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 impartial 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 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 emotionally distressing 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 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.

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
  • 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 emotionally distressing 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.

Child Abuse Prevention – It Takes A Village

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By Glenda Henman, Behavioral Health Counselor

April is National Child Abuse Prevention Month. Most people avoid thinking or talking about child abuse and neglect because it is upsetting and difficult. However, in 2014, there were more than 700,000 children who were sufferers of child abuse and neglect. Knowing how big the problem is means we can take action to reduce this number and support these children as they recover.

We know now that child maltreatment (a phrase that includes abuse and neglect) can have lifelong and even generational impacts on physical and mental health known as Adverse Childhood Experiences (ACEs). It might be Child Abuse Prevention Month, but at NOAH, we work to prevent and heal child abuse every day.

Impact on Children

People usually think of visual, physical abuse or injuries, but child abuse takes many forms. Emotional neglect, medical and educational neglect, and sexual abuse are other forms of child maltreatment. Too often, these children are also facing other negative experiences like parental substance abuse, domestic violence, and poverty.

What to look for:

  • Talking about the abuse
  • Sexual knowledge beyond their age
  • Withdrawing, running away, or avoiding a specific person
  • Nightmares, bed wetting
  • Changes in mood or appetite
  • Being fearful of a parent or caregiver
  • Sudden changes in behavior

Preventing Abuse and Neglect

Many of us here at NOAH, like doctors, nurses, dentists, psychologists, and others are Mandatory Reporters and must report abuse or suspected abuse of children or vulnerable adults. Reporting abuse is an essential step, but we can all be a supporter to prevent child abuse.

The best way to prevent child abuse is by promoting protective relationships and environments. Protective factors are tools and support that help a family stay strong so they can face challenges together like:

  • Social connections
  • Parenting knowledge
  • Reliable and safe support in times of need

If you or someone you know needs additional support, NOAH is a great place to start! Our Community Resource team can connect families to resources, and our Behavioral Health team is here to support parents develop resiliency to face challenges.

Actions for everyone

Whether we have children in our lives or not, we can all take steps to help protect children and support families in our lives and our communities.

  • Read books or articles, attend trainings or classes on parenting, or get involved with trusted resources like community leaders, schools, libraries, clergy, or these organizations:
  • Ask for help when you need it.
  • Offer to help people in your life who are parents or raising young children.
  • Be a friend to a child you know; remember their name, show them you care.
  • Teach children how to be safe from sexual abuse with age-appropriate, open conversations with your children about bodies, sex, and boundaries. If you need help in having these conversations, or how to prepare, our counselors can help.
  • Find out about local resources and refer families. Learn more on 211arizona.org.  

The phrase ‘it takes a village’ is thrown around a lot when talking about raising children. But all too often, people who need that ‘village’ the most, don’t know where to find it. The best way to make sure children are safe and cared for is with a safe, healthy, supported family.

If you have questions, NOAH’s Community Resource team and Counseling team are a great place to start. 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!

It’s About More Than Just Food

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When you hear the phrase “eating disorders,” your mind immediately thinks about food, but what most people do not know is that eating disorders are so much more than just food. Although eating disorders are characterized by an obsession with food, body weight and size, the root of an eating disorder is so much deeper.

What is an Eating Disorder?

  • A way to feel in control when everything else in your life feels out of control
  • Numbing your undesirable feelings with lack of nutrition
  • An attempt to achieve higher self-esteem and perfectionism through body image

The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder. They each have their own signs and symptoms, but have an equally negative impact on someone’s health, emotions, and ability to function in day-to-day life.

Signs and Symptoms

People with eating disorders usually do not think they have a problem. Here are some signs and symptoms to look for if you think someone in your life may have an eating disorder:

  • Skipping meals
  • Making excuses for not eating
  • Intense dieting
  • Excessively working out
  • Avoiding social activities involving food
  • Eating alone rather than with others
  • Lots of talk about body image or weight
  • Using dietary supplements or laxatives
  • Using the restroom immediately after mealtime
  • Eating much more food than a normal portion
  • Shame or guilt around eating

If you are worried that you, or someone you love, has an eating disorder, the best thing you can do to support them is show them love. Eating disorders, like any addiction, are not easy to let go of. You may feel frustration in the process with your loved one and notice that they are not always honest about their progress in recovering from their eating disorder.

