Jo Kottoor, PMHNP-BC, LPC-A.

Mental health has been getting a lot of attention in the media lately. The stress of the past few years has weighed heavily on our mental well-being. Since the start of the pandemic, we’ve had to adapt to one new challenge after another. It was inevitable that our mental health would be affected. Many with new or worsening mental health conditions are facing the prospect of seeking mental healthcare services for the first time.

It’s not always obvious when to seek help for mental health concerns. When we have physical symptoms, like a sore throat or back pain, a quick internet search of ‘when to see a doctor’ can help make this decision. With mental health, it’s harder to know when or even how a professional can help. This and other roadblocks commonly get in the way of getting mental healthcare when you need it.

When mental health declines, quality of life follows close behind. It’s an insidious process. When mental health worsens, we find ways to accommodate for the challenges. Day by day our behavior and decision-making subtly changes. Our brains are built to adapt to stressors as they happen. For example, a change in our thought process, like lowering our expectations, might help us cope. Eventually, these accommodations add up and begin to restrict our lives. At this point it becomes difficult to find our way back to the lives we lived before.

A young man I knew was involved in a serious car accident. Every time he thought of driving after that, images of being in another accident would form in his mind. He began to avoid driving and found excuses not to attend events that were far away. Then he moved to an apartment closer to his work, so he could take the train. He sold his car. He made these decisions to manage his anxiety about driving. He’s now a successful physician but he hasn’t driven a car for seven years. His fear of getting into another accident grew stronger every time he avoided driving. Now, not driving greatly restricts his life and is disruptive to his relationships.

We often forget that the human brain is wired to prioritize survival above all else. Our sense of well- being is lower down on the priority list. When needs go unmet or we feel threatened, our brain adapts by changing how it functions. The more primitive parts of the brain can launch an alarm, with changes like increased heart rate or muscle tension. The more advanced parts of our brain can modify thought patterns. What we pay attention to, what we think about, and even the tone of our self-talk can shift in response to new experiences.

As an example, adults with ADHD commonly relate childhood stories of struggling to pay attention and stay on task in school. This often led to regular reprimands by teachers and embarrassment in front of peers. Children with ADHD are not less able to learn; they have different learning needs. In a classroom created for the neurotypical brain, they have trouble feeling successful and have little control over the situation. Many begin to view themselves as inept. They start to take notice of and preferentially remember mistakes they make while minimizing their achievements. The tone of their self-talk becomes punitive. Perhaps these changes are to help them avoid the pain of future embarrassment or disappointment. It is counterproductive, however, as these changes also make them more vulnerable to anxiety and depression.

When left to its own devices, the brain can create more problems as it adapts to new stressors. Unhealthy coping mechanisms like negative self-talk or avoidance can do more harm than good in the long run. Although it’s not possible to remove all life stressors, we do have some control over how we respond and adapt to them. Identifying our default coping strategies and learning how to choose more effective ones can mean the difference between surviving our daily lives and thriving in them.

Mental health can seem like a moving target. Self-care is one way to gain a sense of control. Self-care is paying attention to and providing ourselves with basic needs like healthy food, good sleep, downtime, exercise, and genuine connection. It can be hard to maintain self-care, especially during stressful times. Self-care has to compete with all the other things vying for our attention.

Productivity and achievement, for example, have the advantage of providing an instant reward. While productivity is a good thing, consistently placing productivity over well-being takes a toll on our mental health. We all have barriers and behavior patterns that get in the way of self-care. Identifying and dismantling them can make it easier to practice self-care more consistently.

When we neglect our mental health, our brains become preoccupied with struggle and survival. Paying attention to and nurturing mental wellness gives us the resources to meet challenges more effectively. It contributes to better body functioning and sleep quality. Motivation and sustained energy become more accessible. It makes us feel more positive, our relationships improve, and we’re able to live fuller lives.

The ultimate goal of mental healthcare is to help people regain optimal functioning and improve their quality of life. If you or a loved one are struggling with a mental health concern, there is help available. Psychotherapists, psychiatrists, and psychiatric mental health nurse practitioners all provide mental healthcare services. A good provider will treat patients with respect, provide genuine empathy, and listen carefully to their concerns. They can help people evaluate their current functioning and create a plan to meet their goals. Treatment can include various types of therapy and, if necessary, medication.

Ideally, psychiatrists, nurse practitioners, and therapists will work together to provide the care you need. No matter which route you choose, your mental health professional can help you decide what services are best for you and how to find them in your community.

Jo Kottoor, PMHNP-BC, LPC-A

Feel free to contact at: This email address is being protected from spambots. You need JavaScript enabled to view it.

It wasn’t that long ago when professionals firmly believed that ADHD was strictly a child/adolescent disorder, and that it could not exist in adults. Now we know that symptoms and behaviors associated with ADHD can exist a lifetime. But defining “inattention” and “impulsivity” in the adult world can be somewhat confusing, so we thought we’d give you some real world examples. So, without further ado…

You May Be A.D.D. if:

• You’ve been pulled over for an expired inspection sticker.

• You can remember every word to “Rapper’s Delight,” but can’t remember how many months have 31 days.

• You walk into a room and immediately forget why you went there in the first place.

• Your definition of time management is shaving (brushing your teeth, applying makeup, etc.) in the car.

• You’ve ever found your car keys in the refrigerator.

• You organize the kitchen and nobody can find anything anymore.

• You put your passport in a safe place so that you won’t lose it again. Ten minutes later, you’ve forgotten the location of the safe place.

• You honestly believe that you can fit an hour’s worth of activities into fifteen minutes.

• Your dentist, doctor, accountant, professor, and hair stylist are always screwing up the date and time of your appointments.

• Your friends and family know that when you say you’ll be there at 8:00, you really mean 8:15.

• When budgeting for a vacation, you have to account for the “A.D.D. Tax,” or money you’ll spend buying all the things you know you’ll forget to bring with you.

• You’ve given up buying expensive sunglasses because you know you’ll just lose them.

• You’re laughing as you read this because this totally sounds like you.

• Winter is one of your favorite seasons because you always manage to find long lost items in the pockets of your jacket. Like your expensive sunglasses.

• You’ve ever left your cell phone:

•  In your pocket before jumping in the pool,

•  On the roof of your car before a road trip,

•  Somewhere. You don’t know where. You’re still looking.

• Organizing your work area means placing all the papers on your desk into a large pile.

• It’s August, and your Christmas/Hanukkah lights are still on the roof.

• Your idea of “relaxation” is doing ten things at once.

• There are roughly 17,345,891 versions of torture that you prefer over being bored.

• You’ve tried, but you just don’t get the appeal of Opera.

• Or yoga.

• Or Ernest Hemingway.

• You go to work and realize you can't use your computer because you left the power cord of your computer at home. The next day, you make a concerted effort to remember the power cord, and end up leaving the computer at home.

• You make a detailed list of all the things you need to do, and then promptly lose it.

• It’s taken you three days to read this far.

• After taking out the trash you go to get a new trash bag from the pantry, and notice that the pantry light bulb has burnt out. So you go to get a new light bulb from the cabinet and notice that the hinge is loose on the cabinet door. You go to the garage to get your screwdriver to fix the hinge when you notice that there’s a pipe leaking in the garage. You put down the screwdriver, shut off the water, and begin to fix the pipe. Your wife comes into the garage, dripping wet, with shampoo in her hair and asks you what in the world you’re doing. You reply, quite simply, that you’re replacing the trash bag. Sheesh!

W. Walker Peacock, Psy.D.