Capital Area Behavioral Health Collaborative (CABHC) is reintroducing a Peer Support scholarship initiative. CABHC will cover the cost to enroll in the Peer Support training class and have secured slots at each training session in Lebanon, PA. Qualified individuals who are interested in applying to receive a scholarship to attend the 10-day Peer Support training class in Lebanon, PA, should visit www.cabhc.org. Please see attached flyer for more information. Thank you.
There are many medications that can be used to treat mood disorders. But finding the right one can be a lengthy process, and the choice can be more complicated than you might imagine. Just because a particular drug worked for a friend doesn’t mean it will work for you. Psychiatrists and doctors who prescribe antidepressants choose a particular drug and dosage based on many factors, including the following:
- Diagnosis. Certain drugs are a better choice for specific symptoms and types of depression. For example, an antidepressant that makes you sleepy may be better when insomnia is an issue. The severity of your illness or the presence of anxiety, obsessions, or compulsions may also dictate the choice of one drug over another.
- Side effects. You may first want to choose a drug based on which side effect you most want to avoid. Medications vary in the likelihood they will cause such problems as sexual effects, weight gain, or sedation.
- Age. As you age, your body tends to break down drugs more slowly. Thus, older people may need a lower dose. For children, only a few medications have been studied carefully.
- Health. If you have certain health problems, it’s best to avoid certain drugs. For example, your doctor will want to consider factors such as heart disease or neurological illnesses when recommending a drug. For this reason, it’s important to discuss medical problems with a primary care doctor or psychiatrist before starting an antidepressant.
- Medications, supplements, and diet. When combined with certain drugs or substances, antidepressants may not work as well, or they may have worrisome or dangerous side effects. For example, combining an SSRI or another antidepressant with the herbal remedy St. John’s wort can boost serotonin to dangerous and, in rare cases, fatal levels. Mixing St. John’s wort with other drugs—including certain drugs to control HIV infection, cancer medications, and birth control pills—might lower their effectiveness. Women receiving tamoxifen for breast cancer should take an antidepressant that does not interfere with tamoxifen’s effectiveness. Eating certain foods, such as aged cheeses and cured meats, while taking an MAOI can cause a dangerous rise in blood pressure.
- Alcohol or drugs. Alcohol and other substances can cause depression and make antidepressants less effective. Doctors often treat alcohol or drug addiction first if they believe either is causing the depression. In many instances, simultaneous treatment for addiction and depression is warranted.
- Personal and family mental health and medication history. If you or a member of your family has had a good response to a medication in the past, that information may guide your choice. Depending on the nature and course of your depression (for example, if your depression is long-lasting or difficult to treat), you may need a higher dose or a combination of drugs. This may also be true if an antidepressant has stopped working for you, which may occur after you’ve used it for some time or after you’ve stopped and restarted treatment with it.
- Cost. Since all antidepressants are roughly equivalent in their effectiveness, you won’t lose anything by trying a generic version first.
- Your preference. Once you have learned as much as you can about the treatment options, your doctor will want to know what approach makes most sense given your lifestyle, your interests, and your judgment.
For more on diagnosing and finding the right treatment on the different types of depression, read Understanding Depression, a Special Health Report from Harvard Medical School.
SOURCE: Harvard Medical School
“The formula for what makes a community livable isn’t particularly complex. For the most part, the features and needs are fairly simple.
“But living in a place that, say, requires having a car for every errand or outing can be a difficult place to live if you don’t have a car or can’t drive.
“Living in a place without access to outdoor spaces, good schools and healthy food isn’t very livable, especially for young families.
“Living in a community that isn’t safe, or offers few activities, can be isolating for people regardless of age.
“On the other hand, a community that includes all of the features pictured in our “In a Livable Community” handout can be great — for people of all ages!”
AND people with a disability!
Aging in Place Technology Watch and GreatCall have published a new white paper about initiatives to fight social isolation — a few of the points are excerpted here:
What has changed in the past two years? First, the research. Once the correlation between social isolation and poorer health outcomes was made, the volume of research spiked. From its pre-correlation measurement in the 1996 UCLA Loneliness Scale, a number of other surveys have been released that include correlation with health care costs, economic status, and lifestyle preferences. In late 2017, research from AARP’s Public Policy Institute concluded that socially isolated older adults cost the U.S. health system an additional $6.7 billion in health-related spending. Newer research from the National Institute on Aging is focusing on the connections between loneliness, long viewed as a predictor of cognitive decline, and other health risks, including: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.
Social isolation – is this a worsening 21st century phenomenon? Is social isolation more of a problem today than in the past. And, what is the prognosis for the future? The recent AARP report zeroed in on the key predictors of loneliness, sometimes referred to as “perceived social isolation.” Living situations and marital status may provide a clue to societal changes that result in social isolation and loneliness. In 2018, the Administration for Community Living (ACL) released its survey profile of older Americans (age 65+). It showed that while only 14 percent of the 65+ population lives alone, almost half (45 percent) of women aged 75+ live by themselves. According to Pew Research, among those 65 and older, the divorce rate has tripled since 1990.
A top predictor of loneliness is size and quality of one’s social network. To assess these elements and their connection to loneliness, the AARP respondents were asked for both the number of people in their lives who have been supportive in the past year and the number with whom they can discuss matters of personal importance. From the study: “As expected, as one’s social network increases, loneliness decreases. Also as expected, as physical isolation decreases (the factor which included items such as disability status, number of hours spent alone and household size), so does loneliness.”
