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    1. Unveiling Client Insights Through Video Gaming

      When you discover that your client's primary pastime is video gaming, consuming 6-10 hours a day, you might catch yourself rolling your eyes. Every spare moment seems to revolve around gaming, and their entire social circle comprises internet gamers. It's easy to engage in negative self-talk, labeling it as a colossal waste of time and questioning the authenticity of their online friendships. Negative stereotypes and overgeneralizations often surround this generation of video gamers. But let's challenge our biases. Would you react the same way if your client told you they were an avid reader, spending most of their free time engrossed in books, attending book clubs, and hosting some themselves? Perhaps not, or at least with less negativity.
      Understanding Video Gaming:
      While it is true that video gaming can become a detrimental behavioral addiction for a small minority, it does not hold true for the vast majority of gamers. The DSM-5 categorizes it as a condition for further study, while the ICD-11 includes it as "Gaming Disorder." Research suggests that gaming disorder affects around 3%-8% of individuals. Whether or not your client's gaming habit reaches the level of a diagnosis, there is valuable information to be discovered if you are willing to invest some time in understanding gaming and its role in their life.
      Building Rapport through Video Gaming:
      In this blog post, I hope to convey the idea that paying attention to video gaming can be beneficial. Just like any other activity that occupies the majority of your client's leisure time, showing genuine interest in it can help you connect with them, develop rapport, and demonstrate positive regard. The wide range of game types, objectives, and available personas within video games can act as a sort of informal "projective test," providing valuable insights into your client's psychological needs and desires. The planning, strategy, skills, and social connections developed through gaming should not be dismissed. The choices they make within games and the personas they create hold meaning for them, much like the narratives young clients construct in play therapy or the subject matter and rendering choices in art therapy. To unlock these insights, we need to set aside our biases and listen and learn.
      Video Gaming 101:
      It's understandable if you haven't played most, if any, of the modern video games. Embrace your lack of knowledge as an advantage because when you ask your client to describe their experiences, favorite games, created personas, and emotional reactions during gameplay, your genuine curiosity will lead to insightful conversations. However, for a rough roadmap, here are some basic game genres:
      Sandbox: Games with open-ended goals that encourage experimentation and building (e.g., The Sims, Minecraft). Real-time Strategy: Games where players and AI control competing factions in real-time, emphasizing strategy and resource management (e.g., Warcraft, Age of Empires). Multiplayer Online Battle Arena: Similar to real-time strategy games, but players can form teams with other gamers in real-time to compete (e.g., League of Legends, Smite). Shooters (First Person/Third Person): Action-packed games where players engage in battles and wars, with a first-person or third-person perspective (e.g., Halo, DOOM). Role-Playing Games: Games where players control characters who navigate a fantasy world, facing challenges and leveling up (e.g., Skyrim, Fallout 4). Action Adventure: These games can have complex plot lines. They are often highly immersive with the players solving mysteries or puzzles in a first-person perspective. Significant combat elements are often present. (e.g. Legend of Zelda, Assassins Creed) Simulation & Sports: Here you fly the airplanes, drive the cars or play the sports in very realistic ways. (e.g. Madden NFL, Forza Motorsport) Other genres: Puzzles and Party Games, Survival and Horror, Platformer. It is not necessary to become an expert in these genres and there is significant overlap between the categories. The bottom line is that when you learn that your client identifies as a video gamer, it will be helpful to understand their favorite two or three games. Ask them which games they play the most and do some research to understand the game and why they might be choosing to spend their time immersed in these worlds.
      One of the most instructive aspects of video gaming for a therapist is understanding the concept of archetypes. When gamers choose or create avatars, they embark on immersive journeys within captivating fantasy worlds. It's not far-fetched to consider that players often deeply identify with their alter egos, reflecting their psychological needs and desires. Let's delve into the prevalent archetypes commonly observed:
      Orphans: The blank slate to project onto Warriors: Natural leaders, eager for battle Healers: Nurturers who keep friends healthy and have with healing abilities Rangers/scouts: Trailblazers, explorers, trackers, and hunters Rouges: Cunning survivors, existing in the shadows as assassins and spies Spellcasters: Masters of magic, wielding spells, and supernatural powers Engineers: Methodical problem solvers, steady and calculated Athletes: Always up for a challenge and striving for superiority Hero: The objective for all the above types as they journey through the game As you learn about your clients favorite games, how the game works and how they have chosen to engage in the game here are some questions for you to consider or even pose to your client.
      Why did you choose this particular game? What draws you to it? How does it surpass others? Describe the enjoyment it brings you. Do you prefer playing the game yourself or watching others play? Why? Do you enjoy team interactions or prefer facing the game's challenges alone? Describe the relationships you have developed. Tell me about your created avatar. What gender are they? What role do they play in the game? What powers do they possess? What are their limitations? Compare/contrast how you solve problems versus how your avatar does. What makes your avatar unique? How did you name your avatar and other characters? What additional powers do you hope to acquire? Describe the game's villain/enemy. What powers do they possess? How do they defeat you? Do you consistently play the same role, or do you switch roles? Why? How do you feel when you are playing, whether winning or losing? Does your game/avatar have limitations and rules which must be abided? Can you draw parallels between your gaming experiences and life outside the game? Are there problem-solving skills in your gaming life that you might employ in life outside of gaming? By delving into your client's video gaming experiences, you not only acknowledge this important aspect of their life but also gain hypotheses and potential insights into their social, cognitive, and emotional functioning.
      Credit where credit is due. Just about everything I know, and I’ve shared here about video gaming comes from the work of Anthony M. Bean, Ph.D. He’s a self-confessed video gamer but also has studied and written extensively about it. He’s the real deal. I’ve listed a couple of references below if you want to get the full story from his primary sources.
      Bean, A. M. (2019) Working therapeutically with video gamers and their families. Journal of Health Service Psychology, 45, 40-46.
      Bean, A. M. (2018) Working with video gamers and games in therapy: A clinician’s guide. Routledge Publishers.
      Pavlovic, D. (2020) Video Game Genres: Everything You Need to Know. HP Tech Takes. https://www.hp.com/us-en/shop/tech-takes/video-game-genre
    2. What the Latest Mental Health Industry Trends Mean for You

