Reasons to tell people about it

Whether or not you discuss your condition with family, friends or coworkers is a personal decision. You may find it hard to talk about your diagnosis, or you may be concerned about how others will react. Ideally, the people around you will accept your illness and be encouraging. Bear in mind that they might not know very much about your condition. While they may want to help you, they may not know the best way to help. You can give them a better chance to support you by thinking ahead about how to tell them about your mental illness.

Why to tell
One reason to tell others about your mental illness is to receive encouragement. Talking to a sympathetic friend or loved one can reduce your stress level and improve your mood. You may no longer feel like you are keeping a secret. You may also want to ask for concrete support, like help finding treatment or rides to appointments. Or, maybe you want to share your crisis plan with a trusted family member.

When to tell
Telling people is a very personal decision and should only be done when you’re ready. It might help to practice how you tell people with a professional, such as a therapist. You can discuss your worries and how to react to issues, questions and comments that might arise. Practicing may help you clarify how you feel about your condition and inform who you want to tell.

Make sure you are in a calm environment when you introduce the topic and give the person time to adjust to the idea, especially if he or she don’t know a lot about your condition.

If you are compelled to tell people during a period where you are unwell, try to locate the most supportive person in your life for support as you go through the process.

Who to tell
You are the expert on your condition and can decide for yourself the right or wrong number of people to tell. Some people will benefit from telling many family and friends. Others may benefit by telling a couple of close friends and waiting to tell others.

Make a list of the people you’re considering telling and include those closest to you. Also list the most emotionally skilled people you know, even if you don’t know them that well.

Personal relationships
When telling family, friends or someone you are in a romantic relationship with about your condition, their response will generally go in one of three directions:

• The person is genuinely comfortable with your disclosure and things stay the same
• The person is very uncomfortable and ends or changes the relationship
• The person says he or she is fine with it, and then does a fast or slow fade from your life

Coworkers
In a job, you have to weigh the advantages against the disadvantages of being open. Weigh the potential negative impact on things like stigma from coworkers against your need for special accommodations, which are considered part of your civil rights. Before you share information about your condition, you should learn about your legal rights and also take into consideration your work environment. Consider approaching your Human Resources contact to gather support.

Once you’ve told someone, you’ll understandably be concerned about their reaction. One sign they can handle it is if they treat you the same during or after the disclosure. Friends stay friends. Colleagues stay polite and interested. If you continue to get the same “vibes” from people, you can be pretty sure that your disclosure has not changed the relationship for worse. And that is the best outcome of all.

Knowing that certain people are aware of an important part of your life and that they accept you and support you can be incredibly helpful and liberating. While some people may disappear, it’s better to have strong social supports around you.

Being able to offer emotional support is not something that everyone knows how to do. It’s a skill that takes practice. Some people may not be able to offer emotional support. If you have relatives or friends who lack this skill, that doesn’t mean they don’t love you. Most likely they don’t understand or fear they may say the wrong thing.

Remember that some conditions may cause you to not want to reach out for help. Sometimes the help from others is exactly what is needed to move toward recovery.

What to talk about
You can get the best support possible by planning the conversation. Consider including three items:

• “Process” talk
• Specific problem
• Suggestions for how loved ones can help

“Process” talk means “talking about talking,” rather than talking to share information. Prepare your listener for an important conversation by using “process” talk. Here are some ways to begin a process talk:

• “I want to talk to you about something important. I’m not sure how to talk about it, though. Can you just listen to me and try to understand? I’m hoping I’ll feel better after talking about it with someone, but I need you to be patient.”
• “There’s something going on in my life that’s bothering me. I think I need to talk to someone about it. I feel embarrassed about it, though, so please don’t laugh it off or make a joke out of it.”
• “I’m not sure if this will make sense. I feel uncomfortable talking about it, but I want to tell someone.

