This tweet literally took on a life of its own.
To date, it’s amassed the most likes (86K times & growing), retweets (9.9K times & growing) and comments I’ve ever received. There are both positive and negative responses. I guess it’s a hot topic. I thought about deleting it, but nah…….
What I thought was an adorable, light-hearted conversation between me and my youngest child, turned out to spark a national conversation on female versus male doctors. The truth is, in 2018, as a black and female physician, I’m still a unicorn; a unicorn in the sense that many people may feel that I’m still a mystical and magical creature, one who doesn’t really exist in this world of discrimination, the #metoo movement, and, particularly for me in the South, with the “good ol’ boy” mentality that still exists. Being a role model for my children, who are both girls, is necessary. I also co-own my practice, which means my daughters have the opportunity to see me in a leadership role and I hope are proud when they come to the clinic to see mommy in action.
My husband is incredible and always has been supportive of what makes me happy and fulfilled in business, life and love. He (and I, for that matter) doesn’t necessarily identify with the label “feminist,” but he understands the importance of women knowing that they are valued and can accomplish any and everything they want. He wants our daughters to know they are beautiful, brilliant and capable–equal to or better than any man on this planet and universe. And, I’m proud of that.
So, when my 5yo asks if “men can be doctors, too,” it’s because of what she sees around her. Her mommy is a female doctor, many of her “Aunties” and loved ones (including her god-mother) are female doctors or professionals, and her Pediatrician is a female doctor. This is normal for her. I don’t want her to have an invisible ceiling. F– that.
And, in this day and age, I’m proud of that.
So, why is the time flying?!!! I feel like we were just planning New Year New You 2018. *deep breath*, time really does fly when you are having fun.
How have you all been? Hopefully, October, and the great year of 2018, have been treating you well. I am excited to share that New Year New You 2019 tickets are now on sale!
All of the conference info is available on Eventbrite (www.nyny2019.eventbrite.com), where you can buy your ticket, and the Facebook event page (Facebook Page), where you can follow along for special announcements!
Our keynote speaker:
Fearless Goddess Entrepreneur.
My girl, Kalilah Wright, CEO of MESS in a Bottle, hailing from Brooklyn, by way of Baltimore, will be blessing us with her wisdom and knowledge for the New Year. She’ll talk about how she made it over! Join us; you don’t wanna miss her!
We’re also happy to collab with Spa Utopia – Luxury Travel Spa (A Division of Utopia Living) & N’aya Powell for a VIP experience like no other during our conference.
The VIP ticket will provide:
-Spa Utopia Pamper Suite Experience-
Includes: mini Utopian Body Aromatherapy gift bag (mist, tea, chocolate) and choice of one of the following spa services:
20 min – aromatherapy table massage or
20 min – aromatherapy reflexology (foot massage)
Ms. Powell will also share with us from her topic, “Utopia Living – 10 Daily Habits -To an Intentional You”
They will have products in tow for sale, including Utopian Body/Living products, bath salts & more
Buy one, or get a couple for your girlfriends as gifts.
Only 50 spots available!
Stay tuned for upcoming announcements of our special guest panel and swag bag participants coming soon!
Breast cancer, unfortunately, has affected each one of us in some type of way. According to the Centers for Disease Control and Prevention (CDC), cancer is the second leading cause of death in the US, with breast cancer being second highest types of cancer in the US. Breast cancer affects both females and males, and it is important that we stay in tune with our bodies so we can recognize some typical signs.
- New lump in the breast or underarm (armpit).
- Thickening or swelling of part of the breast.
- Irritation or dimpling of breast skin.
- Redness or flaky skin in the nipple area or the breast.
- Pulling in of the nipple or pain in the nipple area.
- Nipple discharge other than breast milk, including blood.
- Any change in the size or the shape of the breast.
- Pain in any area of the breast.
All breast cancer information was retrieved from the CDC which can be found here.
Take care and be blessed,
This is right on time.
In the news, media and professional organizations, work-life balance and burnout is all the rage. I’m proud to introduce the 2nd volume of our work to you, released by my publishing company (Swiner Publishing Co.) which became a #1 Amazon best-seller this month: Thinking About Quitting Medicine, vol. 2!
It highlights the struggles that medical and dental providers go through in figuring out what they really want to be when they “grow up.” Don’t be turned away, though, because it’s not just for the medical field. It speaks to a broader issue of burnout that all of us can experience in life and work. Here’s an excerpt from our book, including our Intro and my Chapter about my personal life.
It feels so good to be back here!
