Winter is here and with it comes some possible changes in one’s outlook. With short days, frosty weather, and slushy roads, we can see an uptick in feelings of the blahs and bit of anxiety. But the good news is there are some things we can do to affect our outlook.

First, it’s always good to remember that there’s nothing shameful about recognizing that we may be feeling depressed or anxious. Everyone has ups and downs, especially in the slump after the holidays.

Second, the shorter days and reduced sunlight have been linked to a kind of depression called Seasonal Affective Disorder (SAD). Feelings associated with SAD tend to be more severe than a typical case of the “winter blues.”

People with SAD symptoms may often experience low levels of energy, be more withdrawn socially than usual, and weight gain. Sometimes SAD symptoms include a higher-than-normal craving for sweets, cakes and cookies. People with SAD also sometimes have difficulty in concentrating or sleeping.

The causes of SAD are generally thought to be related to shorter days disrupting one’s “internal clock,” or circadian rhythm. That can cause changes in how your body produces important hormones like serotonin or melatonin, which can disrupt typical sleeping patterns and lower personal energy levels.

The good news is that your medical provider can often successfully treat SAD symptoms with light therapy or by talk therapy (cognitive behavioral therapy) with a professional mental health provider. Light therapy typically includes sitting in front of a special bright light for 30 minutes that helps “reset” your “internal clock.”  Talk therapy can help minimize self-defeating thoughts by reframing perspectives.

Other therapies and means to assist are also available. If you are feeling “blah” or a little depressed, consider having lunch with friends, or finding a means to walk for 30 minutes or more. It may take some effort to move off of center, but it can be rewarding. SAD symptoms can (and sometimes do) go away by themselves, but that can take up to five months.

If you are experiencing higher levels of anxiety or depression, including thinking about harming yourself or even ending your life, that goes beyond SAD symptoms. If these intense feelings are occurring, now is the time to get professional help. Some may harbor some lingering stigma about their mental health or admitting that they’re depressed or anxious, but that is unnecessary, especially in this day and age.

The irony is that holidays can increase feelings of hopelessness or depression, especially following separation or death of a loved one, or other related issues. If you or someone you know are experiencing this, professional help can provide relief and hope.

Sometimes we can see this at work or in groups, where our friends or co-workers may inexplicably exhibit unusual tiredness, personality changes, uncommon conflict, loss of interest or other unusual changes in mood. If you see this, it may be an opportunity to gently open a conversational door. Your human resources professional or provider can provide guidance. If you think this describes you, contact your provider for help.

Whether mild or severe, feelings of anxiousness or the blahs can be dealt with – don’t suffer needlessly – take charge of your mental health!

A Licensed Social Worker (LSW), Breanna White serves as a clinical therapist on SICHC’s behavioral health team. She works to help provide comprehensive healthcare through mental health services for residents of the region.

The post Feeling Anxious or Blah this winter? appeared first on Southern Indiana Community Health Care.

Stout, who has led broad efforts to address and treat substance use in the greater Orange County Indiana area, has spearheaded efforts to elevate the quality of healthcare available to those facing substance use. Instead of treatment only being available through substance use and other treatment centers, Stout and Southern Indiana Community Health Care now increasingly integrate substance use treatment into family healthcare services.

This includes the local administration of MAT (medication-assisted treatment) options, where people facing substance use can be prescribed Suboxone or Vivitrol without having to travel to a specialty clinic (MAT treatment also typically includes a combination of counseling and behavioral therapies).

Properly administered, Suboxone can blunt intoxication from using drugs like heroin, oxycodone and other opiates, reducing cravings and allowing people an opportunity to transition away from a life of substance use. Injectable Vivitrol is also available through a MAT program, which use blocks euphoria or ‘high’ that alcohol and opioids produce. Vivitrol has also proven effective in helping people with substance use issues recover.

“There is still a stigma around substance use, and this stigma serves as a barrier to seeking treatment for those who need it,” Stout said. “By integrating MAT options within family medical treatment, this provides several advantages, including helping those facing substance use issues with improving their general health and also addressing issues like diabetes.”

(Recognizing that physical health and mental health go together, Southern Indiana Community Health Care utilizes an integrated care model. For more information, please visit https://sichc.org/mental-health/)

People with substance use issues can go to a typical facility like SICHC’s Valley Health clinic in West Baden Indiana and confidentially receive treatment. “My MAT patients sit in the same lobby as patients seeking healthcare for other reasons,” Stout said. “They don’t have to drive a long distance to a specialty clinic or face the stigma of publicly going to that clinic.”

