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Parental burnout is real. In fact, it's a diagnosable mental health condition. And the pandemic has made it worse. A survey called “Stress in the Time of Covid-19,” conducted by the Harris Poll with the American Psychological Association, found that 46% of parents with children under 18 said their stress level was very high. Whether it's working longer hours, coordinating working from home with child care, adjusting to new sets of rules, making sure school-aged kids do homework assignments and get to sports practice on time, or just worrying about keeping them safe in the pandemic (and thankfully, the CDC has recently approved vaccines for kids aged 5 and over), there’s a lot on the minds of parents these days. In this article, we look at the research behind parental burnout and ways to mitigate it.
What are the symptoms of parental burnout?
Parental burnout is a distinct psychological phenomenon separate from parents feeling generally stressed and tired (and the latter is pretty normal). Parents typically don’t burn out overnight - it's a longer process - although those feelings of irritability and exhaustion may be early warning signs of something bigger. The World Health Organization recently recognized parental burnout syndrome in its International Classification of Diseases as an occupational condition linked to symptoms such as fatigue, changing sleep habits, and substance use. 
To receive an official diagnosis of parental burnout, you need the following four specific symptoms:
You feel so exhausted you can’t get out of bed in the morning You become emotionally detached from your children; you might even have trouble showing them how much you love them You take no pleasure or joy in parenting, and have become less productive in the process These feelings are a marked change in behavior for you The science behind parental burnout
Much of the recent understanding of parental burnout came from a peer-reviewed, published study done at a Belgian university in 2018. Scientists there found that burnout is much more common than previously understood and that it is associated with four primary factors: exhaustion in the parenting role, contrast with previous parental self, feelings of being fed up with the parenting role, and emotional distancing from children. Primary researcher Isabelle Roskam, PhD, concluded that, “...Parental burnout can be very damaging. As regards to the parents themselves, it can give rise to suicidal and escape ideations, which are much more frequent in parental burnout than in job burnout or even depression. This finding is not surprising considering that one cannot resign from one’s parenting role or be put on sick leave from one’s children.”
A follow-on study done at the same university and published in Frontiers in Psychology, found that although mothers with parental burnout syndrome seem to share some of the same characteristics as postpartum depression, parental burnout differs in that it occurs in mothers with children over 18 months old, and the depressive feelings are not generalized, but experienced specifically in relation to one’s parenting role and tasks.
Ways to address parental burnout
The first thing to do if you are feeling symptoms of parental burnout is to talk to a qualified behavioral health professional. This condition is real, so take it seriously. They can help diagnose your condition and come up with a treatment plan that may include some combination of therapy and medication. 
In addition, experts suggest the following:
Try to reduce perfectionism. Ask yourself “do I actually have to do everything I think I have to do at this moment?” Set up a structure or framework for each day (although it can be flexible). Experts suggest talking with family members and prioritizing by dividing activities into 3 categories: absolute non-negotiables, things you want to see happen, and things you would like to see happen. In this way, everyone’s expectations are on the same page. Look for the positives - even if it feels as if you are forcing yourself at first. Gratitude has been scientifically linked to improved mood. One way to feel more effective might be to keep a journal in which you write down one thing you did well as a parent every day. Schedule time for fun and relaxation - for you and for your family. It's easier said than done, but engaging in activities, guilt-free, that are good for you, not just good for your kids, will make a big difference. Take a walk outside, call a friend, make time for the gym, or promise yourself one episode of a favorite show at least once a week. If you or someone you know are experiencing symptoms of parental burnout, consider consulting a behavioral 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 parental burnout and have experience treating it. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
New York Times
American Psychological Association
Journal of Affective Science
Frontiers in Psychology

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

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

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.
Sources
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

