How good are you at coping with adversity? Somehow, life always finds a way to present you with challenges that you didn’t see coming. Fortunately, you can improve your resilience skills—enabling you to bounce back when confronted with a crisis or an overwhelming change.

1. Differentiate problems from your response to them.

You have the option of reacting with panic, or responding in a calmer, measured way that allows you to proceed logically toward a solution. It’s your choice!

2. View your strengths positively.

Remind yourself that you’ve gotten through tough times before and be confident in your ability to re-apply those successful strategies.

3. Always be ready for change.

Remind yourself that life is always ready to throw you a new curve, and that sometimes the advent of a big, intimidating change can end up being a positive learning experience that helps you grow.

4. Keep your perspective.

No matter how overwhelming your problem might seem, try to view the situation in the longer- term context of your life and the larger world.

5. Lean on close family, friends and peers.

Being able to share concerns— and to brainstorm innovative solutions together—can give you more confidence as you move forward.

6. Stay flexible.

Try not to get locked into a single approach to solving a problem and have a flexible mindset.

7. Don’t forget your own needs.

In times of crisis, staying physically and spiritually fit helps you fight off stressors of all kinds!

8. When in doubt laugh at it.

Try to find those nuggets of humor, shake your head, and laugh at life’s wackiness.

9. Look for light at the end of the tunnel.

No matter how difficult or uncomfortable a situation may be, remember that even the darkest of days won’t last forever.

10. Keep building you resilience skills.

It may take time to learn how to stay balanced when times are tough. Keep learning from others who seem resilient, and build upon your valuable experience and personal strengths.

Holidays are meant to be a joyful time celebrating with family and friends, enjoying time off from work, and indulging in delicious meals. That said, it is also easy to get overwhelmed and anxious as you try to keep up with multiple demands on your personal, family and work life.

Try these sanity savers to help you find the right balance so you can focus on making positive memories this holiday season:

• Keep it simple (and be realistic): Perfection is overrated. Don’t put pressure on yourself by committing to every party or making your own party a gala event. Focus on what makes the holidays special for you.
• Set aside differences: Try to accept family members and friends as they are, even if they don’t live up to all of your expectations. Set aside grievances until a more appropriate time for discussion.
• Stick to a budget: Before you start shopping for gifts, food, and decorations, decide how much money you can afford to spend. Don’t try to buy happiness with excessive gifts or lavish meals.
• Plan ahead: Identify possible challenges that can trigger stress and develop an action plan to feel prepared to deal with them. Set specific days for shopping, cooking, traveling, visiting friends, and other activities.
• Keep healthy habits: Don’t let the holidays become a free- for-all. Overindulgence only adds to your stress and guilt. Get plenty of sleep and make as much time for exercise as you can.
• Take a breather: Pay attention to your own needs and feelings. Spend a little time by yourself if you can. Meditate, do some relaxation breathing, or go for a short walk.
• Control the controllable: As families change and grow, traditions often do as well. Choose a few to hold on to, and be open to creating new ones and finding new ways to celebrate together.

Take steps to prevent stress and find peace and happiness this holiday season.

Magellan’s own Chairman and CEO, Barry M. Smith, was recently featured in Behavioral Healthcare Executive, talking about the importance of prioritizing behavioral health as a part of disaster recovery.

In the article, Barry discusses how delivering innovative access to behavioral health services is critical to enabling not only physical, but emotional renewal.

Read Barry’s complete article here.

Mike* was dancing wildly to hip hop music before running up to me and confidently stating, “I’m a leader.” He told me about how he ran to be a class officer and lost but how he was not going to give up. He talked about his search for a life-long mentor and how he wanted to make the world a better place. Not the type of random conversation you would expect at an outdoor community event, but MY LIFE youth are not average.

Since 2007, Magellan Youth Leaders Inspiring Future Empowerment, or MY LIFE, has proactively sought to change the trajectory of young lives engaged in the foster care and juvenile justice systems, as well as youth with behavioral challenges. Led by Greg Dicharry, Magellan’s national director for youth empowerment, monthly MY LIFE groups and annual MY FEST events have provided thousands of youth an opportunity to connect to their community and hear stories of overcoming hardships and reaching for their full potential. In Florida alone, groups in Tallahassee, Orlando and West Palm Beach enable over 100 youth ages 13 to 23 to meet monthly in a safe environment where fun and inspiration are plentiful.

