According to a recent Commonwealth Fund report, Americans pay more for brand-name drugs than residents of most other countries, including Japan, the United Kingdom, Australia, Germany, France, Canada and Switzerland. From January 2022 to January 2023, the prices of over 4,200 drug products rose, with nearly half exceeding the rate of inflation and an average price increase of $590 per drug product. The rising cost of prescription drug prices in the United States has created challenges for taxpayers, healthcare payers, employers and most importantly patients.

Nearly one in four Americans taking prescription medications say it’s difficult to afford them. The financial burden has led many to take cost-saving measures such as skipping or delaying filling a prescription, missing or reducing doses, or using someone else’s medication, drawing attention to the critical issue of medication adherence.

What Is medication adherence?

Medication adherence is the act or extent of conforming to a provider recommendation/prescription based on timing, dosage and frequency of medication use.

 Why is medication adherence important?

Medication adherence is a primary determinant of treatment success and one of the most important things an individual can do for their health. Failing to follow prescribed medication regimens can have serious consequences for the nearly 67% of Americans who are non-adherent.

• Reduced effectiveness—Medications may not work as intended, leading to inadequate management of health conditions. Non-adherence can account for up to 50% of treatment failures.
• Worsening symptoms—Failure to adhere to prescribed treatments may result in the exacerbation of symptoms or disease progression. According to the CDC, nearly 50% of adults suffer from chronic diseases, such as diabetes and hypertension. Nearly half of these do not adhere to prescribed medication regimens. This failure to adhere is believed to contribute to a minimum of 100,000 preventable deaths and $100 billion in preventable medical costs annually.
• Complications and side effects—Skipping doses or not following medication instructions may contribute to adverse effects or complications. Appropriate medication treatment has the potential to prevent approximately 89,000 premature deaths annually among hypertensive patients.
• Lack of productivity—For chronic conditions, non-adherence may result in a decline in productivity due to increased sick days or disability. If a group of 1,000 employees with diabetes collectively improves their treatment adherence by 10 percent, it could reduce short-term disability and lost work time up to 441 workdays, resulting in potential employer savings of around $94,000.
• Decreased quality of life—Non-adherence may diminish overall wellbeing and hinder individuals’ ability to maintain a satisfactory quality of life. The risk of death due to medication non-adherence is approximately ten times higher than the risk of homicide, escalating to around 30 times for individuals over 50. Morbidity and mortality associated with poor medication adherence costs $528.4 billion annually.
• Risk of hospitalization—Lack of adherence increases the likelihood of severe health events, potentially requiring hospitalization. Twenty percent of Medicare patients are readmitted to the hospital within 30 days. Fifty percent of these are considered non-adherent. Non-adherence can be attributed to up to 25% of hospitalizations in the United States annually.
• Impact on public health—Non-adherence is recognized as a significant public health issue. It leads to poor health outcomes and increased healthcare costs, and can have broad implications for public health, especially when it comes to the management of chronic conditions. As many as 59% of individuals with mental illness inconsistently or do no take their medication. This behavior contributes to broader societal problems, including increased rates of suicide, and increased rates of unemployment and homelessness.
• Increased healthcare costs—Non-adherence can lead to more frequent doctor visits, hospitalizations, and additional medical expenses. Addressing medication adherence has the potential to reduce annual healthcare costs by $100 to $300 billion.

Research has repeatedly found that the primary factor impacting medication adherence is cost. In light of this challenge, innovative programs like Magellan Healthcare’s inforMED Pharmacy Program offer a promising solution by ensuring behavioral health and other medications are prescribed and managed effectively. Visit here to learn more about inforMED and how it reduces pharmacy spend with a 2:1 ROI and gaps in care by up to 40%.

Sources:

• 15 Frightening Stats on Medication Adherence (Plus Infographic) (pillsy.com)
• Changes in the List Prices of Prescription Drugs, 2017-2023 | ASPE (hhs.gov)
• Medication Adherence: The Elephant in the Room (uspharmacist.com)
• Medication Adherence and Compliance: Recipe for Improving Patient Outcomes – PMC (nih.gov)
• Medication Adherence Measures: An Overview – PMC (nih.gov)
• International Price Comparison of Drugs Medicare Is Negotiating (commonwealthfund.org)
• Products – Data Briefs – Number 470 – June 2023 (cdc.gov)
• The Unmet Challenge of Medication Nonadherence – PMC (nih.gov)
• The Workplace Costs of Not Taking Your Medication | The Pursuit | University of Michigan School of Public Health | Chronic Disease | Statistics | Health Informatics | Pharmaceuticals (umich.edu)

The National Football League’s 58^th Annual Super Bowl ended with a winning team and fans who might be recovering from a tough season. Whether you’re an athlete or a fan watching sporting events in person or at home, the competitive nature of sports can be both exhilarating and heart-wrenching. However, what happens when the passion felt for the game triggers emotions such as sadness or depression? In this interview with Magellan Federal’s Performance Coaching Manager Meg Helf, M.S., CMPC®, we explore the concept known as “sports fan depression.”

What is Sports Fan Depression and is it a real diagnosis?

Meg Helf: Although Sports Fan Depression is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), many of us are all too familiar with the emotional rollercoaster that comes along with being a fan. Reactions to any number of life events can linger and develop into diagnosable depression, prolonged grief disorder, or an adjustment disorder with depressed mood. Just as we experience grief with the loss of a relationship or a loved one, a job or an opportunity, we may experience grief at the end of a season or when our favorite team comes up short.

