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  1. As the 2022 Olympics and Paralympics wind down in Beijing and athletes return home, the glow of their accomplishments is sure to last for a while. But what happens after the glow dies down - after the hometown celebrations, victory parties, and media interviews subside? Holly Brooks, a well-known therapist to Olympic athletes, says, "A lot of athletes fall into a deep depression after the Olympics… (They) need a lot of support, a lot of people reminding them of their worth beyond just their athletic achievements and results." In this article, we look at the mental health issues that returning Olympians often face, and what can be done to address this. Post-competition mental health issues are not uncommon It is estimated that one-third of elite athletes around the world experience symptoms of depression or anxiety. In recent years, athletes like Simone Biles, Chloe Kim, and Michael Phelps have helped raise awareness and normalize mental health issues by talking openly about their own anxiety and depression. At the same time, the number of research studies around this topic has increased - confirming the high incidence of mental health issues in this group. Studies have found there are several reasons that athletes may experience post-competition depression. Some athletes are dealing with disappointment over performances that didn't seem to measure up. But even for those who walk away with gold, that post-competition, somewhat “lost” feeling of “what do I focus all my energy and attention on now?” can loom large. One athlete said, “When you get home it’s really lonely… It’s quite depressing, and it is a little bit overwhelming, starting from square one again.” Sports psychologist and director of the Performance Psychology Center at the University of Michigan, Scott Goldman, explains it this way: “This ninety-mile-per-hour ride comes to a screeching halt the second the Olympics are over. …This emotional drop is not that different from the drops we all feel after major milestones, such as getting married or giving birth…. But in the case of Olympic athletes, some find themselves at such a loss they can’t stop the slide—and wind up in clinical depression.” What can be done to address mental health issues faced by athletes? Some experts suggest that athletes should have a plan in place for what to do after the excitement of the competition ends - from going on vacation to beginning a degree, a new job, or even a new athletic season. The key may be in an athlete’s willingness to build and maintain an identity off the playing field - and this may be where these other life goals come in. Support is also critical: The U.S. Olympic and Paralympic Committee formed a mental health task force in 2020 and among other things, made sure Olympic athletes now have access to a dedicated team of counselors and other mental health resources, such as wellness and meditation apps and support groups - during and after the games. One athlete summarized the challenge this way: "People are finally recognizing that these athletes are not superhuman robots like everyone thinks they are. It's like, 'Oh they're a normal person who has their own mental health issues.'" If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources NPR Frontiers in Psychology British Journal of Sports Medicine
  2. This Fall, over 3 million students started college in the US - some attending classes in-person for the first time in over a year. Do you know a loved one who went away to college this year? We know that teens have a lot on their minds anyway, and while some issues are not new, electronic media has amplified some of the struggles that young people face. On top of that, starting college means learning new systems, places, and faces, as well as potentially facing more academic competition than ever before. Not to mention, the stress of separating from family and living alone - potentially for the first time. So just how does the transition to college impact the mental health of this population? It turns out …significantly. Read on for the research behind the headlines, as well as warning signs to watch out for. What the research shows about college students and mental health In the context of the stressors mentioned above, many college students experience the first onset of mental health and substance use problems or an exacerbation of existing symptoms. One study found that 60% of all college students suffer from at least one mental health problem. And according to recent surveys from the American College Health Association, 60% of respondents felt ‘overwhelming’ anxiety, while 40% experienced depression. A 2019 Penn State University study found that demand for campus mental health services spiked by over 30% in one year. The COVID-19 pandemic seems to have made things worse. Measures such as lockdowns, social distancing, and stay-at-home orders introduced negative impacts on the higher education ecosystem. A 2021 study found that 71% of college students indicated increased stress and anxiety due to COVID-19. This study found that contributing stressors included: fear and worry about their own health and the health of their loved ones (91%) difficulty in concentrating (89%) disruptions to sleeping patterns (86%) decreased social interactions due to physical distancing (86%) increased concerns about academic performance (82%) Access to behavioral healthcare is key - but not always a given Studies have shown a link between poor academic performance, and anxiety and depression among college students, so it's critical for students to have easy access to help. A study looking at mental health and academic success found that symptoms of depression or anxiety are a significant predictor of a lower GPA, and a higher probability of dropping out. The problem is that many colleges and universities are not staffed with enough specialists to handle the volume of students that need help. As well, some students are uncomfortable admitting they need help, think that high stress is “a normal part of student life”, or do not know where to find help. One study found that among students with mental health issues, fewer than half received treatment when they needed it. How to spot symptoms of depression or anxiety in college students Recognizing signs of depression may seem difficult - but is critical. After all, everyone has “off days” when they feel overwhelmed with the stresses of college. However, when those days become weeks, and/or getting out of bed every day for class becomes a struggle, take notice. Here are signs of anxiety or depression to look for in college students: not enjoying activities you once loved feeling hopeless no longer attending classes or social outings