David Paine: Welcome to Library Matters with me; David Paine.
Lauren Martino: And I'm Lauren Martino.
David: And today we are looking at mental and physical wellness. As these winter days get shorter and temperatures continue to drop, many of us begin to experience what we might call as winter blues. But while winter can be a challenging time for many of us, health and wellness is of course of your own concern. So joining us today, we have two very special guests who are going to share their knowledge and interest in mental and physical wellness. Welcome to Nicole Lucas, who is Program Officer with the Montgomery County Chapter of the National Alliance on Mental Illness, otherwise known as NAMI, welcome Nicole.
Nicole: Hi, thank you.
David: Welcome also to Elizabeth Lang, who has the very eloquent title of MCPL's Assistant Facilities and Accessibility Program Manager, is quite a mouthful, I hope I got that right?
Elizabeth Lang: You did, hello.
David: Anyway, welcome.
Elizabeth: Thank you.
David: So, let's begin by asking you both. Obviously you come from very different approaches to this. What does wellness mean to you both? Let me start with Elizabeth.
Elizabeth: Okay. Well, being a librarian, I looked it up in the dictionary. So the Merriam-Webster dictionary says that, "the quality or state of being in good health, especially as an actively sought goal." But personally, wellness to me really -- I think of is taking good care of myself physically and mentally.
David: That seems to sum it up. How about you Nicole?
Nicole: Well, I took a different approach just because of my background at NAMI. So the two of mental health and mental illness get interchanged quite frequently, and so we define mental health as how you're taking care of yourself and how you cope with stress and everyday things like work and raising children and getting through the ins and outs of what you're going through and how you handle those the emotions. And then as far as mental illness, that's more of how the illness affects the way people think, feel, behave, or interact with others.
And there are many different mental illnesses and they have different symptoms that impact people in different ways. So I think it's really important to distinguish the two. Because when you think of mental health sometimes people think mental illness when that's not necessarily the case.
David: Thank you.
Lauren: So you can come at it from a really positive perspective as opposed to just looking at what could go wrong.
Nicole: Absolutely yes. And when we do our presentations at NAMI that's one of the questions it's almost like a trick question that we ask is, well, what comes to mind when you think mental health and people automatically started throwing out depression, bipolar, sadness, anxious, worry, all that stuff. But we're just asking like you know what do you do to help deal with? What do you do for fun? And we have to kind of tease that out. But once we get that going, then it's like oh, okay, that's what you mean.
Lauren: Elizabeth, can you tell us a little bit about why the library is a good place to look for health resources?
Elizabeth: Oh sure. The Montgomery County Public Library collections include print and online resources by reputable sources on health and wellness topics, almost anything that you can imagine. Some resources have a broad overview of a topic like managing stress or staying fit. Others cover very specific topics like nutrition for healthy aging or pool workouts. That's an actual book that we have in our print collection. Resources that are available on the shelves in the library include health and wellness books, magazines, documentaries and the MCPL website also has some great resources.
We have a LibGuide about health that collects a dozens of health resources all in one place. The information includes things like getting health insurance through the Maryland Health Connection and health topics that have been in the news recently, such as the opioid epidemic. There's a section devoted to online health resources such as the Gale Health and Wellness Resource Center, which is a huge database of health information covers diseases, conditions, drugs, diagnostics, treatments, therapies, etc.
The health LibGuide also has a section that covers how to find health services locally, a section about kids' health and a listing of trusted health websites. So it's really a one-stop health resource, best of all. All of these resources are free to Montgomery County residents. They just need their library card.
Lauren: Did you mention workout videos? We get a lot of workout videos.
Elizabeth: We have many wonderful workout videos, absolutely.
Lauren: Now I got the belly dance like workout video at some point which is a lot of fun. [Laughter]
Elizabeth: I haven't seen that one -- one that I did have checked out several times as Tai chi -- Tai chi wonderful -- wonderful video, yep.
David: So turning to you Nicole, tell us a bit about NAMI, the Montgomery County Chapter is I think one of many up and down the country. How long has NAMI been in existence, and what are some of the programs that you offer?
