Aurora Offers Primary Care Physician Training on Behavioral Health

Identifying Mental Illness

  • Parents of a teenage son visit their primary care physician to find out why he is suddenly failing classes
  • A new mother sees her obstetrician because she has been sleeping all the time and has lost her appetite.
  • A man and his wife seek advice from the physician to find out why he is absent from work so frequently due to illness
  • A young woman makes a suicide attempt several days after seeing her physician for feeling lethargic and down

woman-in-crowdPeople with mental illness or addictions often seek help for physical symptoms. People with depression, anxiety, bipolar disorder or addictions typically are seen in primary care more than any other setting.  In a recent NAMI survey, 89 percent of families responded that they had discussed mental health concerns with their child’s primary care physician. Addiction, depression and other mental health problems can go undiagnosed  and untreated.  Primary care physicians can play a critical role in identifying a mental health or substance abuse issue and making appropriate treatment referrals.

Nearly one in 10 Americans 18 and older is depressed, according to a Centers for Disease Control and Prevention study in the Oct. 1 Morbidity and Mortality Weekly Report. One in four adults has a diagnosable mental disorder in any given year, according to the National Institute of Mental Health. Primary care providers have significant opportunities to identify behavioral health problems early and intervene in a manner that prevents further deterioration and avoids significant future costs. Screening and early intervention are priorities that may not only improve outcomes for individuals but also, over time, provide savings to the system.

In the primary care setting, physicians should look for signs of mental health problems, such as trouble sleeping and eating, experts say. In children, doctors should look for atypical behavior that begins suddenly, such as irritability or a drop in grades with a good student. Physicians should incorporate behavioral health screenings into wellness check ups for all patients, and routinely screen for depression, particularly with pregnant and perinatal women.

Mental Health America (MHA) believes that primary health care providers should be encouraged to identify signs of mental health or substance use issues at the earliest possible time. This position is also endorsed by the American Academy of Pediatrics and (for depression) the United States Preventive Services Task Force.

Training for Primary Care Providers

Aurora Behavioral Health Services, in partnership with Kubly Foundation, is offering on-line CME modules for primary care providers on the following behavioral health related topics:

If you or someone you know would benefit from addiction treatment or mental health services, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

Overcoming barriers: May is Mental Health Month

Mental Health America continues its tradition of celebrating “May is Mental Health Month,” which began in 1949 to raise awareness of mental health conditions and mental wellness for all.
Mental health month 2014 Mind Your Health
Mental illnesses are medical illnesses. One in four adults experiences a mental health problem in any given year. One in 17 lives with serious, chronic illness.

On average, people living with serious mental illness live 25 years less than the rest of the population. One reason is that less than one-third of adults and less than one-half of children with a diagnosed illness receive treatment.

The U.S. Surgeon General has reported that stigma is a major barrier to people seeking help when they need it. That’s why awareness is so important. We want people to understand mental illness and join a dialogue in our community. The more people know, the better they can help themselves or help their loved ones get the help and support they need.

When mental health care isn’t available in a community, the results often are lost jobs and careers, broken families, more homelessness, more welfare and much more expensive costs for hospital emergency rooms, nursing homes, schools, police and even courts, jails and prisons.

To access free screenings for depression, anxiety and other mental health concerns visit our screening center

If you or someone you know would benefit from addiction treatment or mental health services, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.

mental health month 2013

Are you a “heavy drinker?”

A recent story published by the Milwaukee Journal/Sentinel indicates Wisconsin was the state with the nation’s highest percentage of heavy drinkers — well above the U.S. median of 6.6%.

Aurora offers a full continuum of substance abuse treatment and related services for children, youth, adults and families.

Aurora offers a full continuum of substance abuse treatment and related services for children, youth, adults and families.

Wisconsin ranked number one, with 9.8% of residents considered heavy drinkers. Just what is a “heavy drinker”?

According to the Centers for Disease Control, men having more than 14 drinks per week, and women having more than 7 drinks per week fall into the heavy drinking category.

Binge drinkers are those who have more than 5 drinks in a day for men, or 4 drinks in a day for women.

“Heavy or binge alcohol consumption can negatively affect an individual’s health in many ways” according to David Smith, MD, vice president of Patient Experience and Care Management at Aurora Health Care.

“The impact on families, communities, and workplace are well known. The brain, nervous system, heart, liver, stomach, gastrointestinal tract, and pancreas can all be damaged by alcoholism. In addition, accidents and injuries related to alcohol use are much higher. We are placing a lot of emphasis on encouraging our caregivers to live healthy lifestyles, and limiting alcohol consumption is key to good health”

For more information on the impact of heavy alcohol consumption, visit these resources.

