New research suggests these clients may also live longer when medication is part of their treatment. 

A team of researchers in Sweden, working with U.S. and U.K. universities, sought to answer the question of whether medication for ADHD makes a difference in mortality rates. 

“It’s interesting that researchers have found links between untreated ADHD and longer-term mortality rates,” says James Gurule, child and family therapist and clinical supervisor at 18JAV.  

The observational study focused on nearly 150,000 people, aged 6 to 64 years, who had had “incidents” before their ADHD diagnosis, then followed them during a two-year period after diagnosis and starting medication.  

Researchers found that the risk of dying from unnatural causes, such as accident or overdose, was “” in the medicated group. 

“I’d imagine this is likely connected to the impulsivity, distractibility and hyperactive elements of these disorders that, left untreated, are connected to a wide range of challenges over the lifespan,” says James. 

The research team next plans to study the long-term effects of ADHD medication itself, and differences in gender and dosing. 

A companion editorial in the issue of JAMA that published the study noted that while the medications used to treat ADHD in Sweden are also available in the U.S., “significant barriers exist in accessing medical and psychiatric services, particularly among under-resourced populations. 

“The health care workforce requires training in screening, diagnosing, and treating ADHD, just as has been done for other psychiatric disorders. Our patients, their families, and society will all benefit as a result,” the editorial concludes. 

James concurs: “Unrecognized and untreated ADHD and other children’s mental health conditions really do have a long-term impact on people and families in our communities.  Early engagement and intervention are preventative and certainly beneficial. 

Beyond medication, treatment can include behavioral management for both parents and children, targeting areas such as organizational skills and classroom behavior, to forestall the frustration many children with ADHD and their families face.  

“Our Child and Family clinicians spend years, even decades, crafting interactions with our clients in the hope of creating more understanding families and supportive, helpful interventions,” says James. 

“It’s always inspiring for me to train and supervise clinicians who specialize in services for children and their families.  Even though there are certainly a lot of moving parts, this is what makes our specialty so challenging–and rewarding!”   

The post Study: ADHD Medication Correlates to Lower Death Rate   appeared first on Lifeworks Northwest.

It’s National Alcohol and Drug Facts Week. Here’s one now: Alcohol can cause problems even in people who do not have a substance use disorder. &�Բ�����;

Did you know one night of heavy drinking weakens your immune system for up to 24 hours? You’re vulnerable to whatever viruses or bacteria are floating around out there. &�Բ�����;

Hangovers aren’t so harmless, either. Think of them as mini-withdrawals. Along with the physical discomfort, the brain still reels all the next day, affecting balance, mood, decisions and more.  &�Բ�����;

Speaking of decisions, lots of risky ones get made under the influence: driving, shopping, gambling, sex, taking dares, all of which can have life-changing consequences beyond a night of casual drinking. &�Բ�����;

If drinking is more than casual, that’s a whole different level of risk. Alcohol is a carcinogen, just like nicotine. We’re talking cancer of the breast, colon, oral cavity and rectum. The liver, which processes alcohol, takes a big hit.  &�Բ�����;

What’s “a lot” of drinking? &�Բ�����;

Binge drinking is five or more drinks (male), or four or more drinks (female), in about two hours. &�Բ�����;

Heavy drinking is defined for men as five or more drinks on any day, or 15 or more per week. For women, it’s four or more on any day, or eight or more drinks per week &�Բ�����;

What’s “moderate” drinking? &�Բ�����;

say “moderation” is about 1-2 drinks a day for men and one or fewer drinks daily for women. &�Բ�����;

What’s a “drink”? &�Բ�����;

The National Institutes of Health defines one drink as: &�Բ�����;

• 12 ounces of regular beer, about 5 percent alcohol &�Բ�����;
• 5 ounces of wine, about 12 percent alcohol  &�Բ�����;
• 1.5 ounces of distilled spirits, about 40 percent alcohol (80 proof) &�Բ�����;

But it’s easy to drink a lot more than we realize or intend. Many craft beers and ales are far higher in alcohol. Drinking a 15-percent alcohol beer is actually three drinks in one bottle.  &�Բ�����;

Two servings of port wine or liqueur amount to three or four drinks. &�Բ�����;

Hard liquor of 120 or 150 proof is several drinks in one. &�Բ�����;

Cocktails mixed in a bar are a mystery – there’s no way to know how many “drinks” are in that glass. &�Բ�����;

Humans have been consuming alcohol for thousands of years. Most do not develop substance use disorder, though that doesn’t mean there can’t be consequences from occasional bouts of heavy drinking (see: risky decisions). &�Բ�����;

Awareness is the key to moderation and limiting alcohol’s risks to our health and life.  &�Բ�����;

Learn more &�Բ�����;

Lifeworks NW: When does drinking cross the line into disorder? Check out symptoms &�Բ�����;

National Institute of Alcohol Abuse and Alcoholism:  &�Բ�����;

The post Alcohol’s Impact on the Body and Brain  appeared first on Lifeworks Northwest.

