By ABCS RCM
When discussing physical and mental health the question of “nature versus nurture” is eventually asked. What diseases and conditions are pre-programed in a person’s DNA versus occurring due to lifestyle choices and behavior patterns? But, this is not the best way to look at this question.
A better way to discuss "nature or nurture" is to rephrase the debate as a question of “nature and nurture.” This is due to the fact that a person’s overall health is the result of dynamic interactions between genes and the environment. This makes it difficult to cleanly separate one over the other. For example, both genetics and lifestyle factors—such as diet, physical activity and stress—affect a person’s high blood pressure risk.
Research has already indicated that people’s genetic code determines most of their physical appearance. However, newer studies are linking behavior to genetics. How much of an individual’s behavior is linked to genetics? How many conditions like addiction are controlled by a person’s DNA?
What does the term genetics mean?
All people possess DNA which contains their genetic code and individual genes. These genes are the functional units of DNA that make up the human genome. Surprisingly, research on human genetics shows that after DNA sequencing, on average any two people share 99.9 percent of the same DNA. Yet, it is this 0.1 percent of DNA that has strong influence on people’s physical and mental health.
When mental health professionals are administrating treatments, they often find substantial variability in how individuals respond to these treatments. Part of that variability is due to a person’s genetic makeup. Genes influence the numbers and types of receptors in peoples’ brains as well as how quickly their bodies metabolize medications. Genetic variation even influences how well people respond to specific drug treatments.
What is an addiction?
A straightforward definition of addiction describes the condition as a chronic, relapsing disorder characterized by compulsive drug seeking. This behavior continues even though if creates negative consequences for the individuals. It is considered both a complex brain disorder and a mental illness, and creates long-lasting changes in the brain. Drug addiction is a medical illness caused by repeated misuse of a substance.
Some researchers argue that there are three distinct stages of addiction. They characterize addiction as craving (preoccupation), binge (intoxication) and withdrawal (negative) affect. Experts who study addiction have long argued that it is a disease of the brain, that affects people’s behavior, altering both the way they react to stress and their ability to control their individual actions.
Overall, addictions are a diverse set of common, complex diseases that are to some extent tied together by shared genetic and environmental factors. They are frequently chronic and often have period of relapsing behavior.
Is addiction a genetic trait?
According to newer research, genetics has a role in the development of an addiction. Some people are more likely to develop the disease than others. For this reason, some people develop prescription drug problems while others do not. Some research suggests that addiction can even run in families and are moderately to highly heritable. But, there is more to consider than just people’s genetics, due to the fact the environmental factors also influence addiction.
It is clear that both genetic and environmental variables contribute to the use of addictive substances. Family, adoption and twin studies reveal that an individual’s risk tends to be proportional to the degree of genetic relationship to a relative that has an addiction. The Virginia Twin Study revealed that in early adolescence the initiation and use of nicotine, alcohol and cannabis are more strongly determined by familial and social factors. These gradually decline in importance during the transition to young and middle adulthood. At this point in people’s lives, the effects of genetic factors are the strongest, declining somewhat as a people continue to age.
Addiction as a brain disease:
Over the last two decades, newer research has supported the conclusion that addiction is a disease of the brain. The brain disease model of addiction has yielded effective preventive measures, treatment interventions and public health policies to address substance-use disorders. However, some societal views still see addiction as a moral failing or personal choice. Yet, this outdated view is slowly changing.
Most diseases, like addiction, are incredibly complex. The variations among the many different types of genes likely contribute to a person’s overall level of addiction risk or resistance. While genetics play a major role in people’s risk for addiction, genes are not the only thing to consider. Unlike other genetic diseases, individual choice and environmental factors also play a crucial role in the development of an addiction. The influence of parents and people’s surrounding peer group generates benefits or risk. These environmental factors intermix with a person’s genetics to produce a variety of health outcomes.
According to the New England Journal of Medicine, significant advances in neurobiology are helping researchers clarify the mechanisms that drive addiction. These underlying mechanisms create profound disruptions in people’s decision-making ability and emotional stability. Thankfully, researchers are learning more about the genetic, epigenetic and neurobiological bases of addiction. This is advancing the overall science of addiction and how professionals view the mental health condition.
About Providers For Healthy Living:
For questions about addiction and role of genetics in this disease, please contact the staff at Providers For Healthy Living. With four locations in central Ohio, they are available to treat a wide variety of behavioral and mental health conditions. They are guided by a well-established principle to have every patient feel more hopeful after interacting with a member of their staff.