For sports fans, acute grief is that initial intense feeling after a loss takes place. This may manifest in a range of complex feelings such as sadness, anger, frustration, and disappointment, which often isn’t discussed in the context of sport. When this grief is experienced for extended periods of time and starts to impact our daily functioning (e.g., work, eating habits, sleep, relationships), we might be experiencing what many call Sports Fan Depression.

What is it about sports that can trigger this feeling?

Helf: There are several reasons that sports can trigger these feelings. Fans make emotional, psychological, physical, and sometimes financial investments in their teams. There are a plethora of ways that sports can impact our wellbeing: sports can be integral to one’s identity, sports can drive our daily activities, and, sports have the ability to create communities and develop relationships.

The more someone identifies with their team the stronger they may feel loss about the outcome of the game or result of the season. These events can feel like a blow to our personal identity when we have a sense of pride and belonging. Despite superstitions and lucky shirts, socks, and routines, fans have a lack of influence and impact on the outcome of the game. This may set many up with unrealistic expectations and add a sense of helplessness. A player on the field has the ability to distinguish what went well, identify what they and the team need to develop, and maintain a future focused growth mindset regardless of the outcome. With less control, it is understandable that fans struggle with optimism because they cannot take any action to make the desired change.

For some, being a fan is a part-time (or full-time!) job. Between watching games, competing in fantasy leagues, and researching statistics, our daily lives are filled with something that we are passionate about. Similarly to how some marathon runners experience the “post-race blues,” when a season is over, we may feel a loss for all the time we invested and feel like a large part of our daily excitement and activities are missing. As the season comes to a close, that taste of the adrenaline, tension, energy and anticipation of each game fades and may leave us wanting.

Fans also rarely go it alone. Our favorite team has the ability to connect people, both friends and strangers alike. Fans connect across time zones for draft parties and engage in banter through fantasy leagues, spend hours tailgating before a game, and gather for watch parties. Families strengthen bonds, adorning newborns in gear and creating traditions. Strangers high-five. They hug. They share food, drinks and handwarmers. Even opposing fans engage in playful banter and share stories. Entire cities come together to support their team. We win together. We lose together. And when the season is over, we are losing these opportunities for such a meaningful part of life – connection to others.

How can someone identify if they suffer from this condition?

Helf: A couple of symptoms experienced with depression are diminished interest or pleasure in activities, depressed mood, significant unintentional weight gain or loss, insomnia or sleeping too much, fatigue or loss of energy, feelings of worthlessness or excessive guilt, and diminished ability to think or concentrate, or indecisiveness. Prolonged grief symptoms are intense emotional pain, loss of identity, difficulty moving on with life, emotional numbness, feeling that life is meaningless, and intense loneliness.

Individuals should build self-awareness about the intensity and duration of their symptoms, and the impact they have on their daily lives. Tap into your thoughts. Are they pervasive? Is the loss of the game bleeding over to other areas of your life? Be purposeful with your next steps and be on the alert for destructive or non-productive patterns that may not help you (e.g., alcohol, adrenaline/thrill seeking, substance abuse, risk-taking).

What are steps someone should take if they believe they have Sports Fan Depression?

Helf:

• Make some intentional time to mourn the loss and build self-awareness of when intrusive thoughts creep in so you can shift to more productive, optimistic style thinking.
• Expand your identity – who are you outside of being a loyal, avid fan?
• Develop and maintain healthy habits – make time to move your body, prioritize healthy eating, hydration, and sleep. These habits are always crucial, but especially helpful for individuals who are struggling.
• Cultivate connections with others – reconnect with your fellow fans in a different context and develop new communities. Diversify your portfolio on interests and discover activities that generate positive emotions and engagement.
• Unplug from your fandom. Clear your head and provide an opportunity to get a little emotional distance from the season. Taking time for yourself will sow benefits for you and those around you. If the post-season funk stays around for longer than 2-4 weeks, find a professional to talk to or take a depression screen.

It’s important to understand that it is perfectly natural to have emotional highs and lows when you are so connected and invested with a specific sports team. Just because you experience some grief, sadness, or disappointment does not mean you have depression. It is typical to have reactions when any season changes and normal to reset your compass.

Perhaps consider why you watch sports in the first place. Is it the appreciation of athletic prowess? The comradery and connection with others? Pride in your town? Understanding what is most important to you can help you squeeze every ounce of enjoyment and excitement out of the game, while arming you with strategies to cultivate your wellbeing.

For more information on depression screenings and tips on wellness, please check out: The Journey to Wellness: Do I need a Depression Screening?

And remember…there is always next season!

Resources

Online screens and helplines: 

• Anxiety & Depression Association of America: (1)
• The Reach Institute (2)
• Mental Health America (16)
• Veteran’s Administration (17)
• SAMHSA National Helpline: 1-800-662-4357
• NAMI Helpline: 1-800-950-6264

This article was co-written by David Michael 

Imagine yourself arriving at an airport, getting your ticket, checking your bags, and then heading to security. What if you arrived at the security checkpoint and there was no one there? No screening, no questions or checking your tickets… On the one hand, you might be relieved, and on the other hand, you might be more concerned about your flight! Safety screening has become a regular part of our lives. The screening is brief, systematic, and designed to maintain safety for airline passengers. But what if it was optional?