Here’s an astonishing fact: 48 million Americans aged 12 and older meet the definition of mild to severe substance use disorder (SUD). &�Բ�����;

That’s one in six of us. As young as 12 years old. &�Բ�����;

Meeting even two of these symptoms—used to —constitutes a “mild” disorder. Any two of these can have an alarming effect on a person’s physical, mental or financial stability.    

• Taking the substance in larger amounts or for longer than you’re meant to &�Բ�����;
• Wanting to cut down or stop using the substance but not managing to &�Բ�����;
• Spending a lot of time getting, using, or recovering from use of the substance &�Բ�����;
• Cravings and urges to use the substance &�Բ�����;
• Not managing to do what you should at work, home, or school because of substance use &�Բ�����;
• Continuing to use, even when it causes problems in relationships &�Բ�����;
• Giving up important social, occupational, or recreational activities because of substance use &�Բ�����;
• Using substances again and again, even when it puts you in danger &�Բ�����;
• Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance &�Բ�����;
• Needing more of the substance to get the effect you want (tolerance) &�Բ�����;
• Development of withdrawal symptoms, which can be relieved by taking more of the substance &�Բ�����;

None of us knows who may develop SUD, or who may progress from mild into a moderate or severe disorder that impairs the ability to live a productive, safe, healthy life. That’s why it’s so important to recognize this prevalent disorder and know what steps to take. &�Բ�����;

Here’s a hopeful fact: 18JAV holistic approach to treating substance use disorder helps people get their life back. Contact us to learn about our services. &�Բ�����;

Learn more &�Բ�����;

Substance Abuse and Mental Health Services Administration: on drug, alcohol and tobacco use (pdf) &�Բ�����;

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During February, Heart Health Month, many voices in the health ecosystem spoke about the importance of physical healthcare and caring for the heart. We’ve heard a lot about what causes heart disease (diet, alcohol, tobacco use, among other factors), how men and women have different heart attack symptoms, and how to nurture a healthy heart. 

One thing we don’t hear so much about is that people who live in poverty have twice the risk of heart disease, the leading cause of death in the U.S. Lower socio-economic status was a big factor even aside from behaviors like smoking, diet, high blood pressure or cholesterol.  

According to a study in the Journal of the American Medical Association: 

Compared with individuals of higher status, men and women of low socioeconomic status had twice the excess risk for heart attack and twice the risk for the prevalence of coronary heart disease death. After accounting for traditional risk factors, the simulation calculated that 60% of the excess risk for heart attack and coronary heart disease death was tied to socioeconomic status.

Part of the reason is that , which creates inflammation in the body including the coronary arteries. According to the National Institutes of Health, “Researchers have proposed that the body’s stress response may link poverty with disease risk. Long-term stress can increase inflammation in the body. Chronic inflammation is thought to play a role in the development of many health conditions.” 

Solving for issues related to socio-economic status isn’t just about status: it’s about working toward a better quality and length of life.  

When we help our clients access healthy food, stable housing and productive employment, we put them on the path to improved socio-economic status and lower stress that can reduce heart disease risk and add health and years to their lives, over and above their mental health or substance use recovery.

Learn more: JAMA Cardiology: 

The post How Behavioral Health Plays a Role in Heart Health appeared first on Lifeworks Northwest.

With roots in Confucianism, Buddhism, Taoism and other religions, today, the lunar new year may be a cultural or religious festival, or both. And as in many cultures, celebrations include time with family, sharing traditional meals, visiting friends and remembrance of those who have gone before.  

As with most holidays, the opportunity to create connections to family, friends and one’s community can be part of mental and emotional well-being. And for those of our staff and clients who do not have a supportive and stable family unit, the opportunity to meet with neighbors and other community members can help create much needed connections. 

Our community hosts many observances of the lunar new year that you can share with clients and friends. 