By ABCS RCM
How common are mental health conditions in the United States? In particular, what are current mental health trends for the most vulnerable members of American society – children. Research is suggesting that rates of reported mental illness are on the rise for kids across the nation.
Rates of Mental Illness in America:
Mental health is especially important due to the fact that it is a key indicator for overall physical health. Mental health conditions, especially depression, increases the risk for many types of physical health problems, particularly long-lasting conditions like stroke, type 2 diabetes, and heart disease. Similarly, the presence of chronic health conditions can increase the long-term risk for mental illness.
According to the Centers for Disease Control and Prevention (CDC), mental illnesses are the most common health conditions in America. The CDC states that over 50 percent of Americans will receive a mental illness diagnosis or have a disorder at some point in their lifetime. Roughly 20 percent of the U.S population will experience a mental health condition in a given year. For more serious, debilitating mental illnesses like schizophrenia, bipolar disorder, or major depression; 1 in 25 Americans will have their lives disrupted by these mental disorders.
Out of these sobering statistics, 20 percent of American children either currently have, or will develop a debilitating mental illness at some point in their life.
Schools, Mental Health and Children:
Some observers have called this a silent public health epidemic. With the CDC reporting that 1 in 5 kids displaying signs or symptoms of a mental health disorder in a given year. However, the vast majority of children who need mental health services will not receive any treatment or therapy. This is creating a hidden crisis that is affecting millions of students in the United States.
Whether these behavioral health conditions are treated or not, the problems that these illnesses generate are visible in the educational data. Chronic absenteeism, disruptive behavior, failing grades and dropping out of school are all indicators of deeper mental health problems.
Some experts argue that schools could do a better job of identifying struggling students and providing them with the necessary social and academic supports. However, this is a role that most schools are unable to fully provide. According to NPR, U.S. education does not have the necessary resources to sufficiently treat childhood mental illness. Many schools suffer from a lack of resources which means struggling kids may not receive the support that they need.
Attention Deficit Hyperactivity Disorder and Children:
The nationwide health insurance provider Blue Cross Blue Shield (BCBS) recently released their Health Index. This report looked at the overall health of the nation in a variety of demographics and health conditions. For children’s health, attention deficit hyperactivity disorder (ADHD) was the second most impactful condition in the United States. Children diagnosed with ADHD struggle with paying attention, controlling impulses and are often considered overly active.
BCBS states that this mental health condition accounts for 16 percent of all health conditions for this generation which is named Generation Z (ages 0-19.) In 2017, about 2.4 million commercially insured children were diagnosed with ADHD. This was over a 30 percent increase over the past eight years. ADHD is now the most prevalent as a mental health condition among middle school-aged children ages 11-13 years old. Out of this group, boys are diagnosed with ADHD at about twice the rate of girls. With ADHD diagnosis on the rise, it is crucial to better understand the impact of this condition on the health of American children.
Children and Psychiatric Emergency Department Visits:
According to the American Academy of Pediatrics (AAP), there has been a significant increase in psychiatric emergency department (ED) visits for children and young adults. The AAP conducted the study in April of 2019 investigated emergency department visits between the years 2011 and 2015. What was discovered was that there was a 28 percent increase in overall psychiatric visits among children and young adults, ages 6 to 24 years of age.
The largest increases in ED visits occurred among teens, young adults and non-white youths. Among adolescents, there was an increase in suicide-related visits. This increase in visits was nearly 2.5 times greater in 2015 when compared to the data from 2011.
More than half of these visits lasted longer than three hours. Yet, out of all of the emergency department visits, only 16 percent of patients received treatment from a mental health specialist. Surprisingly, when the ED visits were for suicide or self-harm, only 36 percent of the cases involved treatment by a mental health professional.
The AAP study concludes that the lack of behavioral health providers in U.S. emergency departments is a missed opportunity for a better treatment experience. Clearly, there is a need for mental health professionals in emergency departments.
Beyond Children - From Generation Z, Millennials and Generation X:
The upward trend of mental illness in younger generations of Americans has already been documented. Perhaps, the rising rates of mental illness in children is part of a larger overall health trend in the United States. The previously mentioned health index report from Blue Cross Blue Shield also looked at statistics on the Millennial generation. This cohort of U.S. citizens is made up of roughly 73 million people and includes individuals born between 1981 to 1996. Out of this population group, 55 million Millennial Americans are commercially insured through BCBS.
