You’re Not Alone
TDA wants you to know that if you’re struggling with mental health issues, YOU’RE NOT ALONE. The TDA Council on Professions and Trends has compiled a mental health toolkit to provide you easy access to a diverse supply of resources.
Trying to tell the difference between what expected behaviors are and what might be the signs of a mental illness isn't always easy. There’s no easy test that can let someone know if there is mental illness or if actions and thoughts might be typical behaviors of a person or the result of a physical illness. Each illness has its own symptoms, but common signs of mental illness in adults and adolescents can include the following1:
- Excessive worrying or fear
- Feeling excessively sad or low
- Confused thinking or problems concentrating and learning
- Extreme mood changes, including uncontrollable "highs" or feelings of euphoria
- Prolonged or strong feelings of irritability or anger
- Avoiding friends and social activities
- Difficulties understanding or relating to other people
- Changes in sleeping habits or feeling tired and low energy
- Changes in eating habits such as increased hunger or lack of appetite
- Changes in sex drive
- Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)
- Inability to perceive changes in one’s own feelings, behavior, or personality ("lack of insight" or anosognosia)
- Overuse of substances like alcohol or drugs
- Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing "aches and pains")
- Thinking about suicide
- Inability to carry out daily activities or handle daily problems and stress
- An intense fear of weight gain or concern with appearance
Many of us face challenges that can be stressful, overwhelming, and cause strong emotions. It is natural to feel stress, anxiety, grief, and worry. Learning to cope with stress in a healthy way will make you, the people you care about, and those around you become more resilient. Here are healthy ways to cope with stress2:
- Take Care of Your Body
- Take deep breaths, stretch, or meditate
- Eat healthy, well-balanced meals
- Be physically active
- Get plenty of sleep
- Choose not to drink alcohol, or drink in moderation (2 drinks of less in a day for men; 1 drink or less in a day for women)
- Avoid misusing prescription opioids and avoid using illicit opioids. Also avoid mixing these with one another, or with any other drugs.
- Avoid smoking and the use of tobacco products, including e-cigarettes. People can and do quit smoking for good.
- Continue with routine preventative measures including vaccinations, cancer screenings, and other tests recommended by a healthcare provider.
- Make time to unwind
- Try to do activities you enjoy
- Connect with others
- Talk with people you trust about your concerns and how you are feeling
- Connect with your community- or faith-based organizations
- Take breaks from watching, reading, or listening to news stories (including those on social media)
- It's good to be informed, but hearing about adverse events constantly can be upsetting
- Consider limiting news to just a couple times a day
- Consider disconnecting from phone, tv, and computer screens for awhile
- 911 – call or text
- 988 – Suicide & Crisis Lifeline – call or text
- Crisis Text Line – text SIGNS to 741741 for 24/7, anonymous, free crisis counseling
- Disaster Distress Helpline – call or text 1-800-985-5990
- National Alliance on Mental Illness (NAMI) Helpline – call 1-800-950-6264 or text 62640
- Substance Abuse
- Substance Abuse and Mental Health Services Administration – SAMHSA's National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service for individuals and families facing mental and/or substance use disorders
- SAMHSA Helpline – call 1-800-662-4357
- Professional Recovery Network Helpline: call 1-800-727-5152
- Postpartum Depression
- Postpartum Support International (PSI) Helpline: Call 1-800-944-4773 or text “Help” to 800-944-4773 or join one of their online support group
- National Maternal Mental Health Hotline: Call or text 1-833-943-5746
- National Child & Maternal Health Education Program
- New and Expectant Mothers
- Perinatal Psychiatry Access Network (PeriPAN) - call 1-888-901-2726
- Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
- Older Adults
- The Eldercare Locator – call 1-800-677-1116
- Alzheimer's Association Helpline – call 1-800-272-3900
- Veterans/Active-Duty Military
- Vetera's Crisis Line – call 988, then select 1, or text 838255
- U.S. Department of Veterans Affairs Mental Health Resources
- Help for Military Service Members and Their Families
