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Hidden costs of mental health can hit communities

January 18, 2023/in Sound Mind/by Deidre Ashley

One thing the pandemic has really highlighted is the importance of mental health. We now know that mental health issues are much more common than previously perceived. Seventeen percent of youth and 20% of adults will deal with a mental health issue this year, says the National Alliance on Mental Illness. It is a complicated issue that comes with a lot of stigma, presenting real barriers to treatment.

Mental health issues do not discriminate, affecting individuals of all economic classes, races, cultures, ages and genders. While it is an equal opportunist in prevalence, there are a great many disparities when it comes to treatment and barriers. Those from marginalized populations and those who are financially stretched, underinsured or uninsured, or low income are affected at an equal rate. But they experience barriers to treatment at a much higher level.

This is especially true of the workplace, which is where many of us spend a great deal of time. Few are comfortable talking about their mental health struggles with employers and colleagues. The result can be a failure to receive early care, leading to loss of productivity or a need for more intensive treatment later. According to the World Health Organization, mental health issues may be responsible for millions of lost workdays each year. This means lost productivity to the tune of $1 trillion globally each year. This trend is increasing, and the burden of mental health issues continues to significantly grow.

Early, appropriate and effective treatment can decrease costs significantly while diverting individuals from hospitals or jails, before the issue becomes a crisis. It is important to know where to go as well as to ensure that services are accessible and affordable. Funding is a large part of what drives the availability of mental health services, especially for marginalized populations and those dealing with financial barriers.

Many states are seeing a crisis in the lack of acute inpatient or crisis stabilization services for those experiencing a psychiatric emergency. Wyoming is experiencing this crisis along with geographic complications (transportation) and economy of scale resources with a frontier population. This contributes to individuals ending up in emergency rooms for care.

In addition to overburdening the hospitals, many individuals that fail to receive treatment end up in the criminal justice system. Serious mental illness is found to be much higher in jails and prisons than can be found in the general population (NAMI). The disparity of individuals with mental illness involved in the criminal justice system has a significant affect on both health care costs and public resources. Appropriate and effective intervention and community-based services can improve outcomes and result in cost savings and reduce recidivism.

NAMI estimates that one-third to one-half of those dealing with mental illness will not seek treatment. Barriers include people thinking they can handle problems themselves, not knowing where to go for help, stigma attached to mental illness and accessibility and affordability of appropriate levels of service. In addition to the financial barrier there is also a time investment needed for treatment that many who are living paycheck to paycheck find difficult to prioritize.

What does this mean for Teton County? The state has an open access system that provides subsidized services for all residents in each county. The funding does not cover the entire cost of service and has decreased substantially over the last 10 years while the demand for services has steadily increased. The town of Jackson, Teton County and local donors have been extremely supportive of mental health. Funding cuts that were put on hold due to ARPA funds are set to hit this next fiscal year. In addition the state is looking at moving from the open access system to one where only prioritized populations have access to the subsidies for care.

The price of not investing in mental health is a burden that we all share. The consequences will fall on the individuals affected, family and caregivers, employers, service providers, government entities and, most importantly, quality of care. The responsibility rests on us all to invest in mental health, both our own as well as our most vulnerable community members.

https://jhccc.org/wp-content/uploads/2023/02/dan-meyers-hluOJZjLVXc-unsplash-1.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2023-01-18 17:34:292023-02-05 17:35:41Hidden costs of mental health can hit communities

Talk of suicide can reduce deaths

September 14, 2022/in Sound Mind/by Deidre Ashley

September is the month set aside for suicide prevention, but this topic is in the forefront of most discussions about mental health both in our community as well as across the state and the country. Suicide prevention is important every day. The topic is always difficult to discuss. An interesting statistic that is being studied by the CDC is that while the rates in the U.S. have been increasing steadily over the last decade, they in fact declined nationally 2% in 2019 and again in 2020 by about 3%. While we know more people were struggling over the last couple of years, the pandemic normalized talking about mental health as well as increasing access to treatment through telehealth.

Suicide is a complex issue. Not only can it be affected by an underlying mental illness, it can also be complicated by social, relational and community issues. Not all populations showed a decrease. Rates remained steady for young adults and people of color. While there is positivity in the decreases, we must continue to remain aware, educated and diligent in prevention and treatment efforts with continued focus on those subpopulations most at risk.

The suicide rate in Wyoming tends to be one of the highest in the U.S., usually within the top three with Montana and Alaska. The statistics are heartbreaking for those lives lost but also for all the people left behind. Teton County has been lower in number than other counties for the last decade or so but every single one is a devastating loss.

What can you do? There are several options for free training that can help members of the community recognize and respond to someone who is struggling. The Jackson Hole Community Counseling Center’s Mental Health First Aid program is one. This training deals with a variety of mental health issues in an eight-hour training. Specific to suicide prevention is safeTalk (two hours) and Question, Persuade & Refer or QPR (one hour). These trainings give community members the skills to recognize the warning signs of suicide, ask questions and provide resources for intervention. They are free to the public (offered by Teton County Prevention Coalition) and can be set up for anyone interested.

