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So you’re thinking about starting a private practice. Whether you’re a recent graduate or you’ve been in the field for years, opening your own private mental health practice can be a daunting yet exciting experience.

Beginning your own private practice comes with its fair share of pros and cons, and proper research will surely help you to make the best decisions. Rather than explain the in-depth research process (read more about this here), in this article we will focus on how to successfully establish and market a mental health private practice as quickly and efficiently as possible.

I graduated in 2016 with a Ph.D. in Clinical Psychology. After completing a postdoctoral fellowship, I landed a job at a comprehensive medical practice. While this isn’t technically considered private practice, the caseload was low which meant I had to quickly figure out how I was going to increase my caseload (or else I was going to have to find somewhere else to work).

Web research is crucial, but I realized it takes a lot more creativity to become successful. Here is how I built my caseload:

Devise a Plan

There is so much that goes into a practice. Consider the capital of renting an office, advertising, and the time it will take to build a caseload. Make sure you are financially ready to be independent. It’s important to create a name for your business. Something that is catchy or meaningful will pique the interest of future clients. Also, do you have a specific niche? Can you offer a treatment or specialty that others in your community don’t (e.g., telehealth services, biofeedback, etc)?

Do Your Research

Talk to other clinicians in your community and find out what works and what doesn’t work. There is no sense in reinventing the wheel. Ask around and find out what are the best places in your city/town to set-up shop. Find out if you can sublease an office for an hourly or daily rate while you are developing your caseload. If you are going to be cash-only, learn what the typical rates are in your community.

Get Yourself Out There

This one can be tough. I know in my graduate school, we didn’t learn how to network or market our own private practice. I’m definitely an extrovert, but this was way out of my comfort zone! However, in my experience, this was one of the best ways to get referrals.

Where to GoSchools

School counselors, social workers, and administrators will sometimes refer families to therapists. Don’t expect to be able to talk to any of these people by simply walking through their doors though. I’m a former high school counselor and I can attest that my schedule was crazy! My recommendation would be to send a good e-mail explaining who you are and offer a presentation, along with an old fashioned snail-mail letter (with card & brochures).

Primary Care Offices

Pediatricians, primary care docs, PA’s, and nurses give referrals almost daily. They can be a huge resource! Since they are also busy, it’s unlikely you will be able to see them if you just walk-in. Yet, I learned the benefit of walking into an office and introducing yourself to the office manager. They may give you important information about when you can schedule an in-person meeting. A handy tip to keep in mind is that most of these offices really like free lunches, so if you can offer to bring them lunch, they will be more likely to hear your pitch.

Retirement Communities

This is a great place to find clients! Call the community manager and see if you can stop by with brochures, cards, and offer a short presentation.

Join Your Local Chapter of APA/AAMFT

And be sure to regularly attend meet-ups and networking events

Network With as Many People as You Can

Reach out to other private practice clinicians and ask if you can take them out for coffee. If they have a full caseload, they may be willing to put you on their referral list.

Attend Conferences & Networking Events.

APA offers local conferences (e.g., the Midwestern Psychological Association conference) where you can network. If your focus is on children, go to a medical pediatric conference in your local community and find out if you can advertise.

Once you have referral sources, maintain that list. Send thank you notes and visit their practice at least twice a year. Lastly, when you get yourself out there, remember this: People love food & trinkets. If you can provide lunches or coffee/donuts, do it! Bring pens or stress balls with your name on them. And, always have business cards and brochures available!

Use the World Wide Web!

I can’t tell you enough how important the internet is when it comes to marketing a mental health practice or networking. You can use social media to market yourself (for example, posting to friends/family on Instagram or Facebook) or you can advertise through apps or websites. While getting yourself set up on the various social media platforms may provide long-term benefits, advertising can provide near instant results. Patient support Apps like Reachout, or websites like Psychology Today, or Therapy Sites offer some of the best traffic.

Write a blog. Pick topics that you are passionate about and demonstrate your expertise. Write about problems that are common to your community or population of interest.

Join e-mail list-serves. Sometimes, your local APA or MFT chapter will have a list-serve and people will send out e-mails to find mental health clinicians for specific clients.

Get On Insurance Panels.

This can be a challenging process but there are resources out there to help you out, one example is the American Counseling Association website. Many medical providers advise patients to call their insurance companies and find someone from the list of approved mental health practitioners.

Whilst there’s no definitive, set method to marketing a private mental health practice, many people are able to enjoy success in this field. Just remember that it takes patience and persistence! Take care of yourself during this process and talk to friends/colleagues regularly for encouragement and advice.

The post Tips for Marketing a Mental Health Private Practice appeared first on Reachout.

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Is Cancer Contagious: Can We Pass Cancer To Others?

The short answer would be No, but we will attempt to explain further and answer the question: “Is cancer contagious?” In contrast to viruses and other infectious diseases, we cannot contaminate others with cancer. No reason to be avoided or abandon (sexual) contact, hugs or doing things together. Some treatments (immune-, or chemotherapy) can reduce, however, significantly our immune system (defence against diseases), and in this case doctors’ advice to avoid others having a cold or being sick and places like trains, metro, shopping centers and swimming pools where many bugs jump around must be taken at heart.


Cancer develops because something is going wrong when controlling growth (multiplying) cells, due to errors in overwriting the hereditary material, called genes or DNA. Most errors get repaired, but when they persist, we call them mutations, they will be carried on in any new cells. If more than 5 errors accumulate, cells die or can become cancer, starting to duplicate uncontrollably.

We can be born with already some DNA damage (5% of cancers develop young because of inherited mutations), but far out most mutations happen because of something we are exposed to, such as in food, our work, air, chemicals, cigarette smoke or sunlight. These things are called carcinogens.

They are not inherited and can’t be passed on to our children. They are called acquired mutations. Cancers caused by acquired mutations are called sporadic cancers.

