Teenopause and More!

Last month on JQ99’s “Living Better” show the talk was all about teens and stress. Dr. Carolyn King, a psychiatrist at Pine Rest Christian Mental Health shared information, insights and coping skills.

Coining the term “teenopause” or the period of time following the “tweener” years (ages 10 to 13 when hormones are getting ready to explode) to age 25 when the frontal lobe (the area of the brain responsible for rational decision making) is continuing to develop Dr. King described how unique the teen years are both physically, mentally and socially.

The good news is a lot can be done to help teenagers with stress. Stressed out teens can take positive action to reduce their stress finding healthy stress relievers such as:

• Laugh! Like they did when they were a little kid
• Get a good night’s sleep
• Get a good night’s sleep (Yes, repeated on purpose, Caffeine nation!)
• Exercise and eat regularly
• Set smaller goals by breaking up tasks into smaller more manageable components
• Schedule breaks and fun activities
• Practice muscle relaxation – repeatedly tense then relax all the large muscle groups
• Accept the things you cannot change
• Take a deep breath, then repeat this 5 times slowly
• Share your problems with trusted grownups and friends
• Volunteer
• Find activities that help you relax (music, sports, hobbies, hanging out with friends)
• Turn to God

“Recently, a teenager who attempted suicide and was happy she survived shared her new found recipe for dealing with stress; I love it and use it all the time now: ” Take a minute, take a deep breath, release and remember that it’s going to be alright, you will get through this.”

Catch Dr. King next appearance on JQ99’s “Living Better” Tuesday May 24th from 11am – 1 pm when she’ll be sharing her wit and wisdom on mental health and how to traveling with active kids.

Postpartum Depression – Not Just a Woman’s Illness

While most people have heard of Postpartum Depression (PPD) many do not realize the size and scope of the problem. PPD impacts 15% of new mothers, making it difficult to care for their baby and causes damage to other relationships. And it doesn’t just affect women. Men can get PPD, too. In fact, recent studies have show that 10% of new dads get Postpartum Depression.

Why are men affected? Postpartum Depression in women has been linked to traumatic birth experiences, hormonal changes, thyroid problems, Vitamin D deficiencies, previous history of mental illness, and many other factors. So how is it that men suffer from depression after the birth of a child?

While men may not experience the full spectrum of biological and hormonal changes or other factors that impact women, they are experiencing a change in their role and a major life change. The pressure to be a good dad, the desire to succeed at being a father, and the dramatic life change can bring on PPD in men. Remember, dads also experience the lack of sleep, the frustration of trying to soothe a fussy baby, and the fear of making a mistake.

Some of the symptoms of depression in men include:
• Irritability
• Increased alcohol consumption
• Anger
• Depressed mood
• Weight loss
• Fatigue
• Over-working
• Suicidal thoughts
• Physical complaints such as stomach problems or headaches
• Difficulty concentrating

While there is much to be learned about PPD in men, one thing is sure: It is important to get help. Studies have shown that untreated PPD in men leads to marital problems, increased fighting in the home, and decreased bonding with the baby.

In general, men are less likely to get help than women. Unfortunately, it is challenging for men to seek treatment. Many healthcare providers do not realize that PPD can impact men. Further, the stigma for men is greater than for women. Yet, it is so important to get help.

If you or someone you love is struggling, there is hope; for women and men.

Here are some resources:

www.postpartummen.com
www.postpartum.net

And if you’re in Kent County, Michigan:
www.dadsgrow.com

This is part III in a series.

Gretchen Johnson

Gretchen Johnson, BS, BSN, RN-BC, manages an inpatient unit and the Adult Partial Hospital program at Pine Rest Christian Mental Health. She is a member of the Healthy Kent 2020 Perinatal Mood Disorder Coalition, American Psychiatric Nurses Association, and the Psychiatric Nursing Council of Southwest Michigan.

Teens & Stress

By Dr. Carolyn King

Spring is often described as a hopeful time full of the promise of life and new beginnings, but for teenagers it can be fraught with stress. Finals to prepare for, that big playoff game to win, getting a date to prom, finding a summer job, getting accepted to college, and the list goes on. A lot to go through all at the same time!

