Mental health care starts with a first step, but that first step can be intimidating. Maybe you don’t want to let others know what you’re dealing with, or you’ve heard about friends having poor experiences while seeing a mental health provider.

Susan Hanson, DSW, LCPC, a psychotherapist at OSF HealthCare, is debunking misconceptions about therapy so you can feel comfortable and get the most out of your care.

• Myth: Seeing a therapist is scary.
  
  Fact: “People quickly learn it’s a safe place to talk about trials, tribulations and conflicts. It’s a very warm and inviting place,” Hanson says. She adds that even group therapy shouldn’t be intimidating. Group work can help build empathy and a sense of belonging. When you see others going through the same issues, you can often feel less alone.
   
• Myth: My private health information is at risk of becoming public.
  
  Fact: Hanson says this comes up often with her patients. They don’t want to talk about certain things with friends and family, but they’re also wary of talking with a provider. Hanson reassures that all health care providers abide by confidentiality and use software that keeps your information secure and private. She says the only reasons a provider must breach that confidentiality is if the person is a danger to harm themself or others or if there is evidence of child endangerment.
   
• Myth: I’ll be back to normal after just a few sessions.
  
  Fact: It’s usually not a quick fix, Hanson says. Therapy is something you need to buy into and stick with. Success is often seen after awareness, acceptance and internal structural changes in terms of emotional regulation and setting healthy boundaries.
  
  “Some people can come in and have a quick fix. Maybe they’re nervous about moving. Or they have test-taking anxiety, and we can work through skills for that,” Hanson says. “But many other people have more complex trauma that might take longer to work through.”
   
• Myth: Medication will fix me, and therapy is an easy way to get it.
  
  Fact: Hanson stresses that mental health care providers are not medication dispensaries, nor will medication alone likely heal you.
  
  “Sometimes medication is appropriate if there’s a biological basis [an issue innate within someone’s body, in other words], complex trauma or a diagnosis like ADHD or major depression. The medication can help enhance the talk therapy,” Hanson explains. She adds that a therapist can put a timeline on things. If, for example, anxiety symptoms aren’t improving after a few sessions, the provider could look into medications that could help.
   

• Myth: I’ll see my therapist then go back to normal life.

  Fact: Hanson says you have to put what you learn at therapy into practice. Common activities outside of a session include journaling, meditation, grounding exercises and finding a trusted person who you can go to if, for example, you’re having an anxiety attack. Some of Hanson’s patients have also benefitted from emotional support animals, she says.
  
  “Reframing thoughts around a certain situation can be a good goal. Learn positive word choices. Rewrite the story around a situation,” Hanson says. Reducing anxiety is another big goal she’s seen with patients.
  
  “Therapy is not a straight road. I like to see it like a dance. Two steps forward, one step back,” Hanson adds. “I also tell my clients that this bridge will take you halfway there. The rest, you walk alone. There’s only so much any one person can do for another person. We need to learn how to develop some of the skills outside of a therapy session.”

Learn more

Read more about mental and behavioral health care on the OSF HealthCare website. Mental health care at OSF includes providers like Hanson on the local level and the to-be-built Meadowview Behavioral Hospital in Peoria, Illinois, for people who need a higher level of care.

Interview clips

Related stories

Chewing, breathing, clicking - when does it end?
Turning pain into purpose
Is it depression, ADHD or bipolar disorder?
Don't feel the burn
Difficult, not bad: Navigating tough conversations
Fall into self-care
Seeing a counselor in your golden years? Mind these misconceptions
Finding common ground
Suicide prevention involves all of us
Medication assisted recovery: A primer
The balancing act: Chronic conditions and mental health
No more “tough it out”
College student home? Here's how to check their mental health
Big emotions, bigger solutions
Bullying isn't just on the playground
I'll do it another time
Mental health care in your golden years
Becoming friends with artificial intelligence
PTSD has a wide range of treatments
Mental health care starts with a first step
Being open and honest about mental health

For most adults, spring and summer thunderstorms bring the annoyance of driving in a downpour.

But others dread this time of year for migraines triggered by the environment.

What are migraines?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, describes migraines as episodic disorders that cause severe, throbbing headaches, usually on one side of the brain.

The list of triggers is, unfortunately, long.

“Emotional stress can trigger migraines. Moving, changing jobs, other stressful life situations,” Dr. Ogun says. “A change in sleeping habits can trigger a migraine. Skipping a meal. Your diet: wine, aged cheese, coffee withdrawal and foods high in nitrates.”

Other common triggers include hormones, bright lights, loud sounds and changes in altitude. A propensity for frequent headaches can also run in the family, Dr. Ogun says.

You can prepare

Dr. Ogun says not much is known about weather-induced migraines. But most medical professionals agree there is some evidence for migraines caused by changes in barometric pressure.

How can you prepare?

“Up and move,” Dr. Ogun says, tongue firmly planted in cheek.

More realistically, watch the weather forecast. If there’s a chance for a lot of dust or smoke in the air (think areas like California or Arizona), plan to limit time outside.

Stock up on medication after talking with your health care provider. Dr. Ogun says over-the-counter medicine like ibuprofen will help with pain and can even be taken ahead of when you know a migraine is coming.

“They could have a headache diary where they write down what causes their headaches, where the pain is located, how long does it last, symptoms and what treatment helps,” Dr. Ogun adds.

If your migraines are more frequent, feel different, or come with other symptoms like confusion, neck rigidity, weakness in the arms or legs, fever or chills, see a doctor right away. Some of those symptoms may be signs of a heart attack or stroke.

Any head trauma, like a sports injury or a car crash, should also be checked on by a doctor.

Interview clips

Previous coverage

One big headache
June is national migraine and headache awareness month
A good calendar may be able to help you fight headaches
Three steps to help with severe or frequent headaches
When should you see a specialist for your headaches?
Weather changes can be a pain for migraine sufferers

Ways to cope

“I tell people: get in a routine, especially if you’ve graduated from college and don’t have a job lined up. It can be really hard if you don’t have things going on throughout your day. Have a sense of purpose,” Yuhas notes. “If gyms are your thing, join a gym. You’re getting socialization and helping your body and the chemicals in your brain. Go to the library. Join a community group.

“If you do get a job, be mindful of the Monday through Friday routine,” Yuhas adds. “Make sure you’re doing [pleasurable] things on the weekends, not just the same meal prep and laundry. Try to break it up and have things not be super consistent.”

Parents and other loved ones should also take an active role in helping the young adult blossom, Yuhas says.

“Be open. Be there for that person. Notice things and make observational statements like ‘Hey, I’ve noticed you’ve been late to work a couple times. How are you?’,” Yuhas says. “Or ‘I noticed you’ve been having trouble doing your laundry’ or ‘You haven’t been getting out of your room when you come home from work. How are things going?’

“Gentle check-ins and observations are better than accusing them,” she adds.

If the stress of young adulthood is too much to manage or if the person is a threat to harm themselves or others, see a mental health provider right away. One-on-one sessions, sessions with the parents or group sessions are all options. The provider could even help with career coaching.

“It’s a non-judgmental space to talk about the shift in your life. Because it is hard,” Yuhas says.

Learn more

Read more about mental health resources available at OSF that can help build life skills. Some resources, like behavioral health navigators and support groups at hospitals like the one Yuhas works at, are available even if you are not an OSF patient.

Interview clips

Related stories

Is it depression, ADHD or bipolar disorder?
Turning pain into purpose
Big emotions, bigger solutions
College student home? Here's how to check their mental health
The parent-teen relationship
Don't feel the burn
Difficult, not bad: Navigating tough conversations
Fall into self-care
I'll do it another time

As a pediatrics expert and mother of an eight-year-old, Emily Isom has seen the screen time debate firsthand.

“Kids are being introduced to technology early,” says Isom, a certified medical assistant in pediatrics at OSF HealthCare. “COVID was one of the reasons. Kids did schoolwork on their devices. That turns into using technology throughout the day. They get attached and addicted to scrolling and swiping. It’s glued to their hands.”

One way to break the cycle? Good old-fashioned ink and paper. Isom is reminding people, young and old, about the pitfalls of excessive screen time and the benefits of reading for fun, not just when you have to.

The concerns

Isom says constant screen time can weaken kids’ memory and concentration.

“It’s hard for a kid to focus on a reading assignment in school because they are so used to quick swipes on their device,” Isom says. Long term, Isom says this can lead to poor grades, missed academic opportunities and even a diagnosis of a learning disorder.

“Anxiety is also a big concern. I see this in older kids,” Isom adds. “Bullying online causes a lot of anxiety. There’s social pressure. They want to be not left out. Who’s texting me? What’s going on online? Am I going to miss this party? Is there something going on I should be involved in? They focus on this instead of schoolwork.” Isom also says kids are exposed online to traumatic news stories and adult content, leading to confusion about the world, stress and other mental health concerns.

The benefits

“If kids read on a regular basis, it’s going to sharpen their mind. It’s going to help them excel in academics. It’s going to give them a more open mind to the world. It’s going to help with memory,” Isom says. They’ll be more curious, she adds, not just about the book but about the world. This can pay off when they’re exposed to other cultures in college and the workplace. Books can also be an escape from everyday stress.

“Reading for fun [not just when it’s required for school] helps you find things you’re interested in,” Isom adds. “You might find a book you had no idea about. You open the book and realize ‘I like reading. I like this genre. This is different and cool.’ Then you keep reading. You want to learn more. It’s like being on the edge of your seat with a movie you can’t stop watching. It brings happiness. It’s almost magical.”

Tips for adults

How can parents and teachers get young ones to rediscover their love for reading?

• Let your child pick the book, but give them options that are fun and light. Save the books on heavier topics for when they get older.
   
• Make books available throughout your home. Place books on shelves or nightstands in bedrooms, living rooms and playrooms.
   
• Let kids see you read.
  
  “If they see you read, they’re going to read,” Isom says.
   
• Read with your child.
  
  “I can’t stress that enough. Reading with your child is going to get them to read more,” Isom says. “When you’re with them, showing them words and interacting with them, you’re challenging their brain. Kids love that. They say, ‘Hey mom, can we read this book tonight?’ Next thing you know, it becomes a habit. It’s a nightly thing.”
   
• Create a reward system for reading. For example, put a sticker on a posterboard for every book read. At 10 stickers, the child gets a reward like a toy or special meal. Isom says after a while, the child might forget about the rewards because they’ve developed a love for reading.

Traditional or tech?

We live in a digital world where some people read on electronic devices like a Kindle. Is that OK, or should you stick to paper books?

Isom says e-readers are fine since it’s not a constant scroll like social media.

Learn more

Read more about keeping your child healthy on the OSF HealthCare website. Pediatric care at OSF includes local clinics like the one Isom works at and OSF HealthCare Children’s Hospital of Illinois in Peoria.

OSF also offers resources if your child’s screen time requires a visit to a mental health provider. Some resources are available even if you are not an OSF patient.

Interview clips

Related stories

Dirty nails and mouths don't mix
Don't lose your head over lice
How to get your kids to brush their teeth

“I’ll clean the house later.”

“I’ll fill up the car with gas tomorrow morning.”

“Thinking about putting together a will stresses me out. I’ll deal with it later.”

At one time or another, we’ve all put something off. It may be large or small. It may be put off for five minutes or a year. Whatever the case, procrastination is a part of life. But what’s important is understanding why we procrastinate and how not to let it get out of hand to the point it affects our mental health.

The basics

Ari Lakritz, PsyD, a clinical psychologist at OSF HealthCare, defines procrastination as wanting to do an important task but pushing it off or finding something else to do.

“Despite my best efforts, I just can’t help myself,” Dr. Lakritz says, putting himself in the mind of a procrastinator.

Just like stress activates parts of the brain that control fear and anger, procrastination comes with a sense of relief in the brain, Dr. Lakritz explains.

