Mental Health Awareness

May is National Mental Health Awareness Month. Mental Health Awareness Month has been observed in May in the United States since 1949. Nearly 44 million American adults and millions of children experience mental health conditions each year, including depression, anxiety, bipolar disorder, schizophrenia, and post-traumatic stress. This week, I thought I would share a few myths vs. facts about mental health.

Myth: Mental health issues can't affect me.

Fact: Mental health issues can affect anyone. Based on information from 2020, about:

• One in 5 American adults experienced a mental health condition in a given year
• One in 6 young people have experienced a major depressive episode
• One in 20 Americans have lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

Additionally, suicide is a leading cause of death in the United States. In fact, it was the second leading cause of death for people ages 10-24. Suicide has accounted for the loss of more than 45,979 American lives in 2020, nearly double the number of lives lost to homicide.

Myth: Mental health issues are a result of personality weakness or character flaws, and people just need to "snap out of it".

Fact: Mental health conditions have nothing to do with being lazy or weak and it is not something you can just snap out of. Many people need help to get better. Many factors contribute to mental health conditions, including:

• Biological factors, such as genes, physical illness, injury, or brain chemistry
• Life experiences, such as trauma or a history of abuse
• Family history of mental health conditions

People with mental health conditions can get better and many seek recovery support.

Myth: Therapy and self-help are just a waste of time. Why bother when you can just take a pill?

Fact: Treatment for mental health conditions varies depending on the particular problem and the individual, and could include medication, therapy, or both. Most people do best when they are actively involved in therapy and work with a support system during the healing and recovery process, in addition to their medication treatment.

Myth: There is nothing I can do for a person with a mental health issue.

Fact: Friends and loved ones can make a big difference for people with mental health issues. In 2020, only 20% of adults received any mental health treatment in the past year, which included 10% who received counseling or therapy from a professional. Friends and family can help by doing any or all of the following:

• Reaching out and letting them know you are available to help
• Encouraging them to seek help and helping them find and access mental health services
• Helping them learn self-care and coping techniques
• Learning and sharing facts about mental health, especially if you hear something that isn't true
• Treating them with respect, just as you would anyone else
• Refusing to define them by their diagnosis or using labels such as "crazy".

Myth: Mental health conditions cannot be prevented.

Fact: Prevention of mental, emotional, and behavioral disorders focuses on addressing known risk factors, such as exposure to trauma, that can affect the chances that children, youth, and young adults will develop mental health conditions. Recent evidence indicates exposure to social media during childhood and adolescence increases the risk of developing mental health conditions. Promoting the social and emotional well-being of our fellow human beings leads to:

• Higher overall productivity
• Better educational outcomes
• Lower crime rates
• Stronger economies
• Improved quality of life
• Increased lifespan
• Improved family life

For more information about mental health issues, use this link:

SAMHSA - Substance Abuse and Mental Health Services Administration

If you have any questions about mental health, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Understanding the New 2023 USPSTF Mammogram Guidelines

Screening mammograms are a vital tool in detecting breast cancer early. Early detection significantly improves the chances of successful treatment and can mean less invasive treatments are required. The United States Preventive Services Task Force (USPSTF) regularly reviews and updates guidelines to ensure the best possible care for patients. May 9, 2023, the USPSTF released a Draft Recommendation Statement for updated mammogram guidelines that provide valuable insights into screening practices. It is important to understand these guidelines in order to make informed decisions about your breast health.

What change is the USPSTF recommending regarding mammogram screening?

The new guidelines recommend that all women get screened for breast cancer every other year starting at age 40 to reduce their risk of dying from this disease. (Previously, the recommendation was for regular screening to start at age 50. Women in their 40s were encouraged to make an individual decision about when to start screening, taking into account their health history, preferences, and how they value the different potential benefits and harms.)

What are the potential harms associated with screening mammograms?

Potential harms of screening mammography include false-positive results, which may lead to psychological harms, additional testing, and invasive follow-up procedures; overdiagnosis and overtreatment of lesions that would not have led to health problems in the absence of detection by screening; and radiation exposure.

Are there specific recommendations for women with dense breasts?

Nearly half of all women have dense breasts, which increases their risk for breast cancer and means that mammograms do not work as well for them. Women are generally told by their clinician that they have dense breasts after they've had a mammogram. These women deserve to know whether and how additional screening might help them stay healthy. Unfortunately, there is not yet enough evidence for the USPSTF to recommend for or against additional screening with breast ultrasound or MRI.

The USPSTF is calling for studies to determine how additional screening with breast ultrasound or MRI might help women with dense breasts.

Are there specific recommendations for breast cancer screening for Black women?

Black women are 40 percent more likely to die from breast cancer than White women and too often get aggressive cancers at young ages. Ensuring Black women start screening at 40 is an important first step, yet it is not enough to improve these inequities. It's important that healthcare professionals involve patients in a conversation on how best to support them to ensure equitable follow-up after screening and timely and effective treatment of breast cancer.

The USPSTF is urgently calling for more evidence to better understand whether Black women could potentially be helped by different screening strategies.

