Posts Tagged depression
Robert A. Mines, Ph.D., Chairman and Chief Psychology Officer
Thank you John Oliver and your staff for a significant public service on your show this week! Your commentary and excellent coverage of a major problem in substance use disorder and alcohol treatment will have an impact far beyond what the insurance and professional communities have been able to do.
MINES has patients who have gone out of network, received poor care, the payors have received outrageous bills, the patients are stuck with bills that can only result in medical bankruptcy and as you noted, people die in these disreputable facilities. A major component that you pointed out is patient brokering. When people Google substance abuse/use treatment, the top 20-30 are facilities, mostly in Florida and California, or are patient brokers. Reputable facilities in the person’s community do not even make the list. Then the facilities sometimes even pay the airfare to fly the patient to their facility and if the patient does not meet medical necessity for that level of care, the facility turns them out on the street to find their own way back to the state/community they live in.
You mentioned addictionologists as a resource for finding reputable care. In addition, Employee Assistance Programs as well as managed behavioral health services (insurance) are knowledgeable and informed about substance use and alcohol treatment. They know which facilities and programs are in network with the insurance and which ones do a good job.
Evidence-based treatment supports the use of a continuum of care from outpatient, intensive outpatient, partial hospitalization, residential and detox (medical and social detox). There are medications that also contribute to sobriety and health.
These are chronic illnesses/conditions that require the patients to cope with all their lives. Learning relapse prevention and adherence skills are essential.
If you decide to delve into this national problem further in a future episode, I would be happy to consult with you and your team.
The following clip may be not suitable for some work environments:
This is a link to a pdf of an article published by the Self Insurance Institute of America on predatory treatment facilities and managed behavioral healthcare strategies for helping the patients and the payors. http://www.minesandassociates.com/documents/Predatory_Facility_Article.pdf
Psychology of Performance #62: Veteran’s Mental Health, Memorial Day and President Trump’s Stigmatization During Mental Health Month*
*This blog has nothing to do with party affiliation, it is about leadership, modeling, and stigma and its consequences.
President Trump has made stigmatizing comments related to mental health during Mental Health Awareness month (May 2017). This is unacceptable leadership behavior on many levels. As the Commander-In-Chief of our armed forces, he has now sent a message to our active duty personnel and veterans that it is ok to call people “nut jobs” and other derogatory names related to mental illness, psychological stress, and behavioral problems. The irresponsible nature of this during Mental Health Awareness Month, and right before Memorial Day when we honor those who have served our country, now sends a message to our active duty personnel and veterans that they should not seek help or they will suffer social or job-related consequences.
Why is this a problem?
You may be wondering why am I making an issue of this? The US Department of Veterans Affairs has the following quick facts (not fake news, just the facts).
- In 2011, more than 1.3 million Veterans received specialized mental health treatment from VA for mental health related issues.
- The Rand Center for Military Health Policy Research, Invisible Wounds of War, 2008 noted that of the 1.7 million veterans who served in Iraq and Afghanistan, 300,000 (20%) suffer from post-traumatic stress disorder or major depression.
- The American Psychological Association has identified the critical need for mental health professionals trained to treat post-traumatic stress disorder and traumatic brain injury. Please review this commentary. http://www.apa.org/about/gr/issues/military/critical-need.aspx
The commentary goes on to note:
- suicide rates are increasing for returning service members;
- unemployment rates for veterans outpaces the civilian rate;
- brain injuries are linked to PTSD;
- female veterans are particularly likely to suffer from mental health issues related to “military sexual trauma” (20%);
- many in need (about 60-70%) do not seek help;
- stigma associated with mental illness in military communities; and
- long term consequences of unaddressed mental health needs.
Leadership and Stigma
It is well established in the psychological literature that social learning through the modeling by others has an impact on subsequent learning and behavior. When President Trump engages in direct insults to people while using derogatory mental health terms, his subordinates, employees, constituency, and his military receive the message that he is modelling that implies that having a mental illness (caused by serving our country) or stress (caused by serving our country) means you are less of a person, not competent to work, is something to be ashamed of, and should be kept a secret. Furthermore, it gives others permission to act in a similar manner further pushing those who are concerned about seeking help away and reinforces the stigma in the military and in society. Finally, his comments about grabbing women’s genitalia that came to public awareness while he was a presidential candidate further erode female military personnel’s safety in their own units when twenty percent (20%) have already experienced “military sexual trauma”.
