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Stress Coping Strategies During and After the Pandemic

Stress Coping Strategies During and After the Pandemic

by | Nov 25, 2020 | Being Well

You are not alone if you have been feeling more stressed than usual. This additional stress is likely a result of the COVID-19 pandemic. One way to cope with stress is to utilize stress coping strategies. These strategies can be used as a tool to manage current and future stress that you may encounter.

Here are five coping strategies that may help you manage stress:

Journal writing: Journal writing can help to reduce stress levels. This coping strategy can be done in many ways, such as: recording daily events, creative writing, gratitude journaling, goal tracking, or journal prompts. If you are looking to learn about other ways that you can document what you are experiencing during this time, I encourage you to read this New York Times article.

Physical activity: Physical activity helps your body release endorphins which can make you feel good. Individuals of all ages can benefit from physical activity. To ensure physical activity will be sustainable in your life, choose exercises that you enjoy. If you are looking for some ideas on how to be active, I would recommend visiting Tillamook County Wellness.

Breathing Exercises: Breathing exercises are a good way to lower stress. These exercises are great because you can do them almost anywhere. To learn more about breathing exercises, I recommend reading this Washington Post article.

Do something you enjoy: Take time each day to do something that you enjoy. Try scheduling enjoyable activities the same way as you would schedule an appointment. If you are interested in learning about hobbies that lower stress, I recommend starting with this list for inspiration.

Have a conversation: Having conversations with others can allow you to get emotional support. You can connect with anyone that you trust, such as family members, friends, or a faith leader. If you do not feel comfortable opening up to someone you know, you may want to consider speaking with a health professional. A health professional is trained to help a person improve physical or/and mental health. Examples of these professionals include: physician, nurse, and counselor. If you would like to learn more about health services in Tillamook County check out the Best of Health & Wellness Guide. Another way to get emotional support is through a support group. These groups are facilitated by either peers or health professionals. These groups allow participants to participate in whatever way they feel comfortable. Support groups are ideal for people who want to talk with individuals that have similar lived experiences. One support group that I would like to highlight is the Tillamook Family Counseling Center’s COVID-19 support group. If you would like to learn more about the group call (503)842-8201.

I hope you have found this article helpful. If you would like to learn more about stress coping strategies be sure to follow the Tillamook County Wellness’s #COPEWELL campaign by following Tillamook County Wellness on Facebook.

AUTHOR: Janeane Krongos, Prevention Specialist at Tillamook Family Counseling Center

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Gingersnap Pumpkin Pie & Holiday Health Tips

Gingersnap Pumpkin Pie & Holiday Health Tips

by | Nov 19, 2020 | Eat Well, Recipes

Judy Barbe was a featured speaker for the Tillamook County “Year of Wellness” in 2016.

Thanks to a sponsorship by Tillamook County Wellness partner, Oregon Dairy & Nutrition Council, we will periodically feature articles and recipes from Judy Barbe, author, columnist and nutrition expert. As a registered dietician nutritionist and food enthusiast, Judy offers realistic food solutions to help people “live their best.”   Looking for an easy pumpkin pie recipe? Gingersnap Pumpkin Pie it is! With half the sugar of a traditional pumpkin pie recipe it’s healthier, too.  With the holidays in full swing, I am the Ghost of Christmas Practical. Yes, I’m baking cookies and pies. I mean, it really wouldn’t be a celebration without them, would it? But I’m trying to keep a handle on sugar.
Holiday weight gain
Most of us can use a hand reducing extra calories this time of year. The latest research (https://www.livescience.com/56206-holiday-weight-gain-america-japan-germany.html)  indicates that many of us gain just less than two pounds during the holidays. Two pounds. That’s not much. The good news is that half of us will lose most of the weight, but the other half will still be carrying the extra pounds in summer. Two pounds every year for ten years? Maybe that explains where that extra weight came from…Christmas 2006!
A healthy pumpkin pie recipe
That’s why I am excited about this pie. I reduced the sugar by half from a traditional recipe and the only one who will know it is the baker.
Gingersnap Pumpkin Pie = easy pumpkin pie
Piecrusts can be the enemy of pie bakers, but this crust takes the cake on easy. I use store-bought gingersnaps to make the crust. These spicy little cookies don’t need added sugar and there is no rolling pin required. The filling is spiced up, the sugar is toned down and the topper is a dollop of honey-flavored Greek yogurt. The yogurt provides tanginess to the spicy pie and crust. All in all, a fork-worthy pie. The healthier pumpkin pie could even be breakfast!
Holiday health tips
I’m not sure I’ve ever seen a sugarplum, let alone one dance around my head, but with all the temptations during the next few weeks, this pie is a delicious and practical solution. Here are a few more holiday helpers:
  • Fill up on fiber. Every 10-gram increase in daily fiber reduces hunger and belly fat. Make oatmeal or bulgur your breakfast. Include an apple or pear for lunch. Add beans to soups, salads and stews.
  • Go to bed. Sleeping 6-7 hours per night helps maintain regular weight.
  • Move your feet. Physical activity burns calories and reduces stress. Consider a walk your mental filter for the holidays.
  • Feed your soul. Feeling grateful, volunteering, and laughing with friends boosts your mood and sense of well-being.
P.S. Hungry for more healthy living tips and recipes? Sign up for my newsletter at https://landing.mailerlite.com/webforms/landing/v1q9c9

