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

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

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

Bipolar Disorder, formerly called Manic Depression, is a mental illness associated with dramatic shifts in mood, energy, and the ability to think clearly. Individuals with Bipolar Disorder experience repeated and significant mood swings, or ‘episodes’, that can make them feel very high (manic) or very low (depressive). These moods differ from the typical ups-and-downs most people experience. 
The condition affects men and women equally, impacting approximately 2.8% of the U.S. population. The average age of onset is 25, but it can also occur in teens. With a good treatment plan including therapy, medications, and a healthy lifestyle, individuals can manage their symptoms effectively.
Definition of Bipolar Disorder
There are three types of Bipolar Disorder, according to NIH | National Institutes of Mental Health:
Bipolar I Disorder: when people experience one or more episodes of mania. Most people diagnosed with Bipolar I have episodes of both mania and depression, though an episode of depression is not necessary for a diagnosis. To be diagnosed with Bipolar I, manic episodes must last at least seven days or be so severe that hospitalization is required.
Bipolar II Disorder: when depressive episodes shift back and forth with hypomanic episodes, but never a “full” manic episode.
Cyclothymic Disorder: a chronically unstable mood state in which people experience hypomania and mild depression for at least two years. They may have brief periods of normal mood, but these periods last less than eight weeks.
In addition, some individuals experience symptoms of Bipolar Disorder that do not exactly match the three categories listed above, and are referred to as “other specified and unspecified Bipolar Disorders”.
Symptoms of Bipolar Disorder
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), symptoms of Bipolar Disorder break down into manic and depressive symptoms, depending on what kind of episode is happening. During an episode, the symptoms listed below may last every day for most of the day, and episodes may last for several days or weeks.

It can sometimes be more difficult to identify symptoms of Bipolar Disorder in teens than in adults since moodiness is common in teens anyway. If you or a loved one are experiencing any symptoms, be sure to check with a behavioral health professional who can rule out Bipolar Disorder or make an official diagnosis.
Causes And Risk Factors Of Bipolar Disorder
Most scientists agree that there is no single cause of Bipolar Disorder and it’s likely that multiple factors contribute to an individual’s chance of having the illness. Factors that may increase the risk of developing Bipolar Disorder, or act as a trigger for the first episode include:
Having a first-degree relative, such as a parent or sibling, with the disorder
Periods of high stress, such as the death of a loved one or other traumatic event
Drug or alcohol abuse
Treatment For Bipolar Disorder
Bipolar Disorder is very treatable. Medication or a combination of therapy and medication are used to manage the disorder over time. Since people respond to treatment in different ways, those with Bipolar Disorder may need to try different combinations of medications and therapy before finding the plan that works for them.
Bipolar Disorder doesn't get better on its own. If you or a loved one have any of the symptoms of depressive or manic episodes listed above, see a behavioral health professional. Treatment can help keep your symptoms under control.
Do you or a loved one have symptoms of Bipolar Disorder? 
Telemynd is a nationally delegated telebehavioral health provider for Tricare members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who can diagnose and provide treatment for Bipolar Disorder from the convenience of your home. Click here to find your current insurance provider to request an appointment today!  
Sources
American Psychiatric Association: What Are Bipolar Disorders?
National Alliance on Mental Illness (NAMI): Bipolar Disorder
NIH | National Institutes of Mental Health: What Is Bipolar Disorder?

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!

Much has been written about returning military personnel and Traumatic Brain Injury (TBI) because it’s important to raise awareness of this issue as so many of our men and women who have served overseas live with the lingering effects of serious head injuries. And depending on what part of the brain is injured, TBI is often correlated with mental health problems. In fact, studies show that when people without any prior mental health issues or history of mental illness suffer a TBI, their risk for depression and other mental health issues increases significantly – up to two to five times higher than the general population. In this post, we review the link between TBI and mental health, how to look out for symptoms, and treat them if they develop.
What Is Traumatic Brain Injury & Why Do So Many Military Personnel Get Them?
The TBI Centers of Excellence (part of the Office of the Secretary of Defense) reports nearly 450,000 TBIs among U.S. service members from all branches between 2000 and 2020 - that’s a significant number of our service men and women living with the repercussions of a serious head injury. The CDC defines a TBI as a disruption in the normal function of the brain that is caused by a bump, blow, or jolt to the head, or a penetrating object. Military service members are especially at risk from explosions experienced during combat or training exercises, and in fact, currently, approximately 80% of new military TBI cases occur in non-deployed settings, most often sustained during training activities.
TBIs have persistent, and sometimes progressive, long-term debilitating physical and emotional effects. Typical physical symptoms include headaches, seizures, weakness, numbness and loss of coordination, to name just a few. A TBI may also trigger cognitive symptoms including confusion, frequent mood changes, memory loss, executive dysfunction, behavioral changes and difficulty reasoning or learning.
The Link Between TBI & Mental Health Disorders
Scientists have found that living with a TBI may also lead to mental health disorders, including Major Depressive Disorder (most common), PTSD (second most common), Anxiety Disorder, Panic Disorder, and to a lesser extent, Bipolar Disorder and Schizophrenia – all most likely caused by damage to brain tissue during the original head injury.
Following Is More Detail About The Two Most Common Mental Health Disorders Associated With TBI
Major Depressive Disorder — The prevalence of depression within the first year after brain injury is 33%–42%, and within the first 7 years is 61%. Depression may slow the pace of cognitive recovery, impact social functioning, and lower overall health-related quality of life. In addition, people recovering from TBI who also have depression are 3 times less likely to stay on their prescribed medication. They also report more severe physical symptoms (like headache, blurred vision, and dizziness) compared to non-depressed TBI patients. Depression after TBI may result in part from direct or secondary injury to brain tissue, and it also may result in part from the TBI patient’s frustration with the pace of recovery and loss of “normal” routine and ability to participate in activities of daily life.
PTSD — Studies show that military personnel who suffer a TBI are almost twice as likely to have developed PTSD one year later than those with no TBI. One of the problems in diagnosing PTSD in these situations though, is that post-acute symptoms following TBI overlap somewhat with those associated with PTSD itself. Fortunately, clinicians with solid experience treating PTSD are more apt to be able to tell the difference. Scientists believe that PTSD may develop following TBI due to several factors: unconscious or conscious “encoding” in the brain of sensory factors (the sights and smells) associated with the event that caused the TBI, reconstruction of the trauma memory from secondary sources (for example, other people who were there), and memory of circumstances surrounding the event that also may be emotionally traumatic (like seeing others hurt).
Looking at this issue from another perspective, researchers have also found that veterans seeking help from the VA for mental health issues, were found to have undiagnosed TBI in 45% of the cases studied. In other words, symptoms of depression and other mental health disorders were the tip-off that something was significantly wrong medically; in this case, the patients had suffered a TBI at some point in their military service that had not been diagnosed or treated.
Watch For Symptoms Of Mental Health Disorders If You Have Been Diagnosed With A TBI
Making progress in rehabilitation from a TBI can be especially challenging when it’s complicated by an undiagnosed mental health disorder. That’s why it’s so important for people with TBI to be screened for mental health disorders too, and for loved ones and clinicians to watch for signs of mental health problems after TBI. If you see general symptoms such as the following, consult with a qualified mental health provider (and when in doubt, go ahead and get checked out):
Feeling especially sad or down
Excessive fears or worries, or extreme feelings of guilt
Extreme mood changes
Withdrawal from friends and activities
Detachment from reality, paranoia, or hallucinations
Inability to cope with daily problems
Problems with alcohol or drug use
Excessive anger, hostility, or violence
Suicidal thinking
Mental Health Disorders Associated With TBI Are Treatable
For people with a TBI who are also diagnosed with a mental health disorder, it’s important that treatment for that disorder be integrated into the overall TBI rehabilitation treatment plan as prescribed by a qualified mental health provider. Treatment may include a combination of medications and therapies such as Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing therapy (EMDR) — treatment options similar to those recommended for people who are not dealing with a TBI. So, the good news is that mental health disorders associated with TBI are treatable, but it’s critical to be on the lookout for symptoms so they’re not missed.
Sources
Journal of Neuropsychiatric Disease and Treatment
Centers for Disease Control
Journal of Neuropsychiatry

