of PTSD. Please note, if you or a loved one have thoughts of suicide, you should contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1. Do You Or A Loved One Have Symptoms Of PTSD? Telemynd is a national telebehavioral health provider covered with many insurers. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists from the convenience of your home. Click here to find your current insurance provider and request an appointment today! Sources NIH | National Institutes of Mental Health: Post-Traumatic Stress Disorder American Psychiatric Association: What is Post-Traumatic Stress Disorder? Department of Veterans Affairs, National Center for PTSD: PTSD