Psychology of Performance
Employees’ performance can be negatively impacted by “bullying behavior”, or demeaning comments about their illnesses. It is exacerbated when leadership models this behavior because then it becomes acceptable with no organizational accountability. The consequences are lowered productivity, increased absenteeism, presenteeism, and increased medical costs. The cost of untreated mental illness to employers, families, and society is significant. President Trump’s behavior as a leader in this area is concerning and needs to stop.
This Memorial Day, I ask you to remember those who served and honor those who are still alive by letting them know the pain and suffering they experienced can be healed if they have such symptoms. They deserve our support, compassion, and gratitude. There are many resources available to them, encourage them to use them. Finally, stand up to those such as our President and Commander-In-Chief who model unskilful and unwholesome behavior.
Have a day filled with loving kindness and compassion!
Robert A. Mines, Ph.D., Chairman and Psychologist
As you may or may not know, May is National Mental Health Awareness month in the United States. Here at MINES improving services, knowledge, and awareness around mental health issues, and providing solutions to these issues is our business, our specialty, and our passion. Therefore, it’s safe to say that Mental Health Awareness Month is important to us as it allows us an opportunity to jump into the national conversation around critical behavioral health topics on a national level and help the fight to increase awareness and decrease stigma around mental health.
To shed some light on why this is so critical, consider the following statistics:
US General Stats:
- 1 in 25 adults are currently diagnosed with a serious mental illness; 1 in 5 are currently diagnosed with some sort mental illness
- There are a wide variety of anxiety disorders, including Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, and specific phobias to name a few. Collectively they are among the most common mental disorders experienced by Americans.
- Approximately 10.2 million adults in the U.S. have co-occurring mental health and addiction disorders.
- Serious mental health illnesses cost people $193.2 billion in lost earnings every year in the U.S.
- Nearly 60% of adults with a mental illness did not receive care in the previous year.
- 3% are currently diagnosed with a serious mental illness; 14.3% are currently diagnosed with some sort mental illness.
- Men die from suicide at twice the rate as women.
- 6 milling men are affected by depression per year in the U.S.
- The Top 5 major mental health problems affecting men in the U.S. include: Depression, Anxiety, Bipolar Disorder, Psychosis and Schizophrenia, and Eating Disorders.
- Men are significantly less likely to seek help for mental health issues than women. Causes for this include reluctance to talk, social norms, and downplaying symptoms.
- 5% are currently diagnosed with a serious mental illness; 21.2% are currently diagnosed with some sort mental illness.
- 12 million women in the U.S. experience clinical depression each year. Roughly twice the rate of men.
- Although men are more likely than women to die by suicide, women report attempting suicide approximately twice as often as men.
- Many factors in women may contribute to depression, such as developmental, reproductive, hormonal, genetic and other biological differences (e.g. premenstrual syndrome, childbirth, infertility, and menopause).
- Fewer than half of the women who experience clinical depression will ever seek care. And Depression in women is misdiagnosed approximately 30 to 50 percent of the time.
- 50% of all chronic mental illness begins by the age of 14; 75% by the age of 24.
- 20% of 8 to 13 year of age in the U.S. will be diagnosed with some sort of mental illness in their lifetime.
- Girls 14-18 years of age have consistently higher rates of depression than boys in this age group.
- Nearly 50% of kids with a mental illness did not receive care in the previous year.
- LGBTQ adolescents are twice as likely to attempt suicide than non-LGBTQ youths.
- More than 90% of children who die by suicide have a mental health condition.
This month from MINES
All throughout this Mental Health Awareness Month, MINES will be tweeting out stats to stoke the conversation and resources to help those that may not know where to go. We will also be sharing thoughts, resources, and insight from different members of the MINES team around some of today’s important behavioral health issues right here on MINESblog. So please follow if you are not already, and feel free to share with anyone you think may benefit from the information. And if you or someone you know is struggling with a mental health issue, please encourage them to reach out to one of the resources above to find the help they need. And as always, if MINES is your Employee Assistance Program and you need help, information or just need to talk, call us 24 hours a day at 1-800-873-7138.
- Substance Abuse and Mental Health Services Administration Treatment Referral Helpline –
- National Institute for Mental Health – nimh.nih.gov
- NAMI (National Alliance on Mental Illness) – nami.org
- Mental Health America – mentalhealthamerica.net
- Mental Health America of Colorado http://www.mhacolorado.org/gethelp
- Anxiety and Depression Association of America – adaa.org
- Depression and Bipolar Support Alliance – dbsalliance.org
- National Suicide Prevention Lifeline – suicidepreventionlifeline.org
- Veterans Crisis Line – veteranscrisisline.net
- National Action Alliance for Suicide Prevention – actionallianceforsuicideprevention.org
- United Way- unitedway.org/local/united-states/
Keep the conversation going
As always we ask that you don’t let the conversation end with the end of the month. We don’t have to wait until next year to keep talking about Mental Health especially when there are so many people out there in need of help and information. Keep good track of your own health and wellbeing, don’t be afraid to seek help if you need to, and assist others by talking to them and sharing information and directing them towards care providers that can help them.
