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

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.

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

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

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

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

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

Addiction to drugs and alcohol (often called Substance Use Disorder or SUD) is a mental health problem. It can be caused by a combination of behavioral, biological, and environmental factors, and like other mental health issues, can disrupt the ability to function at work or school, maintain healthy relationships, and cope with stressful situations. According to the Substance Abuse and Mental Health Services Administration (SAMSA), over 20 million people aged 12 or older have a substance use disorder related to their use of alcohol or illicit drugs.
It’s important to know that mental health problems and substance use disorders often occur together (you’ll hear medical and mental health professionals refer to this as comorbidity) - but sometimes it's hard to predict which came first. In this article, we’ll discuss the close connection between addiction and mental health, four facts about that connection, general warning signs, and how to get help.
What causes the connection between addiction and mental health issues?
Multiple scientific studies have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder at some point and vice versa. The 2019 National Survey on Drug Use and Health found that an estimated 9.2 million adults aged 18 or older had both a mental health problem and an addiction to at least one substance in the past year, while another 3.2 million adults had a co-occurring severe mental health problem and substance abuse. Medical and mental health professionals theorize that these problems frequently occur together for various reasons, such as:
Certain kinds of illegal drugs can cause people with addiction issues to experience one or more symptoms of mental health problems Some people with a mental health problems may misuse drugs or alcohol as a form of self-medication Mental and substance use disorders share some underlying causes, including changes in brain composition, genetic vulnerabilities, and early exposure to stress or trauma The bottom line is that dealing with substance abuse and drug addiction is never easy, and it’s even more difficult when you’re also struggling with mental health problems. And to make matters worse, these co-occurring disorders can affect each other. For example, when a mental health problem goes untreated, the substance abuse problem usually gets worse. And when alcohol or drug abuse increases, mental health problems usually increase too.
To expand on the information above, here are 4 important things to know about the connection between addiction and mental health.
Untreated mental health disorders increase the risk of substance abuse. People who suffer from mental disorders are often more likely to turn to drugs or alcohol to relieve their symptoms. And although the substances may provide temporary relief, they can exacerbate symptoms in the long run, leading to further addiction problems and ultimately, an unhealthy cycle.  Substance abuse can cause depression, anxiety, and other mental health problems. Although not everyone who misuses substances like drugs or alcohol will develop mental health problems, if someone is predisposed to a mental health disorder, those symptoms can be triggered by substance abuse.  Substance abuse shares common symptoms with some mental health issues. Alcohol and other central nervous system depressants can trigger symptoms of depression. Conversely, stimulants, such as cocaine, can cause drug-induced psychosis - a symptom usually associated with schizophrenia. In both cases, chronic use can result in irreversible changes to brain chemistry. Mental disorders and substance use disorders - even when occurring together - are treatable. The good news - whether a person has a mental disorder, a substance use disorder, or both, there are a number of treatment options that can result in effective and long-term management of symptoms.  Getting help for co-occurring substance use and mental health disorders
It can take time to tease out which symptoms are associated with a mental health disorder and which are associated with a drug or alcohol addiction problem. The signs and symptoms may also vary depending on the type of mental health problem and type of substance being abused. However, there are some general agreed-upon warning signs that someone may have a co-occurring disorder:
Using alcohol or drugs to cope with unpleasant memories or feelings, or to control pain or mood intensity Feeling depressed, anxious, or plagued by unpleasant memories when using drugs or alcohol  Feel depressed or anxious even when sober A family member who has also struggled with both a mental disorder and alcohol or drug abuse Mental health professionals can help diagnose and treat co-occurring disorders, so the first step if you notice any of these symptoms in yourself or a loved one, is to consult a professional. Although the combination of mental health and addiction issues may seem complicated, there is help. Some people respond to treatment right away. Others will need to try different treatments before finding a combination that works for them. But stick with it as they have been proven effective.
If you or a loved one need help with substance abuse or mental health issues, consider contacting a qualified telebehavioral health professional
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
Substance Abuse and Mental Health Services Administration (SAMSA) National Institute on Drug Abuse MentalHealth.gov

