Hidden Signs of Depression by Alberto Souza, MSN, APRN, FNP-C

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.

 

Trouble Sleeping

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.


Losing Interest
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.”


Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed.


Low Self-Esteem

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.

 

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Sources

Healthtalk.org

helpguide.org

Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

Simple Ways to Improve Mood by Alberto Souza, MSN, APRN, FNP-C

We all have those days when it feels like we woke up on the wrong side of the bed. For whatever reason we are just in a bad mood. Often times these bad mood feelings are associated with difficult or stressful events in our lives such as trouble at work, financial problems or disappointment. Sometimes these bad mood feelings last for only a few hours, but sometimes they might linger for days at a time. There are many simple strategies to improve one’s mood in spite of what it is that might be bringing us down.

Be With People

Often times when we are feeling low just being with a trusted friend or family member and talking about our feelings can make all the difference. Having a sympathetic listener or someone that can get us laughing or looking at the bright side of things can make all the difference. We shouldn’t be embarrassed to talk about our mood or admit that we need help. In fact, many times isolating ourselves can be one of the biggest culprits in a lingering bad mood.

Get Out

Whether its a brisk walk through the neighborhood or a trip to the grocery store, getting out of the house can do wonders for improving our mood. Sometimes we just need a little sunshine or to breathe in some fresh air. The sights and sounds of everyday life can get our mind off of things and be a beautiful distraction.

Enjoy Yourself

When a bad mood strikes we might find ourselves not even wanting to do the things we normally enjoy, but doing them anyways can take our minds off of negative thoughts and often times will help us feel better overall. Think of simple pleasures like reading, exercising, cooking or baking, shopping or just watching a funny movie or show.

Talk to a Professional

Feeling sad or moody are normal human emotions that we all experience from time to time.  Depression is different from these emotions primarily because depression is a pervasive feeling of sadness that impacts our entire life and doesn’t just go away even when things in our lives are good. We should not hesitate to reach out to a professional to help us understand our feelings and deal with them appropriately.

Source: Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

Behavioral Health: Integrated Care and the Future of Whole-Person Treatment

The term behavioral health has gained exposure and popularity more recently, particularly among medical providers and those involved in healthcare reform in the United States. Burg & Oyama1 define behavioral health as, “the psychosocial care of patients that goes far beyond a focus on diagnosing mental or psychiatric illness… [encompassing] not only mental illness but also factors that contribute to mental well-being”. This is the first of a series of articles which will introduce essential concepts and goals for integrated behavioral health treatment.  Why is this important?  The correlation between comorbid mental health and medical issues has mounting evidence for impacting healthcare cost, treatment outcomes, and patient satisfaction.  Comorbidity in this sense refers to the presence of two co-occurring issues influencing the progression and prognosis of either condition.  Well researched comorbid conditions include diabetes & depression2asthma & anxiety/panic3, and chronic pain & psychosocial issues4.  The good news is we are learning innovative ways to effectively treat comorbid conditions concurrently, thereby increasing the likelihood of successful outcomes and improved quality of life for patients. 

The sustainable future of healthcare in the U.S. will likely require efforts to improve consultation/communication, cross-discipline competency, and collaboration among clinical teams.  Traditionally, mental health specialists (i.e. psychologists, LMFTs, LCSWs, LPCs, CMHCs, etc.) have operated in relative isolation from the medical community.  Aside from psychiatrists, who are primarily trained as Medical Doctors (MD), many practicing psychotherapists have minimal training in the biomedical model of treatment.  And the inverse is true as well, wherein medical practitioners often have limited understanding of psychotherapeutic theory, psychosocial problem etiology, and effective behavioral intervention.  This is exceptionally problematic for the patient because practitioners involved in treatment may have dramatically different, and often conflicting, beliefs about mental health problems and their respective solutions.  Sperry5  suggests, “the goal of health care integration is to position the behavioral health counselor to support the physician… bring more specialized knowledge… identify the problem, target treatment, and manage medical patients with psychological problems using a behavioral approach”.  The future of medicine may very well be found in systems which prioritize such supportive collaboration, encourage patient-centered policy, and deliver on whole-person treatment options.  