To your wellbeing,
The MINES Team
What is grief?
Grief is a natural reaction to loss. It can be a loved one, friend, co-worker, pet, and even sometimes objects such as a house or car. It’s important to understand that grief is a way in which our minds and bodies cope and that grief can be a healthy, even necessary, process. Everyone experiences grief at some point in their lives and works through it on their own terms. In fact, 1 in 5 people will experience the death of someone close to them by the time they are 18. Grief can be an extremely personal time where people may reach out to others or isolate themselves. We will discuss the difference between healthy and unhealthy grieving, along with the common stages of grief.
The stages of grief
Depending on where you look you can find anywhere from 5 to 7 stages of grief. For sake of brevity, we will focus on the core 5 stages. The stages are:
While these stages represent an overall progression, it is important to note that it is possible to move back and forth between stages, skip stages and even begin the stages again once you’ve reached acceptance. For instance, you may skip the bargaining stage and go straight into the depression stage but then fall back into the anger stage before finally reaching the acceptance stage. The healing process will be painful and depending on the level of grief you are experiencing can often take a long time. Sometimes it may take weeks, other times it can years to reach some form of resolution to the grieving process. It is important to focus on happy memories and positive thoughts when working through a loss. In 2008 psychologist Dale Lund of California State University surveyed 292 recently bereaved men and women age 50 and older and found that 75 percent reported finding humor and laughter in their daily lives and at levels much higher than they had expected. Other research has shown that being able to draw on happy memories of the deceased helps you heal — those who are able to smile when describing their relationship to their husband or wife six months after the loss were happier and healthier 14 months out than those who could only speak of the deceased with sadness, fear, and anger. Everyone works through grief their own way and in their own time but it is important to recognize when the grieving process has stagnated and is not progressing toward acceptance in a healthy way. This may be a sign that professional help is needed.
When is grieving good/bad?
As we mentioned above grief is a very natural, human reaction to tragedy and necessary to our healing process. Grieving is healthy when we are able to use it to process our thoughts and emotions in a way that lets us heal and eventually reach a state of acceptance that lets us move on from the tragedy. This does not mean forgetting about the people we may have lost or the events that might have happened, but simply reaching a place emotionally that allows us to live our lives normally. Grief is unhealthy when we stop progressing through the stages and get stuck. This may happen in any one of the stages and you may even switch between a couple but are never able to reach the acceptance stage. This can happen for any number of reasons. Depression, isolation, and compounding life sources of stress and grief are just a few factors that could lead to obstacles in the grieving process. If this becomes the case, it is often best to seek professional help. Contacting a professional grief counselor is the best first step in assessing where you are in the grieving process and to determine if there are other areas of concern that need attention. To get in touch with a qualified counselor you can talk to your primary care doctor and they can often make a referral. You may also have direct lines to behavioral health benefits through your employer’s health plan or Employee Assistance Program. Check with your Human Resources Department if you are not sure.
How to grieve in a healthy way
As we said, there is no right or wrong way to grieve, but there is healthy and unhealthy grieving. In order to help yourself stay positive and productive in the healing process it is helpful to keep in mind:
- You are not alone – Friends, family, co-workers, neighbors, church groups, and others you know socially can help. Think about whom you know that can support you.
- Don’t let others tell you how you should feel – Only you know what’s right for you. What someone else went through when they dealt with grief may not be what you experience.
- Let others know how they can help – What you need while navigating the grieving process may be different from moment to moment, day to day, and week to week. Let others know how your needs are changing.
- Everyone’s grief is unique – There is no guide to tell you when to start and stop grieving or when to move from one stage of the process to the next. However, if you feel that your grief is getting worse and that you are not progressing, there is help. Contact a grief counselor or EAP to get in touch with help. If your EAP is MINES our contact information is below.
Of course, this is not a comprehensive list and as you navigate through the healing process you may find that certain things help and others don’t. Find what works best for you.
How to help others grieve
At this point, you should see that grief is personal and can be a sensitive topic to some people. It can be hard to find ways to talk about grief or offer help if you know someone is grieving or struggling with a loss. There are things you can do, however, that offer support without being intrusive or overbearing. Things you might try include:
- Just being around – Sometimes there is nothing you can say that will make a person feel better. But just the fact that you are around can help. By being present and ready should they need something, the grieving person will feel supported even if you or they don’t know exactly what to say at the moment.
