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.

Suicide Prevention: Supporting a Loved One

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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. 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.

  • 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

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:

  • 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.

Summer Screen Time Tips

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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

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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.

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.