Some specific cancers (breast, ovarian, colon, leukemia) can be inherited from a parent and are called hereditary cancers. In these cases, cancer gets diagnosed relatively early in life.

Some of these mutations are now known and a test-kit can be asked to determine family risk. We inherit genes from both our parents. If one of our parents has a gene fault then each child has a 1 in 2 chance (50%) of inheriting it. So some children will have the faulty gene and an increased risk of developing cancer and other children won’t.

Overall, genetics specialists estimate that only about 2 or 3 in every 100 cancers diagnosed (2 to 3%) are linked to a hereditary syndrome.

Movie on 02-04-17 at 19.20 - Vimeo

The risk of your family depends on:

1)Several relatives on the same side of your family have had cancer – the same side of your family means either your father’s relatives or your mother’s relatives

2) The relatives have had the same type of cancer or different cancers that can be caused by the same gene error (breast and ovarian or colon and uterus)

3)The cancers developed when the family members were relatively young, below the age of 50

4) One of your relatives has had a gene error found by genetic tests

It is important to remember that cancer is most common in people over the age of 60 and is rarer in young people. So cancer in older people is less likely to be due to an inherited cancer gene.

Many mutations need to be in place for cancer to develop. Because the other factors are not always in place, cancer may seem to skip a generation. A parent may have the gene and not develop cancer but their child who inherits the same gene can develop cancer.

We need more research to find out what these other factors are for each type of cancer. We also need to find out more about how genes work together to cause cancer so that we can reduce the risk of developing it.

And remember…

For greater insight into interacting with those suffering from the issues mentioned in the article or if you would like to chat with others affected, I highly recommend joining the app, Reachout.

The post Is Cancer Contagious? appeared first on Reachout.

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“I go to the boxing gym to release steam when I’m mad or angry”
“Nothing clears my mind like a nice long run when I find myself frustrated”
“Mediation is the only way I can manage my anxiety”
“I carry a small razor in my purse and cut myself to cope with stress”

One of these coping strategies is different from the others…

Non-Suicidal Self-Injury

As shocking as that last statement may sound, the act of hurting oneself to cope with stress, anxiety or frustration actually has a name, non-suicidal self-injury (NSSI) and it affects 17% of adolescents, 15% of college students, and about 5% of adults.

NSSI, often simply called self-injury, is the act of deliberately harming the surface of your own body, such as cutting or burning yourself. It’s typically not meant as a suicide attempt. Rather, this type of self-injury is an unhealthy way to cope with emotional pain, intense anger, and frustration.

Like many disorders, NSSI can take on many forms. From literally cutting one’s skin with a knife or scissors to rubbing an area of the skin so vigorously as to cause actual physical damage and pain. Each person suffering from NSSI has his or her “preference” and “rituals” for self-mutilation, similar to an alcoholic who may have a drink of choice. However, the physical outcome manifests, the underlying emotional cause of this disorder is the real culprit.

Most people who use NSSI are not suicidal; however, the repeated act of self-mutilation and the emotions that cause them can become more severe over time if not properly and swiftly treated. Depressive and anxiety disorders are common. Many feel emotionally dysregulated due to a variety of factors including, but not limited to, a history of trauma or abuse, bullying, shame, family dysfunction, school or other daily pressures, low self-esteem/worth, loneliness, depression, etc.

Cutting (or any other form of NSSI) sometimes releases endorphins, similar to a strenuous workout (or even sex), killing the pain momentarily and raising one’s mood. On the opposite end, a person who has trouble feeling any emotions at all may use NSSI as a way to feel something, anything “real” to replace the emotional numbness. Typically, after the initial “high” wears off, hurting themselves will cause feelings of guilt and shame causing them to hurt themselves again, suppressing their feelings further, and thus the dangerous cycle is perpetuated and can be extremely hard to find a way out.

What to look for?

Aside from the most common form of NSSI, which is physical cutting of the skin, it is important to note that any of the below rituals may also be considered as NSSI:

  • Scratching
  • Burning (with lit matches, cigarettes or hot, sharp objects like knives)
  • Carving words or symbols on the skin
  • Hitting or punching
  • Piercing the skin with sharp objects
  • Pulling out hair
  • Persistently picking at or interfering with wound healing

Recognizing that someone is using NSSI to cope with their emotions isn’t always easy. The best thing you can do to help is to ensure they start to learn proper and less harmful ways to cope with the emotional pain that is causing the act of self-harm.

How to stop NSSI behavior?

Begin some form of healthy mind-body outlet such as yoga, Pilates, running, Zumba class, kickboxing, etc to begin to integrate your physical and emotional selves.

1. Begin some form of healthy mind-body outlet such as yoga, Pilates, running, Zumba class, kickboxing, etc to begin to integrate your physical and emotional selves.

2. Use your senses. Being mindful of what you see, hear, taste, smell and feel are powerful tools to engage more in the here-and-now. For example, go to the freezer and grab on to ice instead of cutting or rub your hands on a fuzzy blanket for calm-down stimulation.

3. Get support. Talk to someone you trust before you self-harm. Have an emergency plan with a list of names and numbers with you at all times. When you are in the emotional realm and the desire to cut is strong, it can be difficult to “think” about what to do. Create this crisis worksheet when things are calm.

4. Wait for just a little longer each time before you self-harm. If you automatically use self-harm to cope with strong emotions, wait one more minute. See if you can add a minute every day or every week. Try to gain some control over the behavior.

5. Draw the word DO NOT RELAPSE (or an X or another symbol) on the part of the skin where you typically injure as a visual reminder to not harm.

6. Distract yourself with something else – play music, dance, scream, hit a pillow or even sleep.

7. Throw out all sharp objects that you might use. Not having them accessible may provide time to think before acting.

8. Get professional help. Individual and group therapies are extremely effective as is medication or holistic remedies. Seek professional help. This is treatable once new coping strategies are gained and practiced.

The most effective treatment for NSSI is cognitive behavior therapy, specifically dialectical behavioral therapy (DBT), which helps to provide clients with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. When searching for a health care provider, be sure to find a therapist who has training in CBT and/or DBT.