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

Are you one of the many people who have a hard time saying “no”? You’re not alone! There are many reasons experts say we don’t always set the boundaries that we need for good mental health - including wanting to people-please, playing the role of ‘rescuer’, feeling manipulated, or being put on the spot. In this week’s article, we explore ways to set healthy boundaries for better mental health, and why setting boundaries is important for self-care.
What are boundaries and why set them?
A boundary is a limit or space between you and another person, or persons; a clear place where you begin and the other person ends. Setting boundaries is an important part of establishing one’s identity and is a crucial aspect of well-being. Boundaries help us feel safer and more comfortable. Boundaries can be physical or emotional, and they can range from loose to rigid, with healthy boundaries often falling somewhere in between. When healthy boundaries are not present, people may feel angry or sad due to interactions that create a feeling of being taken advantage of, devalued, or unappreciated. In addition, we often feel exhausted by the responsibilities brought on by saying “yes” all the time - leading to what some experts call the “treadmill of over-commitment”.
So why don’t we set boundaries more firmly and frequently? Sometimes we think that saying “yes” will make other people happy regardless of our own feelings. Sometimes, we think saying “yes” all the time confirms that we are needed. And sometimes we respond to the guilt that others may employ to try to break down our boundaries. When we say “yes” for these reasons, we’re out of balance - we’ve inadvertently placed more value on the needs of others than on ourselves.
How to set healthy boundaries
First, know the characteristics of effective boundaries:
Limits are clear and decisive, yet reasonable Value is placed on your needs The focus is on authenticity and self-care, not on pleasing others or playing the rescuer Next, give yourself permission to set personal limits with people. If you feel that love and approval are tied to pleasing others, or that you’re somehow being selfish for setting boundaries, or if it feels “risky” to set boundaries, then consider consulting with a mental health professional who can help you see that it's not selfish to take care of your own needs. 
Next, define your boundaries. This might include things like:
How you will and won’t spend your time and energy Who you will or won’t engage with and when What types of interactions you will or won’t engage in What activities and projects you will or won’t participate in You may find it helpful to practice communicating your boundaries beforehand. Practice staying calm in the face of others’ reactions to your boundary-setting. They may be surprised at first especially if they have come to believe you will always say “yes”, but don't let that stop you! It may feel uncomfortable in the short-term, but there’s definitely a long-term payoff.
And finally, heed the warning signs - and stay away from those who repeatedly don’t respect boundaries you’ve set; who may be invading your space for their own end. 
If you find this all difficult to do, you’re not alone. It’s a big - but very positive step - to take for better mental health. Qualified behavioral health counselors can help with things like learning how to set and maintain boundaries, and recognizing when and what to do when others try to cross those boundaries. As part of improving self-care, consider getting guidance about this from a mental health professional.
Sources
Forbes: The Importance Of Setting Healthy Boundaries
Harvard Business Review: Set Better Boundaries
Psychology Today: 7 Tips to Create Healthy Boundaries

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.
Sources
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

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.
Sources
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

It is no doubt alarming to learn that LGBTQ youth experience more violence, victimization, and report higher suicide risk than their peers; in fact, they are more than 4 times as likely to attempt suicide. Another study found 42% of LGBTQ youth have seriously considered attempting suicide in the past year. Everyone has the right to feel safe and accepted in their community - especially children - and in this article, we discuss some of the things that can be done to address this issue. And to be clear, LGBTQ youth are not inherently more prone to suicide risk because of their orientation or gender identity but are put at higher risk because of how they are stigmatized in society.
Key risk factors for LGBTQ youth suicide
Research shows that multiple factors are key risk factors for LGBTQ youth suicide. Like anyone who experiences highly negative emotional experiences, lack of acceptance amongst family and peers, lack of what would be considered a “safe place” to find peace and comfort, and outright discrimination can cause stress, anxiety, and depression in this group. Research backs up the following experiences that correlate with mental health issues:
Only a third of youth in this group find parental acceptance, another third experience outright parental rejection, and another third do not dislcose their LGBTQ identity until they are adults due to fear of rejection.  Young adults who report high levels of parental rejection are 8 times more likely to report attempting suicide and 6 times more likely to report high levels of depression. 75% of LGBTQ youth report that they have experienced discrimination based on their sexual orientation or gender identity at least once in their lifetime, and more than 50% said they experienced this discrimination in the past year. Those who experienced discrimination attempted suicide at more than 2x the rate of those who did not. 72% of LGBTQ youth reported symptoms of anxiety in the past year, including more than 75% of transgender and nonbinary youth. 62% of LGBTQ youth reported symptoms of depression in the past year, including more than ⅔ of transgender and nonbinary youth. What can we do to help LGBTQ youth?
As with others experiencing mental health issues, nearly half of LGBTQ youth have wanted counseling from a mental health professional in the past year - but in this case, they were not able to receive it for one reason or another. Helping LGBTQ youth find and get good mental health counseling is a good place to start. Telebehavioral health services - qualified therapy done virtually - may be a way to break down barriers, remove stigmas, and increase access for this group.
Studies have also found that LGBTQ youth who had access to spaces that affirmed their sexual orientation and gender identity reported lower rates of attempting suicide. As well, affirming transgender and nonbinary youth by respecting their pronouns and allowing them to change legal documents is also associated with lower rates of attempting suicide.
When asked in a survey what helps them get through daily challenges and feel better about themselves, LGBTQ youth mentioned things like:
Connection with others Identity pride events Art and creative expression Feeling seen and validated Faith and spirituality Moving away from unsupportive situations and people Representation in media Online and offline support groups LGBTQ support in school If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
The Trevor Project
MMWR/CDC
The Trevor Project

