Medication Adherence and the Impact on Mental Health

, , , , ,

By: Kristin Trammell (Therapist/Training Specialist)

Taking prescriptions for mental health needs is a very common practice in America. While medication may not solve or be a complete cure, it can help give people a leg up in being able to regulate themselves and cope with stressors. Medication, however, can only be as effective as we help it to be; meaning that we want to take it regularly, timely, and want to avoid foods, drinks, or activities that may contraindicate the medication’s effectiveness. 

Experiencing mental health difficulties can be a barrier in taking medication regularly and as prescribed. Often times people may not take their medication as they should due to forgetfulness, stigma, denial that they need it for their health, lack of understanding, expense, side effects, or feeling like they do not need it anymore. 

Here are a few tips in maintaining medication adherence to enable further mental health recovery:

  1. Be honest with your doctor about concerns of the medication regarding side effects, necessity of the prescription, or if you feel you do not need it any longer. 
  2. Seek payment assistance for prescriptions through local medbanks or non-profit programs, such as Salvation Army. Utilize non-profit pharmacies, such as Good Pill Pharmacy, https://www.goodpill.org/, and discount programs, such as GoodRX, https://www.goodrx.com/.
  3. Set an alarm on your phone, watch, or clock, or set a reminder in your schedule/calendar each day at the same to ensure you take the medication on time every day.
  4. Eat healthy foods and limit foods that can contraindicate the medication. Two foods that can contribute to anxiety and depression are sugar and caffeine, so it is a good idea to limit or avoid these. 
  5. Exercise daily: Go for a walk, complete a chore, lift weights, stretch, play with your pet or child. Anything to help us get moving is a good place to start! Exercising can help trigger pleasure and happy chemicals in the brain that can have a positive impact on overall mood and health. 
  6. Be honest with your doctor or therapist regarding possible stigma of taking prescriptions for mental health. Remind yourself mental health prescriptions are a resource to assist you in coping, and taking them does not mean there is something wrong with you. Many people in America take some type of medication for physical or mental health every day. Our brains and bodies operate with chemicals and electrical impulses, and sometimes these chemicals can become imbalanced, which medication can support us in balancing out chemicals within the body to help our overall health. 

References

Chisholm-Burns MA, Spivey CA. The cost of medication nonadherence: Consequences we cannot afford to accept. J Am Pharm Assoc. 2012;52(6):823-826.

Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman Med J. 2011;26(3):155- 9. DOI: 10.5001/omj.2011.38. PubMed PMID: 22043406; PubMed Central PMCID: PMC3191684.

National Aliance on Mental Illness. (2016). Medication plan adherence. Retrieved March 24, 2022, from https://www.nami.org/About-Mental-Illness/Treatment/Mental-Health-Medications/Medication-Plan-Adherence

Common Co-Occurring Diagnoses with Alcohol Addiction

, , , , ,

By: Anna Fortune, Director of Substance Use Services and Anna Giddens, Community Support Specialist

Individuals who have both a mental health and a substance use diagnosis are said to have a co-occurring diagnosis (or dual diagnosis). One-third of individuals who have an alcohol use disorder also have a mental health disorder. There are many mental health conditions that can co-occur with alcohol use disorder. According to the National Institutes of Health (NIH), three mental disorders most commonly comorbid with alcoholism are major depression, bipolar disorder and anxiety disorder.

Alcohol Use Disorder can cause symptoms and behaviors of mental health issues such as depression, anxiety, and psychosis both during intoxication and withdrawal. On the other hand, mental health diagnoses such as depression, anxiety, ADHD, and childhood trauma can create an increased risk of someone developing an alcohol use disorder. Co-occurring diagnoses can occur simultaneously or sequentially, yet it is important to note that there is not always a causal factor between the two. There are also many instances where intoxication and withdrawal look like a psychiatric disorder that is not actually there.  

When seeking treatment for co-occurring issues, it is imperative to treat both and not neglect one of the conditions while focusing on the other. This should be a standard part of every alcohol treatment program as the relationship between the two diagnoses can impact each disorder’s symptom severity and frequency. 

Most common symptoms of a dual diagnosis include:

  • Isolating oneself from family and friends
  • Changes in appetite, such as eating more or less than usual
  • Loss of energy and motivation
  • Trouble concentrating or completing tasks
  • Neglecting personal or professional responsibilities 
  • Increased irritability, anger, or anxiety
  • Rationalizing excessive alcohol consumption

References:

https://www.alcohol.org/co-occurring-disorder/Dual diagnosis. Alcohol Rehab Guide. (2022, February 24). Retrieved March 23, 2022, from https://www.alcoholrehabguide.org/resources/dual-diagnosis/

Facts About Sexual Assault and How to Prevent It

, , , , , , , , , ,

By: Megan Eckles (Therapist/Training Specialist)

What is considered sexual assault?