      Mental health professionals learned a vital lesson when pandemic lockdowns were prevalent: mental health is essential and must be delivered to individuals wherever they are. Without the necessary support and work of the mental health industry, people may be left to struggle on their own, further aggravating their condition, especially in times of worldwide stress.
      The latest mental health industry trends tell us the profession is growing to meet modern demands. This is a positive outcome of the stressors brought about by the pandemic. Mental health care services have never been more vibrant and capable of providing the behavioral health care that people need.
      Latest Mental Health Industry Trends
      Reviewing the latest mental health industry trends can provide those working in the industry with an understanding and context for dealing with potential changes. These five mental health industry trends represent the face of 2023 and beyond.
      1. Mental Health Prioritized in the Workplace
      Employers are learning that a healthy workspace is essential to not only productivity, but also mental and physical health. An unhealthy workspace is detrimental to employees and can negatively affect retention and productivity. With greater wellness, employers realize they will reap more benefits for the company, making it profitable to invest in employee mental health.
      With reports that more than 30% of working adults suffer from anxiety and/or depression, employers are taking action to ensure employees have access to mental health services. Organizations are discovering that the payoff for investing in employees’ mental health is worth it.
      2. Efforts Made to Reduce Stigma
      Stigma revolving around mental illness has always been an obstacle to individuals seeking treatment. However, strides are being made to reduce the stigma. More celebrities, athletes, and other big names are talking about their mental health struggles to show that there is no shame in it. The more people talk openly about the issue of mental illness, the less rare it seems. Fewer people will feel the inclination to hide their own mental health problems because there won’t’ be shame attached to doing so.
      Other big names are starting foundations to promote mental health awareness. The greater awareness and discussions among pop culture icons there are, the fewer people will feel the stigma of seeking treatment.
      3. Greater Need for Children’s Mental Health Services
      Another issue that has taken center stage in the mental health industry is the rise of children’s mental health needs. Studies show that even before the pandemic, approximately one in five children was dealing with a mental health disorder. COVID-19 severely affected the mental health of children and young people.
      After the pandemic, the number of children with mental health needs soared, leading to more crises and emergency room visits. The shortage of school psychologists and child psychologists/clinicians is exacerbating the problem. However, the focus is on the need for children’s mental health services, which will open doors for mental health careers in this area of expertise.
      4. Rise of Open Science
      Open science platforms have been used by scientists and researchers in the medical community for some time, especially with the rise of COVID-19. Now the mental health industry is taking advantage of its benefits.
      In the behavioral health field, psychologists and clinicians are using free, open platforms that allow the sharing of scientific research and data. This puts everything out in the open for verification, transparency, and better accuracy, which helps the mental health community. Another side benefit of open science is greater transparency helps reduce stigma also.
      5. Increase in the Use of Technology
      It should come as no surprise that the mental health industry is implementing technology to aid them in doing their work. The rise of telehealth was a welcome convenience for many in mental health careers. As we continue to use all forms of technology, its use in the behavioral health industry will only continue to increase. It offers many benefits for both the provider and the user.
      What Is the Mental Health Job Outlook?
      Individuals that work in behavioral health may wonder about the future of the industry. However, they can be assured that the job growth is stable and growing, as noted below.
      Present Job Outlook for Behavioral Health
      Those working in the behavioral health industry may have sensed a shift in their job and their clients’ needs. This is not surprising considering all the abovementioned trends implicate the various mental health needs nationwide.
      Job growth for healthcare grew in the third quarter of 2022 and going into the new year. The healthcare sector includes all behavioral health jobs.
      Future of Mental Health Careers
      The U.S. Bureau of Labor Statistics reports solid job growth among all mental health positions. Several different types of behavioral health careers exist, with some experiencing higher growth than others. The following is a list of the top mental health careers experiencing predicted job growth. The projected growth is from 2021 to 2031:
      Substance Abuse Counselor (projected growth= 22%) Clinical Social Workers (projected growth= 11.1%) Marriage and Family Therapists (projected growth= 14%) Psychiatrists (projected growth= 8.7%) Clinical Psychologists/Mental Health Therapists (projected growth= 6%) These mental health jobs have higher projected growth rates than the average growth rate for all U.S. jobs, which is 5.3%.
      How Technology Is Shaping the Mental Health World
      According to the Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy, the use of telehealth experienced a dramatic rise recently. Medical professionals across the country are engaging in the use of digital ways to evaluate patients, prescribe medicine, and provide care.
      With the pandemic pushing many people into isolation and shutting down several businesses, technology was a lifesaver for the mental health industry. Since more people were feeling the strain of mental health issues, mental health professionals needed to continue to meet the needs of their patients. This was accomplished through telehealth and telemedicine.
      The CDC reports 37% of adults used telemedicine to connect with their medical provider in 2021, which is the most recent data. This is a big increase from years prior. This percentage will probably only get higher as more providers continue providing telemedicine access.
      Through telemedicine, patients can meet with their mental health provider for the following:
      Assessment and evaluation
      Diagnostic testing
      Creation of a treatment plan
      Evidence-based therapy sessions
      Obtaining prescriptions
      Benefits of Using Technology in Behavioral Health Jobs
      Technology in any industry offers a wealth of benefits. The same can be said for the mental health industry. Using telehealth in mental health provides advantages for both the provider and the patient. Mental health providers can gain the following benefits:
      Allowing a more flexible schedule Meeting with more patients due to a less restrictive environment Saving money because of no commuting to work Offering more convenience since the providers work out of their own home The patient also gains similar advantages. For example, they also can be more relaxed meeting with a therapist while in their own home. People struggling with a depressive disorder may find telehealth a way to get started with therapy. In addition, patients will have a reduction in costs, too, because they won’t need to drive to the appointment. In some situations, insurance companies may have reduced copays for telehealth versus in-person meetings.
      When a person faces an urgent situation and wants to meet with someone immediately, the wait time may be reduced.
      Overcoming Barriers to Mental Health
      Telemedicine merges technology with behavioral health experts. The technology platform can help overcome the various barriers that exist to seeking mental health treatment. Some of these barriers are as follows:
      Stigma: Although stigma has significantly decreased, it’s not gone. Some people are more vulnerable to it and don’t want to seek treatment publicly. Telemedicine allows people to get the help they need while keeping a low profile. Accessibility: Accessibility to mental health services is limited in many areas. Some people live in rural areas and don’t have nearby mental health facilities. Others may not have access because of their socioeconomic status and inability to get transportation to appointments. Whatever the case might be, telehealth removes that barrier, allowing access to people affected by this issue. Cost: People often do not seek care because of the expense. The issue of cost hinders them from taking care of their mental health. Telehealth provides a cost-effective way to bring mental health care to those in need. Learn More About Expanding Your Mental Health Career
      Mental health providers can explore more options for expanding their careers with Telemynd. Join the many professional mental health experts delivering outstanding care and services to their patients through the Telemynd platform.
      Telemynd offers a comprehensive mental health solution for providers and patients. The company delivers personalized behavioral health services that increase care and improve outcomes. By combining technology and the expertise of trained mental health professionals, Telemynd is equipped to meet the mental health demands of 2023 and beyond. Apply to Telemynd’s team today!
    3. 5 Tips for Designing an Effective Therapy Space