Hopefully this educational introduction to behavioral health integration can serve as a starting point for further interest and exploration of the topic.  While this is a relatively new concept, I predict we will see a dramatic increase of integrative efforts emerge over the next several years as clinicians, administrators, policy makers, and third-party payers (i.e. insurance companies) recognize the cost-effectiveness and clinical efficacy of interdisciplinary collaboration.  We do not live our lives in a vacuum, and our problems are rarely isolated conditions in themselves.  Therefore, we will need innovators across various disciplines to create efficient and effective systems which benefit all parties involved with the daunting task of healthcare reform.  As patients, we can empower ourselves with education about how the biopsychosocial model might positively influence our role and options in treatment.  So, the next time you are at the doctor’s office and they ask you questions about mood and/or behaviors, and you think, “What does this have to do with my medical problem?”, now you’ll know.   

References 

1.Burg, M.A., & Oyama, O. (2016).  The behavioral health specialist in primary care: Skills for integrated practice. New York, NY:  Springer Publishing Company.   

 

  1. de Groot, M., Golden, S.H., & Wagner, J. (2016).  Psychological conditions in adults with diabetes. American Psychologist, 71(7), 552-562.    

 

  1. Ritz, R.,Meuret, A., Trueba, A.F., Fritzche, A., & von Leupoldt, A. (2013).  Psychosocial factors and behavioral medicine interventions in asthma.  Journal of Consulting and Clinical Psychology, 81(2), 231-250.  

 

  1. Gatchel, R.J.,McGeary, D.D., McGeary, C.A., & Lippe, B., (2014).  Interdisciplinary chronic pain management.  American Psychologist, 69(2), 119-130. 

 

  1. Sperry, L. (2014). Behavioral health: Integrating individual and family interventions in the treatment of medical conditions.  New York, NY: Routledge.  

 

CCD Smiles: One in a million

I am the only one in my family with CCD (Cleidocranial Dysplasia), which was a random mutation. Having CCD influenced my studies and career choices. I have always been fascinated by the body, genetics, and helping others with physical or emotional health problems. I started my career as an emergency room registered nurse. I did my Master’s thesis on CCD and then went on to obtain a Doctorate in Nursing Practice (DNP) degree. I have been a nurse practitioner for the past 14 years, working in family medicine and mental health. My background in medicine helps me better understand CCD. I want to share my experience and medical understanding with others.  

I was born in Reedley, California in 1975. When I was born, it was obvious to my parents and doctors that something was wrong. My body, mostly my head, was shaped differently than a “normal” baby’s. At 3 months of age, I was diagnosed with Cleidocranial Dysplasia. 

I grew up knowing I was different. The most difficult part of CCD was all the oral and facial surgeries. My baby teeth never fell out on their own, my permanent teeth didn’t grow in on their own, and I had several extra teeth which had to be surgically removed. Everything in my mouth had to be done manually. I started having oral surgeries at age 7 and I spent most of my Christmas, Spring, and Summer breaks undergoing surgery. My last major surgery was when I was 19 years old. 

 CCD dental treatment was not easily navigated. My dentists, orthodontists, and oral surgeons had never treated anyone with CCD. Everything they tried was experimental. 

Medical insurance and dental insurance did not cover the cost of my surgeries. Medical insurance considered my teeth problems to be dental. Dental insurance considered the surgeries cosmetic. My parents were paying for my surgeries until I was in college. 

When I was growing up, I didn’t know anyone with CCD. In 2001, technology helped me to connect with other people with CCD for the first time. I heard about other people’s experiences as I conducted phone interviews for my Master’s thesis “CCD: The lived experience.” Eight years ago, I met Steffani and her daughter Hally, who have CCD, for the very first time. 

 CCD Smiles 

I felt inspired to create a nonprofit organization to help others with CCD. I started working on the foundation in 2013. In 2016, Gaten Matarazzo’s dad contacted me. Together, we made CCD Smiles an official IRS approved nonprofit organization in January 2017. Since it’s official beginnings, we have had gatherings and fundraisers across the country. I have met 38 other people with CCD, which has been a tremendous blessing in my life.  