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

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

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

Good Will Hunting - The main character (Will - played by Matt Damon, who also wrote the screenplay with friend Ben Affleck) was abandoned as a young boy and suffers from attachment disorder because of it. The film details how his mental health has an impact on the choices he makes - he’s clearly a genius who belongs inside the classrooms that he cleans for a living at MIT. The success of his work with a local therapist ultimately gives viewers hope for the future.
 
 
 
A Beautiful Mind - Tells the true-life story of brilliant mathematician John Nash (Russell Crowe), a Nobel Laureate in Economics and Abel Prize winner, who develops paranoid schizophrenia and endures delusional episodes while watching the burden his condition brings on his family and friends.
 
 
 
 
The Soloist - A Los Angeles Times columnist (Steve Lopez) finds and writes about a homeless street musician (Nathanial Ayers) who possesses extraordinary talent. In his attempt to help Ayers, Lopez has to also deal with the mental illness that landed Ayers on the street in the first place, as well as the stigma against those with mental health issues.
 
 
 
When Love Is Not Enough: The Lois Wilson Story - Deals sensitively with addiction. Winona Ryder plays the wife of the founder of Alcoholics Anonymous, Bill Wilson, who made it big on Wall Street before the Crash of 1929 - which wreaked havoc on his sense of worth  - and founded Alcoholics Anonymous in 1935 after getting sober himself. Lois Wilson later founded Al-Anon to help the loved ones of those struggling with addiction.
 
 
 
Cyberbully - Takes a realistic and thoughtful approach to the issue of online bullying as seen through the eyes of a teen victim who attempts suicide. Ultimately has positive messages about tolerance, resilience, getting help and support, and standing up to peer pressure. This would be a good film to start a discussion with any teens in your life.
 
 
 
Are there any films that you would add to the list? Let us know in the comments.
If you or a loved one need help with mental health issues, consider contacting a qualified telebehavioral health professional
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

In April, the Defense Department recognizes military children in an awareness campaign to make sure the well-being and mental health of the youngest members of our military community are brought to light. The DoD says about the Month of the Military Child that the goal of the campaign is to “highlight the unique challenges of military children. Our goal is to improve their quality of life and help mitigate the demands they experience from all the transitions, such as frequent moves, parental separations for military training, and worrying about their parents when they're deployed.”
Unique challenges faced by military children
Unlike kids whose parents are not military, this community of children moves 6 to 9 times on average during their school years. In the past, we’ve written about this particular challenge and have highlighted research that shows that military kids who move frequently are significantly more likely to have mental health issues such as depression or anxiety and that in fact, age is an important predictor of the impact on mental health, i.e., military kids aged 12-17 are four times as likely to need help from a mental health professional as military kids aged 6-11. This makes sense intuitively, as teens are already going through the changes and stresses of puberty. In addition:
Students involved in sports who move later in the year can miss team tryouts, or the new school may not offer the same athletic programs. Kids who move may feel the loss of having to end close relationships with friends at a previous school. It’s more difficult for kids to gain acceptance in a new school where cliques and social networks are already established. In addition to frequent moves, other stressors of military life impact kids. For example, when their parents are deployed, they may miss big milestones such as birthdays, holidays, school and sports events, and graduations. 
Resources for families
We’ve written articles in the past about how parents, teachers, and other community members can help monitor military kids for signs of mental health issues. For example, these warning signs should not be ignored:
Kids who talk about fears or worry frequently Complain about frequent stomach or headaches with no known medical cause Are in constant motion and cannot sit still  Sleep too much or too little, have frequent nightmares or seem sleepy during the day Are spending more and more time alone, are not interested in playing with other children, or have difficulty making friends Struggle academically or have experienced a recent decline in grades Repeat actions or check things many times out of fear that something bad may happen. Have lost interest in things that they used to enjoy As part of publicizing Military Children Awareness Month, the Department of Defense also wants military parents to know that support exists for their kids year-round. For example, at the installation level, there are typically child development centers, youth centers, Military and Family Support Centers, and family life counselors. Off the installations, there is community-partner support for military children through schools and organizations such as 4-H and the Boys and Girls Clubs of America. In addition, the DoD’s militaryonesource.mil website has updated resources and events which are dedicated to the Month of the Military Child.
A DoD spokesperson said, "I'd like us to remember what military children's lives are like and how unique their challenges are. It's quite incredible when we think about the transitions they go through that most children don't, and our military children are so resilient through it all." 