      As a mental health professional, it's important to create a therapy space for yourself and your clients that is polished yet comfortable and conducive to the interactions needed for successful treatment. Much research has been done over the years on elements like comfort and privacy that can help inform the design of an effective therapy space. "A space should be something that supports you as you try to achieve specific goals…that means creating a calm and refreshing environment to balance the rigorous mental and emotional work of therapy," says Dr. Sally Augustin, an applied environmental and design psychologist. 
      Conversely, therapy space that in any way puts your clients on edge or makes them feel uncomfortable can have an adverse impact on their progress. Creating the right space for online therapy is just as important to get the most out of your therapy sessions. In this week’s article, we provide 5 tips for creating a comfortable and effective virtual therapy space.
      Choosing the right technology. Investing in your virtual practice is critical to establishing confidence in your ability to deliver care, and to offer a clear environment for your clients to openly engage in the therapeutic process - even when they are far away. Start by ensuring your camera is enabled and the resolution is acceptable (we recommend 720p display resolution or higher). Make sure your internet connection can support a video session and that the audio quality is clear and concise without degradation. The best position for your camera is at face level and centered so you are able to maintain eye contact. That may mean purchasing a stand for your computer or laptop. In session, the goal is to establish a relationship with new clients, to do this we suggest minimizing the appearance of multi-tasking . In addition, if you provide virtual therapy, choose a platform that meets the needs of your clients like Telemynd. Make your online therapy space calm and comfortable for clients. Set up a designated private space that is conducive to critical conversations. Use ambient light, calming wall art, and soft-colored walls in the background to keep distractions to a minimum. If your space doesn’t have good lighting, consider buying a ring light which is specifically designed to provide lighting for cameras and computers. And keep your office clutter-free, as that can give the impression of focus, clarity, and skill in your relationship with clients. You can also utilize a virtual background during your sessions if your space cannot be augmented.  Privacy is an important ingredient to the therapeutic process. Clients should always feel safe during your therapy sessions, and since they’ll be sharing thoughts they usually keep to themselves, feeling a sense of privacy is key. Even though it may be tempting, don't do your therapy sessions from the car, or with others in the background. Close doors and windows in your workspace so it feels private for your clients to open up. And make sure your phone is turned to silent as ringing phones or alarms can disrupt the session. Eliminate negative distractions from your therapy space. Keep personalization to a minimum in the background (i.e., family photos, personal mementos) to help clients feel “at home” within the space. Keep background artwork calming and neutral; if the colors or images are too loud, too specific, or evoke sadness or violence, they may be disruptive to the therapeutic process. Other distractions to avoid: open doors or views of other rooms in your residence if you are working from home, or doing your sessions in anything other than professional attire (for example, PJs definitely give the wrong impression).  Make the space comfortable for you! Don’t forget to get the right chair - since you’ll likely be sitting for extended periods of time every day, it’s important to find one that is ergonomic and comfortable for you. Some therapists sit in an armchair during an online session, and some prefer to sit in a more typical “desk” chair in front of their computer. Try them out before buying and choose what works best. While there is no single right way to design an online therapy space, you can help ensure your clients have a comfortable therapeutic experience by creating a welcoming, private, and technologically-sound space for when they need to be emotionally vulnerable. What tips would you add to the list? Let us know in the comments.
      Hospital Community Psychiatry: Design considerations for mental health facilities
      Healthcare: Telemedicine Workplace Environments: Designing for Success
      Psychiatry Advisor: Designing the Therapeutic Space: Using Layout, Color, and Other Elements to Get Patients in the Right Frame of Mind
    4. Choosing A Career In Mental Health - The Guide To Making A Difference

      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!
      Substance Abuse and Mental Health Services Administration (SAMSA): Behavioral Health Workforce Report
      National Alliance on Mental Illness (NAMI): Types of Mental Health Professionals
    5. Advantages Of Telemedicine For Mental Health Professionals & Their Patients

      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!
      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
    6. EMDR Therapy And Its Effectiveness In Treating PTSD

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

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

      I believe it is safe to say that Covid-19 has caused widespread disruption to life as we knew it. School, work, travel, relationships - all shaken up during the pandemic - and with it, our mental health. Some of the latest research has found that 25% of US adults are experiencing significantly more anxiety this year than in the past, and 20% are experiencing more symptoms of depression now than in the past. The research also shows that the volume of calls to helplines has increased significantly over the past year.
      The disruptions to everyday life have increased the need for behavioral health care – which has put an even greater demand on what was an already limited supply of mental health providers. Here at Telemynd, we’ve found that providing mental health care virtually, also known as telebehavioral health, has proved to be an effective way to make sure everyone seeking quality care has access. In fact, we believe that if there’s a silver lining to the pandemic, it’s that the adoption of telemedicine by the industry and consumers alike, has been accelerated by at least 5 years. Every indication points to telebehavioral health being here to stay, and if you’re a provider, there may be no need to return to your brick and mortar office.
      Research Supports Overall Satisfaction & Effectiveness For Patients & Providers
      One study published in JIMR Formative Research suggests that more than half of people using telehealth want to keep receiving that care virtually post-pandemic. Another study found that 78% of patients who use telebehavioral health are very or extremely satisfied with their telehealth experiences, and 75% are more likely to continue to use it after the pandemic.
      In addition, in a recent survey of employers who offer healthcare benefits, 90% report that their focus on telemedicine increased during the pandemic, and 52% say virtual medicine will continue to be an important priority within their organization’s health care activities following the pandemic.
      It’s clear that the demand is there for telebehavioral health - but is it effective? The answer is a resounding ‘yes’. A published literature review found without question that “behavioral health virtual visits deliver the same outcomes as in-person visits for many conditions, and meet the same standards of care set by the National Committee for Quality Association.” 
      Our Own Data Shows Record Growth Levels Beyond The Pandemic

      At Telemynd, we’re seeing strong indications from payors and patients that telemedicine is their preferred method for the delivery of behavioral health care services. Between third quarter 2020 and second quarter 2021 we experienced 4X growth in new patients seeking mental health services, an upward trend we continued to see as we move through 2021 at a record-setting 61% increase in demand. Both clinicians and patients have demonstrated their ability to quickly adapt to telemedicine with no sign of slowing down, even in a post-pandemic world. 
      Telebehavioral Health Benefits — For Patients & Clinicians
      Many challenges have been addressed through the implementation of telebehavioral health, including:
      Minimal wait to connect with a quality mental health professional
      Expanded access for patients who may live in a rural area, have limited mobility, or reside in long-term care facilities
      Saving time with virtual screenings and evaluations
      Better treatment for chronic conditions and medication management
      Personalized care from home, which promotes willingness to share in settings they’re already comfortable in
      Eliminating the stigma often associated with seeking mental health services and providing additional patient privacy
      For clinicians, telebehavioral health has many benefits as well, such as:
      Removing the overhead and upkeep of a physical location
      More flexibility to schedule clients at a pace and level that supports your needs
      Added freedom to travel while seeing patients anywhere in the country
      Simple and reliable weekly income direct deposited with complete remittance reports from our finance team
      All of these benefits lead to a true work-life balance. Telebehavioral health is a win-win for clinicians and their patients!
      Telebehavioral Health Allows Clinicians To Be Better At What They Do
      With all the benefits and studies showing adoption and effectiveness, telebehavioral health can now be considered a fundamental component of our healthcare environment – in other words, it’s here to stay. Telemynd helps each provider who joins to expand their practice and eliminate the administrative burden. Giving reliable income and the ability to focus on what matters most — delivering quality mental health care to patients.
      Willis Towers Watson
      American Psychological Association
      Journal of Internal Medicine
    9. Telemynd Earns Spot on Glassdoor Best Place to Work in 2023

      Telemynd is pleased to announce we are among the winners of the annual Glassdoor Employees’ Choice Awards, a list of the Best Places to Work in 2023.
      Unlike other workplace awards, there is no self-nomination or application process, instead it’s entirely based on the feedback our team has voluntarily and anonymously shared on Glassdoor. To determine the winners of the awards, Glassdoor evaluates company reviews shared by current and former team members over the past year. This year, we are proud to be recognized as a Best Place to Work among U.S. companies with fewer than 1,000 team members.
      A huge thank you goes out to everyone on our team who took the time to share their perspective on what it’s like to work here. We appreciate all the valuable feedback as it only helps us improve.
       A Statement from Telemynd CEO, Patrick Herguth
      "As a people-first organization, we are proud to be recognized by our employees and behavioral health providers as being a place they choose to spend their valuable time. We know that high-quality behavioral health always starts with a person. The Telemynd team - from the patient service representatives on the phone helping our clients, to the clinicians providing these valuable services, to the billing team that helps a patient navigate the complexity of their insurance plans – is a mission-driven group that shows up every day to make a difference. This is recognition for everyone on the team and a testament to the culture we have built."
      Below are just a few words employees shared on Glassdoor that contributed toward the award and make us feel incredibly honored
      Innovative and Supportive, Clinical Care Manager 
      “Telemynd has been incredibly supportive since I started about a year and a half ago. They are a company who cares about their clients, employees and care providers. Genuinely interested in making their own footprint in the teletherapy world and bridging gaps in underserved communities. While the company may be virtual it feels anything but. Everyone is very connected and there is an emphasis on human connection and that personal touch.”
      Best Company I Have Worked For, Mental Health Clinician
      “Develop your own schedule. Once the Client is assigned, you reschedule yourself keeping your clients happy as you can choose if you want to work outside of the hours you posted to the scheduling department. Pay is very reasonable and as with any self-employed position it takes a while to build your caseload, so expect it. The pay has always been on time and I have found no inaccuracies. The advertisements are accurate, not like some platforms, that offer a certain amount per hour and then in the fine print only pay you the advertised amount when you work over a certain amount of hours. Support staff are professional, polite and extremely helpful. Also the medication providers can see your documentation and you can see theirs! This is such a plus, to keep the team running efficiently. BRAVO TELEMYND.”
      Professional and Pleasant Working Environment, Licensed Marriage and Family Therapist
      “I very much enjoy working with Telemynd as an independent contractor, very professional and caring staff, quick response to questions, very supportive to both patients and therapists, I highly recommend this company to those who have the love and passion for treating patients toward their healing process.”
      Great Work/Life Balance, Licensed Clinical Social Worker
      “I love working for Telemynd! The people are great and I am able to schedule my own appointments and see as many clients or as few as I wish. I am not stuck in an 8-6 setting seeing clients every hour and then working until late at night to get my notes done (sound familiar?). If you value your work/life balance and want to work for a company that truly appreciates your contribution to the mental health field, please consider Telemynd.”
    10. Controlled Substance Prescriptions in Telehealth: Q &A

      Controlled substances are used to treat many common mental health conditions, like anxiety, depression, sleep disorders, and more. Prior to the COVID-19 pandemic and national health emergency, federal rules regulated how these meds were prescribed and dispensed - including a requirement for an in-person health evaluation prior to a prescription being written. However, during the pandemic, federal regulators temporarily waived these regulations to permit patients the ability to manage their medication and access to prescriptions, including controlled substances via telehealth visits. 
      With the national health emergency waivers expected to expire soon, some states have stepped in to draft their own medication management legislation; the result has been growing confusion over which rules apply and where. In this article, we attempt to answer all your questions about prescribing controlled substances, and have included resources to find out more.
      Why are Some Medications Deemed Controlled Substances?
      Controlled substances by definition are medications with a likelihood for physical or mental dependence. Many of the more common drugs for ADHD, anxiety, sleep disorders, depression, and more, such as Xanax, Klonopin, Lunesta, and Adderall are listed as ‘controlled substances”. The U.S. Controlled Substances Act (1970) puts all substances which were in some manner regulated under existing federal law into one of five schedules. This placement is based on the substance’s medical use, its potential for abuse, and safety or dependence liability. Medications listed as Schedule I have the tightest controls, and those listed as Schedule V have the least restrictive controls. These controls are mandated by the federal government.
      This may all sound complicated - but it boils down to prescribers and pharmacies taking extra precaution to ensure these medications are prescribed for and delivered to the right individuals, for the right reasons.
      What Are the Extra Steps Clinicians Must Take to Prescribe Meds that are Deemed Controlled Substances?
      In general, to prescribe a controlled substance, a clinician must have a DEA (Drug Enforcement Administration) license, and to fill a prescription, a pharmacist must also have a controlled substance license. Further, for a pharmacist to dispense a controlled substance, the prescription must include specific information such as date of issue, patient’s name, address, and DoB, clinician name, address and DEA number, drug strength, number of refills, and the signature of the prescriber. For these kinds of medications, there are also legal limits on the number of refills and the amount that a prescription may contain. Some drugs have zero refills, and the maximum quantity dispensed is 30 days - meaning patients must contact their clinician each month a refill is needed.
      In addition, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 specified that “any practitioner issuing a prescription for a controlled substance must conduct an in-person medical evaluation. A conservative recommendation to support compliance with the act is to conduct an in-person exam at least once every 24 months.”
      How did the COVID-19 Pandemic Impact Prescriptions of Controlled Substances?
      The unprecedented public health emergency created by COVID-19 caused action by state and federal regulators to ensure greater access to health care, while simultaneously limiting the spread of the virus. Therefore, as of March 2020, the DEA declared that practitioners “may issue prescriptions for controlled substances to patients via telemedicine, even for patients for whom they have not conducted an in-person medical evaluation, provided the prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of their professional practice, the telemedicine communication is conducted using an audiovisual, real-time, two-way interactive communication system, and the practitioner is acting in accordance with applicable federal and state laws.” At that time, the DEA also ruled it was “permissible to write controlled substance prescriptions to cover a 90-day supply.”
      However, depending on where you live or who prescribes your meds, you may have had a different experience as certain states and practitioners elected to retain pre-COVID protocols of in-person evaluations given the sensitivity of the medication being administered.  
      What is the Current Status of Controlled Substances Prescriptions?
      As we move through 2022 and the threat of COVID-19 has lessened, requirements for prescribing and dispensing controlled substances in some states have begun making permanent changes to expand policies implemented under the public health emergency, while others have passed laws restricting them. This website has made an attempt to track these ongoing changes - but to be safe, always check with your own state’s official website, or contact your state or federal representatives. 
      The DEA at the federal level said in a March press release, that it “wants medication-assisted treatment to be readily and safely available to anyone in the country who needs it."  However, in the end it is up to each state and provider to do what they feel is best for the safety of constituents and/or patients. Therefore, check with your provider or prescriber to find out if you will need an in-person visit to continue receiving prescriptions of controlled substances or if telehealth visits are an option for you. Telemynd operates as a national practice, meaning that our national network of licensed providers may prescribe many types of medications, they follow federal regulation which prevents the prescribing of controlled-substances via our virtual telemedicine environment. 
      DEA.gov: Rules for Control Substances
      NIH | National Library of Medicine: Pharmacy Prescription Requirements
    11. How’s Our Mental Health in America? New Report Says We Are Struggling

      A growing number of Americans are struggling with mental health every year. In fact, 1 in 5 Americans live with mental health issues on a daily basis. We know this from Mental Health America’s 2022 State of Mental Health in America Report. For the 8th year in a row, MHA released its annual report, which looks at our mental health based on 15 prevalence and access measures for youth and adults. The report confirms the trend that mental health in the US continued to worsen leading into the pandemic and remains problematic. In this article, we summarize key findings and highlight a few policies that can improve access to mental health resources.
      Key findings from the 2022 report: Overall mental health
      Suicidal ideation continues to increase among adults in the US: 4.6% of adults report having serious thoughts of suicide, an increase over prior years.  Rates of substance use are increasing for youth and adults: 7.5% of adults and 4.1% of young people had a substance use disorder in the past year - an increase over the prior year.  A growing percentage of young people in the US live with generalized depression. In fact, 15.1% of young people experienced a major depressive episode in the past year, a 1.3% increase over last year. Another 10.6% of young people in the US have severe depression (depression that severely affects the ability to function), and multiracial youth are at greatest risk for severe depression. These statistics indicate that mental illness is a common problem for many. Most of us will be impacted by it at some point in our lives - or know a loved one who struggles. And if untreated, mental health issues lead to other health problems like insomnia, eating disorders, heart disease, diabetes, arthritis, and other chronic disorders.
      Key findings from the 2022 report: Access to mental health treatment
      Over 50% of adults with a mental illness do not receive treatment - often because in-person treatment is not offered locally, because they do not know how to access treatment, or due to stigma around treatment. The percentage of adults with a mental illness who report unmet need for treatment has increased every year since 2011.  Over 60% of young people with major depression do not receive mental health treatment. Even in states with the greatest access to treatment, nearly 33% go without treatment, and in states where access is the most difficult, nearly 75% did not receive mental health treatment.  Some adults and young people continue to lack adequate insurance coverage for mental health treatment.  Are there policies and programs that can help address the state of mental health in America?
      The MHA report also suggests policies that may improve access to mental health resources in the US - and one has just been implemented. The 988 Suicide and Crisis Lifeline is a national network of more than 200 crisis centers around the country. The 988 Lifeline provides 24/7, confidential support to people in suicidal crisis or mental health-related distress - which they can reach just by dialing 988.
      The report’s second recommendation is to increase mental health education and support in schools to address disparities in access to mental health treatment for youth of color. The report found that students of color disproportionately access their mental health care at school, often because they don’t have access to mental health services elsewhere. Given this data, the report recommends that “increasing access to school-based mental health services can promote equity and reduce disparities in access to care”.
      Read more about the Report’s findings and recommendations here.
      Mental Health America (MHA): 2022 State of Mental Health in America Report
    12. Dial 988: The New Mental Health Crisis Line Launches

      In case you missed it, the new national mental health crisis line launched in July. For those in any kind of mental health distress, including thoughts of suicide, dialing 988 (24/7) immediately connects you with trained mental health counselors who can help you figure out critical next steps. The national health hotline has been several years in the making. Read on to learn how the mental health version of 911 came about. 
      What is the 988 Suicide and Crisis Lifeline?
      The 988 Suicide and Crisis Lifeline is a national network of more than 200 crisis centers that help thousands of people overcome crisis situations every day. These centers are supported by local and state resources, as well as the Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA). The 988 Lifeline provides 24/7, confidential support to people in suicidal crisis or mental health-related distress. 
      Modeled after 911, the new three-digit 988 number is designed to be a memorable and quick number that connects people who feel they are in any kind of mental health crisis, with a trained mental health professional. Currently, the number automatically routes calls by area code to the nearest crisis center.
      Sources of federal funding for 988 are separate from those of the 911 system, so the new hotline is not pulling any funds away from 911.
      Note that veterans can press “1” after dialing 988 to connect directly to the Veterans Crisis Lifeline which serves our nation’s Veterans, service members, National Guard, and Reserve members.
      What’s behind the development of 988?
      In the past, the majority of people experiencing a mental health emergency ended up dialing 911. The problem is that 911 wasn't set up to address mental health needs, so callers may end up in long lines in an ER, or interacting with law enforcement who may not be trained to handle their specific mental health crisis. Mental health advocates pushed for the new 988 hotline in the hopes that it would become a widely known, safer, and more effective alternative.
      In mid-2020, the FCC adopted rules to establish 988 as the nationwide, 3-digit dialing code for people in crisis, and later that year, the National Suicide Hotline Designation Act of 2020 was signed into law. The FCC adopted additional rules in November 2021 to expand access to the hotline by establishing the ability to also text to 988. As a result, covered phone service and text providers in all of the US states and territories were required to direct all 988 calls and texts to the National Suicide Prevention Lifeline by July 16, 2022.
      There is significant government investment to back up the new service - Congress and the current administration have dedicated $432 million toward building the capacity of local and backup call centers, and providing associated services, including a subnetwork for Spanish speakers.
      "One of the goals of 988 is to ensure that people get the help that they need when they need it, where they need it. And so, when a person calls 988, they can expect to have a conversation with a trained, compassionate crisis counselor who will talk with them about what they're experiencing. If it's the case that they need further intervention, then likely the crisis counselor will connect with a local mobile crisis team," says Dr. Miriam Delphin-Rittmon, the administrator of SAMHSA.
      The National Suicide Prevention Lifeline's 10-digit number — 1-800-273-8255 — will remain active, but calls will be routed to 988.
      Substance Abuse and Mental Health Services Administration (SAMHSA): How does the new 988 work?
    13. Trauma-Informed Care: Understanding Patients’ Life Experiences to Deliver Better Treatment

      Health care providers in the medical and behavioral health fields are increasingly recognizing that experiences of past trauma significantly influence our overall health, our relationships, school, work, and our ability to adopt healthy behaviors. And while we often associate trauma with things like soldiers in war settings, victims of crime, or the death of a loved one, it turns out that multiple life experiences clinically qualify as traumatic. In this article, we explore how the concept of holistic, trauma-informed care can improve the outcomes of mental health treatment.
      What is meant by ‘trauma’?
      Recent studies show that by the time they reach college, 66-85% of 18 year-olds report lifetime traumatic event exposure, with many reporting multiple exposures. That’s a lot. According to the American Psychological Association, trauma is an emotional response to a terrible event like an accident, rape, or natural disaster. But a person may experience trauma as a response to any event they find physically or emotionally threatening or harmful - for example, bullying and other character attacks; loss of a friend or loved one whether through death, moving, or a break-up; emotional, physical or sexual abuse; or even seeing something violent or disturbing. What matters is how the individual perceives an event, not how society judges how an individual should perceive an event.
      According to the Substance Abuse and Mental Health Services Administration, “the effects of traumatic events place a heavy burden on individuals, families and communities. Although many people who experience a traumatic event will go on without lasting negative effects, others will have more difficulty. Emerging research has documented the relationships among exposure to traumatic events, impaired neurodevelopmental and immune systems responses and subsequent health risk behaviors resulting in chronic physical or behavioral health disorders.”
      What is a trauma-informed approach to care?
      Trauma-informed care changes the opening question for those seeking mental health services from “what is wrong with you?” (i.e., patient or consumer) to “what has happened to you?” (i.e., survivor). Trauma-informed care is based on the assumption that every patient seeking services is a trauma survivor who can inform his or her own path to healing, facilitated by support and mentoring from a mental health provider.  A trauma-informed approach to care acknowledges that providers “need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation.”
      The six key principles of a trauma-informed approach are:
      Safety Trustworthiness and transparency Peer support Collaboration and mutuality Empowerment, voice, and choice Humility and responsiveness In addition, potential biases and stereotypes based on race, ethnicity, sexual orientation, and age are recognized and addressed within the context of trauma-based care.
      Clinicians who train in trauma-based care also learn there are 10 domains of implementation of this approach, including governance and leadership, policy, physical environment, training and workforce development, progress monitoring and quality assurance, and more.
      Why is trauma-informed care important?
      It’s a win-win for everyone. For patients, trauma-informed care offers the opportunity to engage more fully in their own mental health care, develop a trusting relationship with their provider, and improve long-term outcomes. Studies have found that adopting trauma-informed practices can potentially improve overall patient engagement and adherence to treatment. It also reduces the need to relive experiences and retraumatize the patient. In addition, trauma-based care has been found to improve provider engagement. 
      Overall, adopting a trauma-informed approach to care has the potential to improve patient health outcomes as well as the well-being of providers. If you feel you or a loved one could benefit from trauma-based care, consult your doctor or mental health provider.
      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.
      Substance Abuse and Mental Health Services Administration (SAMSA)
      Center for Health Care Strategies
      National Council for Mental Wellbeing
    14. Telebehavioral Health Will Continue Strong in 2022

      Where is telehealth in 2022? The pandemic showed how telemedicine could change how we think about health care interactions, with virtual visits increasing almost 40 times, according to data from McKinsey. Today, telehealth utilization has stabilized at levels 38 times (yes, that’s 38 times!) higher than before the pandemic. And consumer and provider attitudes toward telehealth have also improved since before the pandemic. Telemynd’s CEO, Patrick Herguth, said only 6 months ago, “between third quarter 2020 and second quarter 2021 we experienced 4X growth in new patients seeking mental health services, an upward trend we continued to see as we move through 2021 at a record-setting 61% increase in demand. Both clinicians and patients have demonstrated their ability to quickly adapt to telemedicine with no sign of slowing down.” 
      In this article, we look at the most recent trends, why telebehavioral health works, how to address any remaining barriers, and predictions for the future.
      Consumer demand for virtual health care remains high going into 2022
      One study found that 78% of patients who currently use telebehavioral health are very or extremely satisfied with their telehealth experiences, and 75% are more likely to continue to use it going forward. In another recent study, 40% of surveyed consumers (including those who have never used telehealth) said they would try it or continue using it — up from 11% prior to the pandemic.
      Why has telebehavioral health been so successful?
      For providers, it remains a convenient, cost-effective way to diagnose and treat many behavioral health issues. As well, it removes the overhead and upkeep of a physical location.
      Consumers continue to see the following benefits of telebehavioral health:
      Creates unprecedented convenience - appointments can be done wherever and whenever is most convenient. Removes the stigma associated with physically going to an office or treatment facility. Saves time with virtual screenings and evaluations. Expands access for those who live in a rural area, have limited mobility, or reside in long-term care facilities. Shortens delays to meet with providers. What’s the future of telebehavioral health?
      Most experts who study trends in health care see telebehavioral health expanding further in the future, where it makes sense. The American Medical Association says that providers and practices “have built successful telehealth systems that are making care more accessible and convenient for patients—there should be no turning back now.” Telemynd’s Patrick Herguth says, “The pandemic exposed and exacerbated the mental health crisis. It is a highly personal matter that requires a real human connection in order to succeed. Telemedicine expands our ability to match the right provider to patients, irrespective of where they’re located. People-oriented technology advancements will lead to even greater innovative care models that improve outcomes while lowering the cost of care for everyone.”
      Telehealth issues like the following will need continued work to create an even better experience for providers and consumers:
      technology security care payment mechanisms patient feedback methods  education and promotion so that more Americans know they can access telehealth As long as we continue to address these, what started off as just ‘a necessity’ during the pandemic will become the norm for health care even beyond 2022. 
      If you 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.
      Yale Medicine
    15. 10 Books To Better Understanding Mental Health Issues In 2022

      New year; new resolutions, right? Let this be the year we try to better understand issues surrounding mental health - for ourselves and for our friends and loved ones who may be dealing with them. In this spirit, we’ve curated 10 books that may be helpful to both clinicians and individuals who want to learn more about mental health issues such as depression, anxiety, bipolar disease, PTSD, OCD, postpartum depression, and more. We broke them into two categories for ease of organization. The factors we considered when choosing which books to feature included: positive reader reviews, consistently high ratings, and author qualifications. All of these books are available at amazon and other online retailers, as well as in independent bookstores. Which books would you add to the list?
      Books about and/or authored by people living with mental health disorders
      A Beautiful Mind: The Life of Mathematical Genius and Nobel Laureate John Nash by Sylvia Nasar
      This iconic and Pulitzer Prize-nominated story of mathematical genius John Forbes Nash, whose brilliant career was cut short by schizophrenia, was published in 1997 but remains a classic, especially after it was turned into an award-winning movie starring Russell Crowe. Nash was eventually honored with a Nobel Prize in Economics, but struggled with schizophrenia his whole life. The book describes his mental health journey and its effects on his family, friends and career.
      Hello I Want to Die Please Fix Me: Depression in the First Person by Anna Mehler Paperny
      After hitting a breaking point in her early 20s, journalist Anna Paperny decided to do what she does best - use her investigative skills to find out everything she could about her own debilitating condition - depression. And thanks to that quest for knowledge, readers benefit from her concise descriptions of everything from types of therapy available to the effects of medication to the stigma around mental illness. Includes interviews with leading medical experts in the US and Canada.
      Everything Here Is Beautiful by Mira T. Lee
      One sister starts hearing voices while the other struggles to find a way to support and protect her in this book about how mental illness impacts friends, family, and caregivers. The book chronicles bipolar disease from the caregivers’ perspective - how one must always walk a bittersweet tightrope between helping and protecting, and backing off to provide independence.
      The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought by David Adam
      The author is a noted scientist and editor at The Journal Nature, and has lived with Obsessive-Compulsive Disorder (OCD) for 20 years. This multiple award-winning book is an exploration of both his mind and the history of the condition that makes his mind a hectic place. He explains what it's like to be plagued by intrusive and obsessive thoughts and compulsions, like hoarding and his multiple but necessary home rituals, and provides research into the history of OCD diagnosis and treatment.
      Down Came the Rain: My Journey Through Postpartum Depression by Brooke Shields
      When actor Brooke Shields welcomed her daughter Rowan Francis into the world, something unexpected followed – debilitating postpartum depression. She assumed she’d bounce back in a few days - but things only got worse. This honest memoir offers a first-person perspective on the devastating condition faced by millions of women after giving birth. Shields talks candidly about her struggles and offers hope for recovery by describing her own.
      Irritable Hearts: A PTSD Love Story by Mac McClelland
      Human rights journalist Mac McClelland spent 2010 reporting on Haiti’s earthquake but when she returned home to California, she was surprised by the lasting effects of the trauma she’d witnessed - nightmares, anxiety, insomnia, crying jags and more. After a diagnosis of PTSD, and in an attempt to help herself heal, she began investigating PTSD, its symptoms and treatment, and how she experienced it in her own mind. 
      Books written to help those living with mental health disorders
      Permission to Come Home: Reclaiming Mental Health as Asian-Americans by Dr. Jenny Wang
      The author is the founder of the Asian, Pacific Islander, and South Asian American (APISAA) Therapist Directory and created this comprehensive resource especially for Asian-Americans, immigrants, and other minorities who may be experiencing behavioral health issues, to provide resources for improving self-care and mental health - a community she feels is underserved for various reasons.
      It Didn't Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle by Mark Wolynn
      Research has recently shown that the roots of mental health disorders may not just reside in our own current life experiences or in the chemical imbalances inside our brains, but in the lives of our parents, grandparents, and even further back. The author is a leading expert in the field and in this book, he looks at how trauma experienced by relatives may be passed down to the next generation and how to address those issues.
      Black Pain: It Just Looks Like We're Not Hurting by Terri Williams
      When successful business executive and mental health advocate Terri Williams was diagnosed with depression, she found that the topic was still taboo especially in the Black community. In this book, she discusses the emotional pain of depression and how it uniquely affects the Black experience, encouraging readers to seek help without feeling ashamed. She reminds readers that they are brave for facing emotional difficulties head-on and finding solutions with the help of others.
      This Too Shall Pass: Stories of Change, Crisis and Hopeful Beginnings by Julia Samuel
      This may be a useful resource for clinicians. In it, psychotherapist Julia Samuel uses hours of conversations with patients to show how individuals act and adapt differently in the face of hardship. Backed by research, her analysis of the stories she shares explains how mental health is different for everybody, yet evidence-based treatment and coping skills work across multiple populations.
      If you need help with behavioral health issues, consider contacting a qualified mental health professional
      If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
    16. 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!
    17. Study Correlates Stress & Lack Of Sleep To Experiencing Concussion-Like Symptoms

      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:
      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. 
      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
    18. Are Mental Health Disorders Genetic?

      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. 
      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
    19. Barriers To Accessing Behavioral Health Care - And How Virtual Care Can Help

      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!
      National Council for Behavioral Health
    20. The Science Behind PTSD: How Trauma Changes The Brain

      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
      Reactive Anger
      Increased Fear
      Decreased Positive Emotions
      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!
      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
    21. What Is Bipolar Disorder?

      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!  
      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?
    22. What Is ADHD? (Attention-Deficit/Hyperactivity 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!  
      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?
    23. Understanding Post-Traumatic Stress Disorder (PTSD)

      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!  
      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
    24. What is Generalized Anxiety Disorder?

      Feeling nervous about life? Having a hard time concentrating or relaxing because you worry all the time? Can't shake the feeling that something bad will happen and you are unprepared?  You’re not alone.
      If you are in a chronic state of anxiety and stress, you may have Generalized Anxiety Disorder (GAD), which can make a person feel constantly worried even when there is little or no reason to. You may worry about missing a deadline, losing a job or a loved one, or having an accident. You may even worry about worrying too much. The stress can become debilitating and can lead to a loss of perspective on your current situation.
      Definition of Generalized Anxiety Disorder
      Generalized Anxiety Disorder is characterized in the DSM-5 (Diagnostic and Statistical Manual of Mental 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”.  An estimated 31.1% of U.S. adults experience an anxiety disorder at some time in their lives. The disorder can begin at any age, and affects children as well as adults. 
      The good news is that GAD is treatable.
      Symptoms of GAD
      People with GAD can't rid themselves of the feeling of worry, even while recognizing that it may be unwarranted. They may be unable to relax and have trouble falling or staying asleep. In addition, they may:
      Feel restless, irritable or feel “on edge”
      Have a hard time concentrating
      Be easily startled
      Feel easily tired or exhausted all the time
      Have headaches, muscle aches, or stomach aches 
      Have a hard time swallowing
      Tremble or twitch
      Feel sweaty, light-headed or out of breath
      Feel nauseous or tingling in the extremities
      Have to go to the bathroom a lot
      Experience hot flashes
      Causes and risk factors
      Scientists find that anxiety disorders result from a combination of genetic, behavioral, and developmental causes. Risk factors include a family history of anxiety and recent periods of stress. People with certain personality traits, such as shyness, may also be more vulnerable to developing anxiety disorders.
      Physiologically, scientists believe that GAD probably arises from over-activation of the brain mechanism responsible for fear and the “fight-or-flight” response. The amygdala is the part of your brain that initiates a response to perceived danger. It communicates with the hypothalamus which then releases hormones that raise your heart rate and blood pressure, tense your muscles, and ready your body to fight or run. According to scientists, in people with GAD, the amygdala may be so sensitive that it overreacts to situations that aren't really threatening, inadvertently provoking an emergency stress response. Over time, anxiety can become attached to thoughts that are not related to true sources of danger -  in a sense, “the brain may inadvertently create its own fears”.
      How does GAD impact daily life?
      All of us worry about everyday things - how we are going to get all our errands done while staying on top of work deadlines; how we’ll pay for the next vacation or the kids’ college education; how we’ll take care of an aging parent or deal with an in-law at the next family holiday. These are all normal.
      It’s when this worry becomes uncontrollable, lasts for months at a time, and interferes with our ability to function, that it’s time to seek a behavioral health professional to diagnose potential GAD. Adults who have been diagnosed with Generalized Anxiety Disorder say things like, “I dreaded going to work because I couldn’t keep my mind focused”, or “I was having trouble falling asleep every night because my mind was racing with worry, so I was always tired”, or “I was irritated with my family all the time”.
      If you or your loved one are in the military or serve as a first responder, there is already a justifiable amount of things to worry about, such as separation from those you hold dear, frequent moves, or parenting alone while a loved one is deployed; however this worry can sometimes develop into something more. Active duty military as well as veterans can develop anxiety disorder after experiencing trauma, or during high-stress situations, such as the transition from military to civilian life. In fact, the VA stated there was a 327% increase in reported anxiety disorders among service members between 2000 and 2012. Caring for a loved one with anxiety disorder presents its own challenges, and you want to make sure you have the best professional resources available to help.
      Children and teens are also susceptible to developing an anxiety disorder. According to NIH, an estimated 31.9% of adolescents have some form of anxiety disorder. Symptoms are identical to adults - excessive, chronic worry plus physical symptoms. Children with GAD tend to dwell about the same things as their non-anxious peers, but do so in excess. They may focus obsessively on things they see in the news, such as forest fires or crime. These worries and symptoms can impair daily functioning, and may cause them to avoid activities that trigger or worsen their feelings of stress, so school work and relationships suffer.
      Treatment for Generalized Anxiety Disorder
      GAD can be treated with a combination of therapy, medication, or both. Speak  with a behavioral health professional on how best to approach a treatment that is right for you. In some cases, a healthy lifestyle including good diet, exercise and the right amount of sleep can help reduce symptoms.
      Although different techniques may work for different people, a therapist can help you identify new ways of thinking and reacting to situations that help you feel less anxious. You may be advised to track your responses over time to discover potential behavior patterns, or learn techniques to promote relaxation. Both medication and therapy take time to work, so it is recommended to continue with your prescribed regimen and not get discouraged too quickly. This is manageable, and there is help to cope with these feelings. You can feel better.
      Feeling like you or a loved one may have some of the anxiety symptoms described here? 
      Telemynd is a nationally delegated telebehavioral health provider for TRICARE members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists from the convenience of your home. You can review benefit coverage or visit our request appointment page to choose your current insurance provider and get started!
      NIH | National Institutes of Mental Health: Generalized Anxiety Disorder
      American Psychiatric Association: What are Anxiety Disorders?
      Harvard Mental Health Letter: Generalized Anxiety Disorder
      National Alliance on Mental Health Illness: Anxiety Disorders
    25. Differences Between Adjustment Disorder, Anxiety Disorder, & Depression

      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: 
      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!  
      Johns Hopkins Medicine: Adjustment Disorders
      Merck Manual 2020: Adjustment Disorders
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