If you or someone you know is battling addiction, contact Aurora Behavioral Health Services us — online or by phone at 1-877-666-7223 — as soon as possible.

drinking

Extreme heat, medication can combine to create extreme health risks

The mercury’s rising across the country, and with the rising temperature comes increased risk of a potentially fatal illness: heat stroke.

The Milwaukee County Medical Examiner’s Office released reports Monday which show five deaths last week could be heat related. Heat-related deaths were also reported in La Crosse, Lone Rock and Janesville, and the death of an Onalaska man is also being investigated as possibly related to the heat.

But, did you know that mental illness and some medications used to treat mental illnesses actually increase the risk for heat stroke? Recently, the Substance Abuse and Mental Health Services Administration blogged this warning, and in this 2006 press release, the National Alliance on Mental Illness appealed to the news media and other authorities to publicize heightened risks of heat exhaustion and heat stroke for people with mental illnesses who take psychiatric medications.

Family and friends should always check in with loved ones living with mental illness to ensure their safety.  Disturbingly, individuals with mental illness may be particularly susceptible to heat stroke.

Certain medications, including anti-psychotics and anti-cholinergics, are known to increase the risk for heat stroke because they inhibit the body’s ability to regulate its temperature. Psychiatric medications—particularly antipsychotics, lithium and topirmate—affect the body’s ability to stay cool by causing a decrease in sweating, promoting fluid loss and dehydration, or changing how people experience heat; i.e., they may not even feel heat.

Additionally, people with mental illnesses who live in low-income housing without air conditioning are also at an increased risk for heat stroke. This combination can be dangerous; According to NAMI, during a 1999 heat wave in Cincinnati, Ohio, almost half of the 18 heat-related deaths were individuals with a mental illness. The Ohio Department of Mental Health provides this information

Heatstroke is the most severe of the heat-related illnesses, and is a medical emergency. It occurs when the body’s temperature-regulating system breaks down. The victim can’t sweat and is unable to cool himself. Internal body temperature can rise as high as 108 degrees, which can cause irreversible brain damage and death. High internal temperatures can injure almost every organ, including the liver, kidneys, lungs, heart, and muscle. It can cause permanent disability and even death.

A few facts about heat stroke:

  • It’s more likely when the outside temperature is very hot. A heat wave is defined by the National Weather Service as three or more consecutive days of temperatures at or above 90°F (32.2°C ).
  • Hyperpyrexia (core temperature greater than 105°F [40.6°C]) and central nervous system impairment causing delirium or coma are characteristic.
  • The death rate for heatstroke ranges from 10% to 75%, depending on several variables, including how promptly treatment is sought.
  • Mentally ill patients are a high-risk group. Some may not have the cognitive abilities to protect themselves; others may be taking psychotropic medications that affect heat regulation.

If you are taking one or more of the following medications or products, please be extremely cautious and avoid unnecessary or prolonged exposure to the extreme heat and high temperatures.

Antipsychotics, especially:

  • Chlorpromazine (Thorazine)
  • Thioridazine (Mellaril)
  • Mesoridazine (Serentil)
  • Clozapine (Clozaril)
  • Risperidone (Risperdal)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Ziprasidone (Geodon)

Antiparkinson drugs, such as:

  • Benztropine (Cogentin)
  • Trihexyphenidyl (Artane)
  • Procyclidine (Arpicolin, Kemadrin)
  • Biperiden

Antihistamines, such as:

  • diphenhydramine (Benadryl)
  • chlorpheniramine (Chlor-Trimeton, Sinutab Sinus Allergy)

Antidepressants, especially tricyclics, such as:

  • Imipramine (Tofranil)
  • Amitriptyline (Elavil)
  • Nortriptyline (Pamelor)
  • Doxepin (Sinequan)
  • Desipramine (Norpramin)
  • Protriptyline (Vivactil)

Do:

  • Educate yourself about symptoms of heat stroke
  • Sleep in a cool place.
  • Drink extra fluids. Water is best because the body absorbs cooler solutions fast. Other fluids you can try include juice, Gatorade, and caffeine-free soda.
  • Increase salt intake if there are no medical contraindications.
  • If you take lithium, be sure to remain well-hydrated.
  • Spend time in cool places (shopping malls, movies, etc.)
  • Wear loose, light-colored, summer-weight clothing.
  • Use fans or air conditioning.
  • When feeling warm, use cool, wet compresses or sit in a tub of cool water.
  • Remain with another person.
  • Monitor loved ones and neighbors during a heat wave for signs of heat stroke

Don’t:

  • Engage in strenuous exercise in the heat.
  • Drink alcoholic beverages, coffee, and soda with caffeine (caffeine and alcohol increase water loss).
  • Spend excessive time outside in the sun.
  • Sleep or spend prolonged time in hot conditions.