Most of us know that a good night’s sleep is important to good health. It’s critical to maintaining brain cognition, concentration, and productivity. Sleep also improves immune function, staves off serious conditions like diabetes and stroke, and maintains our ability to deal with the challenges of everyday life. A new study has also found that many of us could be coping with concussion-like symptoms such as confusion, low energy, and memory loss due to a lack of sleep and compounded stress. 
Participants Included Cadets From U.S. Military Academies & College Athletes
The research published in the January issue of Journal Sports Medicine was conducted by the Concussion Assessment, Research and Education (CARE) Consortium, a founding alliance between the NCAA and U.S. Department of Defense. Participants included cadets within U.S. military service academies – who undergo rigorous training and are required to participate in athletics – and students who competed in NCAA sports at 26 U.S. colleges.
Study Results
Researchers found between 11% and 17% of healthy college or military academy athletes with no history of recent concussion were reporting multiple symptoms – such as memory loss, low energy, and dizziness – that met the criteria for post-concussion syndrome (also known as PCS). The study found lack of sleep, pre-existing mental health conditions, and stress were the most common predictors for these concussion-like symptoms. Furthermore, between 50% and 75% of the athletes surveyed had at least one concussion symptom, with the most common being fatigue, low energy, or drowsiness.
Women who participated in the study reported more symptoms than men: among cadets, 17.8% of men and 27.6% of women experienced concussion-like symptoms, and among NCAA athletes, 11.4% of men and 20% of women. The study concluded that a history of depression or ADHD were key contributing factors for NCAA athletes who experienced PCS-like symptoms.
"The numbers were high, and were consistent with previous research in this area, but it is quite shocking," said lead researcher Jaclyn Caccese, assistant professor at The Ohio State University School of Health and Rehabilitation Sciences. "These are elite athletes who are physically fit, and they are experiencing that many symptoms commonly reported following concussion. So looking across the general population, they'd probably experience even more."
What Are Typical Symptoms?
A concussion can affect your memory, judgment, reflexes, speech, energy level, balance, and muscle coordination. Individuals who have had a recent concussion or are experiencing PCS-like conditions may act confused or dazed. Other symptoms can include:
Headaches
Nausea or vomiting
Memory loss
Ringing ears
Difficulty concentrating
Sensitivity to light
Loss of smell or taste
Fatigue and drowsiness
A key takeaway related to those who have not had a recent concussion may be experiencing identical symptoms due to lack of sleep and/or the burden of stress being carried.
What Do Experts Recommend?
The research was originally designed to gather additional information regarding the effects and recovery of concussion for student-athletes at colleges and military service academies. Concussions are a known problem in sports, particularly contact sports such as football. 
Scientists who performed the research stated the results have implications for how we treat concussions in college athletes as well as how the general population manages sleep and stress.     For example, they suggest athletes recovering from concussions be assessed and treated on a highly individualized basis. In addition, knowing athletes' medical history and baseline symptoms can help clinicians predict which pre-existing factors contribute to concussion recovery times, and ultimately improve treatment and recovery.
For those of us who’re not college athletes, self-awareness and recognizing when our sleep cycle is being disrupted or how stress has been negatively impacting our daily lives is essential. Place greater emphasis on addressing the issues as they arise or develop healthier mechanisms for coping with the guidance of a mental health therapist. Difficulty sleeping or stress related to underlying mental health disorders such as anxiety or depression should always be diagnosed by a qualified and licensed behavioral health specialist.  
Consider Telebehavioral Health
Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re someone seeking mental health services, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider wanting to join our network, apply online. 
Sources
Journal Sports Medicine, 01.11.21: Factors Associated with Symptom Reporting in U.S. Service Academy Cadets and NCAA Student-Athletes without Concussion: Findings from the CARE Consortium
Concussion Legacy Foundation: What is Post-Concussion Syndrome