Lower Sugar Gingersnap Pumpkin Pie

Gingersnap Pumpkin Pie, with half the sugar from a traditional recipe, is a healthier pumpkin pie. And the only one who will know it is the baker! Top it with honey yogurt rather than whipped cream for even more calorie savings.
  • Author: Judy Barbe
  • Prep Time: 20 mins
  • Cook Time: 1 hour
  • Total Time: 1 hour 20 minutes
  • Yield: 8
Ingredients: Crust:
  • 20 gingersnaps, 2 1/4-inch diameter cookies
  • 2 tablespoons melted butter
Pumpkin pie filling:
  • 1/2 cup sugar
  • 1 teaspoon cinnamon
  • 1/2 teaspoon ground ginger
  • 1/4 teaspoon ground cloves
  • 1/4 teaspoon salt
  • 2 eggs
  • 1 tablespoon vanilla
  • 1 15-ounce can pumpkin
  • 1 12-ounce can evaporated milk
  • Honey flavored Greek-style yogurt
  Instructions:
  1. Heat oven to 350 degrees.
  2. To make crust: Break gingersnaps in half. Process in food processor, pulsing 6-7 times until coarse crumbs. Pour in melted butter. Process 5-6 times until butter is incorporated and mixture looks sandy.
  3. Press crumbs into 9-inch pie plate. Use the back of a spoon or custard cup to press crumbs firmly into pie plate. Bake 8 minutes. Remove from oven to cool.
  4. To make pumpkin pie filling:
  5. Heat oven to 375 degrees.
  6. In a small bowl stir together sugar, cinnamon, ginger, cloves and salt. Set aside.
  7. In large mixing bowl or stand mixer, beat eggs and vanilla to blend. Add spices and pumpkin to egg mixture, combine thoroughly. Slowly pour in evaporated milk and stir gently until mixture is uniform consistency.
  8. Pour filling into crust. You may have some leftover filling. Place in 375 degree oven and bake 45-50 minutes. The filling should be set but may have a slight jiggle when you move the pie plate. Internal temperature of pumpkin pie filling should be 165 degrees.
  9. Bake the leftover filling in a custard cup to enjoy later.
  10. To serve, spoon on a dollop of honey flavored Greek-style yogurt.
Recipe source: Judy Barbe, www.LiveBest.info Judy Barbe is a registered dietitian, speaker, and author of Your 6-Week Guide to LiveBest: Simple Solutions for Fresh Food & Well-Being. Visit her website http://www.LiveBest.info for every day food solutions. What are you waiting for? For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.
Getting the Help We Need

Getting the Help We Need

by | Nov 18, 2020 | Being Well

We’ve been sharing ways to cope well during stressful and uncertain times. For the next few weeks, our Wellness Wednesday tributes go out to partner organizations who provide vital services to those struggling to cope. It’s important to reach out and get help even if a person doesn’t think they are “that bad off,” as we so often hear. Just like with other prevention measures, it is better to seek and get help early. This week’s shout out goes to Tillamook County Community Health Centers (TCCHC) and their behavioral health providers who responded to our interview.

What are the more common issues for which people are seeking help right now?

We are noticing an increase in Depression, Anxiety, Mood disorders, PTSD, and Substance Use Disorders. There is also an increase in difficulty managing chronic conditions such as health conditions like hypertension and diabetes as well as insomnia and other sleep issues, fatigue, chronic pain, stress, migraines and headaches. People are also struggling with weight concerns and behavioral challenges for children which can include ADHD.

What are some common warning signs for these conditions and how common are they? 

Warning signs can include insomnia and other sleep issues, emotional dysregulation, difficulty concentrating, increased disassociation, difficulty with organization, no or low motivation, lack of interest in pleasurable activities, irritability, increased risky behaviors, increased use of alcohol, drugs, gambling, food, etc.