Health limitations can exacerbate social isolation. While loneliness and social isolation are emerging as public health issues, less has been published about the health issues that may lead to social isolation: mobility limitations, depression, cognitive impairment and hearing loss. In another study, older adults with mobility impairments were more likely to report being isolated from friends. These surveys underscore the fact that elderly people are the most likely to experience social isolation and its related health effects. According to a UK study, those who provide care — including family caregivers such as children or spouses — are also known to experience loneliness in their roles and would benefit from greater societal appreciation and possible interventions such as respite care.
Untreated hearing loss contributes to social isolation. According to government statistics, among adults aged 70 and older with hearing loss who could benefit from hearing aids, fewer than 30% have ever used them. Denial and unreimbursed cost ($2400/ear) are factors, and delay in acquiring them can worsen the isolation. Hearing aids today also offer features that include fall detection, smartphone integration, and AI capabilities. Moving forward, Medicare Advantage plans are beginning to contribute to a portion of the cost. Audiologists play a role in managing user expectations and training an individual to adjust to the change from little or no sound to the noisy environment of stores, restaurants, office buildings and streets.
“Connection Is a Core Human Need, But We Are Terrible at It | No person is an island, and we need healthy relationships to thrive” – Medium
Illustration: Hélène Desplechin/Getty Images
by Brianna Weist
“In his book Lost Connections, Johann Hari talks about his decades of work in the fields of trauma and mental health and why he believes that the root of almost everything we suffer through is a severed connection we never figured out how to repair.
“At one point, Hari talks about an obesity clinic where patients who were overweight to the point of medical crisis were put on a supervised liquid diet in an effort to try to save their lives. The treatment worked, and many of the patients walked out of the clinic hundreds of pounds lighter and with a new lease on life—at first. What happened later was a side effect no doctor predicted. Some of the patients gained back all the weight and then some. Others endured psychotic breaks and one died by suicide.
“After looking into why many of these patients had such adverse emotional reactions, the doctors discovered something important:” Continue reading this article at Medium; click here.
by Robert Weisman
“WOBURN — Scanning recent police reports from the Massachusetts communities under her jurisdiction, Middlesex District Attorney Marian Ryan was alarmed to spot what she called a ‘tragic spike’ in suicides.
“Fifty-two county residents had taken their lives in the first half of this year, a toll up almost two-thirds from last year. She knew that plenty of young people battle anxiety but was surprised to learn the residents’ average age was 46. A quarter were over 60.
“‘The numbers are dramatically higher than we’ve seen in the past,’ Ryan said. Although it’s impossible to pinpoint one cause, ‘loneliness is definitely a factor,’ she said. ‘“Many older people are feeling disconnected from other folks in their communities.’”
“Your Professional Decline Is Coming (Much) Sooner Than You Think: Here’s how to make the most of it.” – The Atlantic
“The data are shockingly clear that for most people, in most fields, professional decline starts earlier than almost anyone thinks.”
by Arthur C. Brooks
“‘It’s not true that no one needs you anymore.’
“These words came from an elderly woman sitting behind me on a late-night flight from Los Angeles to Washington, D.C. The plane was dark and quiet. A man I assumed to be her husband murmured almost inaudibly in response, something to the effect of ‘I wish I was dead.’
“Again, the woman: ‘Oh, stop saying that.’
“I didn’t mean to eavesdrop, but couldn’t help it. I listened with morbid fascination, forming an image of the man in my head as they talked. I imagined someone who had worked hard all his life in relative obscurity, someone with unfulfilled dreams—perhaps of the degree he never attained, the career he never pursued, the company he never started.
“At the end of the flight, as the lights switched on, I finally got a look at the desolate man. I was shocked. I recognized him—he was, and still is, world-famous. Then in his mid‑80s, he was beloved as a hero for his courage, patriotism, and accomplishments many decades ago.”
This a “long read” — but maybe just right for a Sunday (or any other) morning. Click here to read this article at The Atlantic.
This inventory lists resources for health and social service professionals interested in enhancing their outreach and support for older Veterans and other older adults who have or are at risk for behavioral health conditions. It covers resources on topics including post-traumatic stress disorder, suicide prevention, long term services and supports, and more.
by Ginia Bellafante
“Last fall, a special investigator for the United Nations presented a report to the General Assembly on the global housing crisis, pointing out that a quarter of the world’s urban population now live in ‘informal settlements’ or encampments, increasingly in the most affluent countries. The fact-finding mission took the investigator to cities like Mumbai, Belgrade and Mexico City, where she found rodent infestations, children playing on garbage heaps ‘as if they were trampolines’ and people living in shacks or in damp abandoned buildings full of exposed wires.
“At the invitation of academics and advocates, she also went to to San Francisco, where the median home price is $1.6 million.
“There she witnessed equally deplorable conditions. Crucial to the report’s assessment was the finding that the city’s resistance to providing help and basic necessities in the encampments there qualified as ‘cruel and inhuman treatment,’ which was in line with violations of international standards of human rights.”
by Sharon Jayson
“AUSTIN, Texas — Connor Wilton moved here for the music scene. The 24-year-old singer-guitarist “knew zero people in Austin” and felt pretty lonely at first.
While this capital city is one of the nation’s buzziest places and ranks at the top of many ‘best’ lists, Wilton wasn’t feeling it. He lived near the University of Texas at Austin but wasn’t a student; he said walking through ‘the social megaplex that’s UT-Austin’ was intimidating, with its almost 52,000 students all seemingly having fun.
“‘You definitely feel like you’re on the outside, and it’s hard to penetrate that bubble,’ Wilton said.
Read this article at California Healthline in its entirety — click here.