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

Mental health disorders affect more than 25% of the population in any given year, and for a while now, scientists have understood that these disorders arise from a combination of genetic influence and environmental factors. Even early physicians made clinical observations noting the tendency of mental illnesses to run in families. Recently, several new studies have confirmed that psychiatric disorders do indeed have genetic roots. But how much can genetics be a contributing component to your mental health? Which disorders are you more susceptible to and which have no genetic correlation?
What The Current Science Says About The Role Genes Play In Mental Health 
Advances in genomic research have identified hundreds of genetic variations that contribute to a range of psychiatric disorders. Recent studies published in science and medical journals such as Molecular Psychiatry, The American Journal of Psychiatry, and Cell, have confirmed that most major psychiatric disorders have a familial and heritable component. What they found was that no individual gene contributes much to the risk of a disorder; instead, hundreds of genes each have a small effect. The way it works is this: your genes are made up of segments of DNA; and any alteration in the DNA sequence produces a gene variant, which can then increase the risk for a disorder. 
Specifically, scientists found that the genetic causes of different mental health disorders can range from 20% to 45% for anxiety disorders, obsessive-compulsive disorder, and major depressive disorder; from 50% to 60% for alcohol dependence and anorexia; and from 75% and up for autism spectrum disorder, ADHD, schizophrenia, and bipolar disorder.
These studies should not be inferred as an absolute that any one individual will develop a disorder. People with no family history of mental illness can be diagnosed with mental health disorders too. And even for those at higher genetic risk, environmental factors such as poverty, childhood trauma, exposure to certain toxins, substance abuse and others, also play a significant role in whether or not someone develops a disorder, or the severity of the illness.
One Example: Bipolar Disorder
According to the National Institutes of Health (NIH), irregularities in many genes may combine to increase a person’s chance of bipolar disorder (a disorder associated with episodes of mood swings ranging from depressive lows to manic highs). More specifically, scientists can now predict the chances for getting the illness in this way: there is a one in 100 chance of developing bipolar disorder if you are in the general population; however if one of your parents has it, the chances go to 10 in 100; and if one of your siblings has it, the chances go to 13 in 100.
Remember, just having a genetic predisposition to Bipolar Disorder is not enough to trigger its development. Environmental factors must be present also. It’s also important to note that just because someone has a greater chance of the illness, doesn’t mean they will ever develop it.
Why Research The Genetics Of Mental Health?
Beyond identifying genetic risk variants, a major benefit of this research and its findings is the ability to provide new clues about the biological pathways that contribute to mental illness. Learning how mental health disorders are related at a biological level may inform how we classify and diagnose them in the future. As well, the findings may help develop new treatments that benefit multiple conditions.
While we’ve got a good start, scientists all agree that much more research into the genetics of mental health is needed. Until then, it is still recommended during initial sessions with behavioral health specialists to share your family history of mental health in order to better recognize and treat underlying conditions. If you recognize potential symptoms of a disorder, it is important to receive a proper evaluation from a qualified behavioral health specialist, most mental health disorders can be managed through a combination of therapy and/or prescription medication..
Consider Telebehavioral Health
Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, apply online. 
Sources
Massachusetts General Hospital: Largest study of its kind reveals that many psychiatric disorders arise from common genes
The Journal Nature: The hidden links between mental disorders
American Journal of Psychiatry: Psychiatric Genetics Begins to Find Its Footing

It’s estimated that almost half of all Americans will experience a mental health issue at some point in their lives. We’ve discussed some of these issues in previous posts - Generalized Anxiety Disorder, Major Depressive Disorder, PTSD, Bipolar Disorder to name a few. Although research shows that 76% of Americans believe behavioral health is just as important as physical health, and 56% want to access a mental healthcare provider, there are many barriers. This article discusses those hurdles, as well as possible solutions to getting every individual the care they deserve.
Reasons For Not Being Able To Access Behavioral Health Services
Lack of access to behavioral health providers does not come as a surprise to most Americans. 74% of us do not believe such services are accessible for everyone, and almost half of us (47%) believe options are limited. This is a situation that must be addressed, as without readily accessed mental health services, there can be a significant impact on jobs, relationships, and overall physical health on the individual level. And these individual impacts ultimately affect the economy as a whole.
There are a multitude of reasons for not being able to access behavioral healthcare.
Shortage Of Providers. There are mental health professional shortage areas in every state, according to a study by the Kaiser Family Foundation. This same study showed that nearly 40% of Americans live in regions with a shortage of mental health providers, leading to limited or delayed access to services. Regional shortages cause long wait times (38% of those trying to get help waited longer than a week for care), and some people simply give up rather than wait. Unfortunately, one of the main issues resulting from the behavioral healthcare shortage is that 60% of mental healthcare visits are through a primary care provider and not the specialty care that is necessary to truly address mental health. 
Transportation To Facilities. Related to the above is the fact that not all individuals have reliable transportation to healthcare - whether that is because of the distance they have to travel to seek help or the fact that they have their own mobility issues. This issue often impacts low-income communities, disabled individuals, and those who live in rural areas. 46% of patients report that they or someone they know has had to travel more than an hour to access care in a timely manner.
Lack Of Awareness Or Understanding Of Where Or How To Get Help. While most Americans do try to find care, research shows that 29% who wanted treatment for themselves or loved ones did not seek it because they didn’t know where to go. Leading to a greater need for visibility and education to help identify behavioral health issues and understanding the right type of care to seek for treatment.
Stigma. Several weeks ago, we wrote about the stigma around behavioral health that causes people to avoid or delay seeking treatment due to their perception that they may be treated differently, or that seeking treatment may impact their jobs or social status. In fact, research shows that nearly one-third of Americans worry about others judging them when they told them they sought mental health services. And a study specific to older adults found that the most commonly reported barrier to treatment for that age group was the personal belief that "I should not need help". 
How Virtual Behavioral Health Care Can Help
So how do we address this problem? The issues are complex and will likely require further study and changes to public policy and education. But virtual behavioral health care (also called telebehavioral health) may be one of the solutions. Virtual care expands access to providers, eliminates the problem of transportation or mobility, reduces wait times, and eases concerns about the stigma since visits take place in the privacy and convenience of patients’ homes.
The CDC recently concluded that “telehealth… can improve health care access outcomes, particularly for chronic disease treatment and vulnerable groups.” Another published, peer-reviewed study found that “behavioral health virtual visits deliver the same outcomes as in-person visits for many conditions, and meet the same standards of care set by the National Committee for Quality Association.” And the good news is that 45% of Americans who have not already tried virtual behavioral health services said they would be open to the idea of trying it to address a current or future mental health need.
Considering A Career In Telebehavioral Health Or Know Someone Who Could Benefit From Virtual Access To A Licensed Mental Health Professional?
Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today!
Sources
UnitedHealthcare
National Council for Behavioral Health
NIH