• Feb. 3 – Oregon Chinese Consolidated Benevolent Association hosts a at the Oregon Convention Center.  
• Feb. 10-24 – lantern-viewing evenings and teas. 
• (watch for updates to annual events at this website) 
• Feb. 3 – Oregon City cultural with activities, performances and food 
• Feb. 17 – Washington Square Mall (free) 
• Feb. 17 – Portland’s Chinatown dragon parade (free)  

We join in wishing joy, abundance and good health in the new year for all our 18JAV friends and communities. 

The post Happy (Lunar) New Year to our Asian Communities  appeared first on Lifeworks Northwest.

Even with the pandemic quarantine and its jokes (I finished Netflix, now what?) receding in our memory, it’s a good idea to look at how we keep our brain working when we are forced into idleness. 

Sanjay Gupta, M.D., a neurosurgeon, published a book in the middle of the pandemic that captures some science-based tips in Keep Sharp: Building a Better Brain at Any Age.  

“While our other organs deteriorate over time, our brain doesn’t have to,” he says. We can use his five pillars of brain health every day, whether or not we are homebound. 

These techniques underscore the evidence-based treatment approach that 18JAV clinicians promote to our clients, as well as being healthy reminders for us all.  

Move: “The connection between physical fitness and brain fitness is clear, direct, and powerful,” Dr. Gupta says. If you’re stuck inside, you could break a sweat dancing to a favorite song, do that household task you’ve been putting off or try some yoga or tai chi. 

Discover: While crosswords are fun, challenging our brain to learn something new is more stimulating. That’s never been easier: the internet possibilities are literally endless with podcasts to satisfy every curiosity or videos to learn a skill or hobby. 

Relax: Brains need sleep, just like the rest of our body, ideally seven or more hours a night. Meditation is also helpful, and being confined indoors allows plenty of time for both. 

Nourish: Dr. Gupta recommends we slash sugar intake, increase healthy fats like nuts, seeds and fish and mind our portions. But there’s nothing like being homebound to trigger our comfort-eating reflex. Try water first. “We often mistake hunger for thirst,” says Dr. Gupta. “Even moderate dehydration can sap energy and interrupt brain rhythm.” Keeping hands busy helps too, like a puzzle or project. 

Connect: “Relationships can improve the brain’s ability to change and adapt and preserve its cognitive abilities.” If you’re stuck at home, phone or Facetime a friend – that’s a deeper connection than texting or commenting.

Just as life sometimes coops us up, it can also get in the way of doing these proven behaviors regularly. This is a case of “progress, not perfection.” Do what you can, in whatever combination you can manage, as often as possible.  

“Never forget that the brain is exceptionally plastic,” says Dr. Gupta. “It can rewire and reshape itself through your experiences and habits. It’s like building any other muscle.” 

To be ready for the next weather or other event that keeps us home: stock up on puzzles and games—our area has great thrift stores for those. Get that library account activated to download audio books, stockpile some healthy foods, list some people we’ve been meaning to call and build that dance music play list. 

Learn more 

Healthline:  

Sanjay Gupta:  

The post Keep the brain engaged, even when we aren’t  appeared first on Lifeworks Northwest.

Being depressed puts people at higher risk of other physical and mental health conditions, according to the National Institute of Mental Health. And chronic health conditions put people at higher risk of depression.   

That’s a one-two punch that calls for integrated treatment for mental health issues of all kinds.  

During January, National Mental Wellness Month, it’s important for people to understand how common mental illness is—one in five adults in any given year. And to understand the risk of other medical conditions occurring alongside a mental health diagnosis. 

Research shows people with a mental illness may have more than one, such as depression and an anxiety disorder, says NIMH. Some combinations are more likely to co-occur, such as depression and substance use disorder.   

Conversely, people with chronic health issues like auto-immune disorders and neurological conditions risk developing depression.  

Having one condition can worsen symptoms of the other. A depressed person with lupus, for example, could have worse experience with both conditions. A depressed person is more likely to drop out of substance abuse treatment than one who is not depressed, according to the National Alliance on Mental Illness (NAMI). 

Each condition can be treated successfully, especially with an integrated approach such as 18JAV practices. 

Co-occurring conditions have a wide-ranging effect, according to NAMI: 

• People with depression have a 40% higher risk of developing diabetes and heart disease.  
• People with serious mental illness are nearly twice as likely to develop these conditions. 

