Monitoring your Teen’s Mental Health

Pre-teen and teen years are marked by a rollercoaster ride of emotions making them difficult to navigate for students, parents, and educators. Emotional ups and downs are often normal for this age group, but can be a warning sign of a more serious mental health condition, like depression. While it’s one of the most common mental illnesses, depression is a leading risk factor for suicide. In a recent study by the Centers for Disease Control (CDC), 44% of teens surveyed reported two or more weeks of feeling sad or hopeless in the last year and 9% had attempted suicide.

It can be challenging to tell the difference between normal teen behavior and depression. So how do you know when it’s something more serious?

The JED Foundation suggests watching for these warning signs:

  • Significant changes in eating, sleeping, self-care, or socializing habits
  • Sadness and/or withdrawal from social situations, especially if they persist for a while
  • Extreme mood swings or irritability
  • Seeming much more fearful and/or avoiding certain environments, situations, or social interactions altogether (such as school avoidance)
  • Using drugs or alcohol, especially changes in typical patterns of use
  • Difficulty with or neglect of basic self-care, personal hygiene, etc. 
  • Getting in fights or suddenly not getting along with others 
  • Sudden increase in reckless, impulsive, out-of-control behaviors
  • Changes in social media behavior 

Most importantly, trust your gut. If you feel like something’s not right, act on it.

For expert tips on talking with your teen about mental health, check out The JED Foundation’s guide, “What to do if you’re Concerned about your Teen’s Mental Health,” which addresses topics including:

  • Signs that your teen may be struggling
  • Preparing yourself emotionally to have the conversation
  • What to say and do during the conversation
  • What to do if your teen denies a problem or refuses help but you are still concerned
  • How to follow up after the conversation

Understand that sometimes, no matter how hard you try, talking to your teen about their emotions can be difficult, if not impossible. NOAH can help. Our Behavioral Health Counselors are available to talk in-person or via video call and many of them specialize in young adults and/or depression. Schedule an appointment today.

If you feel your teen may be in danger of harming themself or others, go to the nearest emergency room or reach out to any of the crisis resources below:

  • Mercy Maricopa Crisis Line: 602-222-9444 
  • Teen Life Line phone or text: 602-248-TEEN (8336)
  • Veterans Crisis Line: 1-800-273-8255 (press 1)
  • National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
  • National Substance Use and Disorder Issues Referral and Treatment Hotline: 1-800-662-HELP (4357)

Get the Facts: Medication to Treat Opioid Addiction

Five people die from opioid overdose in Arizona every day according to the Arizona Department of Health Services. Almost twice as many experience non-fatal drug overdoses. Sadly, the nationwide opioid crisis claims 136 lives per day; accounting for more than 70% of all drug abuse related deaths.  

With 1.27 million Americans now receiving medication-assisted treatment (MAT), this method has the potential to change the course of the opioid crisis. Over the past few years, community health centers, like NOAH, have seen an increase of almost 150% in patients receiving MAT for opioid use disorders, but death rates continue to rise. Help us spread the word; talk about it with your friends and family. You never know whose life you might save.

In recognition of National Drug and Alcohol Facts Week, Chief Medical Officer, Dr. Connie Tucker answers the most common questions about NOAH’s MAT option to treat opioid use disorders.

Q: What is MAT?

A: Medication-Assisted Treatment (MAT) is the use of medication, in combination with behavioral therapy like counseling to treat substance abuse disorders. NOAH uses MAT specifically for the treatment of the use of opioids including heroin, morphine, codeine, fentanyl, oxycodone, and hydrocodone.

Q: What are the symptoms of opioid use disorder?

A: Symptoms of opioid use disorder include:

  • Withdrawal (excessive sweating, shaking, feeling nervous)
  • Weight loss
  • Using medication that is not prescribed to you
  • Using medication outside of the directions given on the prescription
  • Buying street drugs to stop the cravings

Q: What type of medication does NOAH prescribe for MAT therapy?

A: Suboxone, which is a combination of buprenorphine and naloxone.

Q: How does it work?

A: Suboxone stops the opioid cravings and prevents the side effects of withdrawal.

Q: How long does treatment take?

A: Most patients feel better less than one week after beginning the medication. There are many factors that affect the length of treatment; some people may complete treatment in a few months where others may take a year or longer.

Q: Can I get addicted to Suboxone?