“All those aversive stimuli in the brain settle and go back to their baseline. Then it’s smooth sailing until at least the next time the issue comes up,” Dr. Lakritz says.

Procrastination is often equated with being able to prioritize and work well under pressure. Don’t confuse the two, Dr. Lakritz warns.

“Procrastination is accompanied by a sense of shame,” he says. “A sense of ‘I know deep down what I’m doing is not the most productive way of working. It’s not the most responsible way of working’.”

For example, take a college student who can type an A+ essay right before the midnight deadline. A provider like Dr. Lakritz may not call them a procrastinator because working at the deadline is part of their plan. They know they are going to finish the task. There’s no opposing force.

The why and the consequences

So why do we put things off?

Dr. Lakritz says for many, it’s about how our brain interprets scenarios. If you pass a coworker in the hallway and they don’t greet you, you may think the person is mad at you. In reality though, the coworker was just lost in their own thought. But your brain doesn’t interpret that.

The same concept applies for procrastinators. And for people with attention deficit disorder, anxiety and depression, it may be worse.

“They’re not so good at understanding or feeling the consequences of what’s going to happen when they come to that big meeting or big test unprepared,” Dr. Lakritz says.

Ironically, those people may be on the other end of the pendulum – too optimistic or confident about what they can accomplish. They lack an understanding of time. They think they can bake a cake in five minutes, for example, when we know it takes longer, no matter your recipe or skill level.

The consequences of procrastination vary by person, but it comes down to missed opportunities and not living up to your potential. For a teenager, putting off homework might lead to missing the work altogether. That means poor grades and fewer chances at the higher education they want. For adults, procrastination may mean missed opportunities to advance up the corporate ladder. And it keeps spiraling from there.

Treatment

Dr. Lakritz says a mental health provider shouldn’t judge how a person organizes tasks or, in general, lives their life. But he says there are some evidence-backed ways to tackle severe procrastination.

•  Find the amount of time you can work without distraction. If it’s 15 minutes, break your project up into small, manageable chunks of around 15 minutes.

“Take a nice little break to revitalize yourself between those small chunks, then get right back at it,” Dr. Lakritz suggests. “You might spend more time overall on this task, but you’ll be working much more consistently.

           “With procrastination, slow and steady wins the race.”

• Rewards like food or music can work, but Dr. Lakritz suggests pairing them with productive work, not after. A work buddy can help here.

“Come up with a contract or rule. You’re only allowed to eat that ice cream or candy bar when you’re working actively,” Dr. Lakritz says. “You’ll begin to associate working with something physically pleasurable. We would expect that to have pretty good effects on your level of motivation going forward.”

Learn more

Learn more about behavioral and mental health resources on the OSF HealthCare website. Just do it today and not tomorrow.

Interview clips

While living in Greene County, Illinois, in the 1980s and 1990s, Lea Anne Varble took a gut punch each time she heard about a suicide in her community. Eight to 10 in total in 15 years, she says.

“It just took me aback,” she says.

What the tragedies had in common: the person faced mental health challenges common to a rural setting.

Varble, a clinical psychotherapist at OSF HealthCare, knew she had to do something about it. So not only did she devote higher education time to studying the problem, but she’s also now getting the word out about the resources available.

The issues

Varble says stress and isolation are often experienced by people living in a rural setting, such as a farmer. There’s also a desire to be self-sufficient – a trope associated with farmers and other rural residents for decades.

“People living rurally often are independent. So, when stress comes, they want to handle it on their own,” Varble says.

Varble also knows the issues – stress, anxiety and even depression – of planting and harvest season.

“Hours and hours,” in the field, she says. “You’re expected to keep working even if you don’t feel well. Even if the stress is getting to you. You have to get up and do it again. Or at least that’s what your father before you did and his father before him.”

The work ethic can be admirable, but it can lead to medical issues if left unchecked.

And, the heads of some rural households are caring for two generations: their kids and their parents. School, chronic illnesses and advanced care planning are just more things to add to the to-do list. Varble adds that older adults in a rural setting are more likely to see themselves as a burden and choose to end their life.

Treatment

Varble says getting better starts simply with noticing the problem and talking about it with a trusted adult, like a friend, family member, faith leader or a medical professional.

The good news is that mental health professionals have made strides in this area, such as telemedicine and mobile health services. And society is more willing to talk about mental health. Farming magazines have articles on mental health, for example.

Other ways to help that Varble has picked up over the years:

• Get to know your neighbors and local organizations, like churches and businesses. Then, lean on them for help when the stress gets to be too much.
   
• Look into resources offered by state or federal agencies. In Illinois, where Varble works, the Family Farm Resource Initiative operates a 24/7 hotline and email.
  
  “Individuals can receive support from trained professionals who understand the unique challenges faced by those in the agricultural sector,” the initiative website states. “The helpline offers specialized assistance, including mental health resources and agriculture-related support, ensuring that farm families have access to the help they need.”
   
• Health care professionals should encourage people with rural backgrounds to become therapists.

               “It’s someone from their community who understands what’s going on,” Varble says.

Interview clips

Related stories

Seeing a counselor in your golden years? Mind these misconceptions
Becoming friends with artificial intelligence
PTSD has a wide range of treatments
How old is too old to drive?
Suicide prevention involves all of us
Being open and honest about mental health
Fall into self-care
Stay safe on the farm

Anger. Sadness. Anxiety. Fear.

The Inside Out movies may be onto something.

They’re examples of “big emotions,” says Rachel Yuhas, LCPC, a psychotherapist at OSF HealthCare. Yuhas says it’s OK to feel these emotions, but you should know how to react to them. When you’re angry, for example, swinging your fists at others is a bad idea.

“A big thing is taking accountability first,” Yuhas says of managing these emotions. “Often when you have a big emotion, it can impact people around you.”

Yuhas also preaches techniques to ground yourself like deep breathing, taking time out from stressful situations, meditation, journaling and practicing mindfulness.

“With children, having them interact in a group might be really effective because they can learn from their peers. They can learn how to have those relationships. They even learn how other kids might be having these emotions,” Yuhas says. “I might also incorporate play therapy with kids because it’s more their style. They might receive that better.”

For adults, Yuhas often uses dialectical behavior therapy (DBT). She says it’s a type of therapy where the person learns skills to use in the outside world.

“We talk about mindfulness skills; meditation and interpersonal effectiveness, which is how to communicate with people in an effective way when you’re experiencing big emotions,” Yuhas explains. “We talk about stress. Say you’re at a nine on the stress scale and you need to come down to a seven. There are also emotional regulation skills we talk about.”

Details to know about some of these tactics:

• Mindfulness: As the name suggests, try to keep your mind full. Use your senses to notice things that you wouldn’t otherwise, such as a painting on the wall or the scent of a food truck.
  
  “We want to come back to the here and now instead of ruminating on the emotional turmoil we’re experiencing,” Yuhas says.
   
• Communication: Yuhas will coach people through tough conversations. For example: You’re mad at your partner. Instead of throwing an object against the wall, think about how you’re really feeling and what triggered the anger. Find a way to communicate that without a “catastrophic reaction,” Yuhas says.
   
• Distress tolerance: Yuhas says it starts when knowing that you’re highly stressed – in the “red zone” or toward the top of the one to 10 stress scale. Step away from the situation and find an outlet that helps you calm down, like going for a run.
  
  “Run off some of the steam,” she says.

Read more about mental health resources on the OSF HealthCare website.

Interview clips

Related stories

Inside Out 2 and the parenting lessons that come with it
Bullying isn't just on the playground
Mental health care in your golden years

From misconceptions about symptoms to stereotypes about drugs like Adderall, there’s a lot to parse out when getting treatment for attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental disorder that affects attention, impulse control and activity levels. ADHD is seen in all ages and can overlap with other issues like depression and anxiety.

“ADHD is different from lack of interest or just not paying attention. It includes emotional dysregulation, chronic impatience, restlessness and constant fidgeting. There’s difficulty managing, planning and organizing things,” says Maghav Sharma, MD, an OSF HealthCare psychiatrist. “That leads to difficulties at home or work. It can cause relationship difficulties or difficulties with bosses. Maybe the person is not completing work on time or are impatient with the result of the work.

“We see symptoms of hyperactivity mostly in kids. They’ll run around their classroom. It’s a common reason why teachers and parents send their students to the doctor to get ADHD treatment,” Dr. Sharma adds. “In adults, that anxiousness and restlessness is not outwardly projected. It’s more inside. A person can feel overwhelmed. They are fidgety, restless or on edge.”

All this is why it’s important to get a treatment plan tailored to your needs. Seeing someone like Dr. Sharma would be a good first step. He says therapy can teach skills, like how to plan and be organized, that can help cope with everyday ADHD issues and, at the same time, help if there are other issues present, like depression. For example, if ADHD is causing you to procrastinate on work projects, you could feel anxious about getting in trouble or sad about missed opportunities to move up the corporate ladder.

“We do quite often see people with symptoms of depression or anxiety, but they have underlying ADHD as well,” Dr. Sharma says. “It’s hard to tell sometimes which symptoms are related to anxiety and which are related to ADHD. So we tend to treat the conditions together. Treatment for anxiety and depression can sometimes alleviate the symptoms of ADHD.”

ADHD treatment “never should be just medication,” Dr. Sharma says. But if ADHD is making daily life difficult, medication can be paired “thoughtfully” with other treatment, he says. Stimulants like Adderall and Vyvanse are often starting options for adults. For kids, health care providers might try methylphenidate (Ritalin is a common brand name). A provider could change your medication if side effects are a problem. They could try a non-stimulant like clonidine or guanfacine.

Lifestyle changes also play a big role in ADHD management, Dr. Sharma says. Sticking to a routine – everything from when you sleep to when you leave for work – can help. Exercise, staying hydrated, eating a healthy diet and getting outside to pursue hobbies or be around others can also help your mood.

Learn more about keeping your mind healthy on the OSF HealthCare website.

Interview clips

Related stories

Click here for more stories on mental health care on the OSF Newsroom.

Whenever Paul Engelman’s wife left the house to join friends at their monthly book club gathering, the Rockford resident found himself looking for something to do. With all their children grown and out of the house, he could watch a sporting event or knock out some items from his honey-do list. But what he really was looking for was a social outlet of his own.

Over the years, Engelman has had plenty of male friends. Guys he grew up with, attended school with or served with in the military. But now in his 60s, he has few friends he would consider close knit.

“There wasn't anybody I thought of if I needed to call somebody for some help,” says Engelman, who works as a defense contractor. “If I'm in a pinch, who would I call around here? The list was short. So, the No Book Book Club (NBBC) was born.” 

For the past four years, members of the NBBC meet on a regular basis, much like their wives do with their book club. Anywhere from five to 10 guys get together to simply hang out. It might be at Engelman’s house to watch a football game, or a visit to a neighborhood establishment for trivia night. Some of the members have even joined an indoor golf league. The only thing the group doesn’t do is read books.

“I put out the call to put together the No Book Book Club, and the response was energetic,” Engelman says. “There are guys who are in our age group, are late in their work life, or retired, have children out of the house, or who have a gap when it comes to male friends.”

Engelman isn’t alone in that sense. According to a survey by the Survey Center on American Life, fewer than half of the men responding are happy with their friendships. Only about one in five said they had received emotional support from a friend in the last week, compared with four in 10 women.

In 2021, 15% of U.S. men admitted to having no close friends, which was five times more than 1990. And men with six or more good friends dropped from 55% to 27% during that same period. 

Forming a bond

Male friendships are important for many reasons, according to experts. Friendships foster bonding, connection, support and even validation. Friendships give men not only social outlets, but opportunities to bond over things that consume our lives, such as family, health, work and financial issues.

Travis Swink, DO, is a primary care provider for OSF HealthCare. He talks about the need for relationships with many of his male patients.