Individuals recovering from an eating disorder need compassion and accountability. It may seem as simple as “just eating,” but the depth of an eating disorder and the control, safety, and comfort it provides individuals is much deeper. The unhealthy coping mechanism is still a coping mechanism that has gotten them through their pain, and it will require a lot of inner work. The goal is to get to the root issue that is being masked with disordered eating patterns. People suffering with an eating disorder can’t get better for someone else, so the best thing you can do is show patience and continuous support.

Children’s Mental Health & Learning During COVID: A Series

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By Zach Clay, Licensed Marriage, Family, and Child Therapy

During this unprecedented and often challenging time in the world, we need to consider the impact everything has on children. The COVID-19 pandemic can be particularly tough for children’s mental health and their ability to learn. NOAH’s Behavioral Health team shares expert insight, best practices, and resources in this series of posts to help children maintain mental health in the era of COVID-19, social distancing, and distance learning.  

Identifying Depression & Developing Coping Skills for Children

Children experience the world around them – the good, the bad, the stressful, the happy, the uncertain – and sometimes need support to navigate everything. In many ways, children are similar to adults with mental health; identifying what is happening, talking about what is happening, and developing healthy coping skills. Here, we highlight ways to identify depression in young children and coping skills that are easy for children to do and remember.

Signs of depression in children

Children who are experiencing depression may show it in a variety of ways. They may express feeling hopeless, helpless, and discouraged and as caregivers, we should listen and help them explain what they are thinking and how they’re feeling. But we must listen without judgement, or without trying to “fix” things. Parents and other caregivers don’t need to agree with what they are saying but do need to let them know that they are heard and supported. For example, “I hear you. That sounds really hard and I’m sorry you are feeling sad. I love you.”

Symptoms of depression may include:

  • Changes to sleep patterns
  • Gaining or losing weight
  • Sadness or irritability
  • Loss of interest in activities they usually enjoy
  • Unusual sadness or irritability, even when circumstances change
  • Reduced feelings of anticipation or excitement
  • Sluggish or lazy
  • Overly critical of themselves, like “I’m ugly.” “I’m no good.” “I’ll never make friends.”
  • Feelings of worthlessness, hopelessness
  • Thoughts of or attempts at suicide

It’s important to understand that this is more than a bad day or two, or occasional behavior changes that go away. If you see one or more of these symptoms for two weeks, they can suggest depression and you should make an appointment to get them professional help and support.

Developing coping skills

An important part of managing anxiety and fear is with healthy coping skills. These skills help you deal with stressful situations in a healthy and productive way. Mindfulness techniques are beneficial for all ages and are especially helpful for children. Mindfulness means taking time to focus on the present, be thoughtful about your feelings, focus your thoughts, and be in the moment.

These exercises take a little effort, but the investment is worth it especially now when there is such uncertainty about the future and what our world will be post-pandemic. These activities can make mindfulness work for both parents and children.

  • Squeeze Muscles: Starting at your toes, pick one muscle and squeeze it tight. Count to five. Release, and notice how your body changes. Repeat exercise moving up your body.
  • Belly Breathing: Put one hand on your stomach and one hand on your chest. Slowly breathe in from your stomach (expand like a balloon) and slowly breathe out (deflate).
  • Meditation: Sit in a relaxed, comfortable position. Pick something to focus on, like your breath. When your mind wanders, bring your attention back to your breath. Do this for just a few minutes.
  • Blowing Bubbles: Notice and talk about their shapes, textures, and colors.
  • Coloring: Color something. Focus on the colors and designs.
  • Listening to Music: Focus on a whole song or listen to a specific voice or an instrument.

Mindfulness doesn’t have to be a big deal or extra work. Take a few minutes in the morning, after school, before bed, or a time that works for your child and family to practice mindfulness.

NOAH’s comprehensive team of behavioral health experts  can work with you, your child and your entire family to address stresses, depression, coping skills, and more.