Stress is a physical or mental reaction brought on by any changes perceived by the body.
These include emotional, mental or physical changes in our lives and it affects everyone. In addition to stressors we all experience, teenagers are going through “the flux,” a time of significant fluctuation. After the flux, they will morph into unique, adult individuals.

During the teenage years, physical changes, peer pressure, life decisions and choices all come together to create sort of a “perfect storm” for kids stress levels. This puts them at risk for everything from acne, colds, stomach aches, and crankiness to depression and suicide.

How do you recognize a stressed out teenager? When is it time to be concerned? First, let’s understand that not all stress is bad. Stress triggers our minds and bodies into a state of “high alert” activating our nervous system and certain hormones (like adrenaline) to help us react quickly and deal with pressure.

“Good” stress perks us up enabling us to perform on stage, step up to the plate when the score is tied with two outs in the bottom of the ninth, or get the nerve to ask a date to the prom. “Good” stress pumps you up. “Bad” stress wipes you out. “Bad” stress can make you sick, nervous, tired, unable to perform and depressed.

What causes teen stress? You (if you are a parent reading this), school and friends. The reality is that teens have to deal with all three. Pressure to do well in school, get accepted to college & get a summer job. As if the kid isn’t stressing themselves enough, parents stress kids about school, chores, respectfulness then add family conflicts over issues of independence like curfew, clothing, piercings and friends, then add friends or peer pressures like body image compared to others, pressures to use drugs and alcohol and…Whew, I am stressed out, just listing the stressors.

At Pine Rest Christian Mental Health Services our inpatient admissions during the school year are at their highest. In the summers, we have fewer children on our units. Can you see how it all makes sense now?

Recognizing the signs of stress in teens is perhaps more important than understanding the causes. What causes stress for one person may not for another. Some signs of a stressed out teen include:
• Increase in physical illnesses and complaints (headaches, stomachaches, pain, tiredness, acne flair ups, rashes, etc)
• Trouble sleeping or sleeping all the time
• Difficulty concentrating
• Lack of appetite or over eating
• Crying more than usual
• Irritability, anger and moodiness
• Worry , anxiety and nervousness
• Withdrawal from friends and/or family

A lot can be done to help teenagers with stress. We can teach our kids how to cope when they are not perfect. Three lessons for dealing with what life throws at you include:
1. Don’t take every rejection or slight personally
2. Don’t make assumptions
3. Value what you do & always do your best

Stressed out teens can take positive action to reduce their stress finding healthy stress relievers such as:
• Laugh! Like they did when they were a little kid
• Get a good night’s sleep
• Get a good night’s sleep (Yes, I repeated it on purpose, Caffeine nation!)
• Exercise and eat regularly
• Set smaller goals by breaking up tasks into smaller more manageable components
• Schedule breaks and fun activities
• Practice muscle relaxation – repeatedly tense then relax all the large muscle groups
• Accept the things you cannot change
• Take a Deep breath, then repeat this 5 times slowly
• Share your problems with trusted grownups and friends
• Volunteer
• Find activities that help you relax (music, sports, hobbies, hanging out with friends)
• Turn to God

Beating Stress happens with the practice of using Stress managing skills. Above are just a few suggestions. Experiment with healthy coping skills that are unique to you. Each time you succeed in finding a new coping skill that works, you reinforce attitudes and behaviors that help you become more resilient.

Recently, a teenager who attempted suicide and was happy she survived shared her new found recipe for dealing with stress: “Take a minute, take a deep breath, relax, and remember that its going to be alright, you will get thru this.”

Additional Information, Resources and Links:
http://kidshealth.org/teen/food_fitness/sports/sports_pressure.html?tracking=T_RelatedArticle
http://kidshealth.org/teen/your_mind/emotions/stress.html
http://parentingteens.about.com/library/sp/quiz/stresstest/bl_screentest.htm
http://teenshealth.org/teen/school_jobs/school/prom.html
http://teenshealth.org/teen/your_mind/body_image/body_image.html?tracking=T_RelatedArticle
http://www.lifespan.org/services/childhealth/parenting/teen-stress.htm
http://www.msnbc.msn.com/id/20322801/ns/health-kids_and_parenting/
http://www.stressfocus.com/stress_focus_article/teen-stress-causes.htm
http://www.thehealthcenter.info/teen-stress/

Carolyn King, MD is a child and adult psychiatrist at Pine Rest Christian Mental Health System in Grand Rapids, Michigan.
Dr. King’s clinical experience includes child inpatient and outpatient, as well as adult inpatient and outpatient psychiatry. Dr. King specializes in the treatment of Depression, Anxiety, ADHD, and Developmental Delays across the Life Span.

