July 1st, 2008 by Dr. Val Jones in Health Tips
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This is the final week of the WOMAN challenge – a great health initiative with a slightly awkward acronym (“Women and girls Out Moving Across the Nation.”) Designed by the department of Health and Human Services, the goal was to get 10,000 steps/day 5 days a week for 8 weeks total. Today they sent me a final list of stress-reducing tips that I thought I’d share with you (along with some personal commentary):
Tips to relieve stress
1. Be physically active – physical activity may prevent stress-induced suppression of the immune system The American Heart Association recommends a minimum of 30 minutes of cardiovascular exercise per day, 5 days a week, and 2 weight training sessions per week for optimum health.
2. Eat regular, healthy meals – with plenty of whole grains, fruits and vegetables.
3. Laugh (especially at yourself) – laughter releases feel-good chemicals in the brain.
4. Have fun with friends – friendship can reduce loneliness and stress inducing symptoms of depression, and may even prolong your life.
5. Confide in someone you trust – you don’t have to go it alone!
6. Make time to relax – if you don’t actively set aside time to unwind, you might not do it.
7. Get a full 8 hours of sleep each night – people who get too little sleep may be at a higher risk for health problems and even death
8. Keep a journal – writing down your thoughts can be cathartic and help you express pent up emotions.
9. Organize your daily tasks – disorganization can add to anxiety and feelings of stress. A cluttered home may be a risk factor for weight gain.
10. Learn healthy ways to deal with anger – your anger may be justifiable, but holding it in may do more harm than good. Alternatively, lashing out at others will certainly increase your stress. In some cases, anger management counseling can help.
11. Ask for help – if stress is severe, you may benefit from talking to a mental health professional. They can help you work out a plan to reduce your stress or anxiety.
12. Talk to your health care provider – if you think your stress may be related to an anxiety disorder, post traumatic stress disorder, or if you’re leaning on alcohol or other substances to deal with your stress – make sure you tell your doctor about it so you can find a way forward together.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 26th, 2008 by Dr. Val Jones in True Stories
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I spent the last few days in Orlando, Florida with my husband’s extended family. His nieces and nephews were looking forward to the vacation for months in advance, because they were really excited about going to Disney World. However, two of their parents have disabilities – my sister-in-law has stage IV breast cancer with metastases to her hip (making it impossible for her to walk), and my other sister-in-law is married to a man who is hearing impaired. Therefore, navigating theme parks can be a real challenge for the family.
As a rehabilitation medicine specialist, I’m always interested in learning about special accommodations for the disabled. So I contacted Bob Minnick, the Technical Director of Global Accessibility and Facility Safety at Walt Disney Parks and Resorts, to find out what Disney had to offer guests with disabilities.
Bob kindly agreed to meet me at his office on the Disney World grounds, and we had an animated 2 hour conversation about all the exciting programs that his team of engineers have designed. I was impressed with the depth and breadth of services they offer and thought I should let my readers know about them – because even if you or a loved one has a disability, you can still experience “the magic of Disney.”
But before I explain the specifics of the special programs at Disney, I wanted to pause to tell you a true story based on some information that Bob shared with me.
***
A young, non-verbal teen with autism (we’ll call him Johnny) was raised in rural America by two loving parents with scarce resources. They spent all their extra income on services for their son, hoping to give him the best chance at social integration possible. Johnny liked to watch cartoons, and was partial to Disney movies. He spent lots of time viewing them, replaying them many times over. His mom would often try to engage him in conversation about the cartoon characters, but sadly, he remained silent.
Years passed and the parents saved up their money to take Johnny on a trip to Disney World since they knew how much it would mean to him. He had been watching Finding Nemo a lot, and they wondered if somewhere inside his mind he could relate to the little fish with the weak fin. So when they were poring over the Disney theme park brochures and found a show at Epcot Center called “Turtle Talk” with Crush (the turtle character from Finding Nemo) they were determined to make sure that Johnny attended.
When they arrived at the auditorium one of the greeters realized that Johnny had special needs and asked if he’d like to sit in the front row. His mom’s heart skipped a beat – this was going to be a great day for Johnny.
As the lights dimmed and the crowd of kids hushed, a large, animated, moving model of Crush floated effortlessly towards the children in the front row. The blue lights and waving seaweed made the stage come alive with ocean wonder. Johnny fixed his eyes on Crush, transported to another sensory world.
As the sea turtle approached Johnny – almost nose to nose – it spoke to him. “Hello dude, how are you today?” Said the turtle.
And with a slow, deliberate voice, Johnny replied clearly, “Hello Crush. Nice to meet you.”
Johnny’s mom burst into tears and glanced at her husband as the two embraced their son – he had spoken his very first words right there in the auditorium in front of hundreds of people. And although no one else understood the significance of his response – to Johnny’s parents, it was the happiest day of their lives.
