Why Feeling Better Doesn’t Always Mean You’ve Recovered

Posted on by Joseph Gerard

Is your teen depressed? Please also review AIHCP's Child and Adolescent Grief Counseling Certification

Written by Marko,

After a long time, you’ve slept through the night and, when your friend made a joke, you actually laughed at it. You have plans for the weekend and, for the first time in forever, you’re looking forward to it instead of thinking about how to get out of it. 

It seems like you’re back to being yourself. It was a long way to go, but you did it. You’re okay.

Then… Well, then you realize you won’t make the deadline at work and the same thing happens again. And this is unfortunately something that (likely) resonates with a lot of people.

You feel this knot in your stomach, and you get overwhelmed by panic. It all rushes right back, as if it never left. As if you never made any progress whatsoever. As if you haven’t recovered.

By triggering the HPA axis and increasing your cortisol levels, stress can reactivate previously reduced symptoms. – Harvard Health, Stress Response and Mental Health

That whiplash can be terrible in more ways than one, but it certainly doesn’t mean that you haven’t made serious progress. This is a normal part of the process, so it’s weird that it’s not talked about more. What feels like recovery doesn’t have to mean actual recovery, and what feels like a failure isn’t failure in the vast majority of cases.

Strange, isn’t it?

Let’s see why this happens.

Feeling Better and Being Recovered Aren’t the Same Thing

You no longer feel heavy, and the dark thoughts seem to be gone. 

And while this definitely is a good thing, this is still not what we consider ‘recovered’; it’s only progress towards this goal.

Clinical mental health recovery requires two things: symptom remission and restoration of functioning (work, social, cognitive). – National Institute of Mental Health (NIMH), Mental Illness & Recovery

Maybe you don’t feel that paralyzing panic anymore, but you can’t focus on the book you’re reading for more than 2 minutes. Sure, our mood might be better, which is great, but you still don’t feel motivated enough to shower or run errands you should’ve completed days/weeks ago; you’re procrastinating. 

It’s great that you feel less emotional pain, but that doesn’t necessarily mean that you can function normally again, which is why people tend to get stuck at this stage. It’s also the reason why feeling awesome for a few days can be so deceptive.

Recovery is complicated. Well, that goes without saying, really. 

But what makes it complicated?

People are different, and it comes as no surprise that the recovery process isn’t equal for everyone. There are some things that everyone does share – that’s the fact that there’s no moment where you instantly go from zero to hero. 

There’s no switch.

Mental health recovery is non-linear, meaning it has periods of improvement, periods of relapse, and periods of stabilization. – Substance Abuse and Mental Health Services Administration (SAMHSA)

Recovery is (usually) slow and messy, with a decent amount of back and forth, where you feel like you’re okay one day, and then the next, you feel like everything you did is wrong and all the work was for nothing. 

So, once you get that string of good days, it’s tempting to just declare you’ve recovered and move on with your life.

Relapse rates for mental health conditions (e.g., depression, anxiety) have recurred in 50-80% of people. – National Institute of Mental Health (NIMH), Depression Recurrence Studies

But no mental health professional would agree with you. 

They’ll pat you on the back for having a few good days, but they’ll also want to see if those days become months, especially when something stresses you out. They’ll want to see that you’re still stable even under pressure because, if you are, then you’re truly okay.

This is also why treatment can change at this point. 

Once the worst is over, the focus goes to building something that lasts.

These early improvements can be quite misleading because people start feeling relief, which is both real and welcome, to the point that they assume they’re healed (or at least mostly healed), while in reality, they’re nowhere near full recovery.

One good thing to remember is that you can always ask for help – in fact, it’s encouraged. 

Being among people who know how to help and people who’ve been where you are right now can be the difference between success and failure. This is why hospitalization institutions come in handy. You can find partial hospitalization in Delaware, Ohio, Texas, Maryland, etc. – all over the country. These types of institutions were designed to make your recovery process as efficient and as easy as possible. 

If you’re struggling, then professional help is the answer.

Recovery Happens in More Than One Area

There’s a lot of misinformation out there about recovery, so it’s really no wonder that many people assume it’s this big moment where you wake up one day, and you’re suddenly great. 

But that’s not how recovery works.

Emotional Relief Doesn’t Mean You Can Function Normally

On the one hand, you feel calm. Or at least calmer than you’ve been recently. 

But on the other hand, you find yourself staring at a computer screen for an hour without doing anything. This happens a lot – panic and sadness ease up, but concentration and motivation are nowhere to be found. This is normal. 

Your brain has been running on empty for so long, it makes sense that it needs a while to rebuild cognitive muscles.

You Have to Rebuild Healthy Routines

Behavioral activation is one of the most effective evidence-based methods for sustaining mental/emotional recovery. – American Psychological Association

When things start to go downhill, the first thing people forget about are routines. And it makes sense, because who wants to go to the gym when you feel like your life is falling apart? 

You no longer sleep well, you don’t eat on time, and when you do, it’s not anything healthy because you don’t feel like cooking.

Once your mood picks up, none of this will be magically fixed. 

What you’ll need to do is force yourself to exercise again, to cook, to run errands on time, to go to bed at a certain hour, and so on. 

It won’t feel too good, and you might still end up doomscrolling on TikTok until 3 A.M., but if you keep at it, all of this will become normal again.

Relationships Recover at Their Own Pace

Just because you no longer feel depressed 24/7 doesn’t mean you want to reach out to your friends and family. It’s been so long since you stuck to a plan without flaking or since you were in the company of other people without feeling irritated, so it’s no wonder this feels awkward.

This will take time, probably more than you think.

Get ready to have some awkward conversations with the people around you because they don’t know what to expect of you or even how to act around you. 

Just be honest and let time do its thing. There’s really nothing else to be done here.

Confidence Gets Back Little By Little

Repeated successes increase self-efficacy, which is linked to sustained long-term mental health recovery. – American Psychological Association

If you feel better, that’s a great sign. But the question is, “How are you doing mentally REALLY?” Do you believe in yourself again? Do you feel good about yourself?

Once you’ve managed to tackle these heavy emotions, that doesn’t automatically mean that confidence is back. 

The way you get back your confidence is by being consistent and steady. 

Keep giving yourself small and achievaeable/realistic goals. 

The more you complete them, the better you’ll feel because this will train your mind that progress is REAL. It’s not some abstract concept. Once you realize that your actions can make a difference, your confidence will (slowly) return.