“You have to have some outlet outside of your family that you connect with, because connection is very important,” says Dr. Swink. “Where I see the most depression and the most issues are with people who isolate. Finding some outside source of entertainment and activity is important.”

Victor Mendoza is a behavioral health provider with OSF HealthCare. He says friendships usually call for some emotional vulnerability which may make some men uncomfortable.

“I think one of the barriers that men have is that we have a hard time opening up, because that has been seen as a weakness,” says Mendoza. “That affects them from communicating with other men about their feelings, and what they have going on. That just creates more isolation, which leads to depression or anxiety.”

Mendoza says male friends often connect over real life situations. It could be marital problems or work-life balance issues. How much you want to unload on your male friends is up to you. Mendoza adds that you could save your problems for another day and simply decide to catch a baseball game and enjoy a hot dog and your favorite beverage.

“Not every single interaction that you have has to be deep,” Mendoza says. “It could also be spending time with other people and having a good time."

Where to start

Mendoza says there’s nothing wrong with hanging out with a male sibling or cousin. But if you’re seeking friendship outside of your family circle, he recommends connecting with community resources such as church, fitness centers or other social gathering places.

“Having a good support system can help with your self-esteem,” Mendoza says. “It could help with your productivity at work, at home. You know, being a better father, a better husband or a better partner. You feel happier and just enjoy life better, in general.”

Engelman says forming his men’s group has been extremely rewarding. He adds that the camaraderie he gets from his male friends provides the balance he was looking for in life.

While members have come and gone, including one who died from cancer, the men have become closer on an individual basis. Engelman is always looking for new members who he thinks might ‘vibe’ with the rest of the group.

“I've found in talking about the No Book Book Club that everyone I've talked to has said, ‘That's a great idea.’ So, we're going to continue and keep going.”
 

Paul Engelman interview clips 

Dr. Travis Swink, Victor Mendoza interview clips 

B-Roll 

While Dry January is coming to a close, the topic of drinking alcohol is still making headlines.

Heavy drinking habits among adults that started during the COVID-19 pandemic haven’t slowed down, according to a study.

The study, published in the Annals of Internal Medicine, found that alcohol use among adults ages 18 and older increased by 4% from 2018 to 2020, with heavy alcohol use increasing by a whopping 20%. Researchers say the increase continued in 2022.

The pandemic caused plenty of stress for people – working from home, remote learning for children and just plain boredom. Experts say alcohol can start as a habit and then become an addiction. It’s also a way to cope with problems and issues that are impacting our daily lives. 

“COVID was a very stressful time for a lot of people,” says Jessy Mathew, MD, a primary care physician for OSF HealthCare. “There was a lot of social isolation, and a lot of emotional turmoil. People lost their friends; they lost family members. There were no outdoor activities, and alcohol became a relief from all these problems.”

The study defined heavy drinking as five drinks a day or 15 drinks a week for men and four drinks a day or eight drinks a week for women. The increase was seen in all age groups, genders, races and regions in the U.S. except for Asian Americans and Native Americans. Adults in their 40s had the biggest increase in consumption.

“It depends on the type of alcohol and your rate of metabolism, which might be different for each person,” says Dr. Mathew. “It also depends on how much you're drinking at the time. Are you binge drinking? Are you mixing it with other drinks? Are you mixing it with other substances or other drugs? There's a variety of reasons.”

There are many risks with heavy drinking. Among the potential health problems include heart disease and cancer, as well as anxiety, depression, the risk of accidents, and social, family, legal and behavioral issues. “Alcohol affects everything, basically, from head to toe, every single organ can be affected by alcohol,” says Dr. Mathew.

The earlier people start drinking, the greater the risk of developing health issues later in life. And women are more prone to get sicker from alcohol, according to Dr. Mathew. “There's a study that says that if you have one extra drink a day, it puts you at a risk of five to nine times more likely of getting breast cancer,” she says. “It also increases your risk of infertility, menstrual problems, osteoporosis or weakening of your bones, which leads to fractures.” 

Dr. Mathew offers several ways to reduce alcohol consumption, including:

·         Avoiding triggers such as people, places or activities that lead to heavy drinking

·         Create ways to deal with stress such as exercise, walking and reading

·         Limit the amount of alcohol you have in your home

·         Find hobbies that don’t involve alcohol

·         Seek support from friends and family or co-workers

Dr. Mathew adds that if you start feeling guilty about drinking, find yourself becoming easily agitated, or drinking at odd times of the day, it might be time to seek professional help. For more information on behavioral health services, visit the OSF HealthCare website. 

 

Interview Clips 

When talking about the good and bad of pregnancy, you might have heard terms like postpartum depression or, more casually, baby blues.

It’s critical new mothers get help in this area, says Tiffany Waters, a birthing center charge nurse at OSF HealthCare. She says up to 80% of moms experience the so-called baby blues. But when talking about maternal mental health, experts prefer the umbrella term: perinatal mood, anxiety and depression (PMAD). Perinatal refers to the time between conception and one year after delivery.

PMAD basics

Waters says for two to three weeks after delivery, most women experience hormone changes, a lack of sleep and general stress related to the “new normal.” Having a traumatic birth, like an emergency caesarean section, can compound mental health impacts. Waters says around one-third of women fall into this category.

All these factors can lead to a variety of longer-lasting PMAD symptoms, including brain fog, weeping, sleep changes, anxiety, depression, obsessive or compulsive behavior and even suicidal thoughts.

“There’s no one single cause that leads to a person experiencing these issues. It’s a combination of psychological, societal and biological factors,” Waters says. “There’s nothing a mom has done to get or deserve this experience. The best we can do is help her work through it.”

Screening and treatment

Waters says health care providers should screen a woman for depression and other mental health issues during and after pregnancy.

“There are commonly used tools,” Waters says. “The woman answers 10 questions. It gives us a rating on how their emotional and mental well-being is.”

She’s referring to the Edinburgh Postnatal Depression Scale (EPDS). Each question is scored 0 to 3, with 3 being the response that most signals a possible mental health issue. That’s 30 total points, and a final tally of 10 or higher would warrant further evaluation.

Waters also says research is ongoing into whether certain biological markers in a woman are a sign of mental health issues to come.

“It can be difficult to admit or even recognize that a person is having depression or anxiety symptoms,” Waters says. “There are lots of reasons for that. There’s societal pressure to be a great mom. Moms might feel like if they admit how they’re feeling, their children might be taken away.”

Waters says journaling or talking to a trusted adult can help a mom document the issues she’s facing, opening the door for her to get help.

If a mom is diagnosed with PMAD, a provider will talk with her about resources like support groups, counseling, spiritual care and medication. Daily things like improved diet and exercise and exploring new hobbies can also help. And Waters says mothers should not be afraid to prioritize themselves. It’s OK to ask for a break from daily housework, for example.

Why it’s important

Waters says untreated PMAD can have consequences for the whole family and the people around the family. Substance abuse and domestic violence can increase. But if treated, it means a better life for everyone.

“It will improve the whole family dynamic,” Waters says. “It will lessen stress for everybody and lead to a happier unit.”

Learn more

Read more about pregnancy and birth and behavioral and mental health on the OSF HealthCare website. If you are in crisis, the Suicide and Crisis Lifeline is 9-8-8.

Interview clips

Related stories

Mental health care starts with a first step
Being open and honest about mental health
Suicide prevention involves all of us
Shining a light on perinatal depression
24-7 connection through OSF OnCall empowers patients and improves outcomes

As the stigma around mental health continues to improve, people are more likely to seek treatment. A woman who has just learned she’s pregnant may wonder: should I stop taking medicines like Zoloft or Prozac? Will they hurt my baby?

Sarah Shoemaker, a certified nurse midwife at OSF HealthCare, says first of all, you’re not alone. She says around one in five women experience a mental health concern during pregnancy, and many of those women are taking medication for things like anxiety, depression and bipolar disorder. Shoemaker says most of the time, you can and should stay on your medication. But it’s a conversation you should have with your health care team.

Shoemaker implores women to talk about medication with their provider early Ideally, it’s before they conceive. Shoemaker says don’t change or stop your medicine routine until you have that talk. You may have your child’s best interest in mind, but a change could compromise your or your child’s health.

“There are some women who take years to find the perfect combination of medications that keep them stable and healthy. We don’t want to mess with that. Very rarely do we have to completely disrupt somebody’s medication regimen,” Shoemaker says. “Nothing in our field is black and white. There’s no such thing as bad medication or strictly dangerous medication. We weigh the pros and cons and decide what’s best for each patient.

“If you look online, you’re going to find all kinds of information. You’re going to find conflicting sources, old studies and poorly written studies,” Shoemaker adds, referencing the temptation to rely solely on your own research.

Shoemaker says a provider may order one or more ultrasounds before making a decision on medication. If a provider advises that a change is needed, you could go on a supplement. For example, Shoemaker says a medicine like valproic acid (a seizure medicine sometimes used for bipolar disorder) may increase the risk of neural tube defects (NTDs) in your unborn child. Spina bifida, or the abnormal development of the spinal cord, is a common NTD. In this case, a provider may advise adding a folic acid supplement at a high dose. Shoemaker adds that for medications like valproic acid, drugmakers and doctors are vocal up front: don’t start taking it if you’re trying to get pregnant. That way, you don’t have to possibly make a change mid-pregnancy.

If you’re on a medication that’s new to the market, that’s also a definite “must talk about” with your provider. That’s because we don’t know a lot about how new medications impact pregnancy. Shoemaker points out that scientists typically don’t do intense studies on pregnant women so they don’t disrupt the pregnancy. Rather, the research is done after birth.

“We discuss what the woman is on, how we can counteract the risk and what the actual risk is for her specific situation. Then we can make a shared decision about what is best for her and her family,” Shoemaker says. She adds that the woman’s entire care team – their primary care provider, their mental health provider and their OB/GYN or midwife – should be working together.

Shoemaker admits all this can be a tough task. But there are tried-and-true ways to get to the root of a pregnant woman’s mental health concern. Providers also build extra time into appointments to talk about mental health. Shoemaker says she often uses humor to break the tension. She can also use personal experiences to relate to the mom-to-be. And she’s also not afraid to ask a lot of questions: are you sure there’s nothing else we can talk about? How are you doing emotionally?

“If you continue to ask in new and different ways, women eventually open up. They say ‘yeah, this is really bothering me. I wondered if it was normal. I was afraid to talk about it,’” Shoemaker says. “Once you make it clear that the provider is a safe person to talk to and mental health is really important, women will open up.

“More women need to talk about how difficult it can be to be pregnant, to be a mother and to be going through this huge life transition,” Shoemaker adds.

Learn more about how you can a successful pregnancy and birth on the OSF HealthCare website.

Interview clips

Related stories

Navigating the baby blues and more
Is it just baby blues or postpartum depression?

Mental health challenges in young people

Brittany Algee, APRN, a board-certified psychiatric nurse practitioner at OSF HealthCare, says people Jamie’s age – late teens to mid-20s – have unique mental health challenges.

“It’s the transition phase into adulthood. They’re transitioning into college or a career. They’re starting a family. They have the pressure of being successful. There are financial constraints. They’re figuring out their lives,” Algee says. “They have this unrealistic expectation at 18 to have everything together. It’s very overwhelming.”

That can lead to anxiety and depression, and Algee says social media can make it all worse. Daily, symptoms can look like a lack of motivation, intrusive thoughts, worrying, eating too little or too much, irritability and poor hygiene. Parents should be on the lookout for all these.

“Maybe the child doesn’t want to talk as much. The child is self-isolating. You ask what they did over the weekend, and they say they stayed in bed. Or, they’re not going to class. Maybe the parent is getting a letter saying the child is on academic probation,” Algee says. “Those are red flags to ask ‘What’s going on? Why are we feeling that way?’

“Ask about sleeping habits, too,” she says. “Are they sleeping too much or not enough? Is there substance abuse going on? They could be doing that to self-medicate.”