And remember…

For greater insight into interacting with those suffering from the issues mentioned in the article or if you would like to chat with others affected, I highly recommend joining the app, Reachout.

The post How to stop cutting and related NSSI behavior. appeared first on Reachout.

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So you’re thinking about starting a private practice. Whether you’re a recent graduate or you’ve been in the field for years, opening your own private mental health practice can be a daunting yet exciting experience.

Beginning your own private practice comes with its fair share of pros and cons, and proper research will surely help you to make the best decisions. Rather than explain the in-depth research process (read more about this here), in this article we will focus on how to successfully establish and market a mental health private practice as quickly and efficiently as possible.

I graduated in 2016 with a Ph.D. in Clinical Psychology. After completing a postdoctoral fellowship, I landed a job at a comprehensive medical practice. While this isn’t technically considered private practice, the caseload was low which meant I had to quickly figure out how I was going to increase my caseload (or else I was going to have to find somewhere else to work).

Web research is crucial, but I realized it takes a lot more creativity to become successful. Here is how I built my caseload:

Devise a Plan

There is so much that goes into a practice. Consider the capital of renting an office, advertising, and the time it will take to build a caseload. Make sure you are financially ready to be independent. It’s important to create a name for your business. Something that is catchy or meaningful will pique the interest of future clients. Also, do you have a specific niche? Can you offer a treatment or specialty that others in your community don’t (e.g., telehealth services, biofeedback, etc)?

Do Your Research

Talk to other clinicians in your community and find out what works and what doesn’t work. There is no sense in reinventing the wheel. Ask around and find out what are the best places in your city/town to set-up shop. Find out if you can sublease an office for an hourly or daily rate while you are developing your caseload. If you are going to be cash-only, learn what the typical rates are in your community.

Get Yourself Out There

This one can be tough. I know in my graduate school, we didn’t learn how to network or market our own private practice. I’m definitely an extrovert, but this was way out of my comfort zone! However, in my experience, this was one of the best ways to get referrals.

Where to GoSchools

School counselors, social workers, and administrators will sometimes refer families to therapists. Don’t expect to be able to talk to any of these people by simply walking through their doors though. I’m a former high school counselor and I can attest that my schedule was crazy! My recommendation would be to send a good e-mail explaining who you are and offer a presentation, along with an old fashioned snail-mail letter (with card & brochures).

Primary Care Offices

Pediatricians, primary care docs, PA’s, and nurses give referrals almost daily. They can be a huge resource! Since they are also busy, it’s unlikely you will be able to see them if you just walk-in. Yet, I learned the benefit of walking into an office and introducing yourself to the office manager. They may give you important information about when you can schedule an in-person meeting. A handy tip to keep in mind is that most of these offices really like free lunches, so if you can offer to bring them lunch, they will be more likely to hear your pitch.

Retirement Communities

This is a great place to find clients! Call the community manager and see if you can stop by with brochures, cards, and offer a short presentation.

Join Your Local Chapter of APA/AAMFT

And be sure to regularly attend meet-ups and networking events

Network With as Many People as You Can

Reach out to other private practice clinicians and ask if you can take them out for coffee. If they have a full caseload, they may be willing to put you on their referral list.

Attend Conferences & Networking Events.

APA offers local conferences (e.g., the Midwestern Psychological Association conference) where you can network. If your focus is on children, go to a medical pediatric conference in your local community and find out if you can advertise.

Once you have referral sources, maintain that list. Send thank you notes and visit their practice at least twice a year. Lastly, when you get yourself out there, remember this: People love food & trinkets. If you can provide lunches or coffee/donuts, do it! Bring pens or stress balls with your name on them. And, always have business cards and brochures available!

Use the World Wide Web!

I can’t tell you enough how important the internet is when it comes to marketing a mental health practice or networking. You can use social media to market yourself (for example, posting to friends/family on Instagram or Facebook) or you can advertise through apps or websites. While getting yourself set up on the various social media platforms may provide long-term benefits, advertising can provide near instant results. Patient support Apps like Reachout, or websites like Psychology Today, or Therapy Sites offer some of the best traffic.

Write a blog. Pick topics that you are passionate about and demonstrate your expertise. Write about problems that are common to your community or population of interest.

Join e-mail list-serves. Sometimes, your local APA or MFT chapter will have a list-serve and people will send out e-mails to find mental health clinicians for specific clients.

Get On Insurance Panels.

This can be a challenging process but there are resources out there to help you out, one example is the American Counseling Association website. Many medical providers advise patients to call their insurance companies and find someone from the list of approved mental health practitioners.

Whilst there’s no definitive, set method to marketing a private mental health practice, many people are able to enjoy success in this field. Just remember that it takes patience and persistence! Take care of yourself during this process and talk to friends/colleagues regularly for encouragement and advice.

The post Tips for Marketing a Mental Health Private Practice appeared first on Reachout.

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Written By: Yvonne DelZenero, Ph.D., Clinical Psychologist

So, you’re thinking about starting a private practice– maybe you are a recent graduate or you’ve been in the field for years, either way, it can be a daunting and exciting prospect to go out on your own and work independently. There are a lot of pros and cons to beginning a private practice, and research will surely help you make the best decision (you can read more about that here). In this article, we will focus on how to establish a successful practice as quickly as possible.

I graduated with my Ph.D. in Clinical Psychology in 2016. After completing a postdoctoral fellowship, I landed a job at a comprehensive medical practice, and while it wasn’t technically private practice, the caseload was low and I had to figure out how to increase my caseload fast (or else I was going to have to look for a different job). Researching on the web was crucial, but I realized it would take a lot more creativity than an internet search to become successful.