Your response to Volume 1 was out of this world. From showing up to support our visionary physician authors across platforms to showing up at the book launches in Atlanta and Durham, you have let us know that we are tuning in to your frequency. You are Thinking About Quitting Medicine and you are ready to do more than bellyache about it. You yearn to feel alive and passionate and in love with each new day again. You long to feel that sense of pride after each task completed as it feels connected to your higher purpose.
You want that feeling of fulfillment that is spreading through the internet world, but you can’t seem to figure out how to manifest that in this life, this hospital, this clinic, this call room, this phone call, this procedure. Maybe you’re bogged down from the new EMR with each hospital administration change. Maybe you’re over the 18-year-old-sounding snarky insurance guy that you get to talk to before you work your way up the chain of command. It shouldn’t bother you as much as it does. It’s a little thing added on to so many other little things and it feels like death by a thousand cuts.
In numbing the stress of the day grind out you may have shut out your emotions and somewhere along the journey forgotten how to turn them back on.
This is the place where the culture and media will throw around phrases like imposter syndrome, emotional exhaustion, burnout, stress-induced executive dysfunction and roll out charts and checklists.
This is not that book. Our physicians dug deep and found the courage to tell their stories and serve as their contribution to the world. Sure, they may pepper the above phrases into their lives here and there, these phenomena are real and there is no denying the physician suicide crisis.
In this book we bring you a reminder that there are other ways to interpret your current situation with an eye on the possibilities. Each physician-author’s deeply moving vignette takes you through what they felt that led them to think about quitting medicine. In each journey, you’ll discover that despite fears similar to yours, setbacks, trials, and tribulations, they chose to continue to believe. They chose to continue to imagine and to walk in their purpose.
We welcome you to volume two. We invite you to join our authors on the Thinking About Quitting Medicine page where you can continue to build a deeper relationship with each of them. Come share your story with our docs so they can help you see what’s possible for you.
Thank you once again for your continued support.
Nicole and Mani
Voted 1 of 10 Best Doctors in NC in 2017, DocSwiner is a family physician, two-time best-selling author, blogger, speaker, wife and mother in Durham. She is also affectionately known as the Superwoman Complex expert and has written two best-selling books on the topic. She loves taking care of the family as a whole—from the cradle to the grave. Her interests include minority health, women’s health, self-care and entrepreneurship. She attended Duke University and went to medical school at the Medical University of South Carolina in Charleston, SC. She’s lived in the Triangle (Durham, NC) since finishing residency at UNC-Chapel Hill and continues teaching as an Adjunct Associate Professor with the Family Medicine department. When she’s not treating patients at Durham Family Medicine, she’s speaking locally and nationally, blogging, teaching others to self-publish and spending time with her family. Her passion is making medicine “plain” to her patients, so that all people, from all walks of life, can understand how to take better care of themselves and their families. She often blogs, guest blogs and speaks locally and nationally on these and other topics. She is also available as an influencer and brand ambassador, as she’s previously represented SheBuysCars, Hyundai, prAna clothing, DurhamKnows HIV awareness and Scarlet Myth Cosmetics. Contact her at firstname.lastname@example.org for further information.
S: 40-year-old (still) full-time doc, publisher, speaker & consultant, continuing to seek joy and balance in work, family and love.
O: Happy, yet not settling for contentment. Still working on “baby” weight five years later, but unashamedly enjoying good food and wine. All faculties secure and intact.
A: Superwoman (#nosuperwoman) in full effect
P: Has given up on the myth of work-life balance, and now will work on more work-life integration. Here’s how:
I turned 40 this year, thank God. Leading up to this milestone birthday, I wondered what kind of emotional and mental changes I’d experience. Nothing much changed, except for my tolerance and patience, a bit. I now know what I want out of life and work, and I’ll fight my hardest to achieve.
Today, as I write, on 7/23/18 at 4pm, two (a mother and daughter pair) of my most challenging patients “let me have it.” They’ve noticed that I’m no longer in clinic on Mondays and Fridays, and on days that I am here, I’ve included some telemedicine slots with my clinic appointments. The elderly mother is none-too-pleased, as she mentions that I should have “thought about that before I went to medical school, if you wanted to work less and take more time off.” Two or three years ago, this would have upset me at the thought that she felt I should let my career and patients control me and my happiness in this way. Today, I laughed to myself and to her middle –aged daughter, who looked at me apologetically and was horrified that her mother would talk to me in such a way. I patted the daughter’s knee and reassured her that I was ok with it, and just said I was “unbothered.” The truth is, I understand and understood where the mother is coming from—she’s used to the old fashioned doctor (and, the old fashioned me) that was at her every beckoning call, would freely work her into the schedule whenever she needed and drop all things to make her happy, even while she was being belligerent to me and the staff at times. The new practicing physician in me now knows that I’m worth more than that.