The Importance of Depression Screenings

There are many optional health screenings that we know to be beneficial and yet we still try to avoid them … everything from annual exams to the blood pressure cuff machine in the pharmacy. Screenings seem to have gotten a “bad rap.” A health screen is designed to be a preliminary tool for providing information at pivotal points when interventions may be crucial.

Learning that depression is more unpredictable and widespread than once thought can produce mixed emotions that reflect on how one conceptualizes depression and its many levels and possible stigma. Depression affects everyone differently; it might surface in the life of someone who has been diagnosed or it may emerge in someone who looks like they have it all together. It is known that most people will face depressed feelings at some point in their life. Life circumstance is bound to “throw a curve ball” and offer the personal support system an opportunity to employ coping skills and reflexive responses to tough situations.

Why get screened for depression?

Here are some ‘Depression Flags’ or Indicators that combined, provide a “road map” recommendation towards further care: (2) (3)

• You have been through a series of tough events or situations and cannot seem to get back to feeling normal again.
• You cannot remember the last time that you felt happy.
• You are irritable and feel down a lot.
• Intrusive negative thinking.
• Change in appetite.
• Change in sleep patterns.
• Change in energy level or motivation.
• Lowered ability to concentrate.
• Change in daily behavior or moods.
• Increased irritability, feelings of helplessness or hopelessness.
• Lowered self-esteem.
• Thoughts about suicide or a desire to have life over with.
• Social withdrawal or isolation.
• Refusals by a child for normal activities such as social gatherings, foods, school attendance.
• For Children: A regression in skills already gained and increased need for reassurances.
• For Teens getting into trouble, concerning behavior changes, or self-harm.
• For Men: irritability, tiredness, anger
• For Women: sadness, worthlessness, guilt.

How to Get a Depression Screening

• Most medical providers or pediatricians will offer a basic depression screen when needed or requested during an office visit.
• Local mental health professionals offer screenings with an office appointment or intake process and can follow up with therapeutic interventions as needed.
• Online screens and helplines:
• Anxiety & Depression Association of America: (1)
• The Reach Institute (2)
• Mental Health America (16)
• Veteran’s Administration (17)
• SAMHSA National Helpline: 1-800-662-4357
• NAMI Helpline: 1-800-950-6264

Tips for Your Wellness Journey

Assemble a Care Team:

• Bring the Guide: A medical professional can provide a depression screening and can also screen for another underlying medical condition exhibiting symptoms of depression, as well as a discussion of the possibility of vitamins and supplement use to balance any deficiencies. A wellness coach, naturopath, chiropractor, or other medical professional can also be consulted. A good first step for support would be to check with the Employee Assistance Program (EAP) provided through your employer for available mental health services.
• Phone a Friend: Talk to a mental health provider, Chaplain, or someone you trust about your inner thoughts and feelings who will offer loving encouragement. Looking for ways to reduce isolation and increase connectedness can be an important step toward wellness.

Bounce Toward Wellness: (13)

• Discover Yourself: Journal your thoughts and feelings to help you get to the bottom of what is bothering you. You may want to discuss this with a trusted professional as old losses or traumas can accumulate and catch up to the one who feels they are well within the rear-view mirror. This can feel overwhelming or like having a lingering ‘emotional cold’ draining your resources.
• Eat Smart: Consuming quality protein and fruits and veggies improves the gut and brain’s ability to provide the neurochemicals needed for feelings of wellness. Junk food and low-nutrient foods increase feelings of depression or low mood in most people. While fast food seems easy, it is the rougher road in the long run. Hydration and taking deep breaths can help your brain have what it needs to perform and calm.
• Pump the Breaks: A daily and weekly break from stress through recreation, creativity, reading, athletics, or other restorative activities can help the body regenerate. Too much stress can produce other physical maladies and drain your emotional and physical batteries. Limiting your schedule can help you regain balance during a stressful time.
• Power Down and Reboot: To drain the body is to drain the mind. Sleep, exercise, and movement increases self-esteem and the immune system almost immediately; the lack of which can produce other urgent issues. While joining a gym might be ideal, even a minimal hour of ping-pong a week or a 10 minute walk a day can have a positive effect on mood and body. Depressed feelings often follow a weary body.
• Screen the Screens: Limit use of devices and time on social media as these influences can contribute to isolation and low self-esteem through comparison, especially at night. Melatonin, which is needed to help one sleep, is depleted with blue light used in devices and the light used can trick the brain into thinking it is time to be awake. Limiting parental screentime and finding ways for family connection through games, conversation, or activities can help kids feel less isolated and more connected providing some protection from depressed moods for all.
• Avoid the Mud: Negative thoughts get one stuck in a negative mind frame. Positive self-talk and optimistic thinking can go a long way to help reduce depressed feelings as evidence of the corresponding relationship between negative thinking and depression. Though it might feel difficult, finding something good in a situation can break up the mire to help one move in the right direction toward wellness. Follow the rule of thumb of thinking and speaking kind thoughts and words to oneself just like a good friend would do. Finding positive and meaningful ways to celebrate wins, whether big or little, can add fuel to the journey.
• Embrace Your Natural State (15): Stimulants and depressants, and other mood-altering substances (even immoderate use of alcohol, sugar, and caffeine) can be addictive, impact the gut, and worsen feelings of unwellness. Alcohol can worsen depressed feelings and interfere with sleep as it turns to sugar in the bloodstream.
• Pack the Jams: Positive or upbeat music and media can go a long way to lighten the mood and lighten thoughts; conversely sad or negative music or media should be used with caution.
• Believe: Research points to many benefits of praying and the belief that there is a purpose to life, a Higher Power and that one is loved. A return to one’s faith and values can help that purpose and meaning to be rediscovered. (13)