Click here for more tips on preventing heat exhaustion and heat stroke.

Warning signs of heat stroke:

  • Nausea, headache, feeling poorly, weakness
  • Irritability, anxiety
  • Fast pulse, rapid breathing, dizziness
  • Hot OR dry skin, confusion, vomiting, diarrhea

The Centers For Disease Control & Prevention (CDC) provides additional information about heat stroke..

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

 

Are your parenting skills effective?

Are your parenting skills effective? Ken Christian, LCSW, a therapist with Aurora Behavioral Health Services, offers some time to developing good relationships with your children.

By today’s standards the traditional family is quite different than it was a generation ago. In the “old days”, dad went off to work while mom stayed home to take care of the children. When dad came home in the evening, the family would have a dinner together. This traditional family setting, as we once knew it, is in danger of extinction.

Today, increases in the divorce rate, two income families, and single-parent families have prompted changes in values and traditional parent roles.  The focus among parents and children has shifted to activities outside the home – kids are doing one thing and parents are doing another. As a result, families are spending less time together.

Parents may be unable to control these societal changes, but with the proper “tools”, they can maintain their own values in the home and develop or maintain closer relationships with their children.

If you are a parent -married, single or divorced- you know it can be difficult to maintain a harmonious relationship with your child. There are a few things you can do to help lay the groundwork for a happy, healthy household:

  1. Focus on developing good communication and listening skills and be honest with your child. If you make a mistake, admit to it. It’s okay to let them know you’re human.
  2. Set expectations and limits for children. Make it clear what the expectations and consequences are, and stick to them. Many parents can fall into the trap of not being consistent and not following through on what they say. Remember – kids can be masters of manipulation. They may say things like “I hate you” or “you’re not fair”. At times you will feel guilty and want to give in. If you say you are going to ground your child if they do not take out the garbage – then do it.
  3. Work toward building your children’s self-esteem. In the long run it will help your relationship with them and help their relationships with others.
  4. Be a good role model. Don’t fall into the “do as I say, not as I do” trap. An example of this is: If you swear when you get upset, your child thinks it is okay to swear too. But when your child swears, they get scolded. Try to avoid sending mixed messages.
  5. Maintain control without turning things into a battleground. When your children reach their teens they will start challenging your judgment. For example, if your teenager wants to say out past midnight but doesn’t know where they will be, you might be inclined to say you don’t want them out past that time. Your teenager might respond by saying “Jimmy’s parents let him stay out past midnight without knowing where he’ll be”. You might respond by saying, “That’s not me. I value knowing where you are going to be and it’s important for me to know because I care about you”. Remember, you don’t always have to defend yourself or your actions. Saying “no” sometimes – and sticking to it – is all you need to do. Children need to learn how to handle hearing “no” for an answer. It is important that children recognize your values and their importance in your life.

If you are experiencing conflict with your children, or if you feel your child is out of control, contact Aurora Psychiatric Hospital. Our Child & Adolescent Day Treatment program can be the perfect resource.

Addiction: why can’t you just stop?

Many people believe overcoming an addiction is simply a matter of will power. You can stop using drugs or alcohol if you really want to. Jennifer Johnston, LCSW, a psychotherapist at Aurora Behavioral Health Services helps explain why recovery is not that easy.

This is quite possibly one of the most common questions I’ve come across in treating individuals and families who struggle with addictions. Some ask it of themselves and others ask it of their loved ones out of anger, disappointment, frustration, and so on. What many people don’t realize is that recovering from an addiction is a process which often requires hard work and many other deliberate changes in order to sustain one’s sobriety. Listed below are some factors that, if not addressed, can make it difficult (but not by any means impossible) to “just stop.”

Physical Dependence

Repeated exposure to a substance of abuse can cause the body to adapt to its presence, altering the body’s physiological constructs, eventually causing the body to expect the substance in order to function according to its new “normal.” Chronic use tricks the brain into thinking it is producing a chemical that is artificially being fed to it, thus altering the brain’s natural production and output of mood regulating chemicals.  When use is stopped, especially abruptly, the system can go into somewhat of a shock causing physical withdrawal symptoms (nausea, vomiting, tremors, seizures, etc.), urging the person to use again in order to stop the withdrawal symptoms.

