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

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

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

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

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

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

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

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

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

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.

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

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

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

No one would argue that it's been a tough year for all of us. We’ve never experienced a global pandemic to this extent in our lifetime. In addition to medical fears and loss associated with the COVID-19 virus itself, health experts say Americans are experiencing Anxiety and Depression made worse by pandemic-related stressors, including job loss, evictions, remote learning, travel restrictions and limits on gatherings with family or friends. As well, the length of time the pandemic has gone on is causing many of us to have increased feelings of emotional exhaustion and hopelessness. 
Survey Confirms Symptoms Of Anxiety & Depression Are Up
A Census Bureau - CDC survey conducted over the past Summer and Fall found that expanded symptoms of Depression and Anxiety have been seen in all 50 states. The survey concluded that 1 in 4 of us reported feeling anxious more than half of the previous week, and 1 in 5 of us reported feelings of depression during the same time period. Results also showed the volume of calls to help lines have increased significantly compared to previous years, driven by COVID-19-related concerns.
The Study Further Found That The Increased Stress, Anxiety & Depressed Feelings May Be Causing:
Heightened fear and worry about health, finances, jobs, and loss of support services
Changes in sleep or eating patterns, as well as difficulty sleeping or concentrating
Worsening of chronic health problems
Increased muscle tension and pain
Increased use of tobacco, and/or alcohol and other substances
What Can You Do To Relieve Stressful Feelings During The Pandemic?
Focus on things you can control rather than the constant barrage of negative information coming at you through the media, colleagues, family, and friends. When you move the center of control from something outside yourself to inside yourself, you can help reduce anxiety. Try the following:
Limit news and media consumption, including social media. When we constantly check our newsfeed and see bad news, it activates our sympathetic nervous system, and can send us into fight-or-flight mode. Doing this hour after hour can exacerbate mental health issues. Experts recommend limiting news and social media checks to once or twice a day, turning off news alerts, getting your information from one or two credible news sources, and only posting positive messages and comments on social media.
Keep your routine, even if it feels disrupted. Experts say establishing and keeping consistent daily and weekly routines is a way for people to feel there is some certainty during the pandemic. Even if you work from home now, try to get up at the same time as before the pandemic and keep as much of your normal morning routine as possible - go for a walk or run, eat a healthy breakfast, and drink that cup of coffee or tea. Keep up regularly-scheduled medical and therapy appointments (most can be done online now). If you used to grocery shop once a week for example, but now are isolating at home, try using an online grocery delivery service, but do your online shopping at the same day/time you used to go out to the store.
Make social connections by checking in with loved ones regularly. While social distancing and limits on gatherings are essential to slow the spread of the virus, you can still check-in with family and friends by phone, Zoom or Facetime, text or email. You might even consider taking live cooking or craft classes online (or whatever aligns with your hobbies) - you’ll connect with the teacher as well as the other students while in the class. Science shows there’s a clear connection between mental health and social contact, so make formal time in your schedule to for social activities, as it's one of the things that can easily fall off your to-do list. 
For most people, the stressful and depressed feelings will resolve on their own over time, but for some, they may not. Health experts recommend you seek professional help if you find yourself overwhelmed by continuing or increasing symptoms like exhaustion, fatigue, guilt, irritability, sleep problems, intrusive thoughts, and a reduced capacity to experience pleasure. 
Are You Noticing Signs Of Increased Anxiety Or Depression During The Pandemic? 
You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who provide treatment for depression from the convenience of your home. Click here to find your current insurance provider and request an appointment today!  
Sources
CDC: Mental Health and Coping with Stress During the Pandemic
The Lancet: The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders
CDC - Census Bureau: Anxiety and Depression Household Pulse Survey

