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.
Behavioral Health, Pediatrics
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Talking to your teen about harassment
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In 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, Pediatrics
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Preventing opioid addiction in young athletes
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More 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.
Behavioral Health, Orthopedics, Weight Loss, Wellness
General Page Tier 3
Working out with a buddy
Blog
We know the benefits of exercise: It can control our weight, reduce our risk of certain diseases, improve our mood and mental health, and lengthen our life. But it can be hard to get motivated.
If you could use a little push, look no further than a workout buddy. “Exercising with a partner holds us accountable and keeps us motivated,” says orthopedic surgeon James York, MD. “It can also help us overcome our fear of trying a new class or exercise equipment, bring variety to our workouts and increase our commitment to achieving fitness goals.”
Your exercise buddy could be a co-worker, spouse, friend, family member or new gym acquaintance. Look for:
Someone who is slightly fitter than you, so he or she can motivate you
Someone with similar fitness goals
Compatible schedules
Once you’ve found your perfect workout partner, try a few of these exercises:
Take a class at the gym, like a spin class or boot camp
Create a no-equipment, high-intensity routine at your home (think squats, push-ups, crunches, planks and high-knees)
Rock climbing
Try one of the martial arts, especially tai chi
Learn about more than 20 fitness classes and workshops available through AAMC.
Author
James York, MD, is an orthopedic surgeon at AAMC and practices with AAMC Orthopedics.
Originally posted February 15, 2017. Last updated Aug. 5, 2019.
Behavioral Health, Community
General Page Tier 3
Approaching gun safety as a public health issue
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About four in ten adults (or 42 percent of Americans) report that there is a gun in their household. Recent data shows that more people died from firearm injuries in the United States last year than in any other year since 1968, according to the Centers for Disease Control and Prevention (CDC). Gun-related injury and death remains one of the most seriously, and largely unaddressed, challenges facing the country. As the number of firearm homicides and suicides rise, the medical community is taking notice and action to treat the issue as a public health concern. Well over 100 professional organizations, including the American Medical Association, the American College of Physicians, and the American Public Health Association, have identified gun violence as a threat to the health of the nation and have issued calls to action around gun safety.
At Anne Arundel Medical Center (AAMC), leaders in ethics and medicine are working together to lay the groundwork for a policy on how clinicians can counsel patients on gun safety. “The perfect storm is brewing for us to no longer turn our back,” says David Moller, Ph.D., chief of clinical and organizational ethics at AAMC, in reference to gun safety. “It’s always about the people and, as medical professionals, we have a moral obligation to keep our communities healthy and safe.”
READ MORE: Tips for talking to kids after traumatic events
What does gun safety look like from a physician perspective?
“My responsibility as a physician is to ensure the safety and wellbeing of patients,” says Vincent DeCicco, DO, family physician at Anne Arundel Medical Group (AAMG) Annapolis Primary Care. “To me, it’s like talking to patients about their risk for heart disease. My moral obligation is to ask patients about their behaviors and help them get on a healthier track. ”
Dr. DeCicco says conversations about gun safety with patients start by encouraging healthy behaviors, which means owning a firearm in a responsible and safe manner. “Public health comes down to encouraging healthy behaviors,” adds Dr. DeCicco. “I won’t take your weapon away as a physician, but I do have a moral obligation to talk to you about the responsibility that comes with it.”
Andrew McGlone, MD, physician at AAMG Annapolis Primary Care, concurs that gun safety is a public health issue. “The medical community is positioned to play a significant role in the reduction of injury and death from firearms,” he says. “We can start by promoting gun safety to decrease unauthorized access for children, adolescents, and patients at risk for suicide. Approximately 40 percent of gun deaths in Maryland are from suicide. Research estimates that 45 percent of suicide victims in the United States were in contact with a primary care provider within one month of suicide. Empowering health providers, patients and their families to have honest and stigma-free conversations about mental health, suicide risk and gun safety is imperative.”
How can a public health approach help with gun safety?
Like other major health threats, Moller says the medical community can help reduce avoidable gun-related injuries and deaths using a public health approach. Using domestic violence as an example, he says medical professionals needed to think bigger and broader about how to solve the problem to achieve substantive change.
“As cases of domestic violence increased, medical professionals began to develop the idea that we needed a different approach, says Moller. “We began to reframe the problem of domestic violence away from the individual encounter and began looking at it as a community and public health problem.”
As a result, health providers today often screen their patients for signs of abuse and many hospitals are providing coordinated services to domestic violence victims. Similarly, Moller says starting a conversation together about reasonable, sensible solutions and recommendations on gun safety, storage, accessibility, and health is pivotal.
“This conversation is not aimed at taking away the legitimate right of people to own and use guns, but at minimizing the violence and the mortality that is associated with the role of guns in American society,” he adds. “It has to start with a conversation, and that conversation has to be reasonable, sensible and civil. For us in the medical profession, this transcends politics. Harm reduction is not the same as gun control. This is not political advocacy, it’s patient advocacy.”
Originally published in What’s Up Magazine.
Authors
David Moller, Ph.D., is chief of clinical and organizational ethics at AAMC.
Vincent DeCicco, DO, is a family physician at Anne Arundel Medical Group (AAMG) Annapolis Primary Care. To reach him, call 443-270-8600.
Andrew McGlone, MD, is a physician at AAMG Annapolis Primary Care. To reach him, call 443-481-1150.