Benefits of a Depression Screening

Ultimately, a depression screening is not mandatory like airport security. It is brief, systematized and can be a good measure of your current state so that you can make the best decision for your wellness. At a minimum, it is designed to give you a ‘snapshot’ of your current resources and your ability to find balance. It can offer some perspective for what might be needed to manage feelings and what kind of support would be best suited to help.

The late Jimmy Buffet’s last song, “Bubbles Up” (12) written during a time of great challenge, reminds the one who is under water to follow the air bubbles as they float to the surface to help re-orient oneself and find the exit where life, air, and light reside. It is a metaphor for life when facing a challenge as negative thoughts are intimately tied to negative feelings and increase feelings of overwhelm. Focusing on the positive can be a necessary lifeline for one who feels life is dark and confusing.

A valley of depressed feelings is not the destination. Regardless of which road brought you or a loved one to it, life does not have to be lived there. With some help and support, one may find themselves on a journey to self-discovery, healing, and hope.

References and Resources:

Depression Screens:

1. https://adaa.org/understanding-anxiety/depression?gclid=EAIaIQobChMIzoWE2f3PgQMVEYvCCB2aEACeEAAYASAAEgJUKfD_BwE
2. https://thereachinstitute.org/reach-and-adaa-anxiety-in-children-and-teens/?gclid=EAIaIQobChMIzoWE2f3PgQMVEYvCCB2aEACeEAAYAiAAEgJwYfD_BwE
3. https://www.mhanational.org/national-depression-screening-day
4. https://adaa.org/living-with-anxiety/ask-and-learn/screenings/screening-depression
5. https://www.myhealth.va.gov/mhv-portal-web/depression-screening

Other References and Resources

6. https://adaa.org/
7. https://thereachinstitute.org/
8. https://mhanational.org/
9. https://mentalhealth.va.gov
10. https://www.samhsa.gov
11. https://www.nami.org
12. https://youtu.be/6j3jDTOG7yI?si=eJQ4Qa5YHlLBcVI_
13. https://www.amenclinics.com/
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9713100/
15. “The Godfather | Plot, Cast, Oscars, & Facts | Britannica”. www.britannica.com. Retrieved December 31, 2021.
16. Mental Health America. https://mhanational.org/
17. Veteran’s Administration https://www.mentalhealth.va.gov/

February 1^st is known around the world as Time to Talk Day. This is a national day that encourages individuals to have an open dialogue about their mental health and to be supportive of others.

In this DocTalk article, Magellan Healthcare’s Medical Director Dr. Chris Squillaro shares why the act of talking about mental health is so important, the common misconceptions about mental health, and advice on how to approach the conversation for all age groups.

Q: In your opinion, why is it important to talk openly about mental health?

Dr. Chris Squillaro: Open conversation is important to communicate our feelings and emotions.  Without the ability to share the things that we are feeling inside, they can become confusing, which can feel out-of-control and lead to worsening emotions and possibly behavior.  Conversing about mental health also normalizes the subject matter.  The more frequently mental health is openly discussed the more accustomed we become to discuss it within our relationships and as a society.  Lastly, talking about it helps us to realize that we are not alone.  Since mental health and substance use is so prevalent in our culture, every one of us likely has a connection to someone struggling with one or the other.

Conversely, not openly discussing mental health has no benefit.  History has already shown that this only leads to stigma and worsens the potential problems associated with unaddressed mental health conditions.  If we’re not openly discussing it, we’re also not openly seeking solutions when needed.

Q: In 2024, what do you think is the biggest misconception about mental health?

Dr. Squillaro: That mental health issues are resolving as fast as our concerns about COVID.  Even though we are moving away from the day-to-day threat of COVID to us and our loved ones, mental health and the mental health system are far from recovered.  We are seeing consequences both in terms of children and adolescents who lost social connection at critical junctures in their development and are struggling to catch up from the delay.  This not only impacts them but also their family unit and their community.  The increase in alcohol and drug use that occurred during the height of the pandemic was not resolved.  Many of the people who developed addictions are just now starting to seek help and there are many who have not realized that there is a problem.

At the same time there is a greater need as the delivery of mental health services shifted.  Services moved from primarily face-to-face to virtual.  With this came a shift in the workforce.  Many mental health workers sought virtual positions and left critical services that required face-to-face interaction.  This left vacancies that have not been filled.  Every service in every level of care is experiencing staffing shortages.  The misconception is that as society normalizes, the mental health system has normalized and can accommodate the demand.  However, we are not seeing that same level of normalization at a time when it is needed.

Q: How do you think we can create a more supportive and understanding community when it comes to mental health?