You might even say it was magical.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 21st, 2008 by Dr. Val Jones in Humor
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A friend of mine sent me this fake advice column entry (“Dear Walter” instead of “Dear Abby”). I’m so sorry that I don’t know who the original author is, but I’ve seen it around on some blogs. Let me know if you think it rings true!
Dear Walter:
I hope you can help me here. The other day I set off for work leaving my husband in the house watching the TV as usual. I hadn’t gone more than a mile down the road when my engine conked out, and the car shuddered to a halt. I walked back home to get my husband’s help.
When I got home I couldn’t believe my eyes. He was in our bedroom with the neighbor lady. I am 32, my husband is 34, and we have been married for twelve years.
When I confronted him, he broke down and admitted that they had been having an affair for the past six months. I told him to stop or I would leave him. He was let go from his job six months ago, and he says he has been feeling increasingly depressed and worthless. I love him very much, but ever since I gave him the ultimatum he has become increasingly distant. He won’t go to counseling and I’m afraid I can’t get through to him anymore. Can you please help?
Sincerely, Sheila
***
Dear Sheila:
A car stalling after being driven a short distance can be caused by a variety of faults with the engine. Start by checking that there is no debris in the fuel line. If it is clear, check the vacuum pipes and hoses on the intake manifold and also check all grounding wires. If none of these approaches solves the problem, it could be that the fuel pump itself is faulty, causing low delivery pressure to the carburetor float chamber.
I hope this helps.
-Walter
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 20th, 2008 by Dr. Val Jones in Expert Interviews
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I met Dr. Harding at a press conference announcing the expansion of the Give an Hour initiative and really enjoyed our candid conversation about the unmet mental health needs of veterans of the war in Iraq and Afghanistan. It is sobering to know that many hundreds of thousands of soldiers are returning to the U.S. with traumatic brain injuries and post traumatic stress disorder. They volunteered to give up their lives for us, will we volunteer to care for them?
An interview with Richard K. Harding, M.D., professor and chair of the Department of Neuropsychiatry and Behavioral Science and an adjunct professor of pediatrics at the University of South Carolina School of Medicine.
Dr. Val: You mentioned that this quote means a lot to you: “One does not escape war by leaving the war zone.” Can you explain what you mean by that?
Dr. Harding: I was referring to my own experience with children rescued from Vietnam and transported to the U.S. Here, 6000 miles away and in a perfectly safe place with lots of support and food, they were still dealing with the trauma of the war zone. And I’ve seen this all along in my career, especially taking care of the National Guard folks in South Carolina. I’ve seen people become depressed and anxious and use substances to try to deal with the recurring thoughts provoked by combat experiences. They have profound changes in how they see the world. These are healthy people who were doing well in their jobs and family life. And then when they come back, they have a considerable amount of anxiety and worry and a loss of optimism about the future. In a way, the war follows them home.
Dr. Val: How do you help your patients to gain maximal recovery?
Dr. Harding: The best treatment begins with an accurate diagnosis and good access to care. There have been some major road blocks in terms of dependents trying to use TRICARE insurance, so access has been limited for family members who need services.
A good diagnostic workup by someone who knows what he’s doing is really important. Military personnel need to see a therapist who has had experience with PTSD [post-traumatic stress disorder] and other combat-related mental health issues.And they also need to get into a good treatment program that is tailored to their needs. Some people need psychotherapy, and others need psychotherapy plus medications. Some may be so severely depressed that they need to be in the hospital temporarily.
Dr. Val: There have been reports of different rates of mental health disorders in different arms of the military. For example, 50 percent of National Guard personnel report mental health issues, whereas only a third of Marines report the same. What’s that about?
Dr. Harding: Well we don’t know why, but I can speculate. If you are a trained military infantry combat soldier, you’ve been through a lot of training. You are camping out in the woods, you’ve been shot at, you’ve been through all kinds of simulations. You also belong to a tight group of individuals with whom you’ve been working for a long time, and your family has support at the military base in which you live.
That’s a lot different than a National Guard outfit composed of citizen soldiers. They’re suddenly asked to come in — not just one or two weeks out of the year — but to deploy to Afghanistan for 15 months. These people are lawyers, doctors and so forth, but they are often put on frontline assignments as soldiers. Unfortunately, they don’t have the same training and experience as the professional soldiers, so they’re more subject to emotional trauma. In addition, their families back home are scattered all over the state and don’t have the same backup and support that a family on a base would have. Spouses are often isolated when their partner is deployed.
Finally, the stigma associated with mental illness makes the military personnel less likely to get help early on because they’re worried that it will limit their opportunity for promotion.
Dr. Val: I heard that the question about mental health treatment was recently removed from the security clearance questionnaire. Is that evidence of the Army’s attempt to embrace and normalize mental health treatment?
Dr. Harding: It’s a very important symbolic victory. There is still a problem with stigma, but the Army is responding to this concern. There’s a tendency to think of mental health issues as a sign of weakness. Tough Army guys aren’t supposed to have emotional problems. They feel that they’re letting down other people if they admit to problems. You’re supposed to be able to pull yourself up by the proverbial “bootstraps.”