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

The Importance of Maternal Mental Health
The journey into motherhood is transformative, bringing joy and challenges, including significant mental health considerations. Maternal mental health is crucial for the well-being of both mothers and their families, yet it's often overshadowed by a focus on physical health. Recognizing this, Telemynd provides essential support to expecting, new, and current mothers, focusing on accessible and comprehensive mental health care personalized to your needs.
Understanding Maternal Mental Health
Maternal mental health encompasses a spectrum that includes conditions like prenatal anxiety and postpartum depression, among others. If left unaddressed, these issues can significantly impact the long-term well-being of both mother and child. Telemynd recognizes the critical need for early intervention and support, providing mothers with resources for understanding, healing, and resilience as they navigate these challenging terrains.
Tailored Support with Telemynd
Telemynd's approach is personalized, recognizing that every mother's experience is distinct. Our licensed mental health professionals have extensive experience working with the situations that impact new mothers. Additionally, Telemynd’s focus on mental health in the military community allows us to provide empathetic and informed care to this specific population of mothers. From handling emotional fluctuations to tackling the deep challenges of motherhood, our providers are dedicated to supporting each mother through their unique journey.
Ease of Access to Care
We prioritize making mental health care accessible and convenient for mothers, utilizing secure virtual platforms for consultations. This approach ensures that help is available when and where it's needed, removing barriers like scheduling conflicts or travel constraints, which are especially pertinent for mothers. To start your journey with Telemynd, click here.
Comprehensive Services for Mothers
Telemynd offers a wide range of mental health services, including therapy sessions, psychiatric evaluations, and medication management. Our services are designed to address the multifaceted aspects of mental health, supporting mothers in every step of their journey towards well-being.
Getting Started: A Streamlined Process
Scheduling an Appointment: Contact us through our website or call our care team to schedule your first appointment. Our friendly and compassionate team members will assist you through a hassle-free scheduling process. Matching with the Right Provider: We believe in the importance of a strong therapeutic relationship. Our personalized matching process ensures you're paired with a provider who understands your specific needs. Your Initial Consultation: Your first session is focused on establishing a connection and starting your personalized plan for care. Ongoing Support: We provide the flexibility to schedule follow-up appointments at your convenience, adapting to your evolving needs as you progress. Telemynd is also covered by TRICARE, ensuring that active-duty service members, veterans, and military dependents receive the support they need.
A New Era in Maternal Mental Health
Telemynd is committed to transforming mental health care for military families, ensuring that expecting and current mothers receive the compassionate, accessible, and tailored support they need. By addressing the distinctive challenges of military life and motherhood, we provide specialized care that makes us the ideal ally for military moms on their mental health journey. To learn more or to start your journey towards emotional wellness with Telemynd, visit our website or give us a call today at 866-991-2103. 

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

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

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

When someone makes the critical decision to start therapy, it can provoke a great deal of nervousness—beyond the underlying anxiety, depression, or other mental health issues that are prompting them to seek therapy in the first place. This is especially true if they've never been in a setting where they've been expected to focus solely on themselves and the sensitive aspects of their lives for a fixed period of time.
As a new therapy client, preparation is key to help calm the nerves. Here are the top six tips for how to prepare for a first therapy session.
1. Have a Quick Reference for Health-Related Information
Psychological and physical health are intricately connected, and during a first therapy session, it'll be important to come prepared to discuss health history details. People should make sure to have a readily accessible list of the medications they are currently taking, including supplements. This can be especially helpful if a person would like to start a new medication in conjunction with their first therapy session.
Beyond current medications, being prepared with a list of medications one has taken in the past can be helpful, especially if certain medications caused adverse side effects or were otherwise ineffective. Be ready to discuss other health conditions, too, as many medical conditions can influence mental health or stress levels—including endocrine conditions (such as thyroid disorders), chronic pain syndromes, or chronic illnesses.
Having these health details written down in a single place can serve as a handy reference and reduce stress during a first therapy session.
2. Think About the Functional Goals of Therapy
Often when starting therapy, the broad goal is to feel better overall. While this is certainly a realistic and achievable goal, it can be helpful to break this goal down into smaller pieces. This way, it's easier to assess progress during a therapeutic journey. Before a first therapy session, people need to take some time to reflect on what they're looking to get out of therapy.
If a person is experiencing depression and hoping that therapy will help their condition improve, they should reflect on the most challenging aspects of their current condition. For example, depression-related sleep challenges are very common. If sleep has been difficult, a goal of therapy could be to increase the number of nights per week that they get quality, uninterrupted sleep. Or, if a person is experiencing tearfulness with their depression, a practical goal of therapy would be to see a reduction in crying episodes per week. Tracking these symptoms can help a person measure the impact of their therapy and make sure they're recognizing improvement in their condition. It's important to ask one's therapist during a first therapy session about how they view and measure progress, as well.
3. Prepare First Therapy Session Questions
Thinking too much about a first therapy session can make it difficult to open up and start a conversation and relationship with one's new therapist. However, going into a first therapy session with a completely blank slate can also make it difficult to know where to start. It can help to prepare a few questions to ask during the first therapy session. Examples include:
What to expect from therapy? What is the therapist's counseling style? How do practical issues like billing work? A good way to come up with questions is for people to think about what details about the first session are nagging at them the most—and then reframe those as a question. For example, if a person is worried about what they should be doing during a therapy session (i.e., should they be sitting at their computer desk, or is it okay for them to be lying on their couch), they should simply ask. Or, if a person is concerned about the billing or financing aspect of a session, they should feel free to get those questions out in the open as well.
4. Focus on Creating a Supportive Environment for the Session
Virtual mental health counseling sessions can help people fit therapy into their busy lives in a way that was never possible before. However, people need to think about where in their living space they will want a session to occur. Being strategic about this can ensure that a first therapy session is as productive and beneficial as possible. Some factors to consider include the following:
Selecting what to wear. Choosing comfortable clothing can be a great way to feel at ease during a therapy session. People shouldn't worry about dressing to make an impression or to appear professional. Instead, they should wear clothing that makes them feel as relaxed as possible. Choosing where to have the session. If possible, people should choose to have a first therapy session in an area of their home where they're free from mental distractions. If having a therapy session in the kitchen means staring at a to-do list on the fridge, or a sink full of dishes, this can introduce more stress into the session. Instead, choose a peaceful, meditative space with as few distractions as possible. Ensuring that this is free from disruption (i.e., by locking the door to prevent roommates from wandering in) can also help one feel more comfortable during a first session. Being intentional about the physical space and nearby items. Once a person has chosen what to wear and where to set up their device for a first therapy session, it can also help to have a few items nearby to make the setting as calm and supportive as possible. Think about keeping a candle, a favorite scent, a comfort item, a framed picture, or a cozy blanket nearby. Practical items, like a box of tissues, may be helpful to have on hand, too. 5. Think Ahead of Time About Conversation Starters or Jumping Off Points
One of the most intimidating aspects of a first therapy session may be the initial ice breaker or conversation starter that answers the question: "What brings you here today?" This question can feel so big that it becomes difficult to answer or even to know how to start answering. However, instead of thinking of a first therapy session as this giant, inaugural jump into a new frontier, it's helpful to realize that each therapy session is simply a resource for whatever a person may be needed at the moment.
Here are some potential topics for jumping-off points people can use when it comes to talking to their therapist during a first therapy session:
When was a period in their life, or a specific moment, that they felt truly happy or joyful? What factors contributed to that moment—who was there, and what was the context? Comparing that moment to the present moment, what factors are different or the same? When was a period in their life that they felt the lowest, and what factors contributed to this? How quickly did they come out of this lowest moment, or what feelings or emotions are residual from this moment and continuing into the present day? What relationships in the past have they considered to be the most nourishing and constructive? On the flip side, what relationships in the past have been the most toxic or difficult? What present hardship or situation would they want to change first if they could? What worries them the most about the future? What are they hoping will happen in the future? What small, annoying thing happened yesterday? What choice did they make recently that they regret? 6. Congratulate Oneself on the Reality of a First Therapy Session
It takes a lot of courage to be vulnerable and to go through the process of seeking therapy and showing up to a first session. A final tip for preparing for a first therapy session is simply acknowledging the groundwork that a person has laid to get themselves into the position of attending a first therapy session.
Showing up for oneself is often more than half the battle, as practicing true self-care takes enormous bravery. Before a first therapy session, people should take a moment to pat themselves on the back for taking this big, important next step forward.
How to Learn More About First Therapy Sessions
The above tips about how to prepare for therapy consultation can make it easier to leap into this rewarding journey. At Telemynd, our mental health professionals view therapy sessions as a resource for clients, and each session can serve whatever purpose is needed at the moment. Telemynd providers understand the dynamics that go into embarking upon a therapeutic journey, and they excel at easing clients into a first session. For more information about Telemynd's personalized approach to therapy, contact us to get started with an appointment today.
 