Psychological Dependence

With continued use, people can condition themselves to rely on their substance of choice as a way to cope with mental and emotional discomfort, and each time relief is provided (real or perceived, regardless of how temporary), the use is reinforced. For instance, if one uses each time he or she is anxious in order to relax, anxiety can become a trigger due to the association between the use and relief from anxiety. This also brings up the topic of co-morbidity, or having more than one disorder at the same time, such as alcoholism and depression. Since substances of abuse can both mask and mimic symptoms of other mental health diagnoses it can be difficult to differentiate what came first and can perpetuate a self-destructive cycle of self-medication.

Lifestyle Changes

Once enslaved to physical and/or psychological dependence, many alter their lifestyles in order to make room for and protect the addiction, preventing physical withdrawal and/or mental and emotional discomfort. For example, someone who may have always been an honest and outgoing person may begin deceiving family or friends, and isolating in order to prevent getting caught and having to face judgment or potential ultimatums. In extreme cases, this can alter a person’s belief system as well as his or her way of thinking and behaving. Even if use is stopped, if people struggling with an addiction do not address the altered lifestyle, they run the risk of becoming a “dry drunk.”

If you or someone you know is struggling with an addiction, there IS hope for successful recovery. Aurora Behavioral Health Services offers many forms of treatment to help people safely address physical withdrawal (medically monitored inpatient detoxification) and to rehabilitate the psychological and lifestyle factors that typically perpetuate addictions (residential, partial hospitalization and intensive outpatient programs as well as outpatient therapy).

If you or someone you know is battling addiction, contact Aurora Behavioral Health Services us — online or by phone at 1-877-666-7223 — as soon as possible.

Are you having a Blue Christmas?

Like me, many of you grew up listening to the song “Blue Christmas” by Elvis Presley. For me it was a holiday tradition, with great harmonies by the Jordaires and one of my favorite Christmas albums. But I never really gave much thought to those who do experience a Blue Christmas.

For many folks this time of year is not a happy, joyful experience. It is common for those that have lost loved ones, divorced, or those with family deployed in the military. For some people, it is a time of self-evaluation, loneliness, reflection on past failures and anxiety about an uncertain future.

The holidays can also exacerbate depression in someone who already suffers from it. Additionally, fluctuations in weather and sunlight caused by the changing seasons can influence depressive symptoms, such as those   experienced by people with seasonal affective disorder.

According to the National Institute of Mental Health, about 19 million American adults suffer from depressive illnesses every year. Unfortunately, many people with clinical depression don’t seek help, even though depression is a treatable condition.

The holiday blues refers to specific feelings and symptoms that can mimic depression such as:

  • Depressed mood
  • Decreased interest in life activities normally enjoyed such as social gatherings, shopping, cooking, hobbies
  • Feeling overwhelmed
  • Irritability
  • Fatigue, feeling drained physically and emotionally
  • Sleep or appetite disturbances
  • Anxiety, feeling nervous, edgy or “keyed up”
  • Excessive guilt

Here are some ways to alleviate the holiday blues:

  • Stay connected.  The worse thing you can do for the holiday blues is to isolate yourself. Many people who are depressed during the holidays are also lonely. Spend time with supportive and caring people. Reach out and make new friends, or contact someone you haven’t heard from in a while.
  • Write a gratitude letter.  Write a letter of gratitude to your parents, God, or yourself – detailing all the things that ARE great about your life today. Focus on the positive will be beneficial.
  • Do something for someone else. Try volunteering some of your time to help others.
  • Get moving.  Exercise – even mild exercise – helps alleviate the symptoms of depression. Taking a brisk walk in the am before your day or to wind down after your day – is a great way to beat the blues.
  • Avoid drinking and drugs.  While you may experience a temporary numbing effect – your feelings of “the blues” will only become magnified once you come down off of your drug of choice.
  • Pace yourself.  If you are feeling depressed, don’t say “yes” to everything. Take on one thing or nothing if need be. Do what you feel is realistic.
  • Tell someone.  It will be easier to get through the holidays if someone else knows how hard it is for you. People that love you – want to help.  Talking about what is going on with you emotionally (in talk therapy) is one of the best ways to get through a depression of any kind.

If you or someone you know is experiencing a blue Christmas, click here or a free, confidential, on-line depression screening tool. For more information about depression,  contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

With supportive solutions, teens can conquer substance abuse

Is your teenager using alcohol or drugs?