A: Addiction to Suboxone is highly unlikely. It is important that anyone on a MAT program use it as directed by your medical provider.

Q: Will Suboxone make me feel sick?

A: Not if you use it as directed by your medical provider.

Q: Do I have to see a behavioral health provider?

A: It is not necessary. You can see either a medical or behavioral health provider who has been trained to prescribe Suboxone. NOAH recommends scheduling regular appointments with a behavioral health provider in conjunction with taking Suboxone for the best long-term results.

Q: How much does it cost?

A: Suboxone is typically covered by insurance and you would just be responsible for the regular co-pay. It comes in a brand name and generic (buprenorphine and naloxone) option which is very affordable on a cash-pay plan as well.

Q: How successful is MAT and Suboxone?

A: It is very successful. Most patients feel better in one week and do not have any cravings after one month.

Q: Why does NOAH offer this treatment option to patients?

A: At NOAH, we believe that an important part of whole person care involves offering all methods of treatment to help patients with a substance use disorder in an unbiased way. MAT also provides an option for treatment for patients who are unable to commit to other formal rehab programs.  

Q: How do I know if MAT is right for me?

A: Ask a medical or behavioral health provider if MAT is right for you. Most patients feel it is time to make a change when their opioid use is taking over a lot of what they are thinking about or doing everyday.

To make an appointment to discuss substance abuse disorder questions, or to see if MAT is right for you or a loved one, request an appointment online or by calling 480-882-4545.

The Not So Social Life: The Effect of COVID on Social Wellness

By Joy Golden, LCSW | Manager Behavioral Health

Over the past two years, we have been asked to stay home, quarantine, socially distance, and more to reduce the spread of COVID. This change in our normal behavior has lasted a long time. It has also caused a very real and serious change to normal life and relationships by not going to school or work, or socially interacting with friends and family. 

While good for managing the COVID spread, these changes caused emotional stress for many people. 

How COVID Impacted Us Socially

Did you know your schedules and routines – whether fun or not – help us feel safe? Starting as babies, people rely on predictable schedules, continuing throughout school, work, and life in general. In these routine activities, you meet, talk to, and work with many people. Those everyday interactions are essential to our health and emotional development. 

Social distancing was hard for most people at first because it wasn’t “normal for us. Then, as we began to accept this behavior as the new normal, COVID risk decreased, and society began to relax restrictions moving back toward the old normal.

Now with COVID infections on the rise again, society is seemingly toggling between open and closed. This back and forth does not support the normal daily schedule or feeling of safety and disrupts exposure to important relationships.

What To Do If You’re Struggling

Start by acknowledging this emotional tug of war and monitor your mental health as you continue to navigate the pandemic. One of NOAH’s providers wrote an article about Social Anxiety with helpful tools to help understand some of your feelings.

According to the American Medical Association, symptoms of emotional stress can include:

  • Feeling powerless
  • Low motivation
  • Feeling tired or burned out
  • Sadness
  • Poor concentration
  • Insomnia
  • Anxiety

Ways to maintain or improve your social wellness:

  • Get fresh air and enjoy the outdoors, don’t stay inside.
  • Limit social media.
  • Use video calling apps for regular check-ins with family and friends or get creative with virtual game nights and happy hours.
  • Find a support person you feel safe talking about your feelings and challenges with. Verbalizing your feelings helps get them out in the open and not stuck inside your head.
  • Slowly introduce more social exposure at parks or outside restaurants.
  • Smile and talk to the cashier at the grocery store, you neighbor walking by, or another person in your day-to-day interactions.

If you or you or someone you know is struggling with social wellness, NOAH behavior health specialists are here to help talk with you, diagnose any illnesses, and help you as you work through these challenges.

Social Anxiety: More Than Shyness

By Daniel Davis, MD | Internal Medicine

It is normal to be anxious or feel some stress about a social event from time to time. Everyone has been anxious about a social occasion like a new job interview, going to a party, going on a first date, giving a speech, etc. But for people with social anxiety disorder this fear can be extreme and cause significant impairment. The good news is that it is very treatable and has many treatment options. 

Examples of automatic negative thoughts in people with social anxiety

What is Social Anxiety Disorder?

Social anxiety is an intense, persistent fear of being watched and judged by others. It can impact work, school, and other daily activities, and it can also make it hard for people to make friends and other lasting relationships. This disorder is extremely common with up to 5-10% of the U.S. population living with it. However, it is underdiagnosed likely because having social anxiety means individuals may not want to get help or talk about it.