With the federal removal of certain data waiver requirements, MAT treatment became a viable option to integrate within more typical medical services. This is now more important than ever, according to Stout, as new illegal drugs in pill form that “look like” opiates are becoming more available on the street. “Dealers mix up illegal and highly dangerous combinations of fentanyl, heroin and other drugs, and illicitly press them in pill form to ‘look like’ oxycodone or other opiates,” she said.

The dangerous illegal and increased use of fentanyl has tragically resulted in additional deaths by overdose, Stout explained said. When prescription opiate availability decreased, people who used opiates turned to heroin as a substitute, opening the door for dangerous fentanyl.

Southern Indiana Community Health Care began exploring MAT treatment options in 2018, when tests showed opiate use among the obstetric population. Initial success of the program promoted SICHC to roll out integrated treatment options to the general public in 2019.

Stout noted that overdoses still tragically occur often. She emphasized that free opioid rescue kits are available without prescription or social contact. Life-saving Naloxone can be administrated by nasal spray or other means in an emergency overdose situation.

“There are many Naloxone Boxes and free distribution points around Indiana,” Stout explained, encouraging any with an opiate issue (or anyone with a family member or friend with an opiate issue) to secure a free, confidential supply at NaloxBoxes around the area. (NaloxBox locations and distribution points can be found at https://www.overdoselifeline.org/naloxone-indiana-distribution/). Several churches, public libraries and facilities, and recovery centers are host to free and accessible opioid rescue kits.

Recovery from substance use takes time and can include complications. In addition to seeking quality medical care, people with substance use are encouraged to take advantage of local peer support groups and 12-step recovery programs like Alcoholics Anonymous and Narcotics Anonymous. Safe Haven Recovery Engagement Center in Orange County offers several options. Interested people can also visit https://www.indianarecoverynetwork.org/

Together with a patient in recovery, Stout presented details about the MAT program and its integrated value during the recent Indiana Rural Health Associations annual state conference in French Lick.

The post Innovative Hope For Those Facing Substance Use Issues appeared first on Southern Indiana Community Health Care.

By Candace Cook-Cline, LPN

Q. How do I contact the AHN, and when are they available?

A. The AHN is available anytime the clinic is closed (early mornings, evenings, nights, weekends, and holidays). A patient needs to call and will be answered by our answering service, evaluated, and referred to the AHN nurse.

Q. Do I have to be a patient of SICHC?

A. Yes. You must be an established patient.

Q. What kind of things can I call for?

A. After Hours service is available for questions or concerns that need to be addressed in a clinical manner outside of normal business hours, that isn’t critical enough to warrant an ER visit. That can include medicine questions, someone’s feeling ill, reactions to meds, concerns regarding an appointment earlier in the day, etc.

Q.  Is the After Hours Nurse an employee of SICHC?

A. Yes. Our AHN Candace has been a nurse with SICHC for 10 years. So our patients will have the same familiar voice when they have concerns.

Q. Can the AHN make a daytime clinic appointment?

A. Yes. Plus the AHN can also make follow up appointments for a patient’s local ER or area urgent care center.

Q. Is there a lot of paperwork to fill out before calling?

A. No. Patient data and records are accessible by the AHN.

Q. Does the AHN have access to your records?

A. Yes. They have access to patient records and are able to order labs, imaging, and if needed, prescribe medications (authorized by on-call provider). 

Q. Will my insurance be billed for the AHN service?

A. No. Insurance is not billed for after hours calls.

Q. Does the AHN speak Spanish? Or can assist the hearing impaired?

A. The AHN has a translation app to work with the hearing impaired. The AHN doesn’t speak Spanish, however they utilize a translator app, while not 100%, does assist in the communication.

Q. Insurance companies often have After Hours Nurse lines, what’s the difference? 

A. SICHC’s AHN line differs from insurance options, due to the continuity of care aspect. Being able to have all patient records readily available in one place and also have a patient’s regular provider informed of the call in a timely manner is a wonderful asset for our patients.

The post Q&A – SICHC Patient After Hours Nurse (AHN) appeared first on Southern Indiana Community Health Care.