I’m not going to explain to every one of my patients (I will to some if asked in the right fashion) why I’m making the decision to cut back to three days a week in clinic and work from the home the other two; but I will explain to you. As I finish this chapter, sitting next to my co-founder, Mani, on a Friday morning, in DC at Busboys and Poets (a restaurant and bar I’ve always wanted to come to), I feel blessed. I’m trying to create a lifestyle and career in which I can work remotely. My kids are now in Kindergarten and second grade, and I’d love to be home more for them and go on some field trips. I’m loving the career consulting and publishing work I’ve been doing for the past three years, and I want to be more free to travel to speak and meet clients. The next step may be to become licensed in other states, so I’m able to do telemedicine visits even when I’m on the road. I think the options are endless.
So, my friends, don’t feel stuck. The road of out your rut or funk may be filled with obstacles, but it’s not impossible to traverse. If you need help—emotional, mental, financial, strategic—then don’t be afraid to reach out to mentors and experts. Create the work-life balance and integration that you desire.
Thinking About Quitting Medicine, vol. 2
Swiner Publishing Co., 2018
The Association of American Medical Colleges projects a shortage of 42,600 to 121,300 physicians by 2030.Getty Images
The news that New York University will offer free tuition to all its medical school students, in the hope of encouraging more doctors to choose lower-paying specialties, offered hope to those wishing to pursue a career in the field.
However, becoming a doctor remains one of the most challenging career paths you can embark upon. It requires extensive (and expensive) schooling followed by intensive residencies before you’re fully on your feet. The idea, generally, is that all the hard work will pay off not only financially, but also in terms of job satisfaction and work-life balance; then there’s the immeasurable personal benefits of helping people, and possibly even saving lives. In terms of both nobility and prestige, few occupations rank as high.
So why is there waning interest in being a physician? A recent report from the Association of American Medical Colleges projected a shortage of 42,600 to 121,300 physicians by 2030, up from its 2017 projected shortage of 40,800 to 104,900 doctors.
There appear to be two main factors driving this anticipated doctor drought: First, young people are becoming less interested in pursuing medical careers with the rise of STEM jobs, a shift that Craig Fowler, regional VP of The Medicus Firm, a national physician search and consulting agency based in Dallas, has noticed.
“There are definitely fewer people going to [med school] and more going into careers like engineering,” Fowler told NBC News.
Fowler also speaks to the desire among millennials to be in hip, urban locations — a luxury you likely won’t get when you’re fresh out of medical school and in need of a residency.
“This is why places in middle America hire firms like ours,” Fowler said. “They’re having a harder time attracting people.”
But perhaps the more interesting story lies not with those deciding to eschew medical degrees; it’s with the people who went through all that training, who became doctors — and then decided to opt for another path.
This drastic career change can be a result of new med school grads being unable to find a residency within a reasonable period of time.
“Graduating med school doesn’t mean you’ll get into a residency,” said Fowler. “There aren’t enough residency slots for medical grads. So you have that population of people who have an MD but didn’t practice for that reason. There is this bottleneck effect.”
The mounting bureaucracy
This “bottleneck effect” doesn’t usually sour grads on staying the course, Fowler finds, but he does see plenty of doctors in the later stages of their careers hang up their stethoscopes earlier than expected. Some cite electronic health records (EHRs) as part of the reason — especially old school doctors who don’t pride themselves on their computer skills. New research by Stanford Medicine, conducted by The Harris Poll, found that 59 percent think EHRs “need a complete overhaul;” while 40 percent see “more challenges with EHRs than benefits.”
And then there are those doctors who left medicine because the cons of the job started to far outweigh the pros.
“After 20 years, I quit medicine and none of my colleagues were surprised. In fact, they all said they wish they could do the same,” Dr. Amy Baxter told NBC News.
“I began to feel like an easily replaceable cog in the health care machine. With the [enforcement] of EHRs, I had to spend more time as a scribe. One night a child I was treating had a seizure and I couldn’t get the medicine to enable them to breathe because their chart wasn’t in the system yet. This kid was fixing to die and I, the doctor, couldn’t get the medicine. It was demoralizing.”
Baxter left pediatric emergency medicine to head a company that develops physiological products for personal pain management.
Dr. Ha-Neul Seo, director of global recruitment at EF Education First in London, was a general practitioner in the U.K. for several years before heading to the U.S. to study health care management and policy. She wound up leaving medicine to focus on education because she felt, to some extent, she’d defaulted into a career that turned out to be more tedious than expected.
“As a patient you want your doctor to love and be passionate about their work — and I realized that wasn’t me,” Seo said. “Some parts were incredible, but the moments when I felt I was making a true difference were too few and far between. And then there was the issue of work-life balance. I had my first child and was barely seeing him. The schedule was relentless.”