Concrete examples of what you mean by “mental illness.” Every case of mental illness is different. To get the best support possible, share one or two examples of what’s causing you stress:

• “I think something’s wrong because I can’t sleep more than a couple hours at night. It’s hurting my work and I feel out of control.”
• “I’ve started skipping classes sometimes. I’m worried I’ll stop leaving the apartment if I don’t get help.”
• “The doctor said I have bipolar disorder. Sometimes I feel like things are getting out of control and I’m not sure how to keep myself together.”

Suggest ways to support you. Family and friends may not know what they can do to help. You can get the best support by asking for specific types of help:

• “I’m scared to make an appointment because that’s like admitting there’s something wrong. But I need to see a doctor. Can you help me find one and follow through?”
• “I’m not thinking clearly these days. I’m getting treatment for a mental illness, but it might take a while to feel right. Until then, when I do something that makes you uncomfortable, can you please tell me what I’m doing instead of getting freaked out?”
• “I’m not supposed to drink alcohol with my medications. I’m going to try not to drink at parties, but I need my close friends to encourage me and help me keep my social life.”
• “I’m feeling better. But once in a while, can you tell me you’re there for me and give me a hug?”
• By telling the right people and suggesting ways for loved ones to help, you can start building a strong social support network. At first, you might be afraid to talk about your experiences. But don’t give up looking for support and encouragement from others. You’ll discover that many people want to help you.

You don’t have to share everything. Decide in advance what parts of your experience you’ll talk about and what parts you won’t. Stand by your decision. It’s perfectly understandable to answer a question with a statement like “I’d rather not talk about that right now.”

Keep in mind
Share the good things. Explain how your illness has taught you new things, or about experiences you were able to have in spite or, or because of, your illness.

Set boundaries. Be clear with people about when you want their advice and when you just want them to listen. Also realize that people come with their own opinions, informed and otherwise, so be patient when explaining. If they try to discredit you, gently remind them that you are the one living with the illness, and you know yourself best.

Let them know how they can support you. Everyone has different needs, and different people respond in different ways. Think about your needs ahead of time, and about whether this person can support you, if there are resources that would help her or him understand what you’re going through, or if she or he says no. Some people may not be able to handle disclosure, so it may be difficult to expect support from them. There are many people who will probably feel honored that you shared this with them, and whom will be happy to do what they can.

Help is available. For additional information, visit MagellanHealth.com/MYMH
Source: NAMI

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

Caring for a family member or friend who has a disability or a chronic illness can be rewarding. But it’s also demanding. One of the keys to being a successful caregiver is to manage stress by seeking support and taking care of yourself. Managing stress is especially important for a caregiver, because stress can weaken his or her immune system. A weak immune system makes the caregiver more likely to get sick.

Think about the kinds of caregiving tasks or situations that trigger stress for you. Then you can focus on one or two things you can do that will help the most to reduce stress. Here are some ideas:

Get support
Ask family members for help. Include them in caregiving decisions.

• Ask family members for help. Include them in caregiving decisions.
• Share the tasks. Make a list of weekly tasks, and share that list with your family. Ask for help with shopping, housecleaning, and errands. You don’t have to do all the work on your own.
• Stay involved. Make time for social activities and friends, even if it’s only a phone call or coffee during the week.
• Join a caregiver support group. Meeting other caregivers helps you know you’re not alone. And it gives you a chance to talk about your worries and concerns with others who understand.
• Find respite care. Respite services provide someone who can stay with your family member while you get away for a few hours or days. Time away can help you manage your stress and be a better caretaker.
• Look up caregiver resources in your community. Hospitals, churches, and other groups may provide transportation or other services that support caregiving tasks. You can reduce stress by planning ahead so you know who to call when you need extra help.

Take care of yourself

• Put your own health first. Be sure to schedule and go to your medical checkups.
• Eat a healthy diet, and get enough sleep. Taking care of yourself will help you deal with stressful situations.
• Get regular exercise. Even a 10-minute walk can relieve stress.
• Take a breath. Try stress reduction techniques like deep breathing and meditation.
• Take a break. It’s important to take time off from caregiving once in a while. Spend some time doing things you enjoy or on things in your own life that need attention.