Dr. Val: It strikes me as somewhat adaptive, though, to choose that kind of attitude in a combat situation.
Dr. Harding: Yes, it may be. Seventy-five percent of military personnel make it through without mental health problems. They show amazing resiliency when you think about it. I’d like to think that I’d have that kind of resiliency too, but I don’t know. You don’t know until you’re in the situation. When good people try to do tough things, some will inevitably fall into the injury category. What we have to do is get recovery going and the “physical therapy” in the mental sense started as early as possible to help them get back to full capacity.
Dr. Val: What’s the most important message that you’d like to relay to a general public audience about mental health services and veterans returning from Iraq and Afghanistan?
Dr. Harding: Services are available, but you have to ask for them. You have to raise your hand and admit that you have difficulties and need help. It’s also important to do this early on before you leave military service because you won’t necessarily get the same amount of care once you’re back in the workforce.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 20th, 2008 by Dr. Val Jones in Expert Interviews
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I had the chance to attend a recent press conference announcing the expansion of a nationwide effort to help U.S. veterans. The American Psychiatric Foundation, the Lilly Foundation, and Give an Hour Foundation joined forces to provide free mental health care for Iraq and Afghanistan war veterans and their families.
This innovative program allows mental health professionals to donate at least one hour a week of their professional time to serve the needs of the military. Collectively, this donated time adds up to a large improvement in access to services beyond the current reach for many of our nation’s heroes.
I am also hoping that the Give an Hour Foundation will join forces with Revolution Health to provide a therapeutic online community for military personnel and families who need support.
An interview with Barbara V. Romberg, Ph.D., founder and president of the Give an Hour Foundation
Dr. Val: Tell me about the Give an Hour initiative. Who came up with the idea, what does it involve, and how is the concept being promoted?
Dr. Romberg: I grew up in the post-Vietnam era and watched my brother’s friends go to war — and they either never came back or they returned as completely different people. So about three years ago, I was watching the Iraq war unfold and I became more and more aware that people were returning home with some very significant mental health issues. I began worrying about whether there were enough mental health services available to meet their needs, and I wondered if we in the mental health community should step up to provide additional services.
The thing that really pushed me to do something about this, as a busy private practitioner, was when I was driving in Bethesda [Md.] with my 9-year-old daughter. We passed a homeless veteran on the street and she said to me, “Mom, how can we?” It was the use of the word “we” that touched me. “How can we let this happen to these men and women who serve our country?”
And I thought, I can’t let her grow up and look to me and say, “Why didn’t your profession do something?” So I said, “OK, I’ve got to do this.” And that was the beginning of the Give an Hour initiative.
The Give an Hour initiative is a national network of mental health professionals — psychiatrists, psychologists, social workers, licensed counselors and therapists — who volunteer an hour of their time per week to serve the needs of the military. Participants are collected in an online database. Military personnel can come to our website at www.giveanhour.org, and enter their ZIP code and the services they seek, and we’ll return a list of providers available in their area. If there is no one listed in the database in the search area, we offer phone support.
Dr. Val: In your opinion, how is the health care system failing Iraq and Afghanistan war veterans who need mental health services?
Dr. Romberg: I’m not sure that it’s failing so much as it’s just being overwhelmed. The Department of Defense and the VA [Veterans Administration] are working really hard, but they’re just overwhelmed. It’s our duty, honor and opportunity to step up as mental health professionals and give back to the military. Regardless of what you think of the war, it’s a wonderful opportunity for our country to heal. The work is also therapeutic for the therapist.
Dr. Val: In terms of access to mental health services, where are the largest shortcomings: 1. Access to psychiatrists? 2. Access to psychologists? 3. Access to affordable therapies? 4. Community support?
Dr. Romberg: Yes. [Laughing.] All of the above. Many of the National Guard and Army Reserves staff return to rural communities after their tours of duty. There often aren’t providers who accept TRICARE [military health care insurance] in rural communities, so access to mental health services is limited. The VA is doing a lot of good work, but there are long waits and not enough therapists for regular ongoing visits. Continuity of care really suffers.
Dr. Val: What’s the most important message that you’d like to relay to a general public audience about mental health services and veterans returning from Iraq and Afghanistan?
Dr. Romberg: These men and women are put in situations that are sometimes horrific and excruciatingly stressful for long periods of time. If you put any of us into those situations, it would affect how we experience ourselves and the world. What we want to do is educate the public so that they understand this and know how to talk to their neighbors and co-workers. When people don’t understand an illness, they can become uncomfortable and fearful that they may say the wrong thing. But by normalizing mental health issues through public education efforts, we can reduce the associated stigma of mental illness.
Military personnel need to be comfortable in accessing services when they need them. For starters, they can visit the Give an Hour website. We’re also affiliated with many other Veterans Affairs associations like the Wounded Warriors program, National Military Family Association, and TAPS. These organizations can offer assistance or put people in touch with us as needed.
*See a continuation of this conference reporting here.*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