Here Is How I Marketed My Mental Health Private Practice

1. Devise a plan– There is so much that goes into a practice. Consider the capital of renting an office, advertising, and the time it will take to build a caseload. Make sure you are financially ready to be independent. It’s important to create a name for your business. Something that is catchy or meaningful that will pique the interest of future clients. Also, do you have a specific niche? Can you offer a treatment or specialty that others in your community don’t (e.g., telehealth services, biofeedback, etc)?

 2. Do some research: Talk to other clinicians in your community and find out what works and what doesn’t work. There is no sense in reinventing the wheel. Ask around and find out the best places in your city/town to set-up shop. Find out if you can sublease an office for an hourly or daily rate while you are developing your caseload. If you are going to be cash-only, learn what the typical rates are in your community.

  3.  Get yourself out there: This one can be tough. I know in my graduate school, we didn’t learn how to network or market. I’m definitely an extrovert, but this was going out of my comfort zone! But, in my experience, this was one of the best ways to get referrals.

Here are some of the places I went to build my clientele–
Schools: School counselors, social workers, and administrators will sometimes refer families to therapists. Don’t expect to be able to talk to any of these people if you simply walk in the door. I’m a former high school counselor and I can attest that my schedule was crazy! But, I would recommend sending a snail-mail letter (with card & brochures) AND an email (because emails often go directly to spam in schools) explaining who you are and offering a presentation of your services.
Primary care offices: Pediatricians, primary care docs, PA’s, and nurses give referrals almost daily. They can be a huge resource! Since they are also busy, it’s unlikely you will be able to see them if you just walk in, however, walking into an office and introducing yourself to the office manager may give you important information about when you can schedule an n-person meeting. Know that most of these offices really like free lunches, so if you offer to bring them lunch, they may be more receptive to your pitch.
Retirement communities: This is a great place to find clients! Call the community manager and see if you can stop by with some brochures and business cards and offer a short presentation.
Join your local chapter of APA/AAMFT and attend meet-ups or networking events.
Network with as many people as you can. Reach out to other clinicians in private practice and ask if you can take them out to coffee. If they have a full caseload, they may be willing to put you on their referral list.
Attend conferences & networking events. APA offers local conferences (e.g. the Midwestern Psychological Association conference) where you can network. If your focus is on children, go to a medical pediatric conference in your local community and see if you can advertise.
Once you have referral sources, maintain that list. Send thank you notes and visit their practice at least twice a year. Lastly, when you get yourself out there, remember this: people love food & trinkets as much as they like to be remembered. If you can provide lunches or coffee/donuts occasionally, do it! Bring pens or stress balls with your name on them. And, always have business cards and brochures available!

4. Use the world wide web: I can’t tell you enough how important the internet is when it comes to advertising, networking or marketing a mental health practice. You can use social media to market yourself (for example, posting to friends/family on Instagram or Facebook). Or, you can advertise through apps or websites. While social media may benefit you long-term, advertising can provide instant results. Patient support Apps like Reachout, or websites like Psychology Today, or Therapy Sites offer some of the best traffic
Write a blog. Pick topics that you are passionate about and demonstrate your expertise. Write about problems that are common to your community or population of interest
Join email list-servers. Sometimes, your local APA or MFT chapter will have a list-server where professionals can send emails to find mental health clinicians for a specific client.

5. Get on insurance panels: This can be a challenging process but there are resources out there (for example, check out the American Counseling Association website). Many medical providers tell patients to call their insurance provider and find someone from the list of approved mental health practitioners.

Many people have successful private practices. Just remember that it takes patience and persistence! Take care of yourself during this process and talk to friends/colleagues regularly for encouragement and advice.

Yvonne DelZenero is a Clinical Psychologist in the Denver-metro area. She practices at Comprehensive Pain Specialists providing therapy and assessments for adolescents and adults. Her specialties include helping people cope with chronic pain, anxiety, depression, and posttraumatic stress disorder from car accidents. She also conducts neuropsychological, ADHD, and learning disorder assessments.

The post Tips for Marketing a Mental Health Private Practice appeared first on Reachout.

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Learning how to avoid heart attacks during Christmas is essential if you are in that category of people who are particularly susceptible to feeling stress or experiencing issues with your heart.

After all, the holiday season can be packed with everything from unending to-do lists, travelling, family visits, festive meals and financial concerns. For many people with heart conditions, it can be hard to stay on track with such increased holiday pressures when it comes to health. These changes and stressors can lead to extreme variations in blood pressure. In turn, that can increase the risk for heart attacks. A heart attack happens when the heart muscle is not getting enough blood.

Recent  Research shows that more heart attacks and heart-related deaths occur during December and January. This article will provide you with tips on how to avoid a heart attack during the holiday season.

Avoid Heart Attacks With These Tips

These small steps can make all the difference. 

Changes in eating and drinking habits

It can be hard to eat healthily during a festive season filled with rich foods and sweet treats. Many people tend to change their eating and drinking habits by overindulging on:

  • Fatty foods: These can have adverse effects on the inner lining of the blood vessels
  • Increased salt intake: This increases blood pressure and puts extra stress on a weakened heart.
  • Excess alcohol intake: This can lead to abnormal heart rhythms, high blood pressure and damage to the heart muscle, which increases the risk of heart failure, stroke and heart attack.
  • Overeating: The flow of blood is diverted away from the heart to help in digestion, this can cause angina..

When you have an underlying heart condition, you should make sure to include healthy meals in your diet and avoid excess salt and excess alcohol consumption.  

Emotional stress

There’s a lot of emotion attached to the holiday season due to the increased interaction with family and friends. The obligation of having to interact with family members whom you may or may not want to meet with, and financial pressures (prepping holiday food, purchasing gifts, decorations, travel expenses, entertainment), can make people feel emotionally stressed. Emotional stress increases the risk of heart attacks.

If you have heart disease, you should steer clear of heart stressors such as anger and emotional stress. You should manage your emotional stress by – for example – taking a deep breath, meditating and exercising. If you are visiting family and friends during the holiday season, it may be a good time for you to talk about your health. Your loved ones can also help you avoid heart attacks at this time of the year.