Dr. Carolyn King

Teens & Stress

This month on JQ99.3’s “Living Better” segment with Pine Rest’s Dr. Carolyn King and JQ morning DJs Chris and Emilee, the topic is “Teens and Stress.”

Stress affects everyone but teenagers have physical, psychological and social realities that make them unique. Physical changes, peer pressure, life decisions and choices all come together to create sort of a “perfect storm” for kids stress levels. This puts them at risk for everything from acne, colds, stomach aches, crankiness to depression and suicide.

Do you know what the number one stress in you teenager’s life is? Grades? Peers? YOU?? Do you know the warning signs to look for? And how do you know if they are suffering from “good” or “bad” stress– did you even know there was a difference?

Tune in Tuesday from 11-1pm to JQ 99.3’s “Living Better” with Dr. Carolyn King and learn what you can do to understand, recognize and help your teenager when they are “stressed-out.”

Baby Blues or Something More?

Part 2 in the series on Post-Partum Depression and PMD

by Gretchen Johnson, BS, BSN, RN-BC

Many women can relate to the emotional roller coaster that dominates the first few weeks after a baby is born—and who wouldn’t be a mess? You’re sore, sleep deprived, in a totally new role (even if this is not your first child), your hormones are out of wack and you have little time to take care of yourself. The term “baby blues” is often used to refer to the mild mood swings that occur after the birth of a child. Nearly 80% of women express experiencing baby blues. Having the baby blues is NOT a disorder. It is completely normal.

Perinatal mood disorders are common (15-20% of women)…but NOT normal. So how do you know if you or a loved one is experiencing something more serious than the baby blues?

The Baby Blues usually has an onset of about one week postpartum and lasts about three weeks. Symptoms include moodiness, tearfulness, anxiety, inability to concentrate, and sadness. These feelings come and go and the predominant mood is actually happiness.

Postpartum Depression (PPD) and Anxiety (about 15% of women) have an onset any time until one year after the baby is born and lasts longer than three weeks. The highest time of risk for new mothers is six months after delivery. Symptoms include excessive worry, sadness, guilt, hopelessness, sleep problems, fatigue, loss of interest in normally pleasurable activities, change in appetite, irritability, and difficulty making decisions.

Postpartum Psychosis occurs in 1-4 per thousand women. 5% of these women commit suicide and 4% commit infanticide. Women with postpartum psychosis experience hallucinations, delusions, and confusion.

Just as you can be proactive about the physical health of the baby and mother, you can also make preparations during pregnancy to take care of the new mom’s (or your own) emotional and mental health. This is crucial and can help combat PPD. Things that can be done include:

• Get support - bring meals, clean house, hold the baby while the new mom takes a nap, be there to talk and listen
• Eliminate stress - let things go that are causing worry
• Talk openly- encourage the new mom to share her needs and how she is doing
• Follow a healthy diet

While perinatal mood disorders are not normal, they are also NOT a sign of weakness. Every mother deserves to enjoy her new baby. If you or someone you love is suffering, get help. For local resources visit www.healthykent.org and look for the PMD resource manual under “infant health”. A great place to find help nationwide is by visiting www.postpartum.net

I would love to hear feedback and other suggestions on what can be helpful to prepare for the postpartum time period. What other topics around PMD would you like to hear about? This is the 2nd post in a series on perinatal mood disorders.

Gretchen Johnson

Gretchen Johnson, BS, BSN, RN-BC, manages an inpatient unit and the Adult Partial Hospital program at Pine Rest Christian Mental Health. She is a member of the Healthy Kent 2020 Perinatal Mood Disorder Coalition, American Psychiatric Nurses Association, and the Psychiatric Nursing Council of Southwest Michigan.

