Why Do I Feel Like This? Stress or Anxiety?

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By Nicole Valdez | Behavioral Health Supervisor

Imagine yourself getting ready for your day. As you get out of bed and jump in the shower, do you find yourself thinking about how busy the week has been and all the things that need to be done around the house? Or are you feeling a deep sense of dread, but you can’t quite figure out why? Your stomach feels nauseous, and you haven’t been able to sleep because your mind never turns off? Both stress and anxiety seem similar because they are part of the same response system in our body when dealing with a perceived threat.  How do you know if how you feel is stress or ongoing anxiety? It can be hard to tell. Here are some things to consider.

Stress is most often related to a specific situation or circumstances in your life and is short term. For example, you are in school and have two exams and a paper due in 3 days. You feel pressured and stay up late to study.  During this time, you experience tightness in your neck and shoulders and find yourself more irritable than normal. Once the tests are done and the paper has been submitted, you feel much better and can now enjoy time with your family and friends.

While anxiety can have very similar symptoms to stress, it is usually more generalized (not focused on one specific event or circumstance) and will linger longer than stress. Many times, a person with anxiety will say they don’t know why they feel worried or can’t sleep. Anxiety shows up in a variety of ways and is different for each person. Irritability, upset stomach, difficulty falling or staying asleep, excessive worry, and feeling like something bad is about to happen are all symptoms of generalized anxiety.

Everyone will experience stress or anxiety at some time in their life. Here are some quick tips to manage your symptoms. First, know that stress and anxiety can often bring with it a range of unpleasant physical symptoms. If you find your heart beating fast or have trouble taking a deep breath, find a way to slow down that works best for you. This could look like:

  • Focus on breathing with intention.
  • Engage in box breathing – https://www.youtube.com/watch?v=tEmt1Znux58
  • Talk to a trusted friend/family member.
  • Move your body by engaging in some enjoyable physical activity.
  • Briefly place your face in cold water.

It can be hard to decide when to seek help for your symptoms. A good rule of thumb is if your symptoms are impacting your everyday life or are getting in the way of taking care of yourself. Seek the advice of your PCP or a behavioral health practitioner. Most people experience symptoms of stress or anxiety at some time in their life and both respond well to treatment. Just know that how you feel does not have to take over and you can find ways to take control of your thoughts and feelings!

Giving Thanks at the Table

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By Kristina Ward, MAS-MFT, LMFT | NOAH Marriage & Family Therapist

Family life is usually busy: with mornings consisting of getting kids moving and out the door, sometimes even fed, and afternoons that include sports, homework, and general catch up. Family meal times have frequently become an occasional activity, just for the days of the month that aren’t horribly hectic and on the run. Between work, children, social media, and other activities, family meal time is often a chore to be avoided. But, the benefits of a regular family meal time is measurable. Studies have shown that regular family meal time together improves the overall outcome of relationships.

In couples with no children, be they pre, post, or no children, regular meals together reduce the levels of conflict within the relationship. Couples are more frequently able to resolve, come to a compromise, or even agree to disagree. The couple increases the level of friendship and companionship during the time spent together. In families with young children, the meal time together has the same protective factor in the couple relationship and improves the overall relationships at the meal allowing for increased conversation and interaction. As parents model communication and interaction, these young children improve in the ability to listen and respond.  Additionally, the conversation at family meals leads to developmental changes in the children. Regular conversation, including and around, young children helps to develop the child’s vocabulary. In families with older children, family meal time is a time to learn the family culture and develop a sense of “who I am” as part of the family system. 

Family meal time has protective factors on the mental health of the family members as well. Allowing children to express his or her thoughts in an opportunity for self-esteem to improve, improve school-related activities, and for the child-parent bond to increase, which in turn decreases the risk of early sex in pre-teen and teenage relationships. Another protective factor observed in regular family meals is the reduction in patterned disordered eating (which can lead to eating disorders), reduce the risk of substance abuse, and an improvement in health. Additionally, multiple studies from Europe to Japan to the US have shown regular family meals decreases depression in all age groups. 

