PTSD and Anxiety Disorders – We Can Help You Help Yourself

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By: Todd Basta, LPC Counselor

Signs and Symptoms

Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD) display excessive anxiety or worry, most days for at least 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.

Generalized anxiety disorder symptoms include:

  • Feeling restless, wound-up, or on-edge
  • Being easily fatigued
  • Having difficulty concentrating; mind going blank
  • Being irritable
  • Having muscle tension
  • Difficulty controlling feelings of worry
  • Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep

Panic Disorder

People with panic disorder have recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that come on quickly and reach their peak within minutes. Attacks can occur unexpectedly or can be brought on by a trigger, such as a feared object or situation.

During a panic attack, people may experience:

  • Heart palpitations, a pounding heartbeat, or an accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath, smothering, or choking
  • Feelings of impending doom
  • Feelings of being out of control

People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks. Worry about panic attacks, and the effort spent trying to avoid attacks, cause significant problems in various areas of the person’s life, including the development of agoraphobia (see below).

Phobia-related disorders

A phobia is an intense fear of—or aversion to—specific objects or situations. Although it can be realistic to be anxious in some circumstances, the fear people with phobias feel is out of proportion to the actual danger caused by the situation or object.

People with a phobia:

  • May have an irrational or excessive worry about encountering the feared object or situation
  • Take active steps to avoid the feared object or situation
  • Experience immediate intense anxiety upon encountering the feared object or situation
  • Endure unavoidable objects and situations with intense anxiety

There are several types of phobias and phobia-related disorders:

Social anxiety disorder (previously called social phobia): People with social anxiety disorder have a general intense fear of, or anxiety toward, social or performance situations. They worry that actions or behaviors associated with their anxiety will be negatively evaluated by others, leading them to feel embarrassed. This worry often causes people with social anxiety to avoid social situations. Social anxiety disorder can manifest in a range of situations, such as within the workplace or the school environment.

Separation anxiety disorder: Separation anxiety is often thought of as something that only children deal with; however, adults can also be diagnosed with separation anxiety disorder. People who have separation anxiety disorder have fears about being parted from people to whom they are attached. They often worry that some sort of harm or something untoward will happen to their attachment figures while they are separated. This fear leads them to avoid being separated from their attachment figures and to avoid being alone. People with separation anxiety may have nightmares about being separated from attachment figures or experience physical symptoms when separation occurs or is anticipated.

How to care for others:

  • Be physically present and available.
  • Look for signs that someone might be feeling unsafe in a space.
  • Learn symptoms and identify who to call in case of an emergency.
  • Ask what their needs are.
  • Educate yourself about healthy coping styles.

How to care for yourself:

  • Build trust with peers.
  • Have a trusted companion.
  • Imagine a safe space during stressful moments.
  • Monitor signs of stress or symptoms of PTSD.
  • Change the setup or design of a space if it cues a traumatic memory.

Resources

http://adaa.org/

http://www.nimh.nih.gov/

https://www.nih.gov/

https://onlinepsych.pepperdine.edu/blog/ptsd-trauma-physical-spaces/

2019-2020 Influenza Vaccine Season – FAQ

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By: Taylor Lukas, PA-C

Every year, the influenza virus causes unwanted, often severe, upper respiratory infections across the US during the months of October-May.

Influenza viruses A and B are the culprits for these infections, and if contracted, can cause

  • high fevers
  • severe coughing
  • fatigue
  • body aches
  • other upper respiratory symptoms

Consequences of this infection can range from physical discomfort and missed days from work for a young, healthy adult, to potentially severe and life-threatening complications for small children, chronically ill adults, pregnant women, and the elderly population. In the 2018-2019 season, the CDC estimated there were over 530,000 hospitalizations and over 37,000 deaths associated with influenza! Fortunately, we have an annual vaccine that targets the anticipated strains of the virus for that season and can help reduce our risk of infection! Below are a few commonly asked questions and concerns regarding the flu vaccine to help you make an informed decision.

Who should get the influenza vaccine, and when?

The flu vaccine is recommended by the CDC for all patients over 6 months of age (that do not have a contraindication to the vaccine). The vaccine is HIGHLY recommended for any adult with chronic medical conditions such as

  • asthma/COPD
  • diabetes
  • chronic kidney or liver disease
  • HIV
  • cancer
  • morbid obesity
  • elderly patients >65 years of age
  • pregnant women are strongly encouraged to get vaccinated due to risks associated with contracting the virus during pregnancy.

The ideal time to be vaccinated is before November, however it is beneficial to be vaccinated at any time during the flu season!

I am fairly healthy and don’t get sick often! Why do I need to get the influenza vaccine?

Even if the virus may not be more than an inconvenience to you, it could mean a life-threatening situation if you are to accidentally pass it along to an elderly or sick individual! You are helping protect others that may be unable to get the vaccine, as well as yourself, when you get vaccinated! Additionally, if you do catch the flu despite getting the vaccine, immunization is shown to reduce the SEVERITY and LENGTH of the illness, which allows you to get back to feeling better faster!

