Living Well May June 2016

mental health

using the whole health approach back pain linked to depression enhancing empathy in kids

May/June 2016

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May/June 2016 ~ living well

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May/June 2016 VOL. 35

in this issue

enhance empathy in babies pg. 6

risk of back pain increases with depression pg. 10

mental health whole health & mental illness pg. 12

PTSD can affect anybody pg. 14

also inside be present in your life pg. 20 suicide rates soar pg. 30 dealing with the blues pg. 34

we all feel anxious sometimes pg. 22

tame that temper pg. 28

May/June 2016 ~ living well

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Enhance empathy & compassion in babies

N

ew expectant parents have fantasies of what a future child’s personality will be like; perhaps cute, charming or even strong-willed. Very few people ever imagine them becoming cruel or being a bully.

Yet it happens.

First and foremost, empathy and compassion are essential elements for building enduring relationships. However, this becomes difficult when children are exposed to a constant stream of compassionless situations while watching television, playing video games or interacting on social media.

To understand more we need to look at early brain development. Scientists know that very early on fetal tissue is largely a group of undifferentiated cells and those cells develop into particular cell lines. We know that brain development goes on well past the age of two, and more likely far into adulthood.

However, early traumatic and neglectful life experiences can influence how that young brain develops. These are called epigenetic changes, the changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself. Epigenetics are an example of how actual life experiences can alter the structure of the brain on a microscopic level. Brain imaging suggests that areas of the brain responsible for understanding the minds of others are part of what is effected during these early painful life experiences.

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Describing the science of attachment theory in all its nuances could easily fill a library but in a nutshell: Let’s think of children as developing in one of two categories, either securely attached or insecurely attached.

What is the recipe for a securely attached child? Typically, when mothers and fathers hear their babies cry they respond with “oohs” and “ahs” and reciprocate with some response, which lets the baby know that his joy or pain is recognized.

Done repeatedly, the child begins to see themselves as a separate individual and that they have some control over themselves with the help of a loving adult. This exercise isn’t simply a playful experience with a child; it becomes the basis for forming relationships later on. Therefore, when this normal back and forth through father and mother and baby occurs much of the time, a child tends to develop the secure attachment and those children tend to be pretty resilient and do well.

But what happens when this back-andforth between parents and babies goes awry? Maybe the parents are depressed or anxious or preoccupied with severe stress or drug and alcohol use? In these cases, the typical back and forth reciprocal interaction between parents and baby

By Dr. Stephen Mandler and Chelsea Mandler

May/June 2016 ~ living well

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Getting children to imagine how their behaviors affect others takes work and time.

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living well ~ May/June 2016

is interrupted, and there’s evidence to show that when this repeatedly happens that cognitive development is disrupted, and it then can affect the child’s thinking in specific ways especially in a manner that affects the understanding of themselves and others. Child psychiatrists and psychologists call this persistent failure to have back-and-forth interactions between the baby and parent a disruption of attachment.

Brain scientists have good reason to believe that the strength of the connections between the deeper primal emotional regions of the brain to the parts of the brain that control thinking, planning, socialization and emotional regulation is affected by this disruption of attachment.

Mental health professionals refer to the idea known as “Mentalizing or Mentalization.” This involves the ability to predict generally someone else’s behavior or emotions based on personal beliefs about the other person. This also is related to our own ability to self-reflect on emotions and actions.

For example, my young son has developed a knack for knowing how to play a joke on me of which he finds it quite funny. Mostly because he can pre-anticipate how I might react. That is mentalizing. Another child with less developed mentalizing abilities might laugh out loud when he sees a stranger trip over a rock instead of rushing to ask how the person is doing. These undeveloped mentalizing skills can land a child or adult in a heap of

trouble, especially when it comes to making friends or knowing how to please parents. “Successful” teens learn that happy parents will bestow them with more trust and with that usually comes more freedoms.

Why is this concept of mentalizing important for parents to think about? Through a specific approach or stance that we take with children, we can actively enhance this mentalization capacity. During my time as medical director of Yellowstone Boys and Girls Ranch, we systematically applied this mentalizing-based approach toward the youth in our care with significant results. We saw marked improvements in children’s ability to show care and concern for others. They often started as very self-centered and angry youth; by the time of discharge they were going out of their way to do kind things for other people. Because they put more thought into the minds of others they had fewer outbursts of aggression toward their peers. Many of the children who completed treatment left with much lower doses of psychiatric medication and in some cases were able to get off of medications completely.