Fact: one in three kids begins drinking before 9th grade.

According to a National Institute on Alcohol Abuse and Alcoholism (NIAAA) report, 1 in 3 children starts drinking by the end of 8th grade – and of them, half reported having been drunk. A 2010 SAMSHA study indicates among youth aged 12 to 17, 10% had used an illicit drug within the 30 days prior to interview.

Consider these additional statistics.

  • Underage drinking costs the United States more than $58 billion every year.
  • 40 percent of those who started drinking at age 13 or younger developed alcohol dependence later in life. Ten percent of teens who began drinking after the age of 17 developed dependence.
  • Teens that drink are 50 times more likely to use cocaine than teens who never consume alcohol.
  • More than 60 percent of teens said that drugs were sold, used, or kept at their school.
  • 20 percent of 8th graders report that they have tried marijuana.
  • 28 percent of teens know a classmate or friend who has used ecstasy

Recently Brian Clark, LCSW started a treatment group for teens dealing with substance abuse issues. “I was struck by the lack of services in our community” noted Brian, “and I was receiving many inquiries for a group like this.”

The group is open to teens between ages 14 and 18 who are struggling with abuse or addiction issues. College students are excluded. Some of the issues that will be addressed include how is addiction defined, medical consequences, marijuana as a gateway drug as well as use vs abuse vs dependence. The group will also foster relapse prevention, emphasizing drink or drug refusal strategies along with sober support systems.

So far the participation has been great. “These kids are very candid in the group. One teen shared that the group was the one place he felt comfortable discussing his struggles to control his use” said Brian. “The group is a unique environment for the teens to share without judgment.”

If you or someone you know would benefit from the adolescent substance abuse support group, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

Prescription painkiller abuse approaches “plague” proportions

Recent stories have continued to highlight the ongoing problem with heroin and prescription opiate abuse in our communities. These instances, along with many others in the past several years, are increasingly occurring in suburban areas.

Dr. Lance Longo, Medical Director of Aurora Psychiatric Hospital

According to Lance Longo, MD, Medical Director of Addictions at Aurora Psychiatric Hospital, the path to becoming a heroin user typically starts with abuse of recreational drugs such as marijuana or alcohol. Some young people begin to experiment with prescription opiates, gaining access from the family medicine cabinet or by getting them from friends or associates off the street.

Other people begin exposure while being treated for a problem with pain. Percocet and Oxycodone are two of the more commonly abused pain medications. And the abuse of prescription pain medications is more common among young people than many realize. According to the Substance Abuse and Mental Health Services Administration (SAMHSA,) over 11% of young adults ages 18-25 used a pain medication for non-medical purposes in 2010.

For some people, it does not take long to become physically dependent on opiates. People initially begin to abuse the medication for the high they experience, but soon they may need it just to feel normal. Dr. Longo indicates that some people experience withdrawal symptoms after only a week of daily use. For an individual who has become dependent on the medication, it becomes increasingly expensive and difficult to acquire the medication they need to avoid withdrawal.

At this point, they may turn to heroin as a less expensive and more accessible way to acquire the drug. Heroin can be snorted or taken intravenously which produces an immediate effect for the user. This accelerates the downward spiral of addiction.

Treatment alternatives are available for opiate dependence. The Opiate Recovery Program at Aurora Psychiatric Hospital, for example uses medication (Buprenorphine) along with an intensive therapy program to assist with recovery. Programs like this can be help in developing the coping skills and support system needed to maintain sobriety.

For more information on opiate abuse and treatment, visit the SAMHSA website.

Aurora Behavioral Health Services offers complete mental health treatment options in a caring, confidential environment.  If you find you may be struggling with stress that is causing significant physical or emotional impairment in your lifecontact us — online or by phone at 1-877-666-7223 — as soon as possible.

Is back-to-school a season of anxiety for your child?

Is your child excited about starting back in the classroom? Or is your child scared, anxious or reluctant to attend school?

A new school year, unfamiliar classroom, new teachers, and new classmates can be sources of anxiety for children and parents. What level of anxiety is “normal”? Is anxiety disrupting routine activities for your child? Being fearful of getting on the school bus can be a sign of extreme anxiety. So can refusing to go out to recess, or participate in class activities.

The Anxiety Disorders Association of America reports that anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse.

If you feel your child is experiencing extreme anxiety, find out how Aurora’s Child and Adolescent Day Treatment program can help.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.