Recent research shows that 42% of U.S. adults are reporting anxiety and depression symptoms - up 11% over previous years. While that is alarming news, many of us are able to reach out to a qualified professional to seek help for mental health conditions if we need it. However, the reality is that the gap between individuals who need mental health care and those who receive it is sizable and grows bigger every year. Certain communities - for example, those who live in rural areas, certain ethnic communities, and even those within the military community - are often unable to find and receive the care they need. 
As far back as 1999, the Report of the Surgeon General on Mental Health found that “despite the existence of effective treatments, disparities lie in the availability, accessibility and quality of mental health services for minorities, and those living in some rural and urban areas.” In this article, we look at underserved communities, the reasons why they are underserved, and what can be done about the problem. 
Communities that are often underserved
Ethnic minority communities. Studies show that ethnic minority populations are as much at risk for mental health issues as the population as a whole, but receive substantially less treatment. For example, for individuals diagnosed with depression, 69% of Asian-Americans, 64% of Latinos, and 59% of African-Americans do not access mental health treatment, compared with 40% of the general population.  Rural communities. Studies have shown that 20% of residents of nonmetropolitan counties in the US have a diagnosable mental health disorder but have significantly less access to care than those who live in metropolitan areas. In this case, the gap is most often due to a chronic shortage of local mental health professionals and facilities. Underserved urban communities. The CDC says that individuals living below the poverty level in urban communities were nearly 2.5 times more likely to have depression than those at or above the poverty level. And recent research finds that that depression may be linked to characteristics of the neighborhoods in which they live - poor-quality housing, few resources, and unsafe conditions impose stress, which can lead to depression. Yet, these individuals are less likely to be able to access the quality mental health care they need. Veterans. Thousands of returning military personnel struggle with mental health conditions, including PTSD, depression, and substance use disorders. But studies show that only 50% of returning vets receive the mental health treatment that they need. Some of the barriers have included long wait times and mental health stigmas.  Older adults. Studies show that up to 20 percent of adults aged 65 and over have a mental health condition, yet this population also struggles to get the help it needs - most often due to inability (lack of transportation) to get to treatment, or inability to navigate complex medical insurance systems. What are the barriers to accessing mental health care?
There are many reasons why certain communities aren’t getting the mental health care they need. These include:
Lack of local availability and resources. Underserved city neighborhoods and rural areas often lack the resources needed to maintain necessary community services, and private treatment facilities tend to locate in areas where they can guarantee a steady income stream - which may not be the case in these areas. Hence the chronic lack of mental health facilities and providers.  Transportation issues, including difficulty finding childcare or taking time off work. Cultural stigmas about mental health. Even when resources are available, cultural stigmas about the nature of mental health prevent many individuals in some communities from seeking proper care when needed. Racial/Ethnic implicit bias. Unfortunately, multiple studies found levels of implicit bias between patient-provider interactions and health outcomes. Concluding that a more rigorous examination should be conducted as it may be contributing to health disparities for people of color. Language barriers and an insufficient number of providers who speak languages other than English. Lack of adequate health insurance coverage. Despite the reduction in the number of uninsured Americans since the ACA was implemented, there are still 28 million lacking any type of health insurance. As well, even for those with insurance, high deductibles and co-pays sometimes make care difficult to afford.  What can be done to address behavioral health access issues?
Interest from academics, practitioners, communities, patients, and families to address the gap in mental health care is growing - and that’s promising. Here are some of the ways we can address the problem (note that none of these will change the problem overnight - all of these suggestions need additional research and validation):
Expanding outreach efforts outside of clinic walls with mobile clinics and technologies like digital and virtual treatment. Technology for telebehavioral health services has shown to help break down barriers, remove stigmas, and increase access Creating local marketing and communication campaigns designed to reduce mental health stigma and educate communities about treatment options. Inviting feedback from individuals about their mental health needs and obstacles to care, in order to better understand the issues. Encouraging mental health organizations to include underserved community members on staff or boards of directors. Contacting legislators—both local and federal—to support efforts to improve access to and the quality of mental health services in local areas. Improving payment options Whether you have personally experienced the challenges associated with mental health care access, or whether you’re advocating for a better mental health system, all of us can help make a difference.
If you need help with mental health issues, consider contacting a qualified mental health professional
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
Journal Administration and Policy in Mental Health
American Psychological Association
National Alliance on Mental Health (NAMI)
Journal of the American Academy of Child & Adolescent Psychiatry

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.

