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How your primary care doctor can improve your mental health
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Most of us wouldn’t think twice about seeing our doctor for stomach pain, a sports injury or the flu. But many people don’t get help for mental health concerns. Sometimes it’s the fear of a label, cultural stigma or worry over not getting the right treatment. Whatever the hesitation, it’s important to see a doctor who will treat both your physical and mental healthcare needs.
According to Raymond Hoffman, MD, medical director of the Division of Mental Health and Substance Use, your first call for mental health concerns can be to your primary care provider. “A primary care doctor can prescribe medications for many common mental health issues,” says Dr. Hoffman. He or she may also act as the point person for additional care, such as referring you to a therapist.
Regardless of who ultimately treats you, Dr. Hoffman notes that addressing mental health concerns involves entering into a trusting relationship with your healthcare provider, who supports healing and recovery.
Many of us think of mental healthcare as treating psychiatric illnesses such as bipolar disorder, major depression and psychosis. But it’s just as important to give attention to everyday concerns such as stress, seasonal depression and anxiety. Medical conditions such as diabetes, multiple sclerosis, Parkinson’s and heart disease can worsen depression or anxiety — and vice versa. That’s why it’s so important to seek treatment that takes your whole health into consideration.
Erasing the Mental Health Stigma
MYTH: Mental health conditions are uncommon.
FACT: Mental illness is more common than most think. According to the National Alliance on Mental Illness, one in five Americans will experience mental illness in their lifetime, and one in 25 will experience a serious mental illness that interferes with their life.
MYTH: Mental health conditions are untreatable.
FACT: Many mental health conditions are not lifelong challenges and might only require treatment for a short time. With advances in modern care, you can successfully manage even chronic mental health conditions.
MYTH: Mental health conditions aren’t real medical conditions.
FACT: Just like heart disease and diabetes, mental illnesses are medical conditions. Primary care doctors and specialists can effectively treat them.
Where to start with mental health help
You don’t need to suffer through a mental health condition alone. Unless you’re dealing with a severe mental health issue, a good place to start is your primary care doctor. Your doctor will review your medical records, talk with you about new symptoms or concerns, and work with you to create a treatment plan.
If you already have a good relationship with your doctor, you may feel most comfortable talking to him or her. Your doctor may also better understand what stressors you’re dealing with at home and work, and how they affect your physical health.
In many primary care offices, a medical assistant screens patients for depression as part of the yearly well visit using a standardized screening tool. This two-question tool can provide information for a doctor to follow up. Doctors can use a more in-depth tool if the initial screening points to depression.
The good news for mental health
The good news is that mental health conditions are treatable. If your doctor identifies a mental health condition, he or she may provide brief counseling in the office, prescribe medication or refer you to a specialist. Your doctor may also suggest individual or group therapy. According to Dr. Hoffman, “The evidence shows that if most people who are suffering because of symptoms from mental health problems or substance abuse get help, they can be in less distress and function better.”
Mental Health and Substance Abuse Services at AAMC
AAMC offers a range of services, such as:
The J. Kent McNew Family Medical Center, a 16-bed mental health hospital for adults, is opening in March.
Pathways, AAMC’s substance use and co-occurring mental health treatment facility
Partnerships with the Department of Health and local mental health and substance use providers to connect patients to resources
Anne Arundel Medical Group Mental Health Specialists, an outpatient mental health clinic for ages 3 and up
AAMC Psychiatric Day Hospital, a partial hospitalization program
The Recovery Navigator Program, which provides screenings and referrals in the primary care setting
Introduction of mental health consultations in primary care offices
Learn more about AAMC’s range of mental health and substance use services, from outpatient group therapy to partial hospitalization.
Author
Raymond Hoffman, MD, is the medical director of the Division of Mental Health and Substance Use.
Originally published Dec. 5, 2016. Last updated Feb. 10, 2020.
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Mind and body: What you eat can affect your mental health
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The brain is the body’s control center that is working day and night. As a result, it requires fuel to keep functioning. By eating higher quality foods — containing a lot of vitamins, minerals and antioxidants — your brain can better protect itself from oxidative stress, or the waste products produced by your metabolism. On the flip side, eating a lot of processed or refined foods can displace other nutrients and be harmful to your brain.
High-sugar, high-fat and high-salt foods cause inflammation. For example, eating a lot of sugar and refined carbohydrates worsens your body’s regulation of insulin. Multiple studies found a link between a diet high in refined sugars and impaired brain function. This included a worsening of mood disorders, such as depression.