 Gaten Matarazzo, from the series Stranger Things, is a huge part of bringing awareness to CCD. As his popularity in Hollywood has grown, so has familiarity with CCD and CCD Smiles.  

CCD Smiles is still in its infancy, but you can go to www.ccdsmiles.org to learn more about us and watch us grow! Currently, the website is a place for donations, purchasing CCD swag and education about CCD. In the future, the website will be a place where those with CCD can connect, share pictures, exchange stories, and find hope. I want others to know they are not alone. It will also provide current and accurate medical information, written in plain English. Doctors, dentists, orthodontists, and surgeons can come together and discuss treatment, research, and options for their patients. 

As CCD Smiles grows and donations are made, we can help cover the costs of oral/facial surgeries. If insurance isn’t going to help, then we can. I don’t want the medical/dental expense to keep parents from being able to provide beautiful smiles for their children. 

My ultimate dream is coming true. July 13-15, 2018 will be the first national CCD conference in Salt Lake City.  Watch the website for more information. If anyone is interested in donating time, money, or talents to this event, please email me at kellywosnik@ccdsmiles.org. 

CCD Smiles Mission Statement: We bring global awareness, provide assistance for dental care, and support research to improve outcomes and quality of life for individuals with cleidocranial dysplasia. 

CCD Smiles can be found in the media and on social media— Instagram, Facebook and Twitter (@ccd_smiles, #ccdsmiles) 

Originally published on Utah Valley Health and Wellness Magazine

Every Day is a Bonus Day: How a terminal cancer patient is inspiring others to live

My name is Melanie Day. I was diagnosed with breast cancer in 2013, just a few weeks after I found out I was pregnant with my third child. I endured chemo, surgery, and too many ER visits, all while pregnant. I eventually gave birth to a healthy baby boy, and then continued more chemo, radiation, and surgeries. After a year and a half of treatment, I had my first clear scan and was so excited to be moving on with my life, free of cancer. However, in 2015, they found cancer in my bones and I was given five years to live.

My perspective on life completely changed. Suddenly, I wanted to do all those things I said I’d do someday. I wanted to go on that Mediterranean cruise with my husband. I wanted to be more forgiving and stop judging others. I wanted to speak more freely and openly. I wanted to make sure that people knew how I really felt, and that they knew that I loved them. I wanted to stop saving my money and instead spend it on making memories with my loved ones. I wanted to stop worrying about what I looked like or what others thought of me. I wanted to instead build people up, make them happy and excited about life. I wanted to learn to enjoy the chaos of a toddler house and to stop obsessing with having a perfectly clean house. I knew I had to make a lot of changes. And I was grateful that cancer was teaching me to wake up!

I’ve always been the person who saved all my pennies and never splurged on anything. I’ve said no to so many adventures because I wanted to save my money instead, or I didn’t think I had the time, or some other excuse like that. But cancer has shown me how important it is to make the most out of life NOW. Making memories with my family and to no longer delay my dreams are top priorities for me now. My family and I have made an effort to go on adventures this past year to cross off my bucket list items. We spent Christmas making memories at a mountain resort instead of buying our kids presents. I skied in Tahoe for a weekend with the Send It Foundation. We took the kids to Disneyland for a magical week, thanks to some generous friends. In February, the BYU and Duke basketball coaches surprised me with the number one item on my bucket list. They got us tickets to the UNC at Duke men’s basketball game, my ultimate sports fantasy. In April, I spent two weeks in New Zealand playing in the World Masters Games with my former college teammates. Just last week, we witnessed thousands of lanterns in the sky at the Lantern Fest in Salt Lake City. A nonprofit organization called Inheritance of Hope is hosting us this next week in Florida at Disneyworld, Universal Studios, and Sea World. After that, we will be in Lake Tahoe for a family reunion. I plan on going to Hawaii in November, Europe the next two years, and NYC in the fall of 2018. I’m sure more opportunities for adventure will arise and we will seize them. I’ve said “no” to so many of these opportunities in the past, so going forward, I’ll mostly be saying, “yes.”

Although this terminal diagnosis drove me into depression and anxiety of my unavoidable death, I eventually realized the importance of sharing my story so that I could help others. That is now my life’s mission. I want to help others see what I see, without having a terminal disease. I want people to ponder their own death and let that motivate them to live their life how they want to NOW instead of waiting until it’s too late. I want people to realize that every day is a bonus day.