Many people first reach out to loved ones, clergy, teachers or friends. Many times there is fear about approaching the subject, not wanting to say the wrong thing. So how can we go about discussing the issue respectfully and responsibly?

• Be as direct as possible when talking about suicide.

• What can you do when you suspect someone you know is depressed or thinking of suicide? Be there and be direct.

• Do not be afraid to ask the question, “Are you having thoughts of suicide?” One of the biggest misconceptions about suicide is if you ask the question, you may plant the idea. But asking the question shows support and concern.

• If someone is experiencing suicidal thoughts, don’t dismiss or minimize the person’s comments (i.e., “It’s really not that bad”). Instead, face it head on.

• Talk to the person about your concern. Ask if she has been thinking about attempting suicide or has a plan for how to do it. Having a plan indicates a higher risk of action.

• Seek help. Contact the person’s doctor, mental health provider or other health care professional. Let other family members or close friends know what’s going on.

• Call a suicide or crisis hotline number (988).

• Make sure the person is safe. If possible, eliminate access to any means used to attempt suicide. For example, remove or lock up firearms, other weapons and medications.

• Call 911 if the person is in danger of self-harm or suicide. Make sure someone stays with that person.

Education plays a crucial role for communities in preventing suicide and eliminating the stigma of mental illnesses. Articles about suicide can educate readers about risk factors, warning signs and local resources for intervention. In addition, there is much more to understand about why people choose suicide as an option.

Many families or loved ones may blame themselves or feel judged by others. Those talking about suicide should be sensitive to tone, content and language. Responsible discussion should avoid judgment — intentional or implied — when reporting the story and should also include education about prevention.

Without a doubt, discussions about suicide should continue to happen throughout our community.

Several organizations and individuals are working as part of the Teton County Suicide Prevention Coalition on initiatives to provide information, support, counseling, training and prevention programs. Contact the Jackson Hole Community Counseling Center, 733-2046, or the Teton County Prevention Management Organization, 264-1536, to schedule or attend a training.

Warning signs and resources:

• Threats of suicide, talking about suicide or wanting to die

• Preoccupation with death, dying or suicide

• Increased alcohol and drug use

• Perception of being a burden to others

• Increased anxiety, agitation or aggression

• Hopelessness, no sense of purpose or reason to live

• Isolation from friends and family

• Rage or uncontrolled anger

• Impulsivity or risk-taking behavior

• Talking about feeling trapped or in unbearable pain

• Sleeping too little or too much

If any of these thoughts and behaviors apply to you or someone you know, seek assistance or advice by contacting a mental health professional. You may also call the Jackson Hole Community Counseling Center’s crisis line at 733-2046; National Suicide Prevention hotline at 988 or 800-273-TALK (you can also text HOME to 741741); or call 911.

https://jhccc.org/wp-content/uploads/2023/02/finn-nJupV3AOP-U-unsplash.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2022-09-14 17:14:512023-02-05 17:18:58Talk of suicide can reduce deaths

Panic attacks can be treated with patience

August 3, 2022/in Sound Mind/by Deidre Ashley

This time of year we are all busy with summer activities, work, fitting everything possible into the short summer season we tend to have here. Outdoor events to plan and attend, family to visit and memories to create.

While summer feels like it should be about getting outdoors or relaxing, this time of year also brings stress and anxiety for many as well. Commuting, traffic, busy and stressful work — it all takes a toll. Anxiety disorders affect 40 million individuals each year. In fact, it is the most common reported mental illness. Panic disorders fall under this category and are experienced by a roughly 3% of the population.

Panic attacks can be a terrifying experience, not only for the person having the attack, but also for those around them. Knowing a bit of mental health first aid to recognize and respond can be helpful. The group Mental Health First Aid describes a panic attack as “a sudden onset of intense anxiety, fear or terror that often occurs for no obvious reason.”

Symptoms (according to Mental Health First Aid):

• Rapid heart rate

• Sweating

• Trembling

• Shortness of breath

• Sense of impending danger

• Hyperventilation

• Faintness or dizziness

• Nausea

• Hot flashes or chills

• Chest pain

• Headaches

• Tightness in your throat, difficulty in swallowing

Panic attacks can come on suddenly and without warning at any time. If you have ever experienced one, you know why many end up in the emergency room. The Mayo Clinic reports the disorder can manifest in late teens or early adulthood and tends to affect women more often than men. The cause is not known but research does support a combination of biological and environmental factors including family history, trauma or life events, substance abuse and cognitive distortions that exaggerate physiological response. Attacks may vary but will usually peak within 10 minutes or so and may cause the individual to feel fatigued afterward.

Once you have a panic attack the fear of having another can become so great that individuals may begin to avoid situations where they may occur. If not treated the condition can affect every area of one’s life. Psychotherapy, biofeedback and medications can all be helpful, as can making lifestyle changes in sleep, diet and exercise. Panic attacks can also resemble serious health problems such as a heart attack, so it is important to seek medical help if you experience symptoms.

Now that you know the symptoms, how can you help someone having a suspected panic attack? Mental Health First Aid classes give some direction in responding. First, you should remain calm and speak in a reassuring but confident manner. Speak using short and clear sentences with clear and slow speech and avoid negative reactions.

• Let the person know that you are concerned and willing to help.

