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              Thanks to Jack Lyons for permission to use this Photo.

Not being a clinician myself, I often rely on my students and readers to make sure I don’t miss important developments. Pete Quily, an adult ADD coach, brought the issue of mental health parity to my attention. Thanks for the heads up, Pete!

What is mental health parity? This is an effort to make health insurance coverage of mental health conditions more in line with coverage of medical and surgical services.The Senate passed S. 558 unanimously on September 18, and now the House is considering H.R. 1424 . I encourage you to read about these bills. Click here for another useful description of mental health parity from the US Department of Health and Human Services. There are a number of tables that show the current status of mental health parity in the US.  This pie chart is from the SAMHSA site as well. (more…)

 
                Thanks to supergiball for permission to use this Photo.

On the surface, it seems that American voters have made their will clear.  Poll after poll shows that they are calling for a major overhaul of our health care system.  But when you look closer, their responses bristle with contradictions, contradictions that I think the reform-minded presidential candidates will have to consider when deciding how to approach health care reform. 

In a poll reported in Health Affairs at the end of last year, sixty-nine percent of respondents rated the US system as “fair” or “poor.” Yet in the same survey, when asked about their own experience with receiving medical services or with their own physician, 80 percent who had received care in the last year ranked their care as “excellent” or ”good.”  Other polls reveal the same pattern.

According to a survey released by Greenberg Quinlan Rosner in July, voters express doubts about the quality of the American health care system (with 49 percent dissatisfied), while 74 percent were dissatisfied with the cost.   Yet, “at another, more personal level,” the pollsters note, “a slightly different picture emerges. Fully eight in ten (82 percent) describe themselves as satisfied with the quality of the health care they receive personally. This number jumps to 90 percent among seniors (64 percent very satisfied), but includes impressive majorities of nearly all groups…”

Nevertheless, when the pollsters asked the same group about health care reform, three-quarters called for “major changes” or “completely rebuilding” the system.  If they are satisfied with the care they are receiving, why would they want radical change? Because they don’t feel secure that they will be able to keep what they have:  “There’s a precariousness to Americans’ contentment with their own health insurance coverage,” the Kaiser Family Foundation reported after looking at a number of polls at the end of last year.  “Among the insured, six in ten are at least somewhat worried about being able to afford the cost of their health insurance over the next few years, and nearly as many (56 percent) said they worry that by losing a job, they or their family might be left without coverage.”

This, then, is why so many Americans want universal health care: it would guarantee that they and their families would always be covered. (more…)

Every fall we look forward to the delightful treat of gaining an hour of sleep during daylight savings time. Wouldn’t it be rejuvenating to sleep like you had an extra hour every night?

Dr. Rubin Naiman, Director of Sleep Programs at the award winning destination spa, Miraval Resort, Tucson, offers expert advice on creating an optimal sleeping sanctuary. Having devoted the last 25 years to promoting sleep health, Dr. Naiman is a distinguished source on approaching the sleep issue comprehensively, from a body, mind and spirit perspective.

Here are some of Dr. Naiman’s unique tips for how to fall back to a healthy sleep this autumn by creating a sleeping sanctuary in your own bedroom:

        Thanks to vieilles_annonces’ for permission to use this Photo.

• Sleep in a warm-colored, darkly painted room to ease into darkness.        
• Awaken to a Circadian Alarm Clock. As it nears the time you has set to wake, the light will slowly grow brighter, starting the body’s natural wake-up process. Once fully awakened to the sunny glow, you will feel refreshed, positive and prepared rather than drowsy and confused as often happens with a blaring, buzzing alarm clock.         
• Replace regular Edison light bulbs with ‘blueblockers’ bulbs. These special light bulbs block the blue components of light allowing melatonin (the sleep inducing hormone) to be produced naturally.         
• Remove the television and all LED lights from the bedroom as these are distractions from falling asleep naturally.         
• Pro Sleep Atmosphere: Use a HEPA Filtration/Humidifier system to circulate the cleanest air which will disseminate allergies and promote healthy breathing.         
• Optimal Bed & Bedding: Dress your bed with organic Pure bedding that is manufactured without dyes and is hypoallergenic that does not contain harmful toxins like cotton sheets.

Now that you’ve made your bedroom, go sleep in it!

Borzack Crave
Creator of Healthy.Lifestyle
Ashworth University Contributing Blogger 

*We are honored to introduce the progressive health perspectives of Borzack Crave to the AU Health Care community.  Borzack’s Healthy.Lifestyle site is one of the most comprehensive resources for health related research, practices, and advice on the Web.  We would like to extend a special thanks to Borzack Crave for giving us the opportunity to share her terrific insights with our student community. 