Loneliness

For many, the holiday season can be a time of cheer with family and friends, but for some who are lonely and isolated, it can be a time of sadness, especially with memories of the past Christmases. Social loneliness is associated with increased risk of heart attack and strokes because it makes it harder for a person to keep up with heart-healthy habits.

Don’t live in isolation and loneliness. If it’s only you during the holiday season, turn to friends and neighbours for support; also, find ways to support others, such as volunteering.

Delay In Seeking Medical Care

Some people delay seeking necessary treatment during holiday seasons because they don’t want to interrupt Christmas and New Year festivities. They tend to wait until after the holiday season and this increases the risk of heart attacks.

If you don’t feel right or show any heart-related signs and symptoms, do not postpone treatment during the holiday festivities. Seek medical treatment sooner rather later.

Missing Medications

Keeping track and taking medications as prescribed can get lost in the holiday season shuffle. Missing medications can cause your blood pressure to be out of control.

If you take medication to manage your heart health, you should continue taking your medication at your regular times as prescribed during the holiday season. This is a simple routine that will help you avoid heart attacks.

Cold Weather

In cold temperatures, the heart works harder to maintain body heat. Therefore, heart rate and blood pressure may increase. On top of that, blood vessels can constrict, which restricts blood flow and reduces the oxygen supply to the heart. These factors could trigger a heart attack, especially in the elderly or those with existing heart disease.

If you have existing heart disease,  you should avoid exposure to severely cold temperatures. You should have regular hot meals and drinks to give your body the energy it needs to keep you warm. In addition, wrap yourself in layers of warm clothing when going outside.

Less Exercise

During holiday seasons, people tend to exercise less, which increases the risk of heart attacks and strokes.

You should maintain your exercise routine or try to stay active during the holiday season. For example, instead of sitting down while catching up, consider taking a walk in a local park. This is good for your heart muscles and your general health and wellbeing.

Stay Healthy This Christmas

Knowing and following the right steps can help you avoid heart attacks and strokes. During the holiday winter months, take care of yourself.

And remember…

For greater insight into interacting with those suffering from the issues mentioned in the article or if you would like to chat with others affected, I highly recommend joining the app, Reachout.

The post Tips To Help You Avoid Heart Attacks During The Holiday Season appeared first on Reachout.

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“They are fighting the wrong people.”

That frantic cry came as a new post on Reachout, where I connect with chronic pain patients. Not for the first time, I heard a patient cry foul over the much-publicized war against opioids. Recently, I have read quite a bit regarding this issue. The harsh reality is that about 100 million chronic pain patients are being considered collateral damage in this war. This is quite disturbing, especially when we realize most are veterans, firefighters, cancer survivors, to name but a few.

Demonization

Demonizing chronic pain patients is nothing new. This practice has taken a new turn since the declaration of an emergency in the fight against opioids and drugs by President Trump a few days ago. Doctors are uncertain how to assess a patient’s honesty regarding their pain. This stems from wondering how to effectively treat them without causing complications as a result of extended opioid use. In talking with some more patients, it became apparent that there has been a renewed push to wean patients off opioid-based prescription drugs. Yet there are hardly any alternative therapies being offered to them. Without a doubt, there is pressure from all sides to reduce opioid prescription writing and opioid prescription dispensing. However, the relationship between weaning chronic pain patients off opioid medicines and the reduction of addiction-related death rates in America warrants a closer look.

As per recent CDC data, almost 90 deaths a day are attributable to opioids and heroin is certainly a cause for urgent action. Opioid misuse rate is estimated to be between 20% and 29% among chronic pain patients and addiction rates are at about 10%, per one study. The story seems like a straightforward case of over-prescribing and misuse/abuse of prescription drugs. Let’s take a closer look to see if that’s true. 

What Is Misuse?

Misuse of all prescriptions drugs in adults is approximately 54%, according to this report. This number is almost double that of pain pills. On top of that, according to the large, annually repeated and representative National Survey on Drug Use and Health, 75% of all prescription opioid abuse starts with people taking pills not prescribed to them. The drugs are stolen from friends, family or acquired from the street. That leaves about 25% of people misusing the drugs prescribed to them. By all accounts, it is still a very large chunk of the population. However, before we jump to conclusions, we should shed some light on the term “misuse”.

Misuse is defined as using medications contrary to instructions, regardless of harmful or adverse effects. Hence, misuse of medications can mean that patients are either taking too much, too little or none of their medications. It is safe to assume that of the 25% of people misusing opioid prescription drugs, not all are getting addicted or dying as a result.

A Closer Look At The Stats

Perhaps the more worrisome stats would be those related to “abuse” of prescription opioids rather than misuse. The statistics indicate that over 70% of those abusing pain pills get them through illicit means rather than by getting a prescription from a doctor.  Another study of 1 million patients shows that only 4.5% of those getting an opioid prescription are abusers. This suggests that although diversion of prescription medications and illicit use is real, the majority are getting high from drugs not prescribed to them.

To corroborate this, a recent study of about 136,000 ER admissions for opioid use revealed only 10% had a chronic pain condition. In effect, 90% of those admitted to ER for opioid use were not chronic pain patients abusing their prescriptions.

It certainly doesn’t seem like chronic pain patients are misusing or abusing their prescriptions and overdosing on them. Even If they are, those numbers are small when compared to the more complex issue of people getting high from drugs not acquired through their doctor. It seems that a vast majority of the population falling into opioid and heroin addiction are not legitimate patients abusing their prescriptions. 

Prescription Opioid Abuse & Taking Care Of Chronic Pain Patients

How then can we understand the astounding rise in deaths per year from these drugs? In an article from the NY Times, it seems that, since 2011, deaths due to prescription opioids have leveled off, suggesting a responsible attitude towards opioid prescription drugs by the chronic pain community of late. Deaths due to non-prescription opioids and heroin are on a steep rise in recent years. However, a flat line for deaths due to prescription opioids suggests that the chronic pain community, and the doctors prescribing to this community, are perhaps not a big contributory factor to the emergency we face today.

