Q: What is stress?

A: Stress is how the brain and body respond to the demands of life, such as family, work, school, life changes and traumatic events. How you respond affects your health, and it is important to understand how to handle these stressful events in a productive and positive way.

There are four different kinds of stress:

Eustress is positive or good stress. This type of stress can feel pleasant and/or rewarding after the stressful situation subsides.

Distress is negative stress. Most people attribute their own stress to distress. Negative stress can be acute or chronic.

Acute stress is extremely intense stress when it occurs but disappears after the event passes. An example of acute stress is being pulled over by a police officer and your heart rate goes up and you begin to sweat.  Once the situation is resolved you begin feeling normal again.

Chronic stress is less intense stress that usually lasts for a long period of time. An example of chronic stress is if you are dealing with pressure from credit card debt. You may feel an increase in headaches and have difficulty sleeping at night. These physical changes take a toll on your health and well-being.

Q: Who does stress affect?

A: Everyone feels stressed from time to time. Some people cope with stress more effectively or recover from stressful events more quickly than others. There are different types of stress–all of which carry physical and mental health risks. A stressor may be a one time or short term occurrence, or it can keep happening over a long period of time.

Q: Is all stress bad?

A: No. Stress can motivate people to prepare or perform, like when they need to take a test or interview for a new job. Stress can be life-saving in response to danger as your body prepares to face a threat or flee to safety. In these situations, your pulse quickens, you breathe faster, your muscles tense, your brain uses more oxygen and increases activity–all functions aimed at survival.

Q: Can stress cause me to gain or lose weight?

A: Yes. Stress can wreak havoc on your eating habits.

When you are under stress, the balance of hormones in your body can change, leading to cravings, increased appetite or a lack of appetite. Limited time, energy and motivation can also affect your physiological approach to food, as well as what types of food you eat and when you eat. Changes in weight vary greatly from person to person depending on how they respond to stressful situations.

Q: Does stress affect my blood pressure?

A: Stress has not been shown to directly cause high blood pressure, but it can lead to unhealthy lifestyle choices that are associated with high blood pressure. Chronic stress can weaken your immune system and cause uncomfortable physical symptoms like headaches and stomach problems.

Q: Can medications help me lower my stress level?

A: Medicines are helpful for many things, but usually not for stress. Some people take tranquilizers to calm them down immediately, but it’s far better in the long term to learn to manage your stress through relaxation or stress management techniques. Be careful not to confuse stress with anxiety. If you suffer from anxiety, speak with your doctor a treatment or management plan including whether you need medication.

Q: What is Post Traumatic Stress Disorder (PTSD)?

A: PTSD develops in some people who have experienced a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD because they may continue to feel stressed or frightened even when they are not in danger.

Q: What causes stress?

A:  A lot of things can cause stress–from personal problems to job and social issues including:

• Health–especially if you have a chronic illness such as heart disease, diabetes, or arthritis
• Emotional problems–anger you can’t express, depression, grief, guilt, or low self-esteem
• Relationships–having problems with your relationships or feeling a lack of friendships or support in your life
• Major life changes–dealing with the death of a parent or spouse, losing your job, getting married, or moving to a new city
• Family–such as having a child, teen, or other family member who is under stress, or being a caregiver to a family member who is elderly or who has health problems
• Conflicts with your beliefs and values–you may value family life, but you may not be able to spend as much time with your family as you want
• Environment–living in an area where overcrowding, crime, pollution, or noise is a problem can create chronic stress
• Social situation–not having enough money to cover your expenses, feeling lonely, or facing discrimination based on your race, gender, age, or sexual orientation can add stress to your life
• Employment–being unhappy with your work or finding your job too demanding can lead to chronic stress. Losing your job or not being able to find work is also very stressful

Q: What can I do to reduce my stress?

A: There are countless quick, easy, and cost-free actions you can take to reduce your stress. Here’s a few to consider: meditate, exercise, create a support network, think positive, avoid excess caffeine, laugh, focus on you.

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

Sources: American Heart Association, National Institute of Mental Health, WebMD

Numerous studies show that job stress is far and away the major source of stress for American adults and that it has escalated progressively over the past few decades.* Negative work stress can come from a variety of factors including having little control but lots of demands, fear of being laid off or fired, working additional overtime due to budget cuts or pressure due to constantly rising expectations.