According to the US Department of Justice, sexual assault is defined as means any nonconsensual sexual act proscribed by Federal, tribal, or State law, including when the victim lacks capacity to consent.

The National Sexual Violence Resource Center mentions that the are several forms of sexual violence, which include:

  • Rape
  • Child sexual assault and incest
  • Sexual assault by a person’s spouse or partner
  • Unwanted sexual contact/touching
  • Sexual harassment
  • Sexual exploitation and trafficking
  • Exposing one’s genitals or naked body to other(s) without consent
  • Masturbating in public
  • Watching someone engage in private acts without their knowledge or permission
  • Nonconsensual image sharing

Who is impacted by sexual assault?

Victims of sexual violence include people of all ages, races, genders, and religions — with and without disabilities.

  • Nearly one in five women in the United States have experienced rape or attempted rape some time in their lives.
  • In the United States, 1 in 71 men have experienced rape or attempted rape.
  • An estimated 32.3% of multiracial women, 27.5% of American Indian/Alaska Native women, 21.2% of non-Hispanic black women, 20.5% of non-Hispanic white women, and 13.6% of Hispanic women were raped during their lifetime (National Sexual Violence Resource Center, 2022).

The Facts:

  • Victims often know the person who sexually assaulted them.
  • People who sexually abuse usually target someone they know.           
    • Nearly 3 out of 4 adolescents who have been sexually assaulted were victimized by someone they knew
    • 1 out of 5 were committed by a family member (RAINN, 2022). 

How to seek help:

National Sexual Assault Hotline:

1-800-656-4673

What can be done?

  • Raising awareness
  • Supporting survivors 
  • Getting involved to help change laws and policies regarding crimes of sexual violence and how survivors are treated

Resources:

https://www.nsvrc.org

https://www.rainn.org

https://www.nsvrc.org/about-sexual-assault

Signs of Child Abuse and How to Help

, , , , , , , , , ,

By: Megan Eckles (Therapist/Training Specialsit)

What are the facts?

  • 1 in 7 children experienced abuse of neglect within the last year (CDC, 2022). 
  • In 2020 Georgia ranked 38th in the nation for child well-being (Georgia Division of Family and Children Services).

Types of Abuse

  • Physical Abuse: injury or death inflicted upon a child by a parent or caretaker other than by accidental means​
  • Neglect: parent or caretaker allows a child to experience avoidable suffering or fails to provide basic essentials for physical, social, and emotional development​
  • Emotional Abuse: parent or caretaker creates a negative emotional atmosphere for the child ​
  • Sexual Abuse: any adult or older or more powerful child employs, uses, persuades, induces, entices, or coerces any minor to engage in any form of sexual intercourse​
  • Endangering a Child: a person intentionally allows a child under the age of 18 to witness the commission of a forcible felony, battery, or family violence, and/or a person knows that a child under the age of 18 is present and sees or hears the act, commits a forcible felony, battery, or family violence (Georgia Division of Family and Children Services).

Warning Signs of Abuse

Mayo Clinic notes multiple signs and symptoms of abuse.

  • Withdrawal from friends or usual activities
  • Changes in behavior — such as aggression, anger, hostility or hyperactivity — or changes in school performance
  • Depression, anxiety or unusual fears, or a sudden loss of self-confidence
  • An apparent lack of supervision
  • Frequent absences from school
  • Reluctance to leave school activities, as if he or she doesn’t want to go home
  • Attempts at running away
  • Rebellious or defiant behavior
  • Self-harm or attempts at suicide

What can I do?

As a mandated reporter, you are required to make a DFCS report. According to GA law, failure to report abuse can be found guilty of a misdemeanor.

How to Report:

Child abuse and/or neglect reports are taken 24 hours a day, seven days a week.

A report can be submitted on online via the portal or by paper and faxed in.

1.855.GACHILD (+1 855-422-4453)

Resources:

Georgia Division of Family and Children Services: https://dfcs.georgia.gov

https://www.cdc.gov/violenceprevention/childabuseandneglect/index.html

https://www.mayoclinic.org/diseases-conditions/child-abuse/symptoms-causes/syc-20370864

http://www.pcageorgiahelpline.org

Overcoming Self-Harm

, , , , , , , , , ,

Self-harm: this is when one hurts themselves as a way of dealing with very difficult feelings.

