Tag Archives: depression

We Lose Too Many Vietnam Veterans to Suicide: Here’s How You Can Help

 

blog-vietnam-vets-day2

By Megan Lacy (Doctoral Student, Palo Alto University)

 

As our Vietnam veteran population ages, many may become increasingly vulnerable for death by suicide. Despite the fact that the Vietnam war occurred approximately 40 years ago, the moral injuries sustained are still felt by many who served our country. It is not unusual for Vietnam Veterans to have coped with difficult times by staying busy at home or at work. As retirement looms, it is not unusual for Vietnam era veterans to experience additional age-related risks such as social isolation, a feeling of burdensomeness, and changes in health status.

These changes can coalesce to hamper coping strategies that previously worked to manage mental distress, such as depression and posttraumatic stress disorder. Alcohol and substance use increases the risk of suicide as the abuse of substances, particularly alcohol, is strongly associated with both suicide attempts and deaths. So what should friends and family watch out for and what could be done in response to warning signs?

 

Warning signs:

In general, individuals most at risk of suicide are white older adult males who have health issues. As risk factors associated with veteran status converge on risk factors associated with later life , there are a few specific things friends and family should be aware of.

 

What’s going on in their life?

  • A major change in routine including retirement or loss of a job
  • The death of a spouse
  • A new medical diagnosis
  • A break up, separation or divorce
  • Not having a stable place to live
  • Inadequate family income

 

How are they behaving?

  • Increase in drinking or drug use
  • Sleeping considerably more or less
  • A loss of interest in things they typically enjoy
  • Social withdrawal
  • Impulsivity – engaging in risky behavior (running red lights, driving recklessly, looking like they have a “death wish”)
  • Becoming aggressive- examples of this are punching holes in walls, seeking revenge, getting into fights
  • Anxiety- worrying excessively about things they cannot control
  • Agitation and mood swings
  • Putting affairs in order such as giving away prized possessions or making out a will
  • Seeking out firearms access to pills
  • Neglecting personal welfare including deteriorating physical appearance or hygiene

 

What are they saying?

  • A sense of hopelessness:
    • “I have no purpose”
    • “I have no value”
    • “Nothing is ever going to get better”
  • Rage or anger: expressed toward people or things
  • Expressed feelings of excessive guilt, shame or failure:
    • My family would be better off without me”
  • Feelings of desperation:
    • “There is no solution”
    • “I just feel trapped”

 

What do they have access to?

Familiarity and access to a firearm makes suicide by firearm more likely. Any means by which a suicide can be attempted, including pills, is something that should be asked about. Veterans are more likely to own a gun and be comfortable using one making death by firearm a common means of suicide among this population.

 

How can you help?

Social support is one of the most effective protective factors against suicide (Cummings et al., 2015). However,  many veterans have isolated themselves and their friends and family struggle to talk to them. Inviting them to an event, writing them a letter or participating in a shared activity (building something, fishing, walking, etc.) are great ways to get things started.

Talk about it. Suicide is an uncomfortable topic but its best to be direct. Ask overtly if they are planning on killing themselves or have had thoughts about killing themselves. Just because they say no doesn’t mean that they don’t still have suicidal intentions so be sure to have additional information to provide such as a suicide hotline number for veterans, apps they could utilize (PTSD Coach), or a therapist’s contact information.

If your loved one has a plan or tell you they are going to kill themselves, call 911. Its better to put their safety first. Demonstrating your support by seeking additional help is always best. If you can, include them in the process of seeking immediate help. Calling 911 or visiting the ER does not have to be a one-sided decision.

These by no means are the only risk factors, signs or solutions for suicidality. However, engagement with friends and family has shown to be extremely effective against suicide. Demonstrating your support with regular calls or visits is an important step toward safety for many veterans.

 

Related Resources:

APA Psychology Topic: Suicide

Resources for Caregivers of Service Members and Veterans

When Will We Face the Facts about Suicide in Older Men?

 

References:

 

Chronic PTSD in Vietnam combat veterans: Course of illness and substance abuse (1996). American Journal of Psychiatry, 153(3), 369–375. doi:10.1176/ajp.153.3.369

Conner, K. R., Britton, P. C., Sworts, L. M., & Joiner, T. E. (2007). Suicide attempts among individuals with opiate dependence: The critical role of belonging. Addictive Behaviors, 32(7), 1395–1404. doi:10.1016/j.addbeh.2006.09.012

Conwell, Y., Van Orden, K., & Caine, E. D. (2011). Suicide in older adults. The Psychiatric Clinics of North America , 34(2), . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107573/

Cummins, N., Scherer, S., Krajewski, J., Schnieder, S., Epps, J., & Quatieri, T. F. (2015). A review of depression and suicide risk assessment using speech analysis. Speech Communication, 71, 10–49. doi:10.1016/j.specom.2015.03.004