experiencing extreme anger or sadness reacting negatively or with apathy to most things talking about death or suicide suddenly turning to drugs or alcohol to suppress feelings family history of depression or anxiety If you or a college student you love shows any of these signs, avoid telling them to "cheer up" or "snap out of it." Many people experiencing mental health issues are aware of their condition, and telling them to “get over it” is not helpful. Instead, encourage them to seek help. If there isn’t help available on campus, consider virtual therapy. Online platforms like Telemynd provide access to mental health specialists from the privacy of a dorm room or home. If you recognize any of these signs of anxiety or depression, consider consulting a behavioral health professional Request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between the stresses of college life and mental health. If you’re a behavioral health provider looking to join Telemynd, see all the benefits and apply here. Sources Journal of Affective Disorders Forbes Journal Medical Research
  3. We spend an average of 2.5 hours per day on social media in the US. And that’s up 31% from 2015. According to the Pew Research Center, 70% of adults and 81% of teens in the U.S. use social media daily. And of course, we all post our best - the best vacation pics, the best party pics, the best outfit pics - it's a recipe for unrealistic comparison on a daily basis. Why do we do it? To boost self-esteem and feel a sense of belonging in our social circles, we post with the hope of receiving positive feedback. But there’s a downside - research shows that time spent on social media has an adverse effect on mental health. The effort spent to achieve and maintain the ideal body so that we look “as good as” others we see on social media, can trigger significant anxiety and depression. In this article, we dig into the research and share suggestions to mitigate the negative impact of social media. What the science says about social media and mental health Facebook, Instagram, Pinterest, Twitter, YouTube, Snapchat, and more recently TikTok (whose use is up 800% in the US since 2018) - all provide an easy means to post, view, and compare ourselves to others, 24/7. Filters that provide the ability to airbrush photos, whiten teeth, and more, are easy to find and use. Now, it’s not only celebrities who look perfect—it’s everyone. In fact, plastic surgeons have seen an uptick in requests in recent years from patients who want to look like their (unrealistic) filtered Snapchat or Instagram photos. Logically, we know this can’t be healthy behavior. And the science backs this up. Research has linked social media use to decreased sleep, increased anxiety and depression, and significant body dysmorphia - which often leads to eating disorders. One study, published by the Public Library of Open Science (PLoS One), found the prevalence of depression and anxiety to be over 48%, for those of all ages and genders who looked at social media frequently. Another study, published in Computers and Human Behavior, found that individuals who used social media over 2 hours per day reported significantly higher body image concerns and internalizing symptoms than peers reporting no use of social media. A 2018 British study tied social media use to decreased or disrupted sleep, which can be associated with depression, memory loss, and poor work or academic performance. One study, published by the Public Library of Open Science (PLoS One), found the prevalence of depression and anxiety to be over 48%, for those of all ages and genders who looked at social media frequently. Another study, published in Computers and Human Behavior, found that individuals who used social media over 2 hours per day reported significantly higher body image concerns and internalizing symptoms than peers reporting no use of social media. A 2018 British study tied social media use to decreased or disrupted sleep, which can be associated with depression, memory loss, and poor work or academic performance. How social media’s ‘ideal body image’ portrayal impacts different communities Some communities are impacted more than others - for various reasons they are more likely to feel pressure to look good on social media and/or more vulnerable to the effects of constant comparison. For example, studies have found that social media use has been linked to higher rates of depression in teens, which in turn has lead to a higher suicide rate among the age group. When there’s a ‘filter’ applied to the digital images, it can be hard for teens to tell what’s real and what isn’t, which comes at an already difficult time for them physically and emotionally. A Pew Research study of teens, technology, and friendships revealed a range of social media-induced stressors: Feeling pressure to post attractive content about yourself Feeling pressure to get comments and likes on your posts Seeing people post about events to which you weren’t invited Having someone post things about you that you cannot change or control Another community adversely affected by the need to achieve a perfect body for social media is the LGBTQ community. For example, research published out of Dalhousie University found that social demands placed on gay men, based on social media images, to achieve a perfect body, have serious mental health consequences. The men in this study talked about how “constantly thinking about food and body ideals often lead to losing themselves in feelings of inadequacy, anxiety, low self-esteem, and depression.” The National Eating Disorder Association similarly found that those who identify as LGBTQ+ experience unique stressors that may contribute to the development of eating disorders - these stressors include the inability to meet body image ideals within LGBTQ+ cultural contexts that are promoted in social media. Women in general, and young black women in particular, are also at greater risk for developing mental health issues due to unrealistic body image portrayals on social media. One study found that celebrity culture, as portrayed on social media, perpetuates the ideology that young black women can only achieve beauty through changes in skin color, extended artificial weaves, and a thin body frame. Another study out of Yale University School of Medicine found that as black teen girls navigate social media, “they are aware that they are seen as less desirable than their white teen counterparts.” Of course, all of this leads to significant mental health issues. How to mitigate the negatives effects of social media Can anything be done to mitigate the downsides of social media? While the biggest changes need to come at a societal level, it turns out that there are some tactics that