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    1. Differences Between Adjustment Disorder, Anxiety Disorder, & Depression

      You or a loved one just received a diagnosis of Adjustment Disorder (AD) from a behavioral health professional. What does it mean? And how is AD different from Anxiety Disorder or Depression? 
      Definition of Adjustment Disorder
      Adjustment Disorder is a condition that can occur when you have difficulty coping with a specific, stressful life event - for example, a death or illness in the family, getting fired or laid off from a job, significant relationship issues like break-ups or divorce, or sudden change in social settings (more isolation, for example) due to the pandemic. Because of this, Adjustment Disorder can also be referred to as “situational depression.” The inability to adjust to stressful events like these can cause one or more severe psychological and/or physical symptoms. 
      According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), in order to be diagnosed with Adjustment Disorder, individuals must have emotional or behavioral symptoms within 3 months of having been exposed to a stressor (like those mentioned above), and symptoms must be clinically significant as shown by one or more of the following: 
      Marked distress that is out of proportion to the stressor
      The symptoms significantly impair social or occupational functioning.
      Stressors that cause AD can even reoccur over time, for example, seasonal business crises, or recurrent hospitalizations for an illness or disability.
      Adjustment disorders can affect both adults and children. It’s estimated that each year, almost 7% of adults in the US are diagnosed with AD. These disorders typically resolve over time and with treatment by a behavioral health professional.
      Symptoms of Adjustment Disorder
      Symptoms vary depending on how the disorder manifests. Adjustment Disorder can be present with these symptoms: 
      Depressed mood, sadness
      Feelings of hopelessness
      Severe changes in emotions manifesting in things like frequent crying
      Feeling or acting unusually argumentative
      Changes in conduct (i.e., acting up in school or work)
      Worry, nervousness, jitteriness
      While the symptoms of Adjustment Disorder can be short-term and usually improve over time, they may resemble other psychiatric conditions, such as Major Depression or Anxiety Disorders. So, how can you tell the difference?
      How to tell the difference between Adjustment Disorder, Depression and Anxiety Disorder
      Individuals with Generalized Anxiety Disorder often have a lengthy and consistent history of anxiety and excessive worry, whereas individuals with Adjustment Disorder only experience their symptoms in times of or in response to stress or change.
      You can have both disorders, and Anxiety Disorder can be made worse by stressors such as change or adjusting to new routines. But if you have Adjustment Disorder, you’ll typically see a reduction in your anxiety as you adapt to the change or learn to cope with the stressor, while anxiety and related symptoms are continual for those with GAD.
      Similarly, there are key differences between Adjustment Disorder and Major Depressive Disorder, with the two differentiating factors being duration and cause. While Adjustment Disorder traditionally resolves within a matter of months, Major Depression tends to last much longer and only resolves with professional treatment. And while AD is triggered by a specific event, Depression seems to be caused by genetic and psychological factors, and cannot be attributed to a specific event.
      Summary of the differences between Adjustment Disorder, Depression and Anxiety Disorder

      Regardless of whether you have symptoms of Adjustment Disorder, GAD, or Depression, it is important to know that treatment is available and feeling better is possible. It’s important to start by having a behavioral health professional diagnose your condition, they can then help to manage your symptoms and learn coping skills. Like GAD and Depression, treatment for Adjustment Disorder is typically a combination of individual therapy, family therapy or group therapy, and to a lesser extent, medication.
      Has a recent stressful event caused you or a loved one to have symptoms of Adjustment Disorder? 
      Telemynd is a national telebehavioral health provider covered with many insurers. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists from the convenience of your home. Click here to find your current insurance provider and request an appointment today!  
      Johns Hopkins Medicine: Adjustment Disorders
      Merck Manual 2020: Adjustment Disorders
    2. Controlled Substance Prescriptions in Telehealth: Q &A