Nicole: So the Montgomery County Chapter has been in existence for about 40 years. We actually predate the national office, so it's kind of like a fun fact that we share with the community. So we operate at three different levels: national, state, and then local. So there's over 900 affiliates or local chapters however you want to describe it, and so Montgomery County is the local chapter.
At Montgomery County, I'm the Director of Programs, and we offer about 14 different programs and our goal and our mission is to provide support, education, and advocacy for people living with mental illness and their family members. The great thing about what we do is everything is free and we also offer a helpline to the community where people can contact us for resources.
David: And how are you funded?
Nicole: We are funded through foundations, through the county government and through membership and private donations. So kind of all of the above. All hands on deck when it comes to funding or non-profit, so.
Lauren: Anyway you can.
Nicole: Anyway, we can, yes. And we are a small staff. We have five full time staff and that's the other differentiator with NAMI is that all of the programs that we offer are run by volunteers because that's the requirement in order to facilitate a support group, a class as you have to have lived experience. So that is who basically helps us run NAMI. So we do a lot of services with very small staff, but a very dedicated volunteer base.
Lauren: So you've got a lot of people in there who know what they're talking about from?
Nicole: Lived experience, that's correct.
Lauren: That's amazing.
David: And I think I read that your motto is you are not alone is that correct?
Nicole: Yes. That's right. You're not alone, which is true because one in five people live with mental illness and so I always tell people in my presentations that if you haven't been touched by it, then I don't know if I quite believe that just because everybody has had it, maybe just you know in the moment or situational. But if you yourself haven't, you definitely have a family member or a friend that has been touched by it because it's so prevalent.
David: And presumably also there's people who may have it, but aren't aware of it.
David: That comes into it too.
Nicole: It does.
David: Nicole, can you tell us about a typical program you might do some of the programs you do offer?
Nicole: Sure, absolutely. So like I said, we provide program, we provide classes, support groups and presentations. And the two populations that we serve are for the individuals with living with mental illness and the family members. But to go back to the history of NAMI and how we were founded was by five family members who had children with mental illness and they could not find any resources.
So they got together and they said this shouldn't be this hard to try to find help for my child and so they form NAMI and so that really was the foundation of NAMI and out of that came one of our signature programs or classes which is called family to family. And that is a twelve week class that we offer because for lack of a better word is a very popular class, but I'm thankful that we have it that we can offer family members who are caregivers to their loved one.
And the class is always full. We always have a waiting list. We try our best to offer it if not monthly, every other month and that's where our volunteers come into play because we need volunteers to keep up with the demand specifically for this particular class.
David: Great, thank you. Tell us more about the typical content you one might find in the program?
Nicole: Sure, so when the family to family class, it's a psycho educational class which basically means that the participants learn about different mental illnesses. They learn about how to set boundaries with their loved ones, so they learn some practical advice and suggestions on how to care for their loved one. They also learn about resources in the community because as you mentioned there are some cases where you have mental illness, but you don't acknowledge that you have it and that's the case a lot of the times.
And it's very frustrating for family members because they don't know what to do. So our class teaches them that. And it's a very full class like I said and it's a lot of content and for that reason sometimes we have multiple -- we have participants who take the class multiple times because I've heard feedback that they learn something new every time. So it's kind of generally speaking of what the content covers.
There's also -- I'm sorry one last thing. There is also an empathy exercise that we do in the class which is great because it shows the family member what it's like to live with mental illness if you're experiencing symptoms. And after we do that exercise, it is very powerful because they come out of it and say.” Wow, now I know why I can't communicate with my loved one” because they're symptomatic, they're hearing voices, they're seeing things, they're feeling you know things on their body. So it really gives a lot of insight to those family members.
David: Wonderful, thank you.
Lauren: Elizabeth, can you recommend any books or magazines that kind of speak to some of these same issues that NAMI deals with or anything else regarding physical or mental health?
Elizabeth: I'm more aware of resources relating to the physical aspect of things. One of my favorites is prevention magazine which I brought a sample of. I know that the listeners can't see it.
Lauren: We can see it.
Elizabeth: But you guys can see it. It's here. It's available in print as well as online and it covers a wide range of health and wellness topics. Sometimes it does cover mental and physical health both, but it focuses mainly on physical health.