• Ask the person if they know what has happened or if they have a history of panic attacks.

• If you are unsure whether it is a panic attack or a serious health condition, check for a medical alert bracelet and follow any instructions and seek medical assistance.

• If the person knows they are experiencing a panic attack, reassure them and ask the person if they would like assistance.

• Reassure the person that you understand the fear and anxiety they are experiencing feels very real.

• Calmly remind them that he/she is safe and that the symptoms will pass.

• Ask the individual how you might be able to best assist them. Grounding exercises are often remarkably effective.

• Stay with the person until help arrives or the panic attack has ended.

• Once the attack has ended, offer resources for learning more about panic attacks such as the Anxiety and Depression Association and HelpGuide.org.

• Encourage the person to speak with a health professional if the attack persists.

To learn about Mental Health First Aid and to find classes near you, visit MentalHealthFirstAid.org or call Jackson Hole Community Counseling Center. We offer free classes throughout the year.

My favorite go-to grounding exercise is the 5, 4, 3, 2, 1. This exercise takes your mind off uncomfortable thoughts and feelings and into the present by using your senses. Notice:

• 5 things you can see around you

• 4 things you can touch/feel

• 3 things you can hear

• 2 things you can smell

• 1 thing you can taste

Additional activities:

• Name things in categories. Pick a category and name things that fall into that category. For example, name five types of dogs, name three types of trees, etc.

• Describe a normal activity in detail. Laundry, for example. Describe what you are doing in detail: “First, I separate colors from darks, then I let the machine fill, then I pour in the detergent …”

• Visualize a calm and safe place. While this may seem vague, try focusing on a pleasant mental image. Imagine yourself on a beach or a mountain, or anywhere you consider to be restful or joyful.

• Turn to humor. Use humor to jolt yourself out of the moment. If you have a smartphone and happen to come across funny videos occasionally, save those videos so you can watch them in moments of panic or anxiety.

• Count. You can also count to 10 followed by counting backward or saying the alphabet very slowly. You can even try to say the alphabet backward.

As always, you can call JHCCC 24/7/365 to speak with a therapist or ask questions about dealing with this issue or any other concern. We also now have an additional resource available to us all — you can call 988 and be routed to a professional trained in handling a variety of crisis.

https://jhccc.org/wp-content/uploads/2023/02/kelly-sikkema-XX2WTbLr3r8-unsplash.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2022-08-03 17:19:012023-02-05 17:21:58Panic attacks can be treated with patience

Mens’ mental health is ‘silent crisis’

June 22, 2022/in Sound Mind/by Deidre Ashley

Last month was Mental Health Awareness month. While there is more awareness in general, there are still areas that need to be addressed.

One issue that is important but does not always get a great deal of focus is behavioral health of men. The suicide rate is four times higher for males than females, and men make up almost 80% of suicide victims in the United State. Men living in small towns and rural areas have particularly high rates of suicide. In fact, Wyoming has the highest rates of suicide in the country. Yet men often seek help for mental health issues less than women yet experience mental illness at the same or greater numbers than women.

While many male celebrities and athletes are being more open regarding behavioral health issues, it is still an area of concern. Why are men less likely to seek treatment for depression, anxiety, substance abuse and general stressful life events? There are several theories about why this happens. There is a great deal of stigma around behavioral health issues in general, but the stigma may be even stronger for men given some perceived norms around masculinity.

Many boys learn early that it is looked at as a weakness to show vulnerability. They are encouraged to suppress most emotional responses like crying. This may become so ingrained that by the time they reach adulthood they may be unable to regulate emotions aside from anger or self-medicating. Anger is one of the few “sanctioned” male emotions. Even when some men do realize that they are depressed or struggling with substance abuse or some other problem, they are still less likely than women to seek help.

Seeking assistance for many men may be viewed in conflict with more historically traditional masculine ideals of toughness, independence and emotional control. A study was done several years ago in the Psychology of Men and it was found that “men with higher levels of traditional masculinity ideology also tended to have a more negative opinion of seeking psychological help.”

Men with these traditional views of masculinity may believe society looks down on a man who can’t “tough it out” on his own. Seeking or needing help has been viewed as a character flaw for men. Even men who do seek counseling may worry about what others think of their need for help. The reality, as found in the study listed above, is that men who score higher on a test of male gender role conflict — a conflict between rigid learned gender roles and the healthy expression of emotion — were more likely to be depressed and also more likely to have a negative opinion of psychological counseling. This leaves many men in a double bind.

So, what can be done to encourage more men to seek treatment?

First, there is much work to be done for reducing the overall stigma attached to behavioral health issues in general, but especially with men. Men’s mental health should be given attention as a social issue like any other health issue, with focus on issues such as post-traumatic stress disorder for veterans, unemployment and familial disruption. In addition to stigma reduction, there should be more choice in mental treatment, with more “male” options focused on the unique needs of men.

One such approach are campaigns such as Man Therapy (ManTherapy.org). Many of these issues have been exacerbated by the pandemic, and the campaign seeks to speak to men about issues important to them using humor and support from other men to normalize not only the struggles but also seeking help. Some of the creative and humorous advertisements include my favorite “You can’t fix your mental health with duct tape” or “Get a few things off your hairy chest” or “It’s OK to cry, even when it’s not about sports.” In general, men are more likely to seek mental health treatment for problems that they think other men share. Campaigns or approaches like theses may go a long way to reducing what has been known as the “silent crisis of men’s mental health.”

Through the support of the Teton County Prevention Coalition, residents have access to this resource at no expense. There are also many qualified providers in our area that can offer support at a sliding fee. One resource for finding the right fit is the St. John’s Health Resource Line at 307-203-7880. The Jackson Hole Community Counseling Center and Curran-Seeley also have 24/7 access to support at 307-733-2046 or 307-733-3908.

https://jhccc.org/wp-content/uploads/2023/02/sasha-freemind-Pv5WeEyxMWU-unsplash.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2022-06-22 17:23:142023-02-05 17:25:53Mens’ mental health is ‘silent crisis’

Mental health starts with awareness

May 11, 2022/in Sound Mind/by Deidre Ashley

Mental Health Awareness Month is upon us. The month of May has been recognized to bring awareness to this important topic since 1949. While the focus should not end with the month, it does provide opportunities. Talking about the issue, in fact, does make it easier to talk about, to personalize the issue rather than seeing just an illness or perceived weakness. This is the importance of awareness, a start to the conversation.

Mental health issues are common; an estimated two out of five of people are dealing with some sort of mental illness. Expand the conversation to include substance use and the numbers are even higher, especially after the strain of the pandemic. There tends to be a barrier to discuss behavioral health issues. It is called stigma, defined as “a mark of disgrace associated with a particular circumstance, quality or person.” In contrast, when there is awareness about mental illness it encourages more open communication, identification and early intervention.

Keep in mind these individuals are not only statistics but make up our community. This is our family, neighbors, friends; or it could be ourselves. This can be especially important for marginalized community members. Early intervention is essential in receiving appropriate care. By raising awareness we can normalize treatment and prevention like we would any other illness.

Behavioral health (includes mental health and substance use) should be seen as part of overall health and wellness rather than the many misconceptions that are out there. These issues can be managed by treatment and prevention efforts. Why should mental illness be any different from physical health conditions, such as diabetes, blood pressure or cancer? In fact, focus on your mental health can positively impact your physical health.

Awareness is also knowledge, and knowledge is power. Power can bring about positive changes in our community. Awareness is essential to understanding issues related to behavioral health and how to access support. Public knowledge is so important in accessing community resources. If you or someone you know needs support, do you know what is available in your community?

Awareness also decreases stigma for those individuals struggling with behavioral health issues. If we are aware of their struggles and strengths, we can begin to develop empathy and see the whole person and not just the illness. Stigma creates an environment of shame and guilt that too often stops those who need help from seeking treatment. Normalizing not only treatment but prioritizing all behavioral health issues and struggles could be a huge step forward.

Awareness can also trigger change on a much larger scale. As awareness from the public increases, more powerful and focused attention is produced. This attention can eventually result in important changes for those with behavioral health struggles and their families. It can lead to changes in policy, research, funding, prevention, innovations in treatment, access to appropriate and affordable services and changes in health care coverage.

Let us choose as a community to make behavioral health a priority. If we continue with more awareness, the pressures may increase and may result in more funding for resources. Let us keep the conversations and awareness on behavioral health issues in our community going. Do not be scared to talk about it. It may be difficult to start, but the power to reach out and educate the community is worth it. The connections we make with others in our community are the most powerful tool to reduce the stigma surrounding mental health and substance use issues.

Resources:

Mental Health First Aid Training — May 26, contact adamwilliamson@jhccc.org

Jackson Hole Community Counseling Center — 733-2046

Curran Seeley Foundation — 733-3908

24-hour crisis line or direct support if you have questions for yourself or loved ones.

National Suicide Hotline 1-800-273-TALK

St. John’s Medical Center Mental Health Resource Line — 203-7880

Call to find help with resources and supports in the community.

https://jhccc.org/wp-content/uploads/2023/02/micheile-dot-com-8tf3e8LaSX0-unsplash.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2022-05-11 17:26:102023-02-05 17:28:21Mental health starts with awareness

Alcohol can heighten depression

March 30, 2022/in Sound Mind/by Deidre Ashley

As we head into April and spring break, along with celebrating the coming of spring it seems like a relevant time to talk about alcohol awareness. While alcohol use issues have always been a public health concern on varying levels, two years of dealing with the pandemic has certainly exacerbated the issue. More individuals are reporting coping with stress with increased substance use, the most common being alcohol.

For most people a glass of wine or a couple of drinks (responsibly) is not cause for concern. For others it may be more of a slippery slope. In a recent community behavioral assessment report, results show that Teton County is not exempt from trends. Community members reported:

“With elevated economic pressures and a widespread tourism-based culture that normalizes drinking, alcohol can become a coping mechanism for stress. The survey showed a high level of excessive drinking in Teton County (44%) compared to the national average (27%). Teton County also has the highest rate of excessive drinking in Wyoming. In particular, men, young adults (18-39), and mid- to high-income individuals are drinking the most. One in every two men in Teton County, regardless of race or ethnicity, reported drinking excessively.”