• 33.5% of U.S. adults with mental illness also experienced a substance use disorder in 2021 (19.4 million individuals) 

Even beyond illness itself, there are substantial personal and community costs.  

• The rate of unemployment is higher among U.S. adults who have mental illness (7.4 percent compared to those who do not (4.6 percent). 
• High school students with significant symptoms of depression are more than twice as likely to drop out compared to their peers. 
• More than one in five people experiencing homelessness in the U.S. have a serious mental health condition. 
• Across the U.S. economy, serious mental illness causes $193.2 billion in lost earnings each year.

This cross-over between mental and physical health conditions illustrates that mind and body cannot truly be separated in health care. That’s why 18JAV mental health programs use evidence-based practices in an integrated team-based approach of whole health care for the whole person. 

Sources: 

• National Institute of Mental Health:  
• National Alliance on Mental Illness: (pdf) 
• Mental Health Services – Portland OR | 18JAV 

The post Mental health one-two punch  appeared first on Lifeworks Northwest.

One study found that didn’t maintain their new behavior past a week. One month into the new year, that number was almost half.  

But don’t give up!  Experts offer hope that by adjusting our goals and being persistent, we can succeed. 

“Change is a process — and processes take time,” says psychologist Susan Albers, Psy.D., of the Cleveland Clinic. “It is not like a light switch.” 

Some proven techniques and strategies can help us stay on track.  

Research indicates that it’s than to stop one. Instead of resolving to quit something, try adding something, and be SMART about it. Let’s see what that looks like. 

• Specific. I will eat more green leafy salad. 
• Measurable. I will eat four green leafy salads a week. 
• Attainable. I can have ingredients at hand, ready to throw together. 
• Relevant. Green leafy salads meet my health goal of eating more raw food. 
• Time-bound. I will eat four green leafy salads a week for four weeks. 

See if your new year resolutions meet the SMART test, and how you can adjust them. And then gear up. 

“Goal pursuit requires focused attention,” says Elliot Berkman, a psychologist at the University of Oregon. “Our minds need to be focused on one thing,” he says. “Clarity is key. 

“In daily life, we’re driven by our habits. Working toward a new goal can require a lot of brain power. We need to fend off distractions. It’s slow going when we’re trying to master a new skill or change our behaviors, Berkman says. “Goal pursuit is so hard compared to habit.” 

Dr. Albers echoes this theme: “Many of the behaviors linked to resolutions involve activities or habits that you’ve had for years. Give yourself time to adapt and make changes.” 

 She offers additional tips to help people succeed. 

• Choose realistic goals that are sustainable for the long term. 
• Be flexible and open to changing them along the way, as needed. 

• Identify obstacles that might get in the way of success. 
• Track your progress.  
• Partner up with an accountability buddy. 

One of the top predictors of success involves social support. One study found that 70 percent of people who sent weekly updates to an accountability partner were successful in reaching their goals, as compared to those who tried to go it alone. 

As hard as we try, there will be days we don’t meet that goal. 

“It happens,” says Dr. Albers. “Be kind and compassionate toward yourself. Real change happens when a person feels ready, not by an arbitrary date on a calendar.  Just come back to your goal. Keep going and be persistent.” 

Learn more 

SMART goals: NPR  

Cleveland Clinic:  

The post New year, new you? SMART Goals Can Help appeared first on Lifeworks Northwest.

In Oregon, 160 cases involving 246 victims were reported in 2021 by the national hotline for human trafficking. But the U.S. Department of Justice says , in part because law enforcement has been unable to identify local trafficking offenses, and inadequate reporting of those incidences that were identified. 

Another difficulty is that even people who are being trafficked—especially young women being traded for sex—are being emotionally manipulated by experts who know how to play on their history of trauma and abuse. 

“Working with this population offers up complex challenges outside of the resulting diagnosis,” says Jeslyn Stamm, program director. “We are often uncovering—slowly—many underlying challenges, including dependence, mistrust and psychological manipulation.  

“Clients who may be presenting for mental health or substance use may also be trafficked, but it’s a difficult situation for a clinician to address,” Jeslyn says. 

That’s why 18JAV has held training sessions for staff and clinicians. 

“We want to educate clinicians on what to keep an ear and eye out for when working with someone they suspect is or has experienced outcomes related to sex work or sex trafficking.” Jeslyn says.  

Being client-focused is a challenge in itself, because, “Many times, they do not see themselves as ‘victims’ and are not interested in necessarily exiting the life (right now) but want to learn ways to better safeguard themselves,” Jesyln says. 