70% of US households have at least one pet and most of us view our companion animals as valued members of our families. We love them, we share our homes, our food, and our lives with them. And it turns out that they give back - in spades. Not only do our companion animals love us back and provide friendship, joy, and fun - but it turns out that they can help reduce stress and anxiety too. And by the way, a pet doesn’t have to be a cat or dog - rabbits, guinea pigs, birds, even reptiles can also provide stress relief. In this article, we’ll discuss the science of this human-animal bond, and explain why it's so beneficial.
Multiple research studies confirm the benefits of companion animals
The human-animal bond is defined as “the mutually beneficial relationship between people and other animals that is influenced by behaviors that are essential to the well-being of both.” Studies show an increase in oxytocin levels in the brains of both humans and animals when they interact positively with each other, and it may be that this explains the neuroscience of the bond.
Taking this a step further, research has found that “pets are able to provide unique emotional support as a result of their ability to respond to their owners in an intuitive way, especially in times of crisis and stress.” Another study showed that the presence of a companion animal “buffers against the negative consequences of stress.” Yet another study on military veterans showed significant findings for the “benefits of animal companionship for veterans with PTSD, including effects on reducing feelings of loneliness, depression, worry and irritability, and increased feelings of calmness.” 
How do companion animals help reduce stress?
One of the reasons for these beneficial effects is that companion animals fulfill the basic human need for touch. Intuitively, we know that patting or hugging an animal - a form of sensory stress relief - can calm and soothe us. And, animals tend to live in the moment — they don’t worry about what happened in the past or what might happen in the future. Therefore, they can help us become more mindful and to appreciate the present moment with less worry.
In addition, companion animals help us in the following ways:
Increase exercise and play. Taking a dog for a walk or hike - or even playing with a cat in the house - are fun and rewarding ways to fit daily activity into your schedule. In fact, studies have shown that dog owners are far more likely to meet their daily exercise requirements. And the more exercise and activity you get, the less stress you’ll feel. Keep us connected. Pets can be a great way to feel part of a community of “dog people” or “cat people”, for example, and can help spark conversations and meet new people in pet stores, clubs, or training classes. Staying social and feeling connected is a great way to reduce stress. Provide a sense of security and calm. The presence of a companion animal at home can help provide a sense of security, ease separation anxiety in kids, and make us feel important -  therefore helping to maintain a positive self-image. Add structure and routine to the day. Most pets require a regular feeding, cleaning, and exercise schedule. Having a consistent routine keeps our pets balanced and calm—and works the same way for us, too. Having a pet to care for makes us get out of bed in the morning, no matter how bad the day may seem. Animals in therapy
Companion animals can be a valuable complement to regular therapy for individuals dealing with anxiety or depression. A study published in Frontiers in Psychology concluded that animal-assisted intervention may prove a good complementary option for trauma and other mental health issues. This study found that ‘therapy animals’:
can act as a comforting reminder that all is calm and safe, act as a base for mindful experiences in the present, and  elicit positive emotions and warmth. To this end, you can find many successful therapy animal programs which visit hospitals, retirement homes, hospice centers, nursing homes, and schools. If this is something you might be interested in, a behavioral health specialist is a good place to start to find out more about these programs and to learn if a companion animal might provide stress relief for you.
If you or a loved one are experiencing symptoms of stress or anxiety, consider consulting a behavioral 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 stress and anxiety, and can help explore animal-assisted interventions. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
Journal Animals
BMC Psychiatry
NIH News in Health
Frontiers in Psychology