Additional data analysis by BCBS compared millennials to generation X members when they were in the same age range. This analysis indicated that older Millennials have higher prevalence rates for chronic and acute health conditions for nearly all of the top 10 conditions than did Generation X members. This means that the rise in mental health conditions among Generation Z could also be reflected in the younger population of Millennials.
With American children facing health challenges at earlier ages than previous generations, it is critical that more resources are allocated to this area. Otherwise, the long-term health and wellness of the children are at risk.
For questions about counseling services for children and adults, contact Providers For Healthy Living. They have been providing experienced behavioral health treatments since 2011. They strive to have every patient feel more hopeful after interacting with a member of their staff. Their practice was built on the values of quality, hope and personal responsibility.
By ABCS RCM
The connection between a person’s body weight, eating behavior and overall health is complex. People can sometimes fixate on what they perceive as an ideal weight, which can distort their relationship with food. This unhealthy relationship with food can eventually develop into an eating disorder. However, a mental health approach that combines the therapeutic support of a nutritionist with experienced behavioral health treatments is a highly, effective method for treating an eating disorder.
Obesity and Overall Health:
Body weight, obesity and health are complex health issues. With genetics, eating behavior, societal influences and lifestyle choices all affecting an individual’s health. The Centers for Disease Control and Prevention (CDC) has stated that excessive body weight is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life.
As a health condition, the CDC cites obesity as one of the leading causes of death in the United States and worldwide, which includes illnesses like diabetes, heart disease, stroke as well as some types of cancer. However, simply prescribing weight loss as a solution to a person’s body weight concerns is not always the best solutions. When people attempt to reduce their health risks, their actions are sometimes ineffective and even harmful.
When people fixate on their body weight, this can create a dangerous cycle of weight gain and severe dieting. To many people’s surprise, this severe dieting does not produce permanent weight loss. Instead, this behavior can produce an unhealthy dieting behavior where a person’s body weight is not consistent. Extreme diets can damage people’s metabolism and their mental perceptions of food and eating. This means that individuals can end up in a worse place versus when they started dieting. Overtime, this behavior is actually very dangerous.
Research from Harvard Medical School states that eating disorders such as anorexia, bulimia and binge eating; impact over 30 million Americans. Beyond this number, many more Americans engage in disordered eating and unhealthy weight control behaviors. As a statistical fact, eating disorders have the highest mortality rate of any psychiatric disorder in the United States.
Misinformation and Unhealthy Attitudes:
Previously unsuccessful attempts to lose weight can lower people’s satisfaction with their body image. This, in turn, creates additional negative emotions and unhealthy behaviors. People who struggle with their body weight tend to have lower self-esteem. Their feelings of being overweight can help to set up a cycle for additional weight gain or the development of eating disorders like bulimia or anorexia.
Individuals at all body weights can respond to stress and anxiety by eating. This emotional-induced eating will likely only encourage more weight gain. An increase in body weight can create a feeling of lower self-esteem and anxiety in a person. People quickly become trapped in an unhealthy feedback loop of weight gain and dieting.
There is considerable confusion and misinformation about how body weight impacts people’s overall health. People should not view obesity or excessive body weight as the measure of their psychological happiness. Having excess body weight is not a moral failing and it is physically dangerous for people to have this attitude.
Instead, people should have a holistic understanding of mental and physical health and how this connects to their body weight. People should focus on healthy behaviors and physical well-being instead of body weight. A more effective approach should focus on behavior changes such as exercise and healthy eating. Body weight is only one piece of important health information. However, many people have a difficult time doing this alone. This is why they need the help of a trained nutritionist.
The Role of a Nutritionist:
Some people may not know what role a nutritionist plays in mental health treatments. A registered dietitian (RD) or registered dietitian nutritionist (RDN) provide help medical nutrition therapy. An RD or RDN will help people to:
* Talk about their eating habits and dieting approaches.
* Set realistic health goals, such as creating a realistic exercise plan.
* Generate a personalized nutrition plan.
An experienced nutritionist and/or dietitian can create a positive and nurturing relationship with individuals who are struggling with their body weight and unhealthy eating behaviors. This relationship is crucial if individuals are going to fully engage in nutritional counseling without out feeling judged or ashamed. A trained nutritionist can help patients understand their irrational feelings about food and body weight while also encouraging healthier associations with eating and body image.