Identifying signs of crisis. Retrieved February 26, 2017, from https://www.veteranscrisisline.net/SignsOfCrisis/Identifying.aspx

Lambert, M. T., & Fowler, R. D. (1997). Suicide risk factors among veterans: Risk management in the changing culture of the department of veterans affairs. The Journal of Mental Health Administration, 24(3), 350–358. doi:10.1007/bf02832668

Lester, D. (2003). Unemployment and suicidal behaviour. Journal of Epidemiology & Community Health, 57(8), 558–559. doi:10.1136/jech.57.8.558

Military Suicide Research Consortium (MSRC) Newsroom. (2017, January 28). Retrieved February 26, 2017, from https://msrc.fsu.edu/news/study-reveals-top-reason-behind-soldiers-suicides

Nademin, E., Jobes, D. A., Pflanz, S. E., Jacoby, A. M., Ghahramanlou-Holloway, M., Campise, R., Johnson, L. (2008). An investigation of interpersonal-psychological variables in air force suicides: A controlled-comparison study. Archives of Suicide Research, 12(4), 309–326. doi:10.1080/13811110802324847

Price, J. L. (2016, February 23). Findings from the national Vietnam veterans’ readjustment study. Retrieved February 26, 2017, from http://www.ptsd.va.gov/professional/research-bio/research/vietnam-vets-study.asp

United States Department of Veterans Affairs. (July, 2016) VA Suicide Prevention Program: Facts about Veteran Suicide. Retrieved from https://www.va.gov/opa/publications/factsheets/Suicide_Prevention_FactSheet_New_VA_Stats_070616_1400.pdf

Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E. (2008). Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting and Clinical Psychology, 76(1), 72–83. doi:10.1037/0022-006x.76.1.72

Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner Jr, E. (2010). The interpersonal theory of suicide. Psychological review117(2), 575.

Warning signs of crisis. Retrieved February 26, 2017, from https://www.veteranscrisisline.net/SignsOfCrisis/

 

Image source: Flickr user Elvert Barnes via Creative Commons


Filed under: Aging, Violence Tagged: depression, post-traumatic stress disorder, substance abuse, suicide, suicide prevention, trauma, veterans, vietnam veterans

How Mindfulness Can Lower Your Stress and Anxiety in 2017

Sharing their spirituality

By Tiffany Chiu (APA Minority Fellowship Program Office Intern and Undergraduate Student at University of California, Irvine)

It’s a new year and we know that 2016 was a stressful year for many of us. Thinking of a way to manage your stress and anxiety in the year ahead? Practicing mindfulness may be the answer.

According to the Centers for Disease Control and Prevention (CDC), in 2010 about 9 percent of Americans reported feelings of hopelessness or despondency associated with depression (CDC, 2010). How can we overcome such negative emotions? Prescription medications help many to alleviate depression, anxiety, and other mental health disorders. However, practicing mindfulness and relaxation exercises (e.g., meditation, yoga), may be equally as effective, if not more so, to alleviate stress and anxiety.

In a psychology study, cancer patients reported lower ratings of pain intensity and attributed pain relief and emotional positivity to praying and framing positive thoughts (Dezutter, Wachholtz, & Corvelyn, 2016). This study shows that we can all use mindfulness to build a therapeutic outcome in stressful situations.

 

There are three subjective themes to Mindful Meditation and Centering Prayer:

  1. Community: Participating in prayer groups can be an opportune time to show vulnerability without the fear of judgment. Having a safe forum allows us to build close friendships and share a sense of connectedness and purpose (Jones, Bodie, & Hughes, 2016).
  2. Peace: Practicing mindful meditation can also lower cortisol levels, the stress hormone (Turakitwanakan, Mekseepralard, & Busarakumtragul, 2013). Practicing mindfulness can give us strong clarity in our thoughts and peace during stressful and uncertain times.
  3. Moral Purpose: Mindful meditation and prayer can allow you to connect with your moral compass. Having a confirmation of your purpose and identity may lessen anxiety and stress in your daily life (Fear, Kenney, Loucks, McPherson, & VanOverbeke, 2005).

As a college student who struggles with anxiety, I became interested in practicing mindfulness after experiencing stigma for seeking professional help from within my community. The discrimination I experienced further fueled my passion for public awareness as a means for reducing the stigma of mental illness. To learn more about mindfulness, I conducted an independent research project on the effects of prayer practices on college students by interviewing and learning about students’ experiences with stress management.

Throughout my research, I discovered the prominent roles that mindfulness may play on the mental health of young adults. I am also interested in pursuing research that demonstrates how mindfulness may be implemented in wellness programs at institutions, such as federal prisons and schools. I would love to learn more about:

  • How we can use mindfulness to lower recidivism rates and increase social support in federal prisons.
  • How we can utilize mindfulness to make learning more effective for so many students in schools.