Dr. Nicole Swiner, a physician and author, has stuck with being a doctor because she loves it so much, but she deeply empathizes with those who decide to leave.
“It has gotten worse for all of us, unfortunately — whether you work in the hospital or in the outpatient setting,” she told NBC News. “We are burdened more by nonmedical business or insurance professionals without any medical training. It’s disheartening. I have transitioned to more part-time clinical work [so as to focus more on] speaking, writing and consulting.”
“Become a full-time consultant, author, speaker, entrepreneur, baker, cheerleader — whatever. Just be happy. Life’s too short,” Swiner said.
Hey, good people!!! So, if you didn’t know I recently joined the 40 & over club this past April. Since joining I have now gained a new characteristic of not caring much about anything but the things I love. I have also re-created my work schedule where I will be in the clinic for only three days, with doing more tele-work from home. It inspired me to post some ideas and questions on Instragram in my Instastories and received some great feedback.
…and what perfect timing it was when I came across an article titled “People Over 40 Should Only Work 3 Days A Week, Expert Claim“….
Click here to read the article.
But while reading the article, it made me think…
Life is expensive! So working 3 days a week is taking a financial back step, or a financial cha-cha, depending on how you look at life. Me? I say let’s dance baby…let’s dance.
But okay, I understand. Working 3 days may not be financially feasible. So that leads me to remember some tips that helped me.
Planning takes time, organization, and dedication. Set some time aside to prioritize your goals, and write them down.
Work less and live more! Life is more than work. You have to enjoy your free time; wait…you have to have free time to enjoy! If you feel that you are working too much, then cut back some on some work. Also, just learn how to say no.
So these next two tips are personal boundaries we have to set for ourselves. And although it will be tough, and take some time to master…I know we can do it!
In addition to the article, I wanted to add a quote from two debt burden and financial experts Drs. Nii-Danko and Renee Darko.
“The debt burden for many physicians and other professionals can be a major factor in determining if cutting back hours is financially possible. For us, significantly decreasing our debt burden allowed us to not only cut back on the number hours that we worked, but actually allowed us to live on Nii’s salary so that Renée could primarily stay at home once our baby was born. Without so much debt, your income can really go a long way.”
If the article and above quote aren’t enough encouragement to cut back, then I don’t know what it! Also, find encouragement and inspiration from your tribe; your community. A good friend of mine tweeted this recently:
–right on time as I was writing this blog. Cutting back is required at times to practice healthy self-care.
Now, I don’t want you all to think that I don’t understand how hard it is to step back from our income. It’s easier said than done. However, I have confidence that we (the 40 & Older Boss Group) can cut back some days to enjoy our life! Let’s take control of our time & finances so we can live our BEST LIVES!
As Lil’ Duval says…….
My comments were featured in a recent article in Healthline Newsletter!
If you are “addicted” to eating ice, take a look here or read below to find out one reason why you might be.
Why Do You Crave Ice?
What causes you to crave ice?
You can crave ice for a number of reasons. Here are the common reasons people crave ice:
If you’re experiencing an insatiable craving to eat ice, you may have a condition called pica. “In medical terms, pica is a disorder defined by a desire to eat substances that lack any nutritional value,” explains Dr. Sarina Pasricha, MD, MSCR.
People with pica often crave nonfood items, like dirt, paint chips, clay, hair, ice, or paper. If ice is the substance you crave, then you may have a type of pica called pagophagia.
While there’s no single cause of pica or pagophagia, they can occur if you have iron deficiency anemia. Malnutrition or a mental health disorder may also be the culprit.
Pica is often seen in children and may have a psychological basis, such as obsessive-compulsive disorder or a pediatric developmental disorder. It’s also commonly related to an underlying nutrient deficiency, typically iron. This then results in anemia.
Iron deficiency anemia
You don’t have to receive a diagnosis of pica to crave ice. Some people with anemia may crave ice as a result of an iron deficiency. One study proposed that this is because ice gives people with anemia a mental boost. Anemia is a medical condition in which your blood doesn’t carry enough oxygen to the rest of your body. This results in less energy.
Other symptoms of anemia include:
- shortness of breath
If you’re pregnant, your doctor may discover that you have anemia. “Pregnant women are often anemic due to the demands on the blood supply and circulation, poor nutritional intake, or from abnormal bleeding,” explains Dr. C. Nicole Swiner, MD. Even if you don’t have a history of anemia, you can become iron deficient during pregnancy.