Getting children to imagine how their behaviors affect others takes work and time. Emerging evidence suggests that mentalization-based treatments may be a very powerful approach that could lead to happier kids and young adults who feel good about themselves and want to contribute positively to the world around them.

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May/June 2016 ~ living well

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Have depression?

By Brooke Tran, DPT

I

t is no secret that chronic pain can contribute to feelings of depression. Surprisingly, however, new studies show that the reverse also is true.

Depression is very common: 121 million people suffer from it worldwide. In fact, according to the World Health Organization, by the year 2030 depression will account for the highest level of disability among all diseases1. Another very common problem is low back pain, which is reported to affect 80 percent of people during some time in their lives.2 Due to the high incidents of both of these conditions, recent studies have begun to examine the relationship between depression and low back pain. These studies found that individuals who report symptoms of depression are at a higher risk of developing back pain in their lifetime.1 To clarify, an individual may have no symptoms of low back pain during the time they report symptoms of depression. Simply expressing the symptoms of depression appears to indicate that individual

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living well ~ May/June 2016

Your risk of experiencing low back pain increases is more likely to experience back pain at some point in the future as compared to someone who does not exhibit symptoms of depression. Current studies are unable to show a direct causation between depression and low back pain, though the more severe the symptoms of depression, the higher the likelihood of future incidence of low back pain.

At this time, the possible reason for this correlation is not well understood. Proposed theories include neurophysiological changes at the level of the brain, as well as risk factors for low back pain that are secondary to depression including decreased activity and social participation, as well as impaired sleep.

As a health care professional, understanding the link between depression and low back pain is important. First, because if someone presents with symptoms of depression they should be educated about the importance of physical activity to reduce possible occurrence of low back pain in the future. Second, if someone is being treated for low back pain, and also has symptoms of depression, they likely will require the collaborative care of both a medical and mental health care approach to resolve symptoms.

Physical therapists play a vital role in this team approach, effecting outcomes in a variety of ways. First, a physical therapist can help an individual with depression develop an exercise program to help prevent the onset of low back pain, as well as to decrease symptoms of depression. Studies have shown that for individuals with depression, participation in a physical therapist guided aerobic exercise program results in reported improvements in perceptions of physical ability and in creating a sense of liveliness, improving their depressed state.3 What’s more, in those who are suffering from low back pain, regular physical activity has been shown to reduce missed work days by 50 percent.2 By promoting function and helping individuals participate in safe and appropriate physical activity, physical therapists can help people stay active, healthy and happy.

References: 1.

2.

3.

Pinheiro, M, et al. Symptoms of Depression and Risk of New Episodes of Low Back Pain: A Systematic Review and Meta-Analysis. Arthritis Care and Research 2015; 67(11): 1591.1603.

Kellett, K, et al. Effects of an Exercise Program on Sick Leave Due to Back Pain. Physical Therapy 1991; 71 (4): 283-291.

Danielsson, L, et al. “Crawling Out of the Cocoon”: Patients’ Experiences of a Physical Therapy Exercise Intervention in the Treatment of Major Depression. Physical Therapy 2016; 96 (2).

May/June 2016 ~ living well

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Whole health and mental illness

By Kay Jennings

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ecently, I was treating a young man with a diagnosis of bipolar disorder. He was in the mental health and Medicaid system since he was a teenager. He was a new patient to me so I ordered extensive blood work to assist me with identifying other underlying conditions that could be affecting his mood. We reviewed the lab results together and several issues came up that could potentially shorten the quality and length of his life. We discussed the interventions together and the lifestyle changes that he could make. At the end of the appointment he stated: “Don’t forget that I have a mental illness.” In his many years of treatment, he had never had a mental health practitioner actually look at his physical health.

According to The Kaiser Commission on Medicaid and the Uninsured, many individuals seeking behavioral health care also have physical conditions that require medical attention.

A 2006 report from the National Association of State Mental Health Program Directors cited research showing that adults with serious mental illness die, on average, 25 years earlier than the general population. The diseases that are killing this group as well as Americans in general are preventable conditions: cardiovascular diseases, obesity and diabetes. These are conditions that I see daily in my practice and they are easily reversed by utilizing lifestyle interventions consisting of diet, exercise, reducing toxins, reducing stressors, managing hormones and cleaning up the gut.