Here are some of the most studied problems caused by a poor diet that researchers have linked to mental health issues:
Chronic low-grade inflammation. This is caused by lifestyle factors, including poor diet, smoking, lack of sleep and psychological stress. And it has been observed in people with depression, bipolar disorder and schizophrenia.
Elevated oxidative stress. Patients with depression experience this. Many people with a mental illness have lower levels of antioxidants in their system compared to control groups.
Brain plasticity. Some research shows healthy dietary patterns improve brain plasticity, or the capacity of the brain to change with learning throughout life.
Gastrointestinal microbiota. There is a link between mental illness and “gut flora,” or the microbe population living in our digestive tracts. When inflammation starts in the gut, paired with a poor combination of nutrients that affect the ‘good’ and ‘bad’ bacteria ratio, it can in turn cause brain inflammation. Ultimately, this causes our brain cells to die. Studies have shown that people taking probiotics have improved their anxiety levels, perception of stress and mental outlook.
Mental illness is a top cause of global disability, and the problem continues to grow. Mental health is complex, and if you’re experiencing a problem you should work with a professional on a well-rounded solution.
Learn more about the J. Kent McNew Family Medical Center, a 16-bed mental health hospital for adults opening in March.
Nutritional psychiatry supports the role of diet in mental health, and its potential role as a modifiable risk factor for mental illness. Some of the nutrients identified – such as magnesium, vitamin D, zinc, omega 3, b-vitamins and probiotics – are prevalent in a Mediterranean diet. The Mediterranean diet is high in vegetables, fruits, unprocessed grains, fish and seafood, with modest amounts of lean meats and dairy. They are also void of processed foods, which are staples of the Western diet.
If you’re interested in seeing how food affects your mood, start keeping a food record. Jot down how eating different foods make you feel, not just in the moment, but the next day. Make positive changes and compare how you feel . Your body — and brain — will benefit.
Authors
Ann Caldwell and Maureen Shackelford are nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them, call 443-481-5555.
Originally published Dec. 3, 2018. Last updated Feb. 10, 2020.
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Behavioral Health, Men's Health, Women's Health
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Depression is not… everything you think it is
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It’s not a disease. It’s not a sign of a weak personality. And it’s not something to be ashamed of.
Sure. Depression drains your energy. Depression makes you sad. Depression makes you feel powerless, tired, less hungry, more anxious. But depression is not always a “bad thing.” And it’s not “incurable.”
Everyone goes through some sort of depression. In fact, depression is just part of being human. Of course, everyone experiences it differently, depending on the person, situation and circumstance. For some people, it’s clinical. But there shouldn’t be stigma associated with it.
“Do I think it’s derogatory? Absolutely not,” says Donna Phillips, clinical director at Anne Arundel Medical Center’s (AAMC) Psychiatric Day Hospital. “I think you can build strength from it. You can enjoy life and grow from it. Everyone experiences it and we all go through some form of it. You can learn from it. The key in getting better is to know what it is and how you can overcome it.”
Learn more about the J. Kent McNew Family Medical Center, a 16-bed mental health hospital for adults opening in March.
What is depression?
Depression is a common but serious mood disorder, according to the National Institute of Mental Health. It can cause severe symptoms that affect how you feel, think and handle daily activities, such as sleeping, eating or working. Some forms of depression are slightly different or can develop under certain circumstances, like it happened to Kathy.
After battling three cancers for seven years, including one that required a hip replacement after she developed a tumor in her pelvis, and going through a divorce amidst all of it, Kathy closed this chapter in 2015 after completing her leukemia treatment. But in August 2016, she got shingles – an event she says that pushed her over the edge.
“I was really sad,” says Kathy, a 65-year-old retiree. “When I was five months into my shingles, the pain was relentless and it was really difficult to deal with.”
Kathy wasn’t taking care of herself, only ate two meals a day and slept until noon. One day, she started to feel sick while driving on her way to meet with her sons for lunch. “I only had a tea for breakfast and felt really bad, so I pulled over,” she recalls.
After calling one of her sons, she decided to go back home to meet them there. Noticing their mother wasn’t well, they encouraged her to go to the emergency room. “I admitted I wasn’t well and that I was very depressed,” she says. “I couldn’t turn it around myself, I needed help.”
Seeking help is not a sign of weakness
After an eight-day visit to Sheppard Pratt, followed by a hospital visit where she discovered she suffered from pneumonia, Kathy continued her mental health care at AAMC’s Psychiatric Day Hospital, an intensive day treatment program.