individuals and families can take - starting with something as simple as monitoring social media use. In an article from Harvard’s McLean Hospital, psychologist Jacqueline Sperling, Ph.D., says “it’s probably unrealistic for most social media users to quit completely. However, they can monitor their behavior to see how their use impacts them.” She adds, “if someone notices that they feel less happy after using social media, they might consider changing how they use the sites, such as viewing them for less time and doing other activities that they enjoy instead.” Experts also suggest the following options: Find and follow body-positive accounts and influencers, or join support groups - this can help shift our mindset about the ideal body image set by society. Take an ethical stand and refuse to read, or view media, or buy advertised products that do not promote a healthy and diverse body image. Use your own social media accounts to become an advocate for positive body image. Give a shout-out to retailers, advertisers, or celebrities who promote natural looks, healthy body size, and diverse body shapes. Consult with a behavioral health specialist if you or someone you love is finding it hard to disconnect from social media overuse. If you recognize some of these signs for anxiety or depression, consider consulting a behavioral health professional Request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between social media and mental health. Seeking a meaningful career in behavioral health? Consider joining our national team of providers making a real impact on the lives of thousands, learn more about the benefits here.
  4. There’s a lot to be stressed about these days - whether it’s news headlines, endless to-do lists, or worry about money and bills. But for some, stress and worry can be so prevalent that it starts to interfere with our ability to function. In this case, we might consult a clinical professional and try talk therapy or medication. In addition, there’s another technique that has gained popularity in recent years to deal effectively with anxiety and depression, called EFT (Emotional Freedom Technique), also known as "tapping." EFT Tapping is a research-based intervention that combines cognitive behavior therapy (CBT) techniques, such as awareness building and reframing of interpretation, with the stimulation of acupressure points on the face and body by literally tapping on them. In our continuing series on treatment modalities, we’ve provided an overview of EFT Tapping here: how it works, some of the research behind it, and who can benefit from it. What is EFT Tapping? EFT Tapping helps tune in to the negative patterns we form around anxious thoughts or troubling memories, by physically tapping with our fingers on identified acupressure points while at the same time focusing on those thoughts and emotions. According to experts, focusing on a negative thought while simultaneously tapping on acupressure points sends a calming signal to the brain, allowing us to acknowledge the stress while calming the body. Think of it as having similar (but noninvasive) effects as acupuncture. EFT Tapping is facilitated by an experienced, certified EFT practitioner in a therapy session, with the ultimate goal of shifting limiting thought processes, resolving past traumas, and promoting healing around emotional issues that may be holding us back. How does EFT Tapping work? EFT Tapping can rewire the brain. From research, it is understood that tapping on specific pressure points can result in a calming effect on the amygdala (the stress center of the brain) and the hippocampus (the memory center), both of which play a role in the unconscious process we use to determine if something is a threat or not, and therefore whether our “fight or flight” response should kick in. Indeed, studies at Harvard Medical School have shown that by stimulating the body’s acupressure points you can significantly reduce activity in the amygdala. Therefore, EFT Tapping works to effectively rewire the brain; to interrupt and change neural pathways so that you want to do the things that are going to improve your life and make you feel better. Research shows EFT Tapping is effective in treating multiple mental health disorders Multiple studies have been done to determine the effectiveness of EFT Tapping for different mental health issues. Here are just a few: Reducing cortisol levels. One study measured changes in cortisol (the primary stress hormone) levels and other psychological distress symptoms after a single hour-long intervention of EFT Tapping and found it reduced those distress symptoms by 24%. Decreasing anxiety. Another study looked at the length of time needed before different therapeutic interventions took effect in patients with anxiety, and found that only three EFT Tapping sessions were needed before study participants’ anxiety was reduced. That same study showed that after a year, those reductions in anxiety were maintained by 78% of participants. Treating depression. In a study exploring EFT Tapping for depression, researchers found that a weighted mean reduction in depression symptoms was 41% after using EFT. Reducing symptoms of PTSD. Another study using EFT Tapping to treat PTSD in veterans found that 60% of participants no longer met clinical PTSD criteria after three EFT Tapping sessions and 86% no longer met the criteria after six sessions. Other studies have shown the effectiveness of EFT Tapping even beyond reducing anxiety, depression, and PTSD symptoms. For example, it can help minimize food cravings and aid in weight loss, or reduce fears around events like public speaking, test-taking, and even childbirth. If you or a loved one are living with mental health issues such as Anxiety, Depression, or PTSD, consider EFT Tapping Like other treatment modalities, therapists can be trained and certified in EFT Tapping. Certification requires a specific number of hours in the classroom and in clinical practice. Many behavioral health specialists offer EFT Tapping therapy; look for one that is experienced and certified. Many of Telemynd’s clinicians specialize in EFT tapping. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here. Sources Journal of Evidence-Based Integrated Medicine EFT International Journal of Nervous & Mental Disease Journal of Nervous & Mental Disease Explore: The Journal of Science & Healing
  5. 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)
  6. 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
  7. 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)
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    Trouble sleeping? You may have a sleep disorder which is impacting your mental health. Find out how sleep and mental health are closely linked.