If parents identify a problem, Algee suggests getting the child in to see their primary care provider, who could provide short-term help like medication while referring them to a mental health provider.

Some other tips from Algee and the Boones:

• Get outdoors to clear your head.
  
  “Exercise. Do some hiking or biking. Find hobbies and things you like,” Algee suggests. “I tell my patients not to wait until you have a buddy to do something you like. Nine times out of 10, you’re going to find some like-minded person you’re going to get along with. So if you want to go hear live music, go do it. There will be people there who like live music, too. That will help you meet new people.”
   
• When talking to a loved one about suicide, Johnny Boone says don’t be afraid to get specific. Ask if they have weapons at home. If so, ask to take them or change the combination to the gun safe, for example.
   
• Be mindful of how you talk about mental health and suicide, too. For example, Anita Boone suggests steering clear of phrases like “committed suicide” or “afflicted with mental health” because the person might feel judged.

Grieving a loss

Since Jamie’s death, Anita and Johnny have been in counseling, and Anita hasn’t returned to her accounting job at the University of Illinois. It’s proof that everyone grieves differently, and there’s no schedule for it, Algee says.

“There are numerous stages of grief,” Algee points out. “It’s imperative that you work through all of those stages. Seeing a mental health professional is going to be very beneficial in helping you get through those stages effectively and process the grief.

“Losing a child is absolutely horrific,” she adds. “It’s not something you can put a timeline on. You’re not going to get through it in a few weeks or years. It’s a void that’s difficult to fill. So just make sure you have resources like a therapist, medication and an overall support system.”

For the Boones, grieving involved changing their routine. Driving through the University of Illinois campus where Jamie once thrived is tough, so they steer clear when they can. A hobby of theirs – camping – is out in favor of a simpler outdoor activity – kayaking. Sometimes the couple talks while on the water. Sometimes they just float and cry.

There are even unconventional ways to grieve, as long as you do them safely. When Anita and Johnny need to get emotions out, they’ll take a baseball bat to a plastic pail in their backyard. Neighbors will peek over the fence, and Johnny will flash a thumbs up to show that no one is in danger.

The Jamie Boone Project

Johnny and Anita are still grieving, but they have turned pain into purpose by founding a nonprofit, the Jamie Boone Project. The pair spends hours toiling in their living room, assembling J.A.M.I.E. bags. It stands for Just A Mental Inventory Everyday. The bags contain things to take your mind off the world (stress balls, fidget spinners, journals and coloring books) and also steps to get long-term help, like information about the 988 Suicide and Crisis Lifeline and the 741741 Crisis Text Line. Johnny and Anita take the bags to schools, hospitals and anywhere else that could use them.

“We know it’s not curative. It’s just one way to get them through the moment,” Anita says. “For example, some people in a mental health slide might struggle to journal about positives in their life. Instead, the J.A.M.I.E. bags ask you to write down three things that didn’t stink today. It could be something as simple as ‘the car started this morning.’”

The couple has also visited schools and had students write what they call S.A.G.E. words. That stands for Student Affirmations of Grace and Encouragement and is a nod to the Monticello High School mascot, a sage owl. Through S.A.G.E. words, students write things they like about their classmates. Johnny compiles the comments and gives them to each child, sometimes at a milestone event like graduation. It emphasizes a simple message, one that’s on a sign outside the Boone home: you matter.

“We always hear the negative things about us,” Johnny says, speaking generally about how words can hurt. “We need to be more intentional. We need to hear positive things. You don’t realize how much you mean to people.”

“I’ve not had anybody not give us positive feedback on all our work,” he adds. “Monticello and the area have embraced us.”

“I think what the Boones are doing is absolutely phenomenal,” Algee says.

Learn more

If you are experiencing mental or behavioral health issues, such as depression, anxiety or addiction to alcohol or drugs, there are resources available.

• The OSF HealthCare website lists resources such as support groups and SilverCloud, an anonymous online platform available to people 18 and up living in an area served by OSF, even if you’re not an OSF patient.
   
• The 988 Suicide & Crisis Lifeline. The lifeline encourages veterans to press one to be linked with resources unique to that group.
   
• The 741741 Crisis Text Line, similar to 988. This hotline’s website encourages you to reach if you simply “need to vent.”
   
• The Substance Abuse and Mental Health Services Administration, or SAMHSA.
   
• The Jamie Boone Project website lists other resources and hotlines.

“Talk to somebody. A professional, a friend,” Johnny urges. “Make a mental health safety sheet. Write down what things calm your spirit and who you can talk to. Anything that will help you get through a stressful situation. When you’re in the middle of the stressful situation, you’re not going to remember that you like to listen to a certain music to calm you down. You need to write it down. And make sure you give a copy to a friend or family member you talk to a lot. That way, they can spot the warning signs.”

“It’s OK to not be OK. You’re not alone. Don’t be afraid to have the hard conversation because suicide does not discriminate,” Anita says.

Interview clips - Johnny and Anita Boone

Interview clips - Brittany Algee

B-roll

Additional B-roll

Johnny Boone explains the Jamie Boone Project

Johnny Boone explains the J.A.M.I.E. bags

Related stories

Is it depression, ADHD or bipolar disorder?
Suicide prevention involves all of us
PTSD has a wide range of treatments
Don't feel the burn
Difficult, not bad: Navigating tough conversations
Fall into self-care
College student home? Here's how to check their mental health
Big emotions, bigger solutions

• Cognitive behavioral therapy (CBT).
  
  “This helps you work on your mind space and teaches ways to be more self-aware of your thought process. But it also helps behaviorally. You learn the triggers that make your body feel a certain way,” Elliott says. “Be aware your heart rate is increasing and that you’re irritable. Then you learn to build those coping skills and protective factors to not let something like misophonia affect the way we function at outings.”
   
• Meditation
   
• Know your limits. This is where loud, crowded holiday parties come into play.
  
  “Make sure you’re separating yourself [from the other partygoers] if that’s what you need to do,” Elliott suggests. “As a host, you can play background music or have a TV going for background noise. That can help muffle those other sounds that might be irritating.”
  
  Separating yourself could mean eating your meal in a separate room or just sitting at the opposite end of the table from the friend who’s a loud chewer. Either way, Elliott says to be self-aware and collect yourself before jumping back into the social swimming pool.

Learn more

Read more about healthy thoughts and behaviors on the OSF HealthCare website.

Photos

Interview clips

Related stories

Is it depression, ADHD or bipolar disorder?
Mental health care in your golden years
PTSD has a wide range of treatments
Don't feel the burn
Difficult, not bad: Navigating tough conversations
Fall into self-care
Big emotions, bigger solutions

• In one-on-one therapy, Varble says you’ll talk about making changes to your thoughts and actions to improve your mood.
  
  “What you think determines how you feel, and how you feel determines your behavior,” Varble sums it up. “So if we can change the way someone is thinking about something, many times it changes how they feel about it. And then it changes how they address it and behave toward it.”

• Varble says many of those same concepts are covered in group therapy. The benefit of a group is having a shared experience. You hear from others in your shoes, feel less isolated and become open to new ways of thinking.
  
  “Maybe they all agree they can’t tell their family [about their struggles]. They won’t understand. Then the therapy part of the group is for me to challenge that. I’ll ask: How else can we think about this?” Varble says.
   
• Learn to be assertive and advocate for yourself.
  
  “Speak directly. Communicate what your needs are. Maybe even argue for what you need,” Varble suggests.
  
  She adds that after a long day of the daily grind while dealing with pain, perhaps the last thing you want to do is talk a lot. But it’s important to speak up. She gives the example of going for a medical procedure. It’s not wrong to tell your provider, “My anxiety and pain are bad today. Is there anything you can give me to calm me down before I go in the MRI machine?”
   
• Recognize that chronic illness burnout (physical, mental or emotional exhaustion that makes it difficult to navigate life) is real. Varble says constant doctor appointments and the logistics that come with them can wear you down. 
  
  “[Friends and family] should watch for the person not taking their medications, becoming more apathetic about taking care of themselves and isolating more,” Varble says.
  
  “Burnout might be resolved by having someone in your circle make the appointments. Or give in and get a case manager who can do these things for you,” Varble adds. “Using resources doesn’t mean you’re not independent. It means we’re independent enough to know what resources to use.”

• Also for friends and family, “listening to their needs is always good,” Varble says. Offer to run an errand for the person struggling. Or propose a way for you to tackle the task together and let your loved one keep some independence.
  
  “See how they innovate new ways of doing it. Encourage their creativity. Have them find their own resources,” Varble says. “They then build confidence.”
  
  For example, if someone is dealing with pain flare ups while grocery shopping, they could explore “plan Bs.” Could I bring someone with me to help? (Varble says to frame this as a blessing of fellowship, not a burden.) Could I leave the store mid-trip? If so, what’s the plan to return the items to the shelves and get to the car? Or could I explore other ways to shop, like curbside pickup or delivery?

Learn more

Read more about healthy thoughts and behaviors on the OSF HealthCare website. If your mental health concerns have reached a crisis where you are thinking about harming yourself or others, talk to a trusted adult or mental health professional or go to the emergency department right away. The 988 Suicide & Crisis Lifeline is also available.

Interview clips

Related stories

Fall into self-care
Big emotions, bigger solutions
Seeing a counselor in your golden years? Mind these misconceptions
Suicide prevention involves all of us
No more “tough it out”
PTSD has a wide range of treatments
How old is too old to drive?

The transition to menopause – when a person permanently stops having menstrual periods – can bring symptoms like hot flashes, night sweats, irregular periods and anxiety. Women may want to find assistance with these symptoms.

Dennis Sands, MD, is an OSF HealthCare gynecologist and chief medical officer at OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois. He cautions you to be wary of over-the-counter medication that claims to help with all menopause symptoms.

“In general, a lot of the at-home remedies are marketed very well. They are touted as cure-alls or things that will work for the most common complaints, like hot flashes,” Dr. Sands says. “What we’ve found is most of them don’t work.”

Dr. Sands adds that these medicines are marketed as dietary supplements, not pharmaceuticals. So, there’s more wiggle room to make claims about their benefits. Dr. Sands says he’s seen menopause medicine labels at the pharmacy that tout vitamin, soy or phytoestrogen ingredients. Equelle is a common brand name. Dr. Sands says these medicines can have a minor effect on menopause symptoms in healthy people, but they are not cure-alls or effective for all people. In particular, he says irregular bleeding usually requires a treatment plan laid out by a health care provider and an evaluation to rule out something more serious.

That’s where your gynecologist comes in, with Dr. Sands reminding that treatment is different for everyone. The first advice you’ll likely hear: keep up with your health.

“We’ve noticed that people who are healthy overall, exercise well, sleep well and are in good relationships generally do pretty well in the menopausal transition,” Dr. Sands says. “The more stress people are under, the more they’re not as healthy as they could be, the more their sleep is disturbed. It seems a lot of those people tend to have a more difficult transition.”

Estrogen patches and progesterone creams can also help, especially in younger women. A provider may also see if other medications you’re taking are making your menopause symptoms worse.

“If you’re struggling, see your provider and review all the options,” Dr. Sands suggests. “There are some great options that are effective and safe. Generally, they’re only used for a short time to get people through the transition.”

Interview clips

Related content

Introduction to menopause
How to cope with perimenopause

College students will soon be home for summer break. They’re embarking on their independent phase, so opening up about mental health to their parents might not top the summer to-do list. It can leave parents wondering: How did the school year go? Did they make friends? Are they doing OK mentally?

Rachel Yuhas, LCPC, a psychotherapist at OSF HealthCare, says there are dos and don’ts to get the most out of a conversation with a young adult.

School stress

Yuhas says going off to college is a huge transition. The student may miss home. They may have trouble being accountable with no 8 a.m. to 3 p.m. structure they had in high school. Making friends can also be difficult. Yuhas says college students may be stressed and scared to branch out and meet people.