Some individuals self-harm as a way to:

-express their feelings when it is hard to put into words

-change emotional pain into physical pain

-reduce overwhelming feelings

-punish themselves for their feelings and experiences

-express suicidal feelings and thoughts without taking their own life

Ways individuals self-harm: 

-cutting yourself

-over-eating or under-eating

-biting yourself

-hitting yourself or walls

-pulling your hair

-picking or scratching at your skin

How to overcome self-harm:

  • Learn to recognize triggers: triggers are people, places, situations, sensations, or events that cause specific thoughts or feelings. 
  • Become aware of the urge to self-harm: being able to recognize urges helps an individual take steps towards reducing or stopping self-harm. 

Urges can include:

-strong emotions like sadness or anger

-racing heart or feelings of heaviness

-disconnection from yourself or a loss of sensation

-unhealthy decisions, like working too hard to avoid feelings 

-repetitive thoughts about harming yourself

  • Identify distractions: identify distractions that can help distract the urge to self-harm. 
  • Keep a diary: a diary can help keep track and understand self-harming behaviors. This is useful to keep track of what occurred before, during, and after self-harming. After a period of time, the diary can help spot patterns of self-harming behaviors (Melinda, 2022). 
  • Use coping techniques: to help overcome self-harm, an alternate coping skill needs to take its place. 
  • If self-harm is to express pain and intense emotion: paint, draw, journal, write a poem, listen to music
  • If self-harm is to calm or soothe: take a hot bath, pet an animal, use a warm blanket, massage your neck, hands, and feet, listen to calming music
  • If self-harm is to disconnect or numb pain: call a friend, take a cold shower, hold ice in hand, chew something with a strong taste
  • If self-harm is to release tension or vent anger: exercise, punch a cushion, squeeze a stress ball, rip something up, make noises with instrument, bang pots and pans
  • Seek professional help: trained professionals can help direct towards overcoming cutting or other self-harming habits. 

Client Support Specialist: a CSS can help identify triggers and develop coping skills.

Therapy: a therapist can help explore past or current trauma that may be triggering self-harming behaviors and can assist in helping develop coping skills (Self-harm, 2020). 

Resources

Melinda. (2022, February 7). Cutting and self-harm. HelpGuide.org. Retrieved February 14, 2022, from https://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm

Self-harm 2020 – mind. (n.d.). Retrieved February 14, 2022, from https://www.mind.org.uk/media-a/5783/self-harm-2020.pdf

Understanding Bipolar Diagnosis

, , , , , , , ,

What is Bipolar Disorder?

According to National Institute of Mental Health, Bipolar Disorder (formerly known as manic-depressive illness or manic depression), is a mental disorder that causes and unusual shift in mood, with extreme highs and lows.

Types of Bipolar:

  • Bipolar I 

Having at least one manic episode followed by hypomanic or major depressive episode. Manic episodes lasting at least 7 days or needing immediate hospital care 

  • Bipolar II

Having at least one major depressive episode and at least one hypomanic, but no manic episodes

  • Cyclothymic

Having periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Types of Episodes:

  • Manic

A manic episode is characterized as at least one week of being extremely high-spirited or irritable most of the days, possessing more energy than usual, and at least 3 of the following: 

  • Decreased need for sleep
  • Fast speech
  • Uncontrollable racing thoughts/quickly changing topics while speaking
  • Distractibility
  • Increased activity 
  • Increased risky behaviors 

Some people in manic episodes report psychotic features, such as false beliefs and/or hallucinations.

  • Hypomanic

Hypomanic is characterized with less severe manic symptoms only 4 days in a row versus a week.

  • Major Depressive

Major depressive is characterized by at least 2 weeks where at least 5 of the following symptoms present:

  • Intense sadness or despair
  • Loss of interest in activities the person once enjoyed
  • Feelings of worthlessness or guilt
  • Fatigue
  • Increased or decreased sleep
  • Increased or decreased appetite
  • Restlessness or slowed speech or movement
  • Difficulty concentrating
  • Frequent thoughts of death or suicide

Treatment:

Bipolar Disorder comes with lifelong treatment. Medication is used to balance and stabilize mood. Along with medication, therapy/counseling has proven to be helpful with managing the symptoms of Bipolar Disorder.

Resources:

https://www.nimh.nih.gov/health/topics/bipolar-disorder

https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders

Statistics on Developmental Disabilities

, , , , , ,

Developmental Disabilities are severe and long-term problems. These disabilities can range from mental disability to physical disability or both. 

Physical disabilities include: blindness, hearing loss, multiple sclerosis, epilepsy, etc. 

Mental disabilities include: anxiety disorders, depressive disorder, personality disorders, etc.