Lauren: We have that available through Flipster, do you know?
David: I believe we do.
Lauren: Okay. That's how I read the current issue. Because it was not on the shelf when I went to find it in print. I read the current issue online.
Elizabeth: It always includes practical tips which I really appreciate. It's not just you know the fury or the research behind things. But it will tell you try this or try that. This might help or that might help.
David: Elizabeth, can you just tell us what Flipster is?
Elizabeth: Sure. Flipster is an online app that allows you to access the digital version of the magazine.
Lauren: I couldn't find the print copy so I went to the electronic copy, which is always available.
Elizabeth: Yeah, you check it out online basically instead of picking it up and sitting down or at a table in the library.
Lauren: What are some of your other favourite resources for physical and mental wellness?
Elizabeth: Okay, I brought a couple of items with me in addition to prevention magazine that I think are really good resources. Just for general information about health, one of them is a book called Whole: Rethinking the Science of Nutrition. It was written by T. Colin Campbell, who is a nutritional biochemist. And the book explores why a plant-based diet is likely the best diet for humans to eat.
It reviews research and talks a lot about the problems that we create for ourselves and we try to examine one nutrient as separate from other nutrients. And how that kind of reduction is, doesn't show us a full picture which is why sometimes there will be studies that are released that say eggs are good for you and then next week there's a study that says that eggs are bad for you. So this book takes sort of a large review and talks about how we can be skeptical of what we're hearing and how to evaluate what health claim might be valid and what might be less valid.
Lauren: That's really important because we're all constantly bombarded with conflicting information and have been for decades and decades and it speaks to that.
Elizabeth: Right, it's hard to know what to pay attention to. So his book just cautions us to be careful basically. So I really -- I recommend that people read that if they have a strong interest in health topics. I also brought a book by a local author, Robynne Chutkan, I believe this how her name is pronounced. She has gastroenterology practice in Chevy Chase I believe. And she talks a lot about gut health and this is a new area of study that science is showing is very important to personal, physical health. She runs a practice and writes some books that talk specifically about the kinds of things that we can do to make sure that our guts are healthy and how that impacts our overall health.
Lauren: Have you read I Contain Multitudes, it is kind of along the same lines, but more of a.
Elizabeth: I have not but, I know what you're referring to.
Lauren: Yeah, that's I mean it's the less you know how to version and more the amazing world of microbiomes.
Elizabeth: Right. It's about all the billions of little bacteria that live inside us that sort of help us run things properly digestively, yes.
Lauren: And what happens when we try to get rid of one and then everything else comes in like they were talking about how like hospitals are now looking at putting germs in the hospital rooms to counteract the bad ones, yeah because what do you do, you just find a way to crowd them out.
David: So a reminder to our listeners is that all of the resources that we mentioned in today's podcast can be found in our program show notes on the podcast webpage. While we are talking about library resources, Elizabeth, are there any documentaries on health and wellness available in the library collection?
Elizabeth: Yes, many. We have documentaries on the shelves in all of our branches and they cover a wide range of topics as we were referring to earlier exercise tai chi, those sorts of things. We have videos that are about eating and on topics that are more related to mental health reducing stress and wellness. My favourite resource though is not actually the DVDs that we have in the shelves.
We have an online on demand film streaming resource called canopy that has over 500 documentaries on health and wellness topics. And they're broken out into categories like sports and fitness, nutrition, mental health, death and dying in addiction. And a lot of these are award winning films. They're really excellent. I have more things on my to-watch list than I will ever have time to get to.
David: That's great. Thank you. Nicole, turning to you in the work that you do, you are so well placed to see and observe developments in the field. What are some of the current trends you're seeing in mental health and wellness?
Nicole: I think the biggest trend that we're seeing is providers are encouraging their patients or their clients to use mindfulness techniques. So they're going back to I mean, there's the traditional therapy, medication, senior doctor, but in terms of concrete treatment that you can do at home, that you could do at work, is mindfulness activities and I feel like that's a little bit of a buzzword, so I wanted to take a minute to describe what that means.