What to think about
Depression is common among caregivers. It’s emotionally draining to care for a loved one whose health is getting worse. Don’t dismiss your feelings as “just stress.” If you’re having trouble coping with your feelings, it may help to talk with a counselor. If you have symptoms of depression, such as a lack of interest in things you enjoy, a lack of energy, or trouble sleeping, talk with your doctor.

Help is available. For additional mental health information and resources, visit MagellanHealthcare.com.

Source: Healthwise

The holidays are a fun and joyous time but also a very busy one, and holiday stress and anxiety in children can and does happen. During the holidays, there are lots of fun activities and events going on, both at home and at school. And while that can be a good thing, the constant hustle and bustle can be just as overwhelming and nerve-wracking for children as it is for adults.

Recognize the signs that your child is stressed out. These signs may include:

• increased irritability or anger
• clinginess
• more crying, whining, or complaining
• sleep troubles (or sleeping too much)
• physical symptoms like headaches and stomachaches
• more or less eating
• isolation and/or refusal to participate in activities
• regressive behavior such as bedwetting or thumb- sucking

Try these tips to help alleviate your child’s stress and make the holiday season a merrier time for everyone:

Set a Calm Example

The most important way parents can help ease anxiety in children during the holidays is by trying to keep things relaxed as much as possible. As with so many situations, the way parents handle an issue can set the tone for how their kids will behave. If you let holiday stress get to you, your kids will definitely pick up on it, and child anxiety is more likely to be a problem in your house. To minimize anxiety in children during the holidays, take steps to handle your own stress and anxiety.

Set Up Conditions for Good Behavior

Avoid taking your child to places such as the mall or holiday gatherings when he is hungry or tired. It’s hard even for grown-ups to deal with noise and lots of stimulation when they’re not feeling their best; kids get hungry more often and become tired more easily, and may understandably have a tough time being on their best behavior and are more likely to experience holiday stress when they’re exhausted or hungry.

Remember the Importance of Routines

The holidays can throw a big wrench into household routines, and that can play a role in anxiety in children.  To minimize holiday stress in your kids, try to get routines back on track once an event or party is over. For instance, if a school holiday concert or a church gathering goes past your child’s bedtime, try to stick to quiet, calm activities the next day and get your child to bed on time the next night.

Watch What They Are Eating

Another thing that can fall by the wayside amidst the holiday hubbub is healthy eating. Between all the extra sugary holiday snacks and the lack of time to sit down  to regular meals, it can be all too easy for kids to eat less healthy foods, which can contribute to holiday stress and anxiety in children. Try packing healthy snacks when you have to go shopping or run other holiday errands and try to minimize the number of sweet treats at home. Whenever possible, offer healthy snacks, such as air-popped popcorn or apple slices with cheese and crackers and limit cookies and candy to after-snack treats.

Get Your Child Moving

Fresh air and exercise are essential for boosting mood and re-setting the spirit, which can alleviate holiday stress and anxiety in children. Make sure you schedule some time to get your child outside to run around and play.

Avoid Overscheduling

As tempting as it may be to accept every invitation from friends and family, try to limit your holiday parties and activities so that you and your child are not overwhelmed. A couple of events a week may be fine, but having an obligation every day can lead to holiday stress and anxiety in children.

Have Your Grade-Schooler Help You

Big kids love to help mom and dad, especially if they get lots of praise for being responsible and helpful. If you have to shop, ask your child to help you look for an item at the store (fun stocking stuffers for cousins, for example). Giving your child a task will not only boost her self-esteem, it’ll distract her and help prevent any holiday stress and anxiety.

Schedule Some Quiet Time

Having some peace and quiet with your child is more important than ever during the busy holiday season. Find a quiet corner and read a book with your child or create holiday pictures for grandma and grandpa. Take a walk outside in nature, away from noise and crowds and obligations.