- Food – When someone is grieving, sometimes food is the last thing on their mind. They may not feel up to cooking or going out to get something. Or they may be suffering from lack of appetite which is common during grief. Being handy with quick, nutritious, easy to eat items such as fruit, veggies, or simple dishes can be a great help. As well as helping them remember when they ate last and ensuring they are getting enough sustenance.
- Support for decisions – When depressed, people’s decision-making ability can suffer. Try to help the griever put off big decisions until they are in a better state of mind. If necessary be there to act as a voice of reason and clear thought should important choices come up that need to be addressed.
- Listening – If and when the grieving person is ready to open up and talk, be there to listen. Offer simple understanding and words of support. Try and keep them talking so that they can vent their emotions when they have a chance. Steer away from any judgment and instead offer encouragement as much as possible. Talking is healing.
- Let them cry – Seeing our loved one’s cry can be painful, but don’t let that make you discourage them from doing so. Crying can be an important part of emotional processing. Instead, comfort them, offer them tissues, and even cry with them.
Be there for the person in need but allow them the chance to choose to open up to you on their own terms and in their own time. Trust that if you are there for them they will let you know when they need you. Intervene only if you sense that they are getting worse and not taking care of themselves in a way that will help them get better in time.
If you are currently grieving, supporting someone who is, or have grieved in the past but have reached acceptance, continue to focus on and preserve the good memories you have. You may always feel the sting of the loss to some extent but as you remember your passed loved one, lost relationship, or even a lost pet, the pain will slowly disappear over time and the fond memories and times that made you laugh and smile will be all that remain. If you are struggling and having trouble reaching the point of acceptance and do not feel as if you are healing, please reach out to someone. Find a close friend or family member you can confide in, seek out a grief counselor to talk to, and again if your employer has an Employee Assistance Program use that resource to find the help you need. If you have MINES as your EAP, we are always here to talk 24/7, please reach out to us anytime at 1-800-873-7138.
To Your Wellbeing,
The MINES Team
Children’s Grief Awareness Day. (n.d.). Retrieved March 24, 2017, from https://www.childrensgriefawarenessday.org/cgad2/index.shtml
Konigsberg, R. D. (2011, March 14). Grief, Bereavement, Mourning Death of Spouse. Retrieved March 24, 2017, from http://www.aarp.org/relationships/grief-loss/info-03-2011/truth-about-grief.html
For National Eating Disorder Awareness Week this year, we wanted to highlight a local community member and eating disorder awareness advocate, Amy Babich. Amy was gracious enough to provide us with her thoughts, experience, and resources to help others that may be struggling with an eating disorder. Amy’s insights are below:
This week is NEDA Week, a.k.a. National Eating Disorder Awareness Week, and every year I make it a priority to openly discuss this deadly disease that is often left in the dark. Unfortunately, it seems that unless a celebrity addresses the topic, or an extremely severe case finds its way to the media, eating disorders are rarely talked about. This makes them more stigmatized, underfunded, and a seemingly ‘less important’ mental health issue. Also, the lack of discussion and education about eating disorders can make it much more difficult for those struggling to seek help.
- Anorexia nervosa has the highest overall mortality rate and the highest suicide rate of any psychiatric disorder.
- Eating disorders have very low federal funding, totaling to only $28 million per year. *To give you an idea of how limited that amount of research money is, Alcoholism: 18 x more funding ($505 million), Schizophrenia: 13 x more funding ($352 million), and Depression: 12 x more funding ($328 million)
- Every 62 minutes, at least one person dies from an eating disorder.
- There are more eating disorders than just anorexia and bulimia; there is also EDNOS (eating disorder not otherwise specified), orthorexia, ARFID(avoidant restrictive food intake disorder), and diabulimia.
- Only 1 in 10 people with an eating disorder will receive treatment in their lifetime.
- Insurance companies’ often refuse coverage for eating disorder treatment. *Based on level of care needed, treatment costs between $500-$2,000 PER DAY.
My Own Battle
It took me many years, and numerous rounds of treatment, to get to where I am today: recovered from anorexia. I wanted to start by saying that so that people can realize if recovering from an eating disorder was as simple as “just eat your food,” it wouldn’t have taken 4+ years, 3 different facilities, and 8 admissions to do so. For me, my eating disorder was a slow suicide, and one of the many self-destructive behaviors I engaged in. It wasn’t about the food, and if you ever are to hear anyone talk about eating disorders, they’ll also tell you the same.