I hope that I can contribute to the answers of these questions as a researcher and school psychologist in the future.

More than adding to my professional capacity in research, mindfulness has improved my personal self-care. Practicing mindfulness in my everyday life has allowed me to create a balance between spending time with myself and connecting with others. Whether it’s praying in solitude or practicing yoga, these practices regulate my emotions and avoid burnout.

 

Here are 3 ways to implement mindfulness and relaxation exercises in your daily life

1. Mindfulness:

blog-prayer-meditation1

Find quiet time to sink into deep thought about the blessings in your life. Remind yourself of the people and things that you are most grateful for. Positively framing your thoughts can remove distractions of distressed thoughts and focus your mind on positive emotions.

2. Yoga:

blog-prayer-meditation2

This relaxing exercise allows you to practice your deep breathing techniques and simultaneously find clarity in your thoughts and emotions. By aligning and disciplining your mind to focus, you may also engage in reflective learning.

3. Reflective Journaling:

blog-prayer-meditation3

Writing in a journal is not only a way to document your thoughts, feelings, and values, but it allows you to know more about yourself by critically thinking, evaluating, and making sense of the events in your life.

 

Other Resources: 

Check out this handy infographic for how to do a 5-minute mini meditation:

blog-prayer-meditation4

Or watch this TED Talk video by psychologist, Dr. Kasim Al-Mashat, on how mindfulness meditation can redefine pain, happiness and satisfaction.

 

Overall, practicing mindfulness is positive for your emotional and physical health!

How do you practice mindfulness in your daily life? Please share your experiences in the comments!

 

References: 

Chiu, T. (2016). Prayer and biblical meditation for college students. (In Progress).

Dezutter, J., Wachholtz, A., & Corveleyn, J. (2011). Prayer and pain: The mediating role of positive re-appraisal. Journal of Behavioral Science, 6, 542-549. doi:10.1007/s10865-011-9348-2

Fear, F., Kenney, P., Loucks, R., McPherson, K. & VanOverbeke, J. (2005) Mindfulness and moral purpose: Exploring connections. Journal of College and Character, 6, 1-9.

Jones, S., Bodie, G., &Hughes, S. (2016). The impact of mindfulness on empathy, active listening, and perceived provisions of emotional support. Communication Research, 3, 1-14.

Turakitwanakan, W., Mekseepralard, C. & Busarakumtragul, P. (2013). Effects of mindfulness meditation on serum cortisol of medical students. Journal of the Medical Association of Thailand, 3, 222-249.

 

Biography:

Tiffany Chiu is currently a fourth year undergraduate student majoring in Psychology and Social Behavior at the University of California, Irvine. She is currently participating in the UCDC Internship Program, with placement in the APA Minority Fellowship Program Office. She is interested in pursuing a graduate degree in School Psychology and ultimately becoming a School Psychologist. If you have any questions regarding her research interests, please contact her at [email protected].

Image sources: #1 (iStockPhoto.com), #2, #3, #4 (Flickr via Creative Commons) and #5 (GuardYourHealth.com)  

 


Filed under: Health and Wellness, Stress and Health Tagged: anxiety, depression, meditation, mindfulness, mindfulness meditation, mindfulness strategy, prayer, stress, yoga

Suffering from Depression is Pointless

blog-depression-screening-day4

By David Palmiter, PhD (Psychology Professor, Marywood University)

Monsters are real, and ghosts are real too. They live inside us and sometimes they win.

Stephen King

October 6th is National Depression Screening Day. This day affords the opportunity to receive a free, anonymous and confidential screen for a mood disorder. Some statistics to keep in mind:

  • About 15.7 million American adults suffered from depression in 2014.
  • Suicide is the 3rdleading cause of death among young people ages 10-24.
  • Depression has a higher mortality rate than cardiac disease.
  • Depression causes more days off from work than any other medical disease.
  • The large majority of people suffering from depression do not get effective care, even though evidence-based treatments yield impressive results.

What would we conclude about our culture if the same statistics were true regarding our dental health? It’s sort of hard to imagine, isn’t it: dental health problems are common, destructive and usually treatable but only a small percentage of people receive said healing treatment. Images of us walking around with our knuckles dragging on the ground would come to mind. Yet, this is the reality regarding our collective mental health. Let’s vow to combat this state of affairs. Let’s agree that such a reality is stupid and beneath us. October 6th affords an opportunity to walk the talk that our mental health matters and that we deserve to live lives filled with joy and meaning.

Those attending a screening event can typically count on being greeted by a gracious person and asked to complete a form. No identifying information is requested and no fee is charged. Participants fill out the form, wait a little (so the form can be reviewed), and then meet with a mental health professional in a confidential space. The primary goal is to figure out whether further evaluation might be worthwhile but there is usually time to discuss other matters as well. Screening sites also typically provide referral information and education materials.