What Are Treatments?

If you are concerned you may have social anxiety, fill out this form from the National Social Anxiety Center and bring the results to your primary care provider, counselor, or psychiatrist. It can be difficult to differentiate this disorder from other diagnoses such as normal shyness, PTSD, autism spectrum disorder, panic disorder, agoraphobia, depression and generalized anxiety. So it is important to discuss your concerns with a PCP, psychiatrist or counselor

Social anxiety is common, but it can be disabling. The silver lining is that this condition improves with treatment. Response to both counseling and medications can be make a big difference for people who suffer from this disorder and the many areas of their life it impacts.

At NOAH we truly want to be able to help our patients in whatever way possible. If you are interested in getting evaluated at NOAH for social anxiety or you can contact us and see either counselors, a primary care provider (internal medicine or family medicine), or one of our psychiatric PAs.   

NOAH’s Sierra Health Center Closing

As of November 1, 2021 the NOAH Sierra Health Center is closing. This community health center location opened in late-2016 at the corner of Bell Road and 59th Ave in Glendale.

Sierra was always different than most of the other eight health center locations because it was focused on a specific service. Sierra offered quality therapy and counseling services to a wide variety of patients of all ages. The providers at this location serviced couples, children, teens, and individuals as they worked to overcome life’s toughest challenges with a holistic approach to counseling.

While Sierra may be closing, providers from Sierra will continue to serve patients throughout the metro-Phoenix area through telehealth counseling and therapy sessions, or at another NOAH location.

NOAH behavioral health professionals incorporate various treatment methods into the counseling process and treat the counseling relationship as a partnership between the patient and healthcare professional working toward shared goals. And, because NOAH believes in whole-person healthcare, your behavioral health provider can work with or refer patients for other services at NOAH, working together with all providers.

To schedule an appointment or for more information on services, request an appointment online or call 480-882-4545.

September is Suicide Awareness Month

By Cassandra Altamirano PA-C | MPAS

If you are having worsening or are thinking about ending your life call 800-273-TALK (8255) or text “NAMI” to 741-741 immediately.

According to the National Alliance for Mental Illness (NAMI) 1 in 5 individuals in the United States suffers from mental illness.  Yet, despite how common it is to suffer from this illness, many people feel uncomfortable reaching out for help. As a medical provider I see many patients struggling to deal with depression, anxiety, and mood disorders. It is important to see this topic more openly discussed in families and communities.

Mental Health Background

There is no shame around being diagnosed or treated for a mental health condition. There are more than 51 million U.S. adults living with a mental illness, so these individuals are not alone.

Our brains are an important part of our body, and we often forget that it plays a key role in our everyday health. Our brain controls our emotions, and those emotions can impact physical health. People with a serious mental illness are at an increased risk for chronic diseases, and metabolic and cardiac conditions.

Suicide Awareness – Signs and Symptoms

Our emotions can be so strong that they disrupt our daily lives. Sometimes this makes life seem very overwhelming. Someone struggling with their emotions might start to have feelings of worthlessness or start to wish they didn’t exist. When these overwhelming emotions snowball, the person can feel so trapped that they think there is no way out. This can lead to thoughts of ending their own life.

It is important for both the individual experiencing these thoughts and feelings, and those around them to know the warning signs of suicide and act on ways to help. Learn about suicide awareness now to save a life.

If you see any of these warning signs of suicidal intent in yourself or someone else, please get help immediately. You can call 800-273-TALK (8255), text “NAMI” to 741-741 or t or visit your local medical professional IMMEDIATELY. If you don’t have one, request an appointment with one of NOAH’s counselors or psychiatrists for a virtual or in-person appointment.

Summer Screen Time Tips

Summer months can feel long with kids when school is out, and the heat keeps many of us indoors. Spending hours in front of a screen – television, computer, tablets, phones – can be tempting to pass the time but don’t lose the summer to screens. Let’s understand what safe and appropriate screen time is for kids of all ages.

Screen Time Guidelines

According to the American Academy of Pediatrics, here are some good rules for screen time with kids:

  • Under 18 months – there should be no screens other than a video call with loved ones.
  • Under 2 years – limit screen time to no more than 1 hour a day of high-quality programs like Sesame Street.
  • Ages 2 – 5 years – screen time should be around an hour and be high-quality, educational shows that are made for young kids.
  • Older kids – it all depends on the kid and what they are doing on the screens. But experts agree, limit screen time for other activities like spending time with friends or family, exercise, or sports.