Getting to spend time with youth involved in MY LIFE underscores the impact. One young man who has been attending a Florida MY LIFE group for three years described how the motivational speaker’s life lessons inspired him to focus on his future instead of focusing on his past. He told me about the hard times he was going through now and how the stories of the speakers going through tragic times provided him with the feeling that “it’s not too late for me.” It was a tough thought to imagine that at only 16 years old, this young man felt like the cards had already been stacked against him. MY LIFE provides a consistent message that he and his peers have the power and support to create a future different from their current reality.

And then there was Mike with his boundless energy. He may never lose that energy, which could either lead him down a path that is damaging to himself and others, or one that honors his strengths and abilities as he contributes to society. MY LIFE has helped him set upon the latter path. His future can now be one where his energy is directed into developing his leadership skills, pursuing higher education and a meaningful career, despite the challenges he might face at home or at school.

MY LIFE is just one way Magellan is supporting young leaders to help make our communities stronger.

*Mike is not this individual’s real name.

I have had the privilege of wearing many hats in a variety of industries throughout my career, including as an entrepreneur, executive, board member, educator, inventor and investor in technology, healthcare, biotechnology and life sciences.

I have seen the development of ideas and innovations that never had the opportunity to come to fruition. There are a number of contributing factors that impact these advancements. However, one of the most frequent causes is that inventors and researchers do not have the proper experiences, training and education to advance their ideas and work from the research setting to the patient or consumer.

In addition to my role as chief innovation officer and chief medical officer of medical and digital innovation at Magellan Healthcare, I also serve as a faculty member at the Yale School of Medicine. It is through my role at Yale that I have the opportunity to lead a unique training program for substance abuse researches from across the country in entrepreneurship starting next spring. The work of these scientists focuses on the prevention and treatment of substance abuse disorders leading to innovative options for improved care. Unfortunately, many of these innovations never reach the market because today’s scientists do not have the training in how to commercialize their ideas.

The training program, called Innovation to Impact: Translation Support and Education, is made possible through the funding of a $1.25 million grant by the NIH National Institute on Drug Abuse (NIDA). Students will participate in a free five-day boot camp on entrepreneurship and product development and will also have access to an extensive network of new venture mentors, seed funding for new ventures and training in how to promote a culture of entrepreneurship locally.  This will also help start what we hope will be an active community hosted virtually as well.

In addition to my work in developing apps and software programs designed to combat substance use disorders, I have also been teaching entrepreneurship for many years. This program is a logical next step to not only advance these innovations, but significantly help people with substance abuse disorders.

Open to researchers across the country who are focused on basic science, epidemiology, prevention, treatment and policy, the program will help advance innovations that impact the substance use field. This work is of the upmost importance as we face a national crisis on substance abuse. I also believe the future innovations of these researchers will soon impact our work at Magellan and the customers and members we serve.

Magellan makes it a priority to advance innovation, as evidenced by its support of my participation in this initiative with the NIH as well as dedicated resources through various innovation initiatives to help develop and commercialize new product ideas or services. It is rare that you find a private sector company like ours that is committed to allowing its executives to undertake educational activities when they fit within our massive transformative purpose of “leading humanity to healthy, vibrant lives.” I’m excited to continue to focus on collective entrepreneurial spirit with an amazing team at Yale to share our lessons with others and bring new ideas to light.

Caring is at the heart of Magellan’s culture. Whether it’s approving grant applications through the Magellan Cares Foundation, utilizing paid volunteer time off (VTO) hours or matching financial gifts, this is continually demonstrated by our associates across the country. Learn more about the Magellan Cares Foundation by visiting our webpage, which includes information about how organizations can apply for grants, or learn more from our associates first-hand in this video.

Every day in the news we hear about the devastating impact of the opioid crisis across the country. While we need to confront this complicated crisis, we also need to examine the larger issue of substance use disorders (SUD) that impact millions of Americans.

This past September, I had the honor to represent Magellan Health at the first meeting of the Substance Use Disorder Treatment Task Force, founded by Shatterproof. The mission of the task force is, “To fundamentally improve substance use disorder treatment in the United States, in terms of both quality and patient outcomes.” It also addresses the underlying cause of our country’s current substance use crisis, and lack of access to quality and evidence-based treatment. The task force has been created to expand access to quality treatment for the estimated 21 million Americans with SUD.