Remind Your Child and Yourself What the Holidays Are Really All About

A great antidote for holiday stress and the bloated commercialism of the season is helping others, whether it’s by shoveling an elderly neighbor’s sidewalk or by wrapping presents for needy kids at your local church. Helping your grade-schooler become a charitable child will help alleviate her holiday stress and anxiety.

Help is available. For additional information, visit MagellanHealth.com/MYMH

Post-traumatic stress disorder (PTSD) can be a challenge for you and your family. Your family may find it hard to accept some of the changes PTSD can bring to your life. By talking and supporting one another, you and your family will be better prepared for these changes.

Family support

Your family is an important part of your recovery. They can be there to listen and to help you through rough times.

It’s also important that you help your family understand PTSD. They may not always know how to respond when they see you hurting. They may feel scared, sad, guilty, or even angry about your condition.

Talking about PTSD can help you and your family cope. Talk about your symptoms and what triggers them. Discuss different treatments and how they can help you recover. When you open up, your family can better understand what you’re going through.

Family therapy can help. This is a type of counseling that involves your whole family. A therapist can teach you how to work through problems and communicate better.

Talking with your kids about PTSD

Teaching your kids about PTSD is important. They may not understand why you’re feeling bad or why you get angry sometimes. This can be scary for kids at any age. They also may blame themselves for things that aren’t their fault. Make sure your kids understand that they aren’t to blame for your PTSD. When talking with your kids about PTSD:

• Be honest and listen to what they have to say.
• Tell them it’s okay to ask questions. Ask them how they’re feeling, and let them know that their concerns are important.
• Make sure they feel safe, secure, and loved. They may be afraid that something bad is going to happen.
• Provide information about PTSD. Let them know what it is, how you got it, and how you can recover.
• Encourage a good support system of friends outside your family. Get them involved in school activities or youth programs in the community.
• Don’t promise that your PTSD is going to go away soon. Instead, talk about how treatment can help you feel better. It’s okay if you don’t have all the answers.
• Be as positive as you can. Your kids will notice how you react in difficult situations, which can influence their reactions.

Triggers Things that suddenly remind you of your traumatic event are called triggers. Triggers can bring up stressful feelings or cause you to have flashbacks, which means you feel like you’re reliving the event all over again.

Trying to avoid triggers is a common reaction. It’s normal to stay away from things that cause you stress. Because of this, you may feel like you can’t do the things you used to enjoy. This may be hard on you and your family.

Talk with your family about your triggers. They need to know what causes you stress. By being aware of your triggers, your family can help you find ways to cope with them.

Some common triggers include:

• Places, social events, or even smells and sounds. For example, smoke may trigger memories in someone who was hurt in a fire. Or a car that backfires may remind a veteran of gunfire.
• Being around others who were involved in your traumatic event. This may happen when veterans have a reunion.
• The anniversary of your traumatic event. Try to plan enjoyable activities on and around the anniversary date. It may help to be with friends or family.

Coping with holidays

Big holidays like Christmas and New Years can be stressful. The holidays can be a painful reminder of past times when life seemed better. Big groups of family and friends are often part of the holidays.

This may be stressful because:

• Groups tire you out or make you feel overwhelmed.
• You feel pressure to join family activities when you’re not up for it.
• You feel like you have to act happy when you’re not.

Your loved ones also might ask you questions about your life or about PTSD. You may not feel comfortable answering these questions. Keep in mind that your family may feel some of the same pressures.

You can cope with holiday stress by:

• Setting limits. Don’t join activities for longer than you can handle. You can choose when you want to be a part of the group.
• Taking breaks. Go for walks, or set aside a place where you can be alone for a while. This can keep you from feeling overwhelmed.
• Getting plenty of rest. Take naps if you feel like you’re not getting enough sleep at night.
• Talking with your family about how you feel. Your family can help you. Be honest with them about your stress.
• Not drinking too much. Alcohol may make your symptoms worse or cause you to have problems with your family.