Family meals do not need to be every day or every dinner. Family meals can be breakfast together on Saturday mornings, Friday night pizza, or Sunday brunch. Scheduling the regular meal times and the family expectation that everyone will be there is the important factor. If the kids have late start on Wednesday mornings, schedule breakfast to be at 6:30am before parents have to leave for work. No time to cook, have cold cereal! Make meal times a social event. Couples can make the meal together, eat, and clean up together. Parents can take turns teaching the children how to cook and prepare meals. The goal is to increase the moments of regular togetherness.

Tell me and I forget, teach me and I may remember, involve me and I learn.

Benjamin Franklin

Sharon M. Fruh, Jayne A. Fulkerson, Madhuri S. Mulekar, Lee Ann J. Kendrick, and Clista Clanton. (2011). The Surprising Benefits of the Family Meal. The Journal for Nurse Practitioners. January 2011, 7 (1) 12-22.

Megan E. Harrison, Mark L. Norris, Nicole Obeid, Maeghan Fu, Hannah Weinstangel, and Margaret Sampson. (2015). Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. Canadian Family Physician. February 2015, 61 (2) e96-e106.

Stay Healthy and Happy This Holiday Season

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By Stanley Aladi, BA and Mimi Hauber, BS | Behavioral Health Technician Leads

The holidays are supposed to be fun and joyful, right? Right! However, with the holiday season comes stress and, in some cases, even depression. Being realistic, planning ahead, and seeking support can help.

Be Realistic

Shopping, wrapping. baking, decorating, and even attending holiday parties and events can leave you feeling overwhelmed during the holiday season. Remember, you don’t have to do it all. Pick a few things that are most important to you and your family. If you always decorate inside and outside, just choose one and alternate year after year. Families change and grow and so do traditions. Select a few to keep and incorporate new traditions, especially ones that aren’t a ton of work.

Sticking to a budget is also important during the holidays. Prior to shopping for gifts and groceries, decide what your budget is and don’t go over it. Money does not buy happiness.

Set realistic expectations for relationships too. Just because it’s the holiday season doesn’t mean everyone suddenly gets along. Setting aside your differences is important. Accept your friends and family as they are even though you may not agree with some of their thoughts and behaviors.

Plan Ahead

Planning ahead can also be helpful in alleviating holiday stress. Set aside certain days to shop, wrap, bake, decorate, and connect with family and friends. Breaking up everything you have to do into manageable blocks of time will help reduce the anxiety that comes with last-minute scrambling. 

Learn to say “no”. You’ll be appreciated a lot less if you are feeling resentful and overwhelmed because you put too much on your plate. If you feel you must help, add time for those projects into your agenda when planning ahead. Be sure to manage expectations by understanding what’s being asked of you and don’t take on additional tasks that weren’t on your original agenda.

Take Time for You

Self-care is important, especially during the holidays. Find something to help clear your mind such as breathing exercises, going for a walk, listening to music, or going for a drive. Spending 15-minutes alone with no distractions can help restore your “inner calm”.

Sometimes just having someone to talk to can ease the burden of a stressful situation. Call a trusted friend or family member and talk about anything! Get your mind off of what’s stressing you out or hit the topic head-on, you’ll know what works for you by how you feel after the conversation. Additionally, there are social media channels, support groups, and even online events that can provide a support system to help ease the tension.

While many people experience stress during the holiday season because there’s just too much to do, sometimes people feel anxious and depressed because they don’t have a packed agenda for the holidays. If you or someone you know feels isolated or lonely, reach out to your community. Get involved in social events through work, school, or even the church you attend. Dedicating some time to volunteering is another great way to fill your schedule and lift your spirit.

It’s important to know when symptoms are becoming unmanageable and you need to seek help. If you’re feeling sad, anxious, irritable, hopeless, or unable to sleep or do your daily tasks, it might be time to reach out to a professional. Mental health providers have tools to help you feel better by talking through and processing your feelings. There is nothing wrong with asking for help! Make sure that you are prioritizing your mental health because we all need time to recharge.

Learn more about NOAH’s counselors and how you can request an appointment here.

Suicide Prevention: Supporting a Loved One

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By Jennifer Mullen, LPC | Counselor

Who is at Risk?