Developmental disabilities can also present both physical and mental disabilities, such as, down syndrome (U.S. National Library, 2021)

  • Approximately 15% of children age 3-17, or 1 in 6 children, in the U.S. has some type of developmental disability
  • Many children and adults have more
    than one type of intellectual or developmental disability.
    Each likely to result in a variety of challenges requiring different types of care and services
  • Recent estimates show there are approximately 4.92 million individuals in the U.S. living with an intellectual disability, which is about 17% of the U.S. population
  • Children from families with low income have higher prevalence of intellectual/developmental disabilities
  • People with intellectual and developmental disabilities have been shown to have poorer health and poorer access to health care
  • Males have been shown to have twice the prevalence of any developmental disability than females
  • It is estimated that 30-35% of all
    people with intellectual or developmental disabilities also have a psychiatric disorder (statistics, 2016)

Resources

Statistics. The Achievable Foundation. (2016, March 21). Retrieved February 14, 2022, from https://achievable.org/developmental-disabilities/statistics/

U.S. National Library of Medicine. (2021, November 9). Developmental disabilities. MedlinePlus. Retrieved February 14, 2022, from https://medlineplus.gov/developmentaldisabilities.html

Teen Dating Violence and Prevention

, , , , , , , ,

In the United States, 26% of women and 15% of men who were victims of contact sexual violence, physical violence, and/or stalking by an intimate partner in their lifetime first experienced these forms of violence by a partner before the age of 18-year-old. 

Teen Dating Violence (TDV) is when an intimate partner behaves in physical, sexual, psychological violence or stalking behaviors. 

1 in every 11 females and 1 in every 14 male High School students report having experienced physical dating violence.

1 in every 8 females and 1 in every 26 male High School students report having experienced sexual dating violence. 

  • Physical Violence: hitting, kicking, pushing
  • Sexual Violence: forcing a partner to take part in a sexual act 
  • Psychological Violence: Name-calling, insulting, threatening 
  • Stalking: repeatedly unwanted or threatening phone calls and messages and/or showing up unwanted. 

Teens who are or have been victims of teen dating violence are more likely to:

  • Experience symptoms of depression and anxiety
  • Engage in unhealthy behaviors (Tabacco, alcohol, drugs)
  • Exhibit antisocial behaviors like lying, theft, bullying, or hitting
  • Think about or commit suicide (CDC, 2021)

How to prevent teen dating violence:

  • Look for warning signs: if someone you know starts having multiple injuries, a decrease in motivation, drop in grades, or loss interest in activities could be a result of dating violence.
  • Act on warning signs: if you notice warning signs, act on them. Speak to the individual about getting help through talking to an adult or seeking counsel. As well as using resources such as dating violence hotlines. 
  • Be supportive: it is important for the individual to feel loved and supported, especially when they have been in an abusive relationship.
  • Educate: it is important for teens to be educated and understand what teen dating violence is and the impacts it can have on well-being. It is also important for teens to be educated on the resources available if they experience dating violence. 

Teen violence does not just occur face to face. Teens can experience dating violence through internet services as well (Taylor et al., 2016)

If you or someone you know is experiencing teen dating violence please get help right away. 

Love is Respect National Teen Dating Abuse Helpline 

Call: 1-866-331-9474  or  TTY 1-866-331-8453

National Domestic Violence Hotline 1-800-799-SAFE

Resources

Centers for Disease Control and Prevention. (2021, March 5). Preventing teen dating violence |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved January 17, 2022, from https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teendatingviolence/fastfact.html

Male survivor guide to help men find support and overcome the trauma caused by abuse or assault

https://www.innerbody.com/resource-guide-for-male-survivors-of-abuse-sexual-assault-and-trauma

Dating violence prevention. Dating Violence Prevention | Youth.gov. (n.d.). Retrieved January 19, 2022, from https://youth.gov/youth-topics/teen-dating-violence

Taylor, Maralyn, Kimani, Hannah, & Antoilyn. (2016, February 5). 5 ways to prevent teen dating violence. URGE. Retrieved January 19, 2022, from https://urge.org/5-ways to-prevent-teen-dating-violence/

Human Trafficking Awareness Statistics in the Mental Health Field

, , , , , , ,

Over 21 million people worldwide are victims of human trafficking, with more than 800,000 enslaved each year (Human Trafficking, 2021). In the United States, there have been 11,193 reported cases in 2021. Since 2007, there have been a total of 5,557 reported cases in the state of Georgia. That is around 396 human trafficking victims per year in Georgia alone (Georgia, 2021).  

Human Trafficking: is defined as the recruitment and movement of people using deception and coercion for exploitation.  