In an effort to help reverse these outcomes I have been trained in functional integrative medicine and psychiatry.

Both of these specialties utilize the concept of root cause of diseases and look to the interconnectedness of the brain and the body.

A typical approach in functional psychiatry is to establish a partnership with the client. This is critical to recovery and maximal whole health. Then the appropriate diagnostic labs are ordered.

Common findings and related symptoms identified by proper lab tests, which I have seen in my practice, are lipid problems, poor blood sugar regulation, adrenal stressors, hormonal imbalances, poor oxygenation of brain, poor utilization of nutrients, nutritional deficiencies, gluten sensitivity and inflammation in the body and brain. Once this screening is complete, the lifestyle interventions that are needed for recovery are discussed.

In my practice, a prescription for whole health consists of eating a mainly whole foods diet, enrollment in the nutritional education, shopping and cooking classes, exercise evaluations and trainers to supervise exercise, all of which are offered by our mental health center.

Typically, a patient in my practice will present with vitamin D deficiency, thyroid problems (often times undiagnosed Hashimoto’s), overweight or obesity issues, lipid problems and blood sugar regulation problems.

Their diet will consist of processed refined foods, they get

little proper interval or resistance exercise, and they have modifiable risks factors such as smoking or drinking soda excessively. Once they receive a written prescription for wellness, they quickly enroll in the program and the results have been amazing. Many, if not all of their symptoms improve, weight is lost and they have a better quality of life.

By improving the health of this population, the cost burden, to us as a society, is reduced. More importantly, the quality of life for people suffering from severe disabling mental illness is greatly improved.

Through this functional, integrative whole health approach, I have seen lives dramatically changed daily. I am so inspired by the power of simple lifestyle interventions that I have committed my professional life to sharing this message of hope.

Kay Jennings owns and operates New Health, Aleph PC and Winds of Change Mental Health Center in Missoula. She also owns and operates Frontier Assisted Living Community in Livingston. Jennings is the only Certified Functional Integrative Medicine and Psychiatry practitioner in the western Montana region.

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May/June 2016 ~ living well

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PTSD intrudes on civilians as well

By Mike Tighe, LaCrosse Tribune

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living well ~ May/June 2016

P

ost-traumatic stress disorder, widely regarded as a military malady that affects service people who can’t erase images of death and destruction in war zones from their memories, actually casts a wider net that snares people in all walks of life and of all ages, Coulee Region medical experts say.

Although the term PTSD was coined only 101 years ago, conventional wisdom now is that this stress-borne brain disruption probably can be traced to the beginning of humanity.

Depending on your historical perspective, that could have been when Adam and Eve were cast from the Garden of Eden or when saber-toothed tigers terrorized cave dwellers.

You can believe this, though: Estimated rates of people afflicted with PTSD at one time in their lives range from 3.5 percent to 10 percent of the population.

The impression that PTSD cases are increasing may be attributed to several factors.

“I think people are more aware of PTSD, and physicians are doing a better job of catching the disorder,” said Lisa Howell, who has a doctorate in clinical psychology and works in behavioral health at Mayo Clinic Health System-Franciscan Healthcare. “But it is also an increase in traumatic occurrences.”

“Traumatic occurrences” are a wide range of experiences, including car accidents; witnessing the deaths of loved ones or even strangers; observing and/or experiencing physical, sexual and verbal assaults or abuse; crimes such as mugging, robbery or home invasion; terrorist attacks even far removed; and natural disasters.

PTSD depends on another perspective — the view of the person afflicted, the medical practitioners say.

“It’s about the experience that the person had rather than the result,” said Marcia Dunn, a behavioral health specialist for Gundersen Health System.

The reaction can depend on one’s age and sphere of knowledge about perilous incidents, Dunn said.

For example, a 3-year-old child riding in the backseat when a car is involved in a fender-bender can be traumatized, she said.

“The kid will be freaking out if there is blood on Mom or Dad” from a slight wound if the parent turns around and asks whether the child is OK, she said.

“Even if nobody is hurt, if you’re a kid and don’t realize what is happening, it is traumatic,” Dunn said.