The report continued:

“Substance use is having a detrimental impact on community members’ mental health. Many community members (40%) report being negatively affected by their own or someone else’s substance use, almost double the national average. A majority of behavioral health providers (68%) name alcohol use as a top factor that strains community members’ mental health. Alcohol is also leading to legal consequences. In 2020, 80% of custodial arrests in Teton County were due to alcohol, the highest in the state. Individuals of greater means and with better legal representation are likely to face fewer consequences as a result of these arrests, while those of less means are more likely to shoulder financial and legal burdens.”

Alcohol use is on a continuum, but when does it become a problem that should concern you?

• Do you feel guilty or ashamed about your drinking?

• Do you lie or hide your drinking habits?

• Have friends or family members who are worried about your drinking?

• Do you feel you need to drink to relax or feel better?

• Have you ever “blacked out” or forgotten what you did while you were drinking?

• Do you regularly drink more than you intended to?

• Have you ever tried to quit drinking and were unsuccessful?

• How much time do you spend each week drinking?

• Do you get urges or cravings for alcohol?

• Do you miss work or other obligations due to drinking?

• Has your alcohol use negatively impacted your work/school or family relationships?

• Have you given up activities or things that you used to enjoy?

• Does your drinking ever put you in dangerous situations?

• Have you developed health issues due to your drinking?

Answering yes does not necessarily mean that you are dealing with an alcohol use disorder. Many people may fall in the category of “problem drinker,” which is not an actual diagnosis but more of a phase to describe those who tend to misuse alcohol but may not need a higher level of intervention. However, some behaviors may fall into the more serious categories.

Binge drinking is defined as consuming four or more standard drinks for women and five or more drinks for men in about two hours. Heavy drinking is defined as consuming eight or more drinks per week for a woman or 15 or more drinks per week for a man. While not everyone who binge drinks or drinks heavily on occasion will develop an alcohol use disorder, this type of risky drinking behavior does increase your risk of harmful consequences. If drinking causes you social, legal or personal problems and you continue to drink despite the negative consequences, it is time to take note.

How does alcohol use relate to mental health? While the two issues can be intricately linked, one may not cause the other but can exacerbate an already present condition. Reaching for a drink may be a way to self-medicate or an attempt to decrease the uncomfortable symptoms that can come with anxiety and depression. While this may seem to help at first, in the end it is counterproductive and can become a difficult cycle to break.

Alcohol is in fact a depressant, but initially it also works as an indirect stimulant. Alcohol alters the levels of neurotransmitters in the brain. Neurotransmitters transmit signals that direct thought processes, behavior and emotions. Alcohol also increases the release of dopamine in your brain’s “reward center.” This increase can make your brain think that you are feeling better. If you are self-medicating, you may keep drinking to get this release, but at the same time you are also altering other brain chemicals that are increasing anxiety and depression. Furthermore, you will have to increase the amount of alcohol over time to attempt to get the same release, creating tolerance.

So if you are already dealing with anxiety or depression, this can exacerbate the issue, and if you drink heavily and regularly you are likely to develop some symptoms of depression. It will take time once you stop drinking for your brain to get back to normal function. In addition, with the decrease in inhibitions that alcohol brings, it can also lead to impulsive behavior. If you are dealing with depression and anxiety, this combination can lead to actions or behaviors that you might not normally engage in if you were not using alcohol, including risky behavior, self-harm and even suicide.

Understanding the relationship between depression or anxiety and alcohol abuse is an important part of removing some of the barriers to seeking treatment. For information on mental health issues, contact the Jackson Hole Community Counseling Center at 733-2046. For alcohol or substance use questions, contact Curran Seeley at 733-3908.

https://jhccc.org/wp-content/uploads/2023/02/eric-ward-akT1bnnuMMk-unsplash.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2022-03-30 17:29:062023-02-05 17:31:25Alcohol can heighten depression

Change can challenge mental health

February 16, 2022/in Sound Mind/by Deidre Ashley

“The only one who likes change is a wet baby.”

` — Mark Twain

What does change have to do with mental health? Great question. How we deal with change and view it can have a significant impact on mental health. Adapting to change is related to resilience and directly affects your mental wellbeing.

Change is part of life. Our lives and relationships are constantly changing. Our world today is also changing at an extremely fast pace, and it sometimes feels overwhelming to keep up. Sometimes we find ourselves spending a great deal of time and energy avoiding change, which can create anxiety and prolong the stress. How do you approach change in your life?

I remember, years ago, reading the book “Who Moved My Cheese?” and the buzz that it created with the story of types of reactions to change. The story involves four characters — Sniff, Scurry, Hem and Haw — who face an unexpected change of movement of their cheese. The cheese is a metaphor for what you want in life, i.e., job, relationship, health. The story demonstrates the main examples of how people tend to deal with change. It is a great, quick read that highlights common responses. It can be enlightening to see which character matches your own style.

Your worldview tends to affect how you deal with change. If you are having a negative view of things, change can be much harder to navigate and causes more stress. When stress and worry increase, so do physical issues (headaches, insomnia, digestive issues, muscle aches, blood pressure, etc.) and potential mental health issues such as depression, anxiety or substance use.