Are you a podcast fan? If so, you’re with 41% of Americans who regularly listen to a podcast. If you haven’t jumped on the podcast trend yet, grab a pair of headphones, turn to Apple, Spotify, or any of the many independent broadcasters, and listen in to be educated, entertained, and inspired by the amazing audio content available. Podcasts are like a mini-radio show, but about a specific topic in which you are interested - and they're free and typically easy to find. Thousands of podcasts are available on every possible topic from business and sports to technology and health - and everything in between.
We’ve curated eight popular and highly-rated podcasts about mental health and listed them here. Topics covered include anxiety, depression, addiction, and more. Whether you are living with a mental health disorder, caring for a loved one with mental health issues, or are a clinician treating patients, we think you’ll find these podcasts informative and inspiring.
The Anxiety Podcast - Host Tim JP Collins suffers from anxiety and panic attacks himself and now supports others with anxiety. Each week on this top-rated podcast, Tim interviews relatable guests of all ages who talk about their own anxiety stories and how they’ve learned to cope with the disorder.
 

 
 
The Hilarious World of Depression - Humor is not the first thing that comes to mind when thinking about depression - but give this 5-star podcast a chance before writing it off. It’s a series of conversations with comedians who suffer from depression - that’s right, comedians (it's a lot more common in the industry than you’d think), and how they’ve dealt with (or not dealt with) the symptoms of depression. Very inspiring. 

 
 

Dear Therapists - Each week, therapists Lori Gottlieb and Guy Winch (who are also popular authors and TED speakers), give advice to ordinary (but anonymous) people looking for help with mental health issues. The audience gets to be a “fly-on-the-wall” and hear the informative and relatable conversations - including actionable advice - between the hosts and the patients.
 
 

Therapy for Black Girls - Licensed psychologist Dr. Joy Harden Bradford offers a weekly discussion about all things mental health, personal development, and personal care - aimed specifically at issues experienced by black women in America.
 
 
 

Terrible, Thanks For Asking - One of our personal favorites; Lest you think your friends and neighbors all seem ‘fine’ on the outside, host Nora McInerny asks real people to share their complicated and honest feelings about how they really are. It’s happy, sad, funny, and truly relatable. We all have issues, and sometimes it's nice to have that feeling validated.
 
 

The Gratitude Diaries - Regularly acknowledging feelings of gratitude has been shown to be a coping skill for anxiety and depression, and in this podcast, host Janice Kaplan explores how gratitude can transform relationships, careers, health, and well-being. She explains the science behind the practice of gratitude and how to make it a regular habit. Also in book form, the podcast can stand alone.
 
 

Latinx Therapy - Host Adriana Alejandre, LMFT, engages in conversations about mental health and well-being issues specific to the Latinx community. She tackles tough subjects and interviews experts in the field. Some episodes are in Spanish. 
 
 
 

The Mental Illness Happy Hour - 500 episodes in and it remains a top podcast in the category. The Mental Illness Happy Hour delivers weekly conversations with comedians, artists, doctors, psychologists, and friends of host Paul Gilmartin - about all things mental illness, trauma, addiction, and negative thinking. There’s something for everyone here.
 
 
What podcasts would you add to this list?
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals are trained in multiple mental health disorders and have experience treating them via online appointments - from the convenience and privacy of your home or wherever works for you. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

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

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

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

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

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

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

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

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

No question, stress is affecting us at work. A 2020 survey by Mental Health America found that over 80% of respondents felt emotionally drained from work and 71% said their workplace significantly affects their mental health. Another study by the Anxiety and Depression Association of America found that over 50% of employees say stress and anxiety impacts their workplace quality and performance. The main culprits of all this workplace stress? Deadlines (55%), interpersonal work relationships (53%), staff management (50%), and dealing with unexpected issues and problems (49%) - not to mention the pandemic.
These statistics seem unsustainable. Some employers recognize this issue and are in the process of creating company policies to address it. In this article, we look at the status of mental health in the workplace, and what both employers and workers can do to address the problem.
The COVID-19 pandemic has had a negative impact on mental health
A 2020 CDC survey found that 1 in 4 of us reported feeling anxious more than half of the previous week, and 1 in 5 reported feelings of depression during the same time period - driven by COVID-19-related concerns such as illness, remote learning, travel restrictions, the switch to remote work, child care issues, and limits on gatherings with family or friends, and more.
A recent McKinsey study found that 9 out of 10 employers say they know that COVID-19 is having an impact on their employees by creating unprecedented anxiety and depression, and 70% say they’re taking action - yet the same study found that almost half of workers anticipate that going back to the office will have somewhat or significantly negative impacts on their mental health. 
Mental health issues in the workplace can impact both employees and employers
Stress, anxiety and other mental health issues on the job can impact:
Job performance and productivity
Physical capability 
Cognitive functioning
Communication with coworkers
Engagement with one’s work
Mental health issues in the workplace are also associated with higher rates of disability and unemployment. All of these issues are damaging to employers as well as workers.
What can employers do to address the mental health crisis?
If you’ve a manager, you’ve probably read about the success of interventions and programs such as the following list - which all start by acknowledging the importance of good mental health at all levels of your organization, and talking openly about the problem. In addition, employers can:
Provide managers with training to help them recognize the signs and symptoms of stress in team members and encourage them to seek help from qualified mental health professionals
Make mental health self-assessment tools available to employees
Distribute materials (such as brochures or videos) about the signs and symptoms of mental health issues and ways to get help
Provide free or subsidized access to coaching, counseling, or stress management programs 
What can workers do to address mental health issues in the workplace?
It can benefit all of us to be on the lookout for warning signs that we might need to make changes at work or get professional help. Experts suggest that each of us can:
Watch out for warning signs. For example, if you start to notice you’re losing interest in your job or your productivity drops, or you start dreading work each day, or you feel so anxious that you have trouble thinking about everything that you’re supposed to do, it’s an indication that something is not right.
Consider setting boundaries. Would it help to have a more flexible work schedule, or  set limits as to when and how often you respond to work messages? Or do you need something bigger like a short-term disability leave (usually decided with a mental health professional)?
Get support. If you find you need help, seek out a trusted friend or family member, peer group, or qualified mental health professional - someone or somewhere you can feel seen, heard and validated. A mental health professional will work with you to determine what mental health condition you are experiencing and come up with a plan to address it.
Note that it's illegal for an employer to discriminate against you if you have a mental health condition. And according to the U.S. Equal Employment Opportunity Commission, if you have a qualifying condition like major depression for example, you may have a right to a reasonable accommodation that would help you do your job. Talk to a qualified mental health professional about this first.
If you identify with any of these signs of workplace-related stress or anxiety, consider consulting a behavioral health professional
If you’re a client, request an appointment online or call our live support for assistance in scheduling care today. Our mental health professionals understand the link between the stresses of college life and mental health. If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.
Sources
Harvard Business Review
Centers for Disease Control (CDC)
McKinsey & Company
McKinsey & Company

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

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

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