Referring back to the Stephen King quote, depression is a lying, liar that lives within its victim’s mind. It sings dirges such as,

“Everything is terrible. It’s all your fault and none of it can be changed.”

“You’ll never feel better again.”

“You suck and have no purpose.”

Depression’s end game is the death of its victim. But, on 10/6/16, an army of lean-mean-healing-machines will be available to help all those who may be so afflicted to begin the process of understanding and healing.

Please do yourself a favor if you are struggling with your mood, and take the brave and wise step to get screened. And, if you have a friend or a loved one who might benefit, ask that person to keep you company as you get screened. Such an act of kindness portends to open a door to transformative change. To find a screening site in your location, click here. For additional resources on fighting depression, visit the APA Help Center.

Biography:

Dr. David Palmiter is a psychology professor at Marywood University and a private practitioner. He is a fellow of APA, The American Academy of Clinical Psychology and the Pennsylvania Psychological Association (PPA). He is also a past president of PPA, a frequent consultant to the media and a blogger. An author of multiple scholarly papers, his two books are Working parents, thriving families: 10 Strategies that make a difference and Practicing cognitive behavioral therapy with children and adolescents: A Guide for students and early career professionals. His website is at http://www.helpingparents.com/; his blog can be found at http://www.hecticparents.com/ and his Twitter moniker is @HelpingParents.

Image source: Graţiela Dumitrică via Flickr Creative Commons


Filed under: Health and Wellness Tagged: depression, depression prevention, depression screening, mental health, National Depression Screening Day, screening, suicide prevention

How to Help People with Mental Health Conditions Quit Smoking for Good

blog-cdc-tips-smokers-mhconditions

By Corinne M. Graffunder, DrPH, MPH (Director of the Office on Smoking and Health,  Centers for Disease Control and Prevention)

Rebecca’s Story                                                                                                                                         

Rebecca, a former smoker featured in CDC’s Tips From Former Smokers campaign, started smoking cigarettes at age 16. Everyone in her family smoked, and once she started smoking, she quickly became addicted. She kept smoking into adulthood. While she tried to stop, she had difficulty quitting. “I probably tried to quit smoking at least half a dozen times, but the addiction was so strong.”

Rebecca was also diagnosed with depression at age 33, and she is not alone. Smoking is more common among people with mental health conditions than among people in the general population. In fact, people with mental health conditions smoke about 4 out of every 10 cigarettes smoked by adults in the United States.

Rebecca recalls the shame she felt when she tried to quit smoking and couldn’t. “All this time, I didn’t even realize that smoking and my depression went hand in hand. I was smoking to try to help my depression, but it only made things worse.” Struggling to quit made her feel even more depressed.

Smoking didn’t just affect Rebecca’s mental health. She also had gum disease and started losing her teeth. The additional toll smoking had on her health motivated her more than ever before to lead a healthy lifestyle. “I finally realized I had to look to myself for my own happiness and health. I had to quit,” she said. She finally quit smoking and received treatment for her depression.

Today Rebecca feels better than ever, both mentally and physically. “Today, I take care of myself. I eat right. I went back into therapy to self-check and to have a professional to talk to about the trials and tribulations that I go through as a single grandmother, and as someone who wants to stay healthy.”

After she quit smoking, Rebecca began running while taking her grandson along for a ride in his stroller. This activity helped her manage stress and depression and to stay smokefree. Six months after starting to run, Rebecca ran her first 5K. “I actually placed third in my age group. That gave me the confidence to keep going,” she said. Learn more about Rebecca’s story, and the wake-up call that  helped her quit smoking for good.

Smoking and Adults with Mental Health Conditions

The percentage of adults with mental health conditions who smoke is at least twice that of the general population, compared with fewer than one in five (17%) adults in the general population.

Smoking-related diseases such as heart disease, lung disease, and cancer are among the most common causes of death among adults. Smoking is not a treatment for depression or anxiety.

Quitting smoking is not easy, but it is possible! Like other smokers, adults with mental health conditions who smoke want to quit, can quit, and can benefit from using proven stop-smoking treatments. By including cessation as part of your treatment plan, you can improve more than just your patients’ physical health – you can improve their overall mental and emotional well-being.

Resources to Help Smokers Quit for Good

Primary care and mental health care providers should routinely screen patients for tobacco use and offer evidence-based smoking cessation treatments. You can help by asking patients about their tobacco use and providing support and education about cessation to those who smoke.

Mental health care professionals and primary care providers can:

  • Ask their patients if they use tobacco; if they do, help them quit.
  • Offer proven quitting treatments, including tailored quit assistance, to patients who use tobacco.
  • Refer patients interested in quitting to 1-800-QUIT-NOW, Smokefree.gov, or other resources.
  • Provide counseling, support, and stop-smoking medicines, as appropriate.
  • Make quitting tobacco part of an overall approach to treatment and wellness.
  • Monitor and adjust mental health medicines as needed in people trying to quit using tobacco.

