Make Mental Health Your Priority Every Month

By Felicia Wong, M.D



As the month of May comes to an end, make a promise to yourself that personal mental wellness will remain a daily priority.  Mental Health America has been working for 100 years to promote well-being for all Americans and recently developed a resource called 10 Tools to Live Your Life Well based on extensive scientific evidence.

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. 

These "10 Tools" provide proven, healthy ways to cope with stress and boost your overall well-being.  Make a commitment to follow this list and feel more relaxed, fulfilled, and focused long after Mental Heath Month is over. . .  

1) Connect with Others. People who feel connected are happier and healthier--and may even live longer.

2) Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.

3) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

4) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Create Joy and Satisfaction. Positive emotions can boost your ability to bounce back from stress.

7) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

8) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

9) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

10) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 

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Posted in: anxiety,balance,coping,depression,exercise,faith,Felicia Wong MD,getting help,happiness,health,healthy eating,mental health,mood,sleep,therapy,worry

Yoga Helps Heal Heart & Emotional Scars of Cancer

By Felicia Wong, M.D.

“Cancer is a very alienating and existential disease. I know of no other common disease that immediately causes so much fear, anxiety, depression, confusion, and a sense of impending disaster in a patient or his/her significant others when they hear the word “cancer” for the first time.” --- Murray Krelstein, MD, a psychiatrist and cancer survivor.

Although oncologists, family members, and friends can provide significant sources of support, adding a mental health professional to a cancer patient’s treatment team is often helpful. Talking about the emotions and worries associated with cancer can be difficult, and it is important to have a therapist who is familiar with these situations. Additionally, cancer patients and survivors often suffer from sleep disorders, depression, anxiety, fatigue, and other mood changes.

Researchers at the University of Rochester Medical Center found that among patients receiving chemotherapy, over three-quarters suffer from insomnia. Those who suffer from insomnia are, in turn, more likely to suffer from fatigue and depression. For 65% of cancer survivors, insomnia continues even after the completion of chemotherapy.

Cancer is a diagnosis that affects both body and mind. So, it makes sense that cancer patients and survivors practice yoga to improve their quality of life.

While research on the use of yoga for cancer is relatively new, there have been recent studies confirming yoga’s mental health benefits. A Harvard Health Publication highlights the benefits of yoga for stress, depression, and anxiety:

- By reducing perceived anxiety, yoga appears to adjust stress response systems. This, in turn, reduces heart rate, lowers blood pressure, and can make breathing easier.

- There is evidence that yoga practices helps increase heart rate variability, an indicator of the body's ability to respond to stress more flexibly.

Optimizing wellness after a cancer diagnosis and beyond involves a complex integration of interventions that address both the mind and the body. Ideally, a psychiatrist is part of the cancer treatment team. However, if this is not available, please ask your doctor for referrals.

For additional resources on coping with cancer:

http://www.cancersupportivecare.com/live.html

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Posted in: anxiety,balance,coping,Felicia Wong MD,heart health,meditation,mental well-being,mood,stress,worry,yoga

Talking To Kids About Disappointment In Sports

By Claudia Reardon, M.D.



Participating in sports is generally thought of as a physically and emotionally healthy activity for children and teenagers. However, it is inevitable that children who play sports will at some point deal with disappointment. Not every play or game will go their way. While dealing with this disappointment can be difficult for children, it's also a great opportunity for growth. The excitement of the Super Bowl and other winter sporting events provide a chance to talk with your children about disappointment.

Here are some tips to keep in mind if you parent or coach a child or teenager who is dealing with disappointment in sports:



1. Acknowledge your child’s feelings about what happened. For example, you can say, “I understand that you are feeling really upset that you didn’t win the race.” Of course, this does not mean that you should agree with catastrophic statements that they might make, such as that they are the worst player that ever played or that their life is ruined because of a bad game.



2. It’s okay if kids don’t want to talk about a disappointing game or event immediately. You might simply acknowledge their feelings and tell them that you’re there for them to talk whenever they want to.



3. Help your children shift focus to what they did RIGHT on the playing field. This is especially important if your child is a perfectionist, in which case he or she is likely to focus on the one mistake rather than seeing the “big picture” of everything he or she has done right.