Visualizing success is a powerful tool, and crafting a vision board is a creative way to manifest your goals. In this step-by-step guide, we'll explore why vision boards work, provide materials and preparation tips, and offer insights on doing it solo or with a group.
Why Vision Boards Work
Unlocking the Power of Visualization: Understand the impact of visualizing goals on the subconscious mind and how it influences positive thinking. Testimonials from Celebrities: Dive into success stories from celebrities who credit vision boards for their achievements, such as Oprah Winfrey, Ellen DeGeneres, and John Assaraf. Getting Started: Materials and Preparation
Materials Needed:
Poster board Magazines Scissors Glue Markers Digital Option: For a modern twist, consider using digital tools like Canva or Pinterest to create a virtual vision board. These platforms offer a wide range of images and customization options.
Setting the Right Mindset: Choose a quiet and comfortable space for your creative process. Set the right mindset by reflecting on the positive changes you wish to manifest.
Reflecting on Your Goals
Self-Reflection:
Consider short-term and long-term goals across various aspects of life. Identify key areas such as career, relationships, personal development, and health. Tips for Solo Vision Boarding:
Collect images and words that deeply resonate with your aspirations. Arrange and glue items strategically to create a cohesive narrative. Personalize your vision board with meaningful touches and embellishments. Regularly revisit and reflect on your vision board to stay aligned with your goals. Group Vision Boarding
Benefits of Group Vision Boarding:
Share goals and aspirations with others for mutual inspiration. Organize a vision board party to create a collaborative and supportive atmosphere. Hosting a Successful Event:
Provide a variety of materials and resources. Encourage participants to share their visions and goals. Foster an environment of encouragement and celebration. Bringing Your Vision Board to Life
Daily Integration Strategies:
Place your vision board in a visible location to reinforce your goals. Regularly revisit and update your goals as circumstances change. Use affirmations and visualization techniques to strengthen your commitment. Troubleshooting and Adjusting Goals
Common Challenges:
Address challenges in goal-setting, such as procrastination or self-doubt. Emphasize the importance of flexibility and resilience in adapting goals to changing circumstances. Embark on the new year with a clear vision and a positive mindset. Share your vision board experiences and goals with our community, and let's inspire each other to manifest success in 2024.