What Actual Recovery Looks Like

As you may have figured out by now, recovery doesn’t look perfect. It actually looks kind of basic, with a little bit of chaos here and there. 

True/proper recovery you’ll find in the form of consistency.

One bad day is just that – a bad day. It doesn’t unravel into something that lasts for weeks, so one bad day is actually progress.

If you want to know about the biggest sign of recovery, it’s simple. 

It’s in how someone handles stress once it shows up. The important thing here is that they’ll deal with it instead of running away. They’ll sit with the discomfort they feel because they’re strong and don’t have to hide from the bad stuff anymore.

Another thing that happens once a person starts to recover is that they notice more meaningful stuff in their life. 

Like their job, for example. 

It no longer feels soul-sucking but worthwhile. 

All these relationships start becoming a source of comfort and connection instead of something that constantly drains you and makes you feel uncomfortable. Stress and the struggle won’t disappear. Everyone gets stressed out, and everyone struggles at one point or another. It’s how we face those things that change (for the better).

Conclusion

Someone who now sleeps better and laughs at jokes is winning life.

Don’t take feeling good for granted. This doesn’t mean that you don’t deserve feeling good – you do. But keep in mind that it takes a lot of work (whether you realize it or not) to keep feeling good and staying positive even though the odds might be against us.

We can do it, of course. 

But once we start feeling a bit too comfortable; once we start getting lazy, all those bad things in life will again start knocking harder at our doors.

The main takeaway here is that you now KNOW that it’s possible; and it’s not THAT difficult once you know what to do and how to do it. You just have to be aware at all times, and you have to train yourself.

​

2 Interlinking Opportunities:

From https://aihcp.net/2025/10/22/emotional-healing-process-in-counseling/ with anchor approach to emotional recovery

From https://aihcp.net/2024/11/21/psychological-recovery-after-crisis/ with anchor limitations of recovery

Author Bio 

Marko is an adamant and eager content writer with a decade of experience in various niches,  with healthcare being one of them. With his way of implementing storytelling, comparisons, and examples into hard-to-grasp topics, Marko’s able to make complex things sound interesting and relatable – key ingredients to make something understandable. As a hobby, Marko enjoys offroading, board games, and spending time with his family and his dog Cezar.

 

 

Please also review AIHCP’s Grief Counselor Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Why Circadian Health Matters for Weight Management in Shift Workers 

Posted on by Joseph Gerard

Man taking at nap at his desk

Written by Deepika,

Weight management, no matter which side of the scale someone is on, is a complex process. That’s mainly because it is seldom a straightforward one. A plateau, either in one’s weight loss or gain journey, is not just about what goes on their plate. 

Patient outcomes are often influenced by so many more factors, including physical activity, sleep, stress, and medications. This means healthcare professionals have no standard formula to apply for effective weight management, especially when matters are related to a patient’s work schedule. 

The rhythm of life is dramatically different today, with nearly 25% of the working population engaged in night or shift work. For these workers, the demands of their job often override sleep, meals, and light exposure, at odds with the body’s internal clock. Now, circadian misalignment is closely connected to altered appetite regulation and energy balance. 

So, a patient struggling to maintain a healthy weight may not necessarily be facing challenges with their dietary choices or physical activity. Has your team considered a holistic approach to circadian health? This article will examine its role in effective weight management, primarily among the shift worker population. 

 

How Shift Work Throws the Body Clock Off Course 

It’s amazing indeed that the human body is bestowed with its own super-functional 24-hour clock that operates on a healthy wake-sleep cycle. Since this system is both automatic and dependent on certain external factors, any changes in the latter affect more than just sleep. Healthcare professionals cannot treat patients’ work schedule as background information. 

Now, the wider consequences of demanding work schedules are challenging to separate from adequate recovery. A recent Fortune article shed light on Japan’s growing push to dismantle its deeply entrenched culture of overwork. Yet, Prime Minister Sanae Takaichi said she has managed with three hours, sometimes even less, of sleep ever since she came into office.

To her, marathon work hours are a source of pride, not distress. Well, do all shift workers hold the same sentiment? That’s highly unlikely, especially since working through the biological night constantly challenges circadian synchronization. As a result, the following factors easily coincide to affect metabolic health, including:

  • Sleep and recovery, since rotating shifts do not allow a worker to enjoy a consistent, restorative sleep routine 
  • Light exposure, with bright, artificial lights sending confusing signals to the internal clock 
  • Meal timings, as irregular eating breaks further confuse the inbuilt mechanism 
  • Blood sugar and energy balance, because circadian timing has a major say in insulin/blood sugar management 
  • Physical activity, for erratic work hours leave little to no room for a proper workout routine 
  • Length and pattern of shift work, where the duration for which someone is involved in this type of work and their arrangement further complicates the health equation 

It’s irrefutable that circadian timing matters even outside of shift work. Healthline shared a US study examining the health effects of different timekeeping policies. It was estimated that permanent standard time, as opposed to changing the clock twice a year, may result in 2.6 million fewer cases of obesity and 300,000 fewer cases of stroke. 

Jamie Zeitzer, a professor of psychiatry and behavioral sciences at Stanford, stated, “Standard time increases exposure to light earlier in the daytime, which is helpful to keep the output of the circadian clock robust.” Now, even on that note, shift workers cannot be treated as a uniform population. 

What equally matters is the changes in shift patterns, timings, and other individual characteristics of a person’s life that contribute to the big picture. So, healthcare providers must take a deeper look than whether a patient’s work is leading to weight gain. Get to know what aspects of an individual’s work and circadian environment are influencing their decline in metabolic health. 

 

Why a Holistic Approach Matters 

As we just discussed, weight management for shift workers is practically inseparable from the conditions their work schedule creates. Sleep disruption naturally affects appetite, energy, and meal timings. There is also limited time for recovery from physical activity. 

A recent analysis of 33,983 workers by the National Institute for Occupational Safety and Health (NIOSH) found that 27% worked shifts, whereas 26% were physically inactive. Moreover, 47% of the overall sample did not meet recommended levels of physical activity. In the case of women, physical inactivity was 17% higher among night-shift workers. 