4. It’s certainly okay if your children’s disappointment leads them to want to improve their sports skills. Help them figure out exactly what skill they would like to improve, and then brainstorm ways to improve in that area. They might even ask for suggestions from the coach. Help your children set realistic goals and then give them praise as they work toward those goals.



5. Ask your children if they think their favorite athletes ever make mistakes in their sport. If these athletes said that they were terrible players and wanted to quit after one bad play or bad game, would your children agree with that? Of course not!



6. Disappointment is a great opportunity to reinforce resilience and determination. Remind your child that he or she is “the kind of person who doesn’t give up easily.”



7. If a child is disappointed in his or her sporting performance, that is not an excuse for poor sportsmanship. It is not okay for them to express their disappointment as anger toward the winner.



8. Remind your children that failing to make a good play or to win a game does not mean that they’re a failure overall. There still are lots of great things about them, and everyone fails sometimes. Remind them of all the things they have done well recently.

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Posted in: caregivers,children,Claudia Reardon MD,coach,coping,disappointment,parenting,sports,teens

Raising Awareness About Stuttering and Speech Disorders

By Adair Parr, M.D.



The Oscar nominations were recently announced and one particular movie in the best picture category is a film which addresses a common problem: stuttering. The King’s Speech depicts the courageous efforts of King George VI of Britain, played by actor Colin Firth, to overcome a stutter which first began when he was a young boy. Although many films have featured characters who stutter, this is the first film to focus on the process of someone overcoming speech difficulties.



The King’s Speech highlights the speech therapy that the king went through to overcome his stutter. The movie aptly demonstrates his frustration with prior attempts at speech therapy. His work with Australian speech therapist Lionel Logue, portrayed by actor Geoffrey Rush in the film, allowed him to move beyond the previous failures that he had in speech therapy and to achieve success. The story is particularly inspiring as you watch this man deliver a powerful speech to the British people on the brink of World War II. Hopefully, the movie will result in less stigma about stuttering.



Here is a video of His Majesty King George delivering his actual speech on Sept. 3rd, 1939.

Stuttering is a type of speech disorder which affects the fluency of speech. Stuttering is a fairly common phenomenon. Approximately 1 percent of children stutter, and up to 5 percent may display transient stuttering. Stuttering begins during childhood, typically between ages 2 and 4 and may last throughout life. It may involve repetitions of words, prolongation of speech sounds and blocked sound.

What should you do if your child has a stutter or other speech disorder? It is recommended that you seek an evaluation from a certified speech-language pathologist. Your pediatrician, physician or school system may help you find local resources. More information on stuttering is available at the American Speech-Language Hearing Association website.

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Posted in: Adair Parr MD,children,coping,speech,stuttering

When Divorce Happens

By Gariane Gunter, M.D. 



A recent study was published in Health Day that discusses the mental health of children of divorced parents. While I am not in the position to support or deny the findings, the topic of divorce when children are involved is often a difficult one. Every family is different, but the following are some general tips for divorcing parents that can be helpful.



1. Attempt to keep a positive attitude during the point of separation. This is often a very trying time for the family. Stick to a routine and embrace the activities your children have always enjoyed.

2. Don’t forget to nurture yourself. Going for a walk, having coffee with a friend, or reading a good book are ways to rest and regain energy. It’s normal to feel exhausted when separating; and possibly for many months to follow.

3. Encourage kids to openly discuss their feelings, positive or negative, about what's happening.

It's important for divorcing, as well as already divorced parents, to sit down with their kids and encourage them to say what they're thinking and feeling. But you'll need to keep this separate from your own feelings. Most often, children experience a sense of loss of family and may blame you, the other parent, or both of you for what is going on in their lives. You really need to be prepared to answer questions your kids might raise. They might feel guilty and imagine that they "caused" the problem. Kids and teenagers may feel angry or frightened, or worried about their future. Counselors can assist with this difficult conversation and provide a safe environment if safety is a concern.

4. Although very tempting, try not to speak negatively about your former spouse when your children are present. This issue, often called “parental alienation” can be a problem. Doing things such as putting your child in the middle, saying negative things about the other parent, and using your child as a messenger puts your child in a “no win” situation and creates lifelong relationship issues for all involved. The reasons include the following:



• The comments may confuse and frighten children.

• Many of your concerns about your former spouse are difficult for you to express. It is very important that you keep these concerns to yourself. Children just do not have the emotional maturity to withstand information/situations that adults find stressful.

