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.