By: Lisa Desai, MindWise Innovations

Welcome to the first Behavioral Health Q&A Column! VPPPA has partnered with experts at MindWise Innovations to present a monthly Q&A article addressing questions that members might be hesitant to ask about. These columns will address your questions about mental health, substance abuse, brain injuries, family issues and more. Stay tuned for future articles and to find out how to submit your own questions to the experts. We will be posting a new column on the third Thursday of each month.  ​What is mental illness or mental health?
We all fall somewhere on the continuum of mental health, from feeling wonderful and functioning well in all areas of our life – to where we are struggling with significant mental health issues.  Mental health problems, mental health disorders, and mental illness can all be used interchangeably.  To think about our emotional, psychological and behavioral functioning on the mental health continuum normalizes the fact that we all have times where we might feel depressed, anxious, or experience other symptoms in reaction to situations or events in our lives. Mental health disorders can stem from biochemically based factors and/or from environmental stressors. 

What does behavioral health mean?
Behavioral health is a term originally used in the clinical world to refer to both mental health problems and substance misuse.  Behavioral health is now more commonly used as it can feel less stigmatizing.

Why am I hearing about fighting stigma in the workplace?
Stigma refers to negative, unfair beliefs that can feel shameful and that are attached to certain ideas or concepts.  Two of the most stigmatized populations are those experiencing mental illness and homelessness.  Stigma can stem from fear and a need to feel safe from a perceived danger by creating psychological distance.  The fact that 70% of the USA population will experience anxiety at some point in their lives shows that mental health issues are more commonplace than we realize.   Campaigns to fight stigma – such as Stamp Out Stigma – are designed to replace negative, and often false, ideas with accurate and positive facts.  Reducing stigma allows us to talk more freely about mental health, which encourages people to support one another and reach out for professional help when needed.  One of the best outcomes of fighting stigma is empowering individuals and communities.

How do I know if I’m depressed?
Most, if not all, people feel sad at times.   Sadness is a feeling which is often a response to painful life events, loss and death, relationship or job difficulties.  Sadness can be a part of depression but can also occur without developing into a full depressive picture.  Depression is characterized by several symptoms which are either acute and debilitating, or chronic and long lasting.  Symptoms of depression include:  fatigue or loss of energy, decreased or loss of interest in activities, irritated mood, sleeping too much or too little, loss of appetite, feeling worthless and poor concentration.  People who have severe depression might have suicidal thoughts.  If you are having thoughts of dying, please reach out for help as soon as you can. It is vital to remember that depression can be treated and the sooner one reaches out for help, the better chance of feeling better. 

How can I help a friend or co-worker who is depressed? 
As a friend and/or coworker, the first thing you can do to help a friend with depression is to listen and offer support.  Simple, yet incredibly effective, listening to a friend in need can provide tremendous relief to someone who may be hiding depressive feelings.  Depression can be isolating; people may stop socializing and experience shame which adds to their silence.  Knowing they can turn to a friend is a big step in reaching out to others and getting help.  Remember, you don’t need to fix the problem – which is not possible, nor do you need to be their therapist.   However, sometimes friends can research therapy or other resources together which is another step closer to receiving professional services that can create real, positive change.

What is the difference between being nervous and anxious?
Nervousness is something that we all experience sometimes, whether it shows up by tapping our pens, biting our nails, having stomach butterflies or nervous laughter.  Anxiety or being anxious refers to having a group of symptoms which occur together for either short or long periods of times.   Symptoms of anxiety can include:  feeling nervous, tense or restless, worrying much of the time, having a sense of impending danger, panic or doom, chronic or severe fatigue, trouble concentrating, trouble sleeping and/or physiological signs like headaches and gastrointestinal problems.   Sometimes, people can experience brief but severe moments of anxiety which can be referred to as panic.  People who experience a panic attack or episode often feel increased heart rate, hyperventilating, trembling and/or sweating.

I’m not sure if things are bad enough, or that I need to see a therapist/counselor?
As a psychologist who has met with kids, adults, teens and families for over 20 years, I can tell you one thing for certain- if you feel the need to reach out, then do it. Life circumstances or relationships do not need to reach a crisis point to warrant therapy.  In fact, many people seek treatment when they are beginning to feel badly and in fact seeking therapy during the early onset of symptoms can be incredibly  effective.  If you feel you need therapy, then you do. Try not to compare yourself to others; life challenges and struggles are unique to each person, so do what is best for you.  In fact, there are many people that go to therapy to work on parts of themselves that are bothering them or getting in the way of relationships or work; they want to grow or change a behavior. 

Like everyone else, I’m worried about how COVID19 will affect my family, my finances, and so much else. How can I manage my stress? 
The current health crisis is taking an emotional, psychological, and financial toll on people.  Human nature is drawn to predictability and the desire to have a certain amount of control over our lives.  Crisis situations like the COVID19 pandemic are particularly alarming because we have no control and little information about what to expect in the coming weeks and months.  We know that to best protect ourselves we can take measures such as washing hands, limiting social contact, and avoiding crowded areas.  Here are some things you can do to bring relief, comfort and maintain good emotional and mental health:

• Stay connected to friends and loved ones – phone calls, facetime, videoconferencing… find ways to gather and engage virtually to decrease loneliness and disconnection.
• Be in nature – If and when possible, get outside and walk, hike, bike, or even find a place to sit  and read.  Nature is calming for the mind and body, and as we know, exercise has tremendous health benefits.
• Create a news-free-zone – online news is available 24/7 and it is tempting to check in frequently to get the latest updates.  It’s important to take a break from the news and socialize, read other materials, or unplug in other ways.
• Keep to a schedule – This cannot be emphasized enough. Self-quarantines can be tough on individuals and families.  Try to keep some elements of a routine, or think of what you’ve been meaning to write, read, draw, etc. and haven’t had the time.  Now might be that time!
• Try new things – With more time at home, sometimes with others, might be a time to learn to cook or try new recipes, meditate, sew, learn an instrument, try yoga.
• If you are worried about yourself – feeling increasingly depressed, anxious, or unlike your self – reach out for help. Clinics, hospitals and hotlines are a phone call away and tele-therapy or health coaching are real and effective options. Take care of yourself in every way.

About the author: 
Lisa Desai is a licensed psychologist and behavioral health professional with 20 years of clinical, management, and consulting experience. Through her work at MindWise Innovations, she helps companies prioritize effective and sustainable behavioral health strategies through the business development, design and implementation, and evaluation of mental health and substance misuse programs. Lisa lives in the Boston area with her husband, two daughters, and beloved black lab. She is of South Asian descent, speaks Gujarati, and enjoys all things social.