People of any age who react to a threat

with a thought such as “Oh, my God, I’m going to die — that’s the thing that sticks with them,” said Dunn, who has a master’s degree in social work and works three days a week in Gundersen’s Prairie du Chien clinic in Wisconsin and another day at the La Crosse, Wisconsin, campus.

Children worry, often unnecessarily, because of their lack of life experience, she said.

“One problem with kids is they have no sense of geography,” Dunn said. “If they hear about wars in Iraq and Afghanistan, lots and lots of kids are afraid we will be bombed here.”

PTSD in a child often isn’t obvious at first glance.

“It can be disruptive behavior or acting out,” said Chelsea Ale, a behavioral health specialist at Mayo Clinic Health SystemFranciscan Healthcare who has a Ph.D. in child clinical psychology.

“It can look like a kid being a kid but who is struggling” because of a traumatic incident such as witnessing domestic violence, seeing a bad accident, experiencing neglect or enduring the death of a parent, Ale said.

Such experiences can trigger nightmares and flashbacks, as well as guilt, because the child has the false impression that he could have done something to prevent it, said Ale, who said Mayo-Franciscan gets referrals from parents or caregivers, schools and child protective services workers.

Asked what attracted her to the profession, Ale said, “I love the idea of helping kids as early as possible. PTSD is treatable, and I like to get in there and get the kid back on track for a productive life.”

The key is helping the child develop a sense of safety to corral the menacing feeling, she said.

“It will never become a good memory, but it won’t be as bad” if the child senses she is working with a safe, reliable person and has a good support system, Ale said.

“We put a system around them,” she said.

“Anyone can be that child’s person. Just having a reliable person in that child’s life can make all the difference.”

Employing trauma-focused cognitive behavioral therapy enlists families in the role of helping children work through and cope with trauma, as well as controlling anxiety.

TF-CBT includes methods to help process the trauma to pinpoint and contain the threat; relaxation techniques, including deep breathing, imagery and yoga; and collaboration between parents and children to master such skills.

May/June 2016 ~ living well

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Another common therapy for both children and adults is eye movement desensitization and reprocessing, which goes by the acronym of EMDR and aims to defuse the danger of traumatic memories and blunt their effects.

“It’s a subtle method that is more about changing the message and reviewing the flashbacks from a distance and containing them. If you can’t do the containment, you can’t do the work,” Dunn said.

Just as childhood traumas can be difficult to connect to behavior, some don’t surface until adulthood, and traumatic incidents for adults may not be apparent at first.

“Symptoms typically begin within the first three months after the trauma, but there could be a delay of even months or years,” Howell said.

“We are unsure why there is a delay, but there are risk factors that could increase one’s chances of PTSD when exposed to traumas,” Howell said.

Such elements include temperament, connected with childhood or parallel mental health concerns, as well as environmental issues such as lower socio-economic status, less education, previous traumas and a low level of social support.

Other reports also suggest that gender plays a part, although Howell cautioned, “It is important to note that there could be bias in these reports since women are more likely to seek out services for mental health issues and are frequently more likely to go to the doctor for issues.”

People in certain occupations, such as EMTs, police officers and emergency room personnel, face an increased 16

living well ~ May/June 2016

likelihood of experiencing trauma, Howell said.

Asked why people can’t just snap out of it, she said, “I wish it was that easy, and, if it was, most would do that. We are not always in control of what sticks with us and what can influence our perspectives of the world.”

Dealing with PTSD

PTSD is drawing increased attention not only from those in the medical profession but also the next generation who plan to serve in the health care field.

Four community health education majors at the University of Wisconsin-La Crosse are working on a presentation titled “PTSD Isn’t Just a Soldiers’ Disease.”

“The first thing people think about with PTSD is combat,” said Alayna Husom, a 22-year-old senior from Ridgeway, Wisconsin.

“The further we looked into it, we found it was an overlooked issue,” with 5 percent of the adult households in Wisconsin affected, said 23-year-old Natalie Frederickson of Racine, Wisconsin.

“A lot of people can go through trauma” seemingly unscathed, without experiencing depression and substance abuse, Frederickson said.

In addition to deployed troops, PTSD also is a significant difficulty for victims of sexual assault, Husom said, adding that programs rarely are in place to help them cope with and process their pain.

