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Mental Health

Telemental Health: Bridging the Gap Between Care, Coronavirus

We are living in unprecedented times. A deadly pandemic has surfaced, the likes of which have not been experienced since the early 1900’s. The impact of this current pandemic has the potential to be even more devastating than the last, as the world is much more interconnected and interdependent than before.

On the other hand, the potential for people to receive applicable treatment for both the physical and psychological impact of this pandemic is in a much better place than in decades past. Thanks to the technological progress which has been made over the past several years, people are often no further from a phone call or video conference away from being able to consult with professionals regarding their concerns.

What Is Telemental Health?

Telehealth refers to any type of health service which is delivered via a medium other than face-to-face contact. It can include telephone calls, texts, video conference, and online interaction. Telemental health refers specifically to the ability to deliver and receive mental health support from a distance. It encompasses other, more familiar, terms such as telepsychiatry, telepsychology, and teletherapy.

Proponents for the widespread availability of telemental health services have long pointed to statistics which indicate that certain portions of the population are lacking in mental health support due to lack of access to physical mental health locations. Individuals who live in rural areas, those who suffer from mobility difficulties, and those who lack transportation and time are often unable to make the journey from their locations to a facility which provides quality mental health care.

The progress toward providing telemental health services has met with some resistance from regulating agencies. These types of agencies were constructed along with the growing popularity of mental health treatment from the mid 1900’s, and were charged with overseeing the requirements of mental health care providers to include best care practices for their patrons. Changes in these regulations have not quite kept pace with the growth of technology, leaving access to quality telehealth services in a gray area.

How Mental Health Care Rules Are Evolving for Coronavirus

With the coronavirus pandemic and associated social distancing guidelines arriving suddenly on the scene, regulators were compelled to take a closer look at the convenience of receiving therapy from a remote location. Data indicating that telemental health is similarly effective in treating a multitude of disorders was placed in the forefront, and privacy rights of patients and clients receiving remote care were scrutinized.

Similarly, insurance companies began to be pressured toward accepting claims for mental health services provided through such avenues. The result is a temporary lifting of former restrictions so that providers can deliver much needed therapy to those who are suffering from mental health symptoms while simultaneously heeding the call to avoid excessive social contact. There are many providers who hold out the hope that these current progressions in acceptance of telehealth as a viable treatment option will remain far into the future.

Telemental Health Services and Support

Telemental health services rely on the effectiveness of talk therapy toward treating mental health concerns and disorders. Talk therapy has been the go-to treatment since its early application by psychotherapy pioneers such as Sigmund Freud and Carl Jung. It has been demonstrated as being effective with disorders ranging from anxiety, depression, bipolar disorder, addiction, and personality disorders.

When it comes to deciding upon the right type of telemental health treatment for you, some insight into how you best learn and communicate can be helpful. If you are a visual person, support provided through video conference may be what provides you with the best outcome. An auditory person will tend to benefit most from sessions provided over phone. Someone who gains more from reading and writing is likely to find therapy bulletin boards and interactive journals useful.

Anxiety Treatment

Anxiety is already the most common disorder experienced in the country. With the stress of COVID-19 in play, there are even more reasons to feel anxious. Our health, finances, and future  plans are all at risk. Receiving telemental health support during this time can help you to examine your core values, reframe your fearful thoughts, and develop coping mechanisms to use when the anxiety levels are high.

Depression Treatment

Experiences of depression run a close second when it comes to prevalence of mental health disorder in America. While anxiety tends to focus on fear of the future, depression tends to focus on current and past situations. Many people are feeling the weight of our current crisis, yet are unable to engage in activities which might otherwise work to alleviate and distract from depressive thoughts and feelings.

Bipolar Disorder Treatment

A hallmark of bipolar disorder is that a person’s mood shifts from highs to lows. While largely thought to be due to a chemical fluctuation in the brain, moods can definitely be negatively and positively affected by situations and mindset. Talk therapy can assist in helping a person with bipolar disorder to learn to recognize the impending mood shifts, and mitigate the drastic responses and behaviors which often result.

Substance Abuse Treatment

Mental health disorders and tendency toward substance abuse are highly correlated. Mental health disorders can prompt a person to self-medicate with drugs and alcohol, and substance abuse can exacerbate pre-existing mental health conditions. With so many people stuck at home, and with idle time on their hands, even old habits of abusing drugs and alcohol may creep back in. Talking with a therapist can help to weigh the pros and cons of giving into the temptation to use substances, and can assist you in finding more healthy ways to cope with the stress and boredom.