Caroline Kocot, MS, BSW, describes her equine (horse) therapy work with veterans and their families as “incredibly rewarding.” Caroline, who has a degree in social work from Indiana University, is currently a Provider Relations Coordinator with Telemynd, routinely meeting with new providers interested in joining Telemynd’s extensive behavioral health network. 
Before Telemynd, Caroline worked with innovative therapeutic programs like Bradford Woods Outdoor Center and Battle Buddies, employing therapy techniques like equine therapy - a type of recreational therapy (also called therapeutic recreation). Evidence-based programs like these use outdoor activities - in this case, games and exercises with horses - to help veterans transition back to civilian life while living with the effects of PTSD, Traumatic Brain Injury, or other combat-related disabilities. Caroline says she enjoyed it so much that she continues to spend her weekends at the programs as often as she can.
Caroline spoke with us recently about her experiences working with veterans and about how therapists use the connection between people and horses to enhance physical or emotional healing.
Veterans face unique challenges when they separate from military service and return to civilian life
Even the most resilient of our veterans can find re-adjustment stressful, and unfortunately, these challenges are also often associated with mental health issues like PTSD, depression, and anxiety. And it's not just soldiers who suffer - studies have found that lengths of deployments are associated with emotional difficulties among military children and spouses too - which is why the programs that Caroline works with involve the families of veterans too.
Traumatic military events such as combat, accidents, or deaths in the field involving themselves or colleagues can have long-lasting negative effects on vets - such as trouble sleeping, anger, nightmares, and alcohol and drug abuse - all symptoms of PTSD. A JAMA Psychiatry study found the rate of PTSD to be 15 times higher in returning veterans than in civilians. The same study found the rate of depression in returning vets to be 5 times higher than for civilians. Worse still, almost 10% of veterans reported a recent suicide attempt in the last year. These are behavioral health trends that must be addressed.
What is recreational therapy, and how does it help veterans?
The National Council for Therapeutic Recreation defines recreational therapy as “treatment services and recreation activities using techniques including arts and crafts, animals, sports, movement, drama, music, and community outings. Recreational therapists are specially trained therapists who treat and help maintain the mental and emotional well-being of their clients by seeking to reduce depression, stress, and anxiety, build confidence, and socialize effectively.”
Recreational therapy offers an innovative approach to managing mental health issues such as behavior management, anger management, coping and adjustment, stress management, and substance abuse. This type of therapy engages individuals and their families to collaborate and cooperate - in activities that may feel like play - in order to accomplish their goals. Caroline’s work with individuals and horses included activities like walks and (easy) obstacle courses with horses, grooming horses, and even finger painting on the sides of horses (she says the horses love this, as it feels like being groomed). She says, “...but it's more than play. This is evidence-based therapy, and it's working.”
Research shows that as a result of participating in recreational therapy, individuals develop a better sense of self-control and competency - which may be missing from their lives. Riding and caring for horses appears to improve self-esteem and anxiety. Other benefits may include:
Promoting general well-being and health Enhancing mood and lessening psychological stress levels Improving teamwork, trust, communication, and social interaction with others Enhancing resilience and helping to overcome negative past experiences Diminishing the focus from disability toward ability, increasing independence, and restoring quality of life Lessons learned from working with veterans and recreational therapy
Caroline says her experience has taught her that there is a multitude of approaches to addressing behavioral health issues with which many veterans live and that recreational therapy may be the right fit for many. However, she stresses that it's really important to stay the course and not give up if one therapeutic approach does not work. She says, “there are resources and help out there; keep asking for it, and don’t give up if one method doesn't seem to work. As the old adage says, “try, try again”.”
If you or a veteran you know are experiencing symptoms of PTSD, depression, or anxiety, consider consulting a behavioral health professional
There are recreational and equine therapy programs located across the U.S. Many involve outdoor activities like the programs Caroline works with. A behavioral health professional is a good place to start to find out more about recreational therapy, local programs, and if this kind of therapy is the right fit for you. 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 the issues facing veterans and their families 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.

As the pandemic nears the 21-month mark, we’re hearing from more and more COVID-19 survivors that the virus’ impact can last beyond the first few weeks of symptoms. For some patients, COVID-19 has a long-term, far-reaching effect on their daily lives, impacting them physically, cognitively, and even emotionally - this is what’s being called “long-haul COVID”, “post-acute COVID” or just “long COVID”. 
Research shows that about 10% of those who’ve had COVID-19 get long COVID. The odds go up to 22% for those 70 or older. Experts don’t yet know exactly why people get long COVID, although many now believe that it’s not caused by just one thing; that there are multiple diseases happening. One thing we do know are its symptoms. People with long COVID may experience joint pain, headache, stomach cramps, a pins-and-needles feeling, heart palpitations, and more. One study found that even after 100 days, patients still reported fatigue, shortness of breath, loss of memory, concentration difficulties, and sleep disorders.
Long COVID also appears to impact mental health - studies show that about 1/3 of those who experience long COVID also develop a mental health issue - primarily depression or anxiety disorders. In this article, we discuss what the latest research says about long COVID’s impact on mental health and what can be done to address it.
Multiple explanations exist for the link between long COVID and mental health
Scientists now know that in general, COVID-19 isn't just a respiratory illness, but a disease that affects many critical organs, including the brain. COVID-19 patients often experience neurological complications, such as confusion, delirium, and other cognitive impairments - which may help explain some of the psychological effects of the disease.
In addition, patients living with long COVID may be unable to exercise, socialize, or work - or otherwise live their lives as before. They may be battling feelings of hopelessness and fear that COVID could affect the rest of their lives. All of this can have a significant impact on emotional well-being. Some patients may have spent long periods of time in the hospital and/or in the ICU, which can be deeply stressful or even traumatizing. 
Echoing this, researchers at University College London interviewed Long COVID patients and found five “themes” which influenced their mental well-being, including: the availability (or lack of availability) of care and understanding from others, perceived lack of treatment options, disruption to ordinary living caused by their symptoms, the lack of clarity about the outcome of their illness, and the changes it caused to their identity
How can we address the mental health impacts of long COVID?
As with most mental health disorders, the first place to turn is to a qualified mental health professional. The American Psychological Association reports that many existing psychological and behavioral therapies — like talk therapy, cognitive-behavioral therapy (CBT), group therapy, and peer support, for example — seem to be effective treatments for aspects of long COVID’s psychological symptoms.
Family members and friends should be validating and supportive when Long COVID patients report psychological symptoms. The University College London research mentioned above found that, as expected, people who felt supported and cared for by their social network and by health professionals were less anxious or depressed than those who did not.
Interestingly, treating the mental health symptoms of long COVID can also help alleviate some of the physical symptoms, as long COVID has a bidirectional association with physical and mental health. In other words, the ‘mind-body relationship’ may be driving some symptoms, and so addressing them on multiple fronts can be highly effective in reducing their impact.
If you or a loved one are experiencing symptoms of long COVID or showing signs of anxiety or depression, consider consulting a behavioral 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 the link between COVID-19 and mental health. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
Journal of Infection
NPR
The Lancet Psychiatry
The American Psychological Association (APA)

