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!

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.

September is Suicide Awareness Month

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By Cassandra Altamirano PA-C | MPAS

Call, text or chat the National Suicide Prevention Hotline at 988 or 988lifeline.org if you or a loved one are experiencing thoughts of suicide.

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 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.

Living with PTSD

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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

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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

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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.

Maternal Mental Health Awareness Month: More Than Postpartum Depression

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By: Alyssa Fagan-Clark, LMSW |Behavioral Health Counselor

During May, we celebrate Mother’s Day and Maternal Mental Health Awareness month! We often think of new motherhood as a time of excitement, care giving, happiness, and a deep sense of love. And while it is often all these things, conditions like postpartum depression can also be a period of intense struggle and uncertainty for many mothers and their loved ones.

According to Postpartum Support International, perinatal mental health disorders are the number one childbirth complication. One out of every seven mothers will face some form of postpartum mental health disorder, and the number is much higher for women of color with one of every three mothers impacted.

According to the CDC, the rate of maternal depression diagnoses at delivery is increasing. In 2015, the rate had increased seven times from where it was in 2000! This is more than the slight emotional changes most women – around 80% – experience in the 3-5 days after childbirth known as the “Baby Blues” period.

The “Baby Blues” happens after childbirth, when a woman’s body undergoes extreme hormonal and physical changes, in addition to the added emotional stress of caring for a newborn. This period typically lasts 2 weeks or less. Symptoms of the “Baby Blues” usually include moodiness, tearfulness, feeling overwhelmed, and general tiredness. While these emotional changes are normal and expected for most women, significant mood changes occurring for moms past this two-week period are a sign that she likely needs additional mental health support. While postpartum depression is a term many people may be familiar with, there are many other types of mental health disorders new mothers face.

Perinatal mental health disorders can include:

  • Anxiety
  • Depression
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • And in rare cases, psychosis

Mothers who experience symptoms of these disorders may find themselves scared, uncertain, or even ashamed. Most mothers don’t expect complications like this during a time they thought they would be their happiest.

There are some risk factors for perinatal mental health disorders, including:

  • Personal or family history of mental illness
  • Economic stress
  • Having a baby who experienced a NICU stay
  • Experiencing an especially stressful or traumatic birth
  • Certain health diagnoses such as a thyroid issue or diabetes

A new mother’s best and most immediate source of help may be close friends and family members, who can recognize if she is struggling emotionally and assist her to get connected with professional support.

Luckily, the NOAH behavioral health team has mental health practitioners who are specially trained to work with new mothers (and fathers) who are struggling with mental health needs in this special time. If you or a parent you know needs care, please contact NOAH today.

Mental Health: Types of Treatment

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By: Mirna Pacheco, LPC

People are more comfortable seeking help for emotional challenges than ever before. The need continues to rise, particularly during COVID-19. But the good thing is that as the need for mental health services increases, so have the options for those services and how telehealth has increased access to services.

Knowing that help is available provides hope, but important questions like, “where do I go?” “what kind of services do I need?” remain. Thankfully, NOAH’s team has some answers.

This guide shares information about different types of mental health treatment. The type of treatment will always depend on each individual and situation. Learning about the different treatment options is important to address stigma around seeking professional help.

Here are the main types of treatment currently available in mental health: 

  • Outpatient Mental Health Treatment:

This is the most traditional level of care where individuals meet with a mental health provider either for psychiatric care and/or counseling services.  Patients meet anywhere from once a week, once a month, or as needed for care.  Outpatient treatment can include services like general mental health for adults, children, and groups; people with serious mental illnesses; specific programs for conditions like substance abuse and eating disorders. Treatment usually starts with a full assessment and creating an individualized treatment plan. This ensures someone gets the proper treatment and level of care.  Depending on the treatment setting, services could include mental health counseling, medication management, case management, and group therapy. 

  • Outpatient Intensive Programs:

Outpatient Intensive Program (IOP) usually refers to types of rehabilitation for individuals who suffer from addiction problems. But IOP can also help people who are facing different types of conditions like eating disorders and depression. This level of care allows people to continue an intensive treatment – typically between three to five days a week – while allowing them to go home, maintain a job, or engage in educational activities in-between treatments. IOP treatment includes group therapy often combined with individual counseling, case management, psychiatric care, and support groups.

  • Residential Mental Health Treatment:

This level of care focuses on a specific type of treatment for mental health. Some centers specialize in long term substance abuse programs while others may provide an intensive treatment for eating disorders.  These programs provide intensive treatment usually for 30 to 90 days and will help individuals learn skills for long term recovery.

  • Psychiatric Hospitalization or Inpatient Care:

This type of care and treatment is for individuals who might be experiencing severe emotional distress to the level of requiring close monitoring. Hospitalization or inpatient care can also be used to continually evaluate and properly diagnose people who need help with mood stabilization and medication adjustment.  Psychiatric hospitalization can be brief, typically 3 to 14 days. After that, the patient will get an evaluation and referral to a long-term level of care, IOP, or outpatient services.

No matter who you are or what you are going through, there is a treatment program and level of care that is right for you. Beyond what is listed above, there are also:

  • 24-hour crisis providers
  • Suicide prevention programs
  • Short-term or long-term residential programs for children with behavioral health conditions
  • Vocational rehabilitation programs for adults and adolescents
  • Different levels of care for substance addiction and eating disorders
  • Referrals to 12-step programs, support groups, and alternative treatments

Life will have challenges. Some days and life experiences will be more difficult than others. But now you know there are programs and support to help you overcome these challenges. One of the benefits of working with NOAH is the integrated approach to healthcare. By working with mental health providers to address those concerns, you will improve other areas of your health as well. Additionally, a medical doctor or nurse can make a simple referral for additional services throughout NOAH. Learn more or request an appointment today.

Equity for Transgender Healthcare

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By John T. Engel | Counselor, MSW, LMSW

Healthcare equality means everyone who comes to NOAH receives the same care, respect, compassion, and one-on-one focus from their providers. Some groups in our society have experienced inequality in their care, often called disparities. One of the groups at the highest risk for healthcare disparities is our transgender community.

Transgender is a term use to describe a diverse group of people whose gender identity or expression may not align with societal expectation of how they should look, act, or identify based on the gender they were assigned at birth. Cisgender is a term that professionals use to describe individuals who do identify with the gender assigned to them at birth and who follow societal expectations for how the gender should look, act, dress and interact with others. Since cisgender individuals make up most people in contemporary society, transgender and other gender non-conforming people are often targets of discrimination and harassment. This can lead to negative health outcomes.

Due to a lack of knowledge, social stigma, ignorance, and discrimination, transgender people are often ignored and underserved by health care providers.

National Coalition of STD Directors

The most pressing health concerns to the transgender community are an increased risk of HIV infection, especially among transgender women of color. In addition, transgender men experience a lower likelihood of preventative cancer screenings. Making things worse, transgender people are less likely than the general population to have health insurance, and therefore more likely to need public programs such as Medicare or Medicaid. These barriers to care are too common in the lives of transgender and gender non-conforming people.

Social stigma associated can also directly contribute to dangerous situations, particularly for people of color.  According to Human Rights Campaign Foundation, at least 85% of violence against transgender and non-conforming people were persons of color. Fortunately, many physicians recognize this and recommend consultation with a mental health professional if the client desires.

Under the Health Care Rights Law, it is illegal for most public and private insurers, providers, and medical centers to discriminate against someone because of their sex. Learn more about rights at National Center for Transgender Equality.

As a professional counselor and a cisgender man, I cannot begin to imagine or to speak from a perspective of being gender fluid or transgender, however as a member of the LGBGQ+ community I feel that healthcare is an essential right for all colors of the rainbow. Sadly, I am aware that healthcare equity for my transgender brothers and sisters has been a concern for years, and if you are a person of color this can have serious consequences.

Our NOAH team works to ensure health care equity for all, by listening, validating, and building upon NOAH’S commitment of inclusivity. If you want to talk with a NOAH counselor, request an appointment today.

Is Kindness Contagious?

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By Katelyn Millinor, LPC | Behavioral Health Quality Manager

Being kind to others is known to have lasting effects on our mental and physical health. But have you heard that kindness is contagious? That’s because it is!

Being kind lights up the pleasure center of the brain and releases serotonin and oxytocin.

  • Serotonin centers our mood, happiness, and overall feelings of well-being.
  • Oxytocin, often known as the “love hormone” controls social interactions, triggers the bond between mother and infant, and so much more.

The release of the hormone oxytocin is tied to decreasing blood pressure and reducing inflammation. Therefore, kindness feels good and is actually good for you.

Catching Kindness

Have you ever had a stranger pay for your coffee or hold the door for you? Experiencing an act of kindness can bring a smile to your face and improve your mood. In today’s fast-paced world, these gestures can be even more meaningful. Kindness benefits both the giver and the receiver. 

We often attach kindness to feelings of happiness. We may think of happiness as a mood or emotion, but really we are usually just feeling neutral which can make you feel cheerful. The feeling of happiness comes and goes with things like giving or receiving kindness, giving a compliment, or getting good news.

So, how can you continue giving random acts of kindness during a global pandemic? The possibilities are endless. With technology, people can send thoughtful text messages, social media comments or posts, Zoom or FaceTime interactions, and more. Outside of technology, think about leaving your mail carrier a “Thank you” letter, sending a picture or card to a front-line worker, or simply making a nice comment while picking up your groceries. Here are a few other ways to spread kindness in your day.

Everyone has experienced some sort of increased stress during this pandemic. That’s why kindness – in big and small ways – is more important than ever. Your one random act of kindness could change someone’s day and start a chain reaction of kindness!