Wednesday, January 11, 2017

Workplace Wellness

From Mental Health America
http://www.mentalhealthamerica.net/workplace-wellness

Do you Love or Hate your Job?

Loving or hating a job can cause more or less stress in life.  Did you know, 70% of those currently employed are searching for other jobs.
Less than one-third of Americans are happy with their work. Half of the workforce is “checked-out.”  Eighteen percent are unhappy with their current position with some even sabotaging the success of their workplace.  An unhappy or unhealthy work environment is bad for a business’ bottom line and bad for employees.
Studies have shown being unhappy with or unfulfilled by work can take a toll on our health, relationships, and even lifespan. Those in unhealthy work environments tend to gain more weight, have more healthcare appointments, and have higher rates of absenteeism. Stress from work can also impact their family life, mental health, and even increase risks for chronic illnesses and heart attacks.
So what separates the few who are excited about their work from the majority of Americans? While there are some differences among age groups and types of employment, a healthy work environment is key to job satisfaction. The happiest employees tend to include interpersonal relationships, commitment to the organization, and a sense of meaning or purpose among the parts of their job with which they are most satisfied. Conversely, those leaving their jobs tend to cite lack of respect, teamwork, and potential for growth among top reasons for quitting.

Top 5 Reasons for Happy Employees
Top 5 Reasons for Leaving Job
  1. Relationship with co-workers
  2. Contribution of work to organization’s business goals
  3. Meaningfulness of the job
  4. Opportunities to use skills/abilities
  5. Relationship with immediate supervisor
  1. Minimal wage growth
  2. Lack of opportunity to advance
  3. Excessive overtime hours
  4. A work environment that does not encourage teamwork
  5. A boss that doesn’t allow you to work flexibly

A healthy workplace is one where individuals feel valued and supported, provides a positive workspace, and shows respect for other aspects of a person’s life. If you’re uncertain as to whether your workplace is on the path to wellness, the signs below may provide some helpful tips:
  1. Productive Atmosphere. Clean, functional and well-lit space. Good working relationship with all staff. Employees feel respected, appreciated, incentivized, and rewarded. Signs of intimidation, bullying, sexual harassment, and fear are absent.
  2. Livable wage. Providing a livable wage encourages a committed and sustained workforce.
  3. Reasonable accommodation. Employers and employees have to work collaboratively to identify reasonable accommodations (not special treatment) in the workplace for physical as well as mental disabilities. From changing physical work space and schedule to the use of interpreters or technologically adapted equipment, it can run the gamut.
  4. Health, Wellness, & Environment. Provide a comprehensive health insurance plan including smoking-cessation, weight-loss, and substance abuse programs.
  5. Open Communication. Keep the communication process transparent. Creating an environment of open communication contributes to a more energetic and productive workforce where all employees can feel invested in the company.
  6. Employee Accountability. It takes two to make a healthy workplace. Employees have to come with a "can-do" attitude and be willing to support each other as well as management.
  7. Management Accountability. Allow employees to provide work-related feedback to their supervisors. It can be anonymous to avoid the possibility of negative repercussions.
  8. Work/Life Balance. We now live in a world where technology is available to keep us connected to work around the clock. Work options such as flexible scheduling, hoteling (reservation-based unassigned seating) or telecommuting ought to be implemented if applicable.
  9. Clear & Positive Values. Be transparent and definitive about what the organization stands for. People in as well as outside of the company should have a good understanding of this.
  10. Fitness. Offer a gym membership, fitness class or even just an exercise space that encourages employees to become physically active and stay fit. If possible, incentivize employees to access such services

