- Behavioral HealthGeneral Page Tier 3BlogMost 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.
- General Page Tier 3BlogThe 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.
- Behavioral Health, Men's Health, Women's HealthGeneral Page Tier 3BlogIt’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.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogIn today’s world, the pressures of being a teenager can be overwhelming. Not only are teens consistently pressured to do well academically and excel in extracurricular activities, but they also face pressure to be part of the crowd. On top of that, add in the struggles of peer harassment or even being the subject of online harassment. Life can quickly become one of misery. A school day can feel like an eternity and, at home, the effects of that day are far from over. Teenage peer-to-peer harassment occurs frequently, but the conversation at home and in school is rare. It can lead to feelings of low self-esteem, anxiety, school refusal and depression. You and your teen should know how to identify harassment. Here are some important things to know: Harassing behaviors often start in childhood. These behaviors among young children are often characterized as “boys will be boys” or as children just being playful. Harassment does not start in a day. It is a behavior that develops over time. Correcting the behavior early on will lead to more appropriate behaviors during your child’s teenage years. Harassment is also verbal. Jokes, innuendos, slurs, name-calling and insults can have a traumatic and lasting effect. Oftentimes, verbal abuse starts in the home. Assess your family’s communication and stop using names and negative labels. It is important to model appropriate language and actions. Boys face harassment, too. We often think about harassment when it comes to girls, but boys do fall victim. Boys are less likely to talk about harassment or even consider the actions that have been taken against them as a form of harassment. Look for changes in behaviors, like becoming solitary or avoiding people or places they used to enjoy. Be sure to keep an open dialogue. Here are some tips to help you: Don’t dismiss your teenager’s concerns. Make them feel comfortable to talk to you if someone is repeating negative behavior toward them. Knowing that you are on their side will ease pain and embarrassment. Talk about social media. Smartphones, online messaging and social media sites make it easy for people to harass. You should also talk to your teenager about unwanted sexual advances, which can happen on any digital platform. Know the policies of your teenager’s school. Contact the school if your son or daughter is being harassed. Be sure to talk regularly with your child and with school staff to see whether the bullying has stopped and not increased. Teens are likely to feel that some behaviors are just normal teenage behavior that they have to deal with. Yet, the behaviors are truly making them feel uncomfortable and negatively affecting their self-esteem and sense of belonging. If your child comes to you with concerns of harassment, be sure to listen, come from a place of understanding and then, together, formulate a plan to stop it. Author For more information about Behavioral Health Care at Luminis Health or to schedule an appointment visit Luminis.Health/BehavioralHealth.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogMore than 38 million girls and boys under age 19 participate in organized sports each year in the United States. Among these kids, injury—from minor sprains to broken bones—is common. In fact, one in three young athletes will miss practice or games due to an injury. When athletes are injured, they want to get back in the game as soon as possible. The doctors treating them will determine the best way to repair their injuries and may prescribe pain medications. This is where some young people can fall into the trap of opioid addiction. A National Crisis Over the past two decades, addiction to opioids, which includes narcotic painkillers like Vicodin, OxyContin and Percocet—as well as heroin—has soared across the nation. In Anne Arundel County, 1,083 overdoses of heroin and other opioids were reported in 2018, according to the county Health Department. In 2015, then-Anne Arundel County Executive Steve Schuh declared a public health emergency related to heroin abuse and Maryland Governor Larry Hogan called it a statewide crisis, creating the Heroin and Opioid Emergency Task Force. Prescription narcotic abuse is often a first step to heroin addiction. Narcotic painkillers are easy to get hooked on, and when people can’t get enough pain medication from doctors to satisfy their need, they may turn to street sources. A shocking 80 percent of all heroin users made the switch to heroin after abusing narcotic painkillers, according to the U.S. Substance Abuse and Mental Health Services Administration. “Substance abuse disorder can happen unexpectedly. Opioid addiction can start with a simple tooth extraction or sports injury. If the pain medication is not taken as prescribed by a doctor, the tolerance level for the drug increases and you will need more of the drug to get the same effect,” says Keshia Brooks, supervisor of prevention education and family wellness at Pathways, Anne Arundel Medical Center’s (AAMC) substance abuse disorder treatment facility. The Danger for Athletes A study in the Journal of Adolescent Health found that boys who participate in organized sports have a higher chance of being prescribed narcotics and a higher chance of abusing them than boys who do not play sports. However, girls are more likely to be prescribed narcotics and to abuse them than boys, whether or not they play sports. Kwasi Sharif, MD, pain management physician with AAMG Orthopedic and Sports Medicine Specialists, urges