Busy Summer Without Screens

Turing off screens can make kids disappointed and even irritable at first, but it is good in the long run. Allowing children to be bored is actually very good for their development. There are some other things to keep kids busy this summer – even in this heat!

  • Chores – studies show that children who do chores (as young as 3) have higher self-esteem, are more responsible, and deal with frustrations better. So, make sure they clean their room, make their bed, and more. Examples of age-appropriate chores here.
  • Read – kids should either read if they can or be read to for at least 20 minutes every day.
  • Exercise – everyone should get active. It might need to be inside or early in the morning because of the heat, but get 30 minutes to an hour of sports, exercise, or other activities every day.
  • Creativity – make something or get creative. Help cook or bake, draw or paint, make music, or any number of other activities.

Screen time can be beneficial for education, something many parents and kids found out with virtual learning during the pandemic. But it’s not good for all kids, and you don’t want to overdo it! Plus it can be bad for a child’s (and adults) sleep. Read more about that here.

Remember that it is also important for parents and other family members to show the same behavior. If older siblings or parents are always on their phone, younger kids will want to do the same. Try to change up screen time in your home together and everyone will benefit!

Living with PTSD

We are all living with Post-Traumatic Stress Disorder (known as PTSD) either personally or as a community. Someone, somewhere in our lives is living with PTSD and understanding it is important.

PTSD is when a person has difficulty recovering after experiencing or witnessing a terrifying or traumatic event. And PTSD can affect anyone. Thankfully in recent years, the public conversations and understanding around PTSD has grown. The more we know and understand this often-serious disorder, the better.

PTSD Causes

A wide range of events can lead to symptoms of PTSD such as:

  • Car crash.
  • Assault or abuse.
  • The death of a loved one.
  • War.
  • Surviving a natural disaster.
  • Diagnosis of a life-changing medical condition or any other event where you fear for your life.

Symptoms of PTSD

Most people experience short term symptoms associated with PTSD like trouble sleeping and flashbacks. This is known as an acute stress reaction and these symptoms will usually go away in a few weeks. However, some people experience symptoms that last much longer. 

Long term symptoms of PTSD include:

  • Reliving aspects of the event that happened.
  • Feeling on edge or overly alert.
  • Avoiding memories or feelings and difficult beliefs.
  • Experience hyper vigilance.
  • Nightmares.
  • Physical symptoms.
  • Difficulty with relationships, education, or employment.

Living with PTSD

If you or someone you know might have PTSD and has some of the symptoms above, NOAH recommends:  

  • Learn more to help yourself or a loved on. The National Center for PTSD has great resources for everyone, but a lot for those veterans living with PTSD.
  • Get professional support like a counselor or psychiatrist. NOAH has a full team!
  • Know your triggers.
  • Confide in a friend, family member, or professional when you are ready.
  • Try peer support groups online or in person.
  • Keep up with your physical health.
  • Avoid drugs and alcohol to cope with difficulty feelings.

There are many treatments for people living with PTSD or PTSD symptoms. A behavioral health professional can help an individual process trauma in a healthy and effective way. There are also medication options to assist in alleviating symptoms. You and your behavioral health team can work together to decide which treatment will work best for you. NOAH has a team of medical and behavioral health professionals to support you on your journey to healing.

If you are ready to talk with someone about questions or challenges you or a loved on has that may be PTSD, contact NOAH today.

June is LGBTQ Pride

By Andres Jaramillo | LPC

During the month of June, you may see more color around your workplace or community as the rainbow flag flies in windows, porches, stores, and websites, but why? Pride month.

June is LGBTQ Pride Month

June was first officially declared lesbian, gay, bisexual, transgender and queer (LGBTQ) pride month by President Clinton in 1999. But the real start of this story, woven into the fabric of American history, goes back to the 1960’s and before, when brave and thoughtful LGBTQ people stood up to raids, rejection, and harassment, paving the right to be supported and loved.

For some, the image of pride month is only rainbow flags, festivals or parades, which are held all around the world, and a chance for the LGBTQ and ally community to come together and celebrate the historical events and progress in the story. Deeper though, Pride month, and the Pride movement that began decades ago, has a much more important message.