      Controlled substances are used to treat many common mental health conditions, like anxiety, depression, sleep disorders, and more. Prior to the COVID-19 pandemic and national health emergency, federal rules regulated how these meds were prescribed and dispensed - including a requirement for an in-person health evaluation prior to a prescription being written. However, during the pandemic, federal regulators temporarily waived these regulations to permit patients the ability to manage their medication and access to prescriptions, including controlled substances via telehealth visits. 
      With the national health emergency waivers expected to expire soon, some states have stepped in to draft their own medication management legislation; the result has been growing confusion over which rules apply and where. In this article, we attempt to answer all your questions about prescribing controlled substances, and have included resources to find out more.
      Why are Some Medications Deemed Controlled Substances?
      Controlled substances by definition are medications with a likelihood for physical or mental dependence. Many of the more common drugs for ADHD, anxiety, sleep disorders, depression, and more, such as Xanax, Klonopin, Lunesta, and Adderall are listed as ‘controlled substances”. The U.S. Controlled Substances Act (1970) puts all substances which were in some manner regulated under existing federal law into one of five schedules. This placement is based on the substance’s medical use, its potential for abuse, and safety or dependence liability. Medications listed as Schedule I have the tightest controls, and those listed as Schedule V have the least restrictive controls. These controls are mandated by the federal government.
      This may all sound complicated - but it boils down to prescribers and pharmacies taking extra precaution to ensure these medications are prescribed for and delivered to the right individuals, for the right reasons.
      What Are the Extra Steps Clinicians Must Take to Prescribe Meds that are Deemed Controlled Substances?
      In general, to prescribe a controlled substance, a clinician must have a DEA (Drug Enforcement Administration) license, and to fill a prescription, a pharmacist must also have a controlled substance license. Further, for a pharmacist to dispense a controlled substance, the prescription must include specific information such as date of issue, patient’s name, address, and DoB, clinician name, address and DEA number, drug strength, number of refills, and the signature of the prescriber. For these kinds of medications, there are also legal limits on the number of refills and the amount that a prescription may contain. Some drugs have zero refills, and the maximum quantity dispensed is 30 days - meaning patients must contact their clinician each month a refill is needed.
      In addition, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 specified that “any practitioner issuing a prescription for a controlled substance must conduct an in-person medical evaluation. A conservative recommendation to support compliance with the act is to conduct an in-person exam at least once every 24 months.”
      How did the COVID-19 Pandemic Impact Prescriptions of Controlled Substances?
      The unprecedented public health emergency created by COVID-19 caused action by state and federal regulators to ensure greater access to health care, while simultaneously limiting the spread of the virus. Therefore, as of March 2020, the DEA declared that practitioners “may issue prescriptions for controlled substances to patients via telemedicine, even for patients for whom they have not conducted an in-person medical evaluation, provided the prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of their professional practice, the telemedicine communication is conducted using an audiovisual, real-time, two-way interactive communication system, and the practitioner is acting in accordance with applicable federal and state laws.” At that time, the DEA also ruled it was “permissible to write controlled substance prescriptions to cover a 90-day supply.”
      However, depending on where you live or who prescribes your meds, you may have had a different experience as certain states and practitioners elected to retain pre-COVID protocols of in-person evaluations given the sensitivity of the medication being administered.  
      What is the Current Status of Controlled Substances Prescriptions?
      As we move through 2022 and the threat of COVID-19 has lessened, requirements for prescribing and dispensing controlled substances in some states have begun making permanent changes to expand policies implemented under the public health emergency, while others have passed laws restricting them. This website has made an attempt to track these ongoing changes - but to be safe, always check with your own state’s official website, or contact your state or federal representatives. 
      The DEA at the federal level said in a March press release, that it “wants medication-assisted treatment to be readily and safely available to anyone in the country who needs it."  However, in the end it is up to each state and provider to do what they feel is best for the safety of constituents and/or patients. Therefore, check with your provider or prescriber to find out if you will need an in-person visit to continue receiving prescriptions of controlled substances or if telehealth visits are an option for you. Telemynd operates as a national practice, meaning that our national network of licensed providers may prescribe many types of medications, they follow federal regulation which prevents the prescribing of controlled-substances via our virtual telemedicine environment. 
      DEA.gov: Rules for Control Substances
      NIH | National Library of Medicine: Pharmacy Prescription Requirements
    3. 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!
      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
    4. The Science Behind PTSD: How Trauma Changes The Brain

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

      According to the Department of Defense, 37% of active-duty military families have children, and like their active-duty parents, military kids make sacrifices in their own ways too. From coping with the challenges of a parent’s deployment to starting a new school to accommodate a recent move (known as a Permanent Change of Station or PCS), military kids commonly experience stressors that can impact their mental health. On average, military kids attend up to nine different schools before graduating high school due to relocations. What kind of impact do these frequent moves have on the mental health of military kids and their families? And what are some ways to cope with the stress?
      Military Kids Move Every Two to Four Years, On Average 
      Military families typically make a PCS move every two to four years (this is over 3 times the civilian family average), which means that the kids are constantly adjusting to new schools and environments, making new friends, and leaving old ones behind. In some cases, PCS moves can occur quickly and unexpectedly, leaving little time for closure, for kids to fully process what is happening to them, or to say goodbye. 
      Multiple studies have been conducted to measure the impact on mental health of PCS moves. The Journal of Adolescent Health published findings that military kids who move frequently were significantly more likely to have a mental health issue. In addition, it found that age was a powerful predictor of the impact on mental health, i.e., military kids aged 12-17 were four times as likely to need help from a mental health professional as military kids aged 6-11. This makes sense intuitively, as teens are already going through the changes and stresses of puberty. Add in the need to rebuild their social connections and form new friendships, and one can see why PCS moves impact teens harder.
      The stress of PCS moves affects parents too. Another study by the School Psychology Review found moving increases tension in the home in general. Kids reported feeling anger or resentment toward their parents and the military because of the disruption to their lives. Some kids reported telling their parents that they refused to move or would run away to avoid moving entirely. 
      Ways The Disruption Of A PCS Move Causes Stress
      What is it about frequent moves that causes so much burden? First, change itself is stressful to us all, as numerous studies have found over the years. And when families make a PCS move, they must adjust to a new home, new school, address, neighborhood, friends, teachers, religious community, routines, and potentially new local culture and weather. That’s a lot of change! In addition:
      Students involved in sports who move later in the year can miss team tryouts, or the new school may not offer the same athletic programs.
      They may feel the loss of having to end close relationships with friends at a previous school.
      It’s more difficult to gain acceptance in a new school where cliques and social networks are already established.
      Because of potentially limited experience with military families, civilian school staff may have a knowledge gap that affects their effectiveness working with military students.
      Parents themselves are swamped with new jobs and to-do lists, and may not have the patience or time to consider a kid having trouble with the transition.
      If one parent is deployed or at risk of being deployed, kids may experience further stress from the constant fear for a parent’s safety.
      All can lead to considerable stress, as kids find they lack a feeling of connection to others in their new community. As a result, symptoms of depression and anxiety can appear, such as separation anxiety, excessive worry, sleep problems, and physical complaints such as headaches or stomach pain. 
      Tips For Coping With The Stress Of A PCS Move
      PCS moves are not all doom and gloom. Research suggests that many kids develop strength and resilience from adapting to frequent military moves. And there are steps parents and schools can take to support them through the moves in order to reduce the impact on their mental health. Number one is simply to be aware of the potential mental health impacts and to watch for signs and symptoms of distress. Our previous release discussing different symptoms of mental health conditions is really helpful. Parents can read up on the impact of PCS moves, and educate themselves on ways to support kids during the transition. And as with all mental health issues, the earlier that symptoms are noticed for intervention and treatment to begin, the better the prognosis and outcomes.
      Experts Suggest These Tips For Coping With The Stress Of PCS Moves
      Keep up established routines and rituals as much as possible, and start new rituals in the new place that encourage parent-child bonding time.
      Talk about the move as much as possible and give kids the opportunity to vent their negative feelings (and help them find positive ones too). Parents are advised to let kids in on a little of their own misgivings about the move and to find ways to address them as a family. This provides more positive feelings of validation and control.
      Connect with other military children and families when possible. As well, in the military community itself, most installations have a resource officer or School Liaison Officer who may be able to suggest appropriate resources.
      Even in a civilian school where there are few military kids, school guidance counselors are the best place to start a conversation between the family and the new school, as they are the gatekeepers to community mental health resources. Even if the counselor does not have experience with military students, he or she may be able to suggest local resources with more expertise.
      Finally, although it may seem simple, making sure that kids get enough sleep, eat healthy foods, and get out and exercise will go a long way toward maintaining better mental health. And when kids do exhibit symptoms of transition distress, seek out a mental health professional as early as possible.
      Military Spouse
      Journal of Adolescent Health
      School Psychology Review
    7. 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.
    8. How EFT Tapping Helps Relieve Symptoms of Anxiety and Depression