Over half of human trafficked survivors receive mental health services. The most common mental health problems associated with trafficking can be: 

-Depression 

-Anxiety 

-Post Traumatic Stress Disorder (PTSD) 

-Self-harm 

-Suicide attempt 

These mental disorders are influenced by pre-trafficking abuse, the duration of exploitation, violence, restriction from movement, a significant number of unmet needs, and no social support.  

As a mental health provider, these are the things to look for in potential trafficking victims: 

  • The client discloses trafficking to a mental health provider 
  • The client has signs of physical and psychological trauma  
  • The client is unable to speak the local language 
  • The client is unable to provide essential identity documents (license, passport, birth certificate) 

Mental health care workers who work with trafficked victims should: 

  • These clients should be routinely asked about current or past experiences of abuse.  
  • Risk Assessment  
  • Safety Plan that includes the risk of re-trafficking 
  • Should explore past emotions such as fearfulness, guilt, shame, hopelessness, anger, easily startled, self-harm, and suicidal ideation.  
  • The treatment for clients who have survived human trafficking should be in line with those clients who have experienced trauma. Evidence-based interventions for PTSD or trauma-focused cognitive-behavioral therapy can help treat survivors of human trafficking. Along with assistance in social, financial, and legal support, help with regulating emotions and coping with dissociation (Altun et al., 2017).

References 

Altun, S., Abas, M., Zimmerman, C., Howard, L. M., & Oram, S. (2017, February 1). Mental health and human trafficking: Responding to survivors’ needs. BJPsych international. Retrieved December 16, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618827/

Georgia. National Human Trafficking Hotline. (n.d.). Retrieved December 16, 2021, from https://humantraffickinghotline.org/state/georgia

Human trafficking. Human Rights First. (n.d.). Retrieved December 16, 2021, from https://www.humanrightsfirst.org/topics/human-trafficking

Most Common Mental Health Diagnoses

, , , , , ,

In the United States, 52.9 million adults experience a mental illness, and 7.7 million youth ages 6 to 17 years old experience a mental health disorder. The most common of these mental health disorders are anxiety disorders. In the United States, over 40 million adults have one or more anxiety disorders. For children ages 3 to 17 years old, 7% have experienced an anxiety disorder (Mental Health Conditions, 2021).  

The four most common types of anxiety disorders are: 

  1. Generalized Anxiety Disorder (GAD): This is chronic, exaggerated worrying about everyday life. GAD can cause exhaustion from worry, headaches, tension, and nausea. GAD is the most common type of anxiety disorder. 
  2. Social Anxiety Disorder: This is intense fear about social interaction, often driven by irrational worries about humiliation. Panic attacks are a common reaction to anticipated or forced social interaction.  
  3. Panic Disorder: This is characterized by panic attacks and sudden feelings of terror that sometimes come without warning. A panic attack causes physical symptoms such as chest pain, heart palpitations, dizziness, shortness of breath, and an upset stomach. 
  4. Phobias: This is where you tend to avoid certain things or situations that make you uncomfortable or even fearful. An individual with a phobia, certain places, events, or objects creates a powerful reaction or strong, irrational fear.  

All anxiety disorders have a unique set of symptoms, but they all have one thing in common: persistent, excessive fear or worry in situations that are not threatening. Other symptoms may include: 

Emotional symptoms: 

  • The feeling of apprehension or dread 
  • Feeling tense or jumpy 
  • Restlessness or irritability 
  • Anticipating the worst and being watchful for signs of danger 

Physical symptoms:  

  • Pounding or racing heart and shortness of breath 
  • Sweating, tremors, and cramps 
  • Headaches, fatigue, and insomnia 
  • Upset stomach  

The cause of anxiety disorders is believed to be a combination of factors. These factors can include genetics, environment, or a combination of both.  

Genetics: Anxiety disorders can run in families. Some families have a higher-than-average amount of anxiety disorders among family members. Therefore, genetics could be the cause of an individual’s anxiety disorder.  

Environment: Stressful or traumatic events such as abuse, death of a loved one, violence, or prolonged illness are linked to the development of an anxiety disorder.  

Treatments that are most common for all anxiety disorders include: 

  • Psychotherapy, which includes cognitive therapy 
  • Medications, including antianxiety and antidepressant medication 
  • Complementary Health Approaches which include stress and relaxation techniques (Anxiety Disorders, 2021).

References 

Anxiety disorders. NAMI. (n.d.). Retrieved December 20, 2021, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Anxiety-Disorders

Mental health conditions. NAMI. (n.d.). Retrieved December 20, 2021, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions