National Minority Mental Health Awareness Month by Cody Randall, PA-C Psychiatric Services

Disparities in access to healthcare exist across all specialties. This proves to be especially true when it comes to mental healthcare, and even more so among minority populations.

A number of barriers exist for patients seeking mental health services including healthcare worker shortage, disparity of access to appropriate medical insurance coverage, stigma of receiving mental healthcare and the fragmented relationship of medical and mental health services. Healthcare providers/organizations can take practical steps to improve patient access by:

  • Making mental health screenings a staple component of primary medical care.
  • Recognizing the social/cultural aspects of a patient population that may impact a patient’s medical and mental health.
  • Medical organizations can conduct community health needs assessments (CHNA) in their patient communities to identify specific needs and limitations among the minority populations that they serve. In identifying these needs of their communities organizations and individual medical providers can help to ensure that patients of minority populations receive quality and affordable mental health services.
  • Working towards a more collaborative approach between medical and mental health practices/providers to reduce barriers to care.

A patient’s care is often more than just medication. The greatest care cannot help unless a patient has support/resources in place to provide them with access to this care and fundamental life necessities. 

For more information on National Mental Health Awareness Month as well as information on general mental health visit the Nation Awareness on Mental Illness (NAMI) at https://www.nami.org/home.

PTSD Awareness Month by Katelyn Millinor, LPC

Post-Traumatic Stress Disorder (known as PTSD) is when a person has difficulty recovering after experiencing or witnessing a terrifying or traumatic event. Most people experience short term symptoms associated with PTSD such as trouble sleeping and flashbacks. This is known as an acute stress reaction and these symptoms will typically subside within a few weeks. However, in some individuals these symptoms can last much longer, even years. 

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.

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.

If you are an individual that may be experiencing PTSD, consider the following strategies: 

  • Get to 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.
  • Find specialist support such as a counselor or psychiatrist.
  • Avoid drugs and alcohol to cope with difficulty feelings.

There are many behavioral health treatments available for individuals experiencing PTSD or PTSD symptoms such as trauma-focused cognitive behavioral therapy and eye movement desensitization and reprocessing (EMDR). 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.

June is World Infertility Month by Katelyn Millinor, LPC

Infertility is defined as the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year.

World Health Organization

June is World Infertility Month. This topic can be difficulty for people to deal with but millions of women and men deal with infertility, and mostly in silence. The CDC reports that 12.7% of women 15-49 years of age have received some type of infertility service. It is important to stay educated on risk factors and strategies to help manage the emotions associated with infertility.

Many risk factors for both male and females are the same while others are gender specific. Infertility is not solely a women’s issue as about 30% of infertility cases involve male factors.

Risk factors for women include:

  • Chronic diseases such as diabetes, hypertension, asthma etc.
  • Hormonal imbalances.
  • Age.
  • Sexually transmitted diseases.
  • Fallopian tube disease.
  • Endometriosis.

Risk factors for men include:

  • Cigarette or marijuana use.
  • Hernia repair.
  • Certain prescription drugs for ulcers or psoriasis.
  • Undescended testicles.

Infertility can often create one of the most distressing issues for couples. Infertility brings to light deep emotions while dealing with the multitude of medical decisions and the uncertainty that follows. Feeling depressed, anxious, or isolated are only a few of the emotions in the process of pursuing infertility or infertility treatments. The journey can be very hard.

If you are struggling with infertility consider the following tips:

  • Give yourself permission to be angry.
  • Allow your partner to cope and feel differently than you.
  • Improve your communication about infertility.
  • Improve relaxation skills such as deep breathing.
  • Try a support group (consider Resolve.org).

Consider discussing this with a mental health professional to clarify thoughts and help with decision making. Counseling may be helpful for learning how to cope with physical and emotional changes, communication with your partner, and to strengthen coping skills to manage moving forward. NOAH is here to help. Our counselors and medical staff are here to support you through your journey of infertility.