Thursday, December 22, 2016

De-stress the Holidays

From Penny Sitler, Executive Director of Mental Health America of Licking County

Are the holidays stressing you out? There are lots of reasons for the stress, often self-imposed. It’s unrealistic to think we can completely eliminate stress in our lives but here are some suggestions to minimize its effects.
Don’t pressure yourself to make everything perfect. Getting organized is step one toward giving yourself a break. Carry a list of the people you need gifts for in your wallet, including what’s already bought, to eliminate overbuying for any one person and exceeding the budget. List tasks from most important to least, and concentrate on the highest priority items first. Ask for help with holiday preparations. Part of the holiday joy is being together. Having a friend or family member help will turn what feels like work into a fun time that will become a cherished memory.
Many of us need to incorporate “no” into our vocabularies – it’s okay to say no if you don’t have time to get something done. Take control of your schedule and avoid overdoing it. Everyone is in the same situation and they’ll understand if you have to miss one cookie exchange.
The holidays can cost a lot but they don’t have to. If you don’t have money to spare, enjoy free activities. Having a grandchild spend time with a grandparent sharing in the beauty of the season can be a treasured gift that costs nothing more than a few hours of their time. Tour the neighborhood’s holiday lighting displays, bundle up and take a walk in the snow or go sledding. People often can’t remember which gift you gave them last year, but they will remember time spent together building memories.
Those of us who live in central Ohio experience about 180 gray days each year and we all need a little sunshine in our lives to keep up our spirits. Put brighter than usual light bulbs in a lamp and sit near it to simulate sunshine. If you feel cooped up during the winter, even if it's cold outside and snow is on the ground, put on some warm boots and get outside for a walk every day. Exercise will help you feel more energetic, sunlight and exercise are great mood lifters, and there’s nothing prettier than a fresh snowfall. If sidewalks are too treacherous, head to the local mall and walk the corridors while enjoying the sights and sounds of the season.
If you feel isolated or sad during the holidays, join in activities that are happening in the community. Ask a neighbor or friend if they need help with gift wrapping or clearing a walkway. If you know someone else who is alone during this time, invite that person to a meal or other gathering. Volunteering at an agency or church in your community is a great way to lift your spirits. If you need help providing food for your family or yourself, there are opportunities to eat a meal at area churches and food pantries are well stocked for the winter.
Give yourself a time out if you’re feeling overwhelmed by the swirl of activities. Fit in some quiet time each day. Take five deep breaths while gazing out the window for a quick relaxation technique. Reading, listening to music or enjoying a hobby like knitting or writing in a journal will provide much needed peace during a hectic season.
To make the most of the holidays, be sure to eat well, making it a priority to eat five or more fruits or vegetables a day. Get plenty of rest and exercise to make you less vulnerable to stress. Take time to enjoy the beauty of the season. Remember to be flexible and have fun.

Best wishes and happy holidays!

Wednesday, December 14, 2016

Anxiety in Older Adults

Mental Health and Older Adults
Have you ever suffered from excessive nervousness, fear or worrying? Do you sometimes experience chest pains, headaches, sweating, or gastrointestinal problems? You may be experiencing symptoms of anxiety.
Excessive anxiety that causes distress or that interferes with daily activities is not  a normal part of aging, and can lead to a variety of health problems and decreased functioning in everyday life. Between 3% and 14% of older adults meet the criteria for a diagnosable anxiety disorder, and a recent study from the International Journal of Geriatric Psychiatry found that more than 27% of older adults under the care of an aging service provider have symptoms of anxiety that may not amount to diagnosis of a disorder, but significantly impact their functioning.
The most common anxiety disorders include specific phobias and generalized anxiety disorder. Social phobia, obsessive-compulsive disorder, panic disorder, and post- traumatic stress disorder (PTSD) are less common.

Common Types of Anxiety Disorders and Their Symptoms

Panic Disorder: Characterized by panic attacks, or sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, and fear of dying.
Obsessive-Compulsive Disorder: People with obsessive-compulsive disorder (OCD) suffer from recurrent unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals, such as hand washing, counting, checking or cleaning, are often performed in hope of preventing obsessive thoughts or making them go away.
Post-Traumatic Stress Disorder: PTSD is characterized by persistent symptoms that occur after experiencing a traumatic event such as violence, abuse, natural disasters, or some other threat to a person’s sense of survival or safety. Common symptoms include nightmares, flashbacks, numbing of emotions, depression, being easily startled, and feeling angry, irritable or distracted.
Phobia: An extreme, disabling and irrational fear of something that really poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives. Common phobias include agoraphobia (fear of the outside world); social phobia; fear of certain animals; driving a car; heights, tunnels or bridges; thunderstorms; and flying.
Generalized Anxiety Disorder: Chronic, exaggerated worry about everyday routine life events and activities, lasting at least six months; almost always anticipating the worst even though there is little reason to expect it. Accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.

Identifying Risk Factors for Anxiety

Like depression, anxiety disorders are often unrecognized and undertreated in older adults. Anxiety can worsen an older adult’s physical health, decrease their ability to perform daily activities, and decrease feelings of well-being.