Statistics cited by the National Institute for Mental Health for these conditions include:

Anxiety: 19.1% of the US adult population (23.4% are female, and 14.3% are male).  31.9% of the US adolescent population ages 13-18 (38.0% female, and 26.1% male)

Depression: 7.1% of the US adult population (8.7% female, 5.3% male). 13.3% of the US adolescent population ages 12-17 (20.0% female, 6.8% male).

Suicide: 10th leading cause of death overall in the US in 2018.  2nd leading cause of death among individuals ages 10-34, and 4th among individuals ages 35-54.

Post-Traumatic Stress Disorder (PTSD): 3.6% of the US adult population (5.2% female, 1.8% male), 5.3% in ages 45-59.  5.0% of the US adolescent population (8.0% female, 2.3% male), 7.0% for ages 17-18.

Substance use: (2018) 60.2% of the US population ages 12 and older (this includes alcohol, drugs, and tobacco). Highest use is 39% among ages 18-25.

(https://www.nimh.nih.gov/health/statistics/index.shtml)

During a study in June 2020, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation. (CDC, https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm)

Nearly half of Americans report the coronavirus crisis is harming their mental health, according to a Kaiser Family Foundation poll. A federal emergency hotline for people in emotional distress registered a more than 1,000 percent increase in April compared with the same time last year. Last month, roughly 20,000 people texted that hotline, run by the Substance Abuse and Mental Health Services Administration. (Washington Post, https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/)

Online therapy company Talkspace reported a 65 percent jump in clients since mid-February. Text messages and transcribed therapy sessions collected anonymously by the company show coronavirus-related anxiety dominating patients’ concerns. (Washington Post, https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/)

What are some of the specific services your organization provides that help individuals with these concerns?             

As behavioral health clinicians who are integrated into primary care our focus is to work with patients around improving health outcomes.  Patients are referred to behavioral health via their primary care provider, and our sessions are generally 30 minutes in length with periodic follow ups as needed or recommended.  We do refer patients to other services as needed; this can include linking with Tillamook Family Counseling Center or a private therapist. Behavioral health is intended to be a short-term consultative service, it is not intended to be long-term intensive psychotherapy.

We engage patients using motivational interviewing, cognitive behavioral therapy, focused acceptance and commitment therapy, behavior activation, and many other tools.

We have a medication assisted treatment (MAT) program for individuals with opioid use disorder; this means we have providers who can prescribe suboxone to treat opioid use disorder.  Individuals must be a patient of the clinic or be willing to establish care, they must have an assessment by the behavioral health provider before they are determined eligible for the program.  MAT participants are then seen by the prescribing provider and behavioral health clinician on a pre-determined schedule to monitor effectiveness, and address any challenges the individual may be experiencing, along with working on their individual goals.

Psychiatry services are available in our clinic; your primary care provider can consult with the psychiatrist, and if needed, the psychiatrist can provide direct services for patients (such as evaluation, follow up, medication starts or changes, and then facilitate return to your primary care provider for ongoing management). Currently this service is only available for patients of the Health Center.

What are common outcomes for people who receive these services?   

We have seen improvements in diabetes management (reduction in a1c’s), improvement in blood pressure control, medication adherence, improved nutrition, improve sleep, and improvements in depression, anxiety, weight management, and stress.

In our MAT program we have seen a reduction in use of opioids and other substances, increased education about overdose and the use of Narcan, and we have seen patients meet their goals, such as getting stable housing, stable employment, improved relationships, etc.

Are these services covered by insurance and/or do you offer a sliding scale for payment?     

TCCHC accepts all forms of insurance, including Oregon Health Plan (OHP), private insurance, and self-payments. We have a sliding fee scale and will not refuse services based on the inability to pay.

What else should people know about your services?

We are a team-based clinic that will assist you in accessing needed resources and services.  We can collaborate with other treatment facilities, and community agencies to help coordinate the care you need.

Individuals may contact us at 503-842-3900 or 800-528-2938.  TTY at 800-735-2900.

 

Pear and Cranberry Crisp

Pear and Cranberry Crisp

by | Nov 12, 2020 | Recipes

Prep and Cook Time: 30 minutes

Ingredients

  • ½ cup old fashioned rolled oats
  • 1 tablespoon brown sugar
  • 2 tablespoons flour
  • ¼ teaspoon cinnamon
  • 2 tablespoons applesauce
  • 4 cups pears, cubed (about 3 pears)
  • 1 cup cranberries, fresh or frozen
  • 1 tablespoon cornstarch

Instructions

  1. In a medium bowl, combine oats, brown sugar, flour, cinnamon and applesauce.
  2. Combine pears, cranberries and cornstarch in an 8×8 inch baking dish. Sprinkle with oat mixture.
  3. Bake uncovered at 400 degrees until juices are bubbling and topping is browned, about 20 minutes.
  4. Refrigerate leftovers within 2 hours.