Start your day off right

After scrambling to get the kids fed and off to school, dodging traffic and combating road rage, and gulping down coffee in lieu of a healthy breakfast, many people arrive at work stressed, and become more reactive to stress at work. In fact, you may be surprised by how much more reactive to stress you are when you have a stressful morning. If you start off the day with good nutrition, proper planning, and a positive attitude, you may find the stress of the workplace rolling off your back more easily.

Be clear about your role

One of the factors that contributes to job burnout is unclear requirements. If you don’t know exactly what’s expected of you, or if the requirements keep changing with little notice, you may find yourself much more stressed than necessary. If you find yourself falling into the trap of never knowing if what you’re doing is enough, it may help to have a talk with your supervisor and go over expectations, and strategies for meeting them.

Stay away from conflict

Interpersonal conflict takes a toll on your physical and emotional health. Because conflict among co-workers is so difficult to escape, it’s a good idea to avoid conflict at work as much as possible.

That means staying away from gossip, not sharing too many of your personal opinions about religion and politics, and steering clear of colorful office humor. Try to limit contact with those who don’t work well with others. If you do have to deal with conflict try these conflict resolution strategies.

Stay organized

Even if you’re a naturally disorganized person, taking the time to plan ahead to stay organized can help you decrease stress at work. Being organized with your time results in less rushing in the morning to avoid being late and being able to leave at the end of the day with a clear mind.

Get comfortable

Another surprising stressor at work is physical discomfort. You may not notice the stress you experience when you are in an uncomfortable chair for a few minutes. But if you practically live in that chair when you’re at work, you can have a sore back and be more reactive to stress because of it. Even small things like office noise can be distracting and cause low-grade frustration. Do what you can to ensure that you’re working from a quiet, comfortable and soothing workspace.

Form positive relationships

While the negative effects of stress are very real, much of the stress we experience can be alleviated simply by talking about it. That’s why positive relationships at work are so important. Even if they can’t solve your problems, the simple act of verbalizing your stress with someone you trust can actually reduce the severity–or clear it up altogether.

Start exercising

Many people are feeling ill effects from leading a sedentary lifestyle. One way you can combat that, and manage stress at work at the same time, is to get some exercise during your lunch break and perhaps take short exercise breaks throughout the day. This can help you blow off steam, lift your mood, and get into better shape.

Keep perfectionism in check

Being a high achiever can help you feel good about yourself and excel at work. Being a perfectionist, on the other hand, can drive you and the people around you a little nuts. Especially in busy, fast-paced jobs, you may not be able to do everything perfectly. But striving to just do your best and then congratulating yourself on the effort is a good strategy. Your results will actually be better and you’ll be much less stressed at work.

Don’t lose sight of your purpose

Each of us is more than the work we do. Taking the time to understand what motivates us and makes us happy is time well spent.  When we starve our purpose—by not engaging with our work, suppressing our creativity, or ignoring our relationships (including the one with ourselves)—we trigger our stress response. When our life is full of nothing but work and obligations, we begin to feel bitter, resentful, depressed, and even angry. The antidote to these feelings is to infuse your life with a sense of purpose and gratitude for what you have every day.

Establish boundaries

In today’s digital world, it’s easy to feel pressure to be available 24 hours a day. Develop some work-life boundaries for yourself. That might mean making a rule not to check email from home in the evening, or not answering the phone during dinner. Although people have different preferences when it comes to how much they blend their work and home life, creating clear boundaries between these realms can reduce the potential for work- life conflict and the stress that goes with it.

For additional information, visit MagellanHealth.com/MYMH

* The American Institute of Stress, Workplace Stress, January 12, 2018. Retrieved from https://www.stress.org/workplace-stress/

“Strung out. Looking for the next fix. A full time job that doesn’t pay, but just takes.”

That’s how one of Magellan’s Recovery Support Navigators defined her addiction to opiates. She has since overcome the stranglehold of addiction and is now in long term recovery.  Her experiences, and those of her fellow Recovery Support Navigators, provide the credibility needed to influence their peers who are still struggling with addiction and mental illness that recovery is possible and that desperation does not have to define a life.