Dr. Squillaro: It starts in the home.  Each generation has gotten better at this.  The best way to influence change is to teach our young.  More knowledgeable and understanding parents teach their children acceptance.  These children then begin to make a difference as they interact in the community and in school.  As the members of the generation mature, they create a more compassionate and embracing community.  When children grow up with these concepts that are taught and modeled in the home, their thinking and behavior is more solidified and less likely to be influenced by many of the external influences that continue to be intolerant.  I doubt anyone feels that society will eliminate extreme points of view that preach intolerance.  But the hope is that these extremes get smaller with the majority being a community that is accepting and supportive.

Q: What role can friends, family, or colleagues play in supporting mental well-being, and how can they contribute positively to someone who may have mental health struggles?

Dr. Squillaro: In terms of having tougher conversations and feeling safe to communicate about mental health and mental health struggles, family and friends are critical. They contribute to each other’s lives by caring and having the best of intentions, even when saying things that aren’t always easy to hear or when someone isn’t necessarily ready for help.  Many times, family and friends will be the first to identify when something is wrong and should be the first to speak up.  The most positive thing you can do for someone is to let them know what you’re seeing and that you are a person they can come to for help.  They may not be ready in that moment and they may need additional encouragement, but being there is the hardest and best thing to do.

On the other end, as things begin to improve, they will also likely see it first.  They can encourage and provide that perspective to continue instilling hope.  They can walk the recovery journey with their loved ones and make the connection even stronger.

Q: What advice would you give to someone hesitant to talk about their mental health issues?

Dr. Squillaro: An analogy I use to make this point is that emotions are like water.  Eventually, there is nothing that can hold it back and when it breaks through, it is one of the most transformative and potentially destructive forces on the planet.  Hesitating to talk about mental health doesn’t mean it’s not there.  We’re only able to hold it back for so long before the pressure becomes so great that we no longer control how it comes out and what it destroys.  Talking about mental health is like choosing to release the pressure and having a more constructive say as to how those emotions come out.

Q: Can you share 3-4 ways to begin an open dialogue with someone about your need for support?

• Identify the issue – you don’t need to know exactly what is wrong, only that your emotions are affecting your functioning.
• Identify someone who has historically made you feel safe.
• Take a risk – anxiety is about feeling conflicted. Choosing to move forward despite that feeling is how you begin to change take control of it.
• Gather information – after you’ve taken one risk, a second, third or more becomes easier. In that process, collect what people tell you and find your own path forward.

Q: Are there unique ways to approach a discussion about mental health with an adult versus a child (under 18) or a young adult?

Dr. Squillaro: Pay attention to the language you use.  Whether it’s a child, adolescent, or an adult, they must be able to understand what you’re saying.  Logically, children will need more simple language and concepts.  It’s okay with adolescents to take a more informal approach to how you communicate.  You’re trying to connect with someone who is at a stage where they may not want to rely on authority figures or feel that they know better.  Adults can have a wide range of capabilities.  Trying to match the language they use will put it in terms they can understand.

Be aware of their developmental stage.  Each age group is at a different stage of brain development.  Children will need to be told the answer and will need help developing the solutions.  They are much more open to direction from authority figures.  Adolescents are more impulsive and tend to believe they can easily overcome the issues.  They may also be more comfortable receiving recommendations from peers, so look to engage people within their age group to help reach them.  Adults have more lived experience, and their decision-making is more progressed.  Predicting the consequences in areas of importance to them helps to prepare them engage in help.  No matter what age group, sometimes people need time to process information.

As a person trying to support someone with a mental health issue, patience and consistent messaging are key.  Very few people react immediately.  Continue to support them through their process and reinforce a message of help and hope that will eventually be heard when they are ready.

Q: What tools or resources would you recommend on this topic?

Dr. Squillaro: This may sound simplistic, but doing an online search can bring you to both national organizations and local resources that may be of benefit.  It offers choices about which sites, information, or resources speak to you.  Specifically, the Substance Abuse and Mental Health Services Administration (SAMHSA) has a resource on this: How to Talk About Mental Health | SAMHSA.  Another great organization to seek support is the National Alliance on Mental Illness (NAMI) Resources | NAMI: National Alliance on Mental Illness.  NAMI also has local chapters and can provide support to families as well.

Your insurance provider will also have resources available on their website and may be able to aid in facilitating referrals or tools to help you understand what you’re feeling or start a conversation with someone who needs help.  Along the same lines, the county you live in has mental health resources and is well-versed in the network of providers who can provide the services needed.

Resources

How to Talk About Mental Health from the Substance Abuse and Mental Health Services Administration

Resources from the National Alliance on Mental Illness

“At heart, I’m an educator. If I can help anyone rethink their approach to money and lifestyle choices, which sets them up for life success, that is a plus.” One of our Personal Financial Counselors, Michael Snowdon, recently described what he likes about working with military families as a Magellan Federal Personal Financial Counselor.

The Role of Personal Financial Counselors

In support of the U.S. Dept. of Defense Personal Financial Counseling program, Magellan Federal provides over 300 Personnel Financial Counselors (PFC) on more than 270 military installations and civilian communities globally to help educate, train, and counsel service members and their families on financial wellness.

PFCs provide financial counseling and education for service members and spouses to assist in evaluating diverse financial circumstances, setting and meeting financial goals, and developing skills and strategies necessary to maintain financial wellbeing. Financial counseling and education services are provided to all active-duty members of the Military Services (Army, Navy, Marine Corps, Air Force, and Space Force), National Guard and Reserve members, veterans, and their immediate families.