Recipe and Photo Source: https://foodhero.org/recipes/pear-and-cranberry-crisp

Caring for Our Veterans

Caring for Our Veterans

by | Nov 12, 2020 | Being Well

The COVID-19 pandemic has been difficult for almost everyone to navigate. Certain populations, such as veterans, may face even greater challenges under stressful circumstances. According to the National Center for PTSD, “the COVID-19 pandemic creates stressors like fear about getting sick, concern for loved ones, isolation, job loss and new childcare and family demands.” They note that many of the ways people normally cope, like eating out or going to the movies, are not an option. Without the usual coping mechanisms, it is critical that our veterans know about local care options and resources available to them.

We asked our veterans’ services advocates to share how local veterans are coping with the anxiety, uncertainty and stress of the pandemic, as well as other local and national events that are impacting people’s sense of safety and well-being.

Are you seeing any trends with veterans needing or seeking additional services during the pandemic?

The VA shut down community-based out-patient clinics for several months, only accepting urgent/emergency care, so a lot of routine healthcare was put off. This is causing delays in getting routine exams and health screenings, many of which also require transportation to Portland.  During the pandemic, there have been more interactions with veterans seeking mental health support. Stress, uncertainty and civil unrest can impact individuals with PTSD, increasing paranoia, anxiety and depression. Treatment for these conditions are often being provided through telehealth.

For many years, veterans were required to receive their healthcare at a VA clinic or hospital, which we do not have in Tillamook County. Now, under the Mission Act (formerly called the Choice Act), veterans can access local care with prior approval. Going through that approval process is a service provided by our Tillamook County Veterans Services office, located at the County Courthouse in Tillamook.

Are there common triggers or events that contribute to increased need for mental health services?

Current civil unrest is putting veterans on edge. There has also been a rise in homelessness and substance use. Like many people, veterans have been impacted by unemployment during the pandemic.  According to an article published in the Military Times, 54% of female vets have sought mental health support, compared to 31% of male veterans. It is thought that female vets are likely balancing more family responsibilities due to pandemic-related distance learning.

Job loss is a concern for veterans, whose unemployment rate was 3.5% prior to the pandemic. That rate is now at 6.4%, which is still lower than for non-military peers at 7.2%. Military training and experience may contribute to increased adaptability and a more resilient perspective during the pandemic.

What services, resources or connections does our county veterans services office provide?

The top priority for veterans services is mental health support and eliminating suicide. All Tillamook County Veteran’s Services office staff attended a recent suicide prevention training called “QPR.” Most of the time when a veteran is in a mental health crisis, they are immediately taken to Portland for specialty care.

What are some common outcomes for people who receive these services?

While outcomes differ from vet to vet, many of them are able to completely avert such a crisis. Often, they may get their medications adjusted and they are always provided follow up care to help them manage and avoid future occurrences.

How are these services covered?

Many people assume the VA is a type of insurance, but it is actually a healthcare provider. The VA contracts with other entities (Tri West in Tillamook County) to provide insurance benefits for eligible vets, under a tiered, income-based system. For example, if a veteran has a service-connected disability, they are fully eligible, while someone who is working may have coverage under their job and may be able to use their veterans benefit as a secondary insurance. Retirees on Medicare are also able to use their VA-sponsored “Tri Care for Life” benefits as secondary insurance.

The key is for veterans to get enrolled, which they can do through our local veteran’s services office.

Is there anything else we should share about veterans’ healthcare services?

When veterans go to the Emergency Department, they visit will only be covered through the VA if they are notified within 72 hours of the admission. A medical staff personnel, family member or the veteran themselves must contact the VA Notification Hotline at (844) 724-7842.

The local office also refers veterans to other services such as, CARE, Inc., Helping Hands and Habitat for Humanity’s Ramps and Rails program. They also coordinate with the PUD Light Brigade for utility vouchers and holiday baskets.

To learn more, call or visit Tillamook County Veterans Services Office, 201 Laurel Ave (Basement, Room 12), Tillamook, OR 97141, (503) 842-4358 during regular office hours. A Veterans Services Facebook page is coming soon!

To celebrate and honor our veterans, join the Veteran’s Day outreach event, Wednesday, November 11th, 10-4 pm at the Air Museum. Free admission to veterans.

AUTHOR: Michelle Jenck, Director of Community Well-Being, Adventist Health

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.