APA released its annual Stress in America survey yesterday, and we have again found that our nation is under pressure. Yes, average stress levels have declined somewhat from their max in 2007 and 2008, but that was at a time of extreme economic uncertainty when the housing crisis began to bubble, and the nation’s economy was on the cliff, about to take a deep fall.

But even as the nation’s economy begins to improve, we found that yet again, the majority of people surveyed said they are experiencing very high degrees of stress at levels that are higher than they consider healthy.

Our snapshot of stress is even bleaker for those who said they are caregivers or living with a chronic condition. Caregivers reported higher levels of stress, poorer health and a greater tendency to engage in unhealthy behaviors to alleviate their stress than the general public. They report feeling overwhelmed by the amount of care their aging or chronically ill family member require of them.

And those with chronic conditions, such as depression, obesity and Type 2 diabetes, are also caught in a vicious cycle. They said they were unable to take necessary steps to reduce their stress and engaged in unhealthy behaviors to manage their stress, thereby reducing their ability to appropriately manage their illness.

We have said for years that people need to be more aware of their stress levels; need to recognize what triggers stress for them; need to recognize how stress can damage their health; and need to manage their stress more effectively.

But while the majority of Americans know this is true, let’s face it, change isn’t easy.

There are a lot of reasons that Americans aren’t taking better care of their stress and their bodies. I believe, along with many others, that while we’re all responsible for our own health, change cannot happen in a vacuum. Aside from individual efforts, supportive social and community networks, as well as a responsive health-care system are needed to help individuals make the changes needed for better health.

We all need to think differently about health and illness.

Most chronic conditions can be prevented by better managing our stress and making better choices about our nutrition, activity level, alcohol and tobacco use, and our strategies for managing stress. By understanding the relationship between stress and chronic illness, we can all take steps to make better choices.

Psychologists working side by side with physicians—as part of someone’s personal health-care team—enhance the possibility that health care focuses on the whole person, not just an illness. Access to the right kind of care from the right kind of health-care provider must be assured in our evolving health care system. More focus on prevention will save lives and health-care dollars in the long run.

We need big changes in our evolving health-care system.

I believe they can happen. They need to happen.

Until then, do your best to make small changes and practice better stress management strategies.

• Engage understanding people who support the changes you want to make for yourself.
• Increase your activity level, and make better food choices.
• Set realistic expectations.

And if your efforts aren’t paying off for you, consider talking to a psychologist who can help you identify and remove those barriers that are standing in the way of the changes you want.

Photos by hradcanska and yourdon (via Flickr)

When any form of catastrophe strikes—from household fires to major earthquakes—people are often bombarded with images of grief. We know that loss, while distressing and upsetting, is a natural part of life. But when it hits us unexpectedly, we can be overcome by shock and confusion, leading to prolonged periods of sadness.

How any one reacts to death varies, and so does each person’s way to cope with grief. Psychologists have learned through research how people grieve, why some people struggle with loss more than others, and how specially trained professionals can help people continue living their own lives and find personal meaning.

From their research, psychologists have learned that:

• Most people can recover from loss on their own through the passage of time, social support and taking good care of themselves.
• People move through their grief at their own pace. For some people, it may take a few months or even a year to fully move on. But other people may be feeling better within just weeks. There is no “normal” time period for someone to grieve, and everyone is on a timeline that works best for them.
• The stages of grief are not really a linear process. We’ve all heard about the five stages of grief: denial, anger, bargaining, depression and acceptance. But new research is challenging that popular notion. Scientists are now reporting that most people do not go through the stages as progressive steps, and some research even indicates the five stages may not even exist.

One key to developing a healthy response to grief is resilience. Human beings are resilient. And most people can endure loss and then continue on with their own lives.

But some people may struggle with grief for long periods of time and be unable to carry out daily activities. These people could be experiencing complicated grief, and may benefit from the help of a psychologist or licensed mental health professional who specializes in grief.

Psychologists are trained to help people better handle the fear, guilt or anxiety that is often associated with the death of a loved one. Informed by research, psychologists can help people build their resilience and develop strategies to get through their sadness.

Letting go of your grief does not mean letting go of people you miss. You can celebrate their lives in special ways that keeps their memory alive. Some people choose to plant trees, pass on a family name to a baby, or donate money to a charity of scholarship fund. What you choose is up to you, as long as it allows you to recognize your loved one and move on with living.

Loss is forever but grief is not. Mourning the loss of a close friend or relative takes time, but research tells us that many can find a renewed sense of meaning that offers purpose and direction.

Photos by rafaelnc and pumpkinpie (via flickr)

A few startling numbers about children and medication:

• 20 percent (one out of five!) of children in 2008 were prescribed medications to treat mood, thinking or behavioral disorders, with stimulant medications for adolescents being the most common.
• The number of children on antidepressant medications almost doubled from 1996-2005.
• More than 500,000 children were on antipsychotic medications in 2009, including several thousand preschoolers. Less than half of them had any kind of mental health assessment.
• Psychological interventions have a low rate of use and that rate is getting lower as more medications are used. For example, in 2007 only 8.5 percent of children with a psychological disorder received psychological treatment while about 58 percent of children were given only medications and no other treatments. For those who do get psychological treatment, they are getting fewer visits.