Teaching is one of the most important professions, especially when it comes to shaping the future. Supporting teachers is critical for ensuring productive communities nationwide, as well as globally. However, teachers face a disproportionate number of professional stressors, which can lead to decreased mental health. Read on for a deep dive into teacher mental health and strategies to help teachers prioritize their mental wellness.
What Factors Are Behind the Decline in Teachers’ Mental Well-Being?
Compared to adults in other full-time professions, teachers report higher rates of anxiety, depression, and burnout. Prior to the pandemic, teachers were burdened with many constraints, including increasing class sizes, lack of resources and funding, safety concerns, and longer work hours. However, the COVID-19 pandemic introduced a whole new host of stressors for teachers. Fears about physical health, personal well-being, and the well-being of students have only increased the psychological burden on educators. In the post-pandemic era, numerous studies reveal that teachers experience significant job-related stress, which can often lead to mental health conditions such as anxiety and depression.
What Do Statistics Say About Teacher Mental Health?
A recent survey of teachers and principals conducted by RAND Corporation showed that almost 75 percent of teachers and 85 percent of principals faced frequent on-the-job stressors, compared to only 33 percent of working adults. More than half of the teachers surveyed reported feeling burned out.
Other RAND survey statistics showed that:
26 percent of teachers sometimes or often feared for their physical safety at school 23 percent of teachers reported that they were likely to leave their jobs by the end of the school year 25 percent of teachers noted that they either did not know if their job provided mental health support or that there was no mental health support available to them at work More troubling still, recent research in the International Journal of Environmental Research and Public Health showed rates of anxiety symptoms among teachers ranging from 38 to 41 percent and depression symptoms as high as 77 percent.
Expert Strategies for Improving Teacher Well-Being
While taking back control of mental wellness can seem intimidating, especially with the numerous challenges facing the education profession, several tips and tricks can help teachers stay above water and continue to enjoy the critical contributions they make to the profession and society at large.
Tip #1: Prioritize Self Care
Teachers are often “helpers” to a fault, meaning that they prioritize the needs of everyone in their orbit before turning to address their own needs. The first step to re-prioritizing one’s mental well-being is recognizing a tendency to defer one’s needs. After acknowledging that underlying trait, teachers can begin to take steps toward putting a greater emphasis on their well-being. Self-care looks a little different for every teacher. These are common self-care activities that many teachers find helpful.
Routine exercise Focusing on nutritious foods Improving sleep hygiene Taking scheduled and unscheduled time off Spending time with sources of positivity, whether family, friends, or pets Engaging with nature Routine spa appointments, massages, facials, or other body-focused therapies Experts at Mental Health America recommend that teachers physically write self-care activities into their schedules or onto their personal calendars in order to safeguard these activities and limit deferrals or excuse-making.
Tip #2: Set Healthy Boundaries
Teachers are altruists at heart, devoting themselves to the education and promotion of others. As such, they often have a difficult time saying “no” and end up taking on more responsibilities and tasks than they truly desire.
Teachers can refocus on their mental health and reduce their sense of being overburdened by setting healthy boundaries and working to maintain them. This means saying “no” despite the fact that it might cause them discomfort in the moment. Playing defense is crucial to controlling one’s time and schedule and, therefore, feeling agency in one’s own life.
To help teachers set healthy boundaries, one expert on maintaining resilience in education suggests the following habits:
Sticking to specific grading times instead of letting work bleed into personal time Scheduling set office hours to help students in order to protect personal time Making no exceptions to the boundaries that are set Enforcing personal breaks that cannot involve work Considering each day a fresh opportunity instead of wallowing or letting emotions carry over from previous days that were challenging Tip #3: Find Social Connection
The power of social connection is real. Staying connected with others in a similar situation can often be particularly therapeutic, as long as it’s done intentionally and does not dissolve into pure commiseration. Experts at Mental Health America suggest that in order to protect their mental health, teachers should routinely check in on one another. This can allow them to express and share their own vulnerabilities, which can go a long way in combatting feelings of isolation. Establishing a group of fellow teachers who can regularly come together to vent and praise each other can help buffer the daily stress of the job.
Tip #4: Deliberately Pursue an Activity Outside of Teaching
Teaching is the ultimate example of a career that “follows one home,” and this is often because teachers are highly dedicated to their jobs and to the well-being of their students. However, allowing the job to bleed into one’s personal life can be detrimental to mental health. One way that teachers can avoid the temptation to fixate on work at home is to deliberately pick up an extracurricular hobby or activity. This can help teachers keep things in perspective, which is an important element of teacher mental health, according to the Mental Health Foundation.
Tip #5: Lean Into Mental Health Support Channels
Focusing on mental health can sometimes feel like one more task for busy teachers who are already experiencing job-related stress and burnout. However, professional mental health support can be an amazing addition to the tips listed above. Teachers who seek professional support can benefit from tailored mental health plans with trained counselors to talk to in a confidential setting.
Telemynd is an online resource that offers virtual appointments with licensed mental health professionals. Telemynd is included in many benefits programs, and it allows teachers and other busy professionals the ability to schedule appointments anytime, anywhere. Its secure platform and licensed therapists and prescribers are ready to give teachers the support they need to keep doing what they love. To learn more, contact us today.

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

It may seem obvious that having supportive friends makes us feel better, but did you know scientists have proven a link between our friendships and mental health? In one study, people who lacked social support were more likely to suffer from mental health disorders such like anxiety and depression. In another study, the presence of social support systems correlated to faster remission of major depressive symptoms. As the saying goes, friendship - defined as affection, emotional attachment, intimacy, and trust between two people - is “having someone who understands your past, believes in your future, and accepts you just the way you are.”
But why is this? How can something as simple as having friends have such a positive psychological impact on us?
Five Mental Health Benefits Of Friendship
Humans are social animals by nature. The power of true friendship can be invaluable, but at times, we need a little extra help. If you are living with a mental health condition such as depression or anxiety, you know how comforting it can feel to just talk with someone. Good friendships also have additional benefits, such as increased feelings of belonging, increased levels of happiness, as well as improved self-worth and confidence. Here are five benefits of friendships that can help our mental health.
Improve Our Mood. Friends can boost our mood by being there for us, whether it’s virtually or socially distanced. There is a simple pleasure in being in the company of other people we like, and it can be a relief to talk to someone else about how you’re feeling. Friends can also provide a distraction: a good laugh with friends releases endorphins (the feel-good hormones) into our bodies. Perhaps even better, research suggests maintaining strong friendships can help you cope with stress more effectively and help lower your chances of facing some types of stress in the first place.
Provide A Sense Of Belonging. We all want to know that we matter to others — and that our life has purpose. Knowing you have a supportive network of friends can help you feel more secure in your life. Even when your friends are in different places, you still have those connections to trusted individuals who always have your back. And when you care for others, you take on the responsibility of offering compassion and emotional support, which can make you a stronger, better person too.
Avoid Feelings Of Loneliness. Loneliness and social isolation can affect mental and physical well-being. A chat with friends can reduce the stress of feeling alone and provide us with a much-needed distraction. And even when you can’t get together in person, simply knowing you share a strong connection with friends can help you feel less alone.
Keep Us Motivated. If you want to create positive change in your life, friends can help you maintain your resolve to practice healthier habits. They’ll cheer you on and might also support your choices by making changes with you. This encouragement can boost your self-confidence, increasing your chances of success. And friends can also help us make changes for the better by providing good examples.
Support Us Through Challenges. A good friend can help cheer us up and offer support when we need it most. Knowing that support is available can improve feelings of security and help to protect against compounded stress. In fact, research suggests that if you have strong friendships, you’ll probably find it easier to handle the challenges that life throws at you. This study also found that while family support also helps boost immediate resilience, good friendships are an even better predictor of greater resilience throughout life.
Talking To Friends About Mental Health Issues
So there are many positive impacts of having good friends. No matter what you’re going through, healthy and close friendships encourage better mental health and well-being. But sometimes it can feel hard to talk to them about mental health issues. If you decide to tell your friends about your mental health condition, don’t be frustrated if they don’t understand right away. Answer questions they may have and remember that they are trying to understand your experience in their own way. If they are still unable to grasp it, be thankful for your time with them and the effort taken to try and comprehend what you’re experiencing. If you are the friend or relative, consider doing some more research to learn about the condition, and remember to check in on your friend regularly, your support can make a huge difference.
Getting Together Safely During The Pandemic
Recently the CDC has amended its guidelines for casual get-togethers with friends. While most of the time, we must continue to socially distance and wear masks, we may now “visit with other fully vaccinated people or those who have a low risk of serious infection indoors without wearing masks or staying 6 feet apart.” Read more about CDC guidelines here.
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 Alliance on Mental Health (NAMI): Friendship and Mental Health PLOS One: Social network structure is predictive of health and wellness
NIH: The correlation of social support with mental health: A meta-analysis