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

Back-to-school can be a time of heightened stress and excitement for kids in normal years, but this year, add in increased health worries and new routines associated with the covid-19 pandemic, and the level of ‘back-to-school anxiety’ is higher than ever. In fact, at Telemynd, we’ve recently seen an uptick in requests for mental health visits for kids and adolescents. So, with families in mind, this article will look at the reasons why back-to-school may cause extra anxiety this year and some actionable ways to address it. 
The number of mental health issues in young people has increased in the pandemic
A recent study published in the Journal of the American Medical Association (Pediatrics) found that the number of young people struggling with mental health issues has likely doubled compared to pre-pandemic levels. The study found that 1 in 4 kids are experiencing elevated symptoms of depression and 1 in 5 have higher levels of anxiety. A CDC study found that in 2020, emergency room mental health visits increased 31% for kids ages 12 to 17, and 24% for ages 5 to 11, compared to the same period the prior year.
And it's no wonder. For many young people, the pandemic has increased worries about sickness, family finances, separation from friends, disruption in routine – even coping with grief from loss. A year of remote learning, although necessary for safety, may have taken an emotional toll on many – some may have fallen behind in their studies, or suffered from lack of academic support. 
Back-to-school transitions will be harder this year
Most mental health specialists agree that, in general, kids are realizing that the world is not as safe as we all thought it was – and that increases anxiety. Dr. Jennifer Louie, a clinical psychologist at the Child Mind Institute, says, “There’s just anxiety in the air, and I think kids feel that. They are wondering: Are we sure it’s safe to go back (to school)? And are other people safe? And is it safe to touch this?”
To be sure, some kids have enjoyed homeschooling and spending more time with family. But for those who are predisposed to anxiety, depression, or other mental health issues, transitioning back to classroom learning this Fall may be harder than ever.
How to help kids deal with back-to-school anxiety
For parents and caretakers, it may feel complicated – on the one hand you want to reassure them that it’s safe to go back to school in-person, while also encouraging them to be cautious, and preparing them to be flexible if rules or situations change. 
Here are 5 ways to address additional back-to-school anxiety:
Emphasize safety measures. Talk about how schools have done months of planning to minimize risk and keep everyone safe — and how kids can do their part by following the rules. It's fine to explain that we can never be 100% sure everyone will stay healthy, but that there are measures in place to try to ensure best possible outcomes if people get sick. 
Validate their feelings. Validate any worries by acknowledging that, like any new activity, going back to school can be hard, but with time, it will get easier. For younger kids, praise ‘brave’ behaviors, e.g., “I love how willing you were to take the bus this morning.” Make sure they know they aren’t alone - that teachers and administrators are watching out for them and that you’ll deal with any safety and health issues together.
Have a routine. Making sure that your child has a predictable school morning routine can help everyone feel more secure. Try to do things at the same time, the same way every day. And practice problem-solving if issues come up; for example, if they worry they can’t find their way around school, help them think through who to ask for help.
Make sure they get enough sleep and good nutrition. The shift from summer to school-year wake-up times can be challenging for a lot of kids, but lack of sleep can make them more vulnerable to anxiety. To deal with this, consider leaving TV, phone, or laptop outside the bedroom at night. And have lots of healthy snacks and lunch material in the house to ward-off unhealthy eating (which also contributes to stress).
Observe your child's behavior. Watch for signs of depression or anxiety, for example, becoming more withdrawn, angry, or having trouble concentrating. Also watch for physical changes like abdominal or other physical pain - which also can be warning signs. Be sure to regularly and directly ask them how they're feeling. It is also not uncommon for kids who struggle with anxiety and depression to “hold it together” during the school day and have a “meltdown” when they arrive home to release some of the pent up feelings they have kept inside while in school. It is important for parents to be prepared for this type of response and to create space for their child to decompress when they arrive home before trying to engage them about their day. Understanding “why” your child may be acting in a way that is unlike them is the first step in recognizing the signs that they may be struggling with a mental health issue.  
When to seek additional help
If you see any of the warning signs mentioned above (and see more here), or if a young person’s worries about school start to interfere with their ability and willingness to attend school or participate in normal activities, like sports, or socializing with peers, consider consulting a licensed behavioral health professional. In some cases, kids may be resisting going back to school because last year’s learning at home “felt” easier than going to school (e.g., kids with a lot of social anxiety, or those with learning disorders may have had an easier time when they could work at their own pace). Mental health professionals can sort out real anxiety and depression symptoms, and provide recommendations to help.
If a young person in your life is showing signs of heightened back-to-school anxiety, consider contacting a mental health professional
With the right mental health support, kids can adjust to school this Fall, make new friends, learn new things, and thrive. 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
Harvard Medical School
Centers for Disease Control (CDC)
Behavior Analysis in Practice
JAMA Pediatrics