 

Originally published on Utah Valley Health and Wellness Magazine

Written by Melanie Day

What You Might Be Missing

 

Funny girl in eyeglasses with eye chart behind

At least once or twice a month, I see patients well into their thirties, and even forties, who inform me that they have never had an eye examination. They claim that their vision has always been very good and that they have had no need for a comprehensive examination. They are also very surprised to walk out of our office a week or two later with their new glasses—and can’t believe what they have been missing! Many wonder, How long have I been struggling to see? Could I have performed better as a child in school and even sports?

The school years are a very important time in every child’s life. All parents want to see their children do well in school, and most parents do all they can to provide them with the best educational opportunities. However, too often, one important learning tool may be overlooked—a child’s vision.

It has been estimated that as much as 80% of the learning a child does occur through his or her eyes…(read the rest of the story)

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Originally published on Utah Valley Health and Wellness

How I Got My Head Back in the Game

 

It was December of 2010. I was sitting on a training table inside Lucas Oil Stadium

in Indianapolis, making a phone call to my wife. She had given birth to our first child a few days earlier, and I was calling to reassure her that everything was alright. It was one of the last games of the season, and our second meeting with the Jacksonville Jaguars. The only thing I recall about the incident was getting ready to catch the ball, and then being face down in the turf with the Colts’ training staff around me. It was an all too familiar scene to the first concussion I had received, just a month and a half before, in Philadelphia. While sitting on that training table, it was pretty clear that I wouldn’t be finishing out the remainder of the 2010-11 season with the Colts.

During the next week I would go through the NFL’s concussion protocol, getting a standard MRI, seeing an independent neurologist, and eventually being told to just “take it easy” during the off-season. One common trait almost all professional athletes share is our desire to identify any weaknesses we may have, and make sure those weaknesses become strengths.

Naturally, my first priority during the off-season was getting my concussions dealt with and decreasing the possible long-term effects. Just resting and hoping it didn’t happen again didn’t sit well with me. For every other injury I had experienced throughout my career, I was told precisely what areas were affected by the injury, and was given an active rehabilitation protocol. This allowed me to strengthen the area affected in order to eliminate any overcompensation or chance of re-injury. It didn’t make sense to me why I wouldn’t take the same approach with the injuries my brain sustained…(read the rest of the story)

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Originally published on Utah Valley Health and Wellness

Photography by Mark A. Philbrick, Copyright BYU Photo 2007, All Rights Reserved

Preventing Sports Injuries

Fall is a special time of year. It’s cool, but not cold, the colors are popping on the trees, and the smell of fall sports is in the air! There are many things you can do before and during the season to perform your best and avoid injury.

First, get some sleep! Student athletes need 8-10 hours of sleep per night to recharge their muscle batteries, otherwise the muscles stay tight and tired, and aren’t able to recover from the previous day’s practice or game. Next thing you know, you just pulled a muscle. Go to bed early and beat your opponent!

Second, eat right. Avoid soda or candy, and try to limit red meat and packaged food. Go to the fish and vegetables like the pros do! Your body will feel stronger, and you’ll have the right fuel to keep your energy up and keep you going all day long.

Third…(read the rest of the story)

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Originally published on Utah Valley Health and Wellness

A Healthy Dose of Back-to-School Anxiety by Brent Black, LMFTA, MS

?????????????????What is a Healthy Dose of Back-to-School Anxiety?  As a family therapist, I often meet with parents who want to know if their child has anxiety and my quick response is “I hope so!” Today the mere mention of the word anxiety tends to induce stomach knots, racing hearts, and cold sweats. However, a proper dosage of anxiety is a key component for healthy and successful children. On the other hand, excessive anxiety and the absence of anxiety are debilitating. Since the launching of school can also launch levels of anxiety for many students, here are a few points for parents to consider as they look forward to a successful year.