  9. 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
  10. 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
  11. You or a loved one just received a diagnosis of Adjustment Disorder (AD) from a behavioral health professional. What does it mean? And how is AD different from Anxiety Disorder or Depression? Definition of Adjustment Disorder Adjustment Disorder is a condition that can occur when you have difficulty coping with a specific, stressful life event - for example, a death or illness in the family, getting fired or laid off from a job, significant relationship issues like break-ups or divorce, or sudden change in social settings (more isolation, for example) due to the pandemic. Because of this, Adjustment Disorder can also be referred to as “situational depression.” The inability to adjust to stressful events like these can cause one or more severe psychological and/or physical symptoms. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), in order to be diagnosed with Adjustment Disorder, individuals must have emotional or behavioral symptoms within 3 months of having been exposed to a stressor (like those mentioned above), and symptoms must be clinically significant as shown by one or more of the following: Marked distress that is out of proportion to the stressor The symptoms significantly impair social or occupational functioning. Stressors that cause AD can even reoccur over time, for example, seasonal business crises, or recurrent hospitalizations for an illness or disability. Adjustment disorders can affect both adults and children. It’s estimated that each year, almost 7% of adults in the US are diagnosed with AD. These disorders typically resolve over time and with treatment by a behavioral health professional. Symptoms of Adjustment Disorder Symptoms vary depending on how the disorder manifests. Adjustment Disorder can be present with these symptoms: Anxiety Depressed mood, sadness Feelings of hopelessness Severe changes in emotions manifesting in things like frequent crying Feeling or acting unusually argumentative Changes in conduct (i.e., acting up in school or work) Worry, nervousness, jitteriness While the symptoms of Adjustment Disorder can be short-term and usually improve over time, they may resemble other psychiatric conditions, such as Major Depression or Anxiety Disorders. So, how can you tell the difference? How to tell the difference between Adjustment Disorder, Depression and Anxiety Disorder Individuals with Generalized Anxiety Disorder often have a lengthy and consistent history of anxiety and excessive worry, whereas individuals with Adjustment Disorder only experience their symptoms in times of or in response to stress or change. You can have both disorders, and Anxiety Disorder can be made worse by stressors such as change or adjusting to new routines. But if you have Adjustment Disorder, you’ll typically see a reduction in your anxiety as you adapt to the change or learn to cope with the stressor, while anxiety and related symptoms are continual for those with GAD. Similarly, there are key differences between Adjustment Disorder and Major Depressive Disorder, with the two differentiating factors being duration and cause. While Adjustment Disorder traditionally resolves within a matter of months, Major Depression tends to last much longer and only resolves with professional treatment. And while AD is triggered by a specific event, Depression seems to be caused by genetic and psychological factors, and cannot be attributed to a specific event. Summary of the differences between Adjustment Disorder, Depression and Anxiety Disorder Regardless of whether you have symptoms of Adjustment Disorder, GAD, or Depression, it is important to know that treatment is available and feeling better is possible. It’s important to start by having a behavioral health professional diagnose your condition, they can then help to manage your symptoms and learn coping skills. Like GAD and Depression, treatment for Adjustment Disorder is typically a combination of individual therapy, family therapy or group therapy, and to a lesser extent, medication. Has a recent stressful event caused you or a loved one to have symptoms of Adjustment Disorder? 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 Johns Hopkins Medicine: Adjustment Disorders Merck Manual 2020: Adjustment Disorders
  12. Guest

    Understanding Major Depressive Disorder