• Your child’s identity and self concept is based on parental behavior. Even if it is next to impossible to say anything good about your former spouse, try to do so. If this is impossible then don’t say anything.

• Children love to eavesdrop. Telephone conversations are their favorite snooping ground. Make all effort to not discuss your divorce-related difficulties on the telephone when your children are around.

5. During the crisis point of separation try to remember that your children need you both parents more than ever. This is not a time to deny access unless a professional deems it necessary to do so for safety related reasons.

6. It is important to accept the fact that a separation involves feelings of loss for children. Try not to panic if the following behaviors occur during the first few months of separation:

• Sleep difficulties like disrupted sleep, an inability to sleep, exhaustion etc.

• Social isolation

• Anger, intolerance, grumpiness

• Avoidance of divorce related conversations

• Obsessing about the divorce

• Appetite changes

• Feelings of worthlessness

• Tears and feelings of overwhelming sadness

7. Although many children do not ask to see a counselor when their parents separate, they usually find counseling very helpful.

8. It is important to acknowledge that children are very loyal and protective of their parents. If children are placed in loyalty binds they can experience anxiety. Try to alleviate their anxiety if they decided to “pick a side.” This is a coping skill which teens in particular use. If your child engages in “picking a side” try not to feel rejected.



9. Think of yourself as a survivor not a victim. And be patient. Everyone takes different times to heal.

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Posted in: children,coping,crisis,divorce,Gariane Phillips Gunter MD,getting help,teens,women,worry

Shootings Stir Emotions, Call for Access to Affordable Care

By Molly McVoy, M.D.



The tragic shooting in Arizona has spurred many emotional headlines and provocative stories in the news. News stories have used the words “insane,” “coldblooded,” “bizarre,” “evil” and “troubled.”



Whenever tragedies such as this occur, emotions are stirred and people often look for clear answers. Unfortunately, tragedies like this do not have easy answers. Whether or not mental illness is involved in this case, this may be a moment to look at every way to reduce the risk of another tragedy such as this in the future.



Rep. Giffords



U.S. Rep. Gabrielle Giffords, currently in an Arizona hospital as a result of the shooting, is a friend to the National Alliance for Mental Illness (NAMI) and has served as co-chair of several fundraisers for NAMI in Southeast Arizona.



There are so many ways in which the mental health system in the United States is broken. Treatment is often hard to access and expensive. Consistent treatment is often nearly impossible for those with severe mental illness. Advocating for improved access to quality mental health care is critically important at a time like this.



In addition, it is also important to remember that the likelihood of violence from those who struggle with mental illness is very low. Most of the violence perpetrated in this country is by individuals without mental illness. Most individuals suffering from mental illness are not violent.



No matter the cause, a time like this calls for reflection and action: examining all the factors that can be changed to minimize the risk of something like this happening in the future.

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Posted in: coping,crisis,Molly McVoy MD,NAMI

Coping with Stress in America

By Adair Parr, M.D.

A survey by the American Psychological Association highlighted the negative impact that stress can have on families and children. This is an extremely important topic that affects many family caregivers, who are under a great deal of stress taking care of loved ones. More and more Americans are affected by stress. The survey indicates that many Americans feel that they are experiencing unhealthy amounts of stress. The economy is one of the main reasons. Fewer are satisfied with the ways that their employer helps employees balance work and non-work demands and many are concerned about job stability.

In addition, stress impacts the entire family. Children recognize when their parents are stressed and that could make them feel sad and worried. Nevertheless, parents frequently underestimate the impact that their own stress has on their children.



Stress affects both our mental and physical health. Some people manage stress by smoking, drinking or over-eating. That can lead to bigger problems. The study shows that Americans understand the importance of healthy behaviors like getting enough sleep, exercising and eating healthy. However, lack of time and motivation gets in the way of following through on these goals. Willpower was identified as a barrier to many healthy behaviors, even when they are recommended by a health care provider.

Managing your stress is extremely important. Stress does affect the family members you care for. There are healthy ways to manage your stress. Some suggestions are: exercising or playing sports; listening to music; spending time with friends and family; going to religious services; journaling; and practicing yoga / meditation. 