Our full-time PFCs assist service members with personal financial matters, including retirement and estate planning, credit management and debt reduction, and budgeting. Financial literacy training provides the pathway for sustaining financial wellbeing and resiliency with benchmarks of meeting all financial responsibilities, building wealth, and obtaining a sound financial future and a secure retirement. PFCs are beneficial in providing service members with training and resources to help avoid debt and create practical solutions for financial goals.

PFCs stay in their position for a minimum of 12 months, and then they can choose to stay in place or move to a new open position, including overseas. “We are actively recruiting for qualified financial counselors. Ideally, we look for people in specific geographic places, but we will move folks to new locations, including overseas when needed,” noted Beth Welch, Magellan Federal PFC Program Manager. Here are a few of the stories of how being a PFC is a meaningful career choice.

PFC Stories: Changing Lives and Building Financial Resilience

While financial planners have a variety of career options, becoming a PFC is a good option for those who like to focus on solving problems, educate, and desire a flexible schedule. For some, such as Byron Clark, being a PFC brings tremendous job satisfaction, knowing they are helping our service members.  “As a retired Air Force Officer, I enjoy working around our young service members. When I was in uniform, I saw so many individuals making bad decisions with their finances, and now I help them see the big picture and make sense of their finances.”

Others, such as Madeleine Grene, entered this field after retirement as a University Professor. She notes that she has met many PFCs who stepped away from their original positions, and this is their second career. She notes that she can spend as much time as she likes with individuals to help them understand their finances. “I encounter people who are confused by investment vocabulary. They don’t know the rate of return on their investments or even how their retirement accounts. It is gratifying to see when someone suddenly understands something that was so confusing.”

For some financial planners who start to feel the strain of selling financial products and services, being a PFC offers more predictability and more consistent hours. Many of our PFCs observed that selling products, while lucrative, may not be for everyone, and the focus on education and counseling brings purpose and fits their life goals better.

As Michael Snowdon said, when he was a Financial Planner, he would ask people about their long-term goals, and we would look at investment and future-oriented strategies. Now, he works with people on budgets to handle short-term problems and plan for retirement. He shares that he really enjoys the educational parts of his job. “I know I may never see the results of my work, but I believe I am helping to change the lives of young recruits with how they look at money,” Snowdon says.

Debra Barker, a director of program management for PFC, also likes when people who have private financial planning practices become PFCs. “It is a win-win. We offer benefits and steady income, which may help a financial planner as they are building their business. Once we ensure there is no conflict of interest, these PFCs are able to bring a wealth of knowledge to our service members.”

Making a Difference

USAA and Blue Star Families found that 37% of the 8,000 active-duty service members, Veterans, and family members surveyed in the spring of 2016 felt insecure about their financial futures, and 63% of them reported feeling stressed out because of their current financial circumstances. Our PFCs seek to give the service members the tools to become more financially resilient.

Besides one-on-one counseling, our PFCs provide educational presentations to groups. A commander may ask for a PFC to talk to a group about rethinking their approach to money. Our society is consumer-oriented, and it is easy to focus on buying. PFCs help people reconsider that mindset and help them live within their budget.

Our PFCs do have strict no-go topics. They cannot recommend stocks or make decisions on behalf of a client and are there to give our service members the tools to achieve financial success.

We are always looking to hire qualified PFCs both in the US and abroad. This is an ideal job for military spouses and veterans and allows for job portability with positions! Go to the Magellan Federal career site for job openings!

Co-authored by Christi Garner, LMFT CYT

Stress around the holidays is a common experience. According to the American Psychological Association, 38% of adults report a significant increase in stress levels during the holidays. Military families may experience additional sources of stress related to the unique challenges of military life, including:

• Deployment of the service member
• Living far from hometowns or families
• Being unable to take leave to travel to be with friends or family
• Financial stress

Utilizing the self-care practices below, along with connecting with a Military and Family Life Counselor (MFLC), can provide much-needed support to service members and their families during the holiday season.

Tips for Navigating the Holidays During Deployment

Sometimes being with family is not possible during the holidays, even when the service member is not deployed. Feeling homesick or missing home during the holidays is very common. Here are some ways to connect with family and friends during deployment:

• Communicate as much as possible; schedule time to connect and virtually exchange presents and stories.
• Think of creative ways to continue family traditions during deployment—reenact them virtually or share through pictures.
• To support children of deployed parents, consider facilitating activities through arts and crafts, such as creating a “feelings tree.”
• Facilitate psychoeducation about mindfulness, which is linked to improve personal stress management.
• Use the Chill Drills app from Military OneSource.

Tips for Handling Holiday Financial Stress

The holidays can be an especially expensive and demanding time. Here are some tips to consider to help plan for common financial pressures:

• Set a S.M.A.R.T money goal—Write down your goal, and make sure it is Specific, Measurable, Attainable, Reasonable, and the Time you will complete it. This will help you get it accomplished.
• For more help—Find a Personal Financial Counselor here.

Food Insecurity Resources

Many military families find it difficult to access healthy meals and maintain a high level of food security. Use these resources to connect with viable resources.

• Military OneSource: 24/7 Hotline can make referrals to local food security resources by state: 1-800-342-9647
• USDA National Hunger Hotline: Referrals for food banks and other social services. 1-866-348-6479 (TTY: 711)
• Supplemental Nutrition Assistance Program (SNAP): Provides supplemental assistance for food. Commonly known as food stamps.
• Women, Infants, and Children Program (WIC): Provides supplemental assistance for nutritious foods for pregnant women, infants and children. Also provides referrals for healthcare.
• Feeding America Network of Food Banks: Resources for local food banks and food programs. Resources and eligibility requirements vary by location.
• Food Insecurity in the Military Community (Webinar Replay)
• Casual Inquiry Questions
• CORE Approach Guide
• Food Insecurity Whitepaper: Best practices to support a professional response
• Additional Food Insecurity Resource List

Tips for Holiday Stress Management

Resilience refers to the ability to handle stress when it arises and to protect oneself against future stress. Research has shown that there are many qualities that contribute to resilience, including social support, optimism, sense of humor, spirituality, self-esteem, and adaptability. Use the tips below to foster resilience in your life during the holidays.

Self-Care To Build Resilience

• Self-care also means taking care of yourself. This means eating regular meals, getting enough sleep, caring for personal hygiene, and anything else that maintains good health.
• Make self-care a priority. There will always be other things to do, but don’t let these interrupt the time you set aside for self-care. Self-care should be given the same importance as other responsibilities.
• Make self-care a habit. Just like eating one apple doesn’t eliminate health problems, using self-care just once won’t have much effect on reducing stress. Choose activities that you can do often, and that you will stick with.
• Unhealthy activities don’t count as self-care. Substance use, over-eating, and other unhealthy behaviors might hide stress temporarily, but they cause more problems in the long run.
• A few minutes of self-care is better than no self-care. Set an alarm reminding you to take regular breaks, even if it’s just a walk around the block, or an uninterrupted snack. Oftentimes, stepping away will energize you to work more efficiently when you return.

Relaxation to Build Resilience

• There are many ways to practice relaxation and help to regulate your parasympathetic nervous system. Some ideas: progressive muscle relaxation, meditation, deep breathing, being in nature.
• Plan where relaxation can fit into a daily routine. It may help to set an alarm as a reminder or connect relaxation practice with another activity. For example, practicing deep breathing for 10 minutes before bed or after leaving work on the drive home or in the driveway before going inside.
• Keep practicing even if the positive effects are small. The benefits of relaxation accumulate and grow with practice.
• Relaxation techniques not only provide immediate stress relief, but the effects also generalize to other parts of life. This means the benefits of relaxation continue to be felt long after the exercise is complete. These techniques work best when done regularly and during times of calm, rather than exclusively when stress is at its peak.

Self-Regulation Resources

Military OneSource Recommended Wellness Apps

• Mood Hacker—To help you improve your mood and enjoy life more, Military OneSource offers MoodHacker, a free resilience tool that lets you track, understand and improve how you’re feeling.
• Breathe2Relax—Trains you on the “belly breathing” technique that has proven benefits for your overall mental health. Use the app’s breathing exercises to learn and practice on your own or as part of a stress management program supervised by your health care provider.
• Chill Drills—Chill Drills is a free collection of simple audio mindfulness exercises to relax the body and mind.
• Virtual Hope Box—The app contains simple tools to help users with coping, relaxation, distraction and positive thinking using personalized audio, video, pictures, games, mindfulness exercises, activity planning, inspirational quotes and coping statements.
• Breathe, Think, Do: Sesame Street—Laugh and learn as you help a Sesame Street monster friend calm down and solve everyday challenges. This app helps your child learn Sesame’s Breathe, Think, Do strategy for problem solving.

Stress Relief Resources

• Basics of Belly Breathing
• Veterans Employment Toolkit: Deep Breathing
• Veterans Employment Toolkit: Progressive Muscle Relaxation
• Life in Balance: Stress Relief Webinar
• Mindfulness Meditation Self Care Strategy
• The important part of self-care is not so much what you do—it’s just that you do it. Many of these strategies can be fostered in non-medical counseling. Contact Military OneSource to find your local Military and Family Life Counselor by calling 800-342-9647 or contracting your installation’s Military and Family Support Center. Or learn more online here.

Sources

• Dunham, T. (2022). “When the Tinsel Gets Tangled: How to Cope with Holiday Stress.” DoD Psychological Center for Excellence, Health.mil.
• Rice, V. J., Liu, B., Allison, S. C., & Schroeder, P. J. (2019). Mindfulness training offered in-person and in a virtual world—weekly self-reports of stress, energy, pain, and sleepiness among US military active duty and veteran personnel. Mindfulness,10, 1815-1827.
• Grafton, E., Gillespie, B., & Henderson, S. (2010) Resilience: the power withing. Oncology Nursing forum (Vol. 37, No. 6, p. 698).
• Rash, J. A., Matsuba, M. K., & Prkachin, K. M. (2011). Gratitude and well‐being: Who benefits the most from a gratitude intervention?. Applied Psychology: Health and Well-Being, 3(3), 350-369.
• Esch, T., & Stefano, G. B. (2010). The neurobiology of stress management. Neuroendocrinology letters, 31(1), 19-39.
  

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  Christi Garner, LMFT CYT, is a Learning & Development Director at Magellan Federal. Christi has served in the Military and Family Life Counseling (MFLC) program since 2016 in various roles, including CONUS and OCONUS MFLC, Regional Supervisor, and training coordinator. Prior to MFLC, Christi dedicated over 15 years as a trauma therapist, clinical trainer, and adjunct instructor. Christi is a military spouse who is passionate about helping other service members and families.