Recovery didn’t come until I really wanted it, which took much longer than the people who were by my side through it all had hoped, including myself. What it really took for me to choose recovery was a very serious medical complication. In my last relapse, I had a seizure on my best friend’s floor at 2 a.m. The seizure was caused by refeeding syndrome, which is a life-threatening reaction that the body has when it is severely malnourished, then suddenly increases its food intake. Unfortunately, it took me losing complete control over my body to want to take back control of my life; and as strange as it may sound, I am so grateful for that seizure, and truly don’t know if I’d be here now, had it not happened.
Because of the struggles I have endured, I am an advocate for eating disorders, mental health, the LGBTQ+ community, women, and children. I believe whole-heartedly that I am here on this earth to let people know that they are not alone.
To Those Struggling
There is help out there, and it’s okay to ask for it. That’s why things like eating disorder treatment facilities, programs, and specialized therapists exist. Know that you are worthy of love, happiness, and freedom and that you are not alone. Asking for support takes a great amount of strength, so please try not to look at it as a weakness. Recovery is possible, and this big, beautiful, chaotic mess of a world needs you. Stay strong, and keep fighting.
NEDA Helpline: 1-800-931-2237
Suicide Prevention Hotline: 1-800-273-8255
Sexual Assault Hotline: 1-800-223-5001
National Domestic Violence Hotline: 1-800-799-7233
With wishes of happiness & health,
Final thoughts from MINES
Eating disorders are serious. Please don’t wait to reach out if you need assistance. Employee Assistance Programs like MINES are here to provide resources and guidance to make sure you get the help you need. We are always here to talk. Please call us at 1-800-873-7138 if you or someone you care about is struggling with an eating disorder, depression, or any other work/life issues that you may need help with.
The World Health Organization estimates that approximately 1 million people die each year from suicide. Consider that number for a moment. Imagine someone asked you to count 1 million toothpicks. How long would it take? Most Americans have been impacted by suicide. The topic of suicide and the workplace is not frequently talked about and often gets overlooked.
A colleague or employee contemplating suicide can be overwhelming for HR representatives, supervisors, and managers. You may not know what your role is or how to offer support without overstepping professional and personal boundaries. One of the most difficult questions has to do with assessment. How does one determine if a person is really at risk for suicide, and if a risk is detected what is the most effective way to intervene?
This blog provides a brief reference, or starting point, for developing strategies to manage suicide in the work place. It addresses warning signs, prevention tips, and postvention tips. It also offers suggestions for what you can do to support those who have lost an employee or co-worker to suicide.
When a person is contemplating taking their own life, they often will not voluntarily tell anybody. They may, however, reach out in non-direct ways. Below are some warning signs that someone may be contemplating suicide:
- Talking, writing about suicide/death. The phrases, “I wish I were dead” or “the world would be better off without me” are common examples of things suicidal people might say.
- Someone might be suicidal if they begin actively seeking access to guns or other weapons, pills, etc.
- They begin putting their affairs in order. Things like making a will, or tying up loose ends as not to be a further burden on friends and family might be a sign that they are contemplating leaving for good.
- A person who appears down, depressed, or hopeless.
- Isolating themselves from others. Somebody who normally engages socially might become isolated or start to withdraw from co-workers, work engagements and other social obligations might be suffering from major depression.
- Increase in risky behavior. If a person significantly increases alcohol, or drug use, incidents of unsafe sex, calling into work, reckless driving, or a host of other harmful activities, they are demonstrating unsafe behaviors and may have given up.
If you witness one or more of the above behaviors the next step is to determine their risk. It is helpful to consider multiple factors that could increase ones risk. The brief list below is a place to start.
- Biopsychosocial factors: The individual is at higher risk if they have a history of trauma or abuse, alcohol or drug addiction, or mental health issues–especially those that have gone undiagnosed or untreated. If there have been previous attempts and/or a family history of suicide then this would increase the likelihood that someone would seriously complete suicide.
- Sociocultural factors: Being part of a stigmatized, non-dominate group in society like LBGTQ can cause a person to feel isolated especially if they do not have the support of friends and family. The person may have been in a social environment where suicide is normalized, they may have had friends or family complete suicide which makes suicide contemplative. Barriers to mental healthcare associated with socioeconomic issues prevent individuals obtaining the help and early intervention they need.
- Environmental factors: These might include a recent job loss, dropping out of school, or loss of a loved one or relationship. The person may live in an environment where access to guns or pills is readily available increasing their means–subsequently increasing risk.
- Does the person have a plan, intent or means to commit suicide? If somebody discloses that they have a specific plan to harm themselves, high motivation to do so, and a way to do it, they are at high risk for committing suicide.