An estimated 20.2 million Americans live with a substance use disorder[1]. That’s the population of my home state of Florida. Of that, 2.1 million Americans live with an opioid disorder. Similar to serious mental illnesses, substance use disorders can be difficult to address. Those with the lived experience of walking the path from hopelessness to wellness are experts at engaging individuals with the services and supports that foster the recovery process. Stories of changed lives are not the only proof.

A January 2018 study of our internal recovery support navigation program at Magellan Health found statistically significant improvements for individuals living with substance use and mental health disorders. A key component of the Magellan’s internal peer support program is meeting people where they are. The first engagement with members often happens in an emergency room, inpatient setting, or on the streets. Members then choose where future meet-ups happen. Often, that choice is in the comfort of their own home.  If they are experiencing homelessness, the member chooses a safe place.

The study compared utilization of services six months prior to receiving peer support services and six months following the completion of peer support services. Seventy-five percent of the members in the study had a co-occurring mental health and substance use disorder and 50 percent had a co-occurring substance use disorder, mood disorder and psychotic disorder. The study found that members in Magellan’s internal peer support program cost the health plan significantly less in the six months following completion of the peer support program than members who only had care management or who did not receive any intervention from the health plan. The study also found that six months after completing peer services, peer support decreased emergency room and inpatient hospitalizations.

The role modeling by a peer specialist of a life lived well in recovery is evidence for the individual struggling that there can be long term sustainment of recovery. In addition, the data from this study replicates prior findings that peer support has a lasting impact on the lives of those living with substance use and mental health disorders.

[1] Substance Abuse and Mental Health Services Administration. (2017). Mental and substance use disorders. Retrieved from https://www.samhsa.gov/disorders

1. Myth: Mental health problems don’t affect me.

Fact: Mental health problems are actually very common.

Annually, about:

• One in five American adults experienced a mental health issue
• One in 10 young people experienced a period of major depression
• One in 25 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression
• Suicide is the 10th leading cause of death in the United States. It accounts for the loss of more than 41,000 American lives each year, more than double the number of lives lost to homicide.

2. Myth: Children don’t experience mental health problems.

Fact: Even very young children may show early warning signs of mental health concerns.

These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before age 24.

Unfortunately, less than 20% of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

3. Myth: People with mental health problems are violent and unpredictable.

Fact: The vast majority of people with mental health problems are no more likely to be violent than anyone else.

Most people with mental illness are not violent, and only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population. You probably know someone with a mental health problem and don’t even realize it, because many people with mental health problems are highly active and productive members of our communities.

4. Myth: People with mental health needs, even those who are managing their mental illness, cannot tolerate the stress of holding down a job.

Fact: People with mental health problems are just as productive as other employees.

Employers who hire people with mental health problems report good attendance and punctuality as well as motivation, good work, and job tenure on par with or greater than other employees.

When employees with mental health problems receive effective treatment, it can result in:

• Lower total medical costs
• Increased productivity
• Lower absenteeism
• Decreased disability costs

5. Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.

Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better.

Many factors contribute to mental health problems, including:

• Biological factors, such as genes, physical illness, injury, or brain chemistry
• Life experiences, such as trauma or a history of abuse
• Family history of mental health problems

6. Myth: There is no hope for people with mental health problems. Once a friend or family member develops mental health problems, he or she will never recover.

Fact: Studies show that people with mental health problems get better and many recover completely.

Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. There are more treatments, services, and community support systems than ever before, and they work.

7. Myth: I can’t do anything for a person with a mental health problem.

Fact: Friends and loved ones can make a big difference and be important influences to help someone get the treatment and services they need by:

• Reaching out and letting them know you are available to help
• Helping them access mental health services
• Learning and sharing the facts about mental health, especially if you hear something that isn’t true
• Treating them with respect, just as you would anyone else
• Refusing to define them by their diagnosis or using labels such as “crazy”

Help is available.

For additional information, visit MagellanHealth.com/MYMH

What is the difference between mental health and mental illness? The former refers to our emotional and psychological state, our social well–being and how we feel about ourselves and interact with others. Mental health is not the same as mental illness, although poor mental health can lead to mental and physical illnesses.

When we have good mental health, we are resilient, can handle life’s challenges and stresses, have meaningful relationships and make sound decisions. Being mentally healthy, like being physically healthy, is important at every stage of life, from childhood and adolescence through adulthood and old age.