For family members If you are the spouse or family member of someone with PTSD, here are some tips for helping your loved one during the holidays:

• Accept the mixed feelings your loved one may have about the holiday.
• Respect and support your loved one’s choices about being involved in the celebration.
• Plan ahead of time how you will cope with stress. This may mean talking about how your loved one will answer questions about PTSD, or deciding how long you will stay at a party.
• Remember to take care of yourself. Do things for yourself to relieve stress.
• Keep your expectations realistic.

The holidays can be a joyful time, offering a chance to reconnect with friends and family. They can also be stressful and hectic. You may feel pressure to buy and give gifts, have concerns about money, or feel like there isn’t enough time to get everything done.

Think about the kinds of events that trigger stress for you during the holidays. Then, you can focus on one or two things you can do that will help the most to reduce stress.

Here are some ideas:

Preparing for the holidays 

1. Know your spending limit. Lack of money is one of the biggest causes of stress during the holiday season. This year, set a budget, and don’t spend more than you’ve planned. It’s okay to tell your child that a certain toy costs too much. Don’t buy gifts that you’ll spend the rest of the year trying to pay off.
2. Give something personal. You can show love and caring with any gift that is meaningful and personal. It doesn’t have to cost a lot. Or, use words instead of an expensive gift to let people know how important they are to you. Make a phone call or write a note and share your feelings.
3. Get organized. Make lists or use an appointment book to keep track of tasks to do and events to attend.
4. Share the tasks. You don’t have to do everything yourself. Share your “to do” list with others. Spend time with friends and family while you share tasks like decorating, wrapping gifts, and preparing the holiday meal.
5. Learn to say no. It’s okay to say “no” to events that aren’t important to you. This will give you more time to say “yes” to events that you do want to attend.
6. Be realistic. Try not to put pressure on yourself to create the perfect holiday for your family. Focus instead on the traditions that make holidays special for you. And remember that just because it’s a holiday, family problems don’t go away. If you have a hard time being around your relatives, it’s okay to set limits on your time at events.

During the holidays

You may not be able to avoid stressful situations during the holidays, but you can plan to respond to them in a healthy way.

1. Take breaks from group activities. Pay attention to your own needs and feelings. Spend a little time by yourself if you can. Meditate, or do some relaxation breathing. Go for a short walk.
2. Keep a regular sleep, meal, and exercise schedule. Limit your alcohol. Taking care of yourself will help you deal with stressful situations during the holidays.
3. Get support if you need it. Holidays can sometimes trigger depression. They can be especially hard if you are already dealing with the death of a loved one or the breakup of a relationship. You may feel embarrassed to ask for help, or you may think that you’ll get over “the blues” on your own. But most people need treatment to get better. Talk with your doctor about counseling and medicine for depression.

Help is available. For additional information, visit MagellanHealth.com/MYMH

By Sam Srivastava and Mostafa Kamal

This week, the federal government took a significant step forward in helping address the opioid epidemic with the signing of the nation’s first comprehensive opioid legislation.

The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act addresses a broad range of Medicare, Medicaid, public health and law -enforcement issues and aims to advance the recovery landscape for individuals living with opioid use disorder (OUD) and other substance use disorders (SUDs).

As longstanding advocates for access to mental health and substance use disorder treatment and services, we’re deeply appreciative of the bicameral, bipartisan work of the Congress to successfully drive this critical effort forward. The legislation contains a number of impactful policies we at Magellan Health, and many others, have pushed for, including those recommended in our testimony to Congress this past spring. These critical policies promote clinically appropriate opioid prescribing, support opioid misuse prevention, and enhance access to evidence-based treatment and recovery services.

The signing of this law marks a significant milestone and step in the right direction, and we believe there are several ways it has the potential to address some of the day-to-day challenges of the nation’s opioid epidemic. Three key areas stand out.

Safer prescribing patterns. The SUPPORT for Patients and Communities Act encourages the use of safe and effective alternatives to opioids for pain management, which – in addition to clinically appropriate prescribing practices – are key in breaking the cycle of prescription opioid misuse. These include the establishment of grant programs incentivizing the use of non-pharmacological opioid alternatives, the required implementation of safety limits for opioid prescriptions, new electronic prescribing requirements in Medicare, and beneficiary screening requirements in initial Medicare prevention exams, to name a few.