The Needs Of Chronic Patients

In our haste to stop prescription opioid abuse and the body count, it is important to consider chronic pain/PTSD patients. Many in this group could spiral towards illicit drugs or suicide as a pain remedy if we take away their pain pills without offering any viable alternatives. We certainly don’t want to trade one opioid-related death statistic for another. We must find the right solutions, rather than continuing to focus on the seemingly obvious targets. These traditional targets are doctors/pharmacies/patients with chronic pain. Generally, they are – at best – a very small part of a much bigger problem. A lot has to be done to curb the illegal trade of drugs, check diversion, theft of prescriptions. And there has been the development of alternative and adjunct therapies for opioid prescription patients.

One thing remains clear, the problem we face today is a social problem of addiction, more than over-prescription of opioids. Perhaps, this quote from another user on this chronic pain app sums it up for chronic pain patients everywhere:

“However, I am 19 and he (pain doctor) refuses to really give them (opioid prescription drugs) to me. I see why he doesn’t. But I handed over the medications to my family and they control them. Not me. That way I can make sure not to become addicted. I take as little as absolutely possible and now I am just frustrated with my doctors.”

And Remember…

For greater insight into interacting with those suffering from the issues mentioned in the article or if you would like to chat with others affected, I highly recommend joining the app, Reachout.

The post Prescription Opioid Abuse: What’s Really Behind This Epidemic? appeared first on Reachout.

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Coping with PTSD is an achievable goal, even if the condition is a four-letter acronym that can be as painful as it sounds. I had heard of it before and knew others that had dealt with it. It was known yet a mystery. I didn’t know what it felt like. I figured it to be something akin to having a headache. Painful, but something that could be dealt with by taking an over the counter pain relief pill.

That is, until I experienced it for myself, and suffered with it. My father died tragically on me when I was just learning to be an adult. I was barely 19, it had just become the summer. I was looking forward to a great summer with my friends and my boyfriend of three years. Sadly, it became the darkest time of my life! The sun was out but my world quickly became cold and filled with nightmares! No fun, no warmth, just tragedy. I found myself indulging in excessive bouts of alcohol, and ending my relationship.

I couldn’t deal with life. Alcohol and smoking ended up being the only way I could survive. My mind was too covered with flashbacks of blood, and sometimes I was confronted by dark scenes in my imagination. It was something I never thought I would experience in my life.

Coping With PTSD: How I Was Struggling

This is when I learned about PTSD, even though I did not know what it was until after I began to feel better about life. However, I knew what it felt like without the official word that it is known by. It was more than just a headache, it was a pain that I still cannot describe in its entirety. The only word that can succinctly describe it in my mind is a nightmare. A long, long seemingly never-ending nightmare. A nightmare that you want somebody to snatch you out of. The reliving, the agony, the scene replaying over in your mind like a loop.

I tried to sleep it away, drink it away, eat it away amongst other things. My belief was that coping with PTSD meant drinking it away more than anything. I felt that without the alcohol, I would not be able to function. Sleeping didn’t help much, as the trauma kept me crying. I would have very vivid replays of the trauma. Somethings I would dream about would be much worse than what I experienced. I would wake up in cold sweats. Furthermore, I never thought I would smile or laugh ever again in my life.

I thought that someone would take me and lock me away for feeling so crazy on the inside. Cops were involved in some instances of my PTSD episodes because I just wanted to end it all.  Nothing seemed to take the pain away. Sometimes the PTSD would relapse after what seemed to be a sense of calm. I couldn’t work or finish school because of it. It took over my life.

Coping With PTSD & Turning A Corner

I prayed and meditated, I went into a deep spiritual mode to try to get over it. This seemed to be the best way for me to pull through. However, it took me a long time to be able to get to this point. The alcohol consumption slowly but surely came to an end. I found joy again. I found counsellors that made me feel better spiritually. The sleep started to become more restful. I started to live and laugh. I smiled again.

After a few years, I found a job that I loved – working with women and children who had been physically and/or sexually abused. I worked this job for 3 years, the longest I’ve ever had employment. When I left, I went overseas for the first time in my life. When I returned, I met my husband and married him less than one year later.  I eventually started my own business, and I teach classes and travel often.

I never thought I would be here, I thought life was over for me. However, after much perseverance, healing, struggle, and tears I found life again. For those suffering from PTSD, it may be dark right now, but darkness won’t last forever. It may not seem like it, but I’ve been through the darkness and now my life is brighter than ever. Hold on, if I can make it you can too!

And Remember…

For greater insight into interacting with those suffering from PTSD  or if you would like to chat with others affected by the condition, I highly recommend joining the app, Reachout.

The post Coping With PTSD: Learning To Live Again appeared first on Reachout.

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After running an errand today, I realized that, due to my personal experiences, I have learnt the ins and outs of supporting those unfortunate enough to be coping with chronic illness.

This afternoon, you see, I took lunch over to my mom’s house. On the table that holds her vintage Singer sewing machine I noticed a picture. It is a photograph of my family on my grandfather’s eighty-ninth birthday. At that time, none of us thought about chronic illness or disease.  Everyone is wearing party hats and we have our arms wrapped around each other. I remember this as a happy day. Today, I feel sadness as I look at each familiar, smiling face in the picture. 

Since that photograph was taken my grandfather and my father have passed away. My father passed away from Alzheimer’s disease. My grandmother was diagnosed two years ago with Chronic Obstructive Pulmonary Disease. Both my mom and uncle have been diagnosed with Parkinson’s disease. The past five years have taken quite a toll on my family. My aunt, stepdad, and I have become caregivers to our loved ones who suffer from chronic disease.