Personality Disorders Treatment

Personality disorders are those which tend to influence a person’s entire approach and evaluation of life. One of the most diagnosed personality disorders is that of borderline personality disorder (BPD). Talk therapies have been shown to be extremely successful for those struggling with this disorder, as such therapy is focused on providing the client with new ideas and techniques for navigating life situations.

Categories
Depression Mental Health Recovery Self-Care Stress

New Study Talks About Stress and Teen Girls

Adolescents experience a lot of stress, more than we may even realize. Stress can come from the natural ups and downs at school because of academic pressure, or via social circles, or from an overwrought family system. For some kids, one thing leads to another, and they find themselves trying to process all of that at the same time. How often are these kids who are struggling in this way, boxed into the at-risk nomenclature? Naming the problem and doing something about it are very different things. Further, if we tell these kids they are at-risk, it evokes a negative connotation. These kids are, in reality, under-served and often ignored.

I teach a yoga class to tweens/teens, and I was warned that one of my new kids was a “problem.” I was told she would be a “nightmare” because she was caught smoking last year, implying that she was also a “bad” kid. I chose not to view her as a problem, or a nightmare, or bad. Instead, I approached her with compassion and kindness and boundaries. I recognized that this kid doesn’t need to be judged; she needs to be seen. She has become one of the most dedicated students in my class. She looks forward to being there. She is kind to her classmates and respectful to me, the teacher. This young lady has allowed herself to be vulnerable enough to allow the process of yoga and conscious breath to disassemble her stress–even if it’s in incremental amounts. The shift has been profound.

A new study talks about teenage girls being more prone to depression when they are exposed to a lot of stress. My class is comprised mostly of girls, most of whom share that they are under stress.  In this recent study, “Jessica Hamilton a doctoral student in the Mood and Cognition Laboratory of Lauren Alloy at Temple University hypothesized that life stressors, especially those related to adolescents’ interpersonal relationships and that adolescents themselves contribute to (such as a fight with a family member or friend), would facilitate these vulnerabilities and, ultimately, increase teens’ risk of depression.”

Researchers examined data from 382 Caucasion and African-American students in an ongoing study. Their findings corroborated Hamilton’s theory, showing increased levels of rumination, depression and emotional vulnerability. Seven months later, when they did follow-up testing, the girls showed higher levels of depressive systems than the boys did. The study also showed that the girls had been faced with more stressors than the boys had. The theory is that if boys and girls faced the same amount of stress, the results of the research would have reflected higher rates in depression regardless of sex.

Stress can be a direct result of consistently not having one’s needs met, feeling disconnected or alone, and from unmitigated change at home: divorce, job loss, violence, poverty, or chronic illness. Additionally, the new independence that comes with the teen years can also be stressful. As much as teens want to individuate, the reality that they have to suddenly do many things themselves can be overwhelming for some.

 

How can we de-stress? Try one or all of these on for size:

1: Time outs are a time in. They are an opportunity for us to reset our minds and bodies.

2: Ask for help.  You don’t have to do this alone.

3: Get some fresh air: go for a walk, or find a way to get outside!

4: Take a media time out: unplug for an hour, and dedicate that time to self-care. If you really want to challenge yourself, turn your phone off for the day!

5: Breathe: 10 deep breaths, extending the exhale each time. Do three or more cycles of this.

6: Say no. No is a complete sentence. Remember this!

Each of these tools encourages an emotional reset. They help turn that fight-or-flight response off and help your body engage its rest-and-digest system. Sometimes, we have to consciously remind our bodies to slow down, but we have to practice. Studies like the one above are a good reminder, a wake-up call, telling us that we have to slow down and process our emotions in a safe, reflective way. Teens need to know they will be ok.

Categories
Recovery

Depression Exposed: 19 yo Kevin Breel’s Courageous Speech

*editors note: Kevin Breel’s speech was not an actual TEDx Teen talk as previously stated. I have made the appropriate edits to the blog and in the tags. 

Real depression crosses our threshold every day at Visions. We see it, treat it, and experience it firsthand. When I saw Kevin Breel’s speech where he openly speaks about his depression, I was deeply moved. He bravely talks about the alienating stigma of mental illness. He talks about the societal push to empathize with what is comfortable (broken bones, sprained ankles), and the deep seeded fear of mental illness. This 19-year-old names the pain, and he sheds light on the darkness that haunts him.