If you have seen the warning signs in someone and determine that they are at high risk and you feel they are in imminent danger you should get them to a mental health professional, call 911, or take them to the nearest emergency room. For long-term suicide prevention tips in the workplace see the ideas below.
- Make help accessible by posting suicide prevention hotlines in lunchrooms, break rooms, and bathrooms.
- Raise awareness regarding resources; make sure employees know that they have an employee assistance program (EAP) and that using the benefit is confidential. Post flyers with numbers to the EAP so that number is accessible to everyone. Oftentimes EAP programs are accessible to human resource representatives, mangers, and supervisors; take advantage and seek advice. Have a list of community resources that offer mental health services. Let employees know that they can also talk with their human resources representative.
- Educate employees by destigmatizing mental health and substance abuse issues by offering lunch and learns or trainings on various topics such as suicide, healthy coping skills for managing stress, anxiety, depression, and substance abuse issues.
- Create a balanced work environment by allowing for “mental health” days or offering work from home days if it’s possible. Managers and supervisors can help by assisting in resolving work problems as they arise and managing conflict effectively between co-workers, managers, and supervisors.
If your company has experienced a suicide, the loss of a colleague or employee can be shocking and traumatic. Below are a series postvention tips that might be helpful in the event of a workplace suicide.
- Acknowledge that your employees may have strong emotions surrounding the suicide and will need opportunities to express their feelings.
- Supervisors and managers should be on alert for PTSD symptoms. A drastic change in behavior may be a sign that a person is having a hard time dealing with the incident.
- Encourage healthy grieving by providing a basic understanding of the stages of grief: Denial, Anger, Bargaining, Depression, Acceptance. The stages of grief affect individuals differently at various rates. Some employees may express their grief as sadness or anger over a long period of time, while others may get back to their normal lives rather quickly.
- Offering empathetic and compassionate listening will give employees permission to talk openly with their supervisors and managers and will give them the opportunity to ask for what they might need in their grief. Being accessible to employees lets them know that they are not alone and that they are supported
- Become a role model for healthy grieving by being open with your feelings surrounding the suicide.
The purpose of this blog is not only to help employers notice the warning signs of suicide and help them assess their employee’s risk for suicide, it also serves as a basic framework on how to instill awareness regarding suicide, prevention and postvention tips in the workplace. It is likely that if there is early recognition and intervention of a person who is contemplating suicide, that there can be a positive outcome. In honor of suicide prevention month remember, asking someone “how are you doing” or “are you ok” should reach farther than the project they’re working on. By asking and being open to talk, you can save a person’s life.
1-800-273-TALK (8255): This number will connect you with a mental health professional who will be able to assist you.
The Jason Foundation: http://jasonfoundation.com/get-involved/student/a-friend-asks-app/
Alea Makley, MA
MINES & Associates
A couple of weeks ago, as a board member of the American Diabetes Association in Colorado, Wyoming, and Montana, I had the privilege of discussing the psychological aspects of diabetes with the Denver CBS affiliate. I’ve included the link here. The following are highlights that are worth consideration.
There are a number of factors that can either enhance or undermine diabetes and other chronic illness management and wellbeing. Depression and/or anxiety can co-occur as a result of receiving one of these diagnoses. If untreated, patients with co-occurring diagnoses have difficulty following through on the numerous daily tasks required to live a healthy life with one or more of these chronic illnesses. In addition, from a payer’s perspective the cost of treatment are over 150% higher when depression co-occurs.
Who would not have some degree of depression or anxiety when faced with a life-long chronic illness to manage? How the person copes with the symptoms is an important variable. Cognitive-behavioral techniques related to adherence and relapse on self-care can be invaluable. Social support and social networks have always been important in managing chronic illness. Alcoholics Anonymous is a great example of peer support for the chronic illness of alcoholism. Patients with chronic illnesses face potential burn-out regarding both the illness and the complexities related to compliance. The social support network provides coping modeling from peers, support from family and friends, and social comparison ideas from others who are successful in managing their illness.
Sometimes, the illness combinations are so complicated that outside help is needed in the form of Intensive Case Management. This becomes necessary when there are multiple providers that need to be communicating about the patient, complex psychological elements that need to be addressed, and family systems that may be fragile or even undermining the patient’s care. Integrated behavioral health systems working in concert with medical systems, data mining, and other auxiliary providers significantly increase the chances for the patient and the payer to successfully manage the illness thereby increasing the patient’s quality of life.
Robert A. Mines, Ph.D., CEO and Psychologist
There are countless resources online that give advice on how to budget, how to get out of debt, how to save, how to invest, and so many more topics on money and finances. The interesting question, then, is why is money still such a difficult issue for people? Why don’t we all feel financially confident and successful, all the time?
At first glance, money and wellbeing (one’s state of overall health, across all components of life) may not seem to go together. However, there are numerous psychological components associated with people and their financial wellbeing. The broad categories include brain chemistry, the behavioral economics of loss aversion, family views of money and what it means, and personal beliefs regarding money, its meaning and how to manage it. There are also many others that will not be addressed in this blog.
The neurochemical elements related to money have to do with brain changes related to spending money versus saving money. It is well documented that when people act on urges for immediate gratification (i.e., I need those shoes NOW!), they activate specific chemical “pleasure centers” in the brain, which can cause them to have stronger, more frequent urges to repeat the gratifying behavior. Some people have a more difficult time delaying gratification than others. This experience alone accounts for significant differences in people who are able to save: they are able to study instead of play, achieve higher levels in education and subsequently higher levels of income, which can be tied to money wellbeing later in life. People who routinely act on spending impulses often run up debt, have cash flow problems and subsequent stress related to these situations. Other neurochemistry-related conditions that negatively affect financial wellbeing include addiction (to food, drugs, alcohol, sex, gambling, etc.), which often includes diverting money to support those immediate gratification demands of addiction with corresponding money problems.
The area of behavioral economics includes a significant body of research related to factors of influence and people’s decisions about money and subsequent financial wellbeing. For example, most people would rather not lose money than take the risk of getting more money. This was played out again in the last recession, when people pulled their money out of a market that was dropping in prices, bonds paid virtually nothing. Yet people who had cash and were risk-aversive did not reinvest ended up missing out on 70-200% returns in stocks over the next few years. Those who thought bonds were safe ended up losing money against inflation, even as low as it was during that time. This clearly had an impact on financial wellbeing.
Family views about money are passed on in the form of modeling, messages and social influence. For example, a family that views money as a typically scarce resource that should be shared equally will expect family members who do succeed in attaining higher levels of financial wellbeing to subsidize them. This can create family stress if the individual who has the money disagrees with the others’ beliefs about it. There is case after case of lottery winners suddenly being contacted by family members they had not heard from in a while asking for money. There are also a number of lottery winners who went bankrupt. Some of the reasons for this can be traced to family views about money, a feeling or belief that they did not deserve it, not knowing how to manage it, and an inability to tolerate the social isolation of being in a different economic stratum than their extended family, among other elements.
Individual beliefs about money play an important role in financial wellbeing. How people think about money plays out in their everyday decisions. If one cannot see their “future self” clearly, they may have difficulty saving or participating in their employer’s 401K. Those who do have a clear view of their future self generally find it easier to save and invest systematically. Some people have “all or none” beliefs about money. If they have it, they spend all of it. If they were going to save, and spent it instead, then they say they will start tomorrow. Unfortunately, tomorrow never comes because they repeat the same sequence the next time. This is in contrast to people who view money with more complexity, who are able to allocate money to budget categories, and value the practice of paying themselves first (saving) versus spending.
What can you do to build your awareness of the psychological aspects of financial wellbeing, and make them work in your favor?
- Spend time becoming aware of your thoughts and beliefs about money. Where did you learn them? How do they serve you? How do they positively or negatively impact your financial wellbeing?
- If your neurochemistry is part of your financial wellbeing in a negative way (addictions, impulse control) consider seeking professional help.
- Identify your family patterns related to money. How do they enhance or detract from your financial wellbeing? How do you feel about what you learned or did not learn from your family related to money?
- Become aware of external factors related to behavioral economics that lead to risk-aversive versus “irrationally exuberant” decisions.
To Your Wellbeing,
Mines, R.A., Stone, W.C., DeKeyser, H.E.
It may be self-evident to many of you reading this blog that alcohol use, sleep deprivation, and obesity can negatively affect performance at work or at home. If this is a correct assumption and you have all three of these areas under control, thank you. On the other hand, after 39 years of working with people and organizations on these issues it is clear to me that our society continues to miss the boat on them.