If you find that you are overwhelmed or suffering physical symptoms from stress like headache, poor appetite and insomnia, or if you are feeling depressed or suffering from chronic irritability and crying spells, you may need to see a mental health provider. The Healthy Minds website has brochures about dozens of mental health issues including early warning signs of mental illness.

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Posted in: Adair Parr MD,anxiety,caregivers,children,coping,family,mental health,stress

Reading, Writing and Anxiety? Helping Children Make the Transition Back To School

By Adair Parr, M.D., J.D.



The arrival of September signals back to school for most children. It is an exciting time of year, as it means meeting new teachers and classmates, starting fall sports and getting back into the swing of the classroom. Most children have some degree of anxiety about starting school, especially when they are just starting school, entering middle or high school or are changing schools.



Despite such worries, many children adjust to a new school year fairly easily. Other children have some initial anxiety, which they overcome in the first days or weeks of school. These feelings are particularly common among elementary school children but may be experienced by middle school or high school students as well.



School-aged children and even teenagers may express feelings of anxiety through frequent headaches or stomachaches, rather than overt worries about school. For tips on how to help transition your child to the new school year, see “The ABCs of Starting School” on Healthy Minds.



When should you seek help if you suspect that school is making your child anxious?




For some children, feelings of anxiety associated with back to school interfere with functioning either at home or at school or socially. If your child continues to have difficulty with school more than a month after school has started, it is important to seek help.




*Talk to your child’s teacher or counselor to see what they have noticed.



*If your child has significant physical symptoms, like recurrent headaches or stomachaches, schedule a visit to the pediatrician.



*Talk to your child and ask whether anything is happening at school that frightens them or worries them.



*Ask your child about bullying, which may be contributing to your child’s anxiety.



After exploring these concerns, some children will need further help and may require a visit to a mental health professional for an evaluation. A school counselor or pediatrician can help with a referral if this is the case. A child’s main job is to learn; untreated anxiety can interfere with social and academic development.



Anxiety is commonly treated with cognitive behavior therapy but some children require medication. By being attentive to the many changes associated with starting school, you can help your child with this important transition.

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Posted in: Adair Parr MD,children,coping,family,teens

“What do I tell my kids?” Tips for talking to children about the Gulf Oil Spill

By Molly McVoy, M.D.





I did a quick Google search of kids and the Gulf oil spill, and I found everything from “Why are they killing all the birds and sea turtles?” to resources for environmentally minded children on how to start an environmental action plan of their own.





The oil spill in the gulf coast has many worried, from children through adults. The resources for how to talk to them are varied and sometimes confusing. Below are some basic tips for talking to children about the oil spill threatening the gulf coast.





Talking to your children about disasters can be challenging. Children ask tough questions and it can be difficult to know how best to answer them. However, times like this, during disasters, can be a golden opportunity with your children. When current events are scary or confusing, it can be a great opportunity for parents to show their children that there are people to help them and the country get through them.





The best advice I can give for talking to children about anything, but disasters in particular, is this - be honest, be simple and repeat, repeat, repeat. Don’t force your child to talk about the oil spill, but, if they ask, tell them the truth in language that fits with their age. Children know if they’re being told the truth, so answer them as simply and straightforwardly as you can. But, being a child, they will likely ask again and again (and again!). It’s okay if you have to repeat yourself, it’s the open dialogue and the reassurance that children are looking for during times of crisis.





So, as Bill Cosby said of fatherhood “You just need a lot of love and luck - and, of course, courage.”

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Posted in: children,coping,crisis,disaster psychiatry,Molly McVoy MD,natural disasters,parenting,television

RELAX: Feel the stress melt away

By Felicia K. Wong, M.D.



The winter snow may still be months away from melting, but now that the hubbub of the holiday season has passed, it’s time to rest, relax and de-stress!



Easier said than done right? For many of us, finishing one project just means we can start the next. We live in a fast-paced society where there is a lot of pressure (both external and internal) to “go-go-go”. In other words, we live in a world that is full of stressors and stress.



Our body responds to stress by producing stress hormones. These hormones help you respond to “fight or flight” situations and historically helped our ancestors run to safety from lions. However, these days there are (usually) no lions to run from and instead, when the body is chronically stressed, these hormones can take a toll on physical and mental health. People who are under a lot of stress are often emotional – anxious, irritable and depressed.



Ideally, you can try to change the situation that is causing your stress. But if the situation is fixed, there are relaxation methods that can be useful strategies to cope with stress.