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

      You may have heard the term mentioned in the context of ways to address behavioral health issues. Cognitive Behavioral Therapy (also known as CBT) is a form of talk therapy that has been found to be effective for multiple mental health conditions including depression, anxiety, alcohol and drug abuse, and eating disorders. Considered a ‘problem-solving strategy’, CBT seeks to change dysfunctional (and often unhelpful) thoughts and behaviors by questioning, identifying and then reframing them. In this article, we look into how and why CBT works.
      How does Cognitive Behavioral Therapy work?
      CBT was built on the idea that our thoughts and perceptions influence our behavior. Researchers have found that when we feel distressed, our thoughts and feelings may distort our perception of reality - so CBT aims to identify and name those thoughts, to assess whether they are an accurate depiction of reality, and then if they are not, to come up with individualized strategies to challenge and overcome them.
      CBT was founded by psychiatrist Aaron Beck at the University of Pennsylvania in the 1960s who wanted to offer his patients a treatment option to the prevailing Freudian psychoanalysis style of the time which dealt primarily with patients' past (childhood) experiences. Beck wanted to develop a type of therapy that was shorter-term and goal-oriented, but also scientifically-validated. Cognitive Behavioral Therapy focuses on current problems and helping patients find ways to help themselves. This does not mean that it completely ignores the influence of the past, but it deals primarily with identifying and changing distressing thought and behavior patterns of the present. 
      For example, CBT may have patients address questions like: What are you thinking right now? What were you thinking when you began to feel anxious? Can we find harmful patterns that emerge when you begin to feel anxious? The goal is to understand what happens in our minds when we are distressed and to change how we respond. In this way, we develop a greater sense of confidence in our own abilities to deal with challenging thoughts and feelings.
      What does CBT look like in practice?
      Research has shown that CBT is appropriate for all ages, including children, adolescents, and adults. It can be effective in a relatively brief period of time, generally, 5 to 20 sessions, though there is no set time frame. Research also indicates that CBT can be delivered effectively online, in addition to in-person therapy sessions.
      In practice, therapists and patients collaborate together to develop an understanding of the problem and to come up with a treatment strategy. Through exercises in-session as well as outside homework exercises, patients learn how to develop coping skills to change their own thinking, problematic emotions, and behavior. Therapy sessions may involve role-playing to prepare for potentially problematic interactions with others, as well as learning ways to calm one’s mind and body in times of stress. 
      Multiple research studies confirm the benefits of CBT
      Research has shown that CBT can address conditions such as major depressive disorder, anxiety disorders, substance abuse, post-traumatic stress disorder, anger issues, eating disorders, obsessive-compulsive disorders, and others. Studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.
      If you are interested in exploring Cognitive Behavioral Therapy, consider contacting a qualified mental health professional
      If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand how to recognize and treat multiple disorders like anxiety and depression, and many are certified in Cognitive Behavioral Therapy. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
      American Psychological Association
      National Institutes of Health (NIH)
      Journal, Frontiers in Psychology
    10. 10 Books To Better Understanding Mental Health Issues In 2022

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

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

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

      Gaming is wildly popular. 60% of Americans say they play video games daily, and 75% of US households own a device they can play games on: phones, tablets, big screens, and other devices. Not unexpectedly, video games saw a 73% growth in sales during the pandemic, as people went online to socialize and escape.
      As popular as they are, games are also controversial; some believe they are addictive and others think they interrupt normal social interaction. However, recent scientific studies have found gaming can play a positive role in mental health, and in this article, we’ll tell you about those studies and debunk a few gaming myths along the way. 
      Survey finds gaming can provide stress relief
      Video games can be a fun way to pass the time, and for those with challenges, they can provide a much-needed distraction from difficult situations. Games can be a low-stakes outlet for people to let off steam when they feel frustrated by school or work. Games which encourage exercise and socializing can even promote emotional wellness. Dr. Alok Kanojia who researches game addiction at Harvard Medical School says on the very positive side, “video games literally allow us to escape negative emotions and suppress them.”
      A 2019 survey found that almost 80% of gamers say video games provide them with mental stimulation, relaxation, and stress relief. The same survey found that some gamers - like competitive athletes who ‘live and breathe’ their sport - also report anxiety associated with game performance and expertise. The key here, like anything, is balance - and having tools and supports in place to manage mental health issues. 
      Two studies find positive correlation between gaming and mental health
      Several research studies have found that some games can play a positive role in mental health. For example, a study at Oxford University which focused on those who play Nintendo’s Animal Crossing, found that people who played more games tend to report greater wellbeing. In fact, Animal Crossing is part of the ‘cozy game’ movement - a new genre of video games that rose in popularity during the pandemic, whose beautiful graphics, clever storylines, soaring soundtracks, and fluid end goals make them feel “approachable, stress-free and bite-sized.” Gamers who play cozy games say these games provide a way for them to “chill out with cute and colorful graphics, meditative tasks, and feel a sense of accomplishment” - all of which can contribute positively to mental health.
      Another study on location-based, mobile games like Pokémon GO (a game that lets players combine gameplay with real-world exercise), found that these games may be able to help alleviate depression symptoms in players, because they encourage exercise, contact with nature, community, and social connection. The researchers reported they were “able to connect use of Pokémon GO to a ‘significant short-term decrease in depression-related internet searches’, which is a common and reliable method of monitoring mental health, and therefore the game may help with mild, non-clinical forms of depression.”
      On a positive side note, the game maker community appears to be tackling the depiction of mental illness within games. Negative tropes about mental illness have existed in games since the beginning, but lately, creators have been trying to change that - even hiring psychologists to make sure there are no negative stereotypes in their games (even if inadvertently). 
      If you or a loved one need help with mental health issues, consider contacting a telebehavioral health professional
      As with anything, if you or your loved one is a gamer and is experiencing symptoms of depression or anxiety, it's best to turn to a qualified mental health professional who can distinguish between everyday stress and something more serious.
      Frontiers in Psychology: Gaming well: links between video games and flourishing mental health
      The Guardian: Video gaming can benefit mental health, find Oxford academics
      Journal of Management Information Systems: Location-Based Mobile Gaming and Local Depression Trends: A Study of Pokémon Go
    14. Mental Health & Aging: All You Need To Know

      It’s estimated that 20% of people aged 55 years or older experience some type of mental health issue - the most common are anxiety and depression. Indeed, more common later-life events such as chronic medical disorders, loss of friends and loved ones, and the inability to take part in once-cherished activities can take a heavy toll on a person’s emotional well-being. But mental health problems are not a “normal” part of aging and should be identified and treated, not tossed off as unavoidable. In this article, we look at the facts about mental health issues in older adults and what can be done to address them.
      Facts about mental health and aging
      Mental health problems are a risk for older adults, regardless of history. While some adults go through life managing a chronic mental illness, mental health problems can also suddenly appear late in life. Changing bodies and chemistry, changes in family and friendships, and changes in living situations – all have an effect on mental health and need to be considered in treatment. Some sobering facts about older adults and mental health include:
      Adults 85 and over have the highest suicide rate; those aged 75 to 84 have the second highest. 75% of those who commit suicide have visited a primary care physician within a month of their suicide. It's estimated that only 50% of older adults who discuss specific mental health problems with a physician receive the right treatment. Up to 63% of older adults with a mental disorder do not receive the services they need. On the good news side, research also shows that if older adults are diagnosed with a mental health disorder, and are able to access services, then 80% will recover or receive the tools to live successfully with their disorder.
      Is there such a thing as psychological aging?
      Recent studies have shown that how old we “perceive” ourselves contributes to our level of well-being also. This is known as psychological aging. Essentially, our ‘subjective age’ (how young or old we perceive ourselves to be regardless of physical age) has a significant effect on our health decisions - the idea being that if we ‘feel’ younger than we are, we will make more healthy lifestyle decisions - including decisions that may help our mental health.
      Depression is common in older adults - what we can all do to help
      One of the most common mental illnesses affecting older adults is depression. Depression can have a negative “halo effect” on the health of older adults in many ways. According to the American Psychological Association, depression “can lead to eating habits that result in obesity or, conversely, can cause a significant loss of appetite and diminished energy levels, sometimes resulting in a condition known as geriatric anorexia; it can also cause higher rates of insomnia and memory loss, and longer-than-normal reaction times'' - making driving, cooking, or self-medicating more dangerous than normal. However most older adults see an improvement in their symptoms when treated with anti-depression drugs, therapy, or a combination of both - so the key is to get help as early as possible.
      Watch for these warning signs in yourself or loved ones that may signal a mental health issue:
      Noticeable changes in mood, energy level, or appetite Feeling flat or having trouble feeling positive emotions Difficulty sleeping or sleeping too much Difficulty concentrating, feeling restless, or on edge Increased worry or feeling stressed Anger, irritability, or aggressiveness Ongoing headaches, digestive issues, or pain A need for alcohol or drugs Sadness or hopelessness Suicidal thoughts And experts say to be tactful when talking to an older loved one about potential warning signs. An older person with fragile self-esteem may interpret well-intentioned encouragement as further proof of their declining condition. Some may even resent attempts at intervention. And because older people tend to be less amenable to lifestyle changes, they may be reluctant to adopt new, healthier habits. A trained mental health specialist who understands aging issues can help friends and family members craft positive approaches for talking about sensitive issues, and can help tailor an individualized therapeutic strategy to combat depression.
      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.
      CDC: The State of Mental Health and Aging in America
      National Institute of Mental Health: Older Adults and Mental Health
      American Psychological Association: Aging and Depression
    15. Does Renaming a Mental Illness Change the Stigma?

      Erratic. Volatile. Complicated. These are the unfortunate words that people often think of when they think of someone with a diagnosis of schizophrenia - which in turn has caused a stigma that has lead to fear and isolation for those most vulnerable. A movement has developed, made up of scientists, medical professionals, mental health advocates, and those with the diagnosis, to change the name. In this week’s article, we’ll look at the pros and cons of the name change proposition as well as explain what led to the idea in the first place.
      What is Schizophrenia?
      Schizophrenia is a brain disorder that affects less than 1% of the population. When it’s in its ‘active phase’, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking, and lack of motivation. Research has shown that schizophrenia affects men and women fairly equally but may have an earlier onset in males. As with any illness, the severity, duration and frequency of symptoms can vary. The symptoms are why Dr. Eugen Bleuler named the disorder in 1908 - the term ‘schizophrenia’ derives from Greek words for “split mind” - because Dr. Bleuler thought the disease was characterized by a “splitting of psychological functions” where “the personality loses its unity.” But it turns out the condition was named erroneously.
      Researchers believe that a number of genetic and environmental factors contribute to the cause of schizophrenia, as well, life stress may also play a role in the start of symptoms. But since multiple factors may contribute, scientists aren’t yet sure of the exact cause in each individual case.
      Modern Treatment Means Symptoms are Very Manageable
      While there is no cure for schizophrenia, the good news is that research has led to innovative and safe treatments which means most symptoms will greatly improve and the likelihood of  recurrence is diminished. A combination of pharmaceutical treatment and therapeutic treatments such as cognitive behavioral therapy or supportive psychotherapy may reduce symptoms and enhance functioning. Additional treatments are aimed at reducing stress, supporting employment, and improving social skills.
      Yet a Stigma Still Exists
      So even while treatment helps dissipate symptoms, the complexity of schizophrenia may help explain why there are misconceptions about the disease. Contrary to what Dr. Bleuler thought when he named the disease over one hundred years ago, schizophrenia does not result in split personalities or multiple personalities. Most people with schizophrenia are no more dangerous than people in the general population. However, you’d never know this based on how people with the diagnosis are portrayed in TV, film, and other media. And as with most stigmas around mental health issues, stigmas perpetuate fear, make “others” out of those with the diagnosis, and in turn encourage isolation - all of which worsen the lives of already vulnerable individuals. Research has found that “public, anticipated, and self-stigma decrease healthcare seeking and treatment adherence, and create barriers to pursuing independent living” for those living with the condition..
      Would a Name Change Help Reduce the Stigma?
      This is how the idea of renaming schizophrenia came about. Said a recent New York Times article, "The idea is that replacing the term ‘schizophrenia’ with something less frightening and more descriptive will not only change how the public perceives people with the diagnosis but also how people with the diagnosis see themselves." Japan and South Korea have already changed the name to “Integration Disorder '', which is the term for which many in the re-naming movement are advocating.
      Most of the mental health community is behind the name change. A survey by the World Psychiatric Association showed that approximately half of mental health professionals around the world believe schizophrenia needs a new label, and over half believe the term is stigmatizing. Another 2021 poll found that 74% of stakeholders (mental health professionals, family members, researchers, government officials, and more) found the name stigmatizing and favored a name change.
      In the Meantime, How Can We Help Reduce the Stigma?
      Regardless of where you stand on the name change, the most important thing is to understand that schizophrenia is a physical disease of the brain - and like other medical diseases - it is treatable today. Much research has been done on how to reduce the stigma around this diagnosis, and that research has found that if we commit to educating society about schizophrenia, promote accurate representations of schizophrenia, and prioritize advocacy, we may help reduce the stigma.
      The New York Times: ‘Schizophrenia’ Still Carries a Stigma. Will Changing the Name Help?
      American Psychiatric Association: What is Schizophrenia?
      National Alliance for Mental Illness: The Consequences of Stigma Surrounding Schizophrenia
      Schizophrenia Bulletin: Reducing Stigma Toward Individuals With Schizophrenia Using a Brief Video: A Randomized Controlled Trial of Young Adults
    16. 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.
    17. How to Form Healthy Behaviors for Improved Wellness