A nutritionist is responsible for designing a meal plan based on their patient’s specific needs. A full nutrition assessment reveals current dietary intake, eating patterns, beliefs about food and weight, supplement use, who prepares meals as well as an overall history of that person’s body weight. Patients are encouraged to express their emotions, feelings and fears around food and body weight as well as the goals they wish to achieve. Ultimately, a nutritionist can help people challenging distorted feelings about food and eating. In time, patients will replace these mental distortions with more positive and healthy emotions and perceptions.
Who We Are:
For additional questions about the connection between body weight, obesity, physical health as well as mental health, contact the staff at Providers for Healthy Living. They have four convenient office locations in the Columbus Metro area. Their mental health programs provide a full range of treatment options for both children and adults.
By ABCS RCM
Mental health treatments from an experienced behavioral health professional is a powerful tool for treating mental illnesses. Yet, for some people, certain level of shame or stigma still lingers around this illness. Even for a behavioral health condition like depression, which is a more common, there is a general lack of understanding and social stigma.
What is a Stigma?
A mental health stigma is when people or society view individuals in a negative way because of their mental health condition. Some people describe a stigma as feelings of shame or judgement that are projected at particular persons. Individuals can even project a stigma at themselves and have internalized feelings of shame and embarrassment. Living with a mental health condition is a challenge. The isolation, guilt and secrecy that is associated with a stigma only creates additional challenges.
According to data from the Anxiety and Depression Association of America (ADAA), roughly 16.1 million (6.7%) adults in the United States are considered depressed (major depressive disorder). It is for this reason that misunderstandings and lingering stigmas about behavioral health therapy are dangerous. People who are suffering from this condition are either too ashamed or embarrassed to seek professional help. This fact is troubling due to the fact that depression is a complex condition by itself. Adding the stigma inspired shame and discrimination can encourage some people to actually hide their symptoms and behave as a person with high-functioning depression.
Educating society about mental health conditions is the first step in minimizing the influence of stigma.
How to Minimize a Stigma?
People experiencing mental health conditions sometimes face judgement, anger and discrimination. People who are impacted by a mental health stigma need to learn how to avoid and address these negative feelings. People with mental health conditions should not project these destructive feelings of shame upon themselves. Once individuals are able to accomplish this task, their ability to recovery is easier. The first step in fighting a stigma is not to have one for yourself. The overall goal is not to hide from the world in shame, but to become a productive member of society.
Proper education provides valuable information to people so they can make better informed decisions about mental illnesses. Research suggest that when people have a better understanding of mental illness, they are less likely to endorse the negative emotions that are connected to this stigma. In this way, proper information about mental illness seems to lessen negative stereotypes.
The stigma that surrounds mental health is a complex and directly affects people with mental illness, as well as their family, friends and local community. When more people understand this stigma, it is easier to reduce the negative impact on individuals with mental health conditions. For people who suffer from mental health conditions, any reduction in the social stigma that surrounds these conditions will help. National organizations like the National Alliance on Mental Illness (NAMI) are a good place to gather information about the complex topic of behavioral health and stigmas.
Seeking Professional Help:
A major hurdle for individuals is the act of reaching out to a mental health professional in order to obtain the needed support. The stigma that sometimes surrounds mental health can create shame and fear which may prevent people from seeking treatment. However, people should not let fear stop them.
When people are living with mental health conditions, they are often afraid to discuss this condition. They may be afraid that it will affect their lives and livelihoods. Unfortunately, the less this topic is talked about, the more difficult it is to humanize and normalize mental health issues. Through open and honest discussions, society can stop the cycle of stigma, prejudice, and discrimination.
Who We Are:
For questions about the social stigma that can sometimes accompany mental health treatments, contact us. At Providers For Healthy Living, we have been delivering mental health services since 2011. As an experienced mental health provider, we strive to have every patient feel more hopeful after interacting with a member of our staff. Our practice was built on the values of quality, hope and personal responsibility.
By ABCS RCM
Depression is a serious mood disorder that can have dangerous consequences. Equally as threatening are eating disorders, which if left untreated; are also dangerous. However, there is actually a connection between these two health conditions. Some people do not realize that major depression and eating disorders can often occur together. Mental health professionals are aware of the correlation between depression and eating disorders like anorexia nervosa and binge-eating disorder (BED).
Understanding These Conditions:
People must understand that depression also inflects many people with more well-known eating disorders like anorexia. In medical terminology this is known as comorbidity. Individuals with anorexia usually fail to consume enough food to maintain a healthy weight.
Individuals with BED, a condition that affects 2.8 million people, may also experience depressive episodes. Yet, many people tend to think of eating disorders and depression as separate conditions.