“They might be anxious or get into a rut of depression. They might isolate. They might sleep too much or not sleep at all,” Yuhas says.

Warning signs

Yuhas says parents should watch for drastic changes in their college student’s appearance as a possible “red flag” of a mental health concern. Some weight gain or loss in college is expected, but significant weight changes should warrant a discussion.

“This might mean they’re not taking care of themselves,” Yuhas says. “Stress might be coming on. They might be depressed. All of those things can cause issues with appetite.”

Other things to watch for:

• The young adult is spending most of their time away from others. Maybe they’re in their room sleeping all day.
   
• They drop hints about their college experience, such as “I didn’t join any new clubs this year.”
   
• The person looks messy. Maybe they used to be a snazzy dresser with groomed hair, but they stopped keeping up that appearance. Or they stopped hygiene practices like using deodorant or brushing their teeth. Parents should ask themselves: Is my child keeping up with daily tasks?

Dos and don’ts

It’s time to talk to your child about their mental health.

• Do: Ask open ended questions, and let the child fill in the blanks. For example: How did final exams go?
  
  Don’t: Ask accusatory questions like: What’s wrong with you? Or: Why aren’t you talking to us?
  
  “If you get mad at them, that makes it worse. They won’t want to open up,” Yuhas says.
   
• Do: Find the right time. Let the child get settled back in, and have a conversation over lunch a day or two later.
  
  Don’t: Bombard your student with questions the moment they get into the house.
   
• Do: Curtail your reactions and judgements. Be kind and mindful.
  
  “Instead of asking ‘Why?’, say ‘Oh my gosh. I didn’t know about this. What’s been going on? Tell me more.’,” Yuhas says.
  
  Don’t: Have knee-jerk reactions like: How could you? Or: Why did you fail that class? Or even: You know I don’t like your major. Why haven’t you dropped it yet?

Next steps

After that first conversation, Yuhas urges parents to not let the issue go.

“I encourage parents to become emotion coaches with their children,” Yuhas says. “Continue to check in. Continue to ask, ‘How are you doing?’ or ‘I saw the college had this event. Was it something you went to?’ Just stay involved in their everyday life, but don’t bombard them.”

If things aren’t improving, the conversation might turn to: I want to help you. Have you thought about talking to a therapist? Would that be a good option?

“Put the ball in their court,” Yuhas says.

“When we go off to college, it can be a huge adjustment. So we try to normalize their feelings,” Yuhas adds, outlining what she might talk to a college student about in a therapy session. “We go over ways to make friends and socialize. We go over how to manage stress, anxiety and depression. We talk about coping skills.”

For example, if a student is leaving their dormitory just for class, Yuhas may suggest going to the library to study. The student may make a friend along the way. Yuhas may suggest exercise or meditation. Or, is homework procrastination causing stress? There are ways to change those habits.

Learn more

Read more about healthy thoughts and behaviors on the OSF HealthCare website. If your stress has reached a crisis where you are thinking about harming yourself or others, talk to a trusted adult or mental health professional or go to the emergency department right away. The 988 Suicide & Crisis Lifeline is also available.

Interview clips

Related stories

Difficult, not bad: Navigating tough conversations
Big emotions, bigger solutions
I'll do it another time
Fall into self-care

Up to 95% of kids age 13-17 and nearly 40% of children age 8-12 use a social media platform, according to the U.S. Surgeon General.

The report “Social Media and Youth Mental Health” says evidence indicates that there are “ample indicators” that social media can have a “profound risk of harm to the mental health and well-being of children and adolescents.” Additionally, the advisory says that social media usage can disrupt vital activities for someone’s health and well-being like sleep and physical activity.

It’s no secret a major part of posting that “picture perfect” moment happens after the picture is taken. Through editing with filters, body positioning, and now even artificial intelligence, the photos you see of those you follow may not be an accurate representation of their life.

Kyle Boerke, Psy.D, is the director of behavioral health outpatient services for OSF HealthCare and a clinical child psychologist. He says what we go through as social media users when looking at the influencers we follow is called “upward social comparison.”

“You, as a teenager, take your worst day and you are comparing it to this video of somebody’s best day. Or I would say, artificial day, because it’s not real due to the filters and editing,” Dr. Boerke says. “We have a lot of research that talks a lot about the direct correlation between time spent on social media and an increase in anxiety and depression. We’re talking about a one-to-one correspondence where every hour spent on social media increases your likelihood of anxiety and depression.”

What can we do?

“Limit your exposure to social media as a whole. But certainly, limit those individuals that are negative and that are body shaming. There are body positive individuals out there.”

Dr. Boerke says, in many cases, the people you follow on social media aren’t your friends. You don’t know them personally, and you’ve probably never met them, and never will.

“More important than who you follow on social media is who you surround yourself with in real life. Surround yourself with positive individuals in real life. Surround yourself with people who truly know you, care about you, support you and are going to be there for you in hard times,” Dr. Boerke adds.

Social media is a tool

While social media is used, whether intentionally or not, for negative purposes, there are some cases where it can be used for positive outcomes.

“There are influencers out there that have a good message on body positivity and being healthy, as opposed to your weight and what your figure looks like. However, for every one of those, there are ten to twenty that by using filters, Photoshop and artificial nature. How they portray themselves can be a huge influence,” Dr. Boerke says.

In most cases, people may hear “social media” and think of the apps Instagram, X (formerly known as Twitter), Snapchat and Facebook. But he says a major social media platform reaching the youngest of kids is YouTube.

“I just want to caution everybody that even at a young age, be aware of what they’re watching and be aware of how much time they’re spending on these,” Dr. Boerke says. “While the themes throughout these YouTube videos are mostly good, there’s still probably some upward social comparisons happening even with our six and seven-year-olds.”

What if I’ve built a community on social media?

Connecting with people going through your same experience can potentially be good.

But Dr. Boerke says that can also be troubling, because you can get into a group with people who feel/think the same way you do, and they recommend you do something that is detrimental to your health.

“If you are struggling, tell an adult in your life and ask to talk to somebody. Start with your pediatrician or primary care physician. They can get you in touch with a therapist or psychologist that can help have those discussions with you,” Dr. Boerke says.

OSF HealthCare offers behavioral and mental health services across the Ministry to support adults, teens and children seeking diagnosis, short-term treatment or long-term management of mental and emotional health challenges.

The services offered can best fit your needs, from outpatient therapy to medication management. If you’re interested in speaking with a medical professional, visit the OSF HealthCare website.

Video Interview Clips

Lavender Zarraga, APRN, a behavioral health provider at OSF HealthCare, says it’s not uncommon for her patients to ask for a medication that isn’t the right fit.

The culprit? She says symptoms of common mental health issues like depression, attention deficit hyperactivity disorder (ADHD) and bipolar disorder can overlap. So, it’s important to stay in contact with your provider to make sure you’re on the best treatment plan.

On depression mimicking ADHD: “You have changed executive functioning. You can’t decide. You feel dull. You can’t concentrate,” Zarraga says. “You have a hard time learning new things. You can’t remember things or forget things easily. Attention and concentration are low. You think ‘Why am I processing everything so slow?.’”

Zarraga adds that she’s seen people with depression take prescribed medicine and feel better, but then residual symptoms that mimic ADHD creep in. And, she says, ADHD can seem like bipolar disorder.

“If you start somebody on an antidepressant and they have an underlying bipolar disorder that they have not been diagnosed with, that can trigger mood symptoms. It could potentially trigger mania [a high energy period where high-risk behaviors can occur],” Zarraga says.

It’s a lot to sort out, and it may make the person feel like they have a whole new set of problems.

“Talk to a provider. See what’s going on,” Zarraga says to people in that situation, noting that kids should not have to carry these issues into adulthood.

“There’s a lot of talking involved,” she adds. “Let’s start from the beginning. Let’s go back to your childhood. How were you doing then? And we relate that to how you are now.”

From there, Zarraga says treatment could include more counseling or different medication. She says medicine for children is more straightforward. But for adults, a provider will make sure the pill isn’t impacting the rest of the person’s body.

There are also science-backed written tests that can help diagnose someone with ADHD. Questions along the lines of: Can you sit still in class? Does your mind wander all the time?

And a word for caregivers, friends and family members: watch for symptoms of these disorders in your loved ones and have a conversation, if needed. Don’t ignore things, Zarraga says.

“There’s nothing wrong with just talking about it. It’s not going to hurt anybody to discuss it,” she says, noting that society is now more accepting of mental health issues.

Signs to watch for in your close companion: irritability, aggression, anxiety and trouble sleeping. If you or someone you know needs to talk to a professional quickly, the national suicide and crisis lifeline is 9-8-8. And the OSF HealthCare website lists other resources.

Interview clips

Related stories

Seeing a counselor in your golden years? Mind these misconceptions
Becoming friends with artificial intelligence
PTSD has a wide range of treatments
Suicide prevention involves all of us
Being open and honest about mental health
Fall into self-care

It’s summertime. Now that kids are off school for a few months, there’s sure to be plenty of changes in their routines including their eating habits. Fast food, candy and fair food can all contribute to tummy aches.

Stomachaches are quite common in young children. It can be something simple that comes and goes quickly or it could be something more severe.

According to a national poll conducted by C.S. Mott Children’s Hospital at the University of Michigan Health, one in six parents say their child complains of a belly ache at least once a month.

“There are so many different reasons that a child could complain of a stomachache,” says Alissa Bartel, a nurse practitioner with OSF HealthCare. “It could be something easy, like constipation or something they ate, food allergies or indigestion. They could have come across a virus at school or on a play date or even in their own home.”

Stomach pain, however, could also mean more serious problems, such as appendicitis, bowel obstructions, urinary tract infections or even hernias.

“If your child is someone who does not complain about things, and they're complaining about a very bad pain that’s bringing them to tears, that serious,” Bartel says. “A fever is another serious symptom, and swelling of the belly can also indicate something more serious.”

But the issue may not be physical; it can also be related to stress or anxiety. Bartel says that if parents notice a pattern every time that they're getting ready to go somewhere, for example, whether it be school or an activity and it turns into a recurrent tummy ache, that's a sign that it may be anxiety related.

Bartel says parents can help their children develop coping skills and change their routine. Most children will eventually outgrow a nervous stomach.

“It's really about looking at patterns, knowing our kids and paying attention to the signs they give us,” she says.

Fortunately, there are ways to help our children overcome their tummy aches. If it’s food allergies, finding those trigger foods can bring relief. If it’s constipation, changing their diet or medications can help. And if it’s anxiety or nerves, Bartel says parents can help their little ones to relax by talking with them, teaching them breathing exercises or distracting them with activities they enjoy such as a game, movie or book.

Bartel says the best advice she can give any parent when it comes to tummy aches is to trust your own gut.

“If you think that something is wrong with your child, take them in to be evaluated immediately,” she says. “There is never anything wrong with erring on the side of caution.”

If your child experiences severe pain, fatigue, trouble breathing, dehydration or blood in vomit along with stomach pain, call 911 immediately or take your child to the emergency department.

Interview Clips 

B-roll

Four of the new emotions in the upcoming Disney/Pixar movie Inside Out 2 – the latest peek inside the mind of now-teenage girl Riley – are sure to ring a bell.

But what’s ennui?

A quick Google search will tell you it’s just another word for boredom. But there’s more to it than that, says Kyle Boerke, PsyD, a clinical child psychologist and the director of behavioral health outpatient services for OSF HealthCare. And you can also count Dr. Boerke as a fan of the Inside Out franchise. He says the first movie and the trailer for the second get a lot right when it comes to kids’ emotions and how parents can help.

Ennui demystified

Dr. Boerke says ennui (pronounced awn-WEE) describes an angst or listlessness-type boredom that develops in the pre-teenage or teenage years. It can show itself in adulthood, too, but the younger years are the prime time.