“Seeking help is a good thing,” she says. “Sometimes you have circumstances, like I did, that push you into a depression where you need help to get out of it. I was ignoring the signs, not really accepting what has happening.”
Kathy spent two weeks in AAMC’s program, which offers several mental health services. The program seeks to provide individuals with the necessary skills so they can continue to manage once they’re done, says Phillips.
“A person who suffers from depression feels isolated, but they’re not alone,” she says. “There are a lot of support groups that can help individuals talk about their situation. Our program helps people develop what we call a wellness toolbox. We talk to our patients about the importance of staying active, socially and physically, having a schedule to adhere to, having good sleep hygiene, eating healthy, and being aware of one’s automatic negative thought patterns (cognitive distortions) that provoke depression.”
Although it might seem like a simple approach, Phillips says she’s seen many patients overcome their depression and move on in life. “There are a lot of steps people can take to overcome depression,” she says. “But it’s important to note that seeking help when you can no longer cope by yourself is one of the first steps.”
Lessons learned during depression apply to life in general
Kathy says she since left treatment, things have changed for the better. “They taught me coping strategies that are helpful and now I set up an alarm to get up at 8 am or earlier,” she says. “I make breakfast for myself, I have lunch dates with my friends and now I’m looking to volunteer.”
Kathy says the biggest change is that she feels better about herself and her future. “I feel good about my life,” she says. “I have a grandson that just turned one and I realize that I have so much to look forward to.”
Although it was a challenging time for her, Kathy credits her faith and treatment for helping her look at things differently. Today, she hopes her experience can help others. She says no one should be embarrassed or afraid to seek help because there are a lot of places and organizations that are willing to help. “Depression is not an end, you can turn things around,” she says. “There is hope and life after depression.”
MENTAL HEALTH RESOURCES:
National Alliance on Mental Illness (NAMI): A nationwide grassroots advocacy group, NAMI represents people affected by mental illness and offers several support services, including education programs and a HelpLine.
On Our Own: A statewide behavioral health consumer education and advocacy group, On Our Own of Maryland promotes equality in all aspects of society for people who receive behavioral health services and develops alternative, recovery-based behavioral health initiatives.
National Suicide Prevention Lifeline: Help is always available. Don’t hesitate to reach out if you need help. Call 1-800-273-8255.
AAMC: If you think AAMC’s Psychiatric Day Hospital can help you or a loved one, talk to your doctor. Your doctor must refer you before you can enroll. If you are looking for a doctor who specializes in mental health, call AAMG Mental Health Specialists at 410-573-9000.
Originally published Dec. 31, 2018. Last updated Feb. 10, 2020.
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Behavioral Health
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Prejudice and Mental Health
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Over the past few months, many people are talking about race relations in America. Those conversations are hard at times, awkward and even uncomfortable. For those who experience prejudice and discrimination based on religion, race or gender identity, the effect on your mental health can be devastating and long lasting.
The day after the assassination of Dr. Martin Luther King Jr., Jane Elliott conducted her now famous “blue eyes, brown eyes” exercise with her third grade class. She separated the class into two groups based on eye color. She told one group that they were superior and had special privileges. Meanwhile, she told the other group they were inferior and didn’t give the same praise and privileges as the superior group. Eventually, the kids who were ‘superior’ soared in confidence and felt they were smarter. The kids in the ‘inferior’ group, on the other hand, started making mistakes that they would not normally make, became timid and were angry.
This experiment only lasted for a couple of days.
Now, imagine if every day of your life felt like Mrs. Elliott’s third grade classroom. And, imagine you are always in the inferior group. Even if no one ever overtly says you are inferior. When people experience prejudice, they may feel that they are not wanted or don’t belong. This causes feelings of mal adjustment that takes a dangerous toll on mental health.
Ways Experiences of Prejudice can Affect Your Mental Health
Depression
If you are constantly in an environment where you are experiencing prejudice, it’s normal to experience feelings of depression. You may start feeling emotionally drained, isolated or lonely. You may also start feeling physical exhaustion, leading to fatigue or insomnia or feelings of low motivation and feelings of wanting to quit.
Anxiety
If you are feeling judged, whether at work, school or in the community, this can lead to feelings of generalized or social anxiety. For example, you may feel nervous about starting projects or taking risks around others in their daily environment. You may also experience worry about what other people think. This can then lead to negative self-talk and low sense of self.