Suicidal thoughts can impact anyone regardless of age, gender, or cultural background. According to the National Alliance on Mental Illness (NAMI), 4.9% of all adults have experienced serious thought of suicide. That number increases to 11.3% in young adults ages 18-25, 18.8% in high school students, and 45% in LGBTQ+ youth. Suicide is the 12th leading cause of death overall in the United States, second leading cause of death among people 10-14, and the third leading cause of death among people 15-24. We can impact these numbers by spreading the word about suicide awareness and prevention.

What to Look For and When to Act?

Everyone has a bad day from time to time, but when that bad day turns into multiple days, or difficulty with routine daily tasks, it’s important to take notice. Some might notice increased isolation from friends or family or decreased interest in social, work, or academic activities. Others may notice a change in anxiety, depression, substance use, performance at work or school, prolonged stress, or difficulty adjusting to situations. Regardless of the change, there is hope and ways to take action and offer support.

What to Do?

It can be extremely difficult and scary when a loved one, child, friend, or family member is experiencing mental health symptoms, especially suicidal thoughts. Have frequent conversations with your children and family about mental health and complete “emotion check-ins”. If you make this a part of your daily routine, you begin to normalize mental health and make it comfortable to have conversations when your loved ones when they are struggling, especially with suicidal thoughts.

Another way to offer support is to listen and validate their experience. You might not understand what they are going through, but you are able to offer support and create a safe place for active listening. Get feedback and support from others: siblings, family members, friends, community members, teachers. Noticing how behaviors change in multiple settings can help assess the severity of the problem and determine what the next steps should be.

The best way to prevent a suicide-related crisis is to seek help and support before the crisis occurs. If someone you love feels worried, but does not feel they are in imminent danger, encourage them to talk to their medical provider or mental health professional. Learn more about NOAH’s counseling or psychiatric services. It’s also important to get friends and family involved, we all need support. If you think your child or loved one is in immediate danger, call a crisis line, take them to the nearest hospital, or call 911.

  • Maricopa County Crisis Line: 1-800-631-1314 or 602-222-9444
  • National Suicide Prevention Lifeline (1-800-273-8255)
  • Crisis Text Line (“NAMI” to 741-741)
  • Suicide and Crisis Lifeline: 988

New 988 National Suicide Prevention Lifeline

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The National Suicide Prevention Lifeline will have a new number beginning July 16. While help will still be available through the current ten-digit Lifeline, access to support through a new three-digit phone number, 988, will make it even easier to get support.

What Does the Lifeline Do?

For every one person who dies from suicide, 316 others seriously consider suicide but do not kill themselves (Substance Abuse and Mental Health Services Administration (SAMHSA)). In many cases, simply talking with a friend, family member, or counselor can mean the difference between life and death.

That’s where the Lifeline comes in. Anyone can call, text or chat with a trained counselor through the Lifeline – 24 hours a day, seven days a week. The Lifeline is connected to over 200 accredited crisis call centers located throughout the country. When someone calls 988, their call is routed to a location near them. Being connected with someone local helps with finding resources for follow-up treatment and support. However, being part of a nationwide program ensures no call goes unanswered when local counselors are not available.

Why the Change?

The new number is easy to remember, quick to dial, and with a universal code like 911, is an an equally accessible option for life-saving care. As an alternative to calling 911 for mental health services, calls to the 988 Lifeline are expected to increase. Lifeline program administrator, Vibrant Emotional Heath, puts it simply, “When you’ve got a police, fire, or rescue emergency, you call 911. When you have an urgent mental health need, you call 988.”    

How Can You Help?

Over 20 million calls have been made to the Lifeline since it became available in 2005. Although some initial support for 988 has come from federal, state and local resources, more help is needed to staff, fund, and raise awareness of the service.

With the anticipated increase in calls, SAMHSA is actively recruiting volunteers, interns, and employees to serve as crisis counselors and managers for the Lifeline. Check out the Lifeline website for more ways you can support your local crisis call center.

If you or someone you know is experiencing a mental health crisis, call, text or chat the National Suicide Prevention Lifeline.

National Suicide Prevention Lifeline

1-800-273-8255 or 988

For non-urgent needs, consider scheduling an appointment with a NOAH counselor.

Monitoring your Teen’s Mental Health

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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

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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.

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

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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

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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

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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.