Eating disorders are more common among females. Males account for only 5 to 15 percent of anorexia or bulimia diagnoses. For BED cases, this number climbs to 35 percent of males reported having this condition. Whether these differences are caused by societal pressures or biological factors is still unclear. There is a profound influence of social norms and mass media on a female’s perception of themselves. However, this is a topic for another article. The reality is that this is a disease that has a larger impact women and girls.
In many cases of anorexia nervosa, a psychological condition to rid the body of food, the disorder is usually associated with a negative self-image. This is also one of the primary traits for people with depression (major depressive disorder). Negative self-image can be the cause or effect of depression. The two conditions are correlated to the same mental health issues.
Connections Between Depression & Anorexia:
There are other behavior examples that are displayed by individuals struggling with these conditions. People with severe depression may have trouble attending social events and other festivities. Similarly, people with eating disorders may find the abundance of food at social activities especially stressful. In either case, people who are grappling with depression or an eating disorder will display similar behavior patterns.
Researchers have discovered that there is a correlation between low serotonin levels in the brain and disordered eating patterns. As a reminder, serotonin is a chemical in the brain which controls things like a person’s mood and appetite. When mental health professionals correctly understand that the root cause of eating disorders is a neurochemical issue in the brain, it provides for additional treatment options.
Of course, the occurrence of depression and eating disorders in people is more complex then simply chemicals in their brains. There are a variety of different issues that can create dangerous health complications. A person’s behavior and mental health is part of a larger social context. An individual’s mental health is also influenced by factors such as school, work and their home environment. Experiencing traumatic incidents and social pressures have an additional impact on the development of either depression and/or dysfunctional eating patterns.
Depression-based feelings can rise from unrealistic physical expectations of the human body. In this case, people with anorexia try to control the body by excessive exercise and unhealthy weight management. Many researchers argue that this compulsion usually arises from a person’s internal perception that she or he is not meeting society’s beauty standards. In turn, this lack of control and despair is usually cited as a primary cause of clinical depression. However, many binge-eaters turn to food in order to deal with psychological stress rather than facing the circumstances.
The Need For Professional Treatment:
Thankfully, depression and eating disorders can be treated at the same time. However, the recovery from one mental health disorder does not guarantee a recovery from the other disorder. Both illnesses must be treated as separate conditions. This is why is extremely important that people seek professional help from experienced mental health professionals.
Research has documented that untreated depression is deadly. According to the U.S. Department of Health and Human Services the majority of people who have depression do not die by suicide. However, having major depression does increase an individual's suicide risk compared to people without depression. The risk of death by suicide is, in part, likely related to the severity of the depression.
Similar statistics exist for individuals with untreated anorexia. Research shows that eating disorders have the highest mortality rate of any mental illness. In fact, people with anorexia are 50 times more likely than the general population to die as a result of suicide.
For questions about treatment options for depression or eating disorders, contact Providers For Healthy Living. They have been treating patients with depression and eating disorders since 2011. As an experienced mental health provider, they strive to have every patient feel more hopeful after interacting with a member of their staff. Their practice was built on the values of quality, hope and personal responsibility.
Often in our lives, the stressors of life just become overwhelming. Our journey to health is hindered. This happens for everyone. And many seek mental healthcare to find help in some way to lessen that internal tension. I’ve sought therapy being burned out by work, struggling with the death of a loved one, not knowing how to get everything done that I believe I should, and feeling inadequate in parenting. All these were true, and therapy helped with each.
But it seems that talking about emotions and feelings is not enough. Something, at times, seems to be missing. You see, we live in a country in which social insecurity abounds. Hatred seems to flourish as images on the news remind us constantly and repetitively that we should be afraid. . . very afraid. Racial, gender, economic, and religious tensions exist between us, and the repetitive nature of the broadcasts enhances the fears. And with that the language to effectively talk about this stuff diminishes. Being part of a targeted group or a group targeting effects us. Our moral sense of ourselves is challenged. This is different from yet connected to our emotional and cognitive selves.
None of this lessens the need for coming up with ways to better manage the ups and downs in emotions and anxiety as they relate to specific events and our lives. Those are needed. I’ve used and benefited from them. But often the fear becomes reduced to event specific and the broader insecurity is not addressed.
The need is to recognize that it is often the bigger picture which intrudes into our emotional well being and mindfulness. Events such as the clean water crisis in Flint often dominate our news cycles. I would feel on some level silly, going to a therapist and stating “I feel socially insecure. Have you seen what happened in Flint? My sense of moral safety is eroded” And yet I do retain an awareness that those images affect my emotional well being and connect to many other images in our culture as well. My moral experience surrounding these is difficult to frame.