Low self-worth
You may question your own worth. For example, you might wonder, “Am I good enough?” or, “Do I even belong here?” Questions like this lead you to start questioning your own value. You will wonder what will you have to do to be treated differently because nothing will ever appear to be good enough. You may feel the effects of imposter syndrome and start to question your own intelligence, your value and your skill level as a result.
Feelings of hopelessness
You may start to wonder, “Will things ever get better?” or you may start to feel like all hope is lost for change. At this point, you may begin to internalize feelings of being in an inferior group. Then, you may stop demanding for things to change, stop using your voice and accept negative treatment because of a lack of equality.
How You can Overcome the Effects of Prejudice
We have to pay attention to our internal selves and listen to our mind and bodies. Then, we can start to take care of ourselves.
Self-care
You can’t pour from an empty cup. Before you can take care of anyone else, you have to take care of yourself first. Take a step back from the TV and social media. Engage in a hobby that you enjoy or spend time with your loved ones.
Breathe
Take time during the day to just breathe. Set breathing interval times throughout the day so you can remember to clear your mind. Relax your body and decrease stimulation that can feel overwhelming.
Positive self-talk
Use daily positive self-talk to help increase your self-esteem and self-worth. Tell yourself that you are good enough and you deserve the best from any position that you are in. By reminding yourself that you are worth it, you will believe that you belong when others may want you to believe otherwise.
Increase self-awareness
Know that you are not the problem. Understand that prejudice exists on many levels in society. When people are able to acknowledge that a greater issue exists, then they can increase self-confidence and be a voice for positive change.
The impact of prejudice can be devastating to a person’s mental health. The repercussions can last a lifetime and those feelings can be passed through generations. It is important for all people to continue to have those uncomfortable, difficult conversations about prejudice in society. When we take the time to listen to each other, we will feel like we are making a change. And when there is change, we will notice a positive effect in mental health based on inclusion and equality.
Author
Jennifer Williams, MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000.
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When Words Hurt: Another Kind of Domestic Violence
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When discussing domestic violence, I often hear comments like, “I’m lucky not to know anyone affected by domestic violence,” or “I have never been exposed to anything like that.” Most people are not only surprised to learn domestic violence is not always as obvious as a black eye—a lot of people, in fact, have been exposed in some capacity.
While domestic violence can include physical and sexual violence, the most elusive kind of abuse is emotional abuse. Unlike physical abuse, the people doing it and receiving it may not even be aware it is happening.
Emotional abuse can be more harmful than physical abuse. Even in the most violent families, the incidents tend to be cyclical—a violent outburst, followed by a honeymoon period with remorse and attention that eventually ends, and then the violence starts over again. But with emotional abuse, it happens every day. The effects are more harmful because they’re so frequent. This emotional abuse can happen between a parent and child, husband and wife, among relatives, and between friends.
The other factor that makes emotional abuse so devastating is victims are more likely to blame themselves. When the words directed at you seem subtle—if the abuser says you’re unattractive, fat, dumb or unlovable—it’s easier to assume this is your own doing. But if someone hits you, it’s easier to see that he or she is the problem. It can undercut what we think about ourselves and impair our ability to be our true selves and escape the abuse.
With emotional abuse, the abuser projects their words, attitudes or actions onto an unsuspecting victim. One person controls the other by undermining his or her trust, value, development, or emotional stability, or causes fear or shame by manipulating or exploiting that person.
And it’s not so much about the words used, rather the threatening effects of the behavior by the abuser. The body language, tone and actions by an abuser oftentimes contradict the words. And this is very destructive to the victims.
Warnings signs of abuse can include: decreased interaction with friends and family, constantly receiving phone calls or text messages inquiring about location and activity, seemingly anxious to please the partner, making excuses for partner’s behavior, going along with everything the partner says and does, decreased productivity at work or school, personality changes, lowered self-esteem, and limited access to transportation and money. These signs of abuse are more common and often overlooked.
The support of family and friends can be helpful. But professional counseling will provide the victim with tools to prevent, cope and move on from an abusive situation.
Anne Arundel Medical Center’s Abuse and Domestic Violence Program has professionally trained staff available to help patients, employees and community members.
For information about abuse, call 443-481-1209. For a 24-hour Domestic Violence Hotline, call 410-222-6800.
Author
Rae Leonard, Anne Arundel Medical Center’s abuse and domestic violence program coordinator, can be reached at 443-481-1209.
Originally published Nov. 12, 2015. Last updated Sept. 16, 2025.
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