Mental Health Awareness Toolkit

Improving Self Esteem by Zach Clay, LMFT

Let’s face it, we are our own best critics. Most everybody has some sort of area in their life in which they doubt themselves. If you’re saying “no I don’t” or “I’m perfect,” then you can stop reading here. LOL. The rest of us have some measure of self-worth. Self-affirmations are a great way to trick your brain into truly recognizing those things that make you unique.
Positive self-affirmations are a way to strengthen aspects of ourselves that have constantly been playing on constant negative beliefs which are seemingly on a loop in our heads, typically from an early age. Short, positive messages can combat these long-held beliefs. These new, positive messages can be rewritten to rewrite your new life story.

Here are just a few simple positive self-affirmation techniques for you to try at home:

  • Write index cards or post-it notes you can put in an area that you frequently look at (ex. a mirror, refrigerator, or on your car dashboard).
  • Write a daily journal to be more aware in those positive aspects and personality traits which can boost your self-esteem (see ‘Self-Esteem Journal’ handout below for a printable copy you can use).
  • For those who enjoy a poetic method to increase awareness of your ‘good-stuff,’ you can fill in the blanks on the printable “I Am” poem below and put it where you can see it or better yet, take a cell picture to look at daily from anywhere you are.
  •  Sing these self-affirming messages to one of your favorite songs.
  • Say these positive messages out loud, in your head silently or record them on your phone to play back later.
  • Identify some common personality traits which most of us aspire to achieving.

These short, positive statements benefit:

  • Physical health.
  • Improve success and wealth.
  • Challenge self-defeating behaviors.
  • Aid and heal emotional pain or trauma.

Try them! What do you have to lose?

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our #medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

Phone Apps to Use for Mental Health by Katelyn Millinor, LPC

In recent months, there’s been quite a few mental health apps available to smart phone users. These, most often free apps, offer a wealth of resources at your fingertips. Our behavioral health expert, Katelyn Millinor, LPC, recommends the following apps for you to try out at home.

Anxiety/Depression

  • Happify – help reduce stress, overcome negative thoughts.
  • What’s Up – utilizes cognitive behavioral therapy and acceptance commitment therapy to cope with anxiety, stress, and depression.
  • Sanvello – teaches cognitive behavioral therapy through journeys that combine videos, audio exercises, mood and health tracking.
  • Mood Kit – utilizes cognitive behavioral therapy for mood improving activities.
  • Worry Kit – short (under 2 minute) activities designed for those in between moments in life where you need to reset your brain.
  •  MoodFit – create/track daily goals, understand relationship between mood and lifestyle factors, gratitude journal, mindfulness.
  • Mind Shift – designed for teens and young adults with anxiety that focuses on riding out intense emotions and facing challenging situations.
  • IMoodJournal – record everything from mood symptoms, sleep, medications, and energy.
  • Panic Relief – better manage and move through panic attacks.
  • Breathe2Relax – teaches breathing techniques to manage stress.

Meditation

  • Calm – guided meditations, sleep stories, breathing programs, and relaxing music.
  • Headspace – meditation and mindfulness.

Other

  • Quit That! – help users beat habits or addictions (drinking, smoking, drugs).
  • eMoods – designed for people with bipolar disorder to track symptoms.
  • notOK – suicide prevention app that users can add trusted contacts and let them know they are not okay.
  • PTSD Coach – education, assessing, and offering easy to understand tips to manage common symptoms.

Ten Basic Rules for Emotional Health

In light of May being deemed Mental Health Awareness Month in the U.S., here are some keys to creating and maintaining emotional wellness.

  1. Take care of yourself. Take time to relax, exercise, eat well, spend time with people you enjoy and activities which you find pleasurable.
  2. Choose to find the positives in life experiences instead of focusing on the negatives. Most clouds have a silver lining and offer opportunities for personal understanding and growth. When you accept that things are sometimes difficult, and just do what you need to do, then it doesn’t seem so hard.
  3. Let go of the past. If you can’t change it, and you have no control over it, then let it go. Don’t waste your energy on things that cannot benefit you. Forgive yourself and others.
  4. Be respectful and responsible.
  5. Acknowledge and take credit for your successes and accomplishments.
  6. Take the time to develop one or two close relationships in which you can be honest about your feelings.
  7. Talk positively about yourself and about others.
  8. Remove yourself from hurtful or damaging situations. Temporarily walk away from a situation that is getting out of control.
  9. Accept that life is about choices and is always bringing change to you. Accept that change also requires personal adjustment.
  10. Have a plan for the future. Develop long range goals for yourself, but work on them one day at a time—or even one minute at a time.