Living Better – Laughter is the Best Medicine

by Dr. Carolyn King

Warning: Please Try This at Home:
Laughing Your Way to a Happier, Healthier Life

It’s true what they say: laughter is often the best medicine. Did you know if you laugh heartily 100 times a day it provides the same health benefits as a 10 mile run? Researchers have found this to be true.
- Feeling tense? Laugh. it makes your tense muscles relax – for up to 45 minutes.
- Feeling depressed or in pain? Laugh. It produces endorphins – natural pain relievers.

These are just a few of the physical health benefits of laughing. Laughter also produces many mental health benefits including renewing a sense of joy, easing anxiety and fear, improving mood and enhancing resiliency. And there are social benefits to laughter as well: strengthening relationships – both personally and professionally, building stronger teams and families, oh, and making you more attractive to others.

Yes, it is everyone’s best interest to laugh, yet as we get older we laugh less and less frequently.

Recently on the “Living Better” segment on JQ 99.3, I shared some techniques to help you and your family laugh more. For example, laughter yoga is a type of “yoga” specifically focused on guided laughter. Laughter yoga’s benefits are based on the premise that the body cannot differentiate between real and fake laughter. Further, fake laughter often turns into real laughter. And anyone can fake it! Carve out a a few minutes with the family to be funny. The dinner table is a great place/time to have each family member share the funniest thing they saw, heard or experienced during the day.

We all know laughter is contagious. If you can start laughing you can get those around you to laugh, giving the gift of health. Laugh for the the health of it, soon you will see that laughter is the most fun you will ever have exercising!

For additional information scroll down and check out the links below.

The Pine Rest Foundation is proud to sponsor “Living Better” a new monthly segment on JQ99.3. The segments will focus on everyday individual and family concerns, and will feature Pine Rest psychiatrist, Dr. Carolyn King in an interview format with JQ 99’s on-air morning personalities, Chris & Emilee.

You can catch “Living Better” on the fourth Tuesday of every month on JQ99.3 between 11am and 2pm.

Carolyn King, MD is a child and adult psychiatrist at Pine Rest Christian Mental Health System in Grand Rapids, Michigan.
Dr. King’s clinical experience includes child inpatient and outpatient, as well as adult inpatient and outpatient psychiatry. Dr. King specializes in the treatment of Depression, Anxiety, ADHD, and Developmental Delays across the Life Span.
Dr. Carolyn King

Additional Information, Resources and Links:

http://health.howstuffworks.com/mental-health/human-nature/other-emotions/laughter4.htm
http://helpguide.org/life/humor_laughter_health.htm
http://hplusmagazine.com/2010/03/31/laugh-loud-laugh-hard-live-long/
http://humormatters.com/definition.htm
http://www.laughteryoga.org/
http://mayoclinic.com/health/stress-relief/SR00034
http://moodletter.com/Humor.htm
http://moodletter.com/Laughter.html
http://psychologytoday.com/articles/199607/happily-ever-laughter
http://thehealthylivinglounge.com/2010/08/16/shift-your-mood-with-a-laughter-experiement/
http://uihealthcare.com/topics/medicaldepartments/psychiatry/laughter/index.html
http://washingtonexaminer.com/entertainment/health/hearty-indeed-laughter-strengthens-immune-system-improves-mood
http://worksmartlivesmart.com/files/File/articles/993-Laughter_And_Mood.pdf
<img src="http://pinerest.files.wordpress.com/2011/03

What Happens When There is No Joy?

Why You Should Care About Postpartum Depression

Part 1 in a Series
by Gretchen Johnson, BS, BSN, RN-BC

A happy time filled with excitement and joy – that’s what most of us envision when someone is having a baby. It’s a celebration of new life – right? The media offers us pictures of smiling (or sleeping) babies and happy, slim, confident, and well groomed mothers. We are so inundated with these images that this has become the expectation of many soon-to-be new moms and the rest of society.

For many women, this is not the reality. Nearly 15% – 1 out of every 7 new moms – experience some form of postpartum depression or perinatal mood disorder (PMD). PMD encompasses mood disorders from pregnancy until one year after a baby is born and includes depression, anxiety, psychosis, bipolar disorder, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Alongside women, more than 1 in 10 men experience postpartum depression.

PMD is the most common complication of childbirth. If it goes untreated, there can be serious complications for moms, babies, and families. Consequences include disruption in mother-baby bonding, interruption in the infant’s development, family and relationship conflicts, and in serious cases, can lead to suicide or infanticide.

You should care about PMD because it is impacting the lives of women, babies, and their loved ones. Chances are it has or will impact you or someone you love. We should care because although it is the most common complication of childbirth, it continues to go undiagnosed and untreated. And we should care because unlike other illnesses during and after pregnancy, PMD has so many stigmas attached to it resulting in a fewer moms asking for help. It is imperative that we educate those around us, prepare women for the possibility of PMD, and work to reduce the stigma of PMD so that women can get early treatment.

This is the first of a series of postings about post partum depression – PMD.

For more resources and information visit:

http://www.postpartum.net/
http://www.healthykent.org/
http://www.postpartumprogress.com/weblog/

Gretchen Johnson, BS, BSN, RN-BC, manages an inpatient unit and the Adult Partial Hospital program at Pine Rest Christian Mental Health. She is a member of the Healthy Kent 2020 Perinatal Mood Disorder Coalition, the American Psychiatrist Nurses Association, and the Psychiatric Nursing Council of Southwest Michigan.

Parenting: Responding to Tragedy

by Krisitn Kuiper, LMSW, MSW

With all of the events in the news lately, many parents are wondering how to respond to what is happening with their children. If you are a parent, maybe your child has come home from school with some questions, perhaps you are glued to the television for the most up to date information and your child is doing homework nearby, hearing bits and pieces of the story. Maybe your anxiety has heightened and your child, however young, feels your worry.

It can be very difficult as a parent to know how to share with our children the sad realities of the world we live in. Our instincts to protect them kick in at times like this. But with the availability of media, social networking, and 24/7 news cycles, parents are often left with questions of what protecting our children actually looks like in our culture today.

There are a couple of tips that I want to encourage you to implement at home. Taking advantage of these recommendations will help your home and the relationships you have with your children be a safe place, a refuge, from everything that is going on around them.

* Keep routines intact—when challenges arise in the family or in the community, keep the home routines going to the greatest extent possible. By routines, I mean mealtimes, wakeup/bedtime rituals, family connection rituals, etc.

* Simplify “screen time”- children, especially when young, are very concrete thinkers. This means that when children are exposed to things such as news programs, they are not able to recognize that the events shown are not happening over and over again, each time they are shown. They are not able to understand that where these events have occurred is not directly near them. Cutting down when and where the TV is on and filtering what images they see or read online is important.

* Nurture a low stress home- When children experience stress, they are less able to learn and trust, and connect with others (the hormone cortisol is to blame for this). Children absorb their parents’ emotions. So, taking care of yourself at times like this is critical—recognizing what you might be unintentionally passing along to your child will help you parent well.

I Have a Secret

Libby and her Mom

Hi my name is Libby Baker Sweiger aka @libbytalks (on Twitter) and I have a secret.

My little blog does not get much readership . It’s my life’s story. It contains information on my secret. I said it on Twitter yesterday in a conversation so I must want to talk about it. So here it is: I have had bi-polar disorder since I was 23 years old. One reason you see me up in the middle of the night is I’m having trouble sleeping, a symptom of this disease. I have fought this thing off from the beginning. I don’t want to be defined by it. Yet it is a big part of my life. I have medicine to take, doctors to see, rules to follow and danger signs to be on the alert for. And I am diligent about them. That is why I am successful despite this disorder. The only reason I am bringing it up is because I think I need some help coming out with this. I feel I need to be honest about it because there are so many people who have it, many who aren’t doing as well as I am who could possible use my help, understanding, empathy, love.

I tried once on Twitter but I went incognito. That is not the way to go. I have to do this as @libbytalks, the real me people know, not some new account under my given name: Elizabeth. There is so much to be born and shared about with others! For instance right now while I’m trying to acclimate to #usguys I am also getting off a medicine that: interferes with memory, concentration, retention of facts, reading comprehension, etc. I’m almost off of it and the clarity is beginning to resound! These are the struggles that people with this illness endure. I want to help.