Research shows that one of the most popular treatments for depression - according to clinicians, researchers and patients - is exercise. The problem with exercise is that it’s very hard to start, or once started, very hard to continue to form a habit. If you’re like me you have a treadmill, a bike, or some kind of gym apparatus collecting dust in a corner of your house.

Here are some ideas to help.

1. Start slowly and set small goals. Aim for things that you can achieve, like walking for 10 minutes each day. If you go for a complete training program straight away then you are more likely to fail. I make this mistake all the time. I plan an elite-style exercise regime, then quietly concede a few weeks later that it never got off the ground.

2. Make exercise a habit. If you start slowly you are more likely to continue. Once you’re over the “exercise hump” - say the first couple of weeks - you will be well on the way to a healthy habit.

3. Do something you enjoy. This will help to associate exercise with positive feelings. Shoot baskets, go for a swim, or walk laps of the local mall. (But remember that ecotherapy is better than shopping center exercise). A symptom of depression and other mood disorders is a loss of pleasure in things that you once enjoyed. If you start and persist with an exercise that you used to enjoy, the pleasure is likely to return.

4. Exercise with other people. Exercise is very hard to start and then continue on your own. Especially if you have a strong gravitational force that prevents you from getting up. You are much more likely to succeed if there is a commitment involved, like a set of expensive aerobics classes, walking with a friend once a week, or hiring a personal trainer to cheer you on.

5. Rethink your attitude to exercise. Exercise is essential for keeping your body and mind healthy. It provides huge benefits to you, that can make a vast difference to your mental well-being. Exercise can also be enjoyable and bring a great sense of achievement or satisfaction. If you develop a positive attitude towards exercise you will find it easier to commit time to it.

6. Is anything else stopping you? Many of us have other barriers to activity, like self-consciousness. There are many different ways to exercise, so find one that you’re comfortable with. Don’t use it as an excuse that just prevents better health.

7. Build your exercise into a task. On the weekend I surprised myself by pulling down a fence (intentionally). Actually I only pulled down most of it - if I finished it in one day my wife would have been suspicious. Anyway, it was a lot of effort to pull it down. A lot of exercise. It is also exercise to walk the dog, or mow the lawn, or wash the car. If you combine your exercise with a task then you will have twice the satisfaction when it’s over.

8. Be reasonable. Exercise and depression don’t seem to go together, just as swimming against the tide doesn’t really work. Don’t be hard on yourself when things don’t go to plan. Give yourself full credit for your successes and keep persevering to form a strong habit.

“I have to exercise in the morning before my brain figures out what I’m doing.”
Marsha Doble

“I gotta work out. I keep saying it all the time. I keep saying I gotta start working out. It’s been about two months since I’ve worked out. And I just don’t have the time. Which uh..is odd. Because I have the time to go out to dinner. And uh..and watch tv. And get a bone density test. And uh.. try to figure out what my phone number spells in words.”
Ellen DeGeneres

“The trouble with jogging is that the ice falls out of your glass”
Martin Mull

James Bishop
Creator of Finding Optimism 
Ashworth University Contributing Blogger

*Mr. James Bishop shares his personal experiences and insights dealing with mental health issues in his inspiring Finding Optimism Blog.  We are grateful to have James, joining us all the way from Australia, as a contributing blogger to our AU Health Care community.

        Thanks to Amanda Cooper for permission to use this Photo.

A report from the National Institute of Occupational Safety and Health quotes the following survey results:

• 40% of workers reported their jobs to be very or extremely stressful
• 25% viewed their jobs as the largest source of stress in their lives
• 26% said they were often or very often burned out or stressed by work.

A study by University of Melbourne researchers last year found that job stress accounts for 1/3 of depression cases in women and up to 1/3 of cases of cardiovascular disease in men.  These are amazing statistics.  The answer to tackling stress at work is two-fold.  Firstly, you can push to make changes to the job itself - a big picture approach.  You need to have a clear idea of what is going wrong.  The following table may help if the problem isn’t readily apparent.

Try to identify the causes of your stress, and work out what you would like to change to eliminate them.  If you can discuss your problem with your manager he or she may be able to make immediate changes.  If the source of stress is your manager then that’s another kettle of fish!  See if there are procedures in place to deal with this.  If there aren’t any then perhaps you can talk to an employee representative, HR department or Employee Assistance service (if you have one).  Don’t be reluctant to talk about stress at work.  No employer should subject their employees to work-related stress. They should take it as seriously as you do.  Secondly, there are changes that you can make that you have complete control over.

     Thanks to Russell Bernice For Permission To Use This Photograph.