We know these things aren’t always as easy as they seem. We are here for you on your journey to wellness!

Bouncing Back to a Better You by Dr. Alethea Turner, Associate Director – HonorHealth Family Medicine Residency Program

Many of us deal with stress on a daily basis. Some causes may include pressures at work, unhealthy relationships, medical issues, financial problems and even past traumas. All of it can lead to bad habits, poor health and a general sense of unhappiness.

Resilience is our ability to bounce back and regain control. We might not always be able to change our circumstances, but we can change how we handle stress.

6 Tips for Coping with Stress

  • Relationships – Think about the relationships in your life. Which ones bring you joy? Take time to connect with those who add positivity to your life. Schedule a weekly date night, monthly dinner with your friends, or even call a relative you love.
  • Nutrition – Emotional eating is real! We often use food to celebrate our wins and to drown our sorrows. Yet, unhealthy eating can make us feel tired and bad about ourselves. Try to cut out sugary drinks, pack only healthy snacks, or cut down on portion sizes. If you are eating out choose items that are healthiest on the menu rather than those packed with calories.
  • Mental Health – Stress can lead to feelings of anxiety and depression, like worrying all of the time or feeling hopeless. Talk to your doctor and consider meeting with a counselor. It might change your life.
  • Exercise – We all know that exercise is good for our health, but did you know that it is also a powerful tool for managing anxiety and depression? Turn on some music and dance in your room, or go for a walk over your lunch break. Getting your body moving can help you in more ways than one.
  • Sleep – Good sleep habits are essential for recovering from a stressful day and for keeping your mind and body healthy. Create a bedtime routine that includes sleeping in a cool, dark and quite room. Try to sleep around the same time every night and avoid looking at a screens (TV, cell phone, tablets…) at least 30-60 min before bed. Aim for at least 7 hours of quality sleep each night.
  • Mindfulness – Mindfulness is another way you can achieve calmness and control over your feelings. It is about being completely aware of your thoughts and emotions, being focused on a single moment or action, and accepting yourself. You can practice mindfulness in many ways including writing in a journal, taking a minute to focus on deep breathing, meditating (there are apps for that), or even listening carefully to someone you are talking to.

Tip the scales in your favor! Introducing even ONE of these practices into your daily life will help balance out stress and negativity, and can help you build resilience and a greater sense of well-being.

Signs and Symptoms of Poor Emotional Health

Mental and emotional illness does not discriminate. It does not care how much money you have, where you live, your age, or the color of your skin. It effects all shapes and sizes of people all over the globe. Do not hesitate to reach out to our team in the event that you or your child are struggling. We are here to help!

Please reach out to us if you or your child experience:

  • Consistent feelings of sadness or hopelessness
  • More than usual irritability, anger, aggression or hostility
  • Tearfulness or frequent crying
  • Withdrawal from friends and family
  • Loss of interest in activities that you used to love
  • Changes in eating and sleeping habits
  • Unusual restlessness and agitation
  • Feelings of worthlessness and guilt
  • Excessive fatigue or lack of energy
  • Difficulty concentrating due to racing thoughts
  • Thoughts of death or suicide
  • Self-Mutilation (e.g. cutting / burns)
  • Declining grades in school or performance at work
  • Substance abuse, including alcohol and drug (illegal and legal drugs) use
  • Neglect in hygiene and other matters of personal appearance
  • Emotional distress which brings on physical complaints (aches, fatigues, migraines, etc.)
  • Risk taking behaviors
  • Suddenly giving away favorite belongings or promising them to friends and family members
  • Extreme cheerfulness following periods of depression
  • Expression of bizarre or unsettling thoughts

At NOAH, we offer behavioral health consulting and traditional outpatient counseling programs and services where these highly skilled and trained behavioral health staff work alongside our medical and dental teams to assess, diagnose and effectively treat the core-symptoms of our patients.

The World Seems Scary – Coping with Anxiety by Andres Jaramillo, LPC

We all have things that make us feel anxious like giving a presentation or having a job interview but it may seem like in our daily life more and more we encounter extreme, awful, or scary things. It makes it easier for our minds to come up with negative, worst case scenarios that end up turning up the volume on anxiety.

What is anxiety?
It is a normal feeling we experience when we predict that something bad could happen.

Living in today’s constantly connected world, the possibility of something scary, awful, or threatening can pop in our head by just turning on the news or driving our kids to school.

Try these 3 things to turn down anxious feelings so you can continue doing the things you want to do.

1 – Relaxed body is tied to relaxed mind. Even seeing or hearing about awful, scary things – perhaps the news on the latest epidemic – can cause the “fight or flight” response to turn on. Our body makes physical changes like increased heart rate, sweating or tense muscles so it can be prepared to fight or run away from the danger.

When we do activities to purposely deactivate our fight or flight response, or relax our body, our mind plays follows the leader.

Try this, notice: 

  • 5 things you can see – notice shapes, colors, brightness, shadows.
  • 4 things you can hear – notice pitches, volumes, tone.
  • 3 things you can feel/touch – notice textures.
  • 2 things you can smell – notice hints of sweetness, bitterness, pungent, etc.
  • 1 thing you can taste – notice hits of spicy, sweet, sour, etc.

Notice and observe things you have never paid attention to before. Maybe say what you observe out loud, or just to yourself. You can mix it up anyway you like, perhaps you are at a restaurant and you can taste 5 things, or smell 5 things. It is just about using your senses in a purposeful, intentional way. By getting out of your head and engaging your body in a slow, mindful activity it is pretty much impossible to focus on the image that turned anxiety up in the first place.

2 – Remind yourself: What you feel is not always true. I feel like I am going crazy! Perhaps you’ve said something like this to yourself and if we are going to turn down the volume on anxiety, we need to challenge how our feelings “prove” that something is going to happen.
A quick peek at your latest social media feed and you see a story about a family who had a burglar break in their house and murder three people. Quickly shock, fear, horror, or sadness fills your experience. It is valid that you may feel that way but the mind, in its amazing abilities, will use those emotions as proof to make a conclusion that may not be true.
I feel scared so that means something bad is going to happen!

Try this:

  •  Take a few deep breaths – deep enough to see your stomach area expand and contract.
  • Acknowledge you are feeling scared – is it a knot in your stomach? Is it racing thoughts?.
  • Take a few more deep breaths.
  • Focus on the facts.

Facts themselves don’t increase anxiety, the perception that it could be a threat does. By placing time and breathing between what you saw/heard and making any decisions, you allow the intensity of the anxiety to subside like the tide on a beach. You will have a better chance to be calm and focus on the facts not the “coulds.”

3 – Accepting the unpredictable but be prepared. You can’t really know if someone will break in to your house, or use a gun in a violent way, or if you will catch the new virus going around but perhaps we can be prepared the best we know how.

If you have noticed that the news, your social media, or stories you heard from friends have increased your anxiety, you went through 1 and 2 above and you still feel uneasy, then maybe prepared action is the next step.
We have active shooter drills, we get trained in CPR, and we wear our seat belt with the mindset of accepting that we will never know IF something bad could happen and just being prepared anyway.

Have a plan:

  • Create a plan for what you and your family would do if [insert awful situation] happened.
  • Talk with your workplace to double check emergency plans.
  • Have a chat with your children’s school to understand what plans they have.
  • Talk with your doctor about your health concerns.
  • Join a neighborhood watch group.
  • Take a self-defense class.

By moving your focus from “What if’s” to accepting that life is unpredictable and doing your best to be prepared will increase your confidence and readiness just like when we plan and study for what we will say in a presentation or practice for our job interview. If we feel confident and ready, there is no room for anxiety.

Everyone experiences anxiety and yes, it is normal. If we have certain tools, like the three above, we can get through any situation that raises our anxiety and be ok even in today’s hectic, scary world.

An important note: Daily, normal anxiety is different than having an anxiety disorder.

If the anxiety you feel is unmanageable, has been going on for more than two weeks, and it is interfering with your daily life or relationships than perhaps you can think about visiting with a mental health professional and figuring out a best course of action.