patients to consider alternative ways to manage their pain. That could include physical therapy, exercise or other medications that are not opioids. He adds that the Centers for Disease Control and Prevention recommends non-opioid treatment for chronic pain, outside of cancer treatment, palliative care and end-of-life care. “If parents and their student athlete decide on use of opioids, it is crucial that they use the lowest possible effective dosage to reduce risks of opioid use disorder and overdose,” Dr. Sharif says. Programs at Pathways Outpatient Opioid Detox Program This program allows patients to safely withdraw from opioids over a period of three to six days, followed by ongoing professional support in recovery. For more details, visit PathwaysProgram.org or call 443-481-5400. Family Wellness Workshop A therapeutic and educational program for family members of adults or teens with substance use disorders brings together family members for on-site group therapy, educational sessions and personal growth. The program equips family members with communication skills, relapse prevention strategies and coping mechanisms for ongoing recovery. Full-day and weekend sessions are available. Call 410-573-5449 or visit PathwaysProgram.org for a complete schedule. Alcohol and Drug Education Program This program teaches adolescents about the current drug trends. It also provides training for parents on how to use Narcan, an opioid overdose reversing drug. This is a free program for Anne Arundel County teens ages 13-18 and their parents. For more details, please call 410-573-5422. Be Cautious About Narcotics “If a child is dealing with a sports injury and needs medication for pain, parents should first educate themselves on the various types of pain medications available and their side effects,” Keshia says. If a physician prescribes an opioid for your child, have a conversation with the physician about the medication, she says. If possible, be the one to monitor and dispense it to your child. “If given an opioid, ask about how long the pain medication should be taken before it can become a problem for the child,” Keshia says. “Parents should also ask what else is available besides opioids that will help with the pain. Can the child take a Tylenol or Ibuprofen?” If you do have leftover pills from an opioid prescription, ask your pharmacy if they accept unused pills, or take them to a medication disposal box. AAMC has two medication disposal drop boxes to dispose of unused or expired medications. The drop boxes are at MedPark Professional Pharmacy, located in the AAMC Sajak Pavilion, suite 170, 2002 Medical Parkway, Annapolis, Md., and at Arnold Professional Pharmacy, 1460 Ritchie Highway, Arnold, Md. READ MORE: Anne Arundel Medical Center installs drop boxes for unused or expired medications Medication Disposal The Anne Arundel County Police Department has drop boxes at four locations for the safe disposal of unused, expired or unwanted medications. Residents can drop off medications at any time daily at the following four district stations: Northern District located at 939 Hammonds Lane in Baltimore, Maryland. Southern District located at 35 Stepneys Lane in Edgewater, Maryland. Eastern District located at 204 Pasadena Road in Pasadena, Maryland. Western District located at 8273 Telegraph Road in Odenton, Maryland. Communication Is Key “It is very important that parents talk to their children about opioids,” Keshia says. “Many news reports, social media, advertisements and commercials can contribute to the start of a conversation about drugs. Parents can explain to the child how some medications, especially opioids, can affect you in a negative way if not taken as prescribed and abused.” She advises parents to discuss the signs and symptoms of substance abuse. “Talk about what drug abuse really is: Taking medication without permission from the parents or the doctor, taking someone else’s medication, taking too much medication, or sharing medication with friends. Discuss the number of overdoses and deaths that opioids have caused right in their own community,” Keshia says. “This conversation should happen when you are teaching a child right from wrong, and should gradually increase in knowledge and understanding as the child grows up.” Keshia also urges parents to educate themselves on what opioids are and what an overdose looks like, as well as take advantage of Narcan training opportunities. “Sports injuries are just one of many paths young people can follow to addiction, but we have to fight this crisis on all fronts, and we don’t want parents left saying, ‘I wish I knew,’” says AAMC Chief Medical Officer Mitchell Schwartz, MD. “Beyond educating parents, we’re encouraging area primary care providers, who are often on the front lines of treating sports-related and other injuries, to know the best practices for prescribing narcotics.” “And one of the most important roles the hospital can play in the community is to talk openly about this, removing the stigma associated with addiction so people aren’t ashamed to get help for themselves or their loved ones,” adds Dr. Schwartz. Removing the stigma is a big step toward ending the crisis. AAMC’s Pathways Treatment Center offers individualized substance abuse and mental health treatment. Call 443-481-5400 for more information. Authors Keshia Brooks, BSPH, MBA, is a prevention education coordinator at Pathways, AAMC’s substance abuse and mental health treatment facility. You can reach her office at 410-573-5400. Dr. Kwasi Sharif, MD, is a pain management physician with AAMG Orthopedic and Sports Medicine Specialists. You can reach him at 410-268-8862. Mitchell Schwartz, MD, is AAMC’s chief medical officer. Originally published Nov. 17, 2015. Last updated Aug. 26, 2019.
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