Relaxation is a skill. It is something that we are not necessarily born knowing how to do. Good news! Relaxing techniques can be learned and practiced.



I’d like to share with you a relaxation technique called Progressive Muscle Relaxation (PMR). This is a great way to reduce overall body tension. Here is a video to introduce the practice and help you get started:





Each person will find for themselves unique ways to relax – be it through exercise, yoga, music or meditation. PMR is just one strategy. There is no right or wrong way to relax, and no one technique that will work for everyone. So, find out which ones work the best for you and get started!



Before practicing PMR, consult with your physician if you have a history of serious injuries, muscle spasms, or back problems, because the deliberate muscle tensing of the PMR procedure could exacerbate these pre-existing conditions.

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Posted in: anxiety,coping,depression,Felicia Wong MD,stress

Coping During Disasters

By Gabriela Cora, M.D., M.B.A.





The earthquake in Haiti hit the most impoverished nation in the Western hemisphere. A land already struck by hurricanes, the loss of life in the thousands magnifies the catastrophe exponentially. What to do onsite and what to in the States when family members worry about loved ones?

Aside from the physical devastation caused by natural disasters, the psychological short and long-term impact may be even more damaging. Keeping up to date with the latest news while not overdoing this all day long will help you cope with the situation. 





Additionally, taking control of simple habits, accepting help, eating, drinking clear water and having some sleep will help through the difficult aftermath. One particularly challenging area is keeping children safe both physically as well as psychologically. As an adult in charge of your own children or caring for other children during a disaster, it’s most important to provide for physical safety, keep them busy helping out others, if they can, and allow them to share their fears and worries. 

Visit Switchboard Miami for additional hotline assistance, available in Creole.

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Posted in: coping,disaster psychiatry,Gabriela Cora MD,natural disasters,parenting,tragedy

Too busy to relax?

By Gina Newsome Duncan, M.D.



For most of us, stress is a part of everyday life—at home, at work, during our commute. Even going on vacation can be stressful. Stress not only has a psychological effect. It also has a physiological effect. That is, it affects us physically, leading to direct changes in our heart rate and blood pressure, and over time, our risk for certain illnesses such as heart attacks and strokes.







Stress also plays a significant role in anxiety, depression and other mental illnesses. This is detailed in the book The Relaxation Response, by Dr. Herbert Benson, a Harvard physician and expert in Mind/Body medicine.



Relaxation, the antidote to stress, can often seem like a luxury. How many of us picture a hot bubble bath complete with scented candles and soothing music, or a long walk on a sun-soaked beach as the perfect way to relax? The problem is that most of us don’t have time to do these things on a regular basis. When you’re in the midst of a crisis, or have a deadline looming at work, it’s not always possible to take an extended break.



The good news is that there are steps we can take psychologically to improve how we feel physically. With practice, you can learn how to relax anywhere and in any situation.



Some of the most common relaxation techniques are:

1. Deep breathing

2. Progressive muscle tension and relaxation

3. Guided Imagery/Visualization

4. Mindfulness



If you have a moment, try this simple exercise right now:



Sit in a comfortable position, either reclining slightly or laying down.

Take a deep breath in while slowly counting “one-thousand-one, one-thousand-two”. Then exhale, while counting “one-thousand-one, one-thousand-two, one-thousand-three, one-thousand-four”. Repeat this for several minutes.



Next, while maintaining a slow, regular pace of breathing, move on to progressive muscle tension and relaxation. This means tensing and relaxing the different muscle groups of your body one at a time. For example, start with your feet, curling your toes under… holding…and then relaxing. Then move on to your legs, stomach, etc, until you have worked your way up to your head.



How did that feel? Don’t worry if you couldn’t relax right away. It takes practice!



Most major bookstores and entertainment stores carry relaxation CDs that incorporate the breathing and muscle relaxation techniques described above. Combined with guided imagery and soothing music, these CDs can be a great way to learn the relaxation response if you don’t feel confident doing it on your own. A quick Google search can also pull up many websites with different types of relaxation exercises, suggestions, and even video.



The best thing is that this can take as little as 5 minutes and can be done anywhere—at your desk or while parked in your car—anytime you need to recharge.



Taking time to relax is not a luxury, it’s a necessity!

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Posted in: anxiety,coping,stress