“As we learn to regulate our emotions better, you’re going to see less of that emotion overtly,” Dr. Boerke says. “It will still be there, but we’re learning to express it better.”

Children experiencing ennui may mope around the house or not be interested in things they used to, like playing with Legos.

How parents can help

Should we learn about emotions from Hollywood? Common sense says to take everything on our screens with a grain of salt and to talk to a health care provider for trusted advice. But Dr. Boerke says parents can use the Inside Out movies to teach kids about healthy behaviors.

“The biggest thing we can do with children from a young age is understanding and naming emotions,” Dr. Boerke says. “If I can get a two, three or four-year-old naming emotions, I have succeeded. And the first Inside Out movie did a fantastic job with that.”

Some things to consider when chatting before, during or after these movies:

• There are no “bad” emotions, Dr. Boerke says.

“If something sad happens, it’s okay to be sad. If something frustrating happens, it’s okay to feel anger,” he says.

“While there are no bad emotions, I can express an emotion in a bad way,” he adds. “I can express happiness in a bad way by overindulging in something. Or sometimes happiness comes out as anger. I’m so excited and happy that I go and tackle my friend to the ground.”

• Dr. Boerke says ennui, like other emotions, has a good middle ground. Children shouldn’t be overstimulated or completely bored. But somewhere in the middle lies a silver lining: a spark of creativity. A child may, out of boredom, go outside and kick a soccer ball around, sparking curiosity in a new hobby. Or they may call a classmate, leading to a new friendship. Dr. Boerke says sometimes it takes a mental health professional to light the spark.

“Often, I don’t even say things that are different than what parents say. But I’m not mom or dad. I’m not the caregiver,” Dr. Boerke remarks. “It’s what we call behavioral activation. Let’s come up with things to do to help you become less bored.”

• Don’t bottle up emotions. The Inside Out 2 trailer even addresses this in a tongue-in-cheek way, showing Riley’s emotions from the first movie – joy, sadness, anger, fear and disgust – in a literal bottle.
  
  “If they do it as well as I think they will, this will be a great conversation starter,” Dr. Boerke says.

“An emotion, if left to its own devices, is going to come up. You’re going to express it, hopefully appropriately. And it’s going to go back down again,” he adds. “However, if we bottle that emotion up, it’s going to fester and rise until it can’t be controlled. Then it comes out in an inappropriate way.”

For example, a child may continually bottle up frustration over being asked to clean their room until they trash the room. Long term, behaviors like this can impact a litany of things: the child’s mental health, physical health, performance in school and relationship with peers. Plus, it strains the rest of the family.

Learn more

Read more about mental health resources on the OSF HealthCare website.

Interview clips

B-roll

Inside Out 2 trailer

Related stories

Digital mirrors: Kids' body perception
Talking to kids about the Kansas City parade shooting
Keeping kids safe in crowds
I'll do it another time
Becoming friends with artificial intelligence
Establishing routines in non-traditional families
Group therapy: Not what you see on TV

A survivor of a 2019 heart attack, Randy Isham was already on notice.

But Randy and his wife Dawn, retirees in Mansfield, Illinois, couldn’t predict the chaotic events of May 24, 2023. An ambulance took Randy to OSF HealthCare Heart of Mary Medical Center in nearby Urbana, and the man was soon fighting for his life due to a second heart attack.

“I’m glad to be alive,” Randy puts it plainly.

The Ishams and their OSF care team have now joined the chorus of heart health advocates, urging others to know when everyday exhaustion or dehydration is something more serious, especially if you have a history of heart issues.

From garage to gurney

On May 24, Randy was assembling a table in the garage when he began to feel weak but had no pain.

“When I touched his arm, it was a cold sweat,” Dawn recalls. “That’s when I got concerned that this didn’t seem right. Let’s call 9-1-1.”

It was in the ambulance that first responders determined Randy was having a heart attack. That’s when the flow of oxygen-rich blood to the heart is narrowed or blocked. Heart cells begin to suffer damage and die, and the heart no longer works how it should. Serious, life-long health issues or even death can result.

Randy coded at the hospital, adding to the urgency.

“It means there is no pulse. The heart stops. There is no blood reaching the brain and the whole body,” explains Tariq Enezate, MD, one of Randy’s OSF cardiologists. “When that happens, you need to know why and act fast.”

As the hospital pastoral care team and other Mission Partners (employees) kept Dawn informed, Randy was fighting for his life. He was without a pulse for 20 minutes, Dawn says, before Dr. Enezate’s team was able to revive him. Along the way, they removed a blood clot stemming from plaque buildup that they believe was the source of the heart attack. They then put in a stent. Randy is up to three stents, he points out, after his 2019 heart attack. It’s something he can speak about with relative ease now, but the nine-day hospital stay was no laughing matter.

“It could have gone either way,” Dawn says. “They wanted me to call the family in.”

Dr. Enezate describes the scene: “I had to go inside his heart while they were doing chest compressions. I was able to open [the blocked area in] his heart. At that moment, blood flow started back to the heart, and his pulse came back.

“Minutes mean muscle,” during heart attacks, Dr. Enezate adds. “The faster you restore flow in the artery and put a stent in, it’s better for the patient. It relieves their pain. It decreases the risk of complications.”

Lessons learned

Dr. Enezate calls Randy his miracle patient, and the Ishams agree.

“It was lucky he made it,” Dr. Enezate says. “I think the fact he came in early helped him.

“When we saw him coming back, that moment I can’t describe. It’s worth the world for all of us,” he adds.

Dr. Enezate’s affirmations “just gave me a nice warm feeling,” Randy says.

“Everybody there treated me like I was the only patient they had,” he adds, noting daily visits from Pastor Dave Jassman gave the couple strength.

Randy is back at home, doing well and receiving care typical for people who have suffered a major heart event, like therapy through OSF Home Care and cardiac rehabilitation. And he and Dawn are back at the healthy lifestyles that became the norm after Randy’s 2019 heart attack. Exercise is good, but no long work periods in the summer heat, for example. You’ll find Dawn cooking fish instead of steak. A tough, but necessary adjustment, Randy chuckles. Recipes from the American Heart Association also help.

“I used to think I was invincible, but I realize I’m not anymore,” Randy says.

The Ishams are also urging others to research trusted sources and learn not just the signs of a heart attack, but how to tell the difference between those signs and everyday pain like Randy thought he had on May 24. And don’t hesitate to call 9-1-1 when something is wrong.

“It could save your life,” Dawn says.

Dr. Enezate says the classic symptom of a heart attack is chest pain. Some people describe it as an elephant weighing on their chest. You may also be short of breath, sweat, feel anxious or feel like you’re going to pass out. Or you may have no warning signs, and suddenly you’ve collapsed.

“If you have symptoms and you’re not sure why, call [a health care provider] for advice,” Dr. Enezate advises.

What about prevention for people who’ve had a heart attack?

Practice healthy habits, Dr. Enezate says. Don’t smoke. Take medication as directed by your provider. Control risk factors like diabetes, blood pressure and cholesterol. Exercise and eat right.

Learn more

Read more about how to care for your heart on the OSF HealthCare website.

Interview clips - Dawn and Randy Isham

B-roll

Related stories

Heart attacks: Care is not one size fits all
Senior heart health tips
Heart attack patient celebrates second chance at life
Keeping an eye on first responder heart health
Heart screenings save lives
Sudden cardiac arrest in women
Keeping heart disease at bay
Young people and heart health
Don't delay care with heart attack symptoms
Exercising your heart
For heart attack patients, timing is everything
The 411 on angioplasty
Sneaky symptoms of heart disease
For major health issues, choose an ambulance

Feeling bloated today? You’re not alone.

It’s not uncommon to get the sensation caused by gas, air or fluid retention in the stomach or small intestine. But what’s important to know: bloating has many causes, says Aminat Ogun, MD, an OSF HealthCare family medicine physician. So don’t let it linger and hope it will go away. If symptoms persist, see a health care provider so they can rule out something more serious and give proper treatment.

“It might feel like your stomach is full, swollen or sometimes tender. It can cause some discomfort,” Dr. Ogun says.

Causes for bloating include:

• The body makes too much gas.
   
• An overgrowth of intestinal bacteria. H. pylori is a common type. Dr. Ogun says it causes chronic inflammation in the stomach lining, and it can lead to peptic ulcers or even stomach cancer if untreated.
   
• Diet issues, like intolerance of certain carbohydrates or a gluten intolerance.
   
• Hormone changes during a woman’s menstrual cycle.
   
• Abnormal gastrointestinal motility. Simply put, this is when your gut is not working properly. Dr. Ogun says one example is gastroparesis.

              “The body takes its time before its able to pass food from the stomach to the small intestine,” she explains.

• Stress, anxiety and depression.

Dr. Ogun points out that we can’t control some of those causes, but others we can. She says a typical first step for a person with bloating is to change their diet. She says doctors may recommend a diet with a long name: fermentable oligosaccharides, disaccharides, monosaccharides and polyols. But just remember the abbreviation: FODMAP. It describes carbohydrates that are difficult for the body to break down.

Foods to avoid on the FODMAP diet: pasta, cereal, bread, yogurt, ice cream, apples, cherries and peaches. Alternatives include quinoa, brown rice, eggs, cheese, grapes, strawberries, chamomile tea, peppermint tea and ginger tea.

“Have a food diary,” Dr. Ogun suggests. “See what triggers your bloating symptoms and see if you can eliminate those foods.”

People with bloating may also take medicine like Gas-X. If you have intestinal bacteria, you’ll be on antibiotic medication.

Dr. Ogun adds for people age 55 and up, bloating is less common, and other health issues are, simply due to older age. So, if you are of that age and have sudden bloating symptoms, see a provider to find out if your symptoms are bloating or something more serious. And for all ages, if you have severe diarrhea, nausea, vomiting or unintentional weight loss, stop by a doctor’s office.

Interview clips

Related content

Gas in the digestive tract
Eating well for digestive health
I ate too much. Now what?
All about the stomach
72 hour fruit diet: myths vs. facts
A punch in the gut
 

·         58% clinical improvement for patients with moderate behavioral health conditions
·         53% improvement in patient depression screening scores
·         50% improvement in patient anxiety screening scores
·         94% patient satisfaction rate with the SilverCloud® by Amwell platform

“Better access to behavioral health services is needed now more than ever. Today, one in every four U.S. adults lives with a mental health condition, yet more than half receive no treatment,” said Ken Cahill, chief behavioral health officer at Amwell. “We are proud to have been selected to enable OSF’s delivery of a hybrid approach to behavioral health care that is delivering such a meaningful improvement in outcomes and patient access to care.”

“The Amwell platform provides a scalable, reliable and flexible framework that can help us meet the growing and evolving needs of our communities now and into the future,” Dietz added.

OSF HealthCare documented alarming trends of suicidal ideation and suicide attempts reaching its emergency departments. The health system selected Amwell to implement a comprehensive hybrid care solution that could enable three main goals: connect individuals with resources as easily and early as possible; manage conditions, reduce severity of symptoms and prevent mental health crises; and provide support for its mental health professionals and care teams.

OSF HealthCare implemented SilverCloud by Amwell, a global, digital mental health platform that provides 24/7 access to digital services for people who have mild to moderate symptoms of stress, depression and anxiety. Starting in 2018, OSF offered the digital program to anyone in its service area without the need for a referral or to be an existing patient and saw steady and positive adoption rates with a 300% increase in enrollments. Today, the program has more than 8,500 patient users.

To extend the powerful benefits of the solution, OSF HealthCare expanded its hybrid behavioral health approach to support teams delivering more acute levels of care, reaching more patients and helping more clinical teams maximize their effectiveness. Most recently, OSF Healthcare extended its use of SilverCloud by Amwell platform through a technology partnership with Illinois State University. This partnership will establish OSF as the sole medical provider for student-athletes and offer access to virtual mental health care via the digital program.