Free resources to support smokers in their quit journey are at CDC.gov/quit.  These tools can help smokers:

  • Choose a quit date. A new month as a start date is a great idea.
  • Let loved ones know about their quit journey, so they can be supportive.
  • List the reasons for quit smoking.
  • Find out what triggers cause them to smoke, especially during the early days.
  • Have places to turn to for help right away.

Just like Rebecca, smokers can end the cycle of nicotine addiction. If you are a mental health professional who works with patients who smoke, please take a look at CDC’s Resources for Mental Health Care Professionals.

No matter what your specialty is, you know the damaging effects that smoking can have on your patients’ health. Most smokers want to quit. Getting started often takes support and motivation from trusted sources, like you. With CDC’s Resources for Health Care Professionals, you can help your patients quit smoking for good and begin a healthy, smokefree life.

For more information, check out APA’s Smoking and Health Disparities resource page.

 

References:

Centers for Disease Control and Prevention. (2013). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years with Mental Illness—United States, 2009–2011. Morbidity and Mortality Weekly Report 2013;62 (05):81–7 [accessed 2016 July 28].

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2013). The NSDUH Report: Adults With Mental Illness or Substance Use Disorder Account for 40 Percent of All Cigarettes Smoked [PDF–563 KB]. March 20, 2013. Rockville, MD [accessed 2016 May 18 ].

Biography:

blog-graffunder

Dr. Corinne Graffunder is Director of the Office on Smoking and Health within the National Center for Chronic Disease Prevention and Health Promotion. She is responsible for providing broad leadership and direction for all scientific, policy, and programmatic issues related to tobacco control and prevention.

Prior to her current position she served as the Deputy Associate Director for Policy in CDC’s Office of the Director, working to strengthen collaboration between public health, health care, and other sectors to advance CDC’s population health priorities. She has more than 25 years of experience with national, state, and local prevention efforts and working with the US Surgeon General and National Prevention Council, led the development of the first ever National Prevention Strategy: America’s Plan for Better Health and Wellness.

Since joining CDC in 1987, she has held leadership positions in the National Center for Chronic Disease Prevention and Health Promotion and in the National Center for Injury Prevention and Control, working on a range of health issues including tobacco control, cancer prevention and control, and violence prevention.  She received her doctorate from the University of North Carolina and her Masters of Public Health and Bachelors of Science from the University of South Carolina.

 


Filed under: Health and Wellness, Health Disparities Tagged: CDC, CDC Tips from Former Smokers Campaign, depression, health disparities, mental health, mental illness, smoking, smoking and mental health, smoking cessation, tobacco

How to Help People with Mental Health Conditions Quit Smoking for Good

blog-cdc-tips-smokers-mhconditions

By Corinne M. Graffunder, DrPH, MPH (Director of the Office on Smoking and Health,  Centers for Disease Control and Prevention)

Rebecca’s Story                                                                                                                                         

Rebecca, a former smoker featured in CDC’s Tips From Former Smokers campaign, started smoking cigarettes at age 16. Everyone in her family smoked, and once she started smoking, she quickly became addicted. She kept smoking into adulthood. While she tried to stop, she had difficulty quitting. “I probably tried to quit smoking at least half a dozen times, but the addiction was so strong.”

Rebecca was also diagnosed with depression at age 33, and she is not alone. Smoking is more common among people with mental health conditions than among people in the general population. In fact, people with mental health conditions smoke about 4 out of every 10 cigarettes smoked by adults in the United States.

Rebecca recalls the shame she felt when she tried to quit smoking and couldn’t. “All this time, I didn’t even realize that smoking and my depression went hand in hand. I was smoking to try to help my depression, but it only made things worse.” Struggling to quit made her feel even more depressed.

Smoking didn’t just affect Rebecca’s mental health. She also had gum disease and started losing her teeth. The additional toll smoking had on her health motivated her more than ever before to lead a healthy lifestyle. “I finally realized I had to look to myself for my own happiness and health. I had to quit,” she said. She finally quit smoking and received treatment for her depression.

Today Rebecca feels better than ever, both mentally and physically. “Today, I take care of myself. I eat right. I went back into therapy to self-check and to have a professional to talk to about the trials and tribulations that I go through as a single grandmother, and as someone who wants to stay healthy.”

After she quit smoking, Rebecca began running while taking her grandson along for a ride in his stroller. This activity helped her manage stress and depression and to stay smokefree. Six months after starting to run, Rebecca ran her first 5K. “I actually placed third in my age group. That gave me the confidence to keep going,” she said. Learn more about Rebecca’s story, and the wake-up call that  helped her quit smoking for good.