Do you find yourself having trouble thinking about big decisions like whether to switch jobs, start or end a relationship, or move to a new city? Or even more basic daily decisions like where to go on vacation, or how to organize your day? If so, you’re not alone - and stress may be having an impact on your decision-making ability.
The American Psychological Association (APA) in concert with The Harris Poll just released the results of their 2021 Stress in America survey. This online survey was conducted in August among adults who reside in all parts of the U.S., and reveals that the uncertainty associated with life during the pandemic has caused day-to-day stress to feel overwhelming for the majority of us. Further, this stress has made daily tasks and decision-making more difficult, particularly for younger adults and parents. This post looks at the startling results of this survey and includes suggestions for dealing with everyday stress.
61% say the pandemic has made them rethink how they are living their lives
Major sources of stress, according to the survey, include:
Work (66%)
Money / finances (61%)
The economy (59%)
Family responsibility (57%)
Personal health (52%)
The top 2 sources of stress (work and money) are up
More than one-third of survey respondents said it has been more stressful to make both day-to-day and major life decisions compared with before the pandemic. Younger adults were more likely to feel both kinds of decisions are more stressful now (daily decisions: 40% of Gen Z adults, 46% of millennials, and 39% of Gen Xers vs. 24% of boomers, and 14% of older adults; major decisions: 50% of Gen Z adults and 45% of millennials vs. 33% of Gen Xers, 24% of boomers, and 6% of older adults). 
Over 60% of all respondents say they have begun to question how they are living their lives and whether they are making the right decisions about it - and increased stress plays a big part of this: 63% say that uncertainty about what the next few months will hold causes them even more stress, and 49% say that the pandemic has made planning for their future virtually impossible.
Parents are citing significantly more stress over the past 18 months
‘Decision-making fatigue’ seems to have had a disproportionate impact on parents, given the big changes to schedules and everyday routines during the pandemic. Many say they are struggling to manage households divided by vaccination status, with one set of rules for vaccinated adults and kids over 12, and another for the younger, unvaccinated kids (although this should resolve soon as the FDA recently authorized a COVID-19 vaccine for 5- to 11-year-olds).
According to the survey, parents with children under 18 were more likely than those without children to say that both day-to-day decisions and major life decisions are more stressful than pre-pandemic (daily: 47% vs. 30%; major: 44% vs. 31%), with 54% of those with younger children under 5 reporting that day-to-day decisions have become more stressful.
The real science behind our inability to make decisions when feeling stressed
Multiple research studies have found that stress has a broad impact on the brain regions involved in decision-making processes. One study found that not only is the methodology of our decision-making altered under stress, but also our ability to make reliable cost-benefit evaluations necessary for bigger life decisions. Stress can cause us to focus too much on potential rewards and too little on potential risks; or put another way, stress biases our decisions toward comfortable (but potentially negative) habits rather than on goals. This obviously becomes problematic when weighing life-changing decisions, such as changing careers or having a baby, for example.
Suggestions for coping with everyday stress
It’s not all bad news. The survey did find that U.S. adults maintain an overall positive outlook. 70% said they were confident that everything will work out after the pandemic, and 77% said that overall they are faring ok. What to do if you are feeling more stressed than usual these days? Experts suggest things like:
Building in regular exercise to your routine - even a brisk, 20 min walk can work wonders to relieve stress
Eating a balanced diet and limiting alcohol
Getting enough sleep
Connecting with supportive friends and family (and the key here is ‘supportive’)
Making time for hobbies and fun
Spending quality time with a pet
Trying meditation, journaling, or yoga if you don’t already practice these 
Feeling prolonged stress or anxiety? Consider Telemynd
Request an appointment online or call our care team for assistance in scheduling a session today. Our mental health professionals understand the link between current stresses and mental health. If you’re a behavioral health provider looking to join our team, see all the benefits and learn how to apply here.
Sources
American Psychological Association
Journal of Neuroscience Research
The Decision Lab