• Make a to-do list. Organize your work to feel more in control.  It’s easy to stop worrying about a future task if you record it on a list.  Only record the tasks you are definitely going to do, not the long-term projects that are always on the backburner.  Make sure you include a couple of things that you’ve already done, to get you off to a good start.

• Cut down on caffeine. Caffeine gets the adrenaline hormone pumping through the body and causing “fight or flight” alertness.  This is stress in itself, so it heightens any other stresses that you are also dealing with at work. Drink lots of water and keep your brain well-hydrated.

• Exercise during the day.  Regular exercise decreases the production of adrenaline which reduces the stress response.  As a bare minimum go for a walk outside during your lunch break. Perhaps find a new place to buy lunch a few blocks away.  Exercise outside of work hours will also help to cut your stress level during the day.

• Take breaks from your computer.  It sucks the life out of you, so by the end of a long day you’re feeling irritable.  Get away from the computer and connect with real people every now and then.

• Slow down. Do you rush to work in the mornings?  Simplify things so that you’re not over-committed and rushed. Can you get up 15 minutes earlier for a calmer trip to work?

• Don’t forget to take vacations.  The company won’t collapse without you (unless you own it).

• Work shorter hours.  Limit your work day to what you agreed to with your employer.  Working long hours is one of the main causes of work-stress.  Protect your time and say “no” to requests that place unrealistic or unreasonable demands on you.

• Rise above office gossip.  Gossip is almost always negative, it brings people down and undermines relationships. Avoid difficult people.  Instead find positive, energetic people to be around.  Deepen friendships that are positive.

• Create a relaxation routine.  When something unexpected comes up you can deal with it without being stressed.  A routine may be something simple like deep breathing exercises, a quick relaxation technique, a walk around the office or outside, a trip to the water cooler or a chat with someone.

• Take mini-breaks during the day.  Use your relaxation routine to good effect.  Make sure that you move around away from your workspace.

In my own experience, most managers are willing to make at least some changes if you present them with the problem and a solution.  If stress is impacting your health then it’s a high priority, and you need to be proactive. As for the changes to your own life?  They will all make a positive difference so they are well worth adding to your work day.  Don’t become another statistic from stress at work!

James Bishop
Creator of Finding Optimism 
Ashworth University Contributing Blogger

*Mr. James Bishop shares his personal experiences and insights dealing with mental health issues in his inspiring Finding Optimism Blog.  We are grateful to have James, joining us all the way from Australia, as a contributing blogger to our AU Health Care community.

The inventory below is suitable for anyone, but it is presented here in the context of mental health.  Everyone experiences stress in day to day life, and a certain amount of “positive” stress is normal for us to function well.  But not everyone can resolve stressful issues immediately or through a “normal passage of time.”  In these cases it can become part of the cause of depression or a more immediate trigger that rekindles depressive episodes. The following inventory is to help you consider how well you are managing stress. Read the statements and record the numbers of those statements that apply to you.

When faced with stressful situations and events…

1. I sleep more than normal
2. I change my outlook and put the stressful situation into perspective                                                                        
3. I worry a lot but I’m unable to do much about it
4. I maintain a healthy diet
5. I indulge in retail therapy and buy myself something
6. I focus on the things that I control and accept the things I can’t
7. I withdraw from everyone emotionally
8. I find something funny to read or joke around
9. I ignore the problem and hope it will go away
10. I take time out and get away from the source of stress e.g.work
11. I drink more alcohol than normal
12. I take time to relax and unwind
13. I take medicine to relax or sleep better
14. I pray, meditate or use a specific method of relaxation
15. I grab a cigarette or coffee
16. I do some exercise
17. I get irritable and lash out at others
18. I confront the source of stress and look for a way to manage it
19. I try to ignore the stress and just get on with things
20. I put more time into a pastime that I enjoy
21. I eat more than usual
22. I seek conversation and support from my partner and / or friends

 
       Thanks to EdAP3437 For Permission To Use This Photograph.

What do the results tell you?

Pat yourself on the back for any even-numbered answers that you recorded. These are the more constructive strategies that are helpful in reducing stress.  Have a look also at any even numbered statements that you didn’t record.  Can you incorporate these as well?  The odd numbered statements are less effective and in some cases unhelpful for managing stress.  If you recorded lots of these then you might give some thought as to whether you need to make changes.  You could start by experimenting with the even-numbered strategies.

Adapted from The Relaxation and Stress Reduction Workbook by Martha Davis, Elizabeth Robbins Eshelman & Matthew McKay.

James Bishop
Ashworth University Contributing Blogger

*Mr. James Bishop shares his personal experiences and insights dealing with mental health issues in his inspiring Finding Optimism Blog.  We are grateful to have James, joining us all the way from Australia, as a contributing blogger to our AU Health Care community.