“We educate them on the dangers and help to identify short- and long-term consequences, while acknowledging that there are rewards being experienced simultaneously. They are hypervigilant to our entire presentation, and this could make or break the therapeutic alliance quickly.” 

In addition to providing therapeutic services, 18JAV staff can connect these clients with community agencies who can better support other needs.  

Learn more: 

—list of county human trafficking task forces 

Oregon human trafficking data  

  or call 1-888-373-7888. 

  or call 1-800-THE-LOST. 

The post Therapeutic Challenges of Addressing Human Trafficking Victims  appeared first on Lifeworks Northwest.

What poses a greater health risk than obesity? 

According to U.S. Surgeon General Vivek Murthy the answer is: Loneliness. 

“Loneliness is more than a bad feeling,” Dr. Murthy said. “It has real consequences on our mental and physical health. It increases our risk of depression, anxiety and suicide, as well as heart disease, dementia and stroke.” 

Dr. Murthy says one in two adults report feeling lonely or isolated. This time of year can heighten those feelings. A showed 64 percent of people with a mental illness reported their conditions worsened around the holidays.  

And it’s not just the holidays. 

“What I am noticing since the pandemic is that we are realizing we are more lonely than ever before,” said Angela, Adult Outpatient Mental Health therapist at 18JAV. “Not only the lack of connections, but also the quality of the connections impact our mental health and overall well-being.  

 “I am seeing more and more adults seeking more meaningful connections but don’t know where to start. Social media and technology exacerbated this. It’s like we have to relearn connecting with others on a more personal level.” 

Angela offers several ideas to get started: “Take small steps to form more meaningful connections with those around us, in our families, (in) community activities, even exploring hobbies or joining a group. Local libraries have events. The National Alliance on Mental Illness has various groups to explore. In Washington County, NAMI has an art room where folks can use their materials to create art.” 

While technology can isolate, Angela pointed out ways it can connect, too: “Nolongerlonely.com, Facebook groups, meetup.com. You have an interest? There is probably a group for that.” 

Her counsel echoes that of , a primary care physician and author of , which offers a road map to connecting: 

• Make something. 
• Have a conversation. 
• Be curious and share an interest. 
• Reach out to people who might be lonely. 

“Just like thirst is a signal you need hydration, loneliness is a signal that you need human connection,” says Dr. Nobel. 

“There’s just no substitute for human connection,” Dr. Murthy says. “There are steps we can take today that will make a difference. Just spend 15 minutes with someone you care about, fully present and not distracted. Look for ways to help others. Small acts of service can be powerful in helping us to feel connected.” 

In relearning to reach out, Angela says, “Be kind to yourself and let go of rules or expectations about connecting with others. Be you in however much or little you decide to show in that moment.” 

Angela likes to quote the fortune cookie she got years ago: “Begin. The rest is easy.” 

Learn more: 

U.S. Surgeon General report, 2023 (pdf): Our Epidemic of Loneliness and Isolation  

Dr. Vivek Murthy (video)  

Resources 

• from Substance Abuse and Mental Health Services Administration (SAMHSA) 
• The a free, statewide 24/7 call service for Oregonians 55 and older. Call 503-200-1633 or 800-282-7035. 
• Call or text 988 or chat at to reach trained crisis counselors at the Suicide & Crisis Lifeline. Spanish speakers can call 988 and press 2, or call 888-628-9454 to reach la Red Nacional de Prevención del Suicidio, text the word “AYUDA” to 988 or chat online at . 
• is a teen-to-teen crisis and help line. Call 877-968-8491 or text teen2teen to 839-863. Trained teens are available to help daily, 4 p.m. to 10 p.m. (adults are also available 24/7). 

The post Loneliness Harms Health; Small Steps Can Help  appeared first on Lifeworks Northwest.

From watching children grow and develop to fostering the growth and development of 18JAV itself, volunteers are involved.  

“From our many students to our board committee members, to Children’s Relief Nursery volunteers, 18JAV deeply appreciates volunteers offering their time, passion and expertise to support our mission,’ says 18JAV President/CEO Mary Monnat. “We are so much stronger for their efforts.” 

In recognition of International Volunteer Day, Dec. 5, we asked a few of our volunteers to talk about their work here and what it means to them.  

Chris, Children’s Relief Nursery, St. Johns 

“I’ve long been interested in kids,” says Chris. He had volunteered with a SMART reading program and spent a lot of time with his toddler granddaughter. 