This task force is unique in that it convenes public and private healthcare companies, advocates and former government officials to take the lead in developing a tactical plan with measurable goals for payers to follow and implement. I am proud to be joined by so many colleagues and experts across the industry.

Our first focus is to implement the recommendations outlined in the November 2016 Surgeon General’s Report on Alcohol, Drugs, and Health. Secondly, we will utilize methods outlined in a 2006 report from the Institute of Medicine which recommends the need for a group of government regulators, accrediting organizations, consumer representatives, providers and purchasers to come together to develop a common, continually improving set of quality measures, specifically for mental health and substance use disorders.

The work of this task force aligns nicely with our efforts at Magellan, helping lead individuals to healthy, vibrant lives. Working with individuals with SUD, from both the behavioral health and the pharmacy benefits management perspective, we are in a unique position to help address these issues. I believe we can make significant contributions on this task force and for the benefit of our customers, members and providers with whom we work.

Post Traumatic Stress Disorder, commonly known as PTSD, comes in many forms and affects children and adults alike. Early descriptions of PTSD are found throughout literature. The hallmarks of war-related PTSD were described in Homer’s The Iliad. Shakespeare wrote of the symptoms in Henry IV and A Midsummer Night’s Dream. In recent times, books such as The Things They Carried (Tim O’Brien) describe the effects of war and the risk for PTSD-related suicide. Movies such as Ordinary People and Mystic River portray the effects that loss and abuse have on families and individuals. The daily ease of access to images on the internet and television puts the fodder for PTSD in front of all exposed to electronic media. We have only to listen to the news to learn of all the possible inputs that can cause PTSD—the tornado that sweeps through a Midwest town, atrocities happening to people in places such as Syria, beheadings, and stories of abused children. PTSD can affect one individual at a time, or a lone event can bring PTSD into the lives of many with a single swath.

Prevalence of PTSD in the U.S.

PTSD is common. The lifetime prevalence of PTSD among adult Americans is 6.8 percent (National Comorbidity Survey Replication). For adolescents, the six month prevalence was estimated to be at 3.7 percent for boys and 6.3 percent for girls (Kirkpatrick, 2003). The prevalence is much higher among Veterans. Men and women who had served in the Vietnam War have a lifetime prevalence of 30.9 percent and 26.9 percent, respectively. Studies of Gulf War Veterans reported a current prevalence of 12.1 percent, and 13.8 percent for Veterans of Operation Enduring Freedom/Operation Iraqi Freedom (Kang, et al 2003; RAND Corporation 2008). Unfortunately, PTSD is often underdiagnosed in the medical setting—with symptoms being attributed to a “normal” response to a trauma, misdiagnosed as depression, or altogether missed because of the physical presentation of the condition.

PTSD Symptoms and Impacts

PTSD symptoms are not limited to only the emotional, but also bring physical impairment in many forms. The condition affects those people supporting the individual with PTSD, often causing distress to family, friends, and colleagues. It is important not to approach PTSD with a single point of view — the victim of a natural disaster may have different experiences and risk factors than a combat veteran, for example. What is the same, however, is a set of symptoms based in some form of exposure to a traumatic event, resulting in significant distress and impairment in an individual’s ability to perform in her or his roles, whether within family, employment, or other social units.

No matter the cause, the response to a traumatic event is similar, whether described in the 8^th Century BC, or in 2016. In 2013, the American Psychological Association updated the criteria used to diagnose PTSD. According to current diagnostic criteria, the diagnosis of and symptoms attributable to PTSD must include at least one month of:

• Direct exposure to a stressor; witnessing the stressor in person; indirectly learning of a loved one exposed to a violent or accidental circumstance; and/or repeated or extreme indirect exposure to aversive details of the event, typically by a professional exposed to the stressor (e.g. first responders)
• Persistent and intrusive re-experience of the event through memories, nightmares, flashbacks (e.g. dissociative reactions), distress after exposure to a reminder of the stressor, and physiological reactivity after exposure to a trauma-related stimuli (e.g. jumping up after hearing a door bang unexpectedly)
• Avoidance of distressing trauma-related stimuli, including thoughts or feelings, and/or trauma-related external reminders such as situations or people
• A negative effect on thoughts and mood, including an inability to recall features of the trauma; persistent negative beliefs; persistent and distorted self-blame and/or blaming others; persistent negative emotions such as fear or anger; diminished interest or pleasure in activities; feeling detached or estranged from others; and having a persistent inability to experience positive emotions
• Alterations in physiological arousal or reactivity including irritable or aggressive behavior; self-destructive or reckless behavior; hypervigilence; exaggerated startle response, problems in concentration, and/or sleep disturbance
• Distress or functional impairment in relationships, social, and occupational roles