In addition to anemia, Pasricha says there are other reasons you may crave ice during pregnancy:
- Pregnancy can cause nausea and vomiting, which can lead to dehydration. In this case, eating ice allows you to stay hydrated without worsening the nausea symptoms.
- Since ice has no odor or taste, many women crave ice during pregnancy.
- Pregnancy increases a woman’s metabolic rate and causes vasodilation (swelling of the blood vessels). Both of these can lead women to feel increasingly hot and therefore crave cold items such as ice.
Should you see a doctor about your ice cravings?
Pasricha recommends seeing your doctor if your desire to eat or chew ice continues to increase for at least one month. Your doctor will likely perform basic lab work to test for iron deficiency anemia, which needs to be evaluated and treated.
It’s also a good idea to have your teeth evaluated. Chewing ice over time can ruin enamel. Ask your doctor to look at your teeth. They can tell you if a visit to the dentist is necessary.
How can you stop your ice cravings?
Once you visit your doctor, the next step is to come up with a plan to stop, or at least decrease, your ice cravings.
If anemia is the cause of your cravings, your doctor may start you on iron supplements and replacement therapy. After your iron stores are replaced, the ice craving usually resolves.
If anemia isn’t the underlying cause, your doctor may look at psychological reasons for the craving. “Some people may have craved ice due to psychological stressors, in which case, cognitive behavioral therapy has been shown to be helpful,” says Pasricha.
The bottom line
Compulsive ice chewing for a period of longer than one month is a sign of a more significant medical or psychological issue that needs to be checked out.
If you’re craving and chewing on ice for reasons other than thirst, make an appointment to see your healthcare provider.
Thanks to blackdoctor.org for featuring my comments in this recent article.
Click here for the official article, or read below. Enjoy!
Depression in Black Children: What Does It Look Like?
What could a child possibly be depressed about? They don’t have bills or responsibilities, so what is there to really be sad about? Unfortunately, that is the misguided thinking in a lot of our homes. While a concerted effort to address mental health needs in the Black community is growing. There’s still a great need to address our little Black boys and girls who are suffering in the dark.
Childhood depression is often overlooked because kids, at the time, don’t have the language or perspective to understand what they’re feeling. Kids like Rhylan Thai Hagan and Stormiyah Denson-Jackson left this world without an explanation of their unspoken pain.
Across the nation suicides amongst Black children under 18 are up 71 percent in the past decade. Researchers are perplexed as to the reason why, but many indicate that factors such as perceived racism might explain the rise. Rheeda Walker, a professor at the University of Houston, believes that the perception that suicide isn’t a Black thing can also explain why it’s hard to detect the warning signs
The National Institute of Mental Health defines depression as “a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.”
Depression is not to be confused with anxiety. People suffering from depression often have delayed or slower reactions. While people with anxiety are often hyper and have racing thoughts. Oftentimes the two get intertwined because of the similarity in symptoms.
If you feel that your child suffers from either you’re strongly encouraged to see a doctor or therapist.
Dr. C. Nicole Swiner and therapist Dr. Alisha Powell provide our readers with an in-depth look at childhood depression in the Black community.
BlackDoctor: How does childhood depression differ from adult depression?
Dr. Swiner: I believe many symptoms and factors may be similar, however, more symptoms are more related to decreased attention, increased irritability and agitation and acting out than low mood and sadness.
Dr. Powell: Child depression looks different from adult depression because children may not be able to tell you what’s wrong. They may become more isolated and less social with their peers.
BlackDoctor: What factors lead to childhood depression?
Dr. Swiner: Genetics, hormonal changes, emotional trauma, abuse or increased stress are factors that contribute to childhood depression.
Dr. Powell: Childhood depression can stem from stressors at home or school. It can also be caused by unhealthy interpersonal relationships or it can be a chemical imbalance in the brain.
BlackDoctor: How can you support your child through depression?
Dr. Swiner: Open communication, counseling, and therapy. Last resort would be medications, natural and pharmaceutical, with the help of physicians.
Dr. Powell: You can support your child with depression by not attempting to fix it on your own. Don’t shame them because of how they feel or tell them to snap out of it. Take them to talk to a licensed mental health professional and be open to different treatment options.
BlackDoctor: Is medicine always necessary?
Dr. Swiner: As a last resort and with the help of a physician, possibly.
Dr. Powell: Medication isn’t always necessary. However, in cases where there’s no identified stressor or trigger, medication can help with the chemical imbalance in the brain. Medication can also be helpful if there is a dramatic decrease in functioning—like if your child is not sleeping or eating and has started to self-harm.
Listen to the recommendations of mental health providers on whether or not medication is a good option for your child.
BlackDoctor: What are free or cost-effective ways to support your child’s mental health needs?