Parents, it’s important to feel comfortable and confident asking questions about your child’s health—whether it is physical or emotional. In the video below, I share a few points that you should discuss with your child’s pediatrician. Medication for an emotional or behavioral problem is often helpful. But children benefit best and for the long-term when receiving the professional help of a trained, licensed mental health professional.

Photo by Carl_C (via flickr)

Two years later, there are still details that need to be worked out to make parity work. That’s why I’ve been at a conference that is bringing together the many different groups with an interest in what parity means and how it can best be put into place. At the conference are experts representing the providers of mental health care (such as psychologists), consumers who use benefits, insurance companies (payers of benefits) and employers. It’s important that these groups come together and have an open and sometimes difficult discussion because there are competing interests.

There is general consensus – the mind and body are connected and mental health and substance use disorders are illnesses. Most people do get better when helped by a mental health professional.

But there are gray areas. The implementation of the regulations governing this law has only just begun. And there remains an outdated notion that mental health care costs too much and that this perceived additional cost could be prohibitive to employers. But research on state parity laws and of the insurance plans for federal employees have shown that this isn’t the case—increased costs are minimal. In fact, the Congressional Budget Office estimated that parity would likely increase costs by just 0.04 percent. But with change, there is often some fear and pushback. Until we can all work out the details of what all those gray areas mean, there will likely be challenging times—for everyone.

What does this mean for you? Mental health parity is real. It is happening. But depending on the kind of insurance plan you have and the kind of treatment you want, you may have to jump some hurdles to get the benefits you deserve. If you talk to your primary care physician about a mental health-related concern, you may not necessarily be advised to connect with someone who can provide therapy. If you visit a therapist, you may be told you need to pay a higher co-pay than what you’d pay your primary care physician. You may be told you can only visit your therapist 20 times a year, whereas there’s no limit to how often you visit a physician. The law removes these hurdles for most patients and makes it easier for you and your family to get the treatment you need.

Check into your benefits coverage. Know what you are entitled to have. Talk to your company’s human resources office if you have questions or think you are being denied fair coverage. Call your insurance company representative. It may be uncomfortable to ask questions but you deserve equal benefits for mental health care. During my many years in clinical practice, I witnessed first hand the obstacles that were put in place to keep people from getting services in my office. I had to deal with insurance companies that wanted to limit the kind of treatment that was needed or wanted people to stop therapy before they were ready or healthy again. So don’t shy away from talking to your mental health provider or your human resources department about any concerns you have.

Mental health parity is a victory for everyone. But there is still a lot of work to do to make sure parity is implemented by insurance plans the way the law intends. We at the American Psychological Association will stay in that fight until parity really does become the law of the land!

Photos by ®oberto and Victius via Flickr

A lot of talk about men’s health is often about physical prevention – getting regular exams, eating healthy meals, finding the time to exercise. But good health is more than just taking care of the body; it also means taking care of the mind. Research has shown the strong connection between mind and body health. And one of the most common contributors to physical health problems is stress.

To kick off the week, we offer a few numbers about stress and men from the recent Stress in America survey by the American Psychological Association.

• 67 – the percent of men surveyed who said money is a significant source of their stress.
• 60 – the percent of men who say work-related demands interfere with their family responsibilities (compared to 49 percent of women).
• 55 – the percent of fathers who said they lay awake at night because of stress.
• 48 – the percent who eat too much or eat unhealthy foods because of stress.
• 27  – the percent who said they feel depressed or sad because of stress.

What we’re writing about for Men’s Health Week (This list will be updated throughout the week as we publish new posts):

• What My Dad Taught Me About Dealing With Stress (June 14, 2010) by Dr. Christopher Ebberwein
• Men Finding Hope and Health During Unemployment (June 15, 2010) by Dr. Nancy Molitor
• Why Men Avoid Physical Exams and How They Can Be Motivated (June 16, 2010) by Dr. Alan Keck
• Postpartum Depression Can Hit New Dads Too (June 17, 2010) by Dr. Rosalind Dorlen
• Men Managing Stress (June 18, 2010) by Dr. Ron Palomares
• Playtime with Dad Helps Kids Take Risks (June 21, 2010) by Dr. Stephanie Smith
• How Dads Can Get Their Kids Moving and Active (June 21, 2010) by Dr. Teri Bourdeau
• Dads: Remain Close to Your Family Even When You Have No Time (June 21, 2010) by Dr. David Palmiter

We offer a few other resources to get better informed about men’s health:

• Men’s Health from the Centers for Disease Control
• Men and Depression from the American Psychological Association
• Men’s Health from Medline Plus
• Men’s Health Network

Photo by disgustipado (via flickr)