Most people tend to cope with change in one of two ways: escape coping or control coping. As the escape coping implies, it is based on avoidance. Control coping is a much more proactive approach. It involves managing emotions and taking an active stance being involved in the changes. Most of us work in both types at various times.

It is interesting to note the similarities of reaction to change and grief. I had a graduate school professor who once mentioned that most of the transitions or changes in our lives involve the grieving process, whether a breakup, loss of a loved one, job or a child leaving home. Noted in a recent article from “Mind Tools” are four common stages of reaction to change — shock and disorientation, anger, coming to terms, acceptance and moving forward.

Much like grief, the progression is different for everyone and rarely linear. Everyone has their own timeframe and own process. That is not to say that there are never skills you can use to navigate in a more productive manner if change is difficult for you. You are building your resilience skills.

When presented with change in your life, focus on the various stages:

• Shock and disorientation

• Emotional response — often anger or fear

• Acceptance

• Moving forward

Notice how you are responding and move to a conscious direction of moving with control coping, which entails regulating your emotions, getting support and being a productive and active part of the change. This type of coping does not mean trying to control the situation; it refers to controlling and managing your response in a mindful manner. Take some tips from the Cognitive Behavior Therapy approach, using positive reframes, radical acceptance and humor.

• Find your grounding in the familiar

• Take note of your perspective of the environment or situation

• Avoid becoming rigid

• Find support. Use your support network

Throughout your life there will be a good amount of change. It feels like it is coming at a faster pace in the world right now and it is normal to feel thrown off at times. Proactively and mindfully moving through the change can make all the difference in your overall mental health.

https://jhccc.org/wp-content/uploads/2023/02/hello-i-m-nik-z1d-LP8sjuI-unsplash.gif 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2022-02-16 17:31:402023-02-05 17:34:05Change can challenge mental health

Loneliness a highlight of health survey

October 13, 2021/in Sound Mind/by Deidre Ashley

From the Jackson Hole News & Guide Column Sound Mind

This last week some of the results from the Mental Wellbeing Survey, a component of the Behavioral Health Needs Assessment, were reviewed and discussed in a town hall forum. Much of the information from the survey is not surprising given what is going on in our community and with the fallout of the pandemic.

The results show that many of us have a strong sense of community and many have struggled with mental health at some point and some level. Increased feelings of loneliness and increased alcohol use may be among the consequences. So, what does that mean for our overall community health?

Social determinants of health are “economic and social conditions that influence individual and group differences in health status. They are the health-promoting factors found in one’s living and working conditions, rather than individual risk factors that influence the risk for a disease, or vulnerability to disease or injury.”

Looking at the underlying issues outside of just medical care related to health in various populations can shed light on solutions. Some common examples include education, income, employment, food insecurity, housing, health services and social isolation.

Locally, there has been a great deal of focus on housing and economic stability related to being determinants of health. That makes sense. We all know there is a large income disparity and housing issue at play.

However, one area that has also been identified as a factor but gets less attention is social isolation or loneliness. While we continue to have that small-town feel, our population is also growing and filled with people who are new to the area and people who are working several jobs to make ends meet. In addition, many of our friends have moved away. The pandemic has made social connection more of a struggle, and individuals may also find themselves isolated by stress, cultural and language barriers, and busy schedules.

It has been identified as a social determinant of health in our community through various needs assessment and is also an issue that more people than you would expect, are reporting. As you might guess, this is reported in even higher numbers by marginalized populations.

Social connection is an important part of overall wellness and can combat loneliness. Connection is the experience of feeling accepted or close to others. It can create a sense of self value and belonging and is an important part of interpersonal health.

Brene Brown has a great definition for social connection: “Connection is the energy that exists between people when they feel seen, heard and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship.”

Is this important for community well-being? The research shows that there is not only a correlation but a strong correlation between levels of social connectivity and physical/mental well-being.

Loneliness and low social connectivity increase the risks in the following ways:

  • Increased illness.
  • Increased aggressive thoughts and actions.
  • Slower recovery.
  • Higher levels of anxiety.
  • Higher levels of depression.
  • Developing unhealthy habits such as smoking, substance abuse and eating disorders.
  • Increased negative self-thoughts.
  • Suicide.

Benefits of high social connectivity include these:

  • Increased longevity.
  • Stronger resistance to illness.
  • Increased emotional regulation.
  • Increased mental and physical wellness.
  • Increased empathy.
  • Higher levels of self-esteem.

Does this mean that we should all have a lot of friends or attend frequent social events? Not so much. As it turns out, the quality of the connection is much more important than the quantity. Levels of isolation and loneliness were on the rise before the pandemic.

Everyone feels lonely from time to time. It is when it begins to affect your ability to function or goes on for an extended amount of time that it becomes problematic and can lead to depression.

Signs that you may be struggling might include the following:

  • Increased illness
  • Sleep disturbances.
  • Depression.
  • Increased anxiety.
  • Increased negative thoughts.
  • Increased defensiveness, negative self-thoughts and antisocial behavior.
  • Short temper, decreased impulse control.

What are some ways to connect if you or someone you know are feeling lonely?