Anxiety is a common disorder - an estimated 31.1% of U.S. adults experience anxiety at some time in their lives. In our previous post, we defined Anxiety Disorders as “6 months or more of chronic, exaggerated worry and tension that is unfounded, or much more severe than the normal, everyday worry most people experience”. This can manifest in symptoms such as feeling restless, irritable, or on edge’, having a hard time concentrating, feeling tired all the time, and experiencing headaches stomaches, or other muscle aches.
Women Are Diagnosed With Anxiety Disorders At 2X The Rate Of Men
Multiple studies have found that women are twice as likely as men to be diagnosed with an Anxiety Disorder — and this holds true for adult women as well as girls under 18. In addition, women diagnosed with one type of Anxiety Disorder are more likely than men to be diagnosed with an additional Anxiety Disorder.
Researchers have also found differences in the way women experience anxiety:
Women report more body-based symptoms - specifically, women who have panic attacks report more shortness of breath and faintness.
Panic Disorder, a type of Anxiety Disorder, appears to be more chronic in women.
Women report a greater number of worries and more separation anxiety than men.
Women tend to deal with their anxiety by avoidance, while men more often turn to substance abuse.
Multiple Theories As To Why Women Are Diagnosed More Than Men
Some researchers theorize that women’s monthly cycle can affect anxiety levels, or that female hormones may contribute to a more quickly activated, longer-acting fight-or-flight response, or that the hormone testosterone — more abundant in males — may help ease anxiety symptoms for men. Other studies revealed women are more likely to experience physical and mental abuse (as children and as adults) than men, and abuse is commonly linked to the development of anxiety disorders. 
Digging Deeper Into The Anxiety Gender Gap
However, one of the biggest differences researchers found is that women are more likely than men to seek help when they experience symptoms of anxiety, and therefore get diagnosed. So the question becomes: are women actually experiencing anxiety more often, or are they more likely to discuss their symptoms with a health professional than men ? In other words, is there a societal influence on the levels of Anxiety Disorder diagnoses between genders?
In his book, Invisible Men: Men's Inner Lives and the Consequences of Silence, author and professor of psychology at Clark University, Michael Addis postulates that "when men struggle with fear, and depression, it can tend to come out more as anger and aggression. And men in our culture are more encouraged to use, let's say, strategies such as substance use... to suppress those emotions...They are more encouraged to talk to their friend and to bottle it up, and to perhaps kind of withdraw and become passive” rather than reporting symptoms to a medical professional.
In fact, a recent study looked at whether male leaders within organizations are penalized by asking for help, and found that in fact, sometimes men “may face backlash when they don’t adhere to masculine gender stereotypes — when they show vulnerability, act nicer, display empathy, or express sadness.” Unfortunately, this may play out by by impeding mens access to treatment, and therefore their overall mental health.
Ultimately, whether in men or women, early recognition of anxiety symptoms is important so that treatment can start. A combination of cognitive behavioral therapy, medication and lifestyle changes (more physical activity, improved eating and sleeping habits) has been shown to be effective in reducing most symptoms of anxiety. 
Considering A Career In Telebehavioral Health Or Want To Access Virtual Care With A Licensed Professional?
Telemynd offers patients the ability to connect with providers from the safety and convenience of their homes. Providers can join our network by applying online. If you’re a patient, choose your current insurance provider to request an appointment or call our live support for assistance in scheduling care today!
Sources
National Center for Biotechnology Information - National Institutes of Health: Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness
Journal of Brain and Behavior: A systematic review of reviews on the prevalence of anxiety disorders in adult populations
NPR: Understanding How Anxiety Might Be Different For Men

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

Last week we talked about how to spot the warning signs of mental health issues in children and adolescents. This week, we’ll address how to go about finding the mental health professional that can best help.
One in six children in the U.S. between six and seventeen years old have a treatable mental health issue such as Depression, Anxiety, or Attention-Deficit/Hyperactivity Disorder (ADHD), so understand that you are not alone - there are many parents and caregivers looking for help for a child or adolescent in their lives.
But where to start? There are a bewildering array of specialists who can help. To help you sift through the wide-range of information out there, we’ve provided a list of the different types of professionals who can diagnose and treat your child, as well as questions to ask those providers during your search.
Getting Started
For most parents and caregivers, consulting your family or child’s physician can be a good first step. The benefit to starting with someone who knows your child is that they may be able to confirm or recognize when behavior is beyond the typical range. They can also conduct medical testing to rule out possible non-psychiatric causes for the symptoms you’ve noticed.
The disadvantage is that family physicians or pediatricians may have limited experience in diagnosing psychiatric and developmental disorders; or may not have the proper time to allocate for lengthy assessments often required for accurate diagnosis. Best practices in diagnosing children and adolescents include using rating scales to get an objective take on symptoms, as well as collecting information from multiple sources, including the child, caregivers, teachers, or other adults in their lives. Other types of mental health professionals may be better able to assess and treat your child.
Understanding The Different Types Of Mental Health Professionals
Most professionals who diagnose and treat mental health issues in children and adolescents have at least a master's degree or more advanced education, training and credentials. Below you'll find some of the most common types of providers.
Child & Adolescent Psychiatrist: A medical doctor with specialized training in general psychiatry, psychiatric diagnosis and treatment in young people; able to diagnose the full range of psychiatric disorders recognized in the Diagnostic and Statistical Manual (DSM); fully qualified if they have completed national examinations that make them board-certified in child and adolescent psychiatry as well as general psychiatry; can prescribe medication.
Psychopharmacologist: A medical doctor who specializes in the use of medications in order to affect feelings, cognition, and behavior. Although they specialize in the use of medications, they should know when other kinds of therapy should be integrated with medication into the treatment plan and be able to refer patients to other professionals for that therapy.
Child Psychologist: Trained to diagnose and treat psychiatric disorders, but are not medical doctors so cannot prescribe medication; have a doctoral level degree and may hold either a PhD or a PsyD; often work together with psychiatrists to provide care to patients who benefit from a combination of medication and cognitive behavioral therapy; can coordinate necessary evaluations and assessments.
Neuropsychologist: Psychologists who specialize in the functioning of the brain and how it relates to behavior and cognitive ability; have completed post-doctoral training in neuropsychology with either a PhD or a PsyD. They perform neuropsychological assessments, which measure a child’s strengths and weaknesses over a broad range of cognitive tasks, and provide results in a report which forms the basis for developing a treatment plan.
Pediatric Psychiatric Nurse Practitioner: Has either a master’s or a doctorate, and can prescribe medication depending on the state; has training in treating and monitoring children and adolescents with psychiatric disorders; may work as part of a team in a pediatricians’ office, or practice independently.
School Psychologist: Trained in psychology and education and may receive a Specialist in School Psychology (SSP) degree; can identify learning and behavior problems, and evaluate students for special education services.
Social Worker: A licensed clinical social worker (LCSW) has a master’s degree in social work and is licensed by state agencies; required to have significant supervised training; does not prescribe medication, but may work with the family and treating physician or psychiatrist to coordinate care. 
Questions To Ask Prospective Mental Health Specialists
It's especially important to look for a child or adolescent mental health professional who has the right background and experience to treat the specific issues your child is exhibiting. Arming yourself with the knowledge to be able to ask the right questions and know what to look for in a professional will help you feel more confident that you are getting a specialist that's right for your child. 
Ask the following questions when meeting with prospective treatment providers:
Tell me about your professional training?
Are you licensed, or board-certified, and if so, in what discipline?
How much experience do you have diagnosing children whose behaviors are similar to my child?
How do you arrive at a diagnosis? What evidence do you use?
Do you provide the treatments you recommend, or do you refer to others?
How will you involve the family in the treatment?
Will you be in contact with my child’s teacher or guidance counselor?
How long do children usually stay in treatment with you?
What are your thoughts about medication?
Can I speak with a parent whose child has worked with you?
Looking For A Qualified Mental Health Specialist For Your Child Or Adolescent?
Telemynd is a nationally delegated telebehavioral health provider. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists – all the specialists discussed above – who can evaluate, diagnose and provide treatment for mental health issues in children and adolescents from the convenience of home. Find your current insurance provider to request an appointment today.
Sources
National Institute of Mental Health (NIMH): Children and Mental Health
American Academy of Child and Adolescent Psychiatry: Family Resources