Dr. Swiner: Encouraging exercise, rest, hobbies, journaling, counseling with in-school therapists and ministers through a church.
Dr. Powell: Talk to your child’s school counselor about low-cost counseling clinics in the community and other resources. Call your insurance company and find out what behavioral health benefits are available. Many times, counseling graduate programs offer low-cost counseling as their students work with people in the community in order to get the hours that they need to graduate.
I also want to add: Depression should be taken seriously—especially in Black kids. Keep the lines of communication open but also understand that your child may also need to speak to someone else that isn’t you. Support your child by letting them know that there isn’t anything wrong with seeking help.
I’ve had 2 wonderful opportunities this month to be in Essence Magazine! One on their #snapchat format, and the other online. Of course, I am beyond excited and would love for you all to check out the articles here or below!
You can also find the snapchat posts through my IG posts.
Written by: Michelle Darrisaw, Essence Mag
May, 30, 2018
The Many Different Types Of Anxiety And Depression
“Nowadays, everyone from celebrities and social media influencers to teens is being more open about their struggles with mental health and giving a face to issues such as social anxiety and depression.
Dr. Marissa Long, a California-based clinical psychologist, who is also the founder of mental health and wellness subscription box, Thrive WISE, attributed the increase in anxiety and depression to societal issues such as school shootings, cyberbullying and economic instability.
“Anxiety is the most common of mental health issues in the U.S., but depression is not far behind as the leading cause of disability in the U.S. for teens and young adults,” stated Dr. Long. “It’s important to differentiate between normal moodiness and serious signs of disorders so that appropriate treatment can be secured.”
With these alarming numbers and the fact that it’s Mental Health Awareness Month, we decided to enlist the help of Dr. Long and other medical experts to break down the many different types of anxiety and depression, as well as things you should do if you’ve started noticing the following and symptoms. But first you should know that we all get nervous, sad or anxious from time to time, but it’s when these feelings persist that we should pay close attention.
“I like to say that anxiety is stress and worry shaken and heated up, which ultimately impacts our body as well,” stated Dr. Long. “It changes the flavor of our experience by diluting the reality of the situation in front of us, and adding in unwarranted and rigid thoughts that support our fear. There are FIVE major anxiety disorders—each with their own symptom presentation.”
Dr. Long summarizes the five disorders, associated symptoms, and treatment options as follows:
1. Generalized Anxiety Disorder (GAD)
With GAD, the name says it all. It can show up as persistent negative thoughts or negative assessments of one’s self, situations and the world around them as being scary, resulting in avoidance and efforts to mitigate the anticipated anxiety.
Physical Symptoms: Muscle tension, poor sleep, upset stomach, and jaw pain.
2. Social Anxiety/Social Phobia
Social anxiety or social phobia is an intense fear of social situations due to concerns about being criticized, embarrassed or humiliated. Something as seemingly simple as making a phone call, sitting in a waiting room, speaking publicly, eating with others, sharing an opinion or even talking with friends can prompt serious anxiety. For some, social phobia can also be experienced relate to specific people or situations such as talking to your boss or parties. There are many different types of phobias but the main thing to keep in mind is that it involves an irrational level of fear about something that is disproportionate to the actual danger. On top of all of this, unfortunately, people can have more than one specific phobia.
Physical Symptoms: Shaking, nausea or diarrhea, sweating, blushing or feeling flushed.
3. Panic Disorder
The experience of a panic attack is a uniquely awful one, but having a panic attack in and of itself does not warrant a diagnosis of panic disorder. Panic attacks involve a gradual build to or sudden experience of intense, and often uncontrollable and racing anxious thoughts combined with physical symptoms. It is when a person has recurrent and disabling panic attacks and/or persistent fears for longer than a month that a diagnosis of panic disorder may be warranted. The occurrence of panic attacks varies from one person to the next, happening as often as several times per day to once every couple of years.
Physical Symptoms: Tightness in the chest, shortness of breath, shakiness, chest pain, dizziness and excessive perspiration.
4. Obsessive Compulsive Disorder (OCD)
OCD is characterized by intrusive and persistent anxious thoughts or behaviors that are carried out with the purpose of relieving the anxiety. The thoughts and behaviors work together as a super team against their host in this disorder, and are quite powerful even when the person is able to identify their thoughts as unrealistic and the compulsions as unnecessary. For teens and young adults, this can result in an inability to attend school, let alone engage in normal social interactions, thus disabling them from engaging with life in a seemingly normal way.