So I kind of see it as two-fold. Mindfulness can be defined as letting go of taking things for granted, meaning mindfulness challenges us to awaken from these mind habits and appreciate the little things. So you know the little things of you know your daughter coming home with a picture that she drew at school that you add to all the other 800 files- [Laughter]
Elizabeth: When you are so tempted you just say I'm just want to cook dinner.
Elizabeth: I don't need to look at that right now.
Nicole: Yes, or listening to your spouse's day or your partner's day and just really staying in the present. And then the second piece to that is that it can be defined as being in the moment. And so being more in the moment of like observing our surroundings like the trees that I'm looking at outside as we're doing this -- having this conversation, looking at Elizabeth's scarf and see how pretty it is and not thinking about what I'm going to cook for dinner and, “Oh gosh I hope my daughter did her homework,” that kind of thing.
And that's one of the things that we do, that's one of the things that we also -- that's included in our class for individuals living with mental illness and that class is called peer to peer, and is mindfulness activities and it has really been helpful. And so that's the biggest trend that I'm seeing is the mindfulness. Do you know of any resources that we have that address mindfulness? I feel like it's also been a big trend in a recent publishing?
Lauren: Yeah, we do. We have mindfulness materials and traditional, the section of the library that offers Buddhist materials. Traditionally, mindfulness is associated with Buddhism. But it has sort of grown beyond that. We do also have mindfulness materials in other areas of the library as well. So you know searching for mindfulness in our catalog online will bring all of those materials up. We've got a number of programs too. I know it's over spring we offer like meditation classes in English and Spanish, and I'm sure there are several others throughout the system that-
Nicole: Yes, we have several branches currently offering yoga, meditation, qigong, and tai chi classes, and all of those or many of those will contain a component of mindfulness.
David: So Nicole, I see you both allowing a list of recommended readings which we will include in the show notes. Can you just tell us a bit about-?
Nicole: Sure -- sure. So this has been a work in progress. So we listen to our members and those that take our classes and reach out to us because that's one of the questions that we get, especially when you're in the beginning stages of crisis for lack of a better word as what can I read. So we develop the list and we have it broken out by mental illness, so specific to the diagnosis and they vary from bipolar to depression to OCD.
So it's a combination of all of the above. And then we also included from a family's perspective because that was a feedback that we got also. That we wanted to hear what the family were saying about caring for a loved one with mental illness. It's not a comprehensive list because it's a work in progress, but it's a good starting point because I think also too when we have participants in our class, they described not way, but people who have taken the class, they are described as a deer in headlights.
Because if you think about you have a loved one with mental illness, you just got a diagnosis, you don't know where to turn to, you show up at this class, and you're like I don't know what's going to happen next or where to go next or what to do and what's going to happen. So we developed this reading list as kind of a starting point and it's somewhat of a roadmap to go along with the programs that we offer.
David: It's great. Sounds like a great start. So in talking about mental and physical wellness of course, we're referring to children as much as adults. Elizabeth, what kind of information does the library have for health and wellness for children?
Elizabeth: Well, we have the same kind of range of materials for children and about children that we do as the materials that are for and about adults. As it mentioned, the health LibGuide on our website has a section that is devoted to children. So it offers information about children's health resources and in our branches any children's department will have materials on the shelf that staff can show to our customers that address both how parents can address children's health issues as well as books for the children themselves to learn about their own health issues or health and wellness in general.
David: It's wonderful. And Nicole presumably NAMI caters as much to children in your offerings as anyone else?
Nicole: That's a really good question, because our model is a little bit different. So we offer the classes for family members who have a loved one over the age of 18 and then we have classes for the parents who have a child under the age of 18. So we don't target under the age of 18 specifically. However, we do have a program when we go into high schools and middle schools and do a suicide prevention resiliency program. So in that case, we do touch that population, but primarily in terms of NAMI's core program, it's really for adults.
Nicole: For the exception of the parents, but it's the parents for the kids under the age of 18.
David: Right, okay. Thanks for clarifying that.
Lauren: Nicole, do you have any particular advice for anybody who's struggling with or has family members who are struggling with mental health problems and I guess they're in that deer in the headlights stage, they been blindsided and they don't know where to turn, they don't know what to do?
