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    1. World Mental Health Day 2023

      World Mental Health Day, observed on October 10th each year, is a critical moment to raise awareness about mental health issues, reduce stigma, and promote overall well-being. In this blog post, we'll explore the significance of World Mental Health Day, take a closer look at the current state of mental health, discuss practical ways to take care of your mental health, offer tips on supporting others, and provide valuable resources, including Telemynd, to help you on your mental health journey.
      The Significance of World Mental Health Day
      World Mental Health Day is a global event recognized by the World Health Organization (WHO) to emphasize the importance of mental health and foster discussions around it. Here's why it matters:
      Destigmatizing Mental Health: One of the primary goals of this day is to reduce the stigma surrounding mental health. Stigmatization often prevents people from seeking help, which can have dire consequences. By discussing mental health openly, we can break down these barriers.
      Promoting Awareness: World Mental Health Day raises awareness about the many mental health issues that individuals face, from anxiety and depression to more severe conditions like schizophrenia. Understanding these issues helps build empathy and support networks.
      Encouraging Action: The day encourages individuals, communities, and organizations to take concrete steps towards improving mental health. These actions can range from self-care to advocating for mental health policy changes.
      The State of Mental Health Today
      To truly appreciate the significance of World Mental Health Day, it's crucial to delve deeper into the current state of mental health worldwide. The statistics and trends below shed light on the scale of the issue and its far-reaching consequences:
      Prevalence of Mental Health Issues
      Depression and Anxiety: Depression and anxiety disorders are among the most prevalent mental health conditions globally. According to the World Health Organization (WHO), depression affects approximately 280 million people worldwide, while over 300 million suffer from anxiety disorders. These conditions can be debilitating, affecting every aspect of a person's life, from their relationships to their ability to work and enjoy life. Substance Abuse: Substance abuse affects over 270 million people worldwide, and often co-occurs with mental health issues. Individuals struggling with depression, anxiety, or other mental disorders may turn to drugs or alcohol as a means of self-medication. This dual diagnosis makes treatment more complex and underscores the importance of addressing mental health holistically. Eating Disorders: Eating disorders like anorexia nervosa, bulimia nervosa, and binge-eating disorder also take a heavy toll on mental well-being. About 70 million people internationally live with this condition that not only harms physical health but also have severe psychological and emotional consequences. Impact on Productivity
      Economic Burden: The economic toll of untreated mental illness is staggering. The World Economic Forum estimates that mental health conditions will cost the global economy $16 trillion by 2030. A significant portion of this cost comes from lost productivity as individuals with untreated mental health issues struggle to perform at their best in their professional lives. Workplace Challenges: Mental health challenges often manifest in the workplace, leading to decreased productivity, frequent absences, and a higher turnover rate. Employers are increasingly recognizing the importance of mental health support programs to retain talent and maintain a healthy, thriving workforce. The Stigma Factor
      Barriers to Seeking Help: Stigma remains a formidable obstacle to seeking mental health treatment. Many individuals hesitate to reach out to professionals or disclose their mental health struggles to friends and family due to fear of judgment, discrimination, or potential social consequences. This stigma perpetuates silence and suffering. Gender and Cultural Disparities: Gender and cultural factors also play a role in the stigma surrounding mental health. In some cultures, discussing mental health is particularly challenging, and gender norms can restrict individuals from seeking help when they need it. Breaking down these barriers is essential for global mental health improvement. Pandemic Effects
      Increased Mental Health Issues: The COVID-19 pandemic has exacerbated existing mental health challenges and created new ones. The stress of living through a global health crisis, coupled with isolation, economic uncertainties, and grief over lost loved ones, has led to a surge in mental health issues. Studies report rising rates of depression, anxiety, and loneliness worldwide. Healthcare System Strain: The pandemic has strained healthcare systems globally, affecting mental health services as well. Many individuals faced difficulties accessing therapy or counseling due to lockdowns and overwhelmed healthcare facilities. Telehealth services like Telemynd have become crucial for maintaining mental health support during these challenging times. Taking Care of Your Mental Health
      Your mental health is just as important as your physical health. Here are practical steps you can take to nurture it:
      Practice Self-Care
      Prioritize self-care routines that work for you, such as meditation, exercise, journaling, or spending time in nature. Get enough sleep, maintain a balanced diet, and limit alcohol and caffeine consumption. Connect with Others
      Build a strong support network of friends and family. Social connections can provide emotional support during difficult times. Reach out and talk to someone when you're struggling. Sharing your feelings can alleviate stress and anxiety. Manage Stress
      Learn stress management techniques like deep breathing exercises, mindfulness, or progressive muscle relaxation. Set boundaries and avoid overextending yourself with commitments. Seek Professional Help
      Don't hesitate to reach out to mental health professionals when needed. Therapy, counseling, and medication can be effective treatments. Telemynd, a telehealth service, offers convenient access to licensed mental health providers through online sessions. How to Support Others
      Supporting someone with a mental health issue requires empathy and understanding. Here's how you can help:
      Educate Yourself: Learn about the specific mental health condition the person is facing to better understand their experiences and needs. Be a Good Listener: Encourage open and non-judgmental conversations. Let them express their feelings without interruption. Offer Practical Support: Assist with daily tasks or chores, when necessary, especially during challenging periods. Also simply remind them periodically that you’re there to help when they need support. Encourage Professional Help: If the person is struggling, encourage them to seek professional assistance, such as therapy or counseling. Resources and Support
      Access to resources is crucial for mental health support. Telemynd is a leading telehealth service that connects individuals with licensed mental health professionals through secure online sessions. Telemynd offers a convenient and confidential way to receive therapy and counseling, eliminating scheduling, transportation, and geographical barriers.
      The platform provides access to a wide range of mental health professionals, allowing you to find the right match for your needs. With the flexibility of online sessions, it's easier to fit therapy into your routine, and Telemynd prioritizes your privacy and security, ensuring a safe space for your therapy sessions.
      In addition to Telemynd, there are numerous helplines, support groups, and online resources available for mental health support. Organizations like the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA) offer valuable information and assistance.
      Conclusion
      World Mental Health Day serves as a reminder of the importance of mental health and the need to support those who may be struggling. By understanding the state of mental health today, practicing self-care, and offering support to others, we can contribute to a world where mental health is treated with the same importance as physical health. Don't hesitate to utilize resources like Telemynd to embark on your journey towards improved mental well-being. Together, we can break down the barriers that prevent individuals from seeking help and create a more compassionate and understanding society.
    2. Why Is There A Stigma Around Seeking Mental Health?

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

      In the three years since the onset of the COVID-19 pandemic and subsequent lockdown policies, there has been a dramatic uptick in mental health concerns among kindergarten through 12th-grade students. According to the Children's Hospital Association, during the height of the pandemic in 2020, the number of children visiting the emergency room for mental health rose dramatically. By 2021, U.S. Surgeon General Vivek H. Murthy issued an advisory declaring a mental health crisis for American children. The report noted that “an alarming number” of young people struggle with “feelings of helplessness, depression, and thoughts of suicide.”
      In the ensuing years, school districts have looked for novel ways to support students in need. Many states have prioritized hiring counselors and school psychologists or offering social-emotional curricula designed to raise awareness of mental health concerns. A few states have started allowing students to take excused absences to manage mental and behavioral health concerns.
      The Value of Mental Health Days
      Students with ongoing mental health struggles often need time during the school day to get the care they need. Appointments with providers may overlap with school hours and lead to absences. Students adjusting to medication changes or managing periods of mental health crisis may not be well enough to attend school.
      Excused absences allow students undergoing mental health treatment to take the time they need without concern about truancy violations or having to repeat a grade. Furthermore, a policy of excusing absences for mental health ensures that students can get support from teachers as they make up missed work.
      Many students who don’t have diagnosed mental health conditions experience periods of mental distress or emotional fatigue. In an interview with the Washington Post, Barb Solish, director of Youth and Young Adult Initiatives for the National Alliance on Mental Illness (NAMI), noted that an excused day off is beneficial to those students as well.
      “When students are feeling physically unwell, there is a universal understanding that they should stay home and they should take time to feel better,” Solish said. “School policies that recognize mental health as an acceptable reason for absence can help students take the time they need to care for themselves and restore their health. Practically speaking, if you have a fever, you’re not paying attention in class, right? You’re not learning the lesson. If you’re feeling overwhelming anxiety, you’re not learning either.”
      What States Allow Mental Health Days in School?
      As of summer 2023, 12 states have passed laws explicitly excusing school absences for mental health reasons. The specifics of the laws vary, with some states requiring a written excuse from a mental health care provider and other states asking only that students and parents explain the reason for their absence. Some states limit the number of days students can be absent for mental health care.
      Arizona: As of 2021, students in Arizona are allowed to take mental health days off from school, though each school district can set its own policies. California: In 2021, California enacted a law that allows students to miss school due to mental or behavioral health concerns. In addition, all public schools must include mental health content in their health education curriculum. Colorado: In 2020, Colorado passed a bill allowing students to take mental health days and requiring school district attendance requirements to include a policy for excused absences for behavioral health concerns. Connecticut: In 2021, Connecticut passed a law permitting all students to take two non-consecutive mental health wellness days per year. Illinois: Starting in 2022, Illinois public schools must allow students to take up to five mental health days per year and treat them as excused absences. Students and parents will need to explicitly state that they are using a mental health day absence when they call into their school. Kentucky: In 2022, Kentucky passed a law making days off from school for reasons related to mental health excused absences. Maine: In 2020, Maine enacted a bill that would allow students to take days off school for mental and behavioral health reasons. Nevada: In 2021, Nevada passed a law allowing students aged 7-18 to miss a day of school for mental health reasons with a written note from a mental healthcare provider. Oregon: In 2019, Oregon passed a law allowing students to take up to five days off school within a three-month period, including days for mental health or physical illness. Utah: In 2021, Utah adopted a law making mental or behavioral health an excused absence. Virginia: In 2019, Virginia passed a law allowing students to use mental health as a valid excuse for absence. Washington: In 2022, the state of Washington enacted a new law that will allow students to use mental or behavioral health reasons as a valid excuse for an absence. A handful of other state legislatures have proposed laws to revise state absence policy to include excused absence for mental health concerns. Since 2019, lawmakers in New York, Maryland, Massachusetts, Pennsylvania, Michigan, Ohio, New Jersey, and Delaware have tried to pass legislation in support of excused mental health days, but the bills were unsuccessful. It is not clear if lawmakers will try again in the future.
      States With No Official Policy on Mental Health Days
      The majority of states have no official guidance about mental health-related absences. That doesn’t mean students can’t take time out of school to care for their mental health, however. Even in states where there aren’t laws on the books, individual school districts may have policies that accommodate students who need time for mental health care.
      For example, Maryland failed to pass a law about excused absence for mental health reasons. However, the New York Times reports that Montgomery County, home to the largest district in the state, implemented a policy of excusing absences taken for “student illness and well-being” beginning in 2021.
      Adults should contact school administrators to find out the attendance policies for their school district and discuss how to arrange for the time their child needs for mental health care.
      What Counts as a Mental Health Day?
      Lawmakers have worked to balance the pros and cons of mental health days for students. Some of the laws protecting time off for mental health reasons are meant as a way for students to access professional mental health care. California’s law was written to “ensure that student absences for behavioral health concerns will be treated the same as excused absences for physical health concerns.” The law’s advocates hope that allowing students to miss school for mental health reasons will reduce barriers to getting the care they need.
      In contrast, Connecticut supports mental wellness days for students who may not have ongoing mental health concerns. The law allows time for kids who need a break to recharge. “The idea behind providing two mental wellness days is first to support self-care and help create good mental wellness habits early in life,” said state Rep. Liz Linehan, co-chair of the Committee on Children. “Secondly, by classifying mental health days, we reduce the stigma of mental health concerns and give our kids a way to talk to the adults in their lives about their struggles.”
      In Illinois, schools are required to follow up with parents when students take more than one day off for mental health reasons. This gives school counselors an opportunity to offer support if the student needs it. Schools can refer students for counseling or work with parents to open a dialog with their students about what they need.
      Changing Policy in Your State
      If your home state doesn’t offer excused absences for students to seek mental health treatment, you can advocate for change. Residents can contact state lawmakers directly to tell them why students should have mental health days. Most lawmakers post their contact information on their official websites. In addition, residents can reach out to state and local boards of education to ask for better policies around student mental health.
      Local and state-level education groups like the PTA often have committees that advocate for state policy changes that benefit students. Joining your school’s PTA and speaking to leadership is a good way to connect with others working to support students. In addition, organizations like the National Alliance on Mental Illness (NAMI) advocate at the state and local levels. You can get on their email list to receive alerts about opportunities to advocate for student mental health.
      In the short term, adults caring for children with mental health concerns can talk to teachers, counselors, and school administrators about accommodating the child’s need for care. There may be local resources available to assist you.
    4. When Soldiers Return Home: Mental Health & Adjusting to Life Post-Deployment

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

      Stress and burnout are concerning - especially regarding our work lives. A recent Deloitte study found that 91% of people say that having an unmanageable amount of stress negatively impacts the quality of their work. Additionally, 77% say they’ve experienced burnout at their current job, with more than half citing more than one occurrence.
      But is there a difference between stress and burnout? Is burnout a kind of stress? Is stress at work always bad? And what can be done about both? In this article, we look at what the research says about the difference between stress and burnout, and how to prevent chronic stress from becoming burnout. 
      What is burnout? What is stress?
      In 1974, psychologist Herbert Freudenberger first coined the term “burnout” - which he said usually occurs within the context of work - to mean emotional exhaustion, depersonalization, and feelings of inefficiency or lack of accomplishment. His studies found that burnout diminishes productivity and ultimately leads to a lesser quality of work. 
      Stress is a physical or mental response to any external cause. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time (chronic stress). Stress can be a negative factor (scientists call this dysfunctional stress) or a positive one (called functional stress or eustress). 
      Surprised about that last part? Yes, stress can be good - in the right context. The American Psychological Association defines functional stress as “stress that involves optimal levels of stimulation resulting from challenging but attainable, enjoyable or worthwhile tasks. It has a beneficial effect by generating a sense of fulfillment or achievement and facilitating growth, mastery, and high levels of performance.” So for example, functional stress can help you perform better in an athletic event or get a job done more quickly at work.
      When too much stress becomes burnout
      However, if stress interferes with your everyday life, causes you to avoid doing things you normally like, or seems to be always present, you may have tipped the scales over into burnout. A recent research review suggests burnout is on the extreme far end of the stress continuum. When you are stressed, although it may feel miserable, you can still take steps to cope with pressures. But once burnout takes hold, you’re emotionally fatigued and have more than likely given up hope of overcoming obstacles. You have less ability to cope with regular stress. Your interests and motivation dry up, and you may fail to meet even the smallest obligations. 
      Here are additional symptoms of burnout:
      Lowered immunity to illness Withdrawal from coworkers and social situations Job absenteeism and inefficiency Sleep deprivation Foggy thinking and trouble concentrating Lack of joy Recent research on the relationship between stress and burnout found that work stress and burnout are mutually reinforcing; however, the effect of work stress on burnout is smaller than the effect of burnout on work stress. This means that the more severe a person's burnout becomes, the more stressed they’ll feel at work. 
      Try these tactics for keeping burnout in check
      Bottom line, don’t let negative stress tip over into burnout if you can help it. Experts suggest these self-care tips for keeping burnout in check:
      Focus on very short-term and realistic goals and wins Make time for yourself Take a break from the situation, if at all possible Exercise, and make sure you are eating healthy, regular meals Stick to a sleep routine, and make sure you are getting enough sleep Avoid drinking excess caffeine Identify and challenge negative and unhelpful thoughts Reach out to friends or family who help you cope in a positive way If none of these tactics work, speaking with a mental health professional is your next step before you experience severe burnout. They can help you develop new coping skills and provide a safe space to vent. They may suggest trying a combination of medication with your therapy. Each person is unique and will respond differently to each technique. Your therapist can help you find the right combination for you.
      Sources
      Journal Personality and Individual Differences: Stress and burnout: The significant difference
      NIH: Work Stress and Burnout Among Nurses: Role of the Work Environment and Working Conditions
      Frontiers in Psychology (Journal): Is Burnout Primarily Linked to Work-Situated Factors? A Relative Weight Analytic Study
    6. What Undiagnosed ADHD Looks Like In Adults

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

      The news is full of stories of natural disasters - hurricanes, tornadoes, blizzards, forest fires, floods, and more. In fact, the number of disasters has increased 5 times over the past 50 years - driven by climate change and the weather extremes caused by it. And the trend won’t be changing anytime soon. But beyond the dramatic pictures on the news of homes and businesses underwater or destroyed by fire - what is the psychological toll that natural disasters take? In this article, we look at the link between natural disasters and mental health, and what can be done to address it.
      Research shows a clear link between natural disasters and mental health
      The impact of a natural disaster is often measured by obvious numbers such as fatalities and injuries, number of homes and buildings destroyed, and the cost of cleanup and repair. But those numbers don’t account for the emotional wounds suffered by survivors. Last year, the Federal Emergency Management Agency (FEMA) said, “the toll that disasters put on mental health is well documented… and more Americans are affected by climate-driven disasters every year”. 
      Multiple studies show that natural disasters often result in a  large number of ‘psychological casualties’. One well-known study, conducted after Hurricane Katrina, found that suicide and suicidal ideation more than doubled in survivors, with 1 in 6 people meeting the diagnostic criteria for PTSD. The study went on to say that the potential for immediate and severe psychological trauma after a natural disaster is high, and related to “personal injury, injury or death of a loved one, damage to or loss of personal property (e.g., home) and pets, and disruption in or loss of livelihood”.
      Another report suggests that natural disaster survivors are at higher risk for depression, anxiety, and other mental health conditions; even more specifically, people whose homes had suffered from adverse weather events had a 50% increase in risk for mental health issues. Following Hurricane Sandy, a telephone screening of local residents 6 months afterward, identified 15% of adults still suffering from PTSD.
      How does our body and brain react to trauma like natural disaster?
      When any kind of trauma occurs, the brain stem - the part of the brain which is responsible for the most vital functions of life (breathing, blood pressure, heart rate, etc.) - takes over. 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. When the threat ceases, the parasympathetic nervous system - that part of the brain that controls activities that occur when the body is at rest - steps in again and resumes the higher functions that were recently shut down. 
      However, for some trauma survivors, after-effects remain. Some survivors become so distressed that they become withdrawn or increase their use of drugs and alcohol. Even after the disaster ends, many people continue to feel an enormous amount of stress and anxiety that, if not dealt with, can turn into long-term mental health problems. Chronic stress can impair the parts of the brain which govern reason and self-control — leading to more unhealthy choices and an increased likelihood of addiction. 
      To add to the suffering, after a natural disaster many are unable to return to work, lack strong social support, or suffer the added financial burden of repairing or replacing damaged property. The long rebuilding process can perpetuate feelings of uncertainty and chronic stress. More vulnerable populations - children and the elderly, for example - are especially susceptible to mental health impacts of natural disasters. They may experience changes in behavior, memory, or executive function.
      Other common psychological responses in the days and weeks following a disaster can be:
      Disbelief Fear and anxiety about the future Disorientation; difficulty making decisions or concentrating Apathy and emotional numbness Nightmares about the event Irritability and anger Sadness and depression Feeling powerless Changes in eating patterns; loss of appetite or overeating Headaches, back, or stomach pains  Difficulty sleeping or falling asleep What can be done to better help survivors of natural disasters?
      Implementing targeted psychological care is critical to saving lives, jobs, and families after a natural disaster. Many have advocated for local and federal government agencies to incorporate psychological recovery programs into their disaster preparedness plans - and that has been happening - but slowly.
      On a local level, experts urge survivors to recognize that symptoms of mental health issues after a disaster are normal. And asking for help is not a weakness. To move toward healing, survivors can:
      Talk about the event: share experiences with others in order to relieve stress. Spend time with friends and family: stay in touch with family outside the area by phone if possible.  Get plenty of rest and exercise, and eat properly. Avoid drugs and excessive drinking: drugs and alcohol may seem to temporarily remove stress, but in the long run, they create additional problems. Limit exposure to images of the disaster: it’s tempting, but watching news about the event over and over increases stress. Take one thing at a time: pick one urgent task and work on it, then once you accomplish that task, choose the next one, and so on. Join a support group of individuals with similar life experiences. Ask for more help when you need it: if you have strong feelings that won’t go away or if you are still struggling more than 4-6 weeks after the event, seek professional help.  Don’t try to cope alone. If you’ve been involved in a natural disaster and need help with mental health issues, consider contacting a qualified mental health professional
      If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
      Sources
      Journal Family Medical Primary Care
      Current Psychology
      International Journal of Emergency Mental Health and Human Resilience
      Scientific American
    8. 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!
    9. 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!
      Sources
      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
    10. 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!  
      Sources
      American Psychiatric Association: What Are Bipolar Disorders?
      National Alliance on Mental Illness (NAMI): Bipolar Disorder
      NIH | National Institutes of Mental Health: What Is Bipolar Disorder?
    11. 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!  
      Sources
      Centers for Disease Control (CDC): What is ADHD?
      Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): ADHD
      NIH | National Institutes of Mental Health: What is ADHD?
    12. Watch & Learn: Top Ted Talks About Mental Health

      Last week, we curated 8 informative podcasts [link] about mental health, and this week, we continue our mental health resources series in a more visual medium. Listed below are 8 compelling and illuminating TED Talk videos about mental health. TED Talk videos are described as “the best talks and performances from the TED Conference, where the world's leading thinkers give the talk of their lives in 18 minutes or less”.
      Topics range from depression to PTSD to schizophrenia and everything in between; and from mental health issues for teens to mental health issues for veterans. The nice thing about TED Talks is that each video is short - meaning you can watch and learn a lot in a small amount of time - maybe even squeeze one in between classes or meetings, or while waiting in line at the coffee shop. 
      Feel free to bookmark this page, go through the videos, and share with friends, family, or if you are a clinician, patients who may also benefit.
      There's no shame in taking care of your mental health - Entrepreneur Sangu Delle found himself suffering from anxiety and depression but up against the stigma that seeking help meant weakness. In this inspiring TED Talk, he describes confronting his own deep prejudice: that men shouldn't take care of their mental health, and then shares how he learned to handle anxiety in a society that's uncomfortable with emotions.
      The voices in my head - She started off college like every other student: hopeful, energized, and ready to meet the world. But author Eleanor Longden soon began hearing voices in her head. Soon the voices became antagonistic, turning her life into a nightmare. Finally diagnosed with schizophrenia and hospitalized, she describes the moving tale of her years-long journey back to mental health.
      Confessions of a depressed comic - “For a long time, I felt like I’d been living two lives…” So starts comedian and perpetual “life of the party” Kevin Breel’s story of the night he realized he had to admit he was suffering from depression in order to save his life. Inspiring and relatable tale of how what looks like a happy life from the outside might not necessarily be so.
      We train soldiers for war. Let's train them to come home, too - Frontline psychologist Hector Garcia urges society to help our soldiers better learn how to transition from the battlefield back to civilian life. He tells stories of real soldiers suffering from PTSD and explains how we can improve our care of veterans’ mental health.
      Why students should have mental health days - Teen mental health advocate Hailey Hardcastle describes how school days can be rife with stress, anxiety, panic attacks, and burnout – but there's often no formal policy to help students prioritize their mental well-being. We have “sick” days but no “mental health” days. She advocates for that to change.
      The brain-changing benefits of exercise - Author and Professor of Neuroscience and Psychology at New York University, Wendy Suzuki discusses the science of how exercise boosts our mood and how it can be used to work alongside therapy and pharmaceutical solutions to address mental health issues.
      How to connect with depressed friends - Very useful and actionable discussion on how to approach friends who may exhibit symptoms of depression or have been diagnosed with depression. Comedian and storyteller Bill Bernat provides ‘dos and don'ts’ for talking to people living with depression - and how to handle the conversation with grace and maybe even a little humor.
       
      Break the silence for suicide attempt survivors - Host JD Schramm addresses this very sensitive topic with care and concern. He advocates for resources for suicide attempt survivors because “it gets better”, and hopes that those who have tried and failed but found their way back to a meaningful life may be willing to speak up to convince those thinking about suicide that their lives matter. [If you or a loved one have thoughts of suicide, call the National Suicide Hotline at 800-273-8255.]Are there any TED Talks that you would add to the list? Let us know in the comments.
      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.
    13. Veteran Mental Health Insights and How You Can Get Help

      Understanding veterans’ mental health statistics and their mental health risks is essential to helping them get the care they need. Veterans’ suicide prevention begins with knowledge and information about the challenges they are facing. They do an important service for the country and deserve the assistance required to face their struggles head-on. Many resources are available to help in times of crisis.
      Understanding Who Veterans Are
      The latest data from 2021 reveals there are approximately 16.5 million military veterans in the United States. Although there are currently more male veterans, the number of females enlisting in the military is rising. There are 1.7 million female veterans in the United States. In 2021, 231,741 women were in active-duty force, and 171,000 women were in the National Guard. This made up 17.3% and 21.4%, respectively.
      The age breakdown of the veteran population is estimated as follows:
      Ages 18 to 34 years comprise 8.2%. Ages 35 to 54 years comprise 24.0%. Ages 55 to 64 years comprise 18.6%. Ages 65 to 74 years comprise 24.8%. Ages 75 and over comprise 24.4%. Risks Veterans Face When Coming Home
      Due to the nature of their service, veterans face various risk factors when returning home from service or getting discharged from their duties. These risk factors contribute to poor outcomes for many of the men and women who’ve served the country.
      Physical Injury
      Men and women in the military are at an increased risk for physical injury. These may include wounds from being in a battle, vehicle accidents, sprains, and strains, hearing loss or tinnitus, head injuries, and chronic musculoskeletal pain (CMP).
      A total of 30% of veterans have some disability.
      Trauma
      Many veterans endure significant trauma after going through combat. Even if they may not engage in warfare themselves, seeing others get killed, maimed, or injured could lead to a traumatized response.
      Also, during times of stress and danger, the body commonly experiences a surge of heightened adrenaline and a fight or flight response.
      Post-traumatic stress disorder (PTSD) is more common among veterans than the general population. According to the U.S. Department of Veterans Affairs, approximately 7% will experience PTSD.
      Vets with PTSD may experience symptoms such as:
      Avoidance of things that trigger memories about the event Hopeless feelings about life and the future Difficulty with memory Intrusive memories and dreams Irritability or angry outbursts Unemployment and Poverty
      Veterans have long been at a higher risk for poverty and homelessness. If a vet is struggling with PTSD or another mental health disorder, it makes it challenging to hold down a job. It’s also challenging to keep up with a full-time job if medical conditions hinder a vet’s ability to perform. These factors can lead to homelessness.
      Veterans Mental Health Statistics
      Aside from PTSD, as mentioned above, many experience an array of other mental health issues. The National Institute of Health (NIH) research reveals that one-third of veterans have at least one mental health disorder diagnosis, and 41% have either mental health or a behavioral adjustment disorder.
      Mental Health Disorders
      Mental health disorders may range in intensity, but even in mild cases can affect the person’s ability to manage life effectively. For example, researchers from the VA New England MIRECC and the Yale School of Medicine conducted a study with veterans experiencing anxiety and PTSD which found that they had a much higher rate of homelessness than the general veteran population.
      PTSD is also linked to higher rates of suicidal thoughts and impulses, making this mental health condition a significant risk. Compared to the general U.S. population, veteran suicides are higher by 57.3%. The total number that committed suicide in 2020 was 6,146.
      However, the suicide rate among veterans is slowly decreasing. According to the most recent VA report, there were 343 fewer veteran suicides in 2020 than there were in 2019.
      Only through the continued work of the VA and qualified mental health professionals can they receive the proper treatment and counseling to help them cope and bring down these statistics even further.
      Substance Use Disorders
      Misusing drugs or alcohol is a common method of escape for many people. Since substances provide a temporary feeling of euphoria, veterans may use them to numb the feelings and memories of combat. However, the risk for addiction is high when using illicit substances.
      Approximately one-fourth of them struggle with illicit drugs, and 80% battle alcohol misuse. One in 10 veterans has been diagnosed with a substance use disorder, which is higher than the general population. Between substance misuse and mental health disorders, veterans are likely to have one or the other condition.
      Some dealing with untreated mental health problems or suffering from PTSD may turn to drugs or alcohol as a “quick fix” to the problem. Yet, it ends up being an additional problem in the end. When someone has a mental health condition like PTSD combined with substance abuse, they need treatment for a dual-diagnosis disorder. This requires therapy for veterans that addresses the underlying problem and detox in some cases.
      Resources for Veterans in Need
      Veterans don’t have to suffer from a mental health disorder in silence. The VA is committed to veterans’ suicide prevention and providing care for mental health issues.
      The Veterans Affairs mental health services department has made mental health a top priority and recently implemented the National Strategy For Preventing Veteran Suicide and Reducing Military and Veteran Suicide programs. These programs provide a roadmap for assisting those at risk for suicide, whether they have benefits or not.
      They also have expanded their benefits to include those who are not currently enrolled but experiencing a crisis. Now, they can seek care at no cost if they are dealing with suicidal thoughts or amid a crisis, allowing access to up to 9 million more veterans.
      In some cases, an individual may be able to go to any VA or non-VA healthcare facility for emergency healthcare at no cost. This may include inpatient or crisis residential care for some time up to 30 days. Outpatient care may be covered for up to 90 days.
      Another way the Veterans’ Affairs mental health services department is working to help with mental illness is to leverage community providers to provide therapy. They would just need to get approval and a referral from the VA. Then they can schedule an appointment with a mental health provider, such as Telemynd, which provides telehealth and telemedicine care.
      Keep in mind that if you are having a crisis, you should reach out to emergency helplines or call 911 right away. Many helplines are available, such as the veteran crisis line at 1-800-273-8255 and the veterans’ suicide hotline by dialing 988. These hotlines are available 24/7.
      How to Access Veteran Mental Health Care
      Veterans should be proactive in their mental health care. In other words, at the first sign of a problem, reach out to the resources available Often, telehealth is a great way to begin the journey, as you can access compassionate, licensed, and experienced mental health care from the comfort of your own home. You can even get a prescription using telehealth services through the VA referral.
      Start this process by consulting with your VA physician and telling them about your mental health concerns. They can give you the referral necessary to seek mental health care and have your VA benefits cover the cost.
      If you lack VA benefits but are experiencing mental health challenges, you are likely covered under the new initiatives mentioned above. Reach out to VA.gov to get the referral necessary for your covered care. You must specifically ask for authorization to seek treatment at Telemynd. Once you receive the authorization, you can contact us directly for an appointment.
    14. Using an HSA or FSA to Offset the Cost of Mental Health Care

      Mental health care is critical to maintaining overall wellness - just as important as caring for your physical health. And as we noted in a recent article, 1 in 5 of us live with mental health issues on a daily basis. As many as 30% of those with a mental health issue don’t seek treatment, and a common obstacle to that care is cost. 
      The good news is that you can pay for some mental health treatments and services with your Flexible Spending Account (FSA) or your Health Savings Account (HSA), to offset out-of-pocket expenses. This week’s article summarizes what mental health services qualify for coverage with FSA and HSA funds and how to use these accounts for mental health care. Be sure to click on the links included in this article, as we’ve referenced the original IRS and government sources for further information.
      What’s the difference between an FSA and an HSA?
      FSAs are an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars. You decide how much to put in an FSA, up to a limit set by your employer. Employers may make contributions to your FSA, but aren’t required to. 
      An HSA is a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. HSA funds generally may not be used to pay premiums. While you can use the funds in an HSA at any time to pay for qualified medical expenses, you may contribute to an HSA only if you have a High Deductible Health Plan (HDHP) — generally a health plan that only covers preventive services before the deductible. 
      It may sound complicated - but FSAs and HSAs are often a win-win for many people, as they allow you to reduce your tax liability and pay for your mental health care expenses, using pre-tax funds.

      Is mental health treatment eligible for HSA or FSA funds?
      According to the IRS, mental health therapy and treatment that is deemed ‘medically necessary’ is eligible for reimbursement with an FSA or an HSA - things like psychiatric care, and treatment for drug or alcohol addiction. So therapy such as marriage or family counseling - that is not required for a medical or mental purpose - may not qualify. The actual wording from the IRS is this: “treatment provided by a psychologist or psychiatrist is eligible for FSA or HSA reimbursement if the purpose of the treatment is for medical care and not for the general improvement of mental health”. Sound a bit murky? The best thing to do is to speak with your your health insurance directly to understand how to approach the situation first. 
      Regardless of the kind of health care services you are getting, an administrator may require you to get a ‘Letter of Medical Necessity’ in order to get coverage. This is a letter written by your doctor that verifies the services you are purchasing are for the diagnosis, treatment or prevention of a disease or medical condition.
      Make the most of your HSA to cover mental health expenses
      The IRS-approved list of mental health care expenses on which you can use your HSA includes services like psychologist visits (including online therapy), psychiatric care, alcoholism and drug treatment, and prescription drugs related to psychiatric care. You can pay for these with an HSA card or by getting reimbursed, but either way, always save your receipts. You’ll need these when you file your tax return each year. You can ask your health care provider for itemized receipts after each service, or a total record of all services at the end of the year.
      If you have health insurance (and remember, it must be a High Deductible Health Plan in order to be allowed to contribute to an HSA), you can use your HSA funds for any qualified expense that’s not paid directly to the provider or for which you’re not reimbursed by your insurance company. This includes co-pays and expenses to meet your deductible, as well as any uncovered medical expense.
      Using an FSA to cover mental health expenses
      Eligible mental health care expenses for which you can use your FSA account include alcoholism and drug treatment, psychiatric care (including online therapy), and prescription drugs related to psychiatric care. You use your FSA by submitting a claim to the FSA (through your employer) with proof of the medical expense and a statement that it has not been covered by your plan. You will then receive reimbursement for your costs. In addition, according to the IRS, you can use FSA funds to pay deductibles and copayments, but not for insurance premiums.
      In summary, understanding how to use FSAs and HSAs to help offset the cost of behavioral health may feel confusing or overwhelming - but it's worth digging into, as these accounts may save you money. For more help, you can ask your employer, an accountant, reference IRS Publication 969, or research online yourself. Here’s a good article that goes into more detail - in an understandable way - about the differences between HSAs and FSAs.
    15. 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.
      Archetypes
      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.
      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
    16. Understanding Types of Depression, Signs, Symptoms, & Treatment Options

      Being aware of the various types of depression is vital for reducing the misconceptions and stigma revolving around mental health conditions. Millions of people in the United States live with some form of depression. Knowing the signs and symptoms of all the types of depression helps increase awareness so people can seek the proper treatment and self-care. The following guide will go through the six forms of depression, including associated signs and treatments.
      Major Depression
      Description
      To understand what Major Depression looks like, we have listed the DSM 5 criteria below for Major Depressive Disorder . The DSM 5 provides health workers with what signs and symptoms to look for and gives a framework for diagnosing. Major Depression goes beyond simply feeling down or sad and includes the listed signs and symptoms below. If you feel like you are experiencing the symptoms below, we encourage you to reach out to a mental health professional for further assessment.
      Signs and Symptoms
      Common symptoms of this condition include:
      Feeling extremely sad, hopeless, and fearful Resorting to angry outbursts Feeling easily irritable or frustrated Disinterest in activities that were once enjoyed Having various sleep disturbances, like insomnia or sleeping too much Being overly tired even performing small, everyday tasks Appetite changes, leading to weight loss or increased cravings for food and weight gain Slower thinking, speaking, or body movements Feeling worthless or guilty Fixating on past regrets and missteps, leading to self-blame Feeling anxious, restless, or agitated Difficulty concentrating, remembering things, and/or making decisions Suicidal ideation, suicide attempts, or suicide Various physical problems, such as headaches and stomach upset Treatment Options
      Treatment plans can look different depending on the individual and can include one or a combination of therapeutic approaches. Below we have listed the three most common forms of treatment:
      Medication like antidepressants Psychotherapy (traditional talk therapy) using techniques from cognitive behavioral and/or interpersonal therapy Electroconvulsive therapy (ECT), used to treat life-threatening depression that hasn’t responded to therapy and medication plans. Persistent Depression
      Description
      Persistent Depression (PDD) is similar in many ways to major depression, sharing some of the same symptoms. However, the difference between the two is the duration of symptoms. In PDD, the symptoms must have been ongoing for at least two years. Adults diagnosed with Major Depression have episodes of symptoms with some gaps in symptom-free time.
      Signs and Symptoms
      The signs and symptoms below are much like Major Depression:
      Feeling depressed and helpless Becoming irritated over little things A change in appetite, either wanting to eat too much or not eating enough Sleep issues, like insomnia or sleeping too much Experiencing fatigue or having low energy Expressing words that indicate a struggle with low self-esteem Difficulty concentrating or making decisions Having feelings of hopelessness Treatment Options
      Like Major Depression, the treatment for PDD includes various medicines (SSRIs) and psychotherapy (talk therapy).
      Bipolar Depression
      Description
      Bipolar Depression is a mental health condition that causes extreme mood swings from an emotional high to an extreme low. These alternating mood shifts are referred to as mania or hypomania (extreme high) and depression (extreme low). Approximately 4.4% of adults in the United States experience bipolar disorder in their lives.
      Signs and Symptoms
      Bipolar Depression can be classified into one of three categories:
      Bipolar I: The person has had at least one manic episode, preceded, or followed by hypomanic or major depressive episodes. Sometimes, during the mania phase, a break from reality (psychosis) can occur. Bipolar II: The person has had a minimum of one major depressive episode and one hypomanic episode but never a manic episode. Cyclothymia: A person with this condition will have had at least two years of several periods of hypomania symptoms and depressive symptoms. The depressive symptoms are not as severe as major depression, though. Treatment Options
      In most cases, a person affected by bipolar depression will need to take mood-stabilizing medication to help manage the episodes. In addition, the provider will use therapies, such as:
      Interpersonal and social rhythm therapy (IPSRT) Cognitive behavioral therapy (CBT) Family-focused therapy Psychoeducation is another helpful tool used to manage bipolar disorder. Psychoeducation is a type of therapeutic approach or intervention that focuses on providing individuals and their families with information and education about mental health conditions, symptoms, treatments, coping strategies, and other relevant topics. The primary goals of psychoeducation are to empower individuals and their support systems, improve their understanding of mental health issues, and enhance their ability to manage and live with these conditions effectively.
      Seasonal Affective Disorder
      Millions of people are affected by Seasonal Affective Disorder (SAD). People with major depression and bipolar depression have a higher percentage of experiencing this condition than the general population.
      Description
      Seasonal Affective Disorder (SAD) is a type of depression that occurs at a specific time of the year, typically during the fall and winter months when there is less natural sunlight.
      Signs and Symptoms
      Some people have fall/winter seasonal affective disorder, while others have spring/summer seasonal affective disorder.
      Fall/Winter
      Oversleeping or sleeping more than usual Appetite changes, with cravings for carbohydrate foods Weight gain or weight loss Fatigue and tiredness Spring/Summer
      Insomnia Low appetite Weight loss Anxious or easily agitated Increased irritability Treatment Options
      The three main forms of treatment for seasonal affective disorder are light therapy (exposure to bright artificial light that mimics natural sunlight), psychotherapy, and medication (such as antidepressants).
      Postpartum Depression
      Description
      Postpartum is a medical condition that affects women after they give birth to a baby. In some cases, women may begin to feel postpartum symptoms during pregnancy. Postpartum is a serious condition that consists of a more severe form of depression related to the physical and hormonal changes as a woman’s body returns to its pre-pregnancy state. This form of depression can last for several months or longer.
      Signs and Symptoms
      Here are some signs and symptoms of postpartum depression:
      Overwhelming tiredness or fatigue Depressed mood or extreme mood swings Less interest in everyday pleasures and activities Crying much more than usual Severe anxiety and panic attacks Intrusive thoughts of harming oneself or the baby Struggling to bond with the baby Feelings of worthlessness, guilt, shame, or inadequacy Difficulty with concentration Indecisiveness Intense irritability and anger Withdrawal from family and friends Changes in appetite Insomnia or over-sleeping Restlessness Recurring thoughts of death or suicide Treatment Options
      Most treatment options for postpartum involve psychotherapy, antidepressants, or other medications, such as antipsychotic medicines, mood stabilizers, and benzodiazepines.
      Since many postpartum symptoms could also mimic those common with becoming a parent, new mothers should consider starting therapy right before/ right after giving birth to monitor any symptoms that arise and help identify postpartum early.
      Atypical Depression
      Description
      Atypical depression is a subtype of major depression with a specific set of symptoms that make it different from typical depression Atypical Depression is milder but more persistent and long-lasting.
      Signs and Symptoms
      Here are some signs and symptoms of atypical depression:
      Mood Reactivity: In atypical depression, individuals experience mood reactivity, meaning their mood can improve temporarily in response to positive events or situations. This is in contrast to the persistent low mood seen in other forms of depression. Increased Appetite and Weight Gain: People with atypical depression often have an increased appetite and may gain a significant amount of weight as a result of overeating. This is a hallmark symptom that distinguishes atypical depression. Hypersomnia: Individuals with atypical depression may experience excessive sleepiness and prolonged sleep durations (hypersomnia). They may sleep more than usual and find it difficult to wake up in the morning. Leaden Paralysis: Some individuals with atypical depression report experiencing a heavy, leaden sensation in their limbs, making them feel physically weighed down. Rejection Sensitivity: People with atypical depression may be highly sensitive to interpersonal rejection, often interpreting social situations negatively and feeling a strong need for social approval. Interpersonal Difficulties: Atypical depression may lead to difficulties in personal relationships due to these heightened sensitivities and emotional responses. Treatment Options
      Atypical depression treatment involves psychotherapy (talk therapy) and/or medication (MAOIs/SSRIs). Other factors can also aid patients in feeling better including lifestyle modifications, such as regular exercise, self-care, or stopping alcohol and/or recreational drug use.
      Misconceptions
      Although much has been done in society to decrease the stigma associated with mental health conditions like major depression and Bipolar Disorder, many people still have misconceptions about it that are important to dispel.
      Misconceptions say that:
      The person simply lacks willpower. The person is only feeling “blue” and will get over it. Medicine alone should resolve the problem. The person is giving into their feelings. The person can snap out of it easily. Depression affects everyone in the same way. Depression only happens when something negative has or is happening. Depression is the same as anxiety. Only adults get depression. Resources
      It’s important for someone who is struggling with a mental health condition, like any of the depressive conditions, to seek out the many available resources. Telemynd is a source of support for those who need to connect with a mental health provider.
      Telemynd offers a comprehensive mental health solution for people who want to be matched with qualified, mental health providers. We also partner with a variety of insurance companies to make necessary healthcare access easier.
      Telemynd's specialists are here to assist individuals or their loved ones on their journey to improved well-being. Contact Telemynd today.
    17. 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!  
      Sources
      NIH | National Institutes of Mental Health: Post-Traumatic Stress Disorder
      American Psychiatric Association: What is Post-Traumatic Stress Disorder?
      Department of Veterans Affairs, National Center for PTSD: PTSD
    18. 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!
    19. Understanding Common Phobias

      Over 12% of adults in the US meet the diagnostic criteria for a specific phobia. However, phobias come with much misunderstanding: some people believe they are just ‘overrated fears’ while others believe phobias can’t be overcome. On the contrary - phobias are a mental health issue. And they can be treated. In this article, we’re setting the record straight about common phobias - what they are, what they aren’t, how they are diagnosed, and how to get help.
      What is a phobia?
      Phobias are a kind of anxiety disorder; so they’re in the same diagnostic category as generalized anxiety disorder, but manifest differently. A phobia is defined as an overwhelming and debilitating fear of an object, place, situation, feeling or animal. But phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object. If a phobia becomes very severe, a person may organize their life around avoiding that thing that's causing them anxiety - so phobias can become debilitating. And in some cases, even thinking about the source of a phobia can make a person feel anxious or panicky (known as anticipatory anxiety).
      Types of phobias
      According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), there are three main types of phobias: 
      Specific phobias. Refers to an intense, persistent, and marked fear of a specific object or situation (such as flying, insects, or heights). People with specific phobias may be aware that their anxiety is out of proportion but feel helpless to control it. Agoraphobia. Refers to a deep fear of being in an environment (often outside or with many other people) where escape might be difficult or help unavailable in the event of developing panic-like symptoms. Social phobia. Also called social anxiety disorder; involves acute fear and self-consciousness in social situations. Can lead people to avoid attending events, meeting new people, or even seeking employment. Studies indicate that specific phobias concerning heights and animals/insects are the most common, but here is a list of other common specific phobias for which people seek treatment:
      Acrophobia - fear of heights Aerophobia - fear of flying Aquaphobia - fear of water Astraphobia - fear of storms Claustrophobia - fear of confined or tight spaces Dentophobia - fear of dentists Hemophobia - fear of blood Nosocomephobia - fear of hospitals Zoophobia - fear of animals In all cases, these intense fears are real for the people experiencing them. They are not figments of imaginations nor deliberate exaggerations of fear.
      People with phobias feel very specific and often debilitating symptoms when they come into contact with the source of their fear. Symptoms may include the following if you find yourself around the phobia source:
      unsteadiness, dizziness, lightheadedness nausea sweating increased heart rate or palpitations shortness of breath trembling or shaking upset stomach Risk factors for phobias
      The causes of anxiety disorders like phobias are unknown but likely involve a combination of genetic, environmental, psychological, and developmental factors. Anxiety disorders can run in families, suggesting that a combination of genetics and environmental stresses can result in a diagnosed phobia.
      Help for phobias
      Mental health professionals can diagnose a phobia - and they can be treated successfully. Often treatment involves a combination of exposure, medication and coping strategies - all of which a qualified professional can provide. 
      Scientists are finding that the phobias start out less intense and grow in acuteness over time - suggesting the possibility that interrupting the course of phobias with treatment early on could reduce their prevalence. A recent study, published in Lancet Psychiatry found that, “phobias can persist for several years, or even decades in 10-30% of cases, and are strongly predictive of the onset of other anxiety and mood disorders. Their high comorbidity with other mental disorders, especially after onset of the phobia, suggests that early treatment of phobias could also alter the risk of other disorders.”
      The key takeaway? Consult with a mental health professional as early as possible if you or a loved one believe you have symptoms of a phobia.
      Sources
      Lancet Psychiatry
      Current Topics in Behavioral Neuroscience
      National Institute of Mental Health
    20. Trouble Sleeping? How It Relates To Your Mental Health

      Do you have trouble falling asleep or staying asleep? You may be one of the 50 million adults in the United States with a chronic sleep disorder. For healthy adults, the recommended amount of sleep is seven hours per night. But if you suffer from a sleep disorder, squeezing that many hours into a single night is a real challenge — but shouldn’t be ignored, because our body’s inability to rest could be linked to underlying mental health conditions. A lack of sleep only exacerbates mental health disorders like depression and anxiety, leading to a negative cycle between overwhelming feelings of hopelessness or stress, and restlessness. 
      So, what are sleep disorders, how can we manage mental health symptoms, and what can we do to achieve better sleep?
      Common Sleep Disorders
      In general, sleep disorders are characterized as chronic sleep conditions that impact your quality of life or ability to function. These include trouble falling or staying asleep, falling asleep at the wrong times, and abnormal sleep behaviors. According to the International Classification of Sleep Disorders (ICSD-3), the official description is a “curtailed sleep pattern that has persisted for at least three months for most days of the week, along with complaints of sleepiness during the day”.
      The five most common are:
      Insomnia. Characterized by the inability to initiate or maintain sleep, it may also take the form of very early morning awakening. Often causes excessive daytime sleepiness, which results in functional impairment throughout the day. 
      Narcolepsy. A neurological disorder that affects the brain’s ability to control sleep-wake cycles. People with narcolepsy may feel rested after waking, but then feel very sleepy throughout the day. They may fall asleep even in the middle of an activity.
      Restless Legs Syndrome (RLS). Characterized by an unpleasant “creeping” sensation, originating in the lower legs, but often associated with overall leg pain. This sensation is seemingly only relieved by moving your legs, walking, or kicking - which of course, prevents sleep. 
      Sleep Apnea. People with sleep apnea often make periodic gasping or “snorting” noises while asleep, during which their sleep is momentarily interrupted. If you snore loudly and feel tired even after a full night's sleep, you may have sleep apnea.
      REM Sleep Behavior Disorder (sometimes called Parasomnia). Characterized by abnormal sleep behaviors which manifest in vivid, often frightening dreams associated with movement during REM sleep, people with this kind of sleep disorder appear to “act out their dreams”. Common symptoms include: movement such as kicking, punching, or jumping from the bed in response to action-filled or violent dreams; making noises, such as talking, laughing, or shouting; and being able to recall dreams if you awaken during an episode. 
      The Link Between Sleep Disorders, Depression, & Anxiety

      Scientists have found that 75% of individuals with depression experience sleep disturbances. And unfortunately, the relationship is bi-directional - meaning that not only does depression exacerbate sleep disorders like insomnia, but having a sleep disorder first can actually help bring on depression (if a person is already predisposed). And like the proverbial chicken and egg, often it’s hard to know which came first.
      Researchers believe sleep problems may contribute to depression by way of abnormal changes in the functioning of the neurotransmitter serotonin, the key hormone that stabilizes our mood and provides feelings of well-being. They have found that not enough sleep impacts the way serotonin works, disrupting our circadian rhythms and increasing vulnerability to depression.
      Sleep problems are also a common symptom of anxiety disorders. If you’ve had anxiety, you know that feeling of your brain “racing”, making it almost impossible to sleep. And even after falling asleep, you may wake up with anxiety in the middle of the night. Sleep disruption like this can lead to sleep fragmentation, which reduces both the quantity and quality of sleep. 
      Scientists say that individuals with anxiety disorders have high sleep reactivity - sleep reactivity being the degree to which stress disrupts sleep, manifesting as difficulty falling and staying asleep when a person is highly stressed. Compounding this is something called anticipatory anxiety, which is when individuals with anxiety know they’ll have problems falling asleep, and so their anxiety increases when they go to bed, causing sleeplessness, and ultimately a downward spiral of anxiety and lack of sleep.
      There’s a clear link between sleep disorders, depression, and anxiety. As a result, taking steps to sleep better can have a significantly beneficial effect on quality of life, so it’s important to seek professional help if you’re experiencing sleep problems or think you recognize any of the symptoms discussed above. And fortunately, once diagnosed, sleep disorders are treatable.
      Tips For Achieving Better Sleep
      Persistent problems sleeping increase the risk of relapse for those who’ve been treated for depression or anxiety, but practicing healthy sleep habits can reduce those feelings and can have a beneficial effect on your overall mood.
      Establish a sleep schedule. Creating a routine to sleep can help your brain get accustomed to getting the full amount of sleep. This means having a set wake-up time regardless of whether it is a weekday or weekend. 
      Follow a routine each night. Building a consistent routine such as washing your face and brushing your teeth can reinforce in your mind that it is time for bed.
      Unplug from devices. Set a buffer to unwind without electronics that can cause mental stimulation. Making it harder to calm thoughts. The blue light emitted from these devices can also decrease melatonin production, taking longer for you to achieve REM.
      Don’t force it. If you’re still tossing and turning after 20-minutes, consider getting up and stretching, reading a book, or doing something that calms you using soft lights before returning to bed to try again. This will help build a healthier mental connection between being in bed and falling asleep.
      Diagnosis & Treatment In Conjunction With Mental Health Issues
      In order to diagnose a sleep disorder, a doctor or mental health professional will gather information about your symptoms, as well as medical and mental health history. They may also order tests, such as a daytime or overnight sleep study to determine a diagnosis. Because of the multifaceted relationship between mental health and sleep, it is common for treatment to include both cognitive behavioral therapy (CBT) and prescription medication. With proper treatment underlying causes of disruption can be addressed; allowing you to achieve better quality sleep. 
      Consider Telebehavioral Health
      Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re a patient, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits here & apply. 
      Sources
      American Psychiatric Association
      Sleep Foundation
      Sleep Foundation
      National Institutes of Health (NIH)
    21. 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.
      Sources
      Substance Abuse and Mental Health Services Administration (SAMSA)
      Center for Health Care Strategies
      National Council for Mental Wellbeing
    22. Transforming Mental Health Care for Women Veterans: A Telemynd Initiative

      At Telemynd, we are deeply committed to addressing the unique and profound mental health challenges faced by women veterans. Our mission is to transform mental health care, ensuring it is accessible, compassionate, and tailored to the specific needs of those who have served our country. Recent studies, including a pivotal report by Disabled American Veterans (DAV), have illuminated a troubling reality: women veterans are at a significantly higher risk for mental health issues, including suicide, when compared to their male counterparts.
      The Urgency for Tailored Screening and Treatment
      The suicide rate among women veterans has risen alarmingly, with a notable increase nearly four times higher than that among male veterans. This increase underscores the critical need for mental health services that address experiences unique to women in the military, such as military sexual trauma (MST), intimate partner violence (IPV), and the challenges associated with pregnancy and menopause.
      Telemynd's Commitment to Women Veterans
      Our virtual mental health services are designed to bridge the gap in care. We offer comprehensive support through virtual medication consultations and therapy sessions, specifically tailored to the experiences of women veterans. Our approach includes:
      Enhanced Screening: Early identification and intervention for MST, IPV, Suicidal Ideation and other risk factors are crucial. We have implemented comprehensive screening processes to ensure that these issues do not go unnoticed. Maternity and Post-Partum Support: Recognizing the vulnerability of expecting and new mothers, we provide programs (I would say services instead of programs) specifically designed to address their mental health needs during pregnancy and the post-partum period. Menopause and Mental Health: Collaborating with experts, we aim to develop targeted strategies that address the link between menopause and mental health, reducing the risk of depression and suicide. A Call for Systemic Change
      The journey towards equitable mental health care for women veterans is ongoing, and Telemynd is dedicated to leading this charge. By advocating for systemic changes and providing immediate support, we are working towards a future where mental health care is inclusive and effective for all who have served.
      Our Collective Responsibility
      At Telemynd, we understand the profound impact of providing care that recognizes and addresses the individual experiences of each veteran. Our collective responsibility lies in offering tailored treatment plans and screenings uniquely designed to meet the specific needs of each person we serve. This personalized approach is crucial in addressing the diverse challenges faced by women veterans, ensuring that every aspect of their mental health care is as unique as their service and life experiences.
      Telemynd stands at the forefront of this transformation, advocating for a shift towards mental health care that truly understands and caters to the individual. Our dedication to the military community reflects our belief in the importance of accessible, empathetic, and personalized mental health services. Together, we can make a significant difference, ensuring that every veteran, regardless of their unique challenges and experiences, has the opportunity to heal.  
      Requesting Care
      To request care through Telemynd, start by contacting your local VA and request a behavioral health authorization specifically for Telemynd. The VA will process this request and send an authorization code directly to both Telemynd and you. If you receive the authorization code, simply call us; we will verify the code and take care of any necessary paperwork for you. In cases where you don't have the authorization code in hand, don't worry—the VA will forward your request along with the authorization to us directly. Upon receiving this, Telemynd will reach out to you to coordinate your first appointment, setting the stage for your journey towards personalized and compassionate care.
    23. Tips for Stress-Free Summer Adventures With Kids