This week alone, I had client organizations call about each of these concerns. In one case a senior executive was observed to drink one bottle of wine at a company function, plus cocktails before dinner. Her behavior became problematic when she propositioned a male colleague, angrily denied she had drank too much and proceeded to accuse others on her executive team of “being out to get her.” To make this situation even sadder, the executive had done something similar three years earlier at the same company function. This became a performance issue at a number of levels. First, upon investigation, it turned out she had a number of days in the last few months where her secretary reported she left early for lunch and never returned resulting in significant loss of individual productivity. Second, she created liability for her company when she propositioned a colleague. This created a potentially hostile work environment/sexual harassment lawsuit. In addition, there was lost time for human resources, management, and legal to review the situation and interview all parties. Third, when confronted with her behavior and the company’s requirement to go to the employee assistance program for an evaluation and potential referral for treatment if indicated, she refused and resigned. This resulted in additional loss of intellectual capital and the personal long term health costs to her. This reminder for everyone in supervisor, management, or executive functions is that alcohol and other substance use disorders have not diminished despite policies, procedures,’ and education interventions. It is important to stay alert to your employees’ and colleagues’ behavior and act in a timely and compassionate manner similar to the company discussed in this paragraph.
The research on sleep deprivation is well documented. Sleep deprived individuals do not function well cognitively and their reaction times are diminished. This finding was significant enough for one researcher to say that sleep deprived drivers were more dangerous than alcohol impaired drivers. What are the costs to your organization related to sleep deprivation? We know that individuals who are sleep deprived eat more, make poorer food and exercise decisions, are more irritable with others, and make poor decisions. Many companies recognize the dangers of sleep deprivation and provide nap rooms, meditation classes, and other options so that employees can refresh themselves and perform better at work.
Obesity, wellness, and financial impact discussions are ubiquitous on the internet and in the professional literature. Our workforces are getting fatter and fatter. Recent research suggested that obesity not only has downstream health costs for the employer, there is some evidence that cognitive functions can be influenced as well. This research needs to be replicated. Then there is the subgroup of morbidly obese individuals who also have co-morbid depression. Depression affects performance in terms of diminished problem solving skills, concentration problems, social withdrawal, lowered energy which is compounded by the lower energy associated with morbid obesity, as well as other symptoms such as memory impairment. Any of these symptoms will negatively affect performance in most jobs. As an employer it will become an even heavier burden going forward to manage the workforce as the obesity incidence continues to grow. What is becoming more apparent is that the typical wellness program is unsuccessful in helping the morbidly obese. A major component that is missing is the psychological aspects of performance related to weight loss and weight gain. The research in this area has been well established for over 25 years. Coors Brewing in 1988 was one of the first companies to incorporate an intensive outpatient obesity program as part of its wellness program. It was a highly successful program. Unfortunately during that time there were many fasting programs and one of the unintended side effects of these programs was an increase in gall bladder surgeries and the corresponding cost. Due to a variety of factors beyond the scope of this blog, all weight loss programs were discontinued a few years later. There are best practice examples of successful interventions with the morbidly obese employee population which apply the psychological elements needed to lose and sustain weight loss.
Contact us if you would like to learn more:
Have a day filled with loving kindness and compassion,
Robert A. Mines, Ph.D., CEO & Psychologist
Happy Holidays from BizPsych! We typically have several requests this time of year to present our “Thriving with the Holidays” seminar for client companies. Surprisingly, this year we have had only one request, from our sister division in Las Vegas. Is it possible that there may be less acute stress this year in many organizations? Is there still much stress, but no time? Perhaps our past years’ efforts have cured all holiday stress (Nice fantasy…)? The holidays are a wonderful time for so many of us. Yet, for many people, the holidays bring an increased stress level that can take away from that delight. For some it’s actually a depressing time of year for a variety of reasons.
The cornerstone of our recommendation about coping or thriving with holiday stress has to do with setting balanced and reasonable expectations of ourselves and of others. There are cultural expectations that can lead to stress and disillusionment, i.e. “we should all be blissfully happy, have beautiful and significant presents for all, and be ever cheerful.” This probably does not work for all of us 100%. We can, however make meaning, be grateful, have authentic interactions, and celebrate what we believe in. One of the ways we can accomplish this is to set meaningful and realistic expectations for the holidays.
A number of years ago I worked out an optimal holiday stress management strategy formula called “Holiday Stress Math.” It is not rocket science, so please enjoy:
Holiday Stress Math
Holiday Stress is a function of: Expectations (E) vs. What Really Happens (WRH)
If E are H (High) and > WRH = HS (High Stress Holiday)
If E are L (Low) and < WRH = LS but DOL (Low Stress) (Depends on Luck)
If E are L (Low) and = WRH = LS but NGT! (Low Stress) (Negative Good Time)
If E are H (High) and = WRH = MS, PGT but HRI(Medium Stress) (Positive Good Time) (High Risk Investment)
BPRE (Best Possible, Realistic Expectation) = WRH(What Really Happens) = GRE (Good, Realistic Holiday)
Have a meaningful and reasonable stress holiday.
Peace and Joy,
Vice President, BizPsych