To learn more about the results achieved through the OSF HealthCare and Amwell partnership, read the case study here. 

A mother is speaking out about water bead safety after her 14 month-old daughter swallowed a bead and wound up in the hospital.

Hannah Reif of Iowa tells Good Morning America that her child was vomiting, and doctors later found a one-inch water bead in the girl's small intestine.

Water beads are tactile toys that are marble-sized and water-absorbing. They are often used to reduce stress and anxiety while helping to develop focus and attention. The National Poison Control Center and the American Academy of Pediatrics say water beads can expand inside a person and cause a life-threatening intestinal blockage.

This latest incident with Reif's family is a reminder to know the signs of poisoning and choking and the steps to reverse the effects of each, says Aminat Ogun, MD, a family medicine physician at OSF HealthCare in Champaign, Illinois.

“Make sure there are no loose coins around  - no small toys they can pick up and swallow,” Dr. Ogun advises as a first step. The Consumer Product Safety Commission has a list of recalled products.

Food should be cut into small bites for kids. Chemicals, like bleach used for cleaning, should be capped and stored out of a child’s reach. Cabinet locks add an extra layer of protection.

If your child does ingest something they’re not supposed to, Dr. Ogun advises taking an ambulance to the Emergency Department of your local hospital. Health care providers will assess the child, consulting with the poison control center if necessary, and decide what to do. One option is to pump the poison out of the child’s stomach. If it’s a small object that doesn’t present a grave threat, Dr. Ogun says doctors may see if it will pass naturally in a bowel movement.

Some children may swallow a poisonous liquid and not say anything, perhaps because they don’t even know the seriousness of what they did. In this case, Dr. Ogun says to watch for changes in your child’s health, like vomiting and lethargy, and see a doctor right away.

If a child is choking, Dr. Ogun says there are life-saving steps you can take at home.

For children under one, Dr. Ogun says to lay the child face down on your lap and pat their back five times. Then turn the child over and repeat the pats on their chest.

For older kids, perform the Heimlich maneuver. Dr. Ogun says stand behind the person, wrap one arm around them and place your hand in a fist between their belly button and the bottom of their sternum. Lay your other hand flat on the fist. Then make upward thrusts.

If you’re alone, you can perform thrusts on yourself or thrust your upper abdomen against the back of a chair or the edge of a counter.

Local first responders or health care organizations may offer training on these life-saving techniques.

One word of caution: “Do not put your hand in the child’s mouth to try to get the object out,” Dr. Ogun says. “That could make it worse.”

If these steps don’t dislodge the object and get the child breathing again within a couple minutes, call an ambulance and get to the Emergency Department.

“If the person is turning blue, not able to speak or gasping, those are signs to go to the Emergency Department,” Dr. Ogun says.

Interview clips

B-Roll

Previous coverage

OSF HealthCare Library: Choking and abdominal thrusts

OSF HealthCare Library: Choking in an infant: What to do

OSF HealthCare Library: Poisons

OSF HealthCare Newsroom: Don't choke when planning for summer fun

Anxiety. Depression. Bipolar disorder. Schizophrenia.

They’re daunting diagnoses, but necessary to think about for many people.

And experts say those concerns don’t magically go away when a person reaches age 60 and beyond. Rather, older adults need to keep mental health care in mind and know the resources available to help with concerns unique to that age group.

Ari Lakritz, PsyD, is a clinical psychologist at OSF HealthCare who has taken a keen interest in this area.

“As individuals grow older, they start to prioritize their emotional needs over their professional, financial or more mundane needs,” Dr. Lakritz says. “So you may be surprised when you work with an individual who’s older at how quickly they want to work on the problems in their life and how solution-focused they are as compared to their younger cohorts.”

Dr. Lakritz has seen plenty of examples of this research-backed idea as he’s conducted counseling sessions. For example, an older adult may want to dive right into talking about death or family disputes that have been festering for years.

How does a mental health professional achieve results with this age group? Dr. Lakritz points to a concept called interpersonal therapy, which focuses on a person’s relationships and their overall place in the world.

“That is really what older adults have on their mind at this stage of their life. Many of them are retired. For many of them, financial issues or their professional climbing of the ladder have kind of taken a backseat,” Dr. Lakritz reiterates. “They are focused on their remaining relationships and making them as good as possible.”

A therapy session for an older adult may be structured the same as a younger person’s visit. But a psychologist would need to keep in mind the person’s needs. If the patient has mobility issues, for example, the office should be easy to get in and out of. If the person is homebound, a home visit or virtual visit would be necessary.

Those telemedicine appointments, Dr. Lakritz says, took on extra importance during the pandemic. Some older adults were already isolated, and COVID fears or government mandates to stay home separated them further from visiting their loved ones and practicing social or coping skills. Card games were replaced with phone calls. A trip to the community theater was scuttled in favor of watching the show on DVD.

“On the plus side, I think everyone saw and was pleasantly surprised at how quickly older adults managed to understand technology,” Dr. Lakritz says.  “[They] understand remote meetings and how to participate almost as fast as younger adults who also had to adjust very quickly.

“That was a big game changer in the field that is not going away anytime soon,” Dr. Lakritz says.

Not to mention the sense of pride from an old dog learning new tricks, as the saying goes.

“It’s very much emphasized, even in old age, to continue to pick up new skills. To acquire new knowledge,” Dr. Lakritz says. “That does lead to a great deal of self-esteem. And cognitive stimulation, learning new things, reasoning and being intellectually challenged are some of the biggest protective factors against dementia.”

One last thing Dr. Lakritz says clinicians should keep in mind when serving older adults: confronting biases or falsehoods about that generation.

For example: older adults are slower workers. The data say that’s more folklore than fact, Dr. Lakritz says.

“Many people have this misconception that working with older adults is something that is fundamentally different than working with younger people,” Dr. Lakritz says. “[Many think] you need specific, specialized training or you need to be an older adult yourself to work with older adults. And that serves as a barrier to older adults’ treatment.”

The OSF HealthCare website outlines mental health resources. Taking a look, then broaching the topic with your older friend or family member is a good first step. A necessary one, too, for some older adults who grew up in a time when “self-care” wasn’t a common term.

“If you’re a trusted person in that older adult’s life, and they trust you with more mundane concerns such as helping them get around the house and giving them rides,” Dr. Lakritz explains, “then, I think there’s a good chance they would trust you if you said, ‘I see you’re dealing with this. You’ve been dealing with it for a very long time. You haven’t been able to talk with anyone about it. There is someone we can go to’.”

And make those check-ins with your parents, grandparents and older friends a habit. They’ll be happy you did.

Interview clips

Related stories

Caring for someone with dementia
Mental health care starts with a first step

Model and media personality Hailey Bieber recently revealed that she has been suffering from post-traumatic stress disorder (PTSD) stemming from a stroke in 2022.

“It was so terrifying, so jarring, so discombobulating in every single way that you could imagine,” Bieber told Vogue.

PTSD is often associated with veterans, but it can affect anyone, says Ari Lakritz, PsyD, a clinical psychologist at OSF HealthCare. It describes the development of symptoms following a traumatic event, either through firsthand or secondhand exposure. Secondhand exposure is usually not as simple as, for example, watching news coverage of a violent crime. A more appropriate example, Dr. Lakritz says, is a police officer who routinely investigates those crimes.

Dr. Lakritz describes what may trigger the beginning of a PTSD diagnosis: “Memories of the event. Dreams or flashbacks. Avoidance of stimuli associated with the trauma.”

Those symptoms then change the person’s moods and level of arousal, Dr. Lakritz says. They may feel guilty or unworthy. They are easily startled, irritable and have trouble concentrating. For example, a sexual assault survivor smelling their attacker’s cologne or deodorant may make the person feel anxious or withdrawn.

“This particular set of symptoms can often very much look like depression,” Dr. Lakritz says.

PTSD symptoms can arise right after the traumatic event, or they can appear months later.

Treatment will vary widely depending on the person’s needs, Dr. Lakritz says. Two evidenced-based methods he sees a lot are cognitive processing therapy and prolonged exposure therapy.

Cognitive processing therapy has people challenge or modify their beliefs about the trauma.

“Try to reframe [the beliefs]. Try to make a different end to the story,” Dr. Lakritz explains. “Try to change their thoughts about what happened and about their future and their ability to recover.”

Prolonged exposure therapy “teaches people to gradually approach the trauma in increasingly closer ways,” Dr. Lakritz says. For example, a shooting victim may come to a counseling session and be shown a picture of a gun. Then at a session days or weeks later, they hear the sound of a gunshot. The stimuli increase in intensity as the person learns there is very little to fear now.

Medicine and treatments outside a doctor’s office, like spending time with animals or picking up a new hobby, are also options. The first step, though, is to make an appointment with a mental health provider.

And when it comes to people like Hailey Bieber talking about mental health, Dr. Lakritz says it’s good because celebrities have great influence. But there’s a caveat.

“The more useful part is when they talk about the help they got,” Dr. Lakritz says.

Learn more about PTSD and mental health care on the OSF HealthCare website.

Interview clips

Previous coverage

Coping with trauma during the holidays

PTSD and the 4th of July

Mental health care starts with a first step

Suicide prevention involves all of us

Elexys Rosales, a 25-year-old petite pregnant woman from Bloomington, Illinois, was plagued by anxiety that seemed to get worse at night during her third trimester. Her concern was not only limited to her anxiety affecting the baby girl she’s carrying, but also having a low-weight baby due to her own below-average weight. Fortunately, her doctor suggested a mobile app and online platform providing her 24/7 contact with a care team made up of a nurse, pharmacist, social worker and licensed therapist.

The tool was developed by Get Well, a digital health company founded by cancer survivor Michael O'Neil, who wanted to be more involved in his own care. Together with Peoria, Illinois-based OSF HealthCare and its OSF OnCall digital health arm, they deliver the kind of experience that provides the necessary support for patients such as Rosales where, when and how they want it.

 For Rosales, it means being able to reach out at 3 a.m. when her anxiety is keeping her awake.

“Being pregnant and having anxiety, you get so emotional, and I would be crying to myself at night. I would call the nurses and they would be on the phone with me for hours sometimes, or just 30 minutes to help me calm myself down. They would talk about different things, including my future with the baby.”

Women enrolled in the OSF OnCall pregnancy and postpartum program receive a blood pressure cuff and regularly report their readings through routine check-ins to avoid having high blood pressure that can lead to pre-eclampsia – a potentially, life-threatening condition. High readings or certain patient messages send alerts through the GetWell Loop platform and prompt an OSF OnCall nurse to reach out. In some cases, the call is escalated to a video visit, or an ambulance run to the hospital emergency department.

OSF HealthCare serves 1 million patients a year. Brandi Clark, vice president of Digital Care, OSF OnCall, says digital tools and platforms such as Get Well can expand access to care and provide wrap-around services to improve a patient’s experience, no matter where they are physically and in their health care journey.

By leveraging remote patient monitoring, education, coaching, navigation and virtual care, OSF OnCall optimizes the expertise of highly engaged nurses, many of whom work remotely, ensuring personalized care for patients through many encounters. It also helps retain experienced nurses who embrace the new opportunity to care for patients in a different way, without some of the physical stressors of in-person care.

The ultimate goal is to improve patient outcomes and experiences while reducing costs. Clark says early metrics reveal supplementing in-person care with additional support is paying off.

“We've enrolled thousands of patients who have been discharged from our hospitals and have demonstrated a 10% or greater reduction in hospital readmissions for those patients who are enrolled in that hospital discharge program. Additionally, we're really beginning to learn about the outcomes that we're achieving with our pregnancy program and beginning to actually see some of those patients that we're taking care of delivering healthy babies.”