Asked how they themselves handle stresses that college life sometimes inflicts, especially at crunch times for papers

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Another member of the study team, 21-year-old Jaime Hilden of Onalaska, Wisconsin, mentioned exercise as useful therapy.

“I’m I runner. I do it more for fun and with friends as more of a social function,” Hilden said of exercise, widely recognized as a mental stabilizer as well as physical necessity.

The group, which leads a yoga exercise class at Ruth’s House to show clients the benefits of relaxation in trauma recovery, is trying to raise public awareness of PTSD in the general population.

“We want to tangibly make a difference in the community,” Hilden said, with Husom adding, “We are trying to change the mindset of having PTSD.” One of the most significant ways to do that is to convince people who have PTSD that it is treatable, said Kim Buchanan, a behavioral health specialist with Mayo Clinic Health System-Franciscan Healthcare who splits her time between Mayo-Franciscan’s Sparta and Onalaska clinics.

“People should get help because they don’t need to suffer alone,” she said. “Sometimes therapy alone can be helpful, and sometimes they need medication to help calm things down.

“It is a brain disease, and a holistic approach is best, including relaxation and meditation to calm regions of the brain,” Buchanan said.

“There is treatment — it may take some time and some work, but PTSD is treatable,” she said.

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Be present Mindfulness therapy reduces rate of repeated depression HealthDay News

M

indfulness therapy may help reduce the risk of repeated bouts of depression, researchers report.

One expert not connected to the study explained the mindfulness

approach. “Mindfulness-based cognitive therapy enhances awareness of thoughts and emotions being experienced, and enables development of skills to better cope with them,� said Dr. Ami Baxi, a psychiatrist who directs adult inpatient services at Lenox Hill Hospital in New York City.

In the new study, a team led by Willem Kuyken, of the University of Oxford in England, analyzed the findings of nine published studies. The research included a total of almost 1,300 patients with a history of depression. The studies compared the effectiveness of mindfulness therapy against usual depression care and other active treatments, including antidepressants.

After 60 weeks of follow-up, those who received mindfulness therapy were less likely to have undergone a relapse of depression than those who received usual care, and had about the same risk of those who received other active treatments, the team reported.

The study authors also believe that mindfulness therapy may provide greater benefits than other treatments for patients with more severe depression.

The study was published online April 27 in the

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living well ~ May/June 2016

Mindfulness is a state of active, open attention on the present.

When you’re mindful, you observe your thoughts and feelings from a distance, without judging them good or bad. Instead of letting your life pass you by, mindfulness means living in the moment and awakening to experience. ~ Psychology Today

journal JAMA Psychiatry.

“Mindfulness practices were not originally developed as therapeutic treatments,” Richard Davidson, of the University of Wisconsin-Madison, wrote in an accompanying editorial. “They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue,” he explained.

“The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage,” according to Davidson.

While this review is the most comprehensive analysis of data to date, it “also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research,” Davidson concluded.

However, another psychologist said she is already using mindfulness therapy in her practice.

“I have increasingly incorporated mindfulness based-interventions into my work with children, adolescents and adults, and I’ve seen how it has improved treatment outcome and overall wellbeing in my clients,” said Jill Emanuele. She is senior clinical psychologist at the Child Mind Institute in New York City.

Emanuele said there is growing evidence that the approach brings patients “increased awareness of emotions and thoughts, and the ability to more effectively regulate and cope with them.”

May/June 2016 ~ living well

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We all feel anxious sometimes

By Annaleah Atkinsons

A

nxiety is a feeling of worry, nervousness or unease, typically about an imminent event or something with an uncertain outcome.

Everyone feels it from time to time, especially when we are faced with something that is new to us. It’s a normal reaction to stress. It becomes a psychological concern when the anxiety levels become so severe as to create panic attacks and excessive uneasiness that interferes with normal functioning.

It feels intensely personal, as if no one in the world could understand how you feel, but you’d be surprised at how universal the experiencing of the above symptoms is. Although we each seem to have specific things that we are anxious about, there are a few areas that many seem to share.

According to researchers, psychological problems among teens have been on the rise since the 1930s, and Americans’ obsession with material gains and success may be to blame.

“We have become a culture that focuses more on material things and less on relationships,” said lead researcher Jean Twenge, author of “Generation Me” and an associate professor of psychology at San Diego State University. Twenge said this focus is affecting mental health on a societal level.”