    Feeling “blue”, “out of sorts”, or “down in the dumps” are ways we describe feelings of sadness or melancholy. Most of us have felt this way at one time or another. However, what’s known as Clinical Depression or Major Depressive Disorder has multiple symptoms in addition to sadness. As well, individuals with true Depression feel these symptoms much more intensely and experience them for longer periods of time. 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. Depression isn't a weakness and you can't just "snap out" of it. In fact, it may cause you to have trouble doing normal day-to-day activities. Fortunately, with early detection and a treatment plan consisting of medication, therapy, and healthy lifestyle choices, many people can and do manage their depression. Definition of Major Depressive Disorder After Anxiety, Depression is the most common mental health disorder. According to the American Psychiatric Association, 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. Depression can occur at any time, but typically first appears during the late teens to mid-20s. People of all ages and all racial, ethnic, and socioeconomic backgrounds experience Depression. Depressive Disorders are defined as “feelings of sadness intense enough to interfere with functioning and/or a decreased interest or pleasure in activities”. There are several types of Depressive Disorders and all are commonly called “Depression”. Major Depressive Disorder, the subject of this article, is defined by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) as experiencing at least 5 of the symptoms listed below nearly every day for a 2-week period, and one of them must be depressed mood or loss of interest or pleasure. Symptoms of Major Depressive Disorder Multiple, persistent symptoms are required for a diagnosis of Major Depression: Persistent sad mood Feelings of hopelessness, or pessimism Irritability and/or anxiousness Feelings of guilt, worthlessness, or helplessness Loss of interest in hobbies and normal activities Decreased energy or tiredness Moving or talking slowly Feeling restless Difficulty concentrating, remembering, or making decisions Difficulty sleeping or conversely, frequent oversleeping Appetite changes Aches or pains, headaches, cramps, or digestive problems without a clear physical cause If you’ve been experiencing some of these symptoms nearly every day for at least two weeks, you may be suffering from Depression. A behavioral health professional can make an official diagnosis. Causes and risk factors The exact cause of Depression is unclear, but reduced levels of key neurotransmitters like serotonin, noradrenaline, and dopamine in the brain are believed to play a part in most cases. These are hormones that stabilize your mood, your feelings of well-being, pleasure, happiness, and your capacity to feel energized, so lower levels can have a very negative impact on your well-being and ability to function on a daily basis. A number of risk factors may make Depression more likely: Heredity (genetic factors contribute to Depression in about half of individuals diagnosed) Significantly emotionally distressing events, particularly those involving a loss Certain physical and anxiety disorders Substance and alcohol use disorders Side effects of certain drugs Social class, race, and culture do not affect the chance that people will experience Depression during their lifetime. How does Depression impact daily life? Even though there are many situations in life that can cause sadness and in which we might describe ourselves as being “depressed”, it is important to know the difference between “everyday” sadness and Clinical Depression. Understanding this difference can assist people in getting the help, support, and treatment they need. If you have any doubts about what you are feeling, contact a behavioral health professional who can make an official diagnosis and suggest the best treatment. Without treatment, individuals with Clinical Depression may be more likely to use alcohol or other drugs in an attempt to help them sleep or to feel less sad. It’s also been found that those with undiagnosed Depression are more likely to smoke or to neglect their health in other ways. Depression may also reduce the immune system's ability to respond to infection; as a result, people with untreated Depression are more likely to get sick more often. All of these things impact our ability to function well on a daily basis, to do our jobs, and to be the best parent, spouse, son, daughter, caregiver, or friend that we can be. Therefore, getting an early diagnosis and treatment plan is critical. Treatment for Major Depressive Disorder Most Depressive Disorders can be treated with a combination of support, therapy, and medication. Speak with a behavioral health professional on how best to approach treatment that is right for you. They will assess your current symptoms and your history of Depression in order to determine the best treatment plan. Once it is chosen, the plan may change over time depending on how well you respond to the care provided. Expect your mood to improve gradually, not immediately. In some cases, a healthy lifestyle including a good diet, exercise, and healthy sleep habits can also help reduce symptoms. In addition, behavioral health specialists may recommend spending time with good friends and family, rather than isolating yourself, as well as continuing to educate yourself about Depression, as information can feel empowering. Please note, if you or a loved one have thoughts of suicide, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1 Do you or a loved one have symptoms of Depression? 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!
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