Smoking and Adults with Mental Health Conditions

The percentage of adults with mental health conditions who smoke is at least twice that of the general population, compared with fewer than one in five (17%) adults in the general population.

Smoking-related diseases such as heart disease, lung disease, and cancer are among the most common causes of death among adults. Smoking is not a treatment for depression or anxiety.

Quitting smoking is not easy, but it is possible! Like other smokers, adults with mental health conditions who smoke want to quit, can quit, and can benefit from using proven stop-smoking treatments. By including cessation as part of your treatment plan, you can improve more than just your patients’ physical health – you can improve their overall mental and emotional well-being.

Resources to Help Smokers Quit for Good

Primary care and mental health care providers should routinely screen patients for tobacco use and offer evidence-based smoking cessation treatments. You can help by asking patients about their tobacco use and providing support and education about cessation to those who smoke.

Mental health care professionals and primary care providers can:

  • Ask their patients if they use tobacco; if they do, help them quit.
  • Offer proven quitting treatments, including tailored quit assistance, to patients who use tobacco.
  • Refer patients interested in quitting to 1-800-QUIT-NOW, Smokefree.gov, or other resources.
  • Provide counseling, support, and stop-smoking medicines, as appropriate.
  • Make quitting tobacco part of an overall approach to treatment and wellness.
  • Monitor and adjust mental health medicines as needed in people trying to quit using tobacco.

Free resources to support smokers in their quit journey are at CDC.gov/quit.  These tools can help smokers:

  • Choose a quit date. A new month as a start date is a great idea.
  • Let loved ones know about their quit journey, so they can be supportive.
  • List the reasons for quit smoking.
  • Find out what triggers cause them to smoke, especially during the early days.
  • Have places to turn to for help right away.

Just like Rebecca, smokers can end the cycle of nicotine addiction. If you are a mental health professional who works with patients who smoke, please take a look at CDC’s Resources for Mental Health Care Professionals.

No matter what your specialty is, you know the damaging effects that smoking can have on your patients’ health. Most smokers want to quit. Getting started often takes support and motivation from trusted sources, like you. With CDC’s Resources for Health Care Professionals, you can help your patients quit smoking for good and begin a healthy, smokefree life.

For more information, check out APA’s Smoking and Health Disparities resource page.

 

References:

Centers for Disease Control and Prevention. (2013). Vital Signs: Current Cigarette Smoking Among Adults Aged ≥ 18 Years with Mental Illness—United States, 2009–2011. Morbidity and Mortality Weekly Report 2013;62 (05):81–7 [accessed 2016 July 28].

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2013). The NSDUH Report: Adults With Mental Illness or Substance Use Disorder Account for 40 Percent of All Cigarettes Smoked [PDF–563 KB]. March 20, 2013. Rockville, MD [accessed 2016 May 18 ].

Biography:

blog-graffunder

Dr. Corinne Graffunder is Director of the Office on Smoking and Health within the National Center for Chronic Disease Prevention and Health Promotion. She is responsible for providing broad leadership and direction for all scientific, policy, and programmatic issues related to tobacco control and prevention.

Prior to her current position she served as the Deputy Associate Director for Policy in CDC’s Office of the Director, working to strengthen collaboration between public health, health care, and other sectors to advance CDC’s population health priorities. She has more than 25 years of experience with national, state, and local prevention efforts and working with the US Surgeon General and National Prevention Council, led the development of the first ever National Prevention Strategy: America’s Plan for Better Health and Wellness.

Since joining CDC in 1987, she has held leadership positions in the National Center for Chronic Disease Prevention and Health Promotion and in the National Center for Injury Prevention and Control, working on a range of health issues including tobacco control, cancer prevention and control, and violence prevention.  She received her doctorate from the University of North Carolina and her Masters of Public Health and Bachelors of Science from the University of South Carolina.

 


Filed under: Health and Wellness, Health Disparities Tagged: CDC, CDC Tips from Former Smokers Campaign, depression, health disparities, mental health, mental illness, smoking, smoking and mental health, smoking cessation, tobacco

Postpartum Depression and Race: What We All Should Know

Give me break!

By Tanya Burrwell (Assistant Director, APA Women’s Programs Office)

“… Mothers are made to feel that a child is the pinnacle of achievement, and the only appropriate feeling on the birth of a child is joy. We’re expected to perform a certain femininity: to nurture and transmit traditions, to uphold honor” – Pooja Makhijani

While the birth of a child can be a wonderful and joyous time for many women, for some women it is a time of sadness, anxiety, loneliness, and worry that does not go away. In fact, up to 1 in 7 women experience postpartum depression, a very real and serious mood disorder (Wisner, et al., 2013).

What if I were to tell you that women of color experience postpartum depression at double the rate of the general population? Studies show that new mothers of color have rates of postpartum depression soaring close to 38% compared with the 13 – 19% rate for all new mothers (Keefe, Brownstein-Evans, & Rouland Polmateer, 2016).