Helping Those Coping With Chronic Illness

In recent years, there have been less of those smiling family photographs. Some family members, unable to handle our loved ones’ diagnoses, have withdrawn themselves from family gatherings. When asked why, they say “it’s too depressing”. The rest of us have been trying to help, picking up the pieces for the past few years. Through this, I have learned that there are different ways to help a loved one who is chronically ill. Their needs may change, as their illness progresses, but some things remain the same.

Just Listen To Those Coping With Chronic Illness

One of the most important ways you can help a loved one who is chronically ill is by being present. When my dad was on Hospice Care, he may not have remembered me, but I remembered him. I held his hand, read books, and played his favorite music. Somedays he would smile and say, “This is love!”. Remember that your presence can brighten someone’s day! When I took my Mom lunch today, I said “let’s bring her some sunshine!”. Our time, our presence is the best gift we can give.

Simply listening to someone can have a big impact on their day and overall well-being. During a family dinner, my uncle was carrying plates into the kitchen for me. I looked at him and said, “Thank you so much for all of your help. I appreciate it”. He replied, “Thank you for making me feel like I still have some value left”. We do not know how someone else is feeling unless we are willing to listen to them. Whether it be a bad day or a good day, approach each conversation with an ear ready to listen.

When we listen we are allowing the speaker to communicate their feelings. This lets us know if that person is happy, frustrated, depressed, sick, or sad. We are able to understand each other more clearly through positive, effective communication. We all need someone to talk with during times of joy and times of sorrow. So, when you listen make sure to pay attention, be non-judgmental, and provide feedback. It makes a world of difference when we feel like our voice has been heard.

Research

After each family member was diagnosed with their different chronic illnesses, I took time to research and learn about their conditions. I could not change their diagnoses, but I could be informed. Remember that with knowledge comes power. I learned the different stages of their respective ailments. By staying informed, I was able to recognize progressions in both my mom and my dad. Through understanding, I empowered myself and became a more effective caregiver.

Three months ago Mom started to wheeze and experienced severe swelling in her feet. Through my understanding, I knew that this could be a progression of her chronic disease. One night, my stepdad called me. My mom was having a hard time breathing.  I went to her house and helped her get ready for the hospital. My mon whispered, “I am not doing well”. I said, “I know. I have known for a while”. In learning about Parkinson’s disease, I was better equipped to handle the progression of her disease.

At the hospital, my stepdad and I were told that my mom’s Parkinson’s has reached one of the later stages. As she progresses, I am still learning how to best help her. The needs of the person you are caring for will change. Learning about these changes will help you to be a better caregiver. I even have had physical, occupational, and speech therapists show me different exercises I can do with her. As a caregiver, I am constantly learning new ways in which I can help.

Ask Questions

Listening, understanding, and being supportive are great ways to help someone who is coping with chronic illness. Ask your loved one how you can best help them. This afternoon I was helping my mom. Her feet froze, on the spot, and her legs were shaky. I asked, “What is the best way to help you right now?”

My mom was able to tell me how I could move her feet. Some of her needs have changed. She needs more physical help right now. Her need for love, understanding, and patience will never change.

People Coping With Chronic Illness Are Still Valuable

Each of us loses sight of our own self-worth at times. It is important to remind people of their value. My mom describes Parkinson’s as a thief. I remind her that hearing her laugh, seeing her smile, and talking to her can brighten my day. As much sunshine as I try to bring her, she gives me that sunshine right back. Reminding someone of their value; what is special about them; what you love about them can be an amazing way to inspire someone who is feeling ill.

Lessons From A Caregiver

I have been a caregiver for the past nineteen years. Before I stopped working to take care of my parents, I worked in home health care. I have held a dying patient’s hand, cried with family members, and was blessed to be able to care for so many people. Nothing could have prepared me for taking care of my own family. It is hard to watch your loved one go from being independent to dependent, struggling and coping with chronic illness. Instead of being my parent’s daughter, I have become my parent’s caregiver. I have learned a lot through this!

I have learned that the best way to help my loved ones is to listen, to understand, to praise them, to be patient, and, most importantly, to be present. For five years, I lived on the West Coast and my parents on the East Coast. I moved back home with my husband and children to care for my parents. My dad, as his Alzheimer’s reached its final stage, would forget that I moved back home. Each time he saw me, he would cry happy tears. This experience taught me the importance of being present.

The most important gift we can give someone is our time. So, as you care for someone who is suffering from an ever-present illness or disease remember that just being there can transform their day. Empower yourself through the understanding of their chronic illness. Listen with your full attention. Be supportive and encouraging on the good and the bad days.

Today, when I brought my mom lunch, I saw her smile. It was at this moment that I knew that this was the perfect way to be helping her while she is coping with chronic illness!

And remember…

For greater insight into interacting with those suffering from chronic illness or if you would like to chat with others affected by chronic illness, I highly recommend joining the app, Reachout.

The post How To Help Those Coping With Chronic Illness: A Caregiver’s Guide appeared first on Reachout.

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Chronic illness and depression can often strike together. If you have dealt with a chronic illness for any length of time, then you’ve probably dealt with depression.

For some, depression is just another symptom of their disease. It’s an unwelcome complication of hormone or chemical imbalances that, at times, seem impossible to correct. Even if this isn’t the case, though, learning to adjust your life to cope with chronic illness can certainly cause feelings of depression. This is especially true if your prognosis isn’t particularly hopeful. My personal walk with depression has been a long and twisted path. I dealt with depression and anxiety long before I was ever diagnosed with my autoimmune illnesses. Some of the doctors I’ve seen posit that the chemical imbalances that left me standing on the edge of a building contemplating suicide at 12 may, in fact, have been due to my chronic autoimmune problems.

Either way, depression for me is sort of like a shadow. When the sun is shining at its brightest, I cannot see it at all. It may as well have disappeared, robbed of the joy in that moment. The trouble is, the sun always sets eventually. The darkness will come, and the only way to make it through the night is to have a plan. To understand that the sun will come again, and to hold onto your determination so that you can watch that beautiful sunrise.

That is going to be the focus here: making it through those periods of depression that can visit you as you work, to learn how to cope with your chronic illness. Some folks choose to use medication for this and that’s perfectly fine – but it isn’t the only way.

I took medication for years to ease my depression symptoms and I will never ever tell you that it is the wrong decision: the choice to take that pill every morning saved my life. I eventually went looking for a solution that didn’t involve medicine. If you are seeking the same, perhaps my story will help you.

Chronic Illness and Depression: Twilight

Believe it or not, chronic illness may actually make you uniquely qualified to notice the onset of a depressive episode. That little heads up can make a big difference in terms of how successfully you’re able to deal with everyday stressors once your mental state takes a turn for the worse.

The reason is you need to pay attention to symptoms. Anyone who deals with flare-ups is pretty accustomed to checking in frequently with their body:

“What is my pain like today?” “I’m not very steady on my feet this week, better cancel that hiking trip” “I’ve been getting a lot of headaches lately – is that a new symptom?” “I really don’t have enough spoons left to make dinner tonight”

Regardless of your individual symptoms, you are all too familiar with paying attention to every little change in your body because a minute issue has the potential to signify something more serious. If you start doing the same thing with your mental health, you will learn to identify the depression as it creeps in, slowly casting a shadow over your day-to-day life.

Do you feel listless? Maybe your energy levels are low, but you realize you’re also not really “tired” because you can’t fall asleep? Are you more irritable than normal, becoming annoyed by simple interactions with others?

Depressive symptoms can be different for everybody; try to check in with yourself and notice little changes in your way of thinking or reactions towards others. These, just like an increase in your physical pain levels, can clue you into a coming “flare up”.  Here is an article about helpful symptom trackers.

Chronic Illness and Depression: Nightfall

The worst part, though, is when night finally, completely, engulfs you. It can make you feel panicked and hopeless as if the light is gone forever. The light is not gone; it is merely dimmed. If you allow these scared feeling to swallow you, then it will just take you that much longer to find the sunlight again.

Sometimes folks who deal with recurring depression get angry at themselves when they become depressed, feeling as if they are broken or weak for being unable to hold onto happiness consistently. To these folks I say: you need to take a deep breath and cut yourself some slack. Dealing with depression and chronic illness, after all, isn’t easy.

You are not a superhero. You are not a robot, either. It is perfectly natural to experience a range of emotional states. Those of us that deal with depression simply get stuck in ditches from time to time. This lesson can be hard to learn, but it is the most important part of coping with depression.

When I first received my official diagnosis, I was overjoyed to finally have an answer. Then I quickly fell into a difficult depression, because part of my diagnosis meant that it would be considered a medical miracle at this point if I were to be able to carry a child through a full pregnancy.

I was 23 years old and devastated. In this moment, I felt that any choice about my future and my ability to create a nuclear family was taken from me. I truly felt broken. The thing is, I’m not broken. I have always had this immune system, always had this illness. Always been this way.

Not Broken

Therefore, it simply cannot be true that I am broken. I did not start from some better, more “whole” place. Even if I did, I exist in the present and not the past. This is simply how I am, right now, in this moment. The same is true of my depression. It is a part of who I am and how I live my life, but I will not let it control my life.

All chronic illness sufferers make this decision. You wake up one morning and you say to yourself: “Yes, this disease limits my life in ways that are new and difficult to work around. No, I will not give up and let it take away my chance at a well-lived life”.

Do the same thing with your depression. Look directly into that darkness that you are afraid of, and get comfortable with being uncomfortable. It will pass; nothing can last forever. Remind yourself that it is only temporary, find the quiet place inside yourself, and wait for the light to return.

Chronic Illness and Depression: Dawn

At some point, you will start to notice that the darkness doesn’t seem as impermeable as it once did. Ever so slowly it begins to lift. Things appear more alive and vibrant than they did before. Celebrate this moment. Recognize that things are about to become wonderfully easy again.

Gratitude

To me, it is so important to practice gratitude. We often focus on our experiences when the bad things first happen to us and gloss over the way our lives improve when they’re finally over. Over time, that gives you a twisted perception of your past. You focused so much on the negative that you overwhelmingly remember it over more positive milestones.

I find that it’s helpful to take a moment when you begin to feel better, just to sit in that positive place. Allow yourself to pay attention to the good things and to be grateful that the darkness has passed. If you intentionally create these memories of positive moments in your life it gives you something to hold onto. It may seem like a small thing, but depression has a way of making you forget the good things, so shoring up positivity where you can is always helpful.

Self-Care

You will always have ups and downs with chronic illness. So, if you should find yourself becoming depressed again, that’s just another flare up. Something that can help is noticing when you feel a little bit down and exercising self-care techniques. These are just little things you can do throughout the day to make yourself feel better. If your friends were upset, wouldn’t you make an extra effort to be nice to them, to be supportive? Well, you ought to be nice to yourself as well.

This can mean anything from a hot bath to blowing off that last load of laundry in favour of craft night. It really just depends on what makes you feel good! Or, if you feel like maybe you need a bit more support, consider using a service like Reachout or Crisis Text Line. These are sites that allow you to talk to somebody about your struggles without even leaving your couch. For some, that anonymous conversation can help relieve pressure and enable you to more effectively deal with depression.

There are very few wrong answers when it comes to helping yourself better cope with depression and chronic illness. Of course, it is important to be safe and if you feel like you may harm yourself or somebody else you should seek help immediately.

Hope

Outside of that, recognize that learning to deal with these issues is a process. Allow yourself the time to become familiar with the challenges involved, and find what works best for you. Most of all, do not lose hope. Hope, after all, is the quintessential light in the darkness that can offer comfort when there is none to be found.

For greater insight into interacting with those suffering from depression and chronic illness or if you would like to chat with others affected by depression and chronic illness, I highly recommend joining the app, Reachout.

The post Chronic illness and Depression: Learning How To Cope appeared first on Reachout.

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