The COVID-19 pandemic has created a ‘new work normal’ for many of us. While around 7% of Americans worked from home regularly before the pandemic, now 33-50% regularly work from home. Working remotely seems great on the surface, as we get to avoid lengthy morning routines (especially if you’re also getting other family members ready for the day), long commutes, and common office distractions, like the cubemate who talks loudly on the phone. However, many of us have found that when those lines of separation between work, family time, and relaxation are blurred, it can actually lead to more stress. 
Why is this? Mental health professionals say that things like lack of social contact with others, overworking, and loss of good sleep and eating habits - all of which can happen when we work from home - contribute to a more stressful work experience. They advise that in order to work smarter, and to reduce the chances of mental health issues like anxiety and depression, we should adopt a set of boundaries and routines when working remotely.
Tips to maintain a healthy work-life balance while working from home
The most important tip is to separate “work” and “life”. This means both dedicating a physical space to do your work that isn’t your bedroom, and separating your work and home activities throughout the day. For example, it can be tempting to use the time between meetings to do the dishes or the laundry, but this can ultimately lead to burnout.
Other tips include:
Establishing a routine. Routines and schedules help us feel a sense of control - so  when work routines are significantly altered, it can feel like we don’t know where to begin or how to be productive. Creating a new schedule can be a good way to regain that sense of control. Start with a robust morning routine – take a shower, meditate, get dressed, etc.  - before logging on for the day. And just like before the pandemic, it pays to remain flexible, as sometimes routines can change. 
Taking regular breaks. In a normal in-office workday, you probably would have stopped to chat with a coworker, gotten up to refill your coffee or tea, or left the office for lunch. When you’re working from home it can be more difficult to find those break times. So try to schedule breaks on your calendar and hold yourself accountable to those times. During a break, you could go for a quick walk, play with your dog, or meditate if you are so inclined. By regularly removing yourself from the work environment for 10 or 15 minutes, you’ll feel refreshed and productive instead of feeling exhausted and unable to focus.
Keeping a consistent sleep schedule. Even if you don’t have a meeting until 10am, get up on time anyway. Resist the urge to binge-watch Netflix late at night. The same wake and bedtimes are critical to self-care because they contribute to better overall sleep quality. Otherwise, you may find yourself feeling groggy during the day, or with fluctuations in energy. (And if that happens, it's much more productive to go outside and take a brief, brisk walk instead of taking a nap.)
Eating healthy food. Stay hydrated throughout the day by filling up a water bottle and keeping it next to you at your desk. Resist the urge to snack all day long - it's so easy  to keep running to the fridge - especially if you are stressed. But if you're particularly challenged by this, consider making your lunch in advance, just as you would have for the office. And be sure to have lots of healthy snacks and less junk food in the house.
Having a clock-out time. It’s very easy when you work from home to keep working into the evening - to “just answer an email or two to get caught up”. But that can lead to burnout over time. To be as effective as possible at your job, know when to start and to quit for the day. Set your ‘do not disturb’ notifications between 5pm and 8am for example. Resist the urge to check email in the evening and on weekends. Turn off the sound on your phone or laptop so you don't hear the email and message notifications as they come in.
Making an appointment for “you time”. Self-care isn’t just about long baths and glasses of wine. It means prioritizing the things that you love - whether that’s reading, hiking, visiting with friends, or whatever makes you feel happy and relaxed. It's about finding healthy ways to comfort yourself, setting priorities, staying connected, and creating structure. In this way, you build a stronger foundation for yourself and your career. 
If you or someone you love shows signs of too much stress or anxiety, consider consulting a behavioral health professional
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
Wall Street Journal
The National Sleep Foundation
Griffis, Hailley

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

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

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!
Sources
EMDR International Association
Journal of EMDR Practice and Research
Journal of EMDR Practice and Research
Brainline.org

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

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

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

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

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
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Sources
American Psychiatric Association
National Alliance for Mental Illness
International OCD Foundation