The factors affecting inactivity and weight may be interconnected. For example, a worker’s disrupted sleep may affect their appetite and energy levels, which in turn makes exercise more difficult. Healthcare professionals can only do justice to the situation when they take a holistic route that considers all these connections. So, the assessment should include the following:

  • When does the patient sleep and for how many hours?
  • Does their sleep schedule change frequently?
  • Are meals delayed, skipped, or concentrated during the night hours?
  • Do the patient’s meals provide the proper nutrition they need?
  • When does the patient get the time and energy to be active, and to what degree?
  • Is work-related stress making it difficult for the patient to maintain mealtimes and physical activity?
  • Are the patient’s shifts rotational or extended hours?
  • How does their schedule impact their social life? 

Such an approach also makes it possible for healthcare providers to distinguish between poor adherence and genuine barriers. All that being said, a holistic approach also leaves room for clinical treatment when lifestyle changes alone do not suffice. 

Based on the patient’s health status and treatment goals, they may receive nutritional counseling, behavioral support, or prescription medications. On that note, treatment access is another practical factor worth discussing. 

Suppose a patient and clinician are considering an FDA-approved medication such as Wegovy. In that case, understanding eligibility, insurance benefits, and Medicare coverage of Wegovy can help place that option within the patient’s treatment and financial circumstances. 

This is important because FDA approvals that also affect Medicare rules are not static. Wegovy is a case in point again since the 2003 law blocked weight loss coverage. That changed further with the 2024 second-use FDA approval for cardiovascular patients. 

The 2026 Medicare GLP-1 Bridge has made some more changes. Life143 highlights the three tiers that may be eligible, with Category A being severe obesity, B being obesity with comorbidity, and Category C being overweight with high risk. What’s important here, from a healthcare perspective, is to first identify the responsible factors, the risks, and then recommend an approach. 

So, only after due consideration is given to sleep, stress levels, and recovery will clinical treatment make any sense. At least, the good news is that healthcare has moved away from the narrow focus of food and exercise for weight management. 

 

A New Way Forward for Weight Management in Shift Workers 

Coming to a point where circadian health is considered an integral part of weight management for shift workers is a milestone in itself. Now, what is needed is to rethink how standard strategies are applied. In other words, established approaches must be adapted to the patient’s work schedule, sleep pattern, meal timings, and ability to recover. 

In a 2025 study, 250 night-shift workers with obesity were assigned to continuous energy restrictions (group 1) and two intermittent fasting approaches (group 2 and 3), each tailored around work schedules. After 24 weeks, all three groups achieved weight loss among those who completed the intervention. However, no significant changes were observed in either of the fasting groups. 

The key takeaway here for healthcare professionals is that rethinking weight management is not about a specific eating window or fasting schedule. It’s important to select interventions based on clinical relevance and the realistic needs of the individual. With that in mind, the following strategies become more practical:

  • Start by understanding the patient’s shift patterns, whether they work permanent nights or have rotational shifts. 
  • Make meal plans workable by considering when the patient can eat, what food is available, and how the proposed eating pattern can be maintained. 
  • Provide flexible activity goals that are independent of a conventional time. 
  • Treat the patient’s main sleep period as important and something that cannot be sacrificed. 
  • Avoid turning weight management into an additional source of strain since the patient’s work schedule may already have little room for extra lifestyle changes. 
  • Keep reassessing from time to time, as what works today may not work tomorrow when shifts change. 

Above all things, assign sleep a high priority. A WIRED report shared emerging research suggesting that even relatively mild sleep deprivation, when ongoing, can contribute to weight gain. In the study it shared, participants gained about 0.45 kg (roughly 1 pound) during a period of reduced sleep. Although the study was not conducted on shift workers, its implications matter to this population. 

 

FAQs 

How does shift work affect weight management beyond sleep disruption?

Shift work can impact meal timings, appetite, physical activity, stress, and light exposure alongside sleep. These factors can interact, making weight management more complex than diet or exercise alone. An assessment of the patient’s overall work pattern can reveal barriers that may otherwise go unnoticed. 

What should healthcare professionals assess for weight management in shift workers?

Assessment should cover shift patterns, sleep duration and consistency, food access, physical activity, stress, and social routines. This should help give the bigger picture, thereby distinguishing between genuine barriers to adherence and poor motivation. Healthcare providers can then provide recommendations that fit the patient’s circumstances. 

Should weight management strategies be different for every shift worker?

The answer is both yes and no in the sense that evidence-based nutrition, activity, behavioral support, and appropriate medical treatment remain relevant for all. However, their timing and implementation may require adjustments based on the patient’s schedule, health status, and recovery capacity. 

 

Important Data Covered in This Article 

Data on night shifts  25% of the working population works night shifts 
Fortune report on tensions in Japan regarding overwork and a four-day workweek  Prime Minister Sanae Takachi proudly boasted of getting zero to three hours of sleep ever since she took office 
Analysis of 33,983 workers by NIOSH  27% of workers worked night shifts, 26% were physically inactive, and 47% did not meet the recommended physical activity levels. The latter number was 17% higher among women night shift workers. 
2025 study on 250 night-shift workers with obesity, each assigned a different approach, one continuous energy restriction and two different intermittent fasting methods  After 24 weeks, all three groups achieved weight loss among those who completed the intervention. But no major difference was seen in either of the fasting groups. 
People report on research presented at the European Congress on Obesity 2026  Reducing annual working hours by just 1% could lower obesity by 0.16% 

Worldwide, the four-day workweek is being pushed, especially for health reasons. Even recently, People shared that research presented at the European Congress on Obesity 2026 estimated how reducing annual working hours by just 1% could lower obesity by 0.16%. Work-related stress is certainly the culprit, especially when it leads to binge eating. 

To add on to that, the amount and structure of work can further alter results, which brings us back to our target population: shift workers. Weight management cannot happen outside a patient’s working life. That context itself is a good start to turn generic recommendations into individualized and sustainable care. 

Author Bio

Deepika has over six years of experience as a writer and editor. Passionate about words and learning, she takes an interest in a variety of niches. Her knack for turning complex ideas into relatable narratives allows her to resonate with the reader. 

When her pen falls silent, you can find her engrossed in a novel or getting her hands messy with fine arts. By these, Deepika is committed to keeping her curiosity and creativity alive. 