Check for Risk Factors

Anxiety in older adults may be linked to several important risk factors. These include, among others:
  • Chronic medical conditions (especially chronic obstructive pulmonary disease [COPD], cardiovascular disease including arrhythmias and angina, thyroid disease, and diabetes)
  • Overall feelings of poor health
  • Sleep disturbance
  • Side effects of medications (i.e. steroids, antidepressants, stimulants, bronchodilators/inhalers, etc)
  • Alcohol or prescription medication misuse or abuse
  • Physical limitations in daily activities
  • Stressful life events
  • Negative or difficult events in childhood
  • Excessive worry or preoccupation with physical health symptoms

Screening for Anxiety

A quick, easy and confidential way to determine if you may be experiencing an anxiety disorder is to take a mental health screening.  A screening is not a diagnosis, but a way of understanding if your symptoms are having enough of an impact that you should seek help from a doctor or other professional. Visit www.mhascreening.org to take an anxiety screening.  If you don’t have internet access, you can ask your primary care doctor to do a screening at your next visit.
Anxiety is common and treatable, and the earlier it is identified and addressed, the easier it is to reverse the symptoms.

Depression and Anxiety

Older adults with mixed anxiety and depression often have more severe symptoms of both depression and anxiety. Learn more about the symptoms of depression by reading the “Depression in Older Adults” fact sheet.

Treatment Options

The most common and effective treatment for anxiety is a combination of therapy and medication, but some people may benefit from just one form of treatment.
If you or someone you know is experiencing symptoms of any form of anxiety, you should seek professional help immediately.
If you or someone you know is in crisis and would like to talk to a crisis counselor, call the free and confidential National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Medicare Helps Cover Mental Health Services

Worrying about health insurance costs should never be a barrier to treatment. Visit the Medicare QuickCheck® on MyMedicareMatters.org to learn more about all of the mental health services available to you through Medicare.
Medicare Part A
Medicare Part A (hospital insurance) helps cover mental health care if you’re a hospital inpatient. Part A covers your room, meals, nursing care, and other related services and supplies.
Medicare Part B
Medicare Part B (medical insurance) helps cover mental health services that you would get from a doctor as well as services that you generally would get outside of a hospital, like visits with
a psychiatrist, clinical psychologist or clinical social worker, and lab tests ordered by your doctor. Part B may also pay for partial hospitalization services if you need intensive coordinated outpatient care.
Medicare Part D
Medicare Part D (prescription drug coverage) helps cover drugs you may need to treat a mental health condition.
Need help figuring out mental health coverage through Medicare? Use the Medicare QuickCheck® to get a personalized report on the best options for your situation.

Works Cited

  1. U.S. Administration on Aging/Substance Abuse and Mental Health Services Administration. Older Americans behavioral health issue brief 6: Depression and anxiety: Screening and intervention. (2013). Retrieved April 2, 2015,    from    http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/IssueBrief_6_ DepressionAnxiety_Color.pdf
  2. Medicare & Your Mental Health Benefits. (2014). Baltimore: Centers for Medicare and Medicaid Services. Retrieved April  2,  2015, from http://www.medicare.gov/publications/pubs/pdf/10184.pdf
  3. Anxiety Disorders. (n.d.). Retrieved April 5, 2015, from http://www.mentalhealthamerica.net/conditions/anxiety- disorders#anxiety  disorders

Thursday, December 8, 2016

How can I tell if I have postpartum depression?

by 
therapist

Up to 80 percent of new mothers get the baby blues, a form of depression that begins soon after delivery and generally lasts no more than two weeks. Those whose symptoms start about six weeks after delivery are more likely to have postpartum depression (PPD), a full-blown clinical depression that affects 10 to 20 percent of new mothers.

Along with symptoms similar to those of the baby blues, such as weepiness and anxiety, you may also become moody and irritable. Women with PPD can lose their appetite or their ability to sleep. Some have panic attacks. A small number of women believe they can't adequately care for their baby. Others report feeling suicidal or having disturbing negative thoughts about their baby.

Unfortunately, the medical community has misunderstood and misdiagnosed PPD for some time. PPD can strike any woman, either immediately after the birth of her baby or many months later. Sometimes healthcare providers don't take new mothers' concerns seriously, dismissing the symptoms as hormonal shifts and trouble adjusting to motherhood.

Our society also makes it difficult to admit to having negative feelings about motherhood or your baby. When mothers do express feelings such as ambivalence, fear, or rage, they can frighten themselves and those close to them.