The benefits of connection are about quality, so you don’t have to go out to where there are a lot of people (which is a good thing right now). There is a difference between being alone and being lonely. Someone can be surrounded by people and still feel lonely. Reaching out to even just one person will make a difference. Something as simple as calling and reconnecting with someone or reaching out for lunch, coffee or a walk. Get to know someone by asking questions and listen to answers. That helps if you are the one feeling isolated or if someone else is feeling disconnected. Take notice of the people around you. Get to know them and what is going on with them, share stories. In addition to helping them it will also make you feel more connected.

If you notice some patterns or are worried about yourself or someone else, reach out for help. It is easy with everything going on to feel isolated and withdrawn. One of the most amazing qualities of this community is how open, helpful and accepting we can all be when someone is struggling.

https://jhccc.org/wp-content/uploads/2021/10/Lonely.jpg 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2021-10-13 10:03:172021-12-13 10:11:44Loneliness a highlight of health survey

Community awareness can help mental health struggles

September 1, 2021/in Sound Mind/by Deidre Ashley

From the Jackson Hole News & Guide Column Sound Mind

It never ceases to amaze me what an amazing and complicated thing a community is — always changing and interconnected. When there are issues, solutions rarely come down to one intervention or agency. Maybe it is because we are in the middle of various needs assessments or dealing with the next COVID-19 round, but as the various human service groups collaborate to address needs, gaps and trends, how systems impact each other becomes more apparent and more and more important.

The needs assessments that have begun to come out for Teton County say that lack of housing, mental health and substance use are the top concerns regarding the mental well-being of our community. Mental health, or wellness, is more than just the absence of a disorder, but more about living a full and productive life. It is the ability to bounce or being able to adapt to life stressors and the ability to form connections to others.

None of us are surprised at this point to hear that housing issues and COVID are causing a great deal of stress on many in our community. It becomes obvious that the solutions will take more than one intervention, or organization and a community wide response; maybe not to entirely solve the issue, but to help the entire community be resilient.

The same approach is needed when looking at mental health. Community issues strain the entire system, reducing the efficacy of interventions and social service organization efforts. The response needs to be communitywide to make an impact.

Mental health issues affect all of us. According to the National Alliance on Mental Illness, before the pandemic 1 in 4 individuals were dealing with a mental illness of some sort. Those numbers have increased, with more than half the population reporting symptoms of anxiety and depression. Roughly half never seek services due to the stigma.

The consequences of not seeking assistance prior to reaching a crisis level are felt by not only the individual and families involved, but entire communities. Added stress in the environment — such as a global pandemic — can exacerbate the issue, and the fallout is felt by employers, law enforcement, hospitals, schools, putting more stress on social service systems. The ultimate consequence, and tragedy, is the loss of life. Suicide is the 10th leading cause of death in the United States (Wyoming tends to rank in the top five with per capita numbers) for adults and the second leading cause of death for ages 10 to 34 (NAMI).

While there are many resources and agencies that deal with specific issues such as youth crisis, substance use, domestic violence or mental health, it also becomes the responsibility of each of us as community members. When people are struggling they often turn to those closest to them first. Many times it is family, someone at school or church or friends who will initially respond and then possibly become an ongoing support system. Thus, it is important to feel comfortable talking openly about mental health. In addition to raising awareness of mental illness issues, it is also important to educate the community, empowering individuals to seek the support they need.

One way to become educated is to take a Mental Health First Aid course. Mental Health First Aid involves an eight-hour course that teaches community members basic mental health first aid. Classes are offered throughout the year, can be broken up through a lunchtime learning format and can be scheduled for groups as well.

The program uses the mnemonic of ALGEE, giving community members the knowledge, skills, and confidence to recognize and respond to mental health crises. The more educated and aware we are as a community, the more impact we will have on early intervention, suicide prevention and stigma reduction.

——

A Assess for risk of suicide or harm

Threats of suicide

Preoccupation with death, dying or suicide

Increased substance (alcohol/drug) use

Perception of being a burden to others

Increased agitation/aggression

Hopelessness, no sense of purpose or meaning

Isolation from friends/family

Rage/uncontrolled anger

Risk taking behavior

L Listen nonjudgmentally

G Give reassurance and information (resources)

E Encourage appropriate professional help

E Encourage self-help and other strategies

——

Reaching out to even just one person can make a difference. That can be done by calling and reconnecting with someone or reaching out for a walk or just a chat. Ask questions and listen to answers. This can help if you are the one feeling isolated or if you notice someone around you who may be struggling. Take notice of the people around you. Get to know them and what is going on in their lives; share stories. This may assist them and at the same time help you keep connected.

If you notice some patterns or are worried about yourself or someone else, reach out for help. It is easy with everything going on to feel isolated and withdrawn. One of the most amazing qualities of this community is how open, helpful and accepting we can all be when someone is struggling.

If you are concerned, contact a mental health professional, or call the Jackson Hole Community Counseling Center crisis line at 733-2046; the national suicide line, 800-273-TALK; or 911. You can also all the St. John’s Health Resource line, 307-203-7880, for assistance in finding a local therapist. Go to MyStrength.com and use access code “jhcommunity” for a free and confidential self-help mobile resource.

https://jhccc.org/wp-content/uploads/2021/12/Community.jpg 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2021-09-01 10:12:072021-12-13 10:19:09Community awareness can help mental health struggles

What to do if someone is not OK

July 21, 2021/in Sound Mind/by Deidre Ashley

From the Jackson Hole News & Guide Column Sound Mind

One positive thing that has come out of the pandemic: Not only are we more OK with being not OK, but we are also taking time to reconnect with others and have real conversations.