- The Blue Dove Foundation – 404-490-2391
- Christian Assistance Ministry (San Antonio) – 210-223-4099
- Hope and Healing Centers (Houston) – 713-871-1004
- Hope for Mental Health – 949-609-8278
- Khalil Center – 1-855-554-2545
- Texas Christian Recovery and Other Support Services (TXCROSS) (Austin) – 512-554-8874
- Well Community (Dallas) – 214-393-5878
- Mental Health Treatment
- FindTreatment.gov – find a provider treating substance use disorders, addiction, and mental illness
- American Psychiatric Association Foundation – find a psychiatrist
- American Academy of Child and Adolescent Psychiatry – find a psychiatrist for children and adolescents
- American Psychological Association – find a psychologist
- Opioid Treatment
- Professional Recovery Network
- The Professional Recovery Network (PRN) is a nationally recognized peer assistance program dedicated to helping health care professional enter a safe, healthy recovery. PRN’s trained staff helps identify, assist, support, and monitor any Texas-licensed dentist, dental hygienist, dental assistant, and other licensed health professionals with a potential impairment due to substance use or mental illness. This program is fully supported and recognized by the Texas State Board of Dental Examiners.
- Receiving a Diagnosis1
- Knowing warning signs can help let you know if you need to speak to a professional. For many people, getting an accurate diagnosis is the first step in a treatment plan.
- Unlike diabetes or cancer, there is no medical test that can accurately diagnose mental illness. A mental health professional will use the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, to assess symptoms and make a diagnosis. The manual lists criteria including feelings and behaviors and time limits in order to be officially classified as a mental health condition.
- After diagnosis, a health care provider can help develop a treatment plan that could include medication, therapy, or other lifestyle changes.
Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness, or a rapid heartbeat3.
Common Signs and Symptoms of Anxiety4:
- Panic or fear
- Feeling nervous, restless, or tense
- Increased irritability
- Rapid breathing
- Increased heart rate
- Coldness, numbness, or tingling in hands and/or feet
- Sleep problems
- Having trouble controlling worry or thinking about things other than the worry
- Having the urge to avoid things that trigger the worry
Everyone experiences sadness at times. But depression is something more. Depression is extreme sadness or despair that lasts more than days. It interferes with the activities of daily life and can cause physical symptoms such as pain, weight loss or gain, sleeping pattern disruptions, or lack of energy. People with depression may also experience an inability to concentrate, feelings of worthlessness or excessive guilt, and recurrent thoughts of death or suicide5.
Depression can affect individuals differently, but typically the symptoms affect how you feel, think, and handle activities of daily life. Symptoms are also usually present for more than two weeks. Some of these common symptoms include6:
- Persistent sad, anxious, or “empty” mood
- Loss of energy
- Lack of concentration
- Feelings of guilt, worthlessness, or helplessness
- Feeling agitated or irritable
- Increased sense of guilt
- Changes in appetite or sleep – increase or decrease
- Lack of interest in previously enjoyable activities
- Feelings of hopelessness
- Feelings and thoughts of wanting to die
- Self-harm or suicidal behavior
Depression is the most common mental disorder. Fortunately, depression is treatable. A combination of therapy and antidepressant medication can help ensure recovery5.
Commons signs of burnout include emotional and physical exhaustion, cynicism, negativity, frustration, anger, anxiety, detachment, reduced work performance, insomnia, muscle aches, and gastrointestinal upset. Recovery from burnout begins with taking positive, constructive steps toward freedom. Dr. Bill Claytor offers the following steps to mitigate burnout while balancing life and work7:
- Define the type of dentistry you want to practice
- Control your schedule
- Minimize your debt
- Stay engaged and don’t isolate
- Develop a collegial community
- Take care of self and family
- Pursue a spiritual life and gratitude
Additional suggestions for mitigating burnout from Texas dentist Dr. Travis Campbell8:
- Stop taking work home – we need a separation of work and home, or we never get a mental break that we really need.
- Define your ideal personal life – then make work fit into that schedule. Work should be secondary and supportive of your personal goals.
- Take more vacation and time off to refresh yourself – unless you are fully booked months out with zero cancellations, your income won’t go down. More likely, taking time off will just help make other days fuller and busier with no overall drop in production.
- Visit a massage therapist regularly – and possibly even a chiropractor. The strain we put on our necks and backs needs support to prevent long-term fatigue.
- Delegate more – improve your strengths, learn to do better on your neutrals, and delegate out your weaknesses.
- Reduce your commute time – while not always easy to accomplish, what a massive difference this change can make.
- Soul search – do you really want to work as many days as you do, or would you rather make the same amount of money working fewer days.
- Find your passion and make time for it – whether it’s a specific area within dentistry or something else outside that keeps you motivated, find more time to devote to that passion.
Perinatal & Postpartum Depression
Did you know? 1 in 7 Moms and 1 in 10 Dads suffer from postpartum depression. You are not alone and you are not to blame. Help is available. You will get better10.
Your body and mind go through many changes during and after pregnancy. If you feel empty, emotionless, or sad all or most of the time for longer than 2 weeks during or after pregnancy, reach out for help. If you feel like you don’t love or care for your baby, you might have postpartum depression. Treatment for depression, such as therapy or medicine, works and will help you and your baby be as healthy as possible in the future11.
Perinatal Mental Health Disorders12:
- Are you feeling sad or depressed?
- Do you feel more irritable or angry with those around you?
- Are you having difficulty bonding with your baby?
- Do you feel anxious or panicky?
- Are you having problems with eating or sleeping?
- Are you having upsetting thoughts that you can’t get out of your mind?
- Do you feel as if you are “out of control” or “going crazy”?
- Do you feel like you never should have become a parent?
- Are you worried that you might hurt your baby or yourself?
Any of these symptoms, and many more, could indicate that you have a form of perinatal mental health disorder, such as postpartum depression. While many parents experience some mild mood changes during or after the birth of a child, 15 to 20% of women experience more significant symptoms of depression or anxiety. Please know that with informed care you can prevent a worsening of these symptoms and can fully recover. There is no reason to continue to suffer. Parents of every culture, age, income level and race can develop perinatal mental health disorders. Symptoms can appear any time during pregnancy and the first 12 months after childbirth. There are effective and well-researched treatment options to help you recover12.
There are some things you can do, in addition to treatment, that may help you feel better13:
- Connect with other moms – look for a mom’s group in your community or online
- Make time for yourself – do something for you, like getting out of the house or taking a hot bath, without interruption
- Do something you enjoy – whether it is listening to music, reading a book, or watching a favorite movie, take a bit of time each day to do something you enjoy
- Be realistic – you don’t have to do everything; just do what you can and leave the rest
- Ask for help – don’t be afraid to ask for help from family and friends, whether it’s caring for the baby or doing household chores
- Rest when the baby rests – sleep is just as important for you as it is for the baby
- Be with others – seek out other adults, like family and friends, who can provide comfort and company
Although the term “postpartum depression” is most often used, there are actually several forms of illness that parents may experience, including12:
The Professional Recovery Network is a nationally recognized peer assistance program dedicated to helping health care professionals enter a safe, healthy recovery14.
Our program has served more than 1,000 healthcare professionals since it was established by the Texas Pharmacy Association in 1981. Our trained staff helps identify, assist, support, and monitor any Texas-Licensed Pharmacists, Pharmacy Students, Dentists, Dental Hygienists, Dental Assistants, Veterinarians, and Optometrists with a potential impairment due to substance use or mental illness. Our program is fully supported and recognized by the Texas State Board of Pharmacy (TSBP), Texas State Board of Dental Examiners (TSBDE), Texas Board of Veterinary Medical Examiners (TBVME), and the Texas Optometry Board (TOB) 14.