What PTSD Feels Like

PTSD doesn’t always occur immediately after the traumatic event. In fact, in some cases, the diagnosis may not be made for up to six months with the gradual onset of the full symptoms. Some individuals with PTSD develop dissociative symptoms as the primary feature of the condition. Those affected describe a sense of being an outside observer or detached from oneself (depersonalization), and/or the sense that things are not real or are distorted (derealization). See the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition for a detailed description of the diagnostic criteria for PTSD.

Unfortunately, PTSD predisposes affected individuals to other behaviors that can be emotionally and physically harmful. Persons with PTSD are more likely than persons without PTSD to develop alcohol use disorder (AUD) and substance use disorder, including tobacco, pain medications, and illicit drugs. Nearly half of people with PTSD can suffer co-occurring depression. Physical symptoms and conditions associated with PTSD include cardiovascular conditions such as hypertension, pain, gastrointestinal symptoms, and musculoskeletal symptoms.

While it is very difficult to predict who will develop PTSD, some factors may increase the risk of developing the symptoms, including:

• Getting physically hurt during the trauma
• Seeing another person get hurt or killed
• Having childhood trauma
• Having a sense of horror or helplessness during the trauma
• Having little or no social support after the event
• Dealing with additional stressors after the event, such as losing a loved one, ongoing pain or injury, or loss of one’s job or home.

Taking Care of Oneself after Trauma

While trauma impacts everyone differently, there are some ways to reduce the risk of developing PTSD. Examples include:

• Seeking out support from other people, including friends and family
• Talking about the trauma soon after it occurs
• Attending a support group with others who may have had similar experiences
• Learning how to acknowledge and accept your actions in the face of the trauma
• Having a positive coping strategy; being able to act and respond effectively despite feeling fear

PTSD does not have a cure, but symptoms can be managed to help an individual function better in day to day life. The recommended treatment of PTSD largely is based on the use of medication and psychotherapy. The earlier treatment is started, the more likely the treatment will have positive effects. Combinations of medication, psychotherapy and support are typically the most effective way to ameliorate symptoms.

Therapy for PTSD

Several therapy types have been shown to reduce the physiologic responses to stimuli, or alleviate intrusive thoughts by teaching a person the skills to identify triggers in order to better manage their symptoms.

• Cognitive behavioral therapy has been shown to be effective in treating PTSD. In addition to educating people of their symptoms, cognitive behavioral therapy can also include prolonged exposure (PE) therapy to address the traumatic event. During PE one gradually approaches trauma-related memories, feelings, and situations that have been avoided since the trauma. By confronting these challenges, PTSD symptoms decrease.
• Novel treatments for PTSD include Eye Movement Desensitization and Reprocessing (EMDR). This is a form of psychotherapy that involves the patient paying attention to a back-and-forth movement or sound while thinking about the upsetting memory long enough for it to become less distressing. During EMDR, one learns about their physical and emotional reactions to trauma, targeting the upsetting memory, discussing the memory, and ultimately focusing on a positive belief or feeling while the memory is in one’s mind.
• Cognitive restructuring or processing therapy helps the affected person work through faulty memories of the trauma, and challenges their interpretations of the event, experience of the event, and beliefs that life is full of ongoing danger. Cognitive processing therapy teaches new ways to handle upsetting thoughts and to develop a new perspective on both past and future.

Other therapies include training in relaxation and anger-control skills, group therapy, couples therapy, family therapy, implementing an exercise program, and sleep hygiene. While often tempting in the short-term, it is essential to avoid self-medication with alcohol or other substances such as pain killers that often are habit forming, and may exacerbate symptoms.

When approaching our programs, we at Magellan recognize the importance of identifying PTSD symptoms early on. We hope to spread the understanding that one’s response to trauma does not reflect failure, or weakness in character. Rather, we believe that raising awareness and understanding of PTSD is essential to tackling this condition, which affects so many Americans. As we move forward in developing and integrating new programs, we are keenly interested in supporting individuals, families and healthcare providers to increase access to resources for PTSD education, treatment and support.

Looking for more information on PTSD support? Click here for a list of resources and tips, or call 1-800-273-TALK if you are in crisis.