Author’s Bio:
Hi, my name is Libby. I have been fighting bipolar disorder for 35 years and winning day by day. My husband and daughter have both helped. My stubborn determination and intense dislike of being overcome by the horribly frightening aspects of this disorder helps — I always take my meds! Talking and writing about it helps. Faith in my Lord is my strength. Be encouraged. There IS LIFE with bipolar disorder.

Pine Rest Foundation is please to share this post from guest blogger Libby Baker Sweiger.

The original post can be viewed at: TheUsGuys.com

Click here to follow Libby’s blog.

Cost Savings and Improved Care: Behavioral Medicine for Chronic Diseases

Jared L. Skillings, PhD, ABPP, FACHP
Pine Rest Director of Behavioral Medicine

Chronic diseases are the largest health-related problem in the U.S (http://www.fightchronicdisease.org/index.cfm). They account for 70% of all deaths. Approximately half of the adult population (133 million Americans) has been diagnosed with at least one chronic disease, such as heart disease, cancer, COPD, asthma, kidney failure, diabetes, etc. There is also a significant cost to the healthcare system. Healthcare spending for a person with one chronic disease on average is 2½ times greater than spending for someone without any chronic conditions. And the financial picture is even worse in public programs. 96% of Medicare spending and 83% of Medicaid spending is for people with chronic illnesses. These national costs are staggering! Unfortunately, Michigan has even higher rates of chronic disease than these national averages.

The World Health Organization (WHO) has estimated that 80% of all heart disease, stroke, and diabetes, and 40% of cancer would be prevented if Americans would do three things: (1) stop smoking, (2) start eating healthier, and (3) lose weight. Essentially the WHO has recommended that Americans make BEHAVIOR CHANGES to reduce their risk of chronic disease.

This recommendation is very important for behavioral health organizations, like Pine Rest, to consider. Smoking cessation, healthy eating, and weight loss are behavioral issues. For example, eating low-calorie salads rather than burgers, exercising 3 times per week, and quitting smoking are all behavioral choices. And behavioral medicine psychologists are perfectly positioned to serve as experts in the healthcare system to help patients change these unhealthy behaviors, as well as mental health conditions such as depression.

In order to positively influence Michigan healthcare, Pine Rest developed its own Behavioral Medicine Department in November 2010. It is led by Jared L. Skillings, PhD, ABPP, FACHP, a board-certified Clinical Health Psychologist. On the national level, Dr. Skillings is also the President of the Academy of Clinical Health Psychologists (ACHP), which is part of the organization that credentials psychologists as experts in behavioral medicine. Within one year’s time the Pine Rest Behavioral Medicine Department has successfully developed onsite, integrated programs within three prominent medical organizations: Spectrum’s Heart and Lung Transplant Program, Spectrum/West-Michigan Heart, and Advantage Health. At each of these locations, empirically-based behavioral medicine services are being offered for patients with chronic disease.

These services have been very successful. For example, Dr. Skillings and his team have become the exclusive provider of psychological evaluations for the new Spectrum Heart Transplant program. And there are also plans to expand this high-quality work to sleep medicine and diabetes care in the near future. In fact, there is such need for behavioral medicine services that more psychologists must be trained to do this work. In July 2011, under the leadership of Dr. Brant VanOrman, the Pine Rest predoctoral psychology internship program will start a brand new intern position that will focus on behavioral medicine training.

These services have been very successful. In recognition of this innovative nature of this program, the Pine Rest Foundation has awarded two grants to the Behavioral Medicine Department. Grant #1 is focused on policy and model development. It is necessary to develop model and policies that describes the “nuts and bolts” of how Pine Rest will provide behavioral medicine services in the medical community. These policies will insure the highest-quality of clinical service, and facilitate replication in even more medical offices. Grant #2 is focused on training. It will provide needed funds to develop a second behavioral medicine predoctoral internship position and a formal postdoctoral training program. It will also allow Pine Rest to recruit a top-notch psychologist to contribute to the clinical work and training needs of the behavioral medicine department.