We adhere to a dual philosophy that provides an opportunity for confidential recovery while protecting the public from unsafe professional practice. We believe that professionals who have a substance use disorder or mental health problem should be offered the chance to enter recovery and confront their problems before having disciplinary action taken against their licenses. We accept self-referrals as well as referrals from any concerned third parties. All referral sources are kept strictly confidential14.
The state of Texas has recognized the need to monitor and provide advocacy services for impaired professionals. Prior to this awareness, if a professional had a mental health or substance use disorder, they were left with only disciplinary action from their licensing board with no treatment. Leading the path for non-punitive rehabilitation, PRN provides referrals, monitoring, education, and advocacy services to help professionals keep their licenses and continue to practice with integrity and concern for the safety of the public14.
Support for Friends, Family, & Colleagues
Suicide and self-harm are preventable mental health crises. We can be proactive by recognizing expressions of someone in distress. While there are different ways people exhibit pain, these are a few types of warning signs9:
- Someone expressing feelings of being trapped, like there is no way out.
- Someone expressing hopelessness or stating no reason for living.
- Someone withdrawing from family, their friends, or usual activities they like.
- Someone talking or threatening to hurt or kill themselves.
When someone experiences a mental health challenge, here is how you can be supportive9:
- Listen – let someone really express their experiences. Being someone they can talk to is essential when giving support.
- Be non-judgmental – don’t criticize or minimize the way they feel. You may not be able to understand exactly what they’re going through, and that’s ok.
- Ask what, not why – when you ask questions, avoid asking ‘why’ questions, and instead ask ‘what’ questions. Asking why can have a judgmental tone even if you don’t mean it that way.
- Give information, don’t diagnose – don’t assume they have an illness or condition. Provide direction to resources that can identify and treat mental health issues.
- Act as a bridge – you can connect someone to mental health resources. Resources include family, school guidance, mental health professionals, and organizations.
- Teammate in support – being supportive doesn’t mean your duty is to ‘fix’ someone. Mental health is complicated and solutions aren’t overnight. As a teammate, the best support you can give is by being a trusting ear, helping to navigate resources, and acting as a source of encouragement.
The following are some of the phrases you can say to help and be supportive9:
- I had no idea that affected you so deeply.
- It sounds like what you were experiencing felt overwhelming and isolating.
- I want to understand your feelings/thoughts more.
- I think it’s time you talk to someone about this. There are safe and confidential people who can and want to help.
- You don’t have to talk if you’re not ready, but I am here and want to listen.
- You are not alone in this. I want to help you, so I think it’s best we reach out together to someone who can help us with next steps.
- I can tell that your experience was not what you expected, and that caused you pain. This is not an uncommon feeling. I’m here for you.
- I can hear this is difficult for you to share. I want to thank you for opening up and trusting me with this information. It’s ok not to be ok.
Resources & References
- Continuing Education
- ADA Accelerator Series – Mental Health, Dentistry, and You (Recorded Webinar; Kasey Franco; Member Price $0; 1 CE Credit)
- ADA Accelerator Series – Wellness in Dentistry: Inspired and Supportive Leadership (Recorded Webinar; Kasey Franco; Member Price $0; 1 CE Credit)
- Resilience Webinar Series Part 1: How Can Dentists Develop Emotional Resilience in a World Full of Stress? (Recorded Webinar; Sheela Raja; Member Price $0; 1 CE Credit)
- Practice Resources – Health and Wellness – find effective resources for taking care of yourself and your staff.
- American Association of Marriage and Family Therapy - https://www.aamft.org/
- American Psychological Association - https://www.apa.org/topics/mental-health
- Anxiety and Depression Association of America - https://adaa.org/
- Centers for Disease Control and Prevention - https://www.cdc.gov/mentalhealth/
- Hope for the Day - https://www.hftd.org/
- Mental Health Texas - https://mentalhealthtx.org/
- Mental Health America - https://mhanational.org/
- National Alliance on Mental Illness - https://www.nami.org/home
The TDA Mental Heath Resource Center is brought to you by TDA’s Council on Professions and Trends as directed by the TDA House of Delegates.