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

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

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

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

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

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

According to the CDC, it’s estimated that one in six children in the U.S. between the ages of 6 and 17 has a treatable mental health issue such as Depression, Anxiety or Attention Deficit/Hyperactivity Disorder (ADHD).
Mental health disorders in children and adolescents are generally defined as delays or disruptions in developing age-appropriate thinking, behaviors, and social skills. These issues can contribute to difficulty in school and in relationships with friends or family. The earlier a diagnosis is determined, a treatment plan can be started. Studies have shown that early treatment can help prevent more severe, or lasting problems. However, that’s sometimes easier said than done, as it can be hard to discern indicators of underlying mental health issues in children and teens from typical childhood “growing pains”. This article will help you learn what symptoms to watch for.
Common Mental Health Issues In Children & Adolescents
The most common behavioral health disorders experienced by children and adolescents fall into the following categories:
Anxiety disorders 
Depression and other mood disorders
Obsessive-compulsive disorder
Attention-deficit/hyperactivity disorder (ADHD)
Autism spectrum disorders
Eating disorders
Schizophrenia and related psychotic disorders (but to a much lesser degree)
Compounding the complexity of identifying common issues is the fact that it’s very common for children and adolescents to have symptoms that cut across multiple disorders. For example, more than 25% of children with ADHD also have Anxiety, and another 25% meet the criteria for Depression and other Mood Disorders. Additionally, even though children can experience the same mental health issues as adults, their symptoms may be different.
Mental Health Issues In Children May Be Hard To Identify; Therefore Initial Evaluations Should Be Done By Clinicians Who Specialize In This Age Group
Evaluation of children and adolescents with mental health symptoms is typically more complex than that of adults. According to the National Institutes of Mental Health (NIMH), evaluation differs in the following ways:
Developmental context is critical when evaluating children; for example, behaviors that are normal at a young age may indicate a serious mental disorder at an older age.
Children exist in the context of a family system, and that system has a significant impact on their symptoms and behaviors; for example, children living in a family with domestic violence or substance abuse may superficially appear to have one or more mental health issues. In these cases, clinicians rely on direct observation, corroborated by observations of others, such as other relatives and teachers, to determine whether to make a true mental health diagnosis or not.
Developmental and behavioral problems, like poor academic progress, or delays in speech and language can sometimes be difficult to distinguish from those that are in actuality due to a mental health disorder. In these cases, it's not unusual for formal developmental and neuropsychological testing to be recommended as part of the evaluation process.
Watch For These Warning Signs Of Mental Health Issues In Children & Adolescents
So how do you know if a symptom is just part of being a kid, or should be treated as a mental health symptom? How do you know when to request a formal evaluation for potential mental health issues? According to the National Institutes of Mental Health (NIMH), children and adolescents may benefit from an evaluation (and ultimately treatment) if they have more than one of these symptoms:
Have frequent tantrums or are intensely irritable much of the time
Talk about fears or worries 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
Fear gaining weight, or diet or exercise excessively
Engage in self-harm behaviors (e.g., cutting or burning)
Smoke, drink alcohol, or use drugs
Engage in risky or destructive behavior alone or with friends
Have thoughts of suicide
Have sudden periods of highly elevated energy and activity, and require much less sleep than usual
Say that they think someone is trying to control their mind or that they hear things that other people cannot hear
Have You Noticed Any Of These Warning Signs In A Child Or Adolescent In Your Life?
Telemynd is a nationally delegated telebehavioral health provider for Tricare members. You can access licensed psychiatrists, psychiatric nurse practitioners, and therapists who can evaluate, diagnose and provide treatment for mental health issues in children and adolescents from the convenience of home. Click here to find your current insurance provider to request an appointment today!  
Sources
CDC: Data and Statistics on Children’s Mental Health
Merck Diagnostic Manuals: Overview of Mental Disorders in Children and Adolescents

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

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

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

As the 2022 Olympics and Paralympics wind down in Beijing and athletes return home, the glow of their accomplishments is sure to last for a while. But what happens after the glow dies down - after the hometown celebrations, victory parties, and media interviews subside? Holly Brooks, a well-known therapist to Olympic athletes, says, "A lot of athletes fall into a deep depression after the Olympics… (They) need a lot of support, a lot of people reminding them of their worth beyond just their athletic achievements and results."
In this article, we look at the mental health issues that returning Olympians often face, and what can be done to address this.
Post-competition mental health issues are not uncommon
It is estimated that one-third of elite athletes around the world experience symptoms of depression or anxiety. In recent years, athletes like Simone Biles, Chloe Kim, and Michael Phelps have helped raise awareness and normalize mental health issues by talking openly about their own anxiety and depression. At the same time, the number of research studies around this topic has increased - confirming the high incidence of mental health issues in this group.
Studies have found there are several reasons that athletes may experience post-competition depression. Some athletes are dealing with disappointment over performances that didn't seem to measure up. But even for those who walk away with gold, that post-competition, somewhat “lost” feeling of “what do I focus all my energy and attention on now?” can loom large. One athlete said, “When you get home it’s really lonely… It’s quite depressing, and it is a little bit overwhelming, starting from square one again.”
Sports psychologist and director of the Performance Psychology Center at the University of Michigan, Scott Goldman, explains it this way: “This ninety-mile-per-hour ride comes to a screeching halt the second the Olympics are over. …This emotional drop is not that different from the drops we all feel after major milestones, such as getting married or giving birth…. But in the case of Olympic athletes, some find themselves at such a loss they can’t stop the slide—and wind up in clinical depression.”
What can be done to address mental health issues faced by athletes?
Some experts suggest that athletes should have a plan in place for what to do after the excitement of the competition ends - from going on vacation to beginning a degree, a new job, or even a new athletic season. The key may be in an athlete’s willingness to build and maintain an identity off the playing field - and this may be where these other life goals come in.
Support is also critical: The U.S. Olympic and Paralympic Committee formed a mental health task force in 2020 and among other things, made sure Olympic athletes now have access to a dedicated team of counselors and other mental health resources, such as wellness and meditation apps and support groups - during and after the games.
One athlete summarized the challenge this way: "People are finally recognizing that these athletes are not superhuman robots like everyone thinks they are. It's like, 'Oh they're a normal person who has their own mental health issues.'" 
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
NPR
Frontiers in Psychology
British Journal of Sports Medicine