“Crazy” is in this year.

Over the past 80 years, there has been a constant rise in the prevalence of anxiety and depression and no one really knows what is causing it. Let that permeate your mind and sink in. This year, I have treated about 1,000 patients in primary care/urgent care settings and 30% of them have a history of anxiety or depression. That data is staggering. My school requires me to input data into a server that organizes information for us to see trends and learn about common themes in healthcare. When I adjusted the settings to display the ratio of patients:mental health issues, I felt a surge of intense questioning. The Association of Anxiety and Depression claims that the prevalence of these disorders is significantly lower. Why?

Perhaps people who are feeling depressed or anxious are more likely to seek medical care, thus skewing the data? Regardless, why are we seeing this dramatic increase and why is this not considered a massive public health crisis? Most of my adult life has been dedicated to questioning things and annoying most of the people around me with my theories…BUT THIS IS A BIG DEAL, Y’ALL.

My database has tangible evidence that suggests about 1/3 people deal with anxiety/depression. I believe that number is even higher because of the lack of accurate reporting. A lot of people do not have the self-awareness to even recognize something is off with the mind and psyche, so who is to say 1/2 of people are actually on this mental health train?

I want to play a guessing game with you. Think back to the last time you saw a medical provider. Perhaps it was your annual physical or an episodic meeting. Did your provider ask you about your mood/stress/energy? As a future provider, I recognize that time is of the essence and you can not perform a full blown psychoanalysis on every patient. With that being said, I value the importance of a handful of screening questions. I try to ask my patients, “how is your energy level during the day/how are you handling your stress/what do you do to for self-care?” It takes about 2-3 minutes and opens the door for a emotional connection.

 

When time permits, I love to teach patients about stress management through alternative methods: belly breathing, guided meditation, and yoga. All this is hunky dory, but back to the point…

What is causing the constant rise in anxiety and depression?

Unsolicited advice/theories I developed that probably hold 7% scientific value:

  • technology
    • after a weekend in the woods, my mind and body are in such a calm state. Being off the grid and “disconnected” is therapeutic for my adrenal glands and neurotransmitters
    • social media (I REALLY spend too much time on that crap) is a forum for “look how amazing I am” and drives feelings of inadequacy
  • food
    • our culture sucks at eating, let’s be honest
    • the era of processed food, sugar, add added hormones is essentially destroying our brain’s ability to regulate emotion and stress hormones…no big deal
    • hypoglycemia can mimic feelings of anxiety and that tends to be an issue when we eat such a high sugar diet–leading to fast metabolism of food and a massive blood sugar crash (you should probably apologize to your pancreas)
  • birth control
    • who doesn’t love good old oral contraceptives…ok, ok, too far, I get it.
    • the estrogen component in most OCP is detrimental to the mind
    • my anxiety was drastically reduced when I changed to a very LOW dose of estrogen
    • all the smart brain docs tell me that estrogen negatively impacts serotonin and norepinephrine
  • lack of community
    • although we are the most “social” generation via social media, we are actually the loneliest
    • in the 1930s-1950s, farming was a critical aspect of society and most people lived on land with many family members and spent very little time alone
    • some people believe that a large social circle will buffer the impact of anxiety/depression, thus serving as protective
    • when is the last time you drove to someone’s house to talk to them instead of text them? Exactly.

My commitment to the medical community is to discover trends and determine how I can make a tiny positive impact in the world. Maybe that is through developing more screening guidelines or writing a self-care novela as a free gift with purchase. “Thanks for getting a Pap today, enjoy your free guide on how to take care of your mind and body.” All jokes aside, I have a lot of questions and a lot of energy to figure them out (thanks to the shit ton of green tea I guzzle). I want to solve this dilemma and save the world. All in a day’s work.

Why do you think we are seeing the consistent rise in anxiety and depression? Comment below!

Love and Light.

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Sources: (http://nymag.com/scienceofus/2016/03/for-80-years-young-americans-have-been-getting-more-anxious-and-depressed.html)

Hybrid.

Modern medicine tends to fixate on diagnosis and treatment, whereas a wellness lifestyle focuses on education, self-awareness, and prevention. Instead of merely treating disease, the wellness lifestyle addresses its causes-what lies beneath the disease and its symptoms.

-The Essential Life

In 5 short months, I will be a family nurse practitioner. My journey in medicine started a decade ago when I began volunteering at a local hospital. At the ripe age of 16, I learned about getting my hands dirty. I mean that metaphorically and literally. Seeing patients in the hospital fascinated me. During a lunch break, I ate my stale bagel and reflected on my experience.

Why did she wait so long to get a check up? Why did he give up on his health? Why doesn’t she seem to care about what is happening to her body?

My thoughts were, perhaps, non-traditional lunch break thoughts. However, I was truly curious why people waited until the brink of death to seek help. I grew up going to the doctor for annual check-ups and learning that preventative health was important. I understood that physical fitness and healthy foods were important. I have carried those core values into my professional life.

So, the question of the hour is this…can you achieve wellness by practicing both complementary and traditional medicine? Is there a market for the nurse practitioner who will prescribe:

  • increased physical exercise
  • essential oil diffusion for stress management
  • antibiotics for strep throat

The hybrid of preventative medicine, wellness, and disease management is possible. I’m just not sure how to achieve it. I see the value in both practice styles. The benefits of holistic, complementary medicine:

  • patient autonomy
  • inexpensive interventions
  • 1,000s of years of anecdotal experience
  • natural
  • less extreme side effects

Let’s play devils advocate and discuss benefits of traditional medicine:

  • societal support
  • greater amount of evidence based practice
  • variety of double-blind research studies
  • mainstream education through medical school
  • quick support/treatment of a variety of illnesses

Healthcare is broken in this country. Again, that is a post for a later time. Could a hybrid of eastern/western medicine be the answer to change our health? As Americans, we are some of the most unhealthy people in the world. Participating in a culture of prevention, rather than treatment, will augment longevity. In a perfect utopia, this is how I want to practice medicine:

55 year old patient presents to the clinic with an acute upper respiratory infection. The patient is very physically active, eats a balanced diet, and denies smoking/drinking. My plan for this patient would be to diffuse Doterra On guard+Breathe at night and prescribe traditional pharmacology (inhalers, steroids.)

Is it possible to create this crossbreed of medicine? If any incredibly rich people want to fund my research, do not hesitate to reach out 🙂

My greatest wish is to see people take care of mind, body, and spirit. Treat yourself kindly and create a body that is strong and healthy. When you do get sick, I am here for you…but take the first steps towards prevention and wellness!