There is great pressure to have certain material things, such as certain clothes, devices, shoes and accessories.

I’ve seen it tear up families. Parents want to be able to provide these things, but just can’t. I would like to tell you that if your friends are judging you by your material things, they are missing everything about you. You are

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living well ~ May/June 2016

Do some soul searching, with your soul and not just your mind, and find out what you think would bring you peace in your life. your precious thoughts, your loving expression, your hopes, your humor, your loyalty, your courage, your creativity, and your worries. But they most often can be turned around in time.

Anxiety relates strongly with ones self-image.

An image is the idea a person has of ones abilities, appearance and personality. Generally speaking, if a person has a good self-image, they have less anxiety than people who have a poor self-image. However, sometimes the image we have of ourselves isn’t accurate. We might think that we’re not attractive when we really are, because we’re looking at some slight imperfections, and not seeing the whole picture.

Or students might think that they are not smart, because they are taking courses in an area that isn’t reflecting their intellectual modality. When they begin to do things in the area that they love, they thrive. Still, we all need to know how to balance a checkbook and write a letter.

Relaxation program

Companies make trillions of dollars from peoples’ anxieties. Clothes, cars, supplements, make-up, places to be seen, boyfriends or girlfriends on your arm are meant to help you build an image of success.

It continues for adults. But it’s shallow stuff. Soon it’s out of style, and you have to find some other external indicator of coolness. More important is what’s going on in you.

You’re the one in control of that. You define what is important to you. Things change. When I grew up people made fun of the computer nerds. Now they rule big business and run our national security programs. We didn’t have phones and tablets. We talked to each other.

We had conversations and parties and when we were troubled, we talked to each other. We found out that we all had a few insecurities, trouble with adults and boyfriends. We supported each other.

We didn’t have the problem with bullying that some face now. But remember that bullies put other people down in the attempt to keep the self-image of whatever they think they have that’s so great. When they are exposed for what they do, they have to face their shallow

self-images.

Some people can understand where bullying comes from and let it bounce off their shoulders. Others feel really hurt, and their anxiety increases. They must seek help and report any harmful bullying, and if one adult doesn’t act on it, go to another, and another. Find friends who are also bullied.

Web MD’s article on Anxiety and Teens suggests that teens start their own relaxation program.

This is also true for adults. Set aside 20 minutes a day for relaxation. Find a comfortable space to lie down or sit. Remove distractions as much as possible, including your devices.

During this time, remain as still as you can. Focus on noticing what parts of your body feel relaxed and which feel tense.

The goal is to imagine that every muscle in your body is becoming relaxed and free of tension.

Picture all the muscles in your body beginning to go loose and limp. Breathe slowly and evenly. Each time you exhale, picture your muscles becoming even more relaxed. Breathe out tension with each exhaled breath.

After 20 minutes, notice the difference.

Some people find that chanting, singing, praying or focusing their eyes on a peaceful object like a candle flame, or flower can help them relax. When you get up the relaxed feeling may fade, but over time many teens find that they are more able to maintain the relaxed feeling beyond the practice session.

Another thing that may cause anxiety is when you have followed a path, and created an image for yourself, and then you find out you don’t really want it. It can lead to depression, a feeling of waste and anxiety about what to do next. No experience is ever wasted if you learn from it.

Re-invent yourself. Do some soul searching, with your soul and not just your mind, and find out what you think would bring you peace in your life. Begin to make a transition toward that. Check it out as much as you can. Our country was founded on people re-inventing themselves. We love those inner and outer adventure stories. It gives us hope too, in case we feel ready for a change.

May/June 2016 ~ living well

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living well ~ May/June 2016

Children and anxiety

By Green Shoot Media

A

nxiety is part of being human, but for children, regular fears can be hard to rationalize and process.

Many adults suffer from anxiety, and oftentimes, those struggles begin at a young age. Children in pre-school, all the way up to high school, can have issues with anxiety and stress. According to the National Institute of Mental Health, approximately 25 percent of 13- to 18-year-olds have a “prevalence” for anxiety, while approximately 5.9 percent may suffer from severe anxiety.

It’s a major issue for children, and most kids battle short-term bouts of anxiety over everything from a school project to a teacher they don’t like.