 

References 

  1. Staels Bart, and Duez Helene. September 2025. Circadian Disruption and the Risk of Developing Obesity. Springer Nature Link. Volume 14, Article 20. 

https://linka.springer.com/article/10.1007/s13679-025-00610-6

  1. Fore Preston. Fortune. Despite Tokyo’s push for a 4-day week for better work-life balance, Japan’s prime minister boasts of sleeping just zero to three hours a night. July 2026. 

https://fortune.com/2026/07/23/japan-prime-minister-sanae-takaichi-little-sleep-no-work-life-balance-as-tokyo-embraces-four-day-workweeks/

  1. D. Fekedulegn, JK Gu, et al. January 2025. Shiftwork and Leisure-Time Physical Inactivity Among US Workers. CDC Stacks. 

https://stacks.cdc.gov/view/cdc/208639

  1. Bonham P. Maxine, et al. July 2025. Intermittent fasting for weight loss in night shift workers: a three-arm, superiority randomized clinical trial. PubMed. 

https://pubmed.ncbi.nlm.nih.gov/40554393/

  1. Shultz, Lynn Cara. May 2026. Long Work Hours Cause Obesity and Stress, Reducing Work Time by 1% Could Cut the Risk, Study Finds. People. 

https://people.com/long-work-days-are-linked-to-obesity-stress-1197168

 

 

 

Please also review AIHCP’s Holistic Nursing Certification program and Nurse Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Sleep/Sleep Disorders and the DSM-V-TR

Posted on by Mark Moran

Sleep is essential part of existence.  It is when the body and brain repairs itself.  It allows one to be resilient in life and return to the next day with new vigor, energy and determination.  When sleep is disrupted, reduced, or prevented, critical functions for both brain and body are impaired.  Lack of sleep is a major health issue and when disorders arise that prevent healthy sleep, individuals suffer the consequences. This blog will examine the nature of sleep, why it is needed and the various disorders listed within the DSM-V-TR related to it.

Sleep disorders can cause significant impairment to social, professional and academic life. Please also review AIHCP’s Healthcare Certifications

Please also review AIHCP’s Healthcare Certifications for both those in healthcare and behavioral health.

 

The Nature of Sleep

Human beings spend 1/3 of their life sleeping (Barlow, et al., 2023).  It is during phases of sleep that individuals recoup, recover and repair both mind and body.   This includes memory consolidation and emotional processing, physical restoration and neural development ((McLeod & Guy-Evans, 2026). Sleep experts utilize a modern scale of sleep phases that that include different periods of human sleep.  NREM1 through REM include the four most critical phases (Cleveland Clinic).  These stages repeat themselves every 60 to 90 minutes so disruptions or disorders can be harmful long term. 

This transitions to phase 2 is referred to as light sleep and is dominated by theta waves but has spikes of activity referred to as sleep spindles that help in memory recovery

(McLeod & Guy-Evans, 2026).  This transitions to phase 2 is referred to as light sleep and is dominated by theta waves but has spikes of activity referred to as sleep spindles that help in memory recovery (McLeod & Guy-Evans, 2026).  This stage refreshes the body and is involved with the highest percentage of total sleep (around 50%), but it is imperative that it gives way to phase 3.  Phase 3 is referred to as a deep sleep.  Within deep sleep, the person’s brain and body finds healing and restoration with various repairs throughout the body.  This deep sleep is associated with delta waves, the lowest and calmest brain wave.  Deep sleep occurs in the first hours of sleep.  Finally REM sleep is the final stage but its frequency spikes with a mixture of low delta but with spikes of actual beta or the awake waves.  This is tied to the essential aspect of the dreaming phase found in rem.  The other phases constitute non-REM states, but the Rapid Eye Movement phase of REM correlates with the process of vivid dreaming.  These phases spike throughout the night and should constitute 20% to 25% of one’s sleep ((McLeod & Guy-Evans, 2026).

Sleep quality and quantity is essential to good health. Please also review

 

Without a sleep regiment that is consistent and possesses the proper percentages of the various stages, then individuals will suffer short term and long term.   Lack of sleep is associated with fatigue obviously, but also forgetfulness, agitation, lack of mood regulation, slow responses, yawning,  and loss of motivation (Cleveland Clinic).  Individuals can suffer from sleep deficits that gradually build up over time as individuals overwork, stay up later, wake earlier, or even face occurrences known as jet lag, where time zones can disrupt sleep cycles (Barlow, et al., 2023).  Different individuals also possess different chronotypes where they are naturally more active or fresh in the morning versus the night or vice versa (Barlow, et al., 2023).

Whatever the case, when sleep is reduced via quality, or quantity, individuals suffer.  It is no wonder then that a type of torture involves purposeful sleep deprivation to prisoners which is outlawed by all civilized nations.   One case study and research involved keeping 350 volunteers awake for 112 hours.  Seven volunteers engaged in behaviors that seemed psychotic (Barlow, et al., 2023).  With this realities in mind, sleep disorders can present mild to serious issues for individuals who suffer from both quality and necessary quantity of sleep.

Sleep Disorders and the DSM-V-TR

Sleep disorders are divided into dyssomnias and parasomnias.  Dyssomnias deal with issues and difficulties regarding sleep quantity and quality, while parasomnias deal with abnormal or psychological events that occur during sleep (Barlow, et al., 2023).  The DSM-V-TR also stipulates that many sleep disorders are comorbid with a variety of other issues, including anxiety and depression (2022).

Dyssomnias 

Insomnia Disorder is one of the most cultural known sleep disorder.  It is frequently used in everyday language when someone cannot fall asleep but the disorder itself is more than one night of lack of sleep but a consistent issue over time.  The DSM-V-TR lists that the occurrence must happen at least 3 times a week over a period of at least 3 months. In addition to lack of quantity or quality of sleep, the individual has difficulty initiating sleep, maintaining sleep, and early awakening.  These disturbances cause significant impairment in social, educational and occupational settings throughout the addressed time frame.  These issues furthermore are not tied to substance abuse, other physiological issues, as well as co-existing and comorbid issues (DSM-V-TR, 2022).  Specifiers include with mental disorder, condition and can be episodic, persistent or recurrent (DSM-V-TR, 2022).

Hypersomnolence Disorder refers excessive sleepiness despite sleep with at least 7 hours.  During the day it can include recurrent periods of sleep or lapses or one prolonged main period of sleep during the day lasting at least 9 hours but not offering any refreshed feeling.  This must last for at least 3 times a week for a minimum of 3 months (DSM-V-TR, 2022).  In addition to causing various impairments and having no other explanations, specifiers can include with medical or mental disorder and acute, subacute and persistent degrees.  It can be considered mild, moderate and severe as well (DSM-V-TR, 2022).

Sleep disorders such as insomnia prevent sleep quantity and quality

Narcolepsy is also a commonly known disorder displayed on television shows that portrays a person who suddenly and completely falls asleep.  The DSM-V-TR states the person falls asleep but immediately enters into a REM state (2022).  This can last a few seconds or even minutes.  These occurrences again need to happen at least 3 times a week over a 3 month period.  These events can occur with cataplexy or weakened or paralyzed muscles or without it.  They can also be tied to a hypocretin deficiency which results in lack of alertness and energy balance.  Specifiers indicate if Narcolepsy is tied to with or without either of these conditions.  Finally, the condition can also be specified as mild, moderate or severe (DSM-V-TR, 2022).

Obstructive Sleep Apnea Hypopnea and Central Sleep Apnea deal with abilities to breath while sleeping.  The DSM-V-TR lists these disturbances to breathing as snoring, gasping or breathing pauses during sleep that results in daytime drowsiness (2022).   Central Apnea is not a result of any obstruction but a more serious situation in correlation with respiratory system during sleep.  The DSM-V-TR lists idiopathic, Cheyne-Strokes and Central Sleep Apnea with opioid use (2022).   Many individuals who suffer from this result in needs a sleep apnea machine to help regulate breathing and to maintain proper oxygen saturation within the body while asleep.

Other sleep disorders within this family include Sleep-Related Hypoventilation as well as Circadian Rhythm Sleep-Wake Disorders.  Again how one breathes during sleep or one’s internal clock of waking are internally affected.  To learn more, please refer to the DSM-V-TR.

Parasomnias

Non-Rapid Eye Movement (REM) Sleep Arousal Disorders are recurrent incomplete awakening from sleep during the first third of the the major sleep episode.  Among the issues tied to this are sleep walking and sleep terrors.  Sleep walking includes episodes of rising from bed and moving without knowledge, or simply sitting up.  It includes a blank stare and unresponsiveness of the person despite communication from others.  Awakening the individual is very difficult.  Often again this symptom is displayed comically in many cartoons or television programs but the reality of it extremely serious (DSM-V-TR, 2022).  Night terrors result in vivid and terror arousals from sleep.  It is tied to all the fight or flight mechanisms that induce high heart rate, sweating and rapid breathing within the autonomic nervous system (DSM-V-TR. 2022).  One has basic amnesia to the dream or event itself.   These issues result in social impairment and daily fatigue. Specifiers include sleep walking with eating, or sexual behavior, or with sleep terror (DSM-V-TR, 2022).

Nightmares and Night Terrors are symptoms of Nightmare Disorder

Nightmare Disorder is beyond a bad dream.  Bad dreams do not awaken individuals, while nightmares awaken (Barlow, et al., 2023).  Nightmare Disorder is also beyond the occasional nightmare but  recurrent and well-remembered dream that threatens security, survival or physical integrity.  These dysphoric dreams cause intense reaction upon awakening and are not due to any substances, medication, or comorbid issues.  They can be specified as mild (1 per week), moderate (multiple per week) or severe (nightly)and also acute and lasting 1 month, subacute and lasting 1 month to 6 months and persistent with a duration of 6 months or more (DSM-V-TR, 2022).  In some cases, sleep paralysis can manifest in which the body itself is paralyzed from movement.  This phenomenon can be tied to nightmare disorder or be independent.  It can result in awareness while being unable to move.  This is tied sometimes to completely explainable issues for alien abduction or demonic attack although these natural explanations may not rule out special cases without certainty.

Obviously, Freud and Jung associate nightmares with psycho analysis and meanings.  Dreams can also stem from traumas and unresolved issues.  These nightmare disorders are a far more severe than a typical nightmare and are tied to multiple issues that need addressed in counseling.

Rapid Eye Movement Sleep Behavior Disorder involves repeated episodes of arousal during sleep associated with talking or movements.  This occurs during REM.  Upon awakening the person is completely alert and not confused (DSM-V-TR, 2022).  Another motor control issue during sleep is Restless Legs Syndrome.

Etiology and Treatment

Sleep issues that are not comorbid with the other related substances, or anxieties or depressions or traumas usually have biological or genetic etiologies.  Sometimes they are tied together.  Most sleep disorders are treated medically, but some also require counseling (Barlow, et al., 2023).   Psycho analytical treatments look for unresolved issues that may be causing sleep disorders.  Carl Jung identified various archetypes associated with dreams and sleep to help individuals understand their dreams and what the subconscious mind is relating.  In addition, more holistic methods can attempt to cause the mind with herbs and calming teas, as well as hypnosis and meditation as ways to prepare the mind and body for sleep.  Slowly preparing oneself for bed and allowing one’s mind and body to destress, and lower brain waves to more a relaxed state can play a role in better sleep and dreams, as well as keeping a regular sleep schedules.  Various apps and health rings can give updated scores on sleep efficiency and give sleep scores.  While these holistic methods are important to compliment and help, many times, core issues need professional counseling and medical assistance.  Medical professionals who are sleep experts can give better diagnosis and aid in helping individuals with more severe and serious issues.

Conclusion

Finding help for sleep disorders is sometimes essential to regain a healthy sleep regiment. Please also review AIHCP’s Healthcare Certifications

Since sleep is essential to mental and physical health and it is critical to have a healthy sleep pattern.  Sleep restores the mind and body and without it basic functioning is impossible.  Due to biological, genetic, or past or current issues in life, sleep as well as dreams can be affected.  Sleep quality and quantity can be negatively affected by sleep disorders that are either dyssomnias or parasomnias in origin.  These can lead to inabilities from a variety of angles in preventing sleep or maintaining it.  Some sleep issues deal with the sleeping mechanisms of the body while others deal with the mental aspect of the body.  Various medical as well as counseling aids can be employed to overcome these difficulties.  In addition various holistic methods can be employed with the consent of one’s primary physician.   The sleep cycle is critical to health so if one is suffering from any of these disorders, it is critical to seek the appropriate medical and mental health providers.

Please also review AIHCP’s Healthcare Certifications as well as its behavioral healthcare programs.

Additional AIHCP Blogs

Spiritual Nature of Dreams and Dream Analysis.  Access here

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorder” DSM-5-TR (5th ed., text revision). American Psychiatric Association Publishing.