5. Post-Traumatic Stress Disorder (PTSD)
PTSD is a common outcome of a traumatic event that is experienced, witnessed or even heard about in such a way that causes trauma. Symptoms can include difficulty relaxing and feeling on edge; hypervigilance, nightmares or flashbacks related to the experience, avoidance of anything related to the traumatic event, and an emotional numbness. PTSD is diagnosed when symptoms have been present for at least a month, but symptoms may not present until long after the trauma.
In recent years, the surviving victims of school shootings have been prime candidates for subsequent PTSD diagnoses, though other events like sexual assault, car accidents or witnessing a death are all examples of traumas that may bring about PTSD.
1. Major Depressive Disorder
Dr. Long also weighed in on six forms of depressive disorders and their overall effects on teens and young adults: She explains that “major depressive disorder is the most common form of depression and is characterized by the occurrence of specific symptoms, over a period of at least two weeks, that impair regular functioning in school or social activities for teens and young adults.”
Far too often, parents and loved ones write off major depressive disorder in their children as hormonal changes or an act of rebellion against authority.
Physical Symptoms: Decrease or increase in appetite, insomnia or hypersomnia, psychomotor agitation or retardation, constant fatigue, feelings of worthlessness or excessive and inappropriate guilt, recurrent thoughts of death and suicidal ideation (with or without specific plans for committing suicide) and cognitive difficulties like the inability to think, concentrate or make decisions.
2. Persistent Depressive Disorder (Dysthymia)
Dysthymia can be quite sneaky, especially among teens and young adults. It is often thought of as the disorder suffered by the beloved cartoon character, Eeyore (from Winnie the Pooh), who moped about his life on a rather consistent basis. The pervasive nature of it often allows people to view it as being the personality of the depressed individual rather than the health issue it actually is.
Persistent depressive disorder commonly goes undiagnosed into later adulthood but presents itself as a consistently low, dark or sad mood. For adolescents, the symptoms need to persist for more than one year, whereas adults require two or more years of persistent symptoms to meet the diagnosis. It’s important to note that symptoms experienced in dysthymia are not as severe as with major depression, and the persistence of symptoms does not mean that those with this disorder would be unable to have happy moments or days. Major depression may co-occur with dysthymia, or precede it, making it that much trickier to catch and diagnose.
Physical Symptoms: Poor appetite or overeating, low self-esteem, poor concentration, difficulty making decisions, low energy or fatigue, feelings of hopelessness, and insomnia or hypersomnia.
3. Premenstrual Dysphoric Disorder (PMDD)
While an extension of premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) should be understood to be much more severe and at times disabling. For teens and young adults, there is a tendency to, again, write the emotional experience off as being moody or “extra” until the heightened physical symptoms bring cause for concern and attention. Symptoms of PMDD usually begin seven to ten days before the start of a menstrual period and continue through the first few days of the period.
Physical Symptoms: Breast tenderness, bloating, fatigue, changes in sleep and eating habits, anxiety or tension, sadness or hopelessness, moodiness, irritability or anger.
4. Depressive Disorder Due to Another Medical Condition
When medical conditions bring about depressive symptoms, it’s called depressive disorder due to another medical condition. This can be tremendously difficult to diagnose because there is generally an assumption that teens and young adults are physically healthy, unless there is a glaringly obvious weight gain or loss. A simple blood panel and urinalysis can determine if a patient is suffering from another medical condition, like hypothyroidism, for example.
Physical Symptoms: Fatigue, weight gain, sleep changes, irritability, memory loss and low mood.
5. Seasonal Affective Disorder (SAD)
Adolescents and young adults with SAD struggle with the symptoms of a major depressive disorder, but it is limited to a specific time of year, specifically winter. The cause of this is related to decreased exposure to sunlight during the shorter days of winter months. For teenagers, this change could cause them to isolate from their friends and avoid participating in physical activities.
6. Bipolar Depression
Bipolar depression is a mixture of depression and manic episodes. It is treated in similar ways as depression, but with more intensive therapy needed.
Physical Symptoms: The feeling of being on a high, but not in a good way, with thoughts of grandiosity. Also, be on the lookout for increased, uncomfortable energy, insomnia and unhealthy hypersexuality.
“Journaling is highly recommended as a tool that can help relieve the symptoms of depression and anxiety, stated Latonia Francois, a mental health expert and founder of Let’s Write Life, which is a journaling and event company. “It’s a healthier alternative to antidepressants and other forms of harmful self-medication. On a mild level, journaling can be recommended as a form of self-care and a way for mental health professionals to help their clients express themselves, track patterns of progress and spark conversations that clients may not be able to vocalize.”
Self-Care Days and Activities
Family doctor and the best-selling author of How to Avoid the Superwoman Complex, Dr. C. Nicole Swiner (#docswiner), recommended the following forms of self-care to help you focus outwardly, instead of turning your attention inward to your anxiety: exercise, journaling, coloring, listening or producing music, being creative in the arts or volunteering to help others.