Nicole: Yeah, absolutely. Everybody situation is different and that's why I go back to always going to your primary care provider. If it's the family member who has a loved one that's experiencing these signs and symptoms, we recommend that they keep a journal of the behaviors. So that when their loved one or if and when their loved one does go to the doctor they have some kind of documentation of the behaviors, we're not doctors at NAMI, so we don't diagnose and that's one of the things that we talk about in our presentations is that, don't diagnose your family member because that's going to-
Lauren: As tempting as it may be.
Nicole: As tempting as it may be, that's going to probably put them on the defensive. But always go to the doctor first, and if they don't go which is often the case also is that you make sure that you take care of yourself. And I know I spent a lot of time talking about the classes, but we also have support groups for both the loved one and for the person with the illness. And there is no commitment and that was one thing I didn't mention. For the classes, there is a commitment. You've to sign up and register family to family as twelve weeks, peer to peer for the person with illnesses eight weeks.
But sometimes people aren't ready to commit and that's okay. So they can do the support group and the support group is exactly what it is you just show up if you want to go and if you don't want to go you don't show up.
Lauren: Low commitment.
Lauren: Fit in the door.
Nicole: Yeah. And I see that is more like the gateway into starting the treatment process, and then once they get more comfortable then they may commit to taking a class to learn more about how they can help themselves.
David: So Nicole now that we've talked a lot about NAMI, where can anybody interested find out more information on NAMI, your services, and how to contact you?
Nicole: Okay. So you can go to our website at namimc.org. You can call us at 301-949-5852. Please like us on Facebook at NAMI Montgomery County and you can follow us on Instagram at nami_mc.
Lauren: We've covered a lot of material in a lot of different areas, but I want to make sure that you both have the opportunity to say whatever it is that you were excited about preparing for us. So what else would you like to tell us about?
Elizabeth: This winter the libraries are offering some health-related classes that I think are pretty interesting. We have at our Kensington Park and only libraries a bone-builders class for people over 55. This is offered on an ongoing basis. And it's an evidence-based bone building and fall prevention program sponsored by Montgomery County's Department of Health and Human Services, the recreation department, and the volunteer center.
Additionally, in partnership with the African-American health program, the Germantown library is hosting classes called kick starting your health, how to prevent and manage chronic diseases. That provide information and resources on how to prevent and manage diabetes, heart disease, cancer, Alzheimer's, and dementia. Those are just a few of the health related programs. If you visit our website, you can search through all of the events that we offer through our events calendar. You can contact any branch or you can look for a print copy of our calendar of events around various locations in Montgomery County.
David: So, Nicole, turning to you, mental illness, the term mental illness is a very brute. Can you tell us some of the warning signs that one might look out for mental illness?
Nicole: Sure, yeah sure absolutely. So this isn't inclusive list, but these are just signs and symptoms to look for either in yourself or for your loved one. If you're feeling sad, if you're isolating, withdrawn, unmotivated that could be a sign of depression. Also self-harming and that is where someone may be making plans to harm themselves or they're cutting, that's definitely a warning sign.
Risk-taking behaviours, where they're out of control, engaging in risky behaviors and this isn't like an all-or-nothing kind of thing, it can be one or two symptoms that you're seeing. Also, the person can be just feeling fearful all the time, sudden overwhelming fear for no reason. Sometimes they have racing heartbeat or fast breathing. Other signs could be weight change and that could be one way, you know either way weight gain, weight loss, that can be an indication for maybe an eating disorder.
Severe mood swings is another symptom or warning signs to look for. Also, the obvious substance use, excessive use of drugs or alcohol, drastic changes in behavior that's unlike them. So as the family member, you know kind of the baseline of your loved one and that's why I go back to the journal writing. It's a little bit easier as the family member to see the symptoms but when you're the person with the illness and maybe sometimes you don't have that support system. So that means they have to have the insight to recognize these things and sometimes that happens, sometimes it doesn't.
Lauren: Well, that's part of a lot of illnesses isn't? That you've just -- you cannot recognize that something is wrong.
Nicole: Right, you lack that; absolutely. And then lack of focus, difficulty concentrating and some of these things like lack of focus, I mean that could be just like not sleeping because my baby won't sleep through the night.
Lauren: No coffee.
Nicole: Right, yeah, no coffee. You're just you know working.
David Paine. Another day at work.
Nicole: Yeah, another day at work. So some of these things that's why again documenting, just monitoring the behavior so that way you have more of a timeline to see the progression of these warning signs. Montgomery County has a crisis center that we always refer to also so in addition to following up with your doctor, but if you don't have that, you can also call the Montgomery County Crisis Center which is 24/7 and that number is 240-777-4000. And they're always have someone on staff to help and they also have a mobile crisis team where they can send someone out to assist in a situation.
Lauren: It's good to know. Is there anything else you wanted to share with us Nicole about your work at NAMI?
Nicole: Sure. One of the things that I just wanted to highlight is that when you have mental illness, it's important to remember that it's not anybody's fault. It's not caused by poor parenting or weak character. It's not preventable at this time, but it's more about following your treatments whether it's medication, seeing your therapist, being involved in activities. And then it's not hopeless.
These illnesses present difficult challenges, but help is available through NAMI and other organizations, use our helpline to help get connected with resources of the community that can help you maintain your recovery. But that's one of the things that we just want to remind people that people living with mental illness, remember it's one in five and there is one, two, three, four, five people in the room right now. So, my point being is that we're all touched by it, and recovery is possible in terms of if you get connected with your treatment and you follow your plan. And that's really the message that we like to lead with at NAMI.
Lauren: Thanks a lot Nicole and thanks Elizabeth. We have one more question that we ask all of our Library Matters guests and that is what are you reading right now? Elizabeth, what would you like to share with us?
Elizabeth: Well, I'm reading several books. The most interesting of those is a graphic novel called Upgrades Soul, written by Ezra Claytan Daniels. It's about an older couple who are offered the opportunity to perhaps participate in experiment that may rejuvenate them mentally and physically. But it's an experimental treatment and they're not exactly sure how it's going to go and then lo and behold, all does not go as was expected. It's a lot of science fiction, it's very interesting, it's a big dick graphic novel which I really like. I like the more complicated stories. It was not written as a serial originally, it's just a standalone, it's very interesting I would recommend it for anybody who likes graphic novels or science fiction.
Lauren: And ties in nicely with our wellness discussion.
Elizabeth: Yes, it does.
Lauren: Nicole, what are you reading right now?
Nicole: Well, mine is work related. Just because we -- like I mentioned we have the help lines, so we get lots of calls from people and I try to stay relevant and being able to give recommendations to our callers. So I'm reading If Your Adolescent Has Depression or Bipolar Disorder, and it's by Dwight Evans and Linda Andrews. I like this book because when we get calls from especially families of adolescence; it's really hard to determine is it adolescent behavior or is it mental illness.
Lauren: Because they're not always super distinguishable.
Nicole: No, they aren't. And so this is a really clear concise road map. It's very easy to read. And one of the things that I try to be mindful of is that when you're in crisis, you probably -- you go through these different steps, you start calling all these different resources, you start reading all these books, you sign up for everything and then you're like on overload. So that's why I like this book because it was a little bit more simple, because I think that when you're going through those different stages simple sometimes, it's the whole 'less is more' kind of thing.
And I think that our callers appreciate that, especially when I tell them let's just do one thing at a time, let's focus on you know, whatever the priority is. We also have a parent support group which is something different at NAMI because it used to be just all family members in general. But now we have parent support group, so if you have a child under the age of 21, we have a specific group just for that population. And we find that to be very helpful for the families who you know, have adolescents that are experiencing these different types of symptoms and behaviors.
Lauren: Thank you so much for this conversation, Nicole and Elizabeth. It's been really informative and really helpful. Listeners, don't forget to keep the conversation going by following us on Twitter, Facebook, Instagram, and Pinterest. Don't forget to subscribe to the podcast on the apple podcast app or Stitcher, or wherever you get your podcasts. Also, please review and rate us on apple podcasts and leave us some comments because we would love to know what you think. Thanks for listening to our conversation today and we'll see you next time.