I always feel under the weather after I get the flu vaccine. Can I get sick from the flu vaccine?

The influenza vaccine typically administered contains an inactivated (dead) virus, so it is impossible to contract influenza from the vaccine itself. The most common side effect of a flu vaccine is arm soreness for 2-3 days after administration. Some patients report experiencing a mild headache, fatigue, or body aches after receiving the vaccine, however studies do not support a direct relationship between the vaccine itself and these symptoms. These mild potential side effects pale in comparison to the influenza symptoms that you will have protection from!

The start of the 2019-2020 influenza season is quickly approaching! Please come in and see us at any of our NOAH locations to receive a flu vaccine! Your medical provider can answer any additional questions or concerns at your office visit, and choose the flu vaccine that is appropriate for you! Here’s to a happy and healthy winter season!

Sources

1) UptoDate – Seasonal influenza vaccination in adults
2) CDC – Misconceptions about Seasonal Flu and Flu Vaccines
3) CDC – 2018-2019 U.S. Flu Season: Preliminary Burden Estimates
4) JAMA – Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults
5) New England Journal of Medicine – The Effectiveness of Vaccination against Influenza in Healthy, Working Adults

Back to School Health Tips

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By Dr. Patricia Avila, Pediatrician

Summer vacation has come to an end and it is now time to get BACK TO SCHOOL!! Here are some ways you can help your children and teens have a healthier school year. We’ve got 5 tips to help your child get off to a great start this school year!

1 – Annual Well Check and Vaccinations

Having an annual well check is the perfect opportunity to make sure your child/teen is developing and growing normally. Part of the well check is to detect health conditions that you may not be aware of such as:

  • Checking their heart and blood pressure.
  • Vision/hearing screenings.
  • Obtaining labs checking for anemia, cholesterol, and diabetes.

During their well check the doctor also has an opportunity to educate you and your child/teen and for you to address any concerns/questions you may have. Vaccinations are also an important part of your child’s annual well check. They are one of the simplest and most proven ways to protect your child/teen from preventable diseases.

2 – Establishing healthy sleep habits

No matter their age all children and teens need proper sleep to stay focused and to learn. Sleep is just as important as eating healthy and exercising. Establish a regular sleep schedule to allow adequate sleep.

  • Toddlers – young children ages 3-5 years need 10-13 hours of sleep per night.
  • School age children ages 6-12 years need 9-11 hours of sleep per night.
  • Teenagers ages 13-19 years need 8-9 hours of sleep per night.

AVOID all use of electronics 1-2 hours prior to bedtime. Electronics including cell phones, TV, tablets, video games, and computers if used prior to bedtime can interfere with your child/teens ability to fall asleep and stay asleep. Instead, try having them read a book or choose a quiet activity prior to bedtime instead.

3 – Proper Nutrition

Studies show that eating a healthy, well balanced meal for breakfast improves your child’s/teen’s ability to do well in school by helping them focus and have increased energy to learn. Make sure to pack a healthy well-balanced lunch too! A well-balanced meal consists of:

  • 1-2 servings of fruits/vegetables.
  • A good source of protein (dairy – cheese, milk, yogurt, eggs, nuts/nut butters, lean meats, fish, beans/lentils, tofu).
  • Whole grains – whole wheat bread, whole wheat pasta, quinoa.
  • A good source of calcium and vitamin D like milk/milk products or almond/coconut/soy/rice/oat milk.

4 – Keeping your child/teen physically active

We have been seeing an increase in obesity over the past 30 years – the rate has
doubled-tripled in children and quadrupled in teens. Children and teens need 1 hour of physical activity per day. Exercise can be anything that keeps your children active including:

  • Sports.
  • Dancing.
  • Biking.
  • Swimming.
  • Hiking.
  • Jump rope.
  • Trampoline.
  • Chasing the family dog.
  • Hula hooping.

The key is to make it fun and enjoyable. It is also helpful to make exercise a family event to increase motivation. Making exercise a part of the routine early with children will help them continue to be active adults.

5 – Homework and Study Habits

Help your child/teen form good study habits by having a quiet space free of distractions to help them stay focused. Keeping this space free of distractions includes setting aside electronic devices including:

  • Phones.
  • Tablets.
  • TVs.

Set aside a designated time for homework to be completed. If you notice your child is struggling with learning and/or completing tasks, talk with your child’s teacher and doctor to help your child/teen succeed.

National Health Center Week – Staff Appreciation

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“Community Health Centers began more than 50 years ago to meet the #healthcare needs of our most vulnerable. Today, that mission continues and is very much alive. We celebrated National Health Center Week (NHCW) with YOU (our wonderful & amazing team), our #patients, and more than 1,400 Federally Qualified Health Centers across the nation this week. NHCW is a national campaign to increase awareness of the ways #healthcenters are providing affordable health care in communities. Health centers are on the front lines of public health challenges, caring for our most needy populations, and address today’s social determinants of health. In addition, centers located in rural areas are often the only healthcare provider for miles around. I am grateful for all of you, for your compassion, and for your dedication to honor, inspire, and empower the communities we have the privilege of serving,” says Wendy Armendariz, CEO. To schedule an appt., please call 480-882-4545.

