When accidents happen, it’s important to talk to kids honestly about what has occurred.

Graphic and detailed information is typically not needed. Brief, accurate, and age-appropriate information can be provided, followed by lots of time for questions and discussion about kids’ thoughts about the incident.

An example might be: “Mrs. Jones was in a bike accident.  She fell from her bike and hurt her neck and broke her leg. When we see her next week she will have a few bandages on her face, a cast on her leg and will be using crutches.”

This might be followed by something like this: “You know, accidents happen.  So that’s why we wear bike helmets and ride on the sidewalks.”

Some other things to be aware of:

• Some kids won’t seem to care about the person who has experienced the trauma.  That’s OK, we all deal with things differently.  They may show concern at a later time, or not at all.
• Kids may become very concerned about their own safety and the safety of their loved ones. For example, in the above case a child might be nervous to ride their own bike following the trauma. Brief re-assurance and a review of safety precautions (helmets, etc) are appropriate.
• Children who have a history of trauma may have a particularly hard time when a new trauma arises, even if it doesn’t concern them directly. In this case, providing extra time for open-ended discussion about the past and current trauma is important.
• Kids who show symptoms of depression or anxiety may benefit from talking to a mental health professional, including a school counselor or psychologist. Symptoms might include, difficulty sleeping, lack of interest in previously pleasurable activities, increased tearfulness, and isolation/withdraw.  Kids might also complain of physical ailments like stomach and headaches.

Photo by mikemcilveen (via Flickr)

There has been a lot of buzz about the American Psychological Association’s recent Stress in America survey. Some question whether it really represents the state of the nation’s stress, others question whether or not we can really do anything about our stress, and some wonder if it even matters.

After all, everyone always has to deal with some stress, right?

Deborah Kotz of the Boston Globe’s Daily Dose questioned whether the APA’s survey results were accurate. She did her own (though admittedly unscientific) poll online.

Interestingly at the time I wrote this post, her results  mirrored those of the APA survey, and in fact, made the situation even more alarming. Her results indicated that 34.28 percent of Americans described themselves as extremely stressed, have gained weight and are having other health problems. And another 29.32 percent of Americans feel frazzled a lot and don’t believe they are dealing well with stress.

Her article has generated lots of comments by people frustrated at the lack of available services. The stigma they feel is attached to a diagnosis of mental illness and the cost of getting help. Others have pointed out the need for increased education about  stress and mental illness and the benefits to individuals and their families.

Here are some very important facts:

• People with serious mental illness have a 25-year shorter life span than those who do not. Three out of five of these people die of mostly preventable conditions, such as obesity and heart disease.
• Estimates are that 11 percent to 36 percent of primary care patients have a psychiatric disorder.
• One recent survey of mental health conditions in urban family medicine practices revealed that more than 40 percent of survey respondents met criteria for a mental health disorder. But, many come to the physicians’ offices with complaints of headaches and stomach issues such as irritable bowel. Too often patients are told to lose weight, take it easy or handed a prescription with no follow-up.

The American Academy of Family Physicians noted the following:

Psychiatric problems are a major health issue. In the United States, neuropsychiatric disorders have now surpassed other disorders such as cardiovascular diseases and malignant neoplasms as the number one cause of disability as expressed as disability-adjusted life years.

According to the most recent data available, mental health expenditures in the United States, expressed as a percentage of total health care expenditures, were more than 6 percent.

Most family practice physicians are not well trained to manage psychiatric issues. As a result, lots of unnecessary and very expensive medical tests are performed when psychotherapy might be what is needed.

So the answer is yes, stress matters! And yes, we need to learn to better manage our stress.

We need to learn about mental illness and make sure we provide and receive appropriate treatment. Financially, we can’t afford not to. The loss of life is so often unnecessary. There is no price to put on the life and unnecessary death of a loved one.

While I recognize that simply taking a bubble bath, as one person commented, will not solve the tremendous financial and family pressures that  people currently are facing, reducing our stress levels in areas where we have control–such as exercise, breathing techniques, massage, meditation and even bubble baths–can clear our minds so we are capable of making better choices and decisions and can be more resilient.

And remember: This is today. It does not mean things will be like this forever.

Photo by isabisa via Flickr

When we are stressed we have higher levels of a chemical (cortisol) that damages our system. It’s like a little hammer chiseling away at our healthy insides. (Watch the effects of stress on the body with this cool graphic.)

The problem is that not everyone understands just how unhealthy this is on our physical health. Because of this, many people may be less likely to use stress management strategies that improve their health.

Have you looked at the recent findings of APA’s Stress in America survey? This survey highlights the negative impact of stress on physical health, and it shows that not all survey respondents were aware of the connection.

According to the survey,

“Although the majority of adults understand that stress has a strong impact on a person’s health,  a sizeable minority still think that stress has only a slight or no impact on their own physical health (31 percent) and mental health (36 percent).”

Notice that reference to mental health. Depression also comes into play. Research shows they are related, but it’s thought to be bidirectional. That means that the more depressed you are, the more you engage in unhealthy eating and physical activity habits; and the more you engage in these behaviors, the more depressed you become. It creates a vicious cycle from which it’s tough to break.

More from APA’s stress survey

Obesity and depression are often exacerbated by stress. Those who suffer from these conditions report that they are unable to take the necessary steps to relieve their stress or improve their health and, therefore, engage in maladaptive coping behaviors.

• People with depression (27 percent) or obesity (24 percent) are more likely than the general population (20 percent) to report feeling dissatisfied with their lives and less likely (76 percent for the general population vs. 69 percent for those depressed or obese) to report feeling satisfied with family relationships.
• Those with depression (33 percent) or who are obese (28 percent) are significantly more likely than the general public (21 percent) to say they do not think they are doing enough to manage their stress.
• As compared to the general public (11 percent), more people who are obese (34 percent) or depressed (22 percent) report that their disabilities or health issues prevent them from making positive changes in their lives (i.e., reducing stress and improving health).

The good news is that research shows that depression, obesity, and stress share common effective treatments. Each can be improved (i.e., increased positive mood, weight loss, and lower stress) by a variety of methods, including cognitive (the way we think) and behavioral (what we do) components.

Here are two techniques to help you started on the road to a happier, healthier, more relaxed life.

Rate your mood before and after an activity. Then, rate your feelings of accomplishment before and after this activity. Begin to recognize those that improve your mood (not just in the moment, but later on) and make you feel better about yourself.

You may find that some of your favorite activities (Friday morning trips to the donut shop or Tuesday night carryout pizza) may cause momentary happiness, but lower your self-confidence in making positive choices or decreased physical health that creates more stress and depressed feelings.

Move more and sit less. Research has linked higher BMIs (indication of overweight) with higher rates of screen time (time spent with TV, video games, cell phones, computer, etc). Make your goal simple. Say something like “I will get a few tasks accomplished before I plop down on the sofa and catch up on TV.” For kids, this could be as simple as having them pick up their belongings and engage in a productive, physical activity prior to watching TV or playing video games.

By starting with these two things, you may find that you are identifying activities that make you less stressed, help you get healthier, and improve your interactions with others. You’re putting down that stress chisel, and improving your mental and physical health.

Photo by practicalowl (via Flickr)

Early-onset dementia is a rare form of the disorder where the onset of the cognitive symptoms begins before the age of 65. It has been estimated that less than 5 percent of all those who have a dementia diagnosis fall into this category. Most who are diagnosed are in their 50s, although there have been documented cases of people in their 30s and 40s with the disease.

Early-onset dementia has a unique set problems: Those receiving the diagnosis at a younger age are often still in careers, have younger children, and can have difficulty finding support services for which they are eligible. In order to maximize a person’s ability to participate in normal daily activities, as well as take full advantage of the treatments available, early identification remains a priority.

Obtaining an accurate diagnosis of the disease, however, can be challenging. Many health care professionals consider dementia to be exclusive to older adults, and therefore the signs and symptoms of the early-onset variant are often misdiagnosed. Further complicating the matter is that the symptoms of early-onset dementia can vary, with memory loss not always being the most notable symptom initially. Personality changes, altered judgment, difficulty with problem-solving, or increased confusion in familiar tasks are only a few examples of the cognitive changes that can be observed.

When she made her diagnosis public, Coach Summit voiced her determination to continue coaching and to fight the disease. In doing so, she has given countless others with the disease a reason to fight.

It is worth noting that Coach Summit spoke clearly about her intention to use her support system to help cope with the challenges ahead. The importance of having the support of friends and loved ones cannot be overstated. Understanding that you are not alone and that support is available is often the first step to healthy coping.

If you have concerns about your cognitive health, or that of a loved one, it is important to talk to a physician or mental health professional who specializes in these types of medical issues. The only way to determine whether memory changes are related to normal aging, or possibly a more serious condition, is to be evaluated. Psychologists offer a number of tests that can help identify dementia and Alzheimer’s disease.

For more information, please visit any of the other blog entries on aging, or view the helpful information on websites for the Alzheimer’s Association and the Mayo Clinic.

Photos by aaronisnotcool and Tennessee Journalist (via Flickr)

Ten years later, for most of us, life has moved on. We’ve experienced weddings, births, new jobs, new milestones. Americans are resilient, and we learned just how true that was in the years after 9/11. But anniversaries, especially the ones which seem to be significant, can make many adults and children experience reactions to memories and images related to 9/11.

What are anniversary feelings and why do they happen to us?

When a highly traumatic event happens in our lives, it is common to experience a host of feelings in the days and weeks prior to, the day of, and after the anniversary.  For example, you may have trouble sleeping and feel more tired. You can’t get upsetting images out of your mind. You find it hard to concentrate, cry more, startle more easily. You might feel generally more nervous or just off. You may feel uncomfortable being alone and have a stronger desire to be with friends or family.  These symptoms are likely to go away on their own soon after the anniversary date.

What can trigger an anniversary reaction?

The triggers of an anniversary reaction are as individual as each person who experienced the day. For some, it could be memories and images from the actual event. For others, it could be watching retrospective news coverage and television documentaries. Still there are those who may feel discomfort hearing emergency sirens, traveling on a plane, or evacuating a tall building through a stairwell.

What are more serious reactions?  

For some individuals, the 9/11 anniversary will trigger more serious symptoms related to Post Traumatic Stress Disorder or PTSD. These symptoms may have started soon after 9/11 or months or years later. Symptoms can be retriggered during anniversaries of overwhelming and frightening events. While most reactions to anniversaries go away on their own, the symptoms of PTSD often do not. This is when it’s important to talk to a mental health professional.

What are some ways to acknowledge 9/11 and my grief? 

We all cope differently and have different needs around dates of traumatic events.  Some individuals will just make a mental note of the date and not give it much more thought.  For others, however, it is important to “do” something to mark the date, experience and loss.  Consider some of these options:

• Take time to be with family or friends. Stay connected instead of being alone.
• Or be alone. Disconnect from the news and visit a park, lake or someplace outdoors. Take time out of a hike to reflect on the quiet, calm and beauty around you.
• Visit a grave or memorial site of a loved one, friend or colleague, if it brings you comfort in any way.
• Attend a community, school or faith-based event in remembrance of 9/11.
• Make a donation to your local emergency responders association, such as a fire, police or EMS department.
• Light a candle in memory of someone special or to mark the day.
• Plant a tree or flowers in memory of someone special. Create and nurture a garden at home or in the community.
• Write about your feelings and what they day means to you now.
• Make a commitment to volunteer with an organization or cause you support.
• Create a new tradition so the day has a positive meaning.

Whatever you chose to do or not do to mark 9/11, remember to take good care of yourself.  It’s common during difficult and more stressful times to forget about good nutrition, exercise and relaxation just at the time when they may be most important to our health and well-being.  The 10^th anniversary of 911 is certainly likely to be a powerful day for so many individuals, families, communities, organizations and countries.

Remember, you were not alone 10 years ago experiencing the day America changed. And you are not alone in your grief 10 years later.

Photo by ClatieK (via Flickr)

RELATED VIDEO

Psychologist Rosemary Schwartzbard, PhD, talks about how 9/11 has become an emotional milestone for many people and discusses how people can change the meaning of the day. Dr. Schwartzbard was one of the psychologists on scene at the Pentagon immediately following the events of September 11.