Being mentally healthy is influenced by life experiences, relationships with others, physical health and one’s environment. Just as people may experience physical problems over the course of their lives, they may also experience emotional or mental health problems that affect their thinking, mood and behaviors. This does not necessarily mean that a person who is going through a difficult time and is experiencing poor mental health has a mental illness. Feeling miserable and socially isolated are red flags that one’s mental health needs attention.

The benefits of improving one’s mental health are well worth the effort. Being mentally healthy helps you feel confident in your worth and abilities, accept your strengths and weaknesses, set realistic goals and create a sense of meaning and purpose in your life. Emotional health and mental health are closely intertwined, and both can positively or negatively impact physical health as well.

What is Mental Illness?
Mental illness refers to a wide range of disorders that affect mood, thinking and behavior. Mental illness can affect anyone regardless of age, gender, social standing, religion or race/ethnicity. People with mental illness often experience distress and problems functioning at work, home and in social situations. Mental illness is not something the person can “overcome with willpower,” and can be caused by biological factors such as genes or brain chemistry, trauma and abuse, and family history of mental illness.

The major types of mental illness include:
• Depression
• Anxiety
• Mood disorders, including bipolar
• Personality disorders
• Schizophrenia
• Trauma disorders
• Eating disorders
• Addictive behaviors

Mental illnesses are common in America, and approximately one in five adults lives with a mental illness (43.8 million in 2015.)1 While depression and anxiety are two of the most common disorders, mental illness includes many different conditions that range from mild to moderate to severe. People who don’t have a mental illness might still be impacted by the mental illness of a friend or family member.

Signs and symptoms of mental illness vary, but may include changes in sleep, appetite, and energy level, severe mood swings, persistent thoughts or compulsions, hearing voices, social withdrawal, feeling sad, hopeless, or agitated, having trouble performing everyday tasks, or wanting to hurt oneself or others.

With the right treatment, people can and do recover from mental illness. Friends and family members can be important influences to help someone get the treatment and services they need. Primary care physicians can refer individuals to psychiatrists and other professionals who specialize in mental health treatment. Treating a physical illness might require medications and physical therapy, and treating a mental illness might also require medications and different therapies. For many people, the first step is to recognize there is a problem and be willing to accept help.

For more information on treatment resources, contact:
National Institute of Mental Health
https://www.nimh.nih.gov/health/find-help/index.shtml

NAMI (National Alliance on Mental Illness)
http://www.nami.org/

Substance Abuse and Mental Health Services Administration (SAMHSA) https://findtreatment.samhsa.gov/https://www.mentalhealth.gov/

Mental Health.gov
https://www.mentalhealth.gov/
Help is available. For additional information, visit MagellanHealth.com/MYMH

1. https://www.nami.org/learn-more/mental-health-by-the-numbersd to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned

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Traumatic events, such as a sudden death, natural disaster, motor vehicle accident, or terrorist attack can leave children and teens feeling stressed, frightened, and helpless. Whether they personally witness the event or are exposed to it on the news or social media, children may experience intense emotions and a heightened sense of insecurity. Children’s reactions to a traumatic event depend on their age and personality, the severity of the event, the availability of support, and previous experience of trauma

Tips for all ages

Traumatic events can disrupt children’s sense of safety and result in fears and worries, nightmares, and physical reactions such as headaches, stomachaches, problems sleeping, and loss of appetite. Here are suggestions to help children through the emotional and physical challenges they may face after trauma:

• Be aware of your own reactions to the event and manage your own stress. Stay calm and offer hugs and reassurance to help restore your child’s sense of safety and security.
• Share information about the event and answer your child’s questions honestly. Listen to your child’s fears and let him/her know it is okay to share his/her feelings at any time.
• Limit or prevent exposure to disturbing news and social media coverage of the event. Children who see graphic images or hear distressing news stories may become re-traumatized.
• Maintain stable routines as much as possible, including regular mealtimes, bedtimes, and exercise.
• Engage in fun activities to help children relax and feel that life is returning to normal.
• Watch for signs of trauma, even after weeks have passed. Children cope with trauma in different ways, and some may show signs of sadness, anxiety, and troubling behavior weeks or months after the event.