So many social interactions are nothing more than polite conversation, but as we emerge from our COVID isolations, conversations are about real connection. I know that things were a bit awkward at first, but now many find themselves asking the question “How are you doing?” and responding with real conversations.

So what do we do when the answer to the question is honest and lets us know someone is struggling? Where do you go from there and what can you do to help?

Depression is more common than you would think and does not discriminate. It affects people of all ages, genders and socioeconomics. Before the pandemic, depression was on the rise, especially in lower-income areas. The impact of the pandemic on mental health is still climbing. The ripples of depression are felt not only by the individuals but also by their families, friends and employers. Depression can make even simple daily tasks feel impossible. Suicide and addiction can be devastating consequences. Fortunately, prevention and treatment options are out there, and the more we talk about depression the more we need to learn to recognize and respond.

Depression is more than just the blues or being sad. Clinical depression is a mood disorder in which feelings of sadness, loss, anger or frustration interfere with everyday life for a longer period. Common symptoms include:

  • Low or irritable mood most of the time
  • A loss of pleasure in usual activities
  • Trouble sleeping or sleeping too much
  • A big change in appetite, often with weight gain or loss
  • Tiredness and lack of energy
  • Feelings of worthlessness, self-hate and guilt
  • Difficulty concentrating
  • Unusually slow or fast movements
  • Lack of activity and avoiding usual activities
  • Feeling hopeless or helpless
  • Repeated thoughts of death or suicide

Deep in the symptoms of depression for those who struggle can be a lack of motivation, energy or insight enabling someone to reach out for help on their own. What can you do when you suspect someone you know is depressed or thinking of suicide, or when it feels like you are trying but nothing seems to make a difference?

Just be there, listen and let them know you care. At times you may not feel your presence is wanted. But don’t underestimate showing up; just being there for someone and listening with empathy can show a person that she is not alone and that someone does care. There can be a great deal of guilt and shame involved in deep depression. Allowing someone to just talk about what they are going through can be so helpful. It is OK for someone to feel sad; don’t feel like you must solve all their problems or cheer them up. A lot of people are not comfortable sitting with sadness and think it must be avoided. The truth is, emotions are part of life and even a healthy response to life stressors.

Ask the question: “Are you having thoughts of suicide?” One of the biggest misconceptions regarding suicide is that if you ask the question that you may be planting the idea. The reality is that by asking the question, you are showing support and concern. Don’t dismiss or minimize (“It is really not that bad”) the person’s comments and ask direct questions.

  • Talk to the person about your concern. Ask if he or she has been thinking about suicide or has a plan for how to do it. Having a plan indicates a higher risk of suicide.
  • Seek help. Contact the person’s doctor, mental health provider or other health care professional. Let other family members or close friends know what’s going on.
  • Call a suicide hotline number. In the United States you can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Use that same number and press “1” to reach the Veterans Crisis Line. You can also call Jackson Hole Community Counseling Center at 733-2046. Better yet, make the call together.
  • Make sure the person is safe. If possible, eliminate access to any means used to attempt suicide. For example, remove or lock up firearms, other weapons and medications.
  • Call 911 if the person is in danger of self-harm or suicide. Make sure someone stays with that person.

Be genuine. You don’t need to walk on eggshells or inadvertently make the person feel like a burden or a problem. Be genuine and voice your concerns about the person. Try not to get into the “fix it” mode. You may not be able to solve all their problems, but the most important thing is your presence and understanding, showing empathy, and making a connection. Avoid judgment. The inability to “snap out of it” is true depression. Depression is not just being sad, it is an illness, so it’s no different from telling someone with another physical ailment to “buck up.” In fact, most who are suffering from severe depression have already tried this approach and may already feel like a failure for not being able.

Reach out and provide social opportunities. Ask them to help you out with a project or something that will include them but not call attention to their depression and make them feel embarrassed or like a burden. Invite them to contribute to your life in some way, even if it’s as small as asking you to go see a movie that you wanted to see.

These are just a few suggestions for supporting those you care about. Be patient with them and yourself, educate yourself and others on depression and resources in our community. Helping people get the treatment they need may take time and many different approaches but can make a difference.

https://jhccc.org/wp-content/uploads/2021/07/Depression.jpg 600 800 Deidre Ashley https://jhccc.org/wp-content/uploads/2021/06/JHCCC.png Deidre Ashley2021-07-21 10:20:532021-12-13 10:27:19What to do if someone is not OK
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Jackson Hole Community Counseling Center

640 East Broadway / PO Box 1868
Jackson, WY 83001

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The Jackson Hole Community Counseling Center is a private, non-profit community mental health center, organized under the 501(c) (3) IRS code. JHCCC is certified by the State of Wyoming and the Commission on Accredidation Facilities (CARF) to provide a full range of mental health services to people in Teton County.

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