Summer Fun in The Sun

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By Dr. Amit Jain, NOAH Pediatrician
“There’s nothing better than having fun outdoors during school vacations. However, especially during summer here in Arizona, we here at NOAH want to remind everyone of some safety tips to keep safe while having some outdoor fun,” says Dr. Amit Jain, NOAH Pediatrician.

Protecting yourself and your children from harmful ultraviolet light exposure is important to prevent melanoma, a deadly form of skin cancer, which often strikes those who have been severely sunburned, especially during infancy and childhood.

The first line of defense against the scorching summer sun is proper clothing and keeping in the shade.

• Try to limit sun exposure during the peak intensity hours between 10am and 4pm.

• Take frequent shade breaks if staying out in the sun for long periods of time.

• Cotton clothing is protective and can also help whisk away moisture to keep you cool while playing outside. Pick tightly woven fabrics for best protection.

• Wear a hat: wide brimmed for best protection of your child’s entire face, including the nose, cheeks, chin, ears, and back of the neck.

• Get your children sunglasses with UV protection. Those from the dollar store, Walmart, Walgreens, or similar stores are nice, economical options that can be easily replaced if they break or get lost. Just be sure they’re labeled as having UV protection.

• Protect your children with a sunscreen that has an SPF (Sun Protection Factor) of 15 or greater. SPF 15 or 30 should be enough for most common uses. Apply this to all areas not covered by clothing. Don’t forget the ears, back of the neck, arms, and legs. Carefully apply around the eyes, avoiding eyelids.

• Choose a sunscreen that has the words “Broad Spectrum” on it – that will cover both UVA and UVB rays. Try to avoid sunscreens that contain oxybenzone that may have hormonal properties.

• Before applying sunscreen for the first time, test a small amount on your child’s back for an allergic reaction.

• Apply sunscreen at least 30 minutes before sun exposure, as it can take this long to become active.

• Reapply sunscreen at least every 1 hour.

• If playing in the water, reapply sunscreen every half an hour, and use a waterproof sunscreen.

• For infants less than 6 months old, avoid direct sun exposure – keep them under shade with a canopy or under a tree. Use wide brimmed hats to help cover their face, ears, and neck. Dress babies in lightweight clothing that covers their arms and legs as well. If this is not available, apply small amounts of sunscreen with a minimum SPF of 15 to your baby’s face, hands, and legs.

• Don’t forget to use sun protection even on cloudy days, as the harmful ultraviolet rays from the sun can even come through clouds.

• Contact your pediatrician if you develop a sunburn, rash, or blistering.

Resources:
American Academy of Pediatrics: https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Swim-Safety-Tips.aspx
Healthy Children: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Swimming-Pool-Safety.aspx

Pool Safety Tips

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By Dr. Amit Jain, NOAH Pediatrician

“Swimming is a great way to beat the summer heat here in Arizona and is a fun activity for children to pass the summer by. Did you know, drowning is the third most common cause of unintentional – injury related deaths? The highest at risk are children ages 1-4 years old,” says Dr. Amit Jain, NOAH Pediatrician.

Our Care Team at NOAH will work with you and your #child to choose the best path for their overall #health and #wellness. Please call 480-882-4545.

  • Never leave children alone, even for a moment, in or near pool areas or other bodies of water (lakes, beaches, and even bathtubs or buckets of water!)
  • Install a fence at least 4 feet tall around the pool, which should ideally surround the pool on all 4 sides and completely separated the pool from your home and yard. It should not have any gaps that a small child could slip over, under, or through. The gate should be a self-closing and self-latching gate that cannot be opened / reached by a small child.
  • Newer technology offers alarms, both for the gate and within the pool, that can alert you to anyone around the pool.
  • When any unexperienced swimmer is around the pool area, make sure there is a designated adult for supervision. This adult should not be under the influence, should not have any distractions (cell phone turned off or handed off to another adult), and preferably knows how to swim and perform CPR.
  • Keep rescue equipment such as a shepherd’s hook and a life preserver to reach/throw for rescues.
  • Avoid inflatable swim aids such as floaties, as they are not a substitution for proper life-preserving equipment such as life jackets.
  • Consider swim lessons for your child if over the age of 1, as it may reduce the risk of drowning. Talk to your child’s pediatrician about your child’s developmental readiness to take swim lessons.
  • Talk to your pool operator to make sure your pool / spa and its drains are compliant with the pool and spa safety act.
  • Be safe and have a fun-filled summer!

      • Resources:
      American Academy of Pediatrics: https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Swim-Safety-Tips.aspx
      Healthy Children: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Swimming-Pool-Safety.aspx