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

Holiday songs, the media, friends and co-workers urge us to be merry during the holiday season. However, that’s not always easy to do! As much as we love the holidays, they are invariably a stressful time of year. According to the American Psychological Association, 61% of us describe our anxiety as elevated during the holiday season.
What causes this extra anxiety? Many things. The additional financial demands of the season, travel, interpersonal family dynamics, balancing work, shopping, cooking and decorating, too many social events, memories of past holidays, as well as unrealistic expectations can contribute to creating the perfect storm of emotions.
Even in normal times, many living with Generalized Anxiety Disorder – a chronic state of anxiety and stress which can make a person feel constantly worried even when there is little to no reason to. The stress can become debilitating and can lead to a loss of perspective on the current situation. GAD is treatable by a behavioral health specialist but nonetheless requires those who live with it to take extra care of themselves with a balance of healthy diet and exercise. The added psychological pressure of the holidays can present a special challenge for those struggling with GAD. You may feel like crawling under a comforter and sleeping until the new year!
It’s important to recognize key signs that things are becoming overwhelming and to know some coping skills to reduce the anxiety as it happens.
6 Signs You Are Experiencing Extra Anxiety During The Holidays
Key signs to look for are changes in mood or behavior that differ from your norm.
Be On The Lookout For:
Erratic or unusual behavior, irritability or impulsivity.
Physical symptoms of anxiety, such as a rapid heartbeat, shortness of breath, shaking, dizziness, sweating, an upset stomach, or a dry mouth.
Social withdrawal as some individuals try to avoid situations that will bring on feelings of anxiety or panic. You may also lose interest in activities you used to enjoy.
Changes in appetite and weight – either up or down.
Insomnia, extra exhaustion and other sleep disturbances.
Panic attacks that cause faintness, trouble breathing, pounding heartbeat, or nausea.
How To Cope With Holiday Anxiety
Below are some practical tips you can do to decrease stress during the holidays. We also recommend creating an Anxiety Action Plan containing helpful coping mechanisms beforehand, so that if you start seeing some of the early anxiety indicators listed above, you can put it into place. 
Prioritize your health. Make sure you are eating healthy foods, staying physically active, and getting enough sleep. Think twice about overindulging in alcohol—as it can worsen anxiety symptoms.
Plan ahead. Think about your triggers and try to head them off. For example, if you're worried about money, put together a budget before the holidays. If holiday shopping causes stress, try to do it early, and avoid the stores by shopping online. If social situations make you uncomfortable, accept just a few invitations in advance and ask a good friend to attend with you. Use a calendar to plan specific days for shopping, baking, or gift-wrapping.
Stick to a routine as much as possible. Wake up at the same time, try to eat at the same time every day, take your regular walk, and journal if you normally do that. Don’t schedule a new hair style or make drastic changes to your environment during the holidays!
Schedule worry time. Yes, you read that right. Instead of worrying all the time, schedule a dedicated time –maybe even once a day – to do nothing but worry for a few minutes. Write the  worries down if possible and even brainstorm solutions. This way, constant worrying won’t burn you out.
Make time for self-care. Schedule time in your day to relax with yoga or meditation, drink a cup of coffee or tea, listen to a podcast, play with the dog, or even take a quick nap. Choose something that relaxes your body and calms your mind.
Ask for support. Let your friends and family know that you might need extra support. It’s always ok to ask for help. Some experts even suggest practicing a secret signal with someone you trust who can help you during events if you become overwhelmed or anxious. And don’t forget to reach out to a behavioral health professional for additional help and resources.
In general, experts advise lowering your expectations during the holiday season, try to keep things as simple as possible, and remember that you're not alone – many others are experiencing holiday anxiety like you.
Do You Recognize Any Of These Signs Of Anxiety? 
You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who provide treatment for anxiety from the convenience of your home. Click here to find your current insurance provider and request an appointment today!  
Sources
National Alliance on Mental Illness (NAMI): Mental Health and the Holiday Blues
Harvard Women’s’ Health Watch: A Holiday Advisory for Your Emotions
Harvard Mahoney Neuroscience Institute: Holiday stress and the brain
U.S. Army Health: Handling stress and anxiety during the winter holidays