A good first step is to have an open conversation with your teen and be accepting of their problems. Be encouraging, and remind them of past experiences in which they overcame adversity. Also help them talk through what they’re worried about, and what could be the cause. If problems persist for a few months with no improvement, consider professional counseling.

Younger children

For younger children – such as pre-schoolers and gradeschoolers – one approach that can help with processing anxiety is to have a discussion to explain exactly what anxiety is to them, on their terms.

For children that young, it can be hard to differentiate between what is real and what’s imaginary. Try to explain to them that just because they think of something scary (such as a dinosaur chasing them), that doesn’t mean it’s actually going to happen. This can extend to the mundane, such as worries about success at school. Explain that just because they’re worried they won’t do well, it doesn’t mean they won’t. Take some additional time to work with your child and encourage her about whatever has her worried. It’s a relatively simple approach, but it can help.

Anxiety in teens

Anxiety gets more complex as a child grows older, and by the time they reach the teenage years, many could be grappling with the issues. One prevalent anxiety issue for teens revolves around social anxiety disorders, which are only exacerbated by the fickleness of teenagers and the challenges of navigating high school.

May/June 2016 ~ living well

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Tame that temper

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living well ~ May/June 2016

By Green Shoot Media

W

hen is the last time you had a timeout? Just because the days of terrible twos and kindergarten are long gone doesn’t mean a timeout can’t help you keep your temper under control.

In fact, taking a few minutes to calm down and diffuse a situation can help you reduce stress that can be harmful to your physical and mental health.

The next time you get peeved by someone cutting you off in traffic or a home repair that drains your bank account by a few hundred dollars, send yourself to the corner. And don’t reemerge until you’re feeling calm and collected.

Self-Control

The Mayo Clinic recommends that people find a calming force in their lives that can help them better handle stressful situations, which are a natural part of life. This can range from actions that you take or people with whom you surround yourself.

Techniques such as making a concerted effort to think before you speak can help you work through issues in your head before projecting onto others, for example. Or allow yourself to vent to others, but only after you’ve had a chance to calm down and express your concerns in a clear manner.

These types of actions can be particularly important if you are in a position of leadership in your company or are a parent.

Set a positive example for your employees and children to create a culture of collaboration and constructive communications.

Exercise

Physical activity has been proven to reduce stress levels that can cause you to become angry, according to the Mayo Clinic.

If you’re feeling stressed or angry — or even if you’re not — a brisk walk or jog can help you keep your cool. It also can serve the same purpose as a timeout, giving you the time you need to consider alternative ways of handling a stressful situation.

You can find clarity during exercise. A halfhour jog can open your eyes to what is going on around you, helping you realize that other people are probably having problems, too.

May/June 2016 ~ living well

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living well ~ May/June 2016

US suicides have soared since 1999

By Melissa Healy, Los Angeles Times

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riven by stark increases in the numbers of white women and Native Americans who are intentionally killing themselves, suicide rates in the United States jumped 24 percent in the years between 1999 and 2014, a new government report states.

Following a slow-but-steady rise in suicides from 2009, the yearly increase in suicide rates accelerated after 2006, as Americans’ financial woes mounted and a battering recession settled in. Between 2006 and 2014, the report shows, the yearly hike in the U.S. suicide rate jumped from 1 percent to 2 percent. Suicide rates climbed among men and women, and in all age groups between 10 and 74 years old.

Suicide rates among non-Hispanic American Indians and Alaska Natives were, in 1999, already the highest of any ethnic group, despite being widely underreported. By 2014, roughly 1 in 2,000 men in this ethnic group committed suicide, a 60 percent increase over the suicide rate among male American Indians and Alaska Natives that prevailed in 1999.

Among all men under 75, suicides surged. In the age group most prone to fatal self-harm —

45 to 64 — almost 30 in 1,000 men committed suicide in 2014, a 43 percent increase over 1999’s rate. Non-Hispanic black males were the only racial or ethnic group of either gender to have a lower suicide rate in 2014 than in 1999.

All told, some 42,773 Americans died of suicide in 2014, according to the Centers for Disease Control and Prevention. That made suicide the 10th leading cause of death for all ages.

“This is definitely harrowing: The overall massiveness of the increase is to me the biggest shocker — the fact that it touched pretty much every group,” said Katherine A. Hempstead, who recently published an analysis of U.S. suicide trends in the American Journal of Preventive Medicine.

