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Do I need a Depression Screening?

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

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



DocTalk: Dr. Squillaro Shares How February’s ‘Time to Talk Day’ Helps to Normalize Mental Health Conversations

February 1st 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




Providing Personal Financial Support to Our Service Members and Their Families

“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!




Holiday Stress Toolkit for Military Families

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.

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


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.

    Christi Garner, LMFT CYTChristi 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.




DocTalk: Dr. Candice Tate Shares Five Ways to Set Healthy Boundaries During the Holiday Season

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.




Using One Word to Take a New Approach to Change in the New Year

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/.




New Youth-focused Certificate Program Enhances Counseling Service for Military Children and Youth

The Military & Family Counseling (MFLC) Child/Youth Behavioral (CYB) Program was created to expand supportive services to military families by providing non-medical counseling opportunities to their children. Magellan offers CYB counseling positions only to independently licensed clinicians who possess education and experience in counseling children in age groups and environments similar to those of their MFLC counseling assignment. CYB MFLC services are utilized frequently. During a one-year period (October 2022 – 2023), Magellan CYB MFLC counselors provided approximately 1,071,000 counseling or consultation sessions focused on child issues.

Military life is complex, challenging, and dynamic. The government and Magellan continue to conduct research and identify new issues impacting military children and families. Best practices continue to emerge or be augmented to address difficulties that may negatively impact military children’s functioning levels and wellbeing. To maintain our commitment to providing the highest level of care for our military children, Magellan has developed a voluntary certificate program for CYB MFLC counselors to:

  • Build on foundational knowledge of child development theories and emotional, behavioral, and psychological challenges that may occur in each stage,
  • Provide information on challenges unique to military children and how they are manifested in day-to-day living, and
  • Enhance knowledge and application of evidence-based protocols to address specific internal and environmental factors that may negatively impact healthy childhood development.

The CYB Professional Certificate program is comprised of two tracks and was designed, sponsored, and administered by Magellan to meet the evolving needs of today’s military youth. MFLC counselors may complete one or both tracks depending on professional development interests and learning needs. Completion certificates are available for each track. All training modules within the program are approved for continuing education units (CEU) for maintaining counselor professional certifications.

The goals of this youth-focused counseling training program are to:

  1. Develop healthy military children,
  2. Reduce the probability of problem escalation to clinically significant levels and
  3. Assure service and family members’ readiness and resilience.

The success of the program is dependent on MFLCs’ abilities to provide developmentally appropriate evidence-based interventions that engage and support military children, their families, and others involved in children’s lives. The CYB Certificate Program enhances the level of expertise among CYB MFLCs and the likelihood of positive outcomes among military children/families, thereby meeting or exceeding program goals and ensuring a resilient, ready military workforce.




Presence: The Best Holiday Present

Our brains are constantly thinking of things we need to accomplish. There are milestones and deadlines at work. At home, there are responsibilities, friends, and families that deserve our attention. Adding to the normal demands and stressors of life, the holiday season is right around the corner.

The holidays bring connection and joy but also a need for decorations, travel arrangements, and planning. Families strive to truly capitalize on their precious opportunity for leave. Military families with a loved one on deployment are considering how this year may feel a little off and are thinking about what they can do to still make it special.

Managing Demands During the Holidays

Thinking of the many demands upon us, it’s easy to see how the feeling of holiday cheer can be overtaken by unpleasant emotions such as anxiety. We can feel drained as we are trying to navigate a conversation or two while simultaneously taking care of some task. It’s in the depleted, attention-divided state that feeling overwhelmed can occur. While common, this doesn’t need to be the case. Instead of letting the holidays pass you by with a sense of overwhelm, give yourself the present of presence by setting boundaries. Here’s how.

  • Identify priorities—When you identify what is most important to you, you can be more intentional about focusing your time, energy, and effort. Prioritize your activities and narrow your focus by considering what you value the most. Whether it’s cooking a special dish, arranging the décor just right, or meaningful conversations with someone, you can focus your time and attention where you most desire.
  • Create boundaries—This may seem limiting at first, but boundaries actually create the opportunity to dedicate yourself fully to what you care about most. Setting boundaries means giving yourself permission to say no to events, certain traditions, or just the pressure to do it all. At times, this can be challenging because we may feel like we’re missing out: however, although we are not doing everything, we are able to get more out of the things we do.
  • Be in the moment—Once you create boundaries, it will enable you to fully bring yourself to the moment. Your thoughts, energy, and attention are present in the moment; you have a sense of complete engagement in what you’re doing, and a greater sense of awareness in each precise activity. When having a conversation, you are truly listening, empathizing, and being aware of each other’s presence. Whether you agree or disagree on a particular topic, you seek to understand and appreciate that person.

The Value of Being Present

When we are mindful, life’s special moments come alive. Noticing the smirk someone gives. Savoring the flavor of each bite. Basking in the bustling of sounds around. Indulging in the pleasures and joys with abandon. This is where we connect, where we create the bonds and memories that last far longer than anyone’s awareness of how clean the house was that day, if we were five minutes late, or if we forgot that critical dish.

Understanding what we value most and leveraging boundaries to reserve our resources gives us the power to be present in the moments that matter. This is the most precious present we can give others…and ourselves.

Happy Present Holidays!