Beliefs about women, race, gender and sexual identity, religion, . . . the list goes on. . . and our interactions with them, can induce fear in ourselves and sometimes in others if we share them. They challenge our own moral safety. We are challenged by our moral experience of events often seeing the wrongs in them and feeling insecure. We know something is not right. This is not the way things should be. Experiencing a powerlessness and hopelessness but not even knowing how to speak about it.
This moral experience and subsequent moral insecurity can undermine our well being and journey towards health if not acknowledged and addressed honestly. I encourage you to challenge therapists to engage in such discussion to examine the impact of our social insecurities on us so some positive answers can be found. And the journey to health continues.
It is commonly held that stress is unhealthy. Health professionals have consistently maintained that stress contributes to a myriad of illnesses that range from the common cold and insomnia to cardiovascular disease and cancer. More recent research, however, suggests that stress may not be a completely bad thing, in fact, in some instances it may be healthy.
In 1998, evidence began to emerge that our understanding of stress was less straightforward than previously thought. Abiola Keller and her colleagues conducted a survey of 30,000 people and then tracked them for 8 years. The survey consisted of two primary questions: “How much stress have you experienced in the last year?” and “Do you believe that stress is harmful to your health?”. Eight years later, they reviewed public records to find out who among those 30,000 had died.
Based on their findings they determined that high levels of stress increased a person’s chance of premature death by 43% but only if they believed that stress was harmful to their health. People who reported high stress but did not believe it affected their health had the lowest risk of death of all the people who participated in the study, lower than even those who reported low to moderate levels of stress. The conclusions of the study were that stress alone was a poor predictor of premature death. People also had to believe stress contributes to poor health.
The conventional view of stress is that it elicits a fight or flight response. When this response is experienced the body readies itself for some type of action-oriented response to this danger. Adrenaline is released, heart rate increases and breathing accelerates and deepens, blood vessels in the muscles dilate while other blood vessels constrict, digestion ceases and the sensory system becomes heightened. This response was intended for survival and was adaptive when people were confronted with the real danger of imminent death or severe injury.
In modern times people experience a fight or flight response for events which while stressful do not reach the level of true survival. This type of stress, when regularly experienced, is believed to contribute to health concerns. Keller’s findings suggest that your mindset about stress also matters and there are health benefits related to adopting a more positive attitude about stress.
Psychologist and researcher Alia Crum offers a three-step approach to adopting a positive attitude towards stress:
• First, acknowledge the presence of stress when you experience it and think about the ways it is impacting you both psychologically and physically.
• Second, recognize that when stress occurs it is typically a response related to something you care about. Connect to the positive motivations that are also present in your stress response.
• Third, when stress is present, the body generates an increase in energy. Figure out ways to make productive use of that energy.
It is generally believed that stress elicits only fight or flight responses, however, other types of stress have been identified, each with a unique physiological profile that motivates different strategies for coping. In contrast to the fight or flight response, these types of stress responses are viewed as beneficial to not only physical health but also mental functioning.
The challenge response results in a similar physical responses to that of the fight or flight response. Heart rate increases, breathing deepens and there is an increase in energy to improve performance. But there are differences. The hormone DHEA, which helps people thrive under stress, is released, the mind is more alert and instead of feeling fearful the individual feels focused. The challenge response has been shown to increase self-confidence and helps a person learn from experience. People who are completely absorbed in what they are doing display signs of experiencing a challenge response.
Another type of stress has been dubbed the tend and befriend response. This stress response motivates people to protect the people and communities they care about. This type of stress response if driven by oxytocin, a hormone that motivates people to connect with others. Oxytocin dampens fears and promotes courage and bravery. It strengthens social connections and helps people be more responsive to the needs of others. The tend and befriend response was most likely the stress response that was in play with the heroic efforts and willingness to come to the aid of victims of the 911 terrorist attack.
While some forms of stress have adverse health effects it is important to remember that all forms of stress have a function whether for survival, or to help achieve goals, or to protect our loved ones or to help others in need or to make social connections. Kelly McGonigal writes, “The stress response is more than a basic survival instinct. It is built into how humans operate, how we relate to one another and how we navigate our place in the world. When we understand this, the stress response is no longer something to be feared. It is something to be appreciated, harnessed, and even trusted.”
Obtaining healthy sleep is important for both physical and mental health. It can also improve productivity and overall quality of life. Everyone, from children to older adults, can benefit from practicing good sleep habits.
Your behaviors during the day, and especially before bedtime, can have major impact on your sleep. They can promote healthy sleep or contribute to sleeplessness. Your daily routines – what you eat and drink, the medications you take, how you schedule your days and how you choose to spend your evenings - can significantly impact your quality of sleep. Even a few slight adjustments can, in some cases, mean the difference between sound sleep and a restless night. Completing a two-week sleep diary can help you understand how your routines affect your sleep.
The term "sleep hygiene” refers to a series of healthy sleep habits that can improve your ability to fall asleep and stay asleep. These habits are a cornerstone of cognitive behavioral therapy for insomnia, the most effective long-term treatment for people with chronic insomnia. CBT can help you address the thoughts and behaviors that prevent you from sleeping well. It also includes techniques for stress reduction, relaxation and sleep schedule management.
Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. Cognitive behavioral therapy for insomnia, sometimes called CBT-I, is an effective treatment for chronic sleep problems and is usually recommended as the first line of treatment. Most cases of insomnia are related to poor sleep habits, depression, anxiety, lack of exercise, chronic illness, or certain medications. Symptoms may include difficulty falling or staying asleep and not feeling well-rested. Treatment for insomnia consists of improving sleep habits (see tips above), behavior therapy, and identifying and treating underlying causes. Sleeping pills may also be used, but should be monitored for side effects.
Cognitive behavioral therapy for insomnia is a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.
How does cognitive behavioral therapy for insomnia work?
The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. This type of therapy can help you control or eliminate negative thoughts and worries that keep you awake. The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. Depending on your needs, your sleep therapist may recommend some of these CBT-I techniques:
The most effective treatment approach may combine several of these methods. If you are struggling with poor sleep or insomnia, talk to your prescriber or therapist today.
Four Quick Sleep Tips:
If you have difficulty sleeping or want to improve your sleep, try following these four tips to establish healthy sleep habits. Talk to your doctor if your sleep problem persists even after trying these tips.
 Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
 Set a bedtime that is early enough for you to get at least 7 hours of sleep.
 Don’t go to bed unless you are sleepy. If you don’t fall asleep after 20 minutes, get out of bed.
 Try an herbal supplement like Valerian root. This over-the-counter supplement is sometimes helpful for the treatment of insomnia.
 Establish a relaxing bedtime routine. A regular nightly routine helps the body recognize that it is bedtime. This could include taking warm shower or bath, reading a book, or light stretches. When possible, try to avoid emotionally upsetting conversations and activities before attempting to sleep.
Use your bed only for sleep and sex.
Additional Sleep Advice:
Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature. Mattress and pillows should be comfortable. The bedroom should be cool – between 60 and 67 degrees – for optimal sleep. Bright light from lamps, cell phone and TV screens can make it difficult to fall asleep, so turn those light off or adjust them when possible. Consider using blackout curtains, eye shades, ear plugs, "white noise" machines, humidifiers, fans and other devices that can make the bedroom more relaxing.
Limit exposure to bright light in the evenings, and be sure to get adequate exposure to natural light during the day. This is particularly important for individuals who may not venture outside frequently. Exposure to sunlight during the day, as well as darkness at night, helps to maintain a healthy sleep-wake cycle.
Turn off electronic devices at least 30 minutes before bedtime.
Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack. Heavy or rich foods, fatty or fried meals, spicy dishes, citrus fruits, and carbonated drinks can trigger indigestion for some people. When this occurs close to bedtime, it can lead to painful heartburn that disrupts sleep.
Exercise regularly and maintain a healthy diet. As little as 10 minutes of aerobic exercise, such as walking or cycling, can drastically improve nighttime sleep quality. For the best night’s sleep, most people should avoid strenuous workouts close to bedtime. However, the effect of intense nighttime exercise on sleep differs from person to person, so find out what works best for you. Avoid consuming caffeine in the late afternoon or evening. On a similar note, avoid consuming alcohol and reduce your fluid intake before bedtime.
Many poor sleepers simply need help relaxing. If you're a habitual insomniac and trying to get to sleep just makes you more anxious and awake, try these alternative choices to help reduce your worry about sleep while relaxing your body and mind. Breathing exercises can promote relaxation.
Here's a routine you can do anywhere, anytime:
* Exhale completely through your mouth.
* Inhale through your nose to a count of four.
* Hold your breath for a count of seven.
* Exhale through your mouth for a count of eight.
* Repeat the cycle three times.
In addition, meditation, yoga, and biofeedback may reduce tension and promote better sleep. Visualization or guided imagery, during which you hold a peaceful image in your mind before bedtime, can also be an effective path to relaxation. You can learn learn more about these techniques from your prescriber or therapist.
If you wake up at night and can't go back to sleep, remain quiet and relaxed. Even normal sleep can be punctuated by periods of restlessness or even waking. Be patient; sleep usually returns. Remember, a few nights of poor sleep do no long-term harm. Even if you toss and turn trying to get to sleep, you are probably getting more periods of sleep than you think.
What medications can cause heat-related illness?
As the weather becomes more hot and humid this summer, keep in mind that almost all psychotropic medications can decrease the body's response to heat which may put you at risk for heat-related illness. Medications that can decrease heat tolerance include common medications prescribed here at Providers For Healthy Living.
Some medications that can decrease heat tolerance include:
• Antidepressants (e.g. Zoloft, Prozac, Wellbutrin, Cymbalta, Effexor, and others)
• Antipsychotics ( e.g. Abilify, Geodon, Seroquel, Latuda, Risperdal, and others)
• Amphetamines (e.g. Adderall, Vyvanse, and others)
• Beta-Blockers (e.g.propranolol, atenolol, nadolol, and others)
• Diuretics or water pills (e.g. furosemide, hydrochlorothiazide, and others)
• Anticholinergics ( e.g. Cogentin, Artane, and others)
• Lithium - Increased perspiration and water loss can cause higher levels of lithium in your blood which puts your at risk for lithium toxicity. Signs and symptoms of lithium toxicity include: dizziness, unsteadiness, tremor, slurred speech, lethargy, and confusion. Please seek immediate treatment or go to the emergency room if signs lithium toxicity occur!
*This is not a comprehensive list. Please consult your medication provider or pharmacist about your specific medication(s).
Are some populations at increased risk of heat-related illness?
Yes. The elderly or those with medical conditions such as diabetes, respiratory disease, heart disease and alcohol use disorders may be more susceptible to heat-related illness. You should know that alcohol, benzodiazepines, and opioids (pain medications) may decrease your awareness of heat-related illness. Drugs such as cocaine, anabolic steroids, hallucinogens, and ecstasy or MDMA may also decrease your heat tolerance.
What are the signs and symptoms of heat-related illness?
Heat-related illness varies from mild forms such as heat exhaustion (with warning signs such as heavy sweating, paleness, muscle cramps, weakness, dizziness, headache, nausea or vomiting) to a severe form such as heat stroke (a deadly form of heat-related illness that occurs when we cannot control our body temperature so the temperature rises rapidly with warning signs that include confusion, unconsciousness, body temperature higher than 103 degrees Fahrenheit, red/hot/dry skin, or throbbing headache). Please call 911 or seek treatment immediately if signs of heat stroke occur!
How can heat-related illness be prevented?
You can help prevent heat-related illness by drinking plenty of fluids, eating regularly, and avoiding caffeinated beverages and alcohol. Wear sunscreen as well as loose fitting and light-colored clothing while outside. Spend time in cooler environments when possible. Try to eliminate heat in your home by keeping the drapes closed during the day. Avoid outdoor activity during the hottest hours of the day.
For more information, please consult with your medication provider about heat-related illness and request the "Heat-Related Illness in Individuals using Psychiatric Medication" pamphlet published annually by the Ohio Department of Mental Health.
Postpartum Depression (PPD) is a mood disorder that affects nearly 1 million women in the U.S. each year. Symptoms of PPD can begin during a woman's pregnancy through the first year following childbirth. PPD is beyond baby blues, which is a normal adjustment period that happens during the first 2 weeks of birth affecting 80% of new moms.
Many people have heard of PPD, but did you know symptoms of PPD can expand beyond depression symptoms and include anxiety, OCD, as well as other psychiatric symptoms? Postpartum depression, anxiety, and OCD symptoms can impact a mother's daily functioning, potentially interfering with her ability to take care of herself or her family.
Symptoms of Postpartum Depression may include:
Symptoms of Postpartum Anxiety & OCD may include:
Any woman who is pregnant or has had a baby in the last year can be at risk for PPD. However, factors like history of mental illness, being a first time mom, ambivalence about the pregnancy, lack of support system, partner problems, infertility, complications during childbirth, and recent stressors can all increase of woman's chances of developing PPD.
A woman's health care provider can help her choose the best course of treatment. Treating PPD can include individual counseling, medication, and postpartum support groups.
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