Our experience demonstrates the power of these and other safe-prescribing interventions—such as the Centers for Disease Control and Prevention’s prescribing guidelines, which Magellan has already implemented—to reduce opioid misuse rates.

Americans consume 80 percent of all opioid painkillers produced worldwide—and the risk of addiction after just four or five days of treatment is high. Opioid prescribing rates have decreased in recent years thanks to nationwide efforts to ramp up provider education. Yet the supply of prescription opioids remains high – approximately 66.5 opioid prescriptions for every 100 Americans in 2016 – reflecting the work still needing to be done.

By exploring alternative therapies to pain management, including non-pharmacological digital therapies, we can eliminate the risk of opioid misuse and addiction, and also equip individuals living with chronic pain with the tools and resources needed to live healthier, more vibrant lives.

Boosted access to evidence-based treatment. One of the most effective, evidence-based treatments for OUD is medication-assisted treatment (MAT)—considered the gold standard for reducing the risk of overdose and death. When combined with psychosocial interventions, like cognitive behavioral therapy and contingency management, and recovery supports, including peer and family, MAT empowers the recovery journey while building resiliency.

Increasing access to MAT is critical to promoting recovery and preventing relapse. Today, while 900,000 U.S. physicians prescribe opioids, fewer than 35,000 physicians are certified to prescribe buprenorphine, one of three medications approved to treat opioid addiction.  Even fewer of these actually participate in prescribing MAT and, as a result, access to care is often limited or stigmatized. The SUPPORT for Patients and Communities Act expands providers’ ability to prescribe MAT, including by expanding eligibility for certification to new provider types. With stigma also playing a role in the lack of widespread adoption of MAT, this provision is a solid and necessary step toward expanding access to treatment.

Reaching underserved communities. The SUPPORT for Patients and Communities Act facilitates telehealth options for OUD treatment. In communities with limited resources for one-on-one OUD recovery support, telehealth services or a combination of virtual and in-office services provide the basis for the most evidence-based, person-centered and well-rounded approach to treatment. The package also authorizes pilot programs to provide temporary housing services for individuals recovering from OUD. We believe this is crucial to supporting those living with OUD and other SUDs, especially in rural and underserved communities, return to healthy and vibrant lives.

 The SUPPORT for Patients and Communities Act provides practical policy solutions necessary for addressing this national crisis. From expanded treatment options, to more effective care coordination, to improved prescription drug monitoring programs used to enhance detection and prevention of opioid misuse in real time, this legislation is an important step in the right direction.

We applaud Congress and the Administration on this bipartisan effort and important law, which will have a deep and lasting impact on health for generations to come.

 About the authors:

Sam Srivastava is Chief Executive Officer of Magellan Healthcare, and Mostafa Kamal is Chief Executive Officer of Magellan Rx Management.

Family members can play an important role in helping a loved one with co-occurring mental health and substance use disorders get on the road to recovery. Support a loved one’s recovery by:

• Helping a loved one remember to take all prescribed medications for one or both disorders
• Listening to any concerns about medications – such as their purpose, benefits, and side effects – and helping address those concerns
• Making sure appointments with treatment providers are kept
• Working with the treatment team to stay informed and help address any issues related to medication

To learn more, visit Mind Your Mental Health.

Source: Behavioral Health Evolution

1. Those who abuse prescription opioids are 40% more likely to use heroin than those who don’t.
2. The United States consumes 80% of the world’s prescription painkiller supply, despite not even making up 5% of the world’s population.
3. It’s possible to die the first time you use cocaine, consumption quadruples the risk of sudden death.
4. An estimated 88,000 people die per year due to alcohol.
5. Only about 11% of those addicted to drugs or alcohol actually receive treatment for their substance abuse disorder.

Source: Drugabuse.com