“I find it so fascinating to watch young children in the development stage,” he said, “watching them grow and learn and make connections.” 

After retiring as a software engineer, he checked with United Way for opportunities to work with children. He found a position with the Children’s Relief Nursery at St. Johns.  

“This was exactly what I wanted to do, and it was icing on the cake that they actually needed me!” 

Volunteering at St Johns, he finds, “Kids need attention, and they respond to attention from adults. They learn to get along and behave and become different people.” The bonus for Chris is that he becomes different, too.  

“When I’m around here, I change completely. I’m open and expressive, which is good for me. I can be as silly as I want to be, and they eat it up. I’m sure I get more out of it than they do. I can give 100 percent for four hours. Then I need to go home and take a nap.” 

Deborah, former member of Board of Directors, currently on Marketing and Development Committee 

“I really believe in the people of 18JAV and the value of their work,” Deborah says. “We’ve all witnessed the effects of mental illness and I wanted to be part of the solution.  

“Over the past 15 years, I’ve served on various committees, attended fundraisers, taken site tours, and had the honor to serve on the board for six years. During that time, I met dozens of amazing, mission-driven people who work for 18JAV and have an outsized impact on our community.  

“They continually inspire me with the strength and healing they bring. 18JAV can be life-changing because they see the whole person, beyond mental illness, and help with factors that support healing, like housing and work. 

“I feel grateful to have experienced so many memorable moments, most especially the testimony from 18JAV ‘grads.’ When they talk about what they went through and how they began to heal and keep coming back to learn and grow and thrive, well, it’s a joy to experience for someone who’s been working from home behind a laptop for over a decade. I’m even more inspired by the many 18JAV grads who now work for 18JAV. That’s so cool! 

“Perhaps because I’m a systems person, I’ve always been impressed by 18JAV’s evidence-based approach, and I’ve enjoyed working on various projects over the years, but it always comes back to the people at 18JAV and the amazing work they do in our community. I’m proud to be a small part of it.”  

Susan, Marketing and Communications writer 

“My profession as a writer gave me a strong sense of purpose,” says Susan. “I’ve written a lot about addiction and mental health over the years, always bearing in mind the impact those issues have had on my family, among millions of others. 

“Volunteering at 18JAV gives me a way to continue that work. Writers always hope to make a difference and in this new role, I have a chance to contribute a tiny bit to the vast good work done here. But I have selfish reasons too. This opportunity helps fend off isolation in retirement and connects me to something bigger than myself.  Like many volunteers, I feel like I get more out of it than I give.” 

The post 18JAV Appreciates its Volunteers  appeared first on Lifeworks Northwest.

“Time, money and gift-giving are the top identified stressors,” says Rich Roell, program manager for 18JAV Washington County Crisis Team at the Hawthorn Walk-In Center. “We are inundated with commercial images about what makes a happy holiday.”  

To help keep your holiday happy, it’s worth reviewing your stress management tools. Even if you practice some of these already, holiday indulgence and family gatherings can throw you off your game.  

Make a plan. Get ahead of some of that pressure around time, money and gifting by deciding early what you can and can’t do. Figure out ahead of time what you will do about feeling overwhelmed or lonely. 

“Ask for help,” Rich says. “You don’t have to be the one person who does it all.”   

Practice saying no. It’s hard to please everyone in the best of times and holidays give rise to many tough choices and situations.  

“Think about your triggers and decide ahead how you’ll handle them,” Rich says. “Rehearse a little speech in your head so you’re ready if people challenge your choices.” 

If you already know you must avoid your family of origin, then of course you must. You don’t have to offer an explanation or apology to people who pick apart any reason to get what they want from you. Allow yourself to just say no, as kindly as you can manage.  

Manage expectations. Holidays are lovely but they don’t magically cure ours and others’ shortcomings. Relish the cheer and be clear-eyed about limits and differences.  

“It’s okay to opt out, but communicate,” Rich says, “If festivities become more stressful than cheerful.”  

Go easy. Avoid maxing out your time, energy and resources striving for holiday cheer. Draining yourself is a recipe for stress or unwise choices, like overeating or substance use.  

“Holidays are a time of indulgence,” Rich says. “But next day, get back on track.” 

Keep your routine. Holiday time gets very busy, which is all the more reason to keep up your health and wellness activities.  

“Get enough sleep, stay on your meds and keep to your routine to stay grounded,” Rich says.  

Give yourself. Taking the focus off ourselves relieves stress, Rich says. “Volunteer. Talk to someone every day. Don’t assume everyone has a support system – checking in with others is good for them and good for us, too. And lean into your own support system.” 

Stress management tools can help you take comfort and joy in the season of merriment and take care of yourself, too. 

“You don’t have to do it all,” Rich says. “Do what’s meaningful to you.” 

Resources 

18JAV during closed hours 971-244-4635 

Washington County Crisis Line: 503-291-9111  

Multnomah County Mental Health Call Center: 503-988-4888 

Clackamas County Mental Health Crisis Line: 503-655-8585 

Call or text 988 for the Suicide and Crisis Lifeline. While it’s a myth that holidays trigger suicides, Rich says, thoughts and ideation may still be present. 

2-1-1 info–Community resources 

Tips to manage holiday stress 

The post Holiday Time: Hone your Stress Management Tools   appeared first on Lifeworks Northwest.

But depression poses a paradox: “It can be really hard to initiate things and find motivation,” said Michelle De Oliveira, occupational therapist and service coordinator at 18JAV’s Zenith Place Residential.

One thing we do every day can help: breathing. Called mindful or intentional breathing, this technique triggers body and brain systems in ways that can address symptoms of depression. Mindful breathing decreases the activity in the amygdala of the brain where emotions are processed, while increasing activity in the frontal lobe where we access logic. It also helps regulate the activity of hormones associated with anxiety, stress and sleep.

According to the , mindful breathing addresses symptoms of depression by:

• Decreasing negative automatic thoughts
• Helping to stay grounded in the present
• Increasing focus
• Improving mind-body connection

To get started, Michelle says, break this new task down into small steps.

“If you want to try mindful breathing, the next step could be selecting a space to do that,” she says. “Next step might be to make it safe, comforting and welcoming. Try using some calming sensory input such as lighting, scents, pillows, blankets or calming music.

“Practice this when you are feeling calm, have cognitive energy and motivation. Practicing will make it easier to do when you’re feeling stressed, depressed and unmotivated.”

Being “in the moment” can be difficult for people with coexisting conditions, like ADHD or trauma, according to Michelle. Focusing on sensory input like music or scent can ease people into their mindful breathing.

Others find it challenging to pause or slow down enough to do mindful breathing. Good news, Michelle said, “this happens naturally in many common activities, such as singing, working out, yoga, walking, running and tai chi. And when done with others, these can provide a way to connect and socialize, all of which can help to improve mood and boost motivation.”

Setting up a special place can be helpful when you first get started, and once you’ve got a routine, you can do mindful breathing anywhere. Apps and online videos show many techniques. Typically, it’s important to:

• Lie down (or sit up straight) so your lungs and diaphragm can expand.
• Breathe from your belly – when you engage your diaphragm you can feel your belly going in and out.
• Breathe in through the nose and out through the mouth to a slow count of four, taking the same amount of time on the inhale and exhale.

Something as simple as breathing mindfully can be one of the many little things that help break through the depression paradox.

“Those small steps can be hard to acknowledge as being part of the big picture,” Michelle said. “But those little things add up to big things.”

Learn more

Depression, even the most severe cases, can be treated. You are not alone. See how 18JAV can help you manage your .

(from choosingtherapy.com)

(from psychcentral.com)

The post Take a Deep Breath to Fight Depression Symptoms appeared first on Lifeworks Northwest.

Dozens of parents get a lifeline through the Healthy Families program. Washington County contracts with 18JAV to administer this national program at locations in Hillsboro and Tigard. Families are referred through the county’s early child development program.

“We form an alliance with families,” says 18JAV’s Hillsboro Program Coordinator Nydia. “Our family support specialists meet with parents weekly on average to support healthy and happy relationships. The national goal is that all children receive nurturing care from their family that leads to a healthy, long and successful life.”

(HFA) is the signature home visiting program of , the nation’s oldest and largest organization dedicated to the prevention of child abuse and neglect. 18JAV has offered this program at two sites in Washington County.

Developed over 25 years and based on extensive and ongoing research, the HFA approach is relationship-based, culturally respectful, family-centered, and grounded in the parallel process. Relationships that Family Support specialists build with parents and families serve as a model for cultivating supporting, positive relationships with their children.

According to HFA, its accredited program by improving mental health, financial stability and reducing domestic violence. Children show improved development and school readiness.

In Washington County, participating families receive services in their first language when possible, as well as bilingual, bicultural support. Each of our eight family support specialists are assigned 13 to 18 families.

“Once a family becomes interested in receiving services, our staff will reach out to learn more about their current needs and explore their strengths,” says Nydia. “The first job of staff is to build a strong connection with the families being served.” 

After learning more about each family’s unique situation, staff will recommend services for families based on their needs, such as food, housing, health care and other safety-net programs. Participation is always voluntary.

While eligibility for Healthy Families is based on risk factors of an expecting parent, helping one child can ripple beneficially throughout the family. Nydia recounted one such case of a client from Central America who entered the program pregnant after having a number of children.

With the aim of helping the qualifying child, Support Specialist Cristina developed strategies that benefited the entire family. Cristina’s help connecting the mother to community resources spurred some wide-ranging results, from supporting her in removing an abusive partner from the home to intervening against repeated eviction threats to collaborating with DHS to help her keep custody of her children.

“It was crisis after crisis,” Nydia says. “There were so many times this family could have ended up on the streets,” but for Cristina’s persistence and resourcefulness.

“Sometimes the mother was so tired, she’d say, ‘I can’t do it.’ It took a lot of courage to persevere in the face of so many obstacles, most rooted in poverty and intense trauma.”

According to Nydia, there is still a lot the mom needs to do and she’s in survival mode constantly, which impacts the children, too. And she’ll have the fierce backing of her Family Support specialist.

“With HFA,” Nydia says, “families will always have ‘someone in their corner’ to support them as they navigate the joys and struggles of parenthood.”

The post Healthy Families Aims to Prevent Child Abuse appeared first on Lifeworks Northwest.

“Oh, she’s so ADHD.”

“Yeah, he’s hyperactive.”

With the popularity of online quizzes, people now “diagnose” themselves or others. But ADHD is a complex condition whose symptoms can mimic or coexist with other health issues.

That’s why a true diagnosis is best entrusted to a medical or behavioral health professional experienced in identifying and treating ADHD. The right medication and therapy can be life-changing for children or adults with this diagnosis.

A primary-school client of Child and Family Mental Health Therapist Sarah exhibited lack of impulse control and emotional regulation, which could stem from many causes, such as trauma or delayed development.

“Since the symptoms look so similar, it can be hard to tell,” she said.

As a result of work in the Parent-Child Interaction Therapy, the client “began regulating emotions more independently and staying on task,” she said. “However, symptom still interfered with peer relations and a client we’ll call Harper was falling behind academically.”

Once hyperactivity was added to the equation, Harper’s doctor arrived at an ADHD diagnosis and the parents agreed to medication.

“They saw improvement in the first week with impulse control,” Sarah said. “Harper was calm and focused during tasks. Confidence increased with more successes. Harper was better able to relate to peers and even joined the soccer team.”

Boys are more frequently diagnosed with ADHD, but it affects girls as well. Some diagnostic prevalence data shows 11.7 percent for males and 5.7 percent for females, while the DSM-V-TR indicates a worldwide prevalence of 7.2 percent of children overall.

While therapy and medication provide significant improvement in symptoms, a stable home life is also crucial to the wellbeing of people with ADHD.

“Parents’ role in providing structure and routine is a critical component in managing ADHD,” says 18JAV Child and Family Therapist Arielle. “Change and turmoil are disruptive and stressful for people with ADHD.”

Moving to a new state and starting a new school are just the kind of stresses that could have triggered Arielle’s middle-school ADHD client we’ll call Dakota.

“The mom is no-nonsense and very structured, which is great for this kind of condition,” Arielle said. “But having experienced outbursts and being labeled a troublemaker before, Dakota was nervous to start at a new school.”

Arielle worked with the client to develop tools for the kinds of situations new kids might face.

“As Dakota was telling me about some trouble from other students, I was envisioning all the ways that could go,” said Arielle. “But Dakota handled it. Told people to stop, walked away or got a teacher.

“Dakota really listened. It’s always wonderful when that happens.”

More about ADHD

18JAV: ADHD treatment is available.

What you need to know about ADHD.

An advocacy organization providing support for people with ADHD and educational resources.

A publication with information for professionals, parents, and people with ADHD.

Resources for those newly diagnosed with ADHD and their families, including virtual peer support groups.

The post ADHD is No Punchline, it is a Complex Condition appeared first on Lifeworks Northwest.