When a person is seen or feels “not normal,” because of their sexual orientation or gender identity, the risks of emotional distress, mental health concerns, and even suicide goes up. Around 2/3 of LGBTQ youth report that someone in their lives tried to convince them to change their sexual orientation or gender identity and suppress who they are. LGBTQ youth contemplate suicide at almost three times the rate of their heterosexual counterparts, and 40% of LGBTQ adults have experienced rejection from a family member or a close friend.

We must choose to accept that what we have been taught or seen as “normal” needs to be challenged for the wellbeing of our family, friends, and neighbors. Recent studies and polls show that about 5.6% of US adults, or about 18 million adults, identify as LGBTQ, so chances are someone around you identifies as LGBTQ and Pride month reminds us to think about the role we have in their lives. What is normal is to choose to stand by someone’s side and be their support. By doing that you can have a positive influence in their emotional, mental, and even physical wellbeing.

Everyone experiences hardships – at work, in our family or relationships, with our friends, with ourselves – and we can all relate to the idea that when we know we are loved and supported, we have more courage, confidence, and flexibility to take on life’s difficulties. It is normal to stand together and support our LGBTQ family, friends, and neighbors. Afterall, we’re all just trying to live our best life.

Happy Pride!

If you or someone you know is struggling with mental or emotional health, NOAH’s comprehensive team of counselors and psychiatrists. Contact us for an appointment today.

Employee Health and Burnout

During this employee health and fitness month, let’s talk about burnout at work. Work can be a source of pride, a social network, offer mental challenges, and so much more. It can also take a lot of time and energy causing people to sometimes experience what’s known as burnout – especially after the year we have all been through.

During a normal year, people can go through times of burnout from work. During 2020 (and into 2021), though, the additional stresses happening all around us likely worsened those feelings. We’ve all been through a lot and feeling overwhelmed or burned out is normal. But being normal doesn’t mean you should ignore it.

What is Burnout?

Job burnout is a type of work-related stress causing physical or emotional exhaustion that also involves a sense of reduced accomplishment and a loss of personal identity.

Throughout the pandemic, many people showed up (virtually or in person) every day, even when it was difficult. Beyond the virus itself, this past year has asked a lot of each of us, with virtual school, cancelled plans and holiday celebrations, career set-backs or job losses, illness, and sometimes even loss.

Expecting to power through like nothing else is going on isn’t realistic; of course it has been hard, and that is on top of nearly half of working adults who were feeling burned out before the pandemic began. According to an Indeed.com study, 52% of people report feelings of burnout from work which is up from 42% before the pandemic began.

Symptoms

“Burnout” isn’t a medical diagnosis, but it has distinct symptoms. Burnout can affect your physical and mental health. Some of the symptoms include:

  • Finding it difficult to concentrate
  • Lack of energy and productivity
  • Being critical or cynical at work
  • Change in sleep habits
  • Loss of satisfaction from work accomplishments
  • Being impatient with coworkers, customers, or patients
  • Using drugs or alcohol to feel better
  • Unexplained headaches
  • Stomach or bowel problems

Causes

Employee burnout is always around. It can come and go. But what everyone experienced during 2020 with the COVID-19 pandemic shifted employee stress and burnout. When the pandemic first began, the initial stress of the virus, possibility of a job loss, and shift to virtual working environments actually accelerated some people’s productivity. After months, though, the stress began to wear on people and the unknow factors of how long things would last, made it harder to manage.

With the causes of burnout listed below, it is easy to see how the COVID-19 pandemic enhanced these issues.

  • Lack of control. Unable to influence decisions that affect your job (schedule, assignments, or workload), and lack of resources to do your work.
  • Unclear job expectations. Being unsure about the authority you have or what others expect from you.
  • Extremes of activity. A job extremely monotonous or chaotic, or swings between the two, requires constant energy to remain focused and causes fatigue.
  • Work-life imbalance. When work takes up so much of your time and effort that you don’t have the energy for family and friends.
  • The imbalance was stretched even more because much of what people balance work with: seeing friends, traveling, visiting families, etc. were cancelled for almost a year. In addition, working from home also blurred the lines between work and home, and meant people needed to find ways to separate the two often with children learning from home as well.

If you are currently struggling, talk to a doctor or a mental health provider because these symptoms can be related to other health conditions. Contact NOAH to request an appointment today.