Hempstead, director of the Robert Wood Johnson Foundation, noted that surging suicides among women — a group that has traditionally committed suicide at a far lower rate than men — was especially significant. While nearly four times as many men as women kill themselves, suicide rates among women grew much faster than those among men, and the gap between men and women narrowed.

“This is definitely harrowing: The overall massiveness of the increase is to me the biggest shocker – the fact that it touched pretty much every group.” ~ Katherine A. Hempstead May/June 2016 ~ living well

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Among all women younger than 75, suicide rates grew across the age spectrum. But in the age of greatest vulnerability — women between the ages of 45 and 64 — the rate of suicide in 2014 vaulted 80 percent higher over 1999’s rates.

Among girls 5 to 15 years old — a segment of the population among whom suicide was a rare phenomenon in 1999, rates of suicide tripled between 1999 and 2014, with one suicide yearly for every 6,660 such girls.

“That we’ve started to see the gender gap close is shocking,” said Hempstead, who was not involved in the current study.

Hempstead’s earlier published study of American suicide rates ended with 2010, and had documented a steep rise that appeared strongly related to financial distress and job problems. That that trend continued for four more years may reflect that “the benefits of the recovery have not been shared by all,” said Hempstead. Recent reports that nonfatal forms self-harm — drug overdoses and alcohol-related diseases — have begun to erode Americans’ life expectancy also underscore the lingering effects of economic hardship on many, she added.

Protect those in crisis

The new report, issued in late April by the CDC’s Center for Health Statistics, also offers a grim look into the changing means by which American suicide victims

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living well ~ May/June 2016

took their lives. Among both men and women, the 19992014 period saw a shift away from the use of firearms, pills and poisons. In 2014, 1 in 4 suicides was by suffocation (hanging, strangulation or suffocation), up from 1 in 5 in 1999.

Firearms continued to be the means of suicide most chosen by male suicide victims, used by 55.4 percent in 2014. Among women, firearms followed close behind poisoning as a means of suicide, accounting for 31 percent of female suicides in 2014.

That fact underscores the importance of coaxing from those in crisis the pills, poison or guns they might use to carry out a suicide, said Catherine Barber, director of the Means Matter Campaign at Harvard’s School of Public Health.

Research suggests that many who attempt suicide act on impulse — and when a gun is available, their attempts are vastly more likely to succeed. By contrast, 9 out of 10 people who attempt suicide and survive will not go on to die by their own hand, suggesting that removing the means to commit such an act is not a gesture doomed to fail.

“Often, the moment for a friend to intervene is related to a crisis that is going to resolve, like a divorce,” said Barber.

“A friend can offer optimism: ‘We’ll get through this,’ ” said Barber. “A friendly way of showing concern” would be to offer to hold a distressed person’s firearms until the crisis has passed, she added.

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Dealing with the blues

By Green Shoot Media

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e’ve all had a bad day. It’s how we bounce back from negative experiences that helps us move forward and achieve our life goals. And the key to bouncing back is having a strong support group around us.

People who are lonely have more physical and mental health problems than those who feel connected to others, according to a new report in Psychological Science.

The report details the importance of creating and maintaining positive relationships in the workplace, family and other social circles. Without people to interact with and vent to, we can become even more inclusive and shut ourselves out to the external world. This behavior has been proven to be harmful to our confidence levels and abilities to cope with negative situations.

The Science Behind Loneliness

Scientific research shows the positive impact that strong social lives can have on our overall health. One Colorado State University study found that the more positive social interactions people with depression had, the more improvement in the symptoms they experienced.

Other research in the journal Health Psychology has shown that you’ll eat less healthful food if you frequently eat by yourself, and you are more likely to be physically inactive the lonelier you feel.

Make New Friends

Your community is likely ripe with opportunities to meet new people and build new relationships. Try visiting local businesses to establish rapport with business owners and workers.

Even if you don’t actually interact with these types of connections on a daily basis, the conversation and camaraderie can be enough to make you feel more comfortable in other social situations.

Other ideas for making new connections include joining a professional association, enrolling in a cooking class at your local community college or signing up for a gym membership.

You will find like-minded people, leading to common ground and easy, comfortable conversations.

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living well ~ May/June 2016

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