      With August right around the corner, we know that the days of carefree summer adventures with your kids are drawing to a close. However, there's still time to make the most of this season before school starts again. Summer for kids is all about relaxation, with no school schedules to worry about. They can stay up late, enjoy family trips, and engage in creative activities.
      This time presents a wonderful opportunity for kids to explore new things, discover their local surroundings, and create lasting memories during family outings. As parents, we all want to ensure that summer adventures with our kids are enjoyable for everyone involved.
      Yet, we understand that summer can be a bit overwhelming for parents, as we try to keep our kids fed and entertained. The days might feel never-ending, and the bickering over toys and screen time can add to the stress. It's not uncommon for the craft ideas we find online to end up causing more mess and frustration than anticipated.
      For parents seeking a stress-free summer experience with their kids, it's essential to plan ahead with kid-friendly activities and family outings. While there's no guarantee of a perfect, stress-free day, we've found that by preparing in advance, staying flexible, and involving our children in the planning process, we are more likely to have successful and enjoyable summer adventures with the little ones.
      If you're looking for stress-free activities to enjoy with your kids during these last days of summer, we've put together some helpful tips for you. Let's make the most of this time and create wonderful memories with our children
      Planning Summer Activities With Children
      When preparing for summer adventures with children, parents can take steps to set themselves up for success. It’s important for parents to consider their child(ren)’s age and be realistic about what activities are the best fit for their schedule and budget.
      The best activities are those parents can set up and demonstrate for their child, which they can enjoy safely with minimal supervision. Open-ended play will keep kids entertained for a long period of time while developing their problem-solving or creative abilities.
      To keep summer activities running smoothly and stress-free, parents should follow these tips for kid-friendly summer adventures.
      Create a Schedule
      Kids can make the most of summer activities when they have a predictable schedule to follow. Children with predictable routines are generally calmer and find it easier to adjust between activities. This doesn’t mean parents need to plan every minute of the day. But they should give kids of all ages some structure for the day. Some ideas for a summer schedule include:
      Do chores right after breakfast Go outside to play in the morning Do 20 minutes of reading Quiet time after lunch Complete workbook activities before screen time Go to the pool on Saturday afternoons If a child is still learning to read, parents can use color-coded papers or pictures to display the schedule for their child.
      Practice Flexibility and Embrace Unpredictability
      Yes, schedules and structure are important. But life won’t look the same every single day of the summer. Children love when little unexpected events change their regular routines.
      Embrace the flexibility of summer days with these simple, stress-free adventures for children:
      Let kids pick out a treat at the grocery store Attend kid craft activities at the library After kids earn allowance from chores, take them out for ice cream or snow cones Fill up water balloons on a hot afternoon Spin a wheel of possible activities for the day Stay up late to catch fireflies Summer allows for more flexible schedules, so be sure to do simple unpredictable summer activities with kids to make the best memories.
      Involve Kids in the Planning Process
      Kids of any age can get involved in planning family-friendly summer activities. Parents who involve their kids in making summer plans will enjoy several benefits.
      Kids who help plan activities are more likely to participate and enjoy with a willing attitude. Parents who ask their kids for ideas are empowering their children to make choices. The whole family can benefit from the unique perspective and ideas kids have. Older children can do research on local places they would like to visit or activities related to their own areas of interest.
      Younger children can draw inspiration from the letters of the alphabet. Invite them to think of crafts, activities, and food related to a different letter each day.
      When planning a family vacation, get input from everyone, including young children. Try to ensure there is something for each person to look forward to and enjoy about a trip.
      Kid-Friendly Summer Adventures
      Parents always need ideas for stress-free summer activities with kids. Some find it’s best to stockpile summer activity inspiration so they always have a suggestion for a rainy day or when a kid complains, “I’m bored.”
      Many parents make a Summer Bucket List of fun things to do with kids and display it on the wall where kids can choose activities each day. Another idea is to make a Bored Jar with small cards listing activities kids can do on their own throughout the summer. Once a child can read, they select an item from the jar and enjoy the prompt activity for the next hour.
      Having fresh, creative ideas for summer activities will get parents through the long, hot days of summer. Parents can add these family-friendly summer activities with kids to the schedule:
      Outside Activities
      Turn on the hose and sprinklers Fill up a baby pool and add floating toys Read a book in the shade Create sidewalk chalk art Mix a bucket of bubble solution, dip tennis rackets and string loops in to make giant bubbles Hang up a sheet and use a projector to make a drive-in movie Make a muffin-tin picnic, with assorted snacks and finger foods in muffin tin cups Hands-On Crafts
      Draw and paint with finger paint or cornstarch chalk, using cut fruit or vegetable pieces as stamps Set up simple age-appropriate science experiments Play with modeling clay, using household objects to make imprints or cut shapes Plant flowers or vegetables so kids can water them and watch for blooms Let kids choose a new skill to learn, like baking, sewing, photography, etc. Go on a nature walk, collect plants to press and trace Local Outings
      Go to a park, playground, or sports field Play at a kid-friendly splash pad Swim at a public pool Visit the library for story-time, themed activities, or Summer Reading programs Ride bikes on a park path or trail Taste-test local sweet treats until you find a family favorite Tips for Stress-Free Family Outings
      Planning summer adventures for the family can be fun and lead to great memories! But going anywhere with kids can be a recipe for stress and exhaustion, especially if parents find themselves unprepared. It’s important to plan ahead and take care of the parents’ needs, too, so the whole family can have a successful trip.
      Parents planning a local day trip or a bigger week-long adventure can practice these vacation tips for families.
      When Packing, Be Overprepared
      For a stress-free family outing, parents need to plan ahead and prepare for the unexpected. This means making an itinerary with flexibility for kids getting tired of walking or needing a midday nap. Pack layers of clothing so everyone is prepared for cold or rainy days. Parents should bring plenty of snacks and water to fuel kids through summer adventures.
      During family outings, many parents bring a basic first aid kit with sunscreen, band-aids, anti-itch ointment, sunburn relief, and children’s fever medicine. That way, they are prepared to help a child feel better immediately without losing time searching for a store.
      Parents should also take time to prepare their child for travel during family vacations. When kids don’t understand where they are going or what the plan is for their trip, they may feel more anxious about the family outing. When parents discuss travel details with their kids and answer their questions, it helps kids relax and enjoy the adventure.
      Self-Care for Stress-Free Family Vacations
      One of the most important vacation tips for families is for parents to remember their own self-care throughout the summer. It’s important for adults to take care of themselves, especially if they are caring for young children. Parents who are nourished, well-rested, and feel emotionally supported will find it easier to relax and be patient during family activities in summer.
      That’s why parents should consider their own self-care before and during family outings. Instead of staying up late packing or eating fast food during a road trip, parents can plan small moments and routines that help them relax throughout the summer.
      Self-care for parents in summer might include:
      Waking up before their kids to enjoy a relaxing morning ritual Walking in nature daily to be rejuvenated Planning time to exercise or be active Staying hydrated, especially on hot summer days Eating fresh produce to get vitamins and fiber Building daily quiet time into their kids’ schedule Engaging socially—in person or via text—with supportive people Going to bed early enough to feel refreshed the next day Taking time to be in the moment and soak it all in When parents take care of themselves and their own basic care needs, they will be better prepared to handle family outings with kids.
      Stress-Free Summer Adventures With Kids
      Parents who want to reduce their stress and enjoy fun summer activities with kids should focus on planning ahead while providing both structure and flexibility. They can make a list of the best age-appropriate activities for their child. When preparing for outings or family vacations this summer, parents should pack for possible challenges. And finally, parents should tend to their own self-care so they’re better able to enjoy summer adventures as a family.
    24. These Films Got it Right: Top Films About Mental Health

      This week, we continue our mental health resources series by curating 8 inspiring and engaging films about mental health topics - from PTSD to depression to bipolar disease and more. We think these films are sensitive and worthy portrayals that explore the nature of mental illness - and ultimately help us get the word out - and more exposure equals greater understanding. 
      Most of these films can be found on the major streaming networks. Share the list with friends and family, or if you are a clinician, with patients who may also benefit. Then grab the popcorn (and possibly a box of tissues) and start watching.
       
      Silver Linings Playbook - This popular, Oscar-winning 2012 romantic comedy is based on Matthew Quick's novel of the same name, and follows two main characters dealing with mental illness. Bradley Cooper plays Pat who is diagnosed with bipolar disease, and Jennifer Lawrence plays a widow dealing with her own mental illness in the aftermath of her husband's death.
       
       
       
      The Perks of Being a Wallflower - 2012 was a good year for quality films addressing mental health issues and this one continues the trend: it explores the social-psychological effects PTSD has on young adults and how love can help heal the wounds. Based on a novel of the same name.
       
       
       
       
      Girl Interrupted - This best-selling memoir turned movie is a firsthand account of a young woman's experience inside an American psychiatric hospital in the 1960s. Care wasn’t as good as it is now - which is hard to watch in the film - and although we still have a long way to go, it's good to see how much treatment for mental illness has improved. 
       
       
       

      Good Will Hunting - The main character (Will - played by Matt Damon, who also wrote the screenplay with friend Ben Affleck) was abandoned as a young boy and suffers from attachment disorder because of it. The film details how his mental health has an impact on the choices he makes - he’s clearly a genius who belongs inside the classrooms that he cleans for a living at MIT. The success of his work with a local therapist ultimately gives viewers hope for the future.
       
       
       
      A Beautiful Mind - Tells the true-life story of brilliant mathematician John Nash (Russell Crowe), a Nobel Laureate in Economics and Abel Prize winner, who develops paranoid schizophrenia and endures delusional episodes while watching the burden his condition brings on his family and friends.
       
       
       
       
      The Soloist - A Los Angeles Times columnist (Steve Lopez) finds and writes about a homeless street musician (Nathanial Ayers) who possesses extraordinary talent. In his attempt to help Ayers, Lopez has to also deal with the mental illness that landed Ayers on the street in the first place, as well as the stigma against those with mental health issues.
       
       
       
      When Love Is Not Enough: The Lois Wilson Story - Deals sensitively with addiction. Winona Ryder plays the wife of the founder of Alcoholics Anonymous, Bill Wilson, who made it big on Wall Street before the Crash of 1929 - which wreaked havoc on his sense of worth  - and founded Alcoholics Anonymous in 1935 after getting sober himself. Lois Wilson later founded Al-Anon to help the loved ones of those struggling with addiction.
       
       
       
      Cyberbully - Takes a realistic and thoughtful approach to the issue of online bullying as seen through the eyes of a teen victim who attempts suicide. Ultimately has positive messages about tolerance, resilience, getting help and support, and standing up to peer pressure. This would be a good film to start a discussion with any teens in your life.
       
       
       
      Are there any films that you would add to the list? Let us know in the comments.
      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.
    25. 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
      Shaking 
      Nightmares
      Hypervigilance
      Hyperarousal
      Reactive Anger
      Impulsivity
      Increased Fear
      Decreased Positive Emotions
      Self-Blame
      Detachment From Others
      PTSD also often occurs with other related mental and physical health conditions, such as depression, substance use, and memory problems.
      PTSD Is Treatable
      The good news is that PTSD is treatable by trained behavioral health professionals. Treatment may include a combination of medications and behavioral therapies which have been proven effective on those with PTSD. And it goes without saying that each PTSD treatment and management plan should be tailored to meet an individual's specific needs since everyone is impacted differently. 
      The important thing to take away is that PTSD is real, it is explained by highly-studied changes in the brain, and that millions suffer from it.
      Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To Licensed Behavioral Health Professionals
      Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today!
      Sources
      National Center for Biotechnology Information - National Institutes of Health (NCBI - NIH): Traumatic stress: effects on the brain
      American Psychiatric Association: What is PTSD?
      US Dept. of Veterans Affairs: PTSD History and Overview
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