MP900405644Too Much?
The better question about anxiety is “does my child have excessive anxiety?” All healthy individuals experience at least some anxiety, but excessive levels of anxiety can lead to harmful behaviors. In order to diagnose an individual with Generalized Anxiety Disorder they must meet certain criteria which include excessive anxiety or worry more days than not for at least 6 months, difficulty controlling the worry, restlessness, fatigue, difficulty concentrating, irritability, or muscle tension. These symptoms cause significant distress or impairment in social, educational or other significant areas of functioning. So, a helpful question in determining excessive anxiety is — “has my child been significantly impaired for an extended amount of time in important areas of their life because of the anxiety that they feel?”

The beginning of the school year is a fitting time for parents to consider the possibility that their actions might be creating additional anxiety. One parental trend that often leads children to experience greater anxiety is an excessive family emphasis on achievement. Children who feel like they have to achieve in order to win the approval and respect of their parents are often filled with anxiety. Their motivation for achieving becomes less about personal growth and more about fear of letting parents down.

Kids on School BusNot Enough?
The opposite of anxiety is apathy or carelessness. Children who are apathetic give off a vibe of indifference, laziness, boredom, and unconcern. Faces are unflinching and tones are flat. The default response for many questions is simply “I don’t know.” There is not an official term of diagnosis to describe these characters but they are easily identifiable.

One parental trend that could lead a child toward apathy is a parent who is inconsistent, indifferent, and un-opinionated about their child’s success. I see exceptions to this trend, but I am often unsurprised by a child’s apathy after meeting both parents and understanding that a child is simply following the example of at least one of the parents. In these cases the apple really doesn’t fall that far from the tree.

Achieving the Right Amount of Anxiety
???????????????????????A great question from parents is ‘how do I help my children have the proper amount of anxiety?’ One of the best ways of helping kids reduce to a healthy level of anxiety is by maintaining high expectations while also assuring children both verbally and non-verbally that parental love is not dependent on child outcomes. In other words, parents need to convey that regardless of achievement level their children will always be genuinely loved.
One of the main ways that parents can increase the anxiety level of their apathetic children is to get actively involved. Parents who sincerely check-in and follow-up with their children are likely to see the kind of anxiety that will help motivate their children to succeed.

Although anxiety is often viewed in a negative light, a healthy dosage of anxiety helps children to be successful. Of concern are children who are experiencing excessive anxiety or no anxiety at all. Great parents are those who feel appropriate anxiety about helping their children to be balanced in their anxiety.

brentAbout the Author: Brent is an Associate Marriage and Family Therapist. During his Master’s Degree at Brigham Young University he worked at Wasatch Mental Health where he gained experience in working with families who have children that struggled with depression, anxiety, autism, trauma, or addictions. Learn more about Brent at st.georgefamilies.com.

4 Components of Successful Concussion Treatment

 

As a scientist who studies concussion and does research on concussion treatment, I was recently asked what I would do if I needed concussion treatment. What questions would I ask, from my perspective as an expert? To answer this, my questions would focus on what I see as the four components of successful concussion recovery—diagnosis, assessment, treatment, and maintenance.

Diagnosis

How will my concussion be diagnosed? How will my concussion symptoms be distinguished from other potential health issues that might cause similar symptoms?

I would want to know what kind of health professional is best able to find answers to these preliminary questions, and what diagnostic tests will be used. A family doctor will typically be able to help get this process started and should refer you to a neuropsychologist, in the opinion of most concussion research experts. Among the tools that neuropsychologists use, a Functional Neurocognitive Imaging (fNCI) test is ideal. This is a type of MRI brain scan that can detect problems in brain functioning caused by concussion.

Assessment

After determining what my symptoms are, I would want to know exactly which parts of my brain have been affected, how that relates to the symptoms I am currently experiencing, and how my treatment will help my particular brain injury. A neuropsychologist, especially one who can use and interpret fNCI brain scanning, is usually best suited to do this assessment. In order for an assessment to be truly useful, it needs to go beyond being simply “informative” and give you and your medical providers a clear treatment plan for your individual rehabilitation program.

Treatment

Although post-concussion symptoms can vary widely from person to person, there are four general categories that scientists and doctors use to group common symptoms:…(read the rest of the story)

Originally published on Utah Valley Health and Wellness

Written by: Dr. Mark D. Allen