 

In his speech, Keven Breel says, “Unfortunately we live in a world where when you break your arm, everyone runs over to sign your cast. But if you tell people you’re depressed, everyone runs the other way. That’s the stigma. We are so so so accepting of any body part breaking down, other than our brains.” He goes on to say, “Depression is one of the best documented problems we have in the world, yet it’s one of the least discussed.” In his speech, Breel recognizes that his hurt allows him to hope; his darkness allows him to recognize light.

 

I’ll leave you with one of my favorite quotes from this speech:

 

“The world I believe in is where where embracing your light doesn’t mean ignoring your dark. The world I believe in is one where we are measured by our ability to overcome adversities not avoid them.” Amen to that. Watch the whole thing. It’s only 11 minutes and well-worth your time.

 

 

Categories
Depression Mental Health

Depression in Adolescence

Image via Wikipedia

Depression affects teens as well as adults but is often missed partly because it can co-occur with the natural emotional ups and downs that are part and parcel to being a teenager. Simply put, growing up is a naturally stressful process, and that’s without any external conflicts acting as a contributing factor! The other organically occurring components fostering an environment for adolescent depression are things like hormones, and conflict with parents. When we include disturbing events like a breakup, death of a friend or relative, or difficulty at school, one’s susceptibility to depression increases.

Adolescence is a time for expressing independence, which sometimes means drawing a firm line in the sand with one’s parents in order to create autonomy. On occasion, those efforts can create a snag in parent/child communication. Puberty is inherent to the organic and experiential part of being human. It also means there is going to be infallibility and imperfection. Sometimes, as parents, we forget what it was like and spend too much time reacting and taking things personally and not enough time taking action. Think of it this way: if a teen is suffering from depression, they more than likely won’t tell you. In fact, they may be surreptitiously hoping that you take notice, because talking about it might be too scary or embarrassing.

According to the National Comorbidity Survey-Adolescent Supplement (NCS-A) via the National Institute of Mental Health (NIMH): “About 11% of adolescents have a depressive disorder by age 18. Girls are more likely than boys to experience depression. The risk for depression increased as a child gets older.” And according to the World Health Organization (WHO), “Major depressive disorder is the leading cause of disability among Americans age 15-44.” Further, the NIMH site notes that since childhood behaviors vary from one childhood stage to another, “it can be difficult to tell whether a child who shows changes in behavior is just going through a temporary ‘phase’ or is suffering from depression.

Since symptoms of adolescent depression differ slightly than those of an adult, it’s important to pay attention to any idiosyncrasies that may occur (sans getting over-analytical and paranoid). A child who’s depressed may complain of being sick, they may suddenly become excessively clingy, and they may often refuse to go to school; A teen, on the other hand, may sulk, get in trouble at school, be an overall grump, and feel a general sense of being misunderstood.

Symptoms of depression can include some or all of these factors:

  • Appetite changes (usually a loss of appetite but sometimes an increase)
  • Difficulty concentrating
  • Difficulty making decisions
  • Episodes of memory loss
  • Fatigue
  • Feeling upset, restless, and irritable
  • Feeling worthless, hopeless, sad, or self-hatred
  • Loss of interest or pleasure in activities that were once fun
  • Thinking or talking about suicide or death
  • Trouble sleeping, too much sleeping, or daytime sleepiness

Sometimes a person’s behavior may change, or there may be problems at home or school without any symptoms of depression:

  • Acting-out behaviors (missing curfews, unusual defiance)
  • Criminal behavior (such as shoplifting)
  • Irresponsible behavior
  • Poor school performance, grades dropping
  • Pulling away from family and friends, spending more time alone
  • Use of alcohol or other illegal substances

If you notice any of these behaviors lasting for more than two weeks, it’s time to seek help, particularly if these behaviors are beyond the normative rollercoaster ride consistent with adolescence.

For additional information and for documentation of sources for this article:


Depression in Children and Adolescents (Fact Sheet)
Use of Mental Health Services and Treatment Among Children (www.nimh.nih.gov)
Adolescent Depression (www.nlm.hih.gov)
Adolescent Depression (PubMedHealth: www.ncbi.nlm.nih.gov)
Adolescent Depression (https://health.nytimes.com)