      We all have a sense of the big things we should be doing to stay healthy in mind and body: things like eating well, exercising, and getting enough sleep. But sometimes life gets in the way, and as much as we want to add healthy behaviors to our routine, we just don’t. So how exactly do we form those good habits to improve wellness? In this article, we explain the steps. 
      And we know that healthy habits are good for both physical and mental health, so as a bonus, we’ve included 6 top healthy behaviors to try today.
      How to form healthy habits
      Start by making it easy and simple. Research says we’re more likely to form new habits when we clear away the obstacles that stand in our way of doing them. And don’t try to completely change your life in one day. It’s easy to take on too much. For example, start by packing your gym bag and putting it by the door the night before, or walking for just 10 minutes at first, or choose an exercise that doesn’t require you to leave the house at all.
      Here are four additional tips to help you form healthy behaviors:
      Make a plan for the behaviors you want to change. Include small, reasonable goals and specific actions you’ll take to move toward them. Consider what you’ll need to be successful and get those things in place. For example, stock up on healthy foods, or plan a special spot to relax in advance. (And don't forget to plan for obstacles. Think ahead to what will happen when you're faced with extra stress or temptation.) Keep a record. Use a journal or mobile app - whatever makes most sense to you - to track things like diet, exercise, stress levels, or sleep patterns. Experts say that even if you think you’re about to ‘fall off the wagon,’ continue to track your behavior, as sometimes when you feel like you’re failing, you learn the most. Do the behavior every day. Research says the amount of time it can take for a behavior to become a habit ranges from 18 to 66 days, but they form faster when we do them more often, so start with something easy and simple, and do it often. Once the habit is formed, you can explore more complex or harder behavior changes. Reward yourself - early and often This is an important part of habit formation - especially as some results of habit changes take longer to show up. So, build in some immediate rewards to help you reinforce the habit, like listening to an audiobook while running, or watching a favorite Netflix series while on the treadmill. Lastly, be patient with yourself! Healthy habit-forming is hard work and even though the payoff is big, there may be missteps along the way - and that’s ok.
      How do you form healthy behaviors? Leave a comment below or tell us on social media.
      Experts say these are top behaviors for improved wellness
      Now that you know how to form a healthy habit, here’s how experts weigh in on some of the top healthy behaviors that benefit body and mind (besides the big ones - eating healthy, exercising, and getting enough sleep). Some may be familiar but others may be a surprise.
      Drink lots of water. Check with your doctor to find out how much is right for you. If it gets boring, add fresh mint, lemon, or cucumber slices to switch it up. Plan your meals. Experts recommend you get into this habit, as it reduces the chances for unhealthy eating, and also saves time and money (and who doesn’t need more of both?!) Train your muscles. Strength training helps replace body fat with muscle - so you burn more calories overall. And it’s really important for women - especially as they get older. Go offline. So hard to do! But this gives our eyes and brains a big break and frees up time for other healthy habits. Learn something new. New skills keep our brains really healthy and may even provide you with new free-time activities and friendships. Get outside in nature. More and more, researchers are learning the benefits of fresh air, sunshine (vitamin D), and the peace that comes from being in green spaces.  Healthy habits ensure a better quality of life. Commit to forming healthier behaviors by starting with just one today.
      The New York Times: How to Build Healthy Habits
      Harvard Business Review: Building Healthy Habits When You’re Exhausted
      NIH News in Health: Creating Healthy Habits
    18. Social Media, Body Image, & Mental Health

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

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

      EMDR (Eye Movement Desensitization and Reprocessing) therapy has been around since the 1980s, and recent stories featuring several well-known media personalities have credited the technique with helping them heal from past trauma. In the news or out, EMDR is an evidence-based, extensively researched therapeutic modality that is commonly used by behavioral health specialists to help support clients’ recovery from past trauma. EMDR has proven particularly effective for those living with PTSD, and as the date draws nearer for US troops to pull out from Afghanistan, we’re focused on sharing vital resources and techniques that can help military families and their loved ones cope with the transition.
      What Is EMDR?
      In plain language, EMDR is an individual therapy technique aimed at helping people process trauma during therapy in a more detached way than talking about the event (which can be emotionally intense and often lead them to shut down). It had been thought that emotional pain from past trauma required a long time to heal. But studies have shown that our minds can mend from psychological trauma in a similar way that our bodies recover from physical trauma - and often in as little as 6 to 8 weeks, depending on the individual and their engagement in the program. In fact, one of the important benefits of EMDR is that by using this therapy, people can experience progress that normally can take years. In one study, 77% of combat veterans were free of PTSD symptoms in only 12 therapy sessions.
      EMDR works in eight phases. The clinician first learns about the client’s history, while also helping them to create a sense of safety and awareness in the body. Key traumatic memories are identified and reprocessed. After the clinician has determined which memory to target first, they ask the client to hold different aspects of that memory in their mind while using their eyes to track the therapist’s hand as it moves back and forth. As this happens, internal associations arise and the client starts processing the memory and associated disruptive feelings. Once the memories are reprocessed in this way, the brain develops new neural pathways free from the associated negative emotion so that the traumatic memories do not cause the same repeated “fight, flight or freeze” survival response. 
      As the psychologist who originated EMDR, Dr. Francine Shapiro said, “unlike straight talk therapy, the insights clients gain in EMDR therapy result not so much from clinician’s interpretation, but from the client’s own accelerated intellectual and emotional processes.” The EMDR International Association has a more specific description of the eight phases here.
      How Does EMDR Help Veterans Recover From PTSD?
      It’s estimated that almost 4% of the general US population is affected by PTSD — a number that rises to 55% of those who have served in the military. A few months ago, we wrote about PTSD and how it negatively impacts the lives of those suffering from it. For example, remembering and reliving the initial trauma may cause problems at work or at home – triggering an out-of-perspective or inappropriate emotional response to everyday experiences. Individuals who have PTSD avoidance symptoms may do things like avoiding driving a car or visiting certain locations. Others may feel stressed and angry all the time and isolated from friends and family. Left untreated, PTSD can cause adverse impacts on relationships and work, and even dependence on drugs or alcohol.
      EMDR therapy has been recognized as effective for PTSD in the treatment guidelines of the US Department of Veterans Affairs (VA) and the World Health Organization (WHO). EMDR treatment options for veterans range from intensive daily therapy sessions to weekly sessions. In multiple research studies, both frequencies were found to be equally effective, with a substantial decrease in PTSD symptoms ranging between 36% and 95%, depending on the framework of the study. As well, studies show that EMDR therapy can produce stable long-term effects for PTSD sufferers.
      But how exactly does EMDR therapy reduce the symptoms of PTSD? As we wrote a few months ago in How Trauma Changes the Brain, stress responses are a protective part of our natural instincts. But in those diagnosed with PTSD, the distress from the trauma remains in the memory, and those upsetting thoughts and emotions can create an overwhelming feeling of being “back in that moment” - even if you are sitting safely at home. 
      EMDR therapy is thought to help improve the way the mind processes these memories, which can sometimes be too difficult to do by just talking about them. EMDR  allows guided self-healing to happen in a natural way that has long-term benefits. Moving your eyes in a rhythmic back-and-forth motion in EMDR therapy, while recalling the trauma, causes shifts in the way that you experience that memory, and information from the past is allowed to finally process. Essentially, the experience is still remembered, but the protective need for the fight, flight, or freeze response related to the original event is resolved. In effect, EMDR is helping to ‘retrain the brain’.
      If You Or A Loved One Has Been Diagnosed With PTSD, Consider EMDR Therapy
      Many behavioral health therapists offer EMDR therapy. Look for therapists who are EMDR-certified. Among other requirements, EMDR certification requires 20 hours of training and 20 hours of clinical practice, 50 EMDR therapy sessions, and adherence to EMDR International Association policies. Telemynd supports veterans and their families, and many of our clinicians are EMDR-certified. Through our national partnership with TRICARE, we’re able to offer you and your beneficiaries access to licensed therapists or psychiatrists from the convenience and privacy of your own home. Request an appointment online or call our live support for assistance in scheduling care today!
      EMDR International Association
      Journal of EMDR Practice and Research
      Journal of EMDR Practice and Research
    21. 5 Tips for Designing an Effective Therapy Space

      As a mental health professional, it's important to create a therapy space for yourself and your clients that is polished yet comfortable and conducive to the interactions needed for successful treatment. Much research has been done over the years on elements like comfort and privacy that can help inform the design of an effective therapy space. "A space should be something that supports you as you try to achieve specific goals…that means creating a calm and refreshing environment to balance the rigorous mental and emotional work of therapy," says Dr. Sally Augustin, an applied environmental and design psychologist. 
      Conversely, therapy space that in any way puts your clients on edge or makes them feel uncomfortable can have an adverse impact on their progress. Creating the right space for online therapy is just as important to get the most out of your therapy sessions. In this week’s article, we provide 5 tips for creating a comfortable and effective virtual therapy space.
      Choosing the right technology. Investing in your virtual practice is critical to establishing confidence in your ability to deliver care, and to offer a clear environment for your clients to openly engage in the therapeutic process - even when they are far away. Start by ensuring your camera is enabled and the resolution is acceptable (we recommend 720p display resolution or higher). Make sure your internet connection can support a video session and that the audio quality is clear and concise without degradation. The best position for your camera is at face level and centered so you are able to maintain eye contact. That may mean purchasing a stand for your computer or laptop. In session, the goal is to establish a relationship with new clients, to do this we suggest minimizing the appearance of multi-tasking . In addition, if you provide virtual therapy, choose a platform that meets the needs of your clients like Telemynd. Make your online therapy space calm and comfortable for clients. Set up a designated private space that is conducive to critical conversations. Use ambient light, calming wall art, and soft-colored walls in the background to keep distractions to a minimum. If your space doesn’t have good lighting, consider buying a ring light which is specifically designed to provide lighting for cameras and computers. And keep your office clutter-free, as that can give the impression of focus, clarity, and skill in your relationship with clients. You can also utilize a virtual background during your sessions if your space cannot be augmented.  Privacy is an important ingredient to the therapeutic process. Clients should always feel safe during your therapy sessions, and since they’ll be sharing thoughts they usually keep to themselves, feeling a sense of privacy is key. Even though it may be tempting, don't do your therapy sessions from the car, or with others in the background. Close doors and windows in your workspace so it feels private for your clients to open up. And make sure your phone is turned to silent as ringing phones or alarms can disrupt the session. Eliminate negative distractions from your therapy space. Keep personalization to a minimum in the background (i.e., family photos, personal mementos) to help clients feel “at home” within the space. Keep background artwork calming and neutral; if the colors or images are too loud, too specific, or evoke sadness or violence, they may be disruptive to the therapeutic process. Other distractions to avoid: open doors or views of other rooms in your residence if you are working from home, or doing your sessions in anything other than professional attire (for example, PJs definitely give the wrong impression).  Make the space comfortable for you! Don’t forget to get the right chair - since you’ll likely be sitting for extended periods of time every day, it’s important to find one that is ergonomic and comfortable for you. Some therapists sit in an armchair during an online session, and some prefer to sit in a more typical “desk” chair in front of their computer. Try them out before buying and choose what works best. While there is no single right way to design an online therapy space, you can help ensure your clients have a comfortable therapeutic experience by creating a welcoming, private, and technologically-sound space for when they need to be emotionally vulnerable. What tips would you add to the list? Let us know in the comments.
      Hospital Community Psychiatry: Design considerations for mental health facilities
      Healthcare: Telemedicine Workplace Environments: Designing for Success
      Psychiatry Advisor: Designing the Therapeutic Space: Using Layout, Color, and Other Elements to Get Patients in the Right Frame of Mind
    22. 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.
      Lancet Psychiatry
      Current Topics in Behavioral Neuroscience
      National Institute of Mental Health
    23. 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.
    24. What is Generalized Anxiety Disorder?

      Feeling nervous about life? Having a hard time concentrating or relaxing because you worry all the time? Can't shake the feeling that something bad will happen and you are unprepared?  You’re not alone.
      If you are in a chronic state of anxiety and stress, you may have Generalized Anxiety Disorder (GAD), which can make a person feel constantly worried even when there is little or no reason to. You may worry about missing a deadline, losing a job or a loved one, or having an accident. You may even worry about worrying too much. The stress can become debilitating and can lead to a loss of perspective on your current situation.
      Definition of Generalized Anxiety Disorder
      Generalized Anxiety Disorder is characterized in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) as “6 months or more of chronic, exaggerated worry and tension that is unfounded, or much more severe than the normal, everyday worry most people experience”.  An estimated 31.1% of U.S. adults experience an anxiety disorder at some time in their lives. The disorder can begin at any age, and affects children as well as adults. 
      The good news is that GAD is treatable.
      Symptoms of GAD
      People with GAD can't rid themselves of the feeling of worry, even while recognizing that it may be unwarranted. They may be unable to relax and have trouble falling or staying asleep. In addition, they may:
      Feel restless, irritable or feel “on edge”
      Have a hard time concentrating
      Be easily startled
      Feel easily tired or exhausted all the time
      Have headaches, muscle aches, or stomach aches 
      Have a hard time swallowing
      Tremble or twitch
      Feel sweaty, light-headed or out of breath
      Feel nauseous or tingling in the extremities
      Have to go to the bathroom a lot
      Experience hot flashes
      Causes and risk factors
      Scientists find that anxiety disorders result from a combination of genetic, behavioral, and developmental causes. Risk factors include a family history of anxiety and recent periods of stress. People with certain personality traits, such as shyness, may also be more vulnerable to developing anxiety disorders.
      Physiologically, scientists believe that GAD probably arises from over-activation of the brain mechanism responsible for fear and the “fight-or-flight” response. The amygdala is the part of your brain that initiates a response to perceived danger. It communicates with the hypothalamus which then releases hormones that raise your heart rate and blood pressure, tense your muscles, and ready your body to fight or run. According to scientists, in people with GAD, the amygdala may be so sensitive that it overreacts to situations that aren't really threatening, inadvertently provoking an emergency stress response. Over time, anxiety can become attached to thoughts that are not related to true sources of danger -  in a sense, “the brain may inadvertently create its own fears”.
      How does GAD impact daily life?
      All of us worry about everyday things - how we are going to get all our errands done while staying on top of work deadlines; how we’ll pay for the next vacation or the kids’ college education; how we’ll take care of an aging parent or deal with an in-law at the next family holiday. These are all normal.
      It’s when this worry becomes uncontrollable, lasts for months at a time, and interferes with our ability to function, that it’s time to seek a behavioral health professional to diagnose potential GAD. Adults who have been diagnosed with Generalized Anxiety Disorder say things like, “I dreaded going to work because I couldn’t keep my mind focused”, or “I was having trouble falling asleep every night because my mind was racing with worry, so I was always tired”, or “I was irritated with my family all the time”.
      If you or your loved one are in the military or serve as a first responder, there is already a justifiable amount of things to worry about, such as separation from those you hold dear, frequent moves, or parenting alone while a loved one is deployed; however this worry can sometimes develop into something more. Active duty military as well as veterans can develop anxiety disorder after experiencing trauma, or during high-stress situations, such as the transition from military to civilian life. In fact, the VA stated there was a 327% increase in reported anxiety disorders among service members between 2000 and 2012. Caring for a loved one with anxiety disorder presents its own challenges, and you want to make sure you have the best professional resources available to help.
      Children and teens are also susceptible to developing an anxiety disorder. According to NIH, an estimated 31.9% of adolescents have some form of anxiety disorder. Symptoms are identical to adults - excessive, chronic worry plus physical symptoms. Children with GAD tend to dwell about the same things as their non-anxious peers, but do so in excess. They may focus obsessively on things they see in the news, such as forest fires or crime. These worries and symptoms can impair daily functioning, and may cause them to avoid activities that trigger or worsen their feelings of stress, so school work and relationships suffer.
      Treatment for Generalized Anxiety Disorder
      GAD can be treated with a combination of therapy, medication, or both. Speak  with a behavioral health professional on how best to approach a treatment that is right for you. In some cases, a healthy lifestyle including good diet, exercise and the right amount of sleep can help reduce symptoms.
      Although different techniques may work for different people, a therapist can help you identify new ways of thinking and reacting to situations that help you feel less anxious. You may be advised to track your responses over time to discover potential behavior patterns, or learn techniques to promote relaxation. Both medication and therapy take time to work, so it is recommended to continue with your prescribed regimen and not get discouraged too quickly. This is manageable, and there is help to cope with these feelings. You can feel better.
      Feeling like you or a loved one may have some of the anxiety symptoms described here? 
      Telemynd is a nationally delegated telebehavioral health provider for TRICARE members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists from the convenience of your home. You can review benefit coverage or visit our request appointment page to choose your current insurance provider and get started!
      NIH | National Institutes of Mental Health: Generalized Anxiety Disorder
      American Psychiatric Association: What are Anxiety Disorders?
      Harvard Mental Health Letter: Generalized Anxiety Disorder
      National Alliance on Mental Health Illness: Anxiety Disorders
    25. Trauma-Informed Care: Understanding Patients’ Life Experiences to Deliver Better Treatment

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