Feeling “blue”, “out of sorts”, or “down in the dumps” are ways we describe feelings of sadness or melancholy. Most of us have felt this way at one time or another. However, what’s known as Clinical Depression or Major Depressive Disorder has multiple symptoms in addition to sadness. As well, individuals with true Depression feel these symptoms much more intensely and experience them for longer periods of time.
Depression is a clinical mood disorder that affects how you feel, think, and behave and can lead to a variety of other problems if left untreated. Depression isn't a weakness and you can't just "snap out" of it. In fact, it may cause you to have trouble doing normal day-to-day activities. Fortunately, with early detection and a treatment plan consisting of medication, therapy, and healthy lifestyle choices, many people can and do manage their depression.
Definition of Major Depressive Disorder
After Anxiety, Depression is the most common mental health disorder. According to the American Psychiatric Association, Depression affects an estimated one in 15 adults in any given year, and one in six people will experience it at some time in their life. Depression can occur at any time, but typically first appears during the late teens to mid-20s. People of all ages and all racial, ethnic, and socioeconomic backgrounds experience Depression.
Depressive Disorders are defined as “feelings of sadness intense enough to interfere with functioning and/or a decreased interest or pleasure in activities”. There are several types of Depressive Disorders and all are commonly called “Depression”. Major Depressive Disorder, the subject of this article, is defined by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) as experiencing at least 5 of the symptoms listed below nearly every day for a 2-week period, and one of them must be depressed mood or loss of interest or pleasure.
Symptoms of Major Depressive Disorder
Multiple, persistent symptoms are required for a diagnosis of Major Depression:
Persistent sad mood
Feelings of hopelessness, or pessimism
Irritability and/or anxiousness
Feelings of guilt, worthlessness, or helplessness
Loss of interest in hobbies and normal activities
Decreased energy or tiredness
Moving or talking slowly
Feeling restless
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping or conversely, frequent oversleeping
Appetite changes
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause 
If you’ve been experiencing some of these symptoms nearly every day for at least two weeks, you may be suffering from Depression. A behavioral health professional can make an official diagnosis.
Causes and risk factors
The exact cause of Depression is unclear, but reduced levels of key neurotransmitters like serotonin, noradrenaline, and dopamine in the brain are believed to play a part in most cases. These are hormones that stabilize your mood, your feelings of well-being, pleasure, happiness, and your capacity to feel energized, so lower levels can have a very negative impact on your well-being and ability to function on a daily basis.
A number of risk factors may make Depression more likely:
Heredity (genetic factors contribute to Depression in about half of individuals diagnosed)
Significantly emotionally distressing events, particularly those involving a loss
Certain physical and anxiety disorders
Substance and alcohol use disorders
Side effects of certain drugs
Social class, race, and culture do not affect the chance that people will experience Depression during their lifetime.
How does Depression impact daily life?
Even though there are many situations in life that can cause sadness and in which we might describe ourselves as being “depressed”, it is important to know the difference between “everyday” sadness and Clinical Depression. Understanding this difference can assist people in getting the help, support, and treatment they need. If you have any doubts about what you are feeling, contact a behavioral health professional who can make an official diagnosis and suggest the best treatment.
Without treatment, individuals with Clinical Depression may be more likely to use alcohol or other drugs in an attempt to help them sleep or to feel less sad. It’s also been found that those with undiagnosed Depression are more likely to smoke or to neglect their health in other ways. Depression may also reduce the immune system's ability to respond to infection; as a result, people with untreated Depression are more likely to get sick more often.
All of these things impact our ability to function well on a daily basis, to do our jobs, and to be the best parent, spouse, son, daughter, caregiver, or friend that we can be. Therefore, getting an early diagnosis and treatment plan is critical.
Treatment for Major Depressive Disorder
Most Depressive Disorders can be treated with a combination of support, therapy, and medication. Speak with a behavioral health professional on how best to approach treatment that is right for you. They will assess your current symptoms and your history of Depression in order to determine the best treatment plan. Once it is chosen, the plan may change over time depending on how well you respond to the care provided. 
Expect your mood to improve gradually, not immediately. In some cases, a healthy lifestyle including a good diet, exercise, and healthy sleep habits can also help reduce symptoms. In addition, behavioral health specialists may recommend spending time with good friends and family, rather than isolating yourself, as well as continuing to educate yourself about Depression, as information can feel empowering.
Please note, if you or a loved one have thoughts of suicide, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1
Do you or a loved one have symptoms of Depression?
You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists from the convenience of your home. Click here to find your current insurance provider and request an appointment today!

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