“Regular exercise increases endorphins aka the feel-good hormone,” Dr. Swiner stated. “Restful sleep, [maintaining] fulfilling relationships, and [adopting] healthy hobbies outside of school and work can help mild cases of depression. You just have to be aware of when things get out of control.”
Medication and Therapy
“One way to treat depression is, of course, with use of medications,” Dr. Swiner advised. “I’d say the biggest thing in our community that prevents us from seeking help with depression and similar issues is that we’re too proud to talk about it. Or, it’s because we don’t want to be put on a ‘crazy pill’ and have bad side effects (like weight gain or decreased sexual desires). Medicine is not the only way to treat these things, however, so keep an open mind and talk to someone about it in counseling and therapy.””
Here’s an article I penned in 2010 around this time of year. Still very relevant…..
This month makes a year that I’ve been writing articles for medical education. My first article centered on the issue of depression and being self-aware of the warning signs.
Here are some of the most common stress-related disorders that I see on a daily basis.
- Depression and anxiety/panic disorders. This is pretty easy to understand. The more stress a person has, the worse underlying mental health disorders can become. The stress of loss of a loved one, loss of a job or threat of losing your job, or a strained relationship can lead to overwhelming sadness or symptoms of panic. Insomnia and sleep disturbances can occur as racing thoughts and worry increase at night. Alcohol and tobacco abuse can also occur concurrently as ways to self-medicate in the absence of correct ways of treatment such as prayer, counseling, therapy or prescribed medication.
- Hypertension and heart disease. Otherwise known as high blood pressure, stress can cause an increase in constriction of blood vessels. Stress has not been proven as a direct cause of high blood pressure, but it can have an overall effect on the release of hormones from the nervous system and circulatory systems, which makes it harder for the heart to pump blood to our vital organs. If blood pressure is chronically high and blood vessels have enough damage or cholesterol buildup, heart disease can be the result. Some chest pain can even be linked to stress.
- GERD (acid reflux) and stomach ulcers. Emotional stress can lead to an increased production of acid from proton pumps and H2 receptors in our stomachs. If acidity is prominent, a burning sensation can be felt and pain can extend from the stomach (in the center and to the left of the middle of the stomach) all the way up to the esophagus and throat. Foods that we eat, including caffeinated beverages, spicy ingredients and citrus can make this worse. If left for too long, ulcers, or an eating away of the lining of the stomach, can develop and even worsen to the point of bleeding.
- Obesity. Stress can cause an increase of the hormone cortisol to be released from the adrenal glands. Cortisol is linked to increased glucose (blood sugar) and weight gain. Also, while some of us eat less with stress, many of us eat more “comfort foods,” which are generally more sweet and fatty, and have more calories.
- Headaches. Migraines are thought to be the most common type of headache, but tension is probably higher on the list of causes of headache. Both types can increase with stress. With tension headaches, a tense pressure or squeeze can be felt in any part of the head, usually with muscle tension and soreness of the neck and even shoulders. Migraines are thought to be associated with signals from the nervous system that relax blood vessels. When vessels relax, blood rushes to them and cause dilation. If too dilated, this can cause pain.
- Abnormal menstrual cycles. Skipping a period can be very distressing for a woman, especially if unexplained. Although we don’t know what the certain cause is, it is thought that emotional stress affects release of certain pituitary hormones that can cause irregular periods. If weight is lost or gained due to stress, estrogen or a lack thereof, it can also cause irregular periods.
- Viral infections. When we’re stressed or fatigued, our immune system doesn’t work as well to prevent us from infection. We all have antibodies from vaccines or from previous infections that have built up in memory cells and are programmed to increase when we are exposed to infections. Stress reduces this response. Colds can occur more frequently and, even worse, viruses such as herpes and HPV (human papilloma virus can show themselves during these “down” times.
- Cancers. This one is controversial, as some studies say one thing and some say another. The conflicting data questions whether stress can be a direct cause of some cancers. In 2002, a study was done on patients who had breast cancer that was treated. The question was asked if stress could be linked to the cancer coming back. The study could not prove it to be true. However, in animal studies, an increase of stress hormones was linked directly to growth of some tumors. Long story short, the evidence is inconsistent, but there may be truth to the claim that stress can lead to certain cancers.
All in all, be self-aware of the signs. If you’re feeling overwhelmed, as we all at some point do, be pro-active by exercising, drinking plenty of water, getting good restful sleep and doing those things that you enjoy doing with those you love. If it still feels like life is crashing down on you or your body is breaking down, please see your doctor.