Tips by age group

Preschool age

After a traumatic event, children who are age five and under may display behavior from an earlier stage of their lives, such as bedwetting, thumb-sucking, clinginess to parents, and fearfulness of strangers. They may have tantrums or cry more than usual, or become withdrawn from others. Parents and other adults can help children by providing comfort and reassurance, maintaining routines as much as possible, encouraging them to express their feelings, and giving simple explanations to children’s questions about the event. Children look to their parents for cues as to how to feel and react, and will pick up on a parent’s distress or anxiety. It is best not to expose young children to the news on TV or the radio about the traumatic event. Involving toddlers and preschoolers in fun activities and playtime with others will provide a healthy distraction.

Early childhood

Children ages 6 to 11 may show some of the same reactions that younger children have, such as reverting to more childish behaviors. They may have nightmares or trouble sleeping, find it difficult to concentrate in school, become irritable, anxious or disruptive, or lose interest in family, friends, and fun activities. Parents should reassure children that they are safe and will be taken care of no matter what. Encourage family discussion about the event and answer questions, but be careful about exposing children to news and TV footage. Keep bedtime and meal routines as normal as possible, and involve children in activities that keep them busy. Identify the positives such as community recovery activities and the ways people help each other get through difficult times.

Adolescence

Older children ages 12 – 17 may have stress reactions such as nightmares and flashbacks of the event, lose interest in school, hobbies, and friends, feel angry, guilty, or depressed, withdraw from others, have physical symptoms such as headaches, or abuse alcohol or other drugs. As with younger children, parents can help teens rebuild a sense of trust and safety by listening to their concerns without judgment and providing them with peer support opportunities. Age-appropriate volunteer activities can help teens feel useful and productive.

When to get help

Be aware of signs that a child may need extra help coping with the trauma. If six weeks or more have passed since the traumatic event and your child is not feeling better, has trouble functioning at school or at home, is withdrawn from friends and family, or continues to have physical complaints such as headaches, stomach pains, and problems sleeping or eating, contact a mental health professional.

 National Eating Disorder Awareness Week is observed annually on the last week of February , to mark the occasion, we are sharing some important Dos and Don’ts for families and friends of people suffering from an eating disorder.

Eating disorders can be among the most difficult afflictions for family members and friends to understand. Feelings of frustration and helplessness are common. Early diagnosis and treatment can save the life of a person with an eating disorder, but it is important to remember that only an experienced doctor or therapist can treat them effectively.

If the person has lost a significant amount of his or her normal body weight, or you feel that his or her life is in danger, seek immediate medical attention. The following are some additional tips if someone you know is suffering from an eating disorder.

Eating Disorder Dos . . .

• Educate yourself. Read as much as possible about eating disorders. This will help you understand the problem and put you in a better position to help those around you.
• Listen. People with eating disorders often feel ashamed and alone. Your support may provide the strength the person needs to seek professional help.
• Encourage the person to get help. Try to get the person to seek professional help, but don’t be too forceful. This will make the person more anxious, and could discourage the person from seeking help. Unless in immediate danger, avoid forcing the person to get help.

Eating Disorder Don’ts . . .

• Nag about eating or not eating. People with eating disorders are extremely self-conscious about their eating habits. By nagging, you will just make them more uncomfortable and reinforce the behavior.
• Hide food to keep the person from binge eating. Although people with bulimia or binge eating disorder may ask for your help, hiding food from them will only create resentment.
• Force the person to eat. Forcing the person to eat will make him or her feel childish, out-of-control, disapproved of, and scolded. Once again, this just reinforces the behavior.

Help is available

An eating disorder is an illness that is difficult to understand. Identifying and treating these disorders can also be hard. But the sooner a person is diagnosed, the better the chances are for recovery. While you can’t force someone to seek help, you can educate yourself and develop a support system for those around you who may be at risk. The good news is that most people do well in treatment and can recover from eating disorders.

Today, much of the conversation around opioid use focuses on ways to more tightly control access, including limits on usage and the mandatory use of databases that can alert physicians to patients’ opioid histories. But for those suffering from Opioid Use Disorder (OUD), combatting addiction is a difficult feat, particularly due to treatment barriers, lack of qualified providers, and waitlists for evidence-based treatments.

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