What causes PPD? Most experts agree that it results from a combination of hormonal, biochemical, psychosocial, and environmental influences. Although experts suspect that hormones play a large part in PPD, we also know that new fathers and adoptive mothers can have PPD, which tells us that it's not strictly hormonal.

Some women are more likely than others to get PPD, so being informed and prepared long before you give birth is helpful. You're more at risk for PPD if:

• You or anyone in your family has a history of depression or other mental health issues, or you were prone to bouts of intense anxiety or depression while you were pregnant.

• Your pregnancy wasn't planned, and you were unhappy to find out that you were pregnant.

• Your spouse or partner is unsupportive.

• You've recently gone through a separation or divorce.

• You went through a serious life change, such as a big move or loss of a job, at or around the time you had your baby.

• You had obstetric complications.

• You were subject to early childhood trauma, have been abused, or come from a dysfunctional family.

Remember, though, that these risk factors don't necessarily cause PPD. Many women can have a number of them and never get depressed. Others can have just one risk factor or even none at all and still end up with a full-blown major depression.

We don't know exactly why PPD happens to one woman and not another. We do know that these risk factors make a woman more vulnerable. If a woman knows she's at risk, she can begin to take preventative measures — such as mobilizing a support network and fortifying her resources — before the birth of her baby.

It's important to know the difference between normal emotional changes after birth and a need for professional care. It's not just what you're feeling that indicates that something may be amiss, but thefrequency, intensity, and duration of your feelings.

In other words, new mothers often feel sad and anxious periodically during the first few months following childbirth. But if you're crying all day long and are up at night with panic attacks, you should contact your doctor.

In addition to talking with your healthcare provider, you can take steps to elevate your spirits. These ideas may seem simple, but they're often last on the list of things for a new mother to do.

It's important to make sure your own basic needs, such as getting enough rest and good nutrition, are being met. Try to get some help around the house. It might also be good to talk with other new mothers who are also experiencing the highs and lows of motherhood.

If you feel violent or aggressive toward your baby, or if you think you're incapable of responsibly caring for your newborn, seek professional help immediately. You are not going crazy. You are not a bad mother. Postpartum depression is real and treatment is available. You will feel better again.


Tuesday, October 11, 2016

Left behind after suicide

Left behind after suicide

Originally published: July 2009

People bereaved by a suicide often get less support because it's hard for them to reach out — and because others are unsure how to help.
Every year in the United States, 33,000 people take their own lives. Every one of these deaths leaves an estimated six or more "suicide survivors" — people who've lost someone they care about deeply and are left grieving and struggling to understand.
The grief process is always difficult, but a loss through suicide is like no other, and the grieving can be especially complex and traumatic. People coping with this kind of loss often need more support than others, but may get less. There are various explanations for this. Suicide is a difficult subject to contemplate. Survivors may be reluctant to confide that the death was self-inflicted. And when others know the circumstances of the death, they may feel uncertain about how to offer help. Grief after suicide is different, but there are many resources for survivors, and many ways you can help the bereaved.