The USPSTF is also urgently calling for more research that will allow them to build on the existing recommendations and help all women live longer and healthier lives. Specifically, we need to know how best to address the health disparities across screening and treatment experienced by Black, Hispanic, Latina, Asian, Pacific Islander, Native American, and Alaska Native women.

When should mammogram screening for breast cancer end?

The Task Force found that there is not enough evidence to make a recommendation for or against screening in women ages 75 and older. These women should decide together with their clinicians what is best for their individual health needs, based on their preferences, values, and health history.

The Task Force is calling for more studies on the benefits and harms of screening in older women so they can make a more definitive recommendation for these women in the future.

Why is this change in the USPSTF recommendations important?

Among all U.S. women, breast cancer is the second most common cancer and the second most common cause of cancer death. In 2022, an estimated 43,250 women died of breast cancer. Incidence has gradually but significantly increased among women ages 40 to 49 years from 2000 to 2019, with a higher rate of increase 2015-2019.

The change in recommendation to earlier screening could result in 19 percent more lives being saved.

If you would like to read the full recommendation statement, you can find it here:

Draft Recommendation: Breast Cancer: Screening | United States Preventive Services Taskforce (uspreventiveservicestaskforce.org)

If you have any questions about mammogram screening , please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

REM Sleep is Magical

Sleep is essential for our physical and mental health, and the quality of sleep is just as important as the quantity. Rapid Eye Movement (REM) sleep is a crucial stage of sleep that has numerous benefits for our overall health and well-being. Let's talk about the benefits and importance of REM sleep.

What is REM Sleep?

REM sleep is a stage of sleep that occurs approximately 90 minutes after falling asleep. During this stage, the brain becomes more active, and the eyes move rapidly. It is during REM sleep that we experience vivid dreams. REM sleep is essential for our overall health and well-being as it provides numerous benefits.

What are the benefits of REM Sleep?

• Improves memory and learning - During REM sleep, the brain processes and consolidates the information that we have learned throughout the day. This consolidation of memory helps us to retain and recall information better. It also helps prepare and maintain neural connections to improve future learning.
• Plays a key role in brain development - Did you know that the brain is still developing until you are about 25 years old? Adequate sleep during childhood and young adulthood is crucial to get the most out of our brain for our lifetime. Kids need a lot more sleep than adults and part of the reason is to help with brain development.
• Improved emotional processing and creativity - Studies have shown that people who get enough REM sleep have better emotional regulation and are better equipped to manage stress and anxiety.
• Improves recovery from stressful events - Research has found that obtaining large amounts of REM sleep after a traumatic event may reduce the chances of developing post-traumatic stress disorder (PTSD).
• Physical restoration - REM sleep is crucial for physical restoration. During this stage of sleep, the body repairs and regenerates tissues, and the immune system is strengthened. Adequate REM sleep can help reduce inflammation in the body and improve overall physical health. It may lower your risk for type 2 diabetes, high blood pressure, heart disease, stroke, and even early death.
• Beneficial effects on weight - REM sleep helps protect against obesity by helping to regulate certain hormones in the body.

How much REM sleep do you need?

Adults need 7-8 hours of sleep every night. Children need more sleep. You can see the recommendations here: Are You Getting Enough Sleep? (cdc.gov). Your body regulates itself to maintain a balanced level of sleep stages within the time you are asleep, with REM sleep making up around 20-25% of your total time asleep.

What can affect REM sleep?

Some underlying conditions, such as depression or insomnia, can affect the length or quality of REM sleep. Some medications can suppress REM sleep, including medications to help you sleep. Obstructive sleep apnea can cause interruptions in sleep that reduce the amount of time spent in REM sleep. And of course, not getting enough sleep decreases REM sleep.

How can you maximize your REM sleep?

• Establish a consistent sleep routine - One of the best ways to maximize your REM sleep is to establish a consistent sleep routine. Go to bed and wake up at the same time every day, even on weekends. This helps to regulate your body's internal clock and improves the quality of your sleep.
• Create a sleep-conducive environment where you sleep - Make sure your bedroom is cool, dark, and quiet. Invest in a comfortable mattress and pillows that support your sleep posture.
• Avoid using electronic devices such as laptops, tablets, and smartphones in the bedroom, particularly in bed. Also avoid using these devices before bedtime outside the bedroom, as the blue light they emit can interfere with sleep.
• Exercise regularly - Exercise during the day helps drive your sleep at night.
• Avoid alcohol, caffeine, and tobacco. Alcohol can delay REM sleep onset and cause you to spend less time in REM overall. Caffeine and tobacco can also interfere with the normal progression through sleep stages. Cut down or avoid them altogether, particularly late afternoon through bedtime.
• Treat sleep disorders - If you are concerned you might have a sleep disorder, talk with your doctor about getting tested.
• Avoid sleep aid medications - If these are prescribed by your doctor, talk with your doctor about the risks vs. benefits and find out if there are other options.

I think you will find that getting enough REM sleep can be magical for your health and overall well-being.

If you have any questions about REM sleep, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor