Shining a light on mental health in Cortland County

Editor's Note: This article was submitted by the Cortland County Mental Health Department. Submit press releases and other community announcements to [email protected].

Dr. Francesca Decker is a licensed family physician who just moved to Los Angeles after working and training in the Rochester and Ithaca areas over the last six years.  She grew up in Richford, NY and has worked with an underserved, inner city population, and an affluent student population.  She has seen the importance of mental health for people from all walks of life. *Note: patient names and details changed to protect private patient information.

“Dr. Decker, I’m working two jobs, one of them driving truck.  I don’t have time to sleep, never mind exercise.  I know my pressure is high, but I don’t know what to do about it!”

Mr. Jones has just turned 27 and is tall, with a normally cheerful manner. Today, I can see his frustration.  He’s young and feels like his body is already failing him.  I notice some signs of anxiety and mild depression.  He tells me he drinks on the weekends to unwind and I explain that alcohol has a similar chemical effect as anti-anxiety medications, but heavy use also raises blood pressure, disrupts sleep, and can worsen depression over time.  He’s skeptical, but listens, and at our next appointment has cut back on his drinking.  His blood pressure, mood, and energy are all noticeably improved.

Ms. Klein is 60, polite and patient, but highly anxious, with a lot of medical concerns at every appointment, and multiple visits to the emergency room for ongoing pains in her neck, back and shoulders.  After brainstorming how she can stay out of the ER, she rates her pain as an 8 out of 10.  For thirty seconds, I guide her through an exercise to focus on her breathing.  Afterward, she tells me with surprise, “Hey! Wow, it’s down to like a 4!”

The tragic suicides of icons like Kate Spade and Anthony Bourdain bring mental health into our daily conversations, and rightly so, as suicide is the tenth leading cause of death in this country.  Part of preventing suicide is learning to recognize and treat mental illness before it reaches that point.  One out of four U.S. adults struggles with mental illness every year, but there’s a lot of confusion and shame surrounding this topic, so people don’t talk about it.  As a family doctor, I find mental health is the most important part of a person’s wellbeing.  My patients have more work to do, but their stories show why mental health matters, and how it’s connected to physical wellness.

Mental health issues are not just about being worried or sad for months at a time.  Depression, for example, can be diagnosed after just two weeks of symptoms.  And the most noticeable problems may not be mood at all, but changes in sleep, concentration, or appetite.  Some depressed people overeat, sleep more and move slowly.  Others lose weight, can’t sleep, and are restless.  The good news is that most people who are treated for mental illness do improve, or recover completely!  Changes in mood can also be caused by physical problems.  Feeling depressed or tired can be symptoms of low thyroid levels.  So it’s important to talk to your doctor if you’re concerned.

Some people are afraid to talk about these issues or avoid asking for help.  Others think talking about their feelings is a sign of weakness.  Many patients don’t want therapy, medication, or either.  But when you break your leg, you go to the hospital.  If you have an annoying cough for weeks at a time, you see a doctor.  Mental health concerns, whether nagging or emergent, are just like other concerns in the body.  Seeking help is the first step to feeling better.  A good doctor should listen to your concerns and work with you to find solutions that balance your wants and your needs.

You may even be surprised by some of your doctor’s suggestions.  There are so many ways to improve mental wellness these days.  Small changes in food choices or activity level, journaling, or getting out of the house can all help.  At my last practice, we had special prescription pads for prescribing time in nature.  There’s good research showing this improves mood and concentration, and patients and doctors both loved it. I find mindfulness and gratefulness are two fast-acting strategies that help my patients cope with stress.  I also use them regularly myself.

My advice for anyone considering seeking mental health care is to do it, and don’t give up if the first person you talk to isn’t the right fit.  Medications take time to work, and therapy is best done by building mutual trust and respect between patient and therapist.  It may take a few tries to find the right therapist and treatment.  If you aren’t getting something you think you need, ask about it.  It’s important that you are both active members in your care.

Take some time to take care of your mental health.  It is the first and most important step on a path to overall wellness.

Resources: The National Suicide Prevention Hotline is available for free, confidential support, 24/7, at 1-800-273-8255.  For crises, call the Cortland Regional Medical Center crisis line, also 24/7, at 607-756-3771.  For less urgent issues, talk to your primary care doctor or call a local mental health clinic, like Cortland County Mental Health (607-758-6100) and Family Counseling Services of Cortland (607-753-0234). FSC Cortland also helps arrange Medicaid transportation.

On Thursday, Sep. 6, from 12 p.m. - 3:30 p.m., the Cortland County Mental Health Department will co-host a resource fair at the Cortland County Office Building Gymnasium. A suicide prevention walk will follow the event. Follow the Cortland County Mental Health Department Facebook Page for future updates.