This is because a disproportionate number of women of color are not screened for depression and do not receive the necessary treatment and services. In fact, it is estimated that up to 60% of women of color do not receive any services! Think about the devastating impact this can have on them and their families.

Research tells us that screening pregnant and postpartum women for depression can significantly reduce the symptoms of depression. In fact, the U.S. Preventive Services Task Force (USPSTF) just included pregnant and postpartum women in the new depression screening guidelines. If we know that screening works, we must ask ourselves why young moms of color experience this disparity.

Historically, studies show that women of color are less likely to seek mental health treatment due to cultural barriers and stigma surrounding mental illness. For many women of color, seeking the help of a mental health professional is seen as a sign of weakness.

“… No one talks about mental instability in the black community. The idea of seeking treatment never crossed my mind. I wasn’t some hysterical white woman with the privilege to lie in bed for days crippled by my emotions. There was nothing wrong with me, and besides, black people don’t do therapy.” – Tyrese Coleman

 

“Our cultures place a significant emphasis on us being silent about our struggles, taking care of everyone else before ourselves, turning to religion in an effort to overcome, and on being strong in the face of adversity-particularly in the face of oppression, racism and other socioeconomic stressors” – A’Driane Nieves

In addition, there are documented racial and ethnic differences in the perceptions and treatment experiences of low-income women of color vs. White women (Doulbier et al., 2013; Kozhimannil et al., 2011). These include:

  • limited access to health care services,
  • a disconnection with providers,
  • a lack of access to providers that look like them, and
  • unavailability of culturally/linguistically appropriate services.

A new study directly questioned low-income mothers of color about what they needed in order to access screening and treatment (Keefe, Brownstein-Evans, & Rouland Polmateer, 2016). Here’s what they found:

  • Access to Information and Resources: Educational campaigns must include women in all of their diversity. Information must be available in multiple languages (i.e., pamphlets, brochures, PSAs) and highly visible and accessible in communities (i.e., schools, doctor’s offices, grocery stores). They should also provide tip cards identifying local resources or national hotlines.
  • Access to Services: Women need insurance coverage; transportation to and from the doctor’s appointments. Childcare services should be made available and/or the availability of child-friendly offices and doctor’s appointments.   
  • Flexibility: Women need flexibility when making appointments. The choice to go to the doctor may mean not going to work, and vice versa, going to work may mean missing an appointment. Women need flexibility among health care providers, as well as sick leave benefits to allow time off for appointments.
  • Community-based Support Services: Providers should develop partnerships to establish local community-based services and/or peer-support groups in community centers, churches, and schools to increase awareness and dispel the myths and stigma about mental illness.

While it is critical that we advocate for screening for postpartum depression to identify women who are at risk, that is only half the battle. It is equally imperative that providers break down these barriers so that low-income women of color can successfully seek the treatment that they need.

In addition to supporting family friendly legislation, policymakers should recognize racial and ethnic disparities in access to care and incentivize programs that train women and men of color to become medical and mental health providers.

“The essays I found online by women with postpartum mood disorders were either by celebrities or white women. And while I truly appreciated these new parents shedding light on these issues, I never found a mirror to my experience.” – Pooja Makhijani

Postpartum depression knows no color, it can affect any woman regardless of age, race, ethnicity, or economic status. Primary care providers, social services agencies and mental health professionals must work together to educate, communicate and provide services that enable and empower ALL women. The time is now!

 

Resources:

APA Help Center – or call 1-800-964-2000

APA Postpartum Depression Resource (available in English, Spanish, French, and Simplified Chinese)

Black Women Birthing Justice

Black Women’s Health Imperative

National Institute of Child Health and Development – Info for Moms and Moms-to-Be

Postpartum Support International

Postpartum Progress

Postpartum Depression Facts

National Suicide Prevention Lifeline

SISTERSONG, Women of Color Reproductive Justice Collective

 

References included:

Breland-Noble, A. (2014, May 13). When our sisters are hurting… [Blog post]. Retrieved from https://psychologybenefits.org/2014/05/13/when-our-sisters-are-hurting/

Coleman, T. (2015, October 21). What it’s like having PPD as a Black woman. [Blog post]. Retrieved from https://www.buzzfeed.com/tyresecoleman/what-its-like-having-post-partum-depression-when-youre-black?utm_term=.hrRJ3BnZp#.rreWpJZA1.

Corby-Edwards, A. (2016, February 11). Depression screening works and now it can work for pregnant and postpartum women. [Blog post]. Retrieved from https://psychologybenefits.org/2016/02/11/depression-screening-works-and-now-it-can-work-for-pregnant-and-postpartum-women/

Dolbier, C.L., Rush, T.E., Sahadeo, L.S., Shaffer, M.L., Thorp, J., and the Community Child Health Network Investigators. (2013).Relationships of race and socioeconomic status to postpartum depressive symptoms in rural African American and Non-Hispanic White women. Maternal Child Health Journal, 17(7), 1277-1287.

Howell, E.A., Balbierz, A, Wang, J., Parides, M., Zlotnick, C., % Leventah, H. (2012). Reducing postpartum depressive symptoms among Black and Latina mothers: A randomized controlled trial. Obstetrics & Gynecology, 119(5), 942-949.

Keefe, R.H., Brownstein-Evans, C. & Rouland Polmanteer, R.S. (2015). Having our say: African-American and Latina mothers provide recommendations to health and mental health providers working with new mothers living with postpartum depression. Social Work in Mental Health, 1 -11.

Kozhimannil, K.B., Trinacty, C.M., Busch, A.B., Huskamp, H.A, & Adams, A.S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, 62(6), 619-625.

Makhijani, P. (2015, December 7). We can save one another’s lives: A conversation with women of color about postpartum mood disorders. [Blog post]. Retrieved from https://www.buzzfeed.com/poojamakhijani/we-can-save-one-anothers-lives?utm_term=.eber1PGqX#.vu4pZPNXV.

Nieves, A. (2015, January 6) Women of color and maternal mental health: Why are we so underserved? [Blog post]. Retrieved from http://www.postpartumprogress.com/women-color-maternal-mental-health-underserved.

Wisner, K.L., Sit, D.K., McShea, M.C., Rizzo, D.M., Zoretich, R.A., Hughes, …, & Hanusa, B.H. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70(5):490-498.


Filed under: Culture, Ethnicity and Race, Women and Girls Tagged: access to treatment, depression, equal access, health disparities, health equity, postpartum depression, racial disparities, women of color

Depression Screening Works and Now It Can Work for Pregnant and Postpartum Women

uspstf depression

By Amalia Corby-Edwards, MS (Senior Legislative and Federal Affairs Officer, APA Public Interest Directorate)

You may not have heard much about this, but something just happened that could positively impact millions of women and their families. The U.S. Preventive Services Task Force (USPSTF) just included pregnant and postpartum women in the new depression screening guidelines. 

Psychologists know that depression is common during pregnancy and after birth. Approximately one in seven women experience depression in the year after their child is born, and many of the symptoms begin during pregnancy. In addition to its psychological harms, perinatal depression is linked with pregnancy risks such as preeclampsia, preterm birth, and low birth weight. It is also linked to outcomes which can negatively affect children, including stopping of breastfeeding, family discord, and child abuse and neglect (AAP 2010).

Depression screening works. While health care providers may not always be able to prevent the onset of depressive symptoms, they can reduce the risks of perinatal depression by screening pregnant and postpartum women and referring them to an appropriate treatment provider. Thanks to the new guidelines issued in January 2016, screening for these women will begin to be incorporated into routine medical care.

The USPSTF is an independent panel of national experts in prevention and evidence-based medicine. The Task Force makes evidence-based recommendations on clinical preventive services, including screenings. Surprisingly, previous 2002 and 2009 USPSTF depression screening guidelines applied to all adults with the exception of pregnant women, citing a lack of evidence for this population.

The Task Force chose to revisit the body of evidence again in 2014, and made their research plan available for public comment. APA weighed in, emphasizing the need for a fresh look at the balance of the harms and benefits of screening pregnant and postpartum women. APA and other supporters of women’s reproductive health enthusiastically welcomed the inclusion of pregnant and postpartum women in the revised 2016 USPSTF depression screening guidelines.

Yet, much work remains. Meeting the mental health needs of parents is essential, because it is so closely linked to the well-being of their children.  Congress and the federal government should take a leading role. For example, the Melanie Blocker Stokes MOTHERS Act, which authorized support and education on postpartum depression and psychosis, was included in the 2010 health reform law (PL 111-148), but it has never been funded. Again in 2015, Congress introduced a number of bills focused on maternal mental health and substance use disorders, and even passed the Protecting our Infants Act of 2015 (PL 114-91), which addresses prenatal opioid exposure. Yet there has been no additional funding allocated for these issues, rendering the laws toothless.

APA’s Public Interest Directorate continues to educate congressional and federal agency staff on the importance of these issues. You can help us! Contact your Senators and Representatives to advocate for funding for these and other programs that address maternal mental health through APA’s Federal Action Network.

 

References

American Academy of Pediatrics (AAP). (2010). Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics, 126(5), 1032-1039.

 

Image courtesy of Flickr user Frank de Kleine via Creative Commons


Filed under: Health and Wellness, Public Policy, Women and Girls Tagged: depression, depression prevention, depression screening, perinatal depression, postpartum, postpartum depression, pregnancy, pregnant women, public policy, U.S. Preventive Services Task Force