Walk into any store after Halloween and you more than likely will see the twinkle of holiday lights, trees, and decorations that quickly remind us that the Christmas season is upon us. For some, these reminders are a welcomed sight, and, for others, these reminders may trigger feelings of stress.

One way to help ease stress levels can be by setting healthy boundaries. Magellan Healthcare’s medical director Candice Tate, MD, MBA, shares advice on the importance of setting healthy boundaries during the holiday season.

Q: What are some factors that you feel are adding to stress this holiday season?

Dr. Tate: I think people are still trying to get that pre-pandemic holiday spirit back. People feel overworked and underpaid. Many stressors do not seem to have a deadline or an endpoint. This is also the time when people tend to mourn the loss of loved ones or feel emotional because they are unable to attend family gatherings.

Q: What are the steps to setting healthy boundaries during the holiday season?

Dr. Tate:

1. What are your needs and/or what are your stressors? This first step is important because it is difficult for others to know what you need and what stresses you. This can be effective by focusing on your top five.
2. You should expect resistance from others because your needs may conflict with their needs. This can be a challenging step in establishing boundaries for that reason. This is also challenging because you are imposing a change from past behavior.
3. You must communicate the boundaries and any subsequent changes. This may result in uncomfortable discussions and possibly conflict, but this is a necessary step in establishing boundaries. This is important for the people who will be directly impacted by the changes.
4. You must be consistent with the boundaries and hold yourself accountable. Others may intentionally or unintentionally challenge your new rules and habits. It is important to stand firm and remind others of what has been discussed. For this step, practice makes perfect. The longer you are consistent in reinforcing your boundaries, the more beneficial the boundaries will become.
5. Be prepared to distance yourself if necessary. On occasion someone may wholly reject your boundaries and object to any change. That is okay for them to do, and it is okay for you to distance yourself from the person or the situation. The boundary has been created to provide you with peace of mind and protection.

Q: What are examples of healthy boundaries? Is this important for both adults and children? How so?

Dr. Tate: An example of a healthy boundary during the holidays is setting a budget. Many people are faced with financial challenges due to rising costs of food and gifts. Many people feel that their disposable income has decreased over the past few years. Setting a budget for holiday spending to include gifts, decor, travel, and entertainment is a form of a boundary. Overspending causes anxiety, depression, and relationship problems. A budget can be beneficial for an individual and/or a family. It can be shared electronically or on paper, and it can be discussed with significant others and children. This allows for spending a certain amount, managing expectations, sparking creativity, and establishing new standards for the holidays.

The holiday season is an optimal time to take a social media break as another example. Recent reports in the news highlight how social media harms teenagers and children. Not only is this information not new, but we also know that social media negatively affects adults too. This is an opportunity to disconnect from what others are doing (or pretending to do) and allows you the space to focus on your values and the needs of your family.

There is so much pressure for us to experience a certain type of holiday season that usually includes overspending, indulgence, and being happy about it. Establishing boundaries is an opportunity to show yourself and your children that you can create positive and meaningful memories by doing things that suit your family based on your means and your values.

As we approach the holidays, our minds are filled with to-do lists of people to see, activities to participate in, and events to attend. It’s also a time that many begin thinking of changes they would like to make in the coming year. Sayings such as “New Year, New You” have become embedded in our lexicon, and making resolutions is an annual tradition even though most resolutions are not kept past the end of January (Statista, 2023). While keeping resolutions may not have a high success rate, there is still a way to incorporate change as we head into the new year.

The One Word concept is an alternative approach to making resolutions. Instead of creating a specific goal, you pick a word to focus on the entire year. The word then becomes a filter and guide, helping you to grow in unexpected ways throughout the year.

For example, if you would like to improve your financial stability, you may choose the word, Intention. From there, you would consider how to be intentional with your money and what steps you could take to improve your financial situation. Going deeper, you may start to think about how to be intentional in your daily decisions, the dreams you pursue, and the time you spend as it relates to the financial stability you want to achieve.

Choosing one word to focus on can guide every aspect of your life and because of its simplicity, it is much easier to stick with than a list of resolutions. According to Gordon, Britton, & Page, “One Word creates clarity, power, passion, and life-change. The simple power of One Word is that it impacts all six dimensions of your life – mental, physical, emotional, relational, spiritual, and financial” (Gordon, J., Britton, D., & Page, J., 2023).

For a successful One Word journey, follow these tips.

• Begin by making a list of five to ten possible words.
• Narrow your list to 3-5 words and look up the definitions, synonyms, and antonyms.
• Give yourself about a week to think about the words.
• Choose your word. One may seem to jump out at you, or one may seem to scream “not me”. Any word you choose has the capacity to help you grow if you focus on it for an entire year.
• Make your word visible. Create a poster with your word, definition, and a quote, use the word as a screen saver, get a bracelet or key chain with your word, write it on post it notes, and/or write it in your planner every week.
• Commit to journaling about your word at least once per week using online journal prompts. Focus on how you are implementing your word in your health, finances, spiritual journey, etc.
• Share your journey with a trusted person to help you keep focused.
• Remain open and curious about how your word can apply to every area of your life.
• Write a beginning of the year reflection focusing on how you think your word will change you in different areas. Then write an end of the year summary about what actually happened.
• Enjoy the journey!

Additional One Word resources: https://getoneword.com/ and https://myoneword.org/.