Barlow, D.H., Durand, V.M., & Hofmann, S.G. (2023). Psychopathology. An integrative approach to mental disorder (9th  ed.). Cengage Learning

Additional Resources

“Sleep: How Much You Need and Its 4 Stages” (2021). Cleveland Clinic: Health Essentials.  Access here

McLeod, S. & Guy-Evans, O. (2026). “5 Stages of Sleep (REM and Non-REM Sleep Cycles)”. Simply Psychology.  Access here

 

 

Behavioral Therapy Video Blog

Posted on by Mark Moran

Behavioral Therapy is an empirical based therapy and school of thought that recognizes behavior and cognition as key factors in mental pathology.  Learned behaviors and how one thinks play key roles in how we feel and how we react and think to things.  This does not dismiss genetic and biological issues, but it does point to many behaviors and quirks that trace themselves back to one’s upbringing, culture and thinking processes.  Behavioral therapy looks to change how we act and think by teaching one to react and think differently through a variety of behavioral and cognitive modification.  CBT is an offshoot of it from it and was formulated by behavioral therapists.

Please also review AIHCP’s Behavioral Health and Healthcare Certifications

 

What Gets Missed When Healthcare Is Too Fragmented?

Posted on by Joseph Gerard

A small plastic sign that says "Holistic"Written by Marchelle Abrahams

Lacy Mae Loos was a vivacious, bubbly 9-year-old. She loved playing with her friends. She was happy, funny, and smart. Then came the sudden change in her behavior, says her mother, Crystal Loos.

One minute her daughter was a fun, outgoing child; the next, she disappeared into herself. In July 2024, Loos told PEOPLE that Lacy Mae “completely changed overnight.” Lacy Mae was initially diagnosed with anxiety and depression and treated accordingly. But the diagnosis didn’t quite sit right with Loos.

After multiple hospital visits, the prognosis was always the same: anxiety and depression. Desperate for answers, she admitted Lacy Mae to a behavioral health unit. With nowhere to turn, she joined Facebook support groups and explained her predicament. And that’s when a few members suggested PANS/PANDAS, clinical conditions triggered by immune and inflammatory reactions to infections. 

According to the National Institute of Mental Health (NIH), one of the main symptoms is a sudden, dramatic onset of obsessive-compulsive disorder (OCD). Following extensive research, Loos was convinced that this is Lacy Mae’s affliction. The doctors refused to do tests. Sent from pillar to post, only a year later did she get a proper diagnosis from an Indiana-based specialist.

Crystal Loos advocated for her daughter when the system refused to. But a patient shouldn’t have to be coordinating their own healthcare. This is what happens when services are delivered across providers without shared information, clear accountability, or consistent follow-up. 

Why is Care Fragmented?

Maybe we should start with a question: What else does a patient need to stay well? It entails looking at the whole person.

When care is fragmented, it revolves around appointments, specialties, and systems instead of the patient’s overall healthcare journey. As a healthcare provider, you know that this could happen for various reasons.

It often starts at the doctor’s office, where patients may have to repeat their medical history each time they see a new provider. 

Care plans aren’t communicated. Lab results may be missed or incomplete. No one person or group takes ownership or accountability for the treatment support.

Unbundled and Rebundled Healthcare

The World Economic Forum (WEF) explains that most health systems serve institutions rather than patients. This hits hard for professionals in a revenue-based field.

The alternative? The WEF is unflinching in its stance. 

“The future needs the architecture of healthcare systems to be built around outcomes that matter: people living healthier, longer, at lower cost and using technology smartly to get there.” – The World Economic Forum.

Community health is cut off from facilities. Hospitals are siloed by department. The WEF suggests unbundling these stumbling blocks into functional components:

  • Discovery
  • Navigation
  • Diagnosis
  • Planning
  • Treatment
  • Monitoring and prevention

The Whole-Person Care Checklist 

Below is a practical mental checklist for healthcare professionals, case managers, and care teams. 

Oral Health: The Frequently Forgotten Piece 

Oral health can broaden care plans as it affects nutrition, pain, and quality of life.

Identifying a need for dental care is only step one. Patients still need to find and access an appropriate provider. This is where local SEO for dentists becomes relevant from a patient-access perspective. 

A dental practice’s local search visibility can help patients discover nearby providers. Most patients use search terms such as “dentist near me” or “emergency dentist”.

Growth Saloon notes that local SEO differs from general SEO because it focuses on visibility in local search and Google’s map results.

Physical Health: What Is Happening Beyond the Immediate Complaint? 

Don’t stop at presenting symptoms, particularly with older adults. They’re more likely to live with multiple chronic conditions and on several medications.

Primary care providers see this firsthand. Their jobs become harder when systems limit visibility into hospital stays, specialist recommendations, and medication changes.

The CDC advocates for value-based care models. When implemented well, they support prevention, coordination, and continuity.

Emotional Health: The Mental Health-Oral Health Connection 

The mental health angle shouldn’t be ignored, either. 

The latest findings published in Cureus show that mental and oral health are interlinked. Disorders such as schizophrenia, depression, and anxiety impair oral health, resulting in dental caries, periodontitis, and tooth loss.

The study authors suggest that mental health and dental practitioners working together could produce integrated care models. Currently, this isn’t the case. Very seldom do psychiatrists and dentists share or collaborate on a care plan.

Social Needs: What Is Happening Outside the Clinic? 

Healthcare providers tend to skip the “small talk.” However, knowing what’s happening in a patient’s daily life could be a reason why they’re receiving fragmented care.

MedCity News reports that the U.S. loses about $150 billion annually to missed medical appointments. Oftentimes, that’s out of a patient’s control. In rural communities, access to transport is a rarity.

The publication says that a single missed appointment doesn’t register as a failure anywhere in the chain of providers. That’s because no one is accountable for knowing. Despite Medicaid NEMT being readily available, it isn’t utilized properly by those who need it the most.

Once again, there’s a disconnect between case managers and non-emergency medical transportation.

 

FAQs

What is fragmented healthcare?

Fragmented healthcare occurs when a patient’s care is divided between providers, departments, or systems that don’t share information or coordinate treatment.

Why is whole-person care important?

Whole-person care looks beyond a patient’s immediate diagnosis to consider physical health, mental well-being, oral health, and other factors that influence outcomes.

Why should oral health be part of whole-person care?

Oral health can affect nutrition, pain, quality of life, and mental well-being. Research also highlights connections between mental health conditions and oral health problems.

How can local SEO for dentists improve access to dental care?

Local SEO helps dental practices become more visible when people search for nearby services such as “dentist near me” or “emergency dentist.”

 

Stats: What Gets Missed When Healthcare Is Too Fragmented? 

Statistic What it Tells Us
$150 billion annually  The estimated cost of missed medical appointments in the U.S., according to MedCity News
6 stages  The WEF’s proposed healthcare architecture
2 healthcare disciplines  Mental health and dental professionals are two groups that could collaborate more closely to address the relationship between oral and mental health
Multiple chronic conditions  Older adults are more likely to manage several chronic conditions and medications simultaneously

What Now?

The system won’t change overnight. However, as a healthcare provider, you stand at the intersection between fragmented and holistic care.

It doesn’t take a team to implement the above suggestions. It can start with one person: you. 

Do that, and others will follow. And soon, the whole-person care checklist will become part of your entire team’s toolkit.

 

References

 

Author bio

Writer by day, dream catcher by night. Marchelle Abrahams cut her teeth in the infancy of the internet when the dial-up sound of the modem was more than a soundbite at a rave. Not a Millennial and not a Boomer, Marchelle is an in-betweener, making her a special breed of human.

Please also review AIHCP’s Holistic Nursing Certification program and Nurse Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Nutritional Choices for People Living with Urinary Incontinence

Posted on by Joseph Gerard

smiling nutritionist doctor with stethoscope pointing symbols fruits icons and medical texts isolated on white background, healthy food supplements diet plan concept

Written by Lucy Peters,

Urinary incontinence (UI), or the involuntary leakage of urine, is a condition that is prevalent in older adults, impacting double the number of women as men and significantly impacting quality of life. However, senior individuals are by no means the only persons struggling with this issue. Statistics show, for instance, that among women aged 20 to 39, 7% to 37% experience some degree of incontinence. In women older than 60, up to 39% experience UI daily. Treatment approaches depend on the type of UI involved; common options range from conservative management (including fluid intake control) to medication and surgery. Nutrition, too, can play a role in improving symptoms. Effective strategies can include avoiding triggering foods, regulating fluid intake, and avoiding pro-inflammatory diets. Maintaining a healthy weight is also key, since obesity can put pressure on the bladder. General practitioners frequently recommend conservative approaches as a starting point, noting that simple adjustments to daily habits often yield noticeable improvements. Alongside dietary changes, strengthening the pelvic floor is a highly effective, non-invasive option.

Types of Urinary Incontinence

There are five main types of UI, resulting in different treatment options. Understanding these categories helps medical professionals tailor advice to individual patients:

  • Stress urinary incontinence: The first type is stress urinary incontinence, an involuntary leakage of urine that occurs with increased intra-abdominal pressure during activities such as coughing or exertion. This type is sometimes caused by urethral sphincter weakness, pelvic floor weakness, or urethral hypermobility.
  • Urge incontinence: Second, there is urge incontinence, which is often preceded or accompanied by a sense of urinary urgency. Urge incontinence can be caused by an overactive bladder or other issues, including Parkinson disease or multiple sclerosis.
  • Mixed UI: Third, there is mixed UI, caused by a mix of stress and urge UI.
  • Overflow UI: The fourth type is overflow UI, in which the bladder is overdistended due to factors such as bladder outlet obstruction or bladder muscle weakness.
  • Functional UI: Finally, there is functional UI, caused by environmental or physical barriers to toileting.

For urge incontinence, lifestyle changes such as reducing caffeine consumption, avoiding alcohol, and reducing one’s fluid intake can all help alleviate symptoms. However, urologists may recommend additional approaches, including Botox injections into the bladder, if lifestyle changes alone are insufficient.

Avoiding Dietary Triggers

Certain foods, including caffeine, alcohol, acidic foods, and artificial sweeteners, are known bladder irritants. When these items enter the bloodstream and eventually reach the kidneys, they alter the chemical composition of urine. This highly concentrated or acidic urine can provoke sudden spasms in the bladder muscle, so avoiding these specific triggers is a highly practical first step. Studies also reveal that higher total and saturated fat intake, as well as higher carbohydrate intake, may contribute to symptom intensity. Pro-inflammatory diets can also worsen UI symptoms and trigger additional issues such as IBS and bowel incontinence. This is because inflammation in the urinary system, particularly in the bladder region, can irritate the bladder lining, increasing the sense of urgency and pain during urination and leading to more frequent urination. The same goes for the bowel. Inflamed tissues in the digestive system can impair bowel control, leading to leakage or to an intense need to empty the bowels.

Which Foods Cause Inflammation?

Harvard Health reports that individuals with UI should aim to avoid refined carbohydrates (such as white bread, cookies, and pastries), deep-fried foods, soda and other sugary beverages, red meat (such as burgers and steaks), processed meats (such as hot dogs and sausages), and margarine, shortening, or lard. These foods are capable of exacerbating UI, and they are also linked to a higher risk of chronic diseases such as Type 2 diabetes and heart disease. Moreover, they contribute to weight gain, which, in itself, is a risk factor for inflammation and UI. Carrying excess weight places constant physical strain on the pelvic muscles, forcing the pelvic floor to work harder to keep the urethra closed. Over time, this strain causes the muscles to stretch and weaken, making them less capable of preventing sudden leaks during everyday movements, so losing even a small amount of weight can relieve this physical burden.

Foods to Embrace

To help deal with stress-caused UI, consider switching to an anti-inflammatory diet containing foods such as tomatoes, olive oil, nuts (including almonds and walnuts), green leafy vegetables (such as spinach, kale, and collard greens), fruits (including strawberries, cherries, and oranges), and foods rich in Omega-3 essential fatty acids (such as salmon, tuna, mackerel, and sardines). When shopping, read the labels on food and opt for items containing natural antioxidants and polyphenols, a class of compounds including flavonoids, phenolic acids, lignans, and stilbenes, all of which are found in specific plant foods. Polyphenols are also abundant in beans, cereals, and soy. These compounds also have a powerful ability to combat environmental harm such as UV damage and pollution, helping to keep inflammation, diabetes, neurodegenerative diseases, cardiovascular diseases, and certain cancers at bay.

To incorporate these beneficial nutrients into a daily routine, patients can make simple swaps without feeling overwhelmed. For breakfast, replacing sugary cereals with a bowl of porridge topped with fresh berries and chia seeds offers immediate nutritional benefits. At lunchtime, swapping processed meats for grilled chicken or a bean-based salad provides necessary protein while avoiding inflammatory triggers. Snacking on a small handful of unsalted walnuts instead of crisps, and aiming for at least two portions of oily fish per week, will effectively boost Omega-3 levels.

Diets Providing Protection

One 2025 review found that diets such as the Mediterranean or DASH diets significantly improved pelvic-floor dysfunction and incontinence. The Mediterranean diet comprises lean proteins, fruits and vegetables, whole grains, nuts, legumes, and Omega-3 essential fatty acids. The DASH diet, meanwhile, focuses on specific servings of fruits and vegetables, whole grains, low-fat or fat-free dairy foods, lean proteins, and nuts, seeds, and legumes. It also limits sodium consumption to help maintain healthy blood pressure readings.

Healthy Hydration Habits

Many individuals experiencing leaks drastically cut back on their water intake, but this coping mechanism often backfires. When a person drinks too little water, their urine becomes highly concentrated. This strong, acidic liquid irritates the lining of the bladder, causing spasms that trigger a sudden, intense need to visit the toilet. Rather than avoiding drinks entirely, experts suggest sipping smaller amounts consistently throughout the day. This provides the body with the hydration it needs without overwhelming the bladder capacity all at once. Timing is also crucial, as stopping all fluid intake around two to three hours before bedtime can dramatically reduce night-time waking and help patients secure an uninterrupted night of sleep.

A Comprehensive Approach to Management

Diet is a potential aid in the fight against UI, but it is most effective for urge incontinence rather than other types of UI. Studies indicate that diets high in sugar, refined carbohydrates, and other inflammatory foods can exacerbate UI. Diets that battle inflammation, meanwhile, such as the DASH and Mediterranean diets, can help to reduce symptoms and help keep individuals at a healthy weight. They can also reduce the risk of a wide array of diseases, ranging from Type 2 diabetes to cardiovascular diseases. Consulting a medical professional, such as Dr Jones, can help tailor these strategies to individual needs. A combined approach of healthy eating, appropriate fluid management, and pelvic floor exercises provides the strongest foundation for regaining confidence.

Author bio

Lucy is a freelance writer who enjoys contributing to a range of publications, both in print and online. She spent almost a decade working in the care sector with vulnerable people before taking a step back to start a family and now focuses on her first love of writing.

 

 

Please also review AIHCP’s Life Coach Certification program and Life Coach Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Christian Counseling: Demonic Diagnosis in Counseling

Posted on by Mark Moran

Since the demonic is a metaphysical belief without any empirical proof or external verification according to the norms of the empirical method, obviously there is no psychological diagnosis for demonic possession or demonic influence upon mental health within the DSM-V-TR.   This does not mean within the history of pastoral care there has not been cases that were considered demonic in origin and required deliverance or exorcism.  Universally, all human cultures have rituals, as well as theological commentary, on dark forces.  While their etiology and origin stories may differ, the unexplainable belief in the evil and dark forces remains a constant even in the modern world.  It is true many cases of mental defect in the past were attributed to the demonic influence due to lack of scientific explanation and that these beliefs led to further psychological damage to the  person, as well as causing social turmoil but the opposite extreme of modern psychology to reject all spiritual and demonic causes is equally dangerous.  Modern psychology has separated body and mind from soul and has restricted all mental defect to the realm of the scientific method.   This stems from a atheistic and humanistic philosophy.

The rite of exorcism is a spiritual ritual that must in its modern form validate the ritual by first eliminating and natural or mental defect within the person
The rite of exorcism is a spiritual ritual that must in its modern form validate the ritual by first eliminating and natural or mental defect within the person

A proper balance is needed that respects the scientific method but does not become intoxicated with atheistic and humanistic rejection of spiritual realities.  It also involves realizing that all reality is not measured or observed but there remains other sciences of theology and philosophy that have recorded human experiences that point to deeper realities than merely natural cause and effect within empirically observable phenomenon.   Phenomenology is a type of science that looks to judge realities via the experience of the human person.  Within these experiences are numerous other realities that escape the narrow and restricted lens of the empirical method.

So while it is important within psychology and diagnosis not to be caught up in superstition, it is also important to not necessarily neglect the spiritual aspect of humanity from a total atheistic outlook.  Instead, it is important to recognize unexplainable situations, to measure them with reason, rule out all possible explanations and remain open to the person’s spiritual wellbeing.  This involves having resources and referral capability to help clients find the individuals who are able and better equipped to help an individual within these rare and odd cases.

This blog will help clinical as well as non clinical professionals identify rare cases of unexplainable phenomenon and then the proper steps in addressing these issues within a professional and ethical framework that is both beneficial for the client as well as licensed counselor.

Please also review AIHCP’s Christian Spiritual Direction Certification, as well as AIHCP’s Christian Counseling Certification.

A Balance Between Science and Superstition

Where does mental defect end and spiritual affliction? Please also review AIHCP’s Christian Counseling Program

One could contend that if one believes a demon is behind every rock, then one may have serious issues.  One could also contend that those who feel God is talking to them may need a serious mental health assessment to rule out psychosis.   Simply put, if one were to meet a modern day Moses, or Abraham, who said God has spoken to them, then that bold statement would require sufficient proof and evidence.  One can only imagine what neighbors thought of Noah, or for that matter Abraham.  If a person today, like Noah, started to build a large boat in the middle of dry land, most would consider this individual quite mentally ill.  And for that matter, one who would lead their son to the top of a mountain to be sacrificed based upon the voices in his head would immediately be arrested and kept for psychological evaluation!  Yet all these bold claims were verified with bold miracles.  However, these extraordinary events are rare in human history and usually when individuals hear voices or think they are seeing demons, there are natural explanations.  Unlike the pre-scientific world and its understanding of mental illness, modern science has afforded humanity with numerous explanations that were once considered demonic or metaphysical.

This does not mean though that with the dawn of the scientific era that all spiritual occurrences remained explainable.   The opposite error in thinking is to purge all spiritual and metaphysical realities simply because some cases have natural origin.   The fact remains that numerous unexplainable experiences that are have no natural explanation continue to occur.  Individuals continue to experience spiritual revelations, apparitions, as well as, evil encounters with the demonic despite the modern era of science.  Many of these experiences are witnessed and testified by sane individuals and professionals, as well as healthcare professionals who have no explanation for the phenomenon.  Hence, it is important to balance an over superstitious mindset with