What makes suicide different

The death of a loved one is never easy to experience, whether it comes without warning or after a long struggle with illness. But several circumstances set death by suicide apart and make the process of bereavement more challenging. For example:
A traumatic aftermath. Death by suicide is sudden, sometimes violent, and usually unexpected. Depending on the situation, survivors may need to deal with the police or handle press inquiries. While you are still in shock, you may be asked whether you want to visit the death scene. Sometimes officials will discourage the visit as too upsetting; at other times, you may be told you'll be grateful that you didn't leave it to your imagination. "Either may be the right decision for an individual. But it can add to the trauma if people feel that they don't have a choice," says Jack Jordan, Ph.D., clinical psychologist and co-author ofAfter Suicide Loss: Coping with Your Grief.
You may have recurring thoughts of the death and its circumstances, replaying the final moments over and over in an effort to understand — or simply because you can't get the thoughts out of your head. Some suicide survivors develop post-traumatic stress disorder (PTSD), an anxiety disorder that can become chronic if not treated. In PTSD, the trauma is involuntarily re-lived in intrusive images that can create anxiety and a tendency to avoid anything that might trigger the memory.
Stigma, shame, and isolation. Suicide can isolate survivors from their community and even from other family members. There's still a powerful stigma attached to mental illness (a factor in most suicides), and many religions specifically condemn the act as a sin, so survivors may understandably be reluctant to acknowledge or disclose the circumstances of such a death. Family differences over how to publicly discuss the death can make it difficult even for survivors who want to speak openly to feel comfortable doing so. The decision to keep the suicide a secret from outsiders, children, or selected relatives can lead to isolation, confusion, and shame that may last for years or even generations. In addition, if relatives blame one another — thinking perhaps that particular actions or a failure to act may have contributed to events — that can greatly undermine a family's ability to provide mutual support.
Mixed emotions. After a homicide, survivors can direct their anger at the perpetrator. In a suicide, the victim is the perpetrator, so there is a bewildering clash of emotions. On one hand, a person who dies by suicide may appear to be a victim of mental illness or intolerable circumstances. On the other hand, the act may seem like an assault on or rejection of those left behind. So the feelings of anger, rejection, and abandonment that occur after many deaths are especially intense and difficult to sort out after a suicide.
Need for reason. "What if" questions may arise after any death. What if we'd gone to a doctor sooner? What if we hadn't let her drive to the basketball game? After a suicide, these questions may be extreme and self-punishing — unrealistically condemning the survivor for failing to predict the death or to intervene effectively or on time. Experts tell us that in such circumstances, survivors tend to greatly overestimate their own contributing role — and their ability to affect the outcome.
"Suicide can shatter the things you take for granted about yourself, your relationships, and your world," says Dr. Jordan. Many survivors need to conduct a psychological "autopsy," finding out as much as they can about the circumstances and factors leading to the suicide, in order to develop a narrative that makes sense to them. While doing this, they can benefit from the help of professionals or friends who are willing to listen — without attempting to supply answers — even if the same questions are asked again and again.
Sometimes a person with a disabling or terminal disease chooses suicide as a way of gaining control or hastening the end. When a suicide can be understood that way, survivors may feel relieved of much of their what-if guilt. "It doesn't mean someone didn't love their life," says Holly Prigerson, Ph.D., associate professor of psychiatry at Harvard Medical School. Adds Dr. Prigerson, "The grieving process may be very different than after other suicides."
A risk for survivors. People who've recently lost someone through suicide are at increased risk for thinking about, planning, or attempting suicide. After any loss of a loved one, it's not unusual to wish you were dead; that doesn't mean you'll act on the wish. But if these feelings persist or grow more intense, confide in someone you trust, and seek help from a mental health professional.

Support from other survivors

Research suggests that suicide survivors find individual counseling (see "Getting professional help") and suicide support groups to be particularly helpful. There are many general grief support groups, but those focused on suicide appear to be much more valuable. In a small pilot study that surveyed 63 adult suicide survivors about their needs and the resources they found helpful, 94% of those who had participated in a suicide grief support group found it moderately or very helpful, compared with only 27% of those who had attended a general grief group. The same study found that every survivor who had the opportunity to talk one-on-one with another suicide survivor found it beneficial. These results were published in the journal Suicide and Life-Threatening Behavior (July 2008).
"Some people also find it helpful to be in a group with a similar kinship relationship, so parents are talking to other parents. On the other hand, it can be helpful for parents to be in a group where they hear from people who have lost a sibling — they may learn more about what it's like for their other children," says Dr. Jordan.
Some support groups are facilitated by mental health professionals; others by laypersons. "If you go and feel comfortable and safe — [feel] that you can open up and won't be judged — that's more important than whether the group is led by a professional or a layperson," says Dr. Prigerson. Lay leaders of support groups are often themselves suicide survivors; many are trained by the American Foundation for Suicide Prevention, which has a support group locator on its Web site (see "Selected resources").
For those who don't have access to a group or feel uncomfortable meeting in person, Internet support groups are a growing resource. A 2008 study comparing parents who made use of Internet and in-person groups found that Web users liked the unlimited time and 24-hour availability of Internet support. Survivors who were depressed or felt stigmatized by the suicide were more likely to gain help from Internet support services. Interestingly, people in urban areas were just as likely to make use of the Internet as those in more isolated places.
You can join a support group at any time: soon after the death, when you feel ready to be social, or even long after the suicide if you feel you could use support, perhaps around a holiday or an anniversary of the death.
Mental Health America of Licking County has a Survivors After Suicide Loss Support Group the second Tuesday of each month from 6:30 to 7:30 pm
For more information call (740) 522-1341
Local Crisis Information:
Suicide 24-Hour Crisis Line- 2-1-1 or (740)345-HELP
Mental Health Emergency Number- (740) 522-2828