OSF OnCall Digital Care Manager Kara Roat says Get Well has a nationally recognized library of medical education that includes videos and tutorials that can be customized for specific OSF patient populations. The company’s digital platform was also used to quickly respond to patient needs, such as remote patient monitoring for babies and young children when RSV hit earlier and harder last year. The GetWell loop can offer education to individuals with a new diagnosis, in addition to training for a patient and their- family when preparing to leave the hospital. Roat says communications can include reminders and questions.

“We ask questions like did you pick up your medications from the pharmacy after you left? Do you have a follow-up visit with your provider? Do you have transportation to that visit with your provider to ensure that they're successful as they leave our hospitals, so they don't get readmitted to our hospital if we can prevent it?”

Helping navigate care options

Following the COVID-19 pandemic, engagement via digital technology has rapidly become the preferred form of communication for many, but not all. For patients who need help getting enrolled and learning the basics, OSF OnCall digitally enabled community health workers help patients get connected. Clark explains tools are easy to use and the Get Well platform makes it simple to assess if patients need other support such as food, transportation, rental assistance or other drivers of health.

“If needs are identified, we're able to connect them through our digitally upskilled community health workers who are able to help ensure those members of our community and our patients are getting all the services that they need.” 

Those community health workers are often deeply engaged in neighborhood activities and can be embedded within organizations such as the Salvation Army or the YM or YWCA. They can also be stationed at OSF OnCall Connect Bars that are in select, easy-access medical offices.

 Roat emphasizes the various programs available through GetWell Loop offer a digital safety net that builds trust through a growing relationship with patients.

“All of our services are in addition to the in-person care that patients should be receiving each and every day. We really strive to fill in the gaps for these patients. It allows them to receive care at any time of day or night and have the opportunity to meet with the provider (virtually) or chat with a nurse whenever is needed.”

Part of the education through GetWell Loop includes live, online birthing classes. Rosales likes that she can keep her camera off if she doesn’t feel like engaging. She says sessions dealing with anxiety have been helpful, particularly when she hears other would-be moms talk about how they cope with their struggles. With her own family in Colorado, Rosales says she’s comforted by having round-the-clock support.

“The nurses are like my family of course. So I know they will always be there for me and support me so I would definitely ask many questions about this pregnancy of mine, especially my first time. I just don't want anything to happen to me or the baby so I think it's best to ask as many questions as you can.” 

Rosales also plans to enroll in the postpartum support option available through OSF OnCall, which offers depression screening, education and 24/7 support after delivery. The pregnancy and postpartum program has been able to provide five times the amount of depression screening than is traditionally provided.  Mental health is a growing concern for all ages across health care. Clark says her team is developing more mental health digital support options in the coming months. OSF already offers SilverCloud – a free, secure, anonymous and interactive platform to manage the feelings and causes of mild to moderate stress, anxiety or depression.

Elexys Rosales, Brandi Clark and Kara Roat

Nearly 1 in 10 Americans experience depression. That number is even higher when it comes to young people, with a study in the American Journal of Preventive Medicine finding 1 in 5 adolescents and young adults dealing with depression.

Effects of depression know no bounds, with even the highest-ranking public officials experiencing it. In February, U.S. Sen. John Fetterman, D-Penn., received treatment for his depression at Walter Reed National Military Medical Center. He was discharged in late March, and returned to the U.S. Senate in April. 

After he left Walter Reed, Fetterman opened up about his depression and urged Americans to seek help if they need it.

“Go to the doctor or whoever you’re able to. Address your depression. I was skeptical it would make anything better, but it did. It works. And I’m so grateful,” Fetterman told People Magazine.

OSF HealthCare offers mental health support for patients across the Ministry. Katie Koeller, a behavioral health navigator with OSF, says that speaking with a trusted source can help you get back to being your best self.

“If you’re struggling through all this, you’re not living your best life,” Koeller says. “The sooner you’re able to open up and talk to someone about what’s happening, the better off you are and the sooner you can feel like yourself again.”

Koeller says she, and other behavioral health navigators at OSF, can help people get connected with helpful resources in their local communities.

“I’m a resource that’s free to the community,” Koeller says. “It doesn’t have to be something in our hospital.”

Koeller adds that finding support is very important, but says sometimes it just takes that one person to help you get back on track.

“Find that person who you can confide in. Make sure they’re comfortable with that, but have somebody who can help guide you. Because it’s really hard to do that on your own, especially when you’re struggling,” Koeller says.

If you’re struggling and need immediate help, call the Suicide & Crisis Lifeline at 988. It’s a national network of local crisis centers that provide free and confidential support, and is available 24/7.

OSF HealthCare provides a wide variety of behavioral and mental health treatment options. You can find services, care providers and locations at osfhealthcare.org/mental-health/.

Video Interview Clips

The pros and cons of social media are well documented. It allows you to connect with friends and pursue passions, but bullying and misinformation can be rampant.

But can frequent social media use lead to changes in brain development during the formative adolescent years? A recent study suggests so, but much more investigation is needed, says Karna Sherwood, MD, a neurologist at OSF HealthCare in Alton, Illinois.

The study tracked 169 sixth and seventh graders and found those who habitually checked social media were more sensitive to rewards and punishments. To view it a different way, kids who constantly refresh Facebook hoping the likes on their post will go up may be more impulsive to seek out real-life recognition.

“At a certain point, 10 likes or 20 likes are no longer gratifying enough,” Dr. Sherwood says. “And then you have to find another way to get even more likes or more appreciation.”

That “another way” could lead to risky behaviors such as substance abuse. But Dr. Sherwood says more study is needed to conclusively make the link. Just how much does our life in the digital realm affect our life away from the device?

“A follow up study would certainly investigate if [frequent social media use] has an effect on rates of anxiety and depression,” says Dr. Sherwood. “Could this affect addiction? And what interventions could be taken to nullify those behaviors?

“As a society, if we want to raise happy and healthy people in an age where we are getting better technologically, what steps do we need to take?”

Until then, Dr. Sherwood has some good advice no matter your age or number of Twitter followers.

“Until you get the rest of the information, it’s better to have some degree of regulation,” and restraint with social media, Dr. Sherwood says.

Learn more about how the brain works on the OSF HealthCare website.

Interview clips

Previous coverage

Tackling pediatric mental health

Bullying and the era of technology

Is social media impacting your mental health?

Kids' screen time: How much is too much?

From child care and finances to social situations or the uncertainty of a pandemic, life comes with worries – both big and small. For some, these worries easily come and go, but for others daily concerns become crippling, in the form of chronic anxiety.

According to the U.S. Preventive Services Task Force (USPSTF) Nearly 42% of adults reported experiencing anxiety or depression in February 2021, up from about 36% in August 2020. Many experts believe that while the jump in anxiety cases is concerning, some cases are still going unreported or undiagnosed.

The USPSTF is proposing new guidance that all patients under the age of 65 be screened for anxiety during visits to clinics and doctors’ offices. The panel found that screening tools, some as simple as a quick survey, are effective in identifying anxiety at its early stages among adults in that age range.

Dr. Ralph Velazquez is the chief medical officer for OSF HealthCare. He says mental health screenings like this have been a successful tool in OSF’s arsenal for more than a decade.

“We've known these problems have existed for a long time. We know the screening tools have been validated in multiple venues for a number of years,” he says. I think it's part of our commitment to value based care and to understand we take care of the continuum of care for patients throughout their entire life. So as they're struggling, we're going to be in contact with them. We have to help them throughout these episodes.”

Anxiety disorders can be life altering for those who suffer through them, causing major events like panic attacks, or manifesting in other physical ways like fatigue or sleep issues or chronic low energy. Despite how common anxiety issues are, however, for some adults there is still a stigma attached to talking about mental health issues. 

October is National Depression and Mental Health Screening Month – an observance designed to help erase that stigma. It’s a movement Dr. Velazquez says has already started in the young adult population.

“As we get older, they're giving us cues and giving us nudges, to go in for help. And some of them are demonstrating it by going in for the help themselves if they need it and showing the benefits of their treatment,” says Dr. Velazquez.

But after it is determined help is needed, what happens next? A primary care physician could refer a patient to behavioral health, but in some parts of the country behavioral health professionals are hard to come by. According to the Association of American Medical Colleges (AAMC), more than 150 million people live in federally designated mental health professional shortage areas.

Dr. Velazquez says that while OSF HealthCare has a robust behavioral health presence, providers are finding innovative ways to make sure patients receive the care they need.

“One other thing OSF has introduced is using online behavioral health solutions to help with this, do some cognitive behavioral therapy using your phone, using a tablet, things along those lines,” he explains. “So recognizing there may not be as many resources as we'd like. We have to look at other alternatives to help patients who are struggling.”

One of those digital solutions is OSF Silver Cloud. The free mental health digital support tool is available in communities served by OSF.

OSF HealthCare also offers free behavioral health navigation services to help understand all resources available in your area. 

The USPSTF is accepting public comments on its draft recommendation on anxiety screening until mid-October. You can find the panel’s full recommendations, along with links to studies and opportunities to provide feedback on the USPSTF’s website.

Interview Clips - Dr. Ralph Velazquez

Tackling any task – from a child walking to an adult learning a new job – starts with a first step. The same goes for taking care of your mental and behavioral health, but even the experts admit it may be daunting to ask for help. During the holiday season where some people may experience loneliness and depression, experts are reminding you there are resources to bridge the gap between “what do I do?” and “I have the care I need.”

Katie Koeller is a behavioral health navigator (BHN) at OSF HealthCare in Alton, Illinois. BHN is a free, ministry-wide service at OSF HealthCare, but you don’t have to be an OSF HealthCare patient to use it. The program helps people in areas like depression, anxiety, drug or alcohol use, and problems with work, school, or relationships. The BHN talks to the patient – either at a provider’s office or over the phone – about what care they need, and they point the person to that care as close to home and as soon as possible. The BHN also checks the patient’s insurance coverage to see how it lines up with the care needed.

“We would do an intake,” Koeller explains. “So we'd ask questions, making sure that they're not in a crisis situation at the time and see what their symptoms are. And then that way we can better judge what they would be suited for as far as counseling, psychiatry, substance use treatment, whatever it may be.”

Koeller notes the treatment could be out-patient (the typical office visit) or in-patient (live-in treatment). She says a BHN will also check-in with the patient via phone call or message on OSF HealthCare’s secure online portal. Koeller says it’s usually three check-ins over a month, but each case is different.

“Some people just decide maybe it's not what they need, maybe just talking with somebody like me and just getting educated and feeling like they have that opportunity or just the knowledge about the community resources is enough,” Koeller says. “Because then they were like, ‘Well I can decide later on if that's what I need.’  But for the most part, I feel like a lot of patients are appreciative and do really like the service and find it helpful.”

Koeller, a BHN for three years, says even if the patient is on a good path, the BHN tells them they can always call back if they need more help.

The tendency to stay quiet about mental health is still an issue, Koeller says. But she’s seeing another roadblock to care.

“A lot of people just feel like they don't have time for it. I've heard a lot of people say that ‘I can't take off work for it.’” Koeller says. “I feel like a lot of people don't consider it to be [a crisis]. You don't want it to get to that [crisis] point. So they kind of push it back like it's not as important as my physical health.”

But in reality, Koeller says, mental health does impact physical health. In other words, if your mind hurts, your body may hurt, too.

Koeller also notes that some insurance providers can help with transportation – getting a ride to a counselor appointment, for example. Telehealth – a digital appointment with a provider from home – is also an option that’s growing in use. OSF SilverCloud is another resource designed for workplaces. These are some of the many things a BHN can check on and, at a minimum, educate the patient on what’s available.

Patients who are experiencing a mental or behavioral health issue can contact their primary care provider or – if you live within OSF HeathCare’s footprint – use the behavioral health navigator program. If you’re in a crisis situation that needs a first responder, call 9-1-1. If it leans toward a mental health crisis, call the National Suicide Prevention Lifeline at 9-8-8.

Interview Clips