THRIVE Volume 3

Spring 2022 | Vol. 3

Thrive

Official newsletter of Synergy Strive Coaching & The Psychiatric Practice of Steven M. Gordon & Associates

What’s In This Issue:

  • The Chain of Human Dignity
  • Managing Transitions
  • Diagnosis & Treatment of Bipolar Disorder
  • Meet our newest team member!

Just a reminder!

We ask for a minimum of 24 hours notice to cancel appointments so our clinicians can offer canceled appointments to other patients.

Same day cancellations or failing to show for an appointment will result in a $100 charge.  Thank you for helping us improve our clinicians’ availability to all patients!

Getting Into the “Spring” of Things!

 

Spring has sprung!  We made it through the long winter, and now the days are getting longer, the weather is getting warmer, and nature is exploding with life all around us.

Spring is such a lovely time of year, and it also brings a lot of change and new growth for many of us.  Students are wrapping up their school year, with some moving on to high school, college, or graduate school, while others may be starting a career, or maybe just going back into the office.  Change can be exciting, but it can also be stressful – even “good” changes.  Inspirational author and motivational speaker, Mimi Novic writes, “Sometimes we can only find our true direction when we let the wind of change carry us.”

May is Nurses’ Month and National Mental Health Awareness Month, and Synergy Strive would like to recognize our incredibly talented team of Advance Practice Psychiatric Mental Health Nurse Practitioners and Doctors of Nursing Practice for all they do to help others manage their mental health.  This newsletter is just one way we try to create awareness around mental health, and some of the ways we can improve it.  In this issue, we’ll take a look at how to take transitions in stride, and why stepping outside of ourselves on occasion is important not only for others, but also for ourselves.  We’ll also touch on bipolar disorder, and how diagnosis can sometimes be challenging.  Last but not least, we’ll introduce you to the newest member of the Synergy Strive team!  Now, let’s get into the “spring” of things!

The Chain of Human Dignity

Written by Steven M Gordon, PMHCNS/NP-BC

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Chain of Human Dignity: Breaking Through Self

 

How often do we think outside our own self-centeredness or ethnocentricity?  Here’s a concept:  edifying or giving to those people around us or outside our own culture.

The Chain of Human Dignity is linked by: giving or helping physically to those in need, giving spiritually through prayer, and giving emotionally through words of encouragement and acts of kindness.  At times we forget to show appreciation, love, a helping hand, or even encouragement to those who are the closest because we are self-consumed in our own minds and needs.

Not thinking about others around us can be hurtful, destructive, or saddening to those closest to us, putting walls up in relationships. It is so important to remember that relationships, people and cultures are not random. We are all here on earth to live with purpose. Yet, at times, we ignore the people closest to us. Our relationships in people’s lives are very powerful, but we take that for granted at times  because our self-consumption in our own problems and issues becomes more important, and often evolves into self-destruction in our minds and behavior. 

It requires us to have forethought, energy, and at times, empathy or understanding. Meeting others’ needs instead of ours can not only be self-nurturing, but can also be healing, improve feelings of self-worth, and empower us to change. Focusing on others whether physically, spiritually or emotionally not only allows us to redirect our thoughts about our own personal stress, anxiety, and sadness, and focus our energy on giving to those in need. Knowing we are helping others gives us feelings of purpose and empowerment, whether it’s putting a smile on someone’s face, sending a note of encouragement, or a prayer or meditation for a war-torn culture.

Words of simple encouragement can be an act of power. Remember that there is a world of individual and collective suffering, and a simple act outside ourselves can provide relief for an individual or group. We can become so focused within ourselves, missing out on the powerful opportunities to build a person’s dignity. We hold power not only in our own lives, but we can be a powerful tool in others’ lives as well!

Think…these small words and deeds affect the human mental status, relationships, and cultures around the world, and each is a link in a chain.  When we give of ourselves, we collectively LIFT the human spirit, creating a HUMAN CHAIN of DIGNITY!

Diagnosis Digest:  Bipolar Disorder

written by Dr. Samantha A. Rogers, DNP, PMHNP-BC

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Bipolar disorder, which was formerly known as “manic depression” is a mental disorder that causes unusual shifts in mood, energy, sleep patterns, appetite, concentration, and activity levels. Those that have bipolar have a 20 times higher suicide rate than the general population and about 60 percent of those with the disorder abuse alcohol and other substances. It is the 6th leading cause of disability worldwide, with about 30 billion dollars in direct healthcare costs annually in the US. Unfortunately, it can often go misdiagnosed, with Major Depressive Disorder being the most common misdiagnosis, as people usually tend to seek treatment in a depressive state versus a hypomanic or manic episode. Symptoms often can be similar to Attention-Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder, making it challenging for a healthcare provider to make a correct diagnosis. It is also not uncommon for people that have the disorder to also have ADHD and an anxiety disorder. Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins School of Medicine reports, “The average length of time between a person’s first episode and getting the correct diagnosis is eight years.”  Symptoms of bipolar disorder typically begin between late adolescence and early 20’s. The exact cause of bipolar disorder is still unknown although genetics, a person’s environment, altered brain structures, and abnormal brain chemistry are all thought to play a role in its development.  Although it is a lifelong illness, it can be effectively treated with medications, therapy, and even electroconvulsive therapy (ECT).  Medications generally used to treat bipolar disorder include mood stabilizers and atypical antipsychotics. Sometimes, a person might require an antidepressant as an added treatment for a depressive episode. Sometimes, taking an antidepressant alone can trigger mania in patients who have bipolar disorder, which is why a correct diagnosis is extremely important. Manic symptoms include having a decreased need for sleep, irritability, an abnormal elevated mood (feeling like you are “on top of the world”), pressured speech, hyper-talkative, racing thoughts, doing many tasks at once, spending large amounts of money, becoming hypersexual, increased substance use, and feeling like you are unusually important or talented. Check out https://www.nimh.nih.gov/health/topics/bipolar-disorder to learn more about bipolar disorder and be sure to speak with your mental health care provider if you believe you may be experiencing these symptoms, or have in the past.

Transitions

written by Derek Walcker, PMHNP-BC

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We’ve all heard the axiom that “the only constant in life is change.” How blithely we roll our eyes every time someone tosses out this platitude, as they watch us clumsily meander through, or lament the struggle of, adjusting to some change in our life. However, the cliched stigma of this phrase is only equaled by its accepted truth: every area in our life is in a state of ceaseless flux, be it relationships, career, school, finances, environment, or health; and the continuance of our existence is predicated on our ability to acclimate and reconstruct our thoughts, emotions, and behaviors to these changes. The timing of exploring this absolute couldn’t be more pertinent, as we all need to address the inevitable upcoming -or present- transitions of our life, be it matriculating to middle school, high school, or college; returning to the workplace, adjusting finances; socializing or shopping in-person, or just venturing outside to enjoy the inviting weather of Spring and Summer. The good news is that we are all -and I mean all of us regardless of age- are already experts at doing exactly this.

 

Our brains are designed with an innate drive to push our limits, expand our abilities, and confront challenges, all of which is facilitated by our brain’s extraordinary ability to adapt and redesign neural pathways to meet any expectations. This process of neurogenesis and neuroplasticity is what allows us to continually progress in life. Notice I used the word “progress,” as opposed to “change” or “transition;” because that is what we are doing as we adjust: we are learning, building upon our existing foundation, and developing new methods of perception, processing emotions, and behaviorally responding, so we can thrive in any situation. We do this every day, at every age and station, without even realizing it. Drop a 4-year-old off for their first day of pre-school and what do they do? They fall to pieces. Their perception is abandonment, their emotional reaction is anger, sadness, and fear, and finally their behavioral response is to cry, wail, clutch your leg, or lash out at you with their tiny fists of fury. But give them two weeks and what happens? Suddenly, they’ve gone from dreading the unknown, to yearning to be marooned in this new atmosphere. Their perception turns from abandonment to one of adventure, autonomy, and opportunity to explore. Their emotional processing has enhanced, as they now more readily manage sadness, anger, fear, and instead feel excited and eager. Finally, this is all observed in their actions as they now engage with their peers, play with the toys, and are eager to learn and exhibit an understanding of the pre-school curriculum. We have all progressed through this stage as we incredibly adjusted to a completely foreign and frightening environment full of strangers, unusual activities, and rigid expectations of learning. It truly is remarkable.

 

Let’s use a less grand example and focus on the everyday adaptations that are easy to overlook. Consider the first time you had to drive to work in the snow -certainly a change from the typical commute weather. You probably thought it was unfair to be expected to brave the snow-covered roads, feeling infuriated or exploited, and were pounding on the steering wheel while cursing your boss’ name. However, after a few bouts of traversing inclement weather to work, and now you can more readily acknowledge that driving to work in the snow is just an inescapable imposition during the winter months, have tempered your rage down to annoyance or even acceptance, and have converted from having a conniption in the car, to simply shrugging your shoulders and leaving earlier in the morning. With no real awareness of this organic process occurring, you’ve evolved your perception, emotions, and behavior in order to acclimate and surmount this deviation from your routine day; and you do it every day -as you have been, since birth.

 

Now ask yourself this: how are the above examples any different from starting high school, college, or a new job, or even returning to something with which you already have familiarity like shopping at the store or interacting with people in-person? You’ve already been down this road countless times before, especially over the past two years during the pandemic with almost every facet of how you experience life being radically redefined. And you made it! Here you are!

 

Fortunately, there are methods to help expedite the process and minimize the stress of acclimating to these new challenges. We’ve already tackled perception ad nauseam, in that everything you’ve read above is my attempt to remold how you perceive the inevitable process of adaptation and growth. You can ask either ask yourself “HOW can I progress through this,” or, “WHY can’t I progress through this?” Challenge that self-doubt.

 

Next is your emotional response: will your emotions govern you or will you govern them? I tell all my patients to accept and never endeavor to invalidate your primary emotions, which are the first emotions you experience in response to a situation or event. If you’re angry, feel angry. If you’re afraid, feel afraid. The issue is not what we feel so much as how we respond to these emotions. Can you feel anger but process it in a controlled manner that will not dictate your behavior? If not, try repeatedly reminding yourself that it is okay to feel whatever you feel, emotions don’t control you, but rather you control them, and if all else fails, just leave the environment and breathe which will help dial down that limbic system activity and mitigate the intensity of your emotions.

 

Which brings us finally, to behavior, in how will you respond via actions to this new demand?  Most of our behavior is the repetition of routines, and without a doubt, we all currently find solace in the routines we have developed over the past 2 years. Fortunately, a key component of adaptation is just making new routines. But this needs to be done slowly or else it will feel overwhelming. Small steps like waking up 15 minutes earlier every 3 days to eventually reach that new morning wake time of 6am for returning to the office; or just looking online for summer engagements before focusing on matriculating to the next grade level in the Fall. Don’t focus on changing everything overnight -it’s too much to ask. Instead, limit your goals to gradual changes and minute deviations from your current behavior/routine, which will culminate over time into complete acclimation to this new demand, and the creation of a new routine.

 

To conclude, what lies ahead may be new, but your innate ability to adjust your perceptions, emotions, and behaviors to surmount adversity, and progress forward, is not. You’ve been doing it daily on some scale since infancy when you first raised your head. To paraphrase Louisa May Alcott: “I am not afraid of storms, for I know how to sail my ship.”

Ruth Bissell, PMHNP-BC

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Ruth Bissell earned a BSN at Drexel University (PA) with a focus on addiction studies because of the current addiction crisis. She assisted with the long process of recovery for adolescents and adults by using Medication Assisted Therapy (MAT), counseling, education, and group therapy. Ruth realized that addiction problems affect more than just the patient, and continued her studies to become certified to treat addiction. Addiction treatment often requires treating other psychiatric problems, so Ruth gained expertise and certification in the treatment of psychiatric disorders such as anxiety, depression, bipolar, and ADHD. To offer more comprehensive treatment, she studied Motivational Therapy (MT) and psychotherapy under Aaron Beck, the father of Cognitive Behavioral Therapy (CBT). As Trauma became understood as a root for psychiatric problems, Ruth became recognized as an expert in crisis intervention by licensure as a forensic nurse. For years she assisted survivors of sexual assault and domestic violence in hospital emergency departments. She was licensed as a Psychiatric Nurse Practitioner at Monmouth University (NJ) before moving to Maryland. Recently, she’s been treating patients with post-COVID problems, PTSD, OCD, and eating disorders.

Hope Scope

Personal Perspectives on Mental Health

images “Survival Tactics” Written by a Synergy Strive patient When I experienced a delusional manic episode at 26, I was faced with a decision. I had the choice of accepting my bipolar diagnosis and moving forward with treatment, or denying that anything was wrong and simply forcing myself to exist as an anxious, depressed, delusional mess until I died. That’s how it felt, at least. So I chose survival. Adaptation. Medication. Therapy. Guidance. Understanding. It wasn’t a hard decision.

 

To call my life since my diagnosis a roller coaster would be an understatement, but, when the pandemic hit, I noticed something. I had felt like I was in survival mode for years, just trying to be alive from day to day. Suddenly, everyone was right there with me. People were dying. People were scared. Things changed so quickly that people did not know what to do.

 

Masks. Social distancing Stay at home orders. Sanitation. Vaccines. Boosters. We were given answers and guidance. It wasn’t easy, though. It was confusing. There was conflicting information. There was misinformation. It was a lot. Too much. People wanted things to just go back to the way they were, but things didn’t.

 

I get upset. I’m an essential worker in a medical field. I have patients who downright refuse to accept that it is time for humanity to adapt. All they can focus on is returning to their old routines. They should be looking at life and it’s new challenges and asking how best to adjust.

 

It’s life or death. Survive.

 

We are the most adaptable species on Earth. We can do anything. This is a moment for all of us. A time for change. For improvement. It won’t get better if we stick to old traditions. We can’t long for the past. The old ways of the world are archaic and dated. We can be better for it, though. We can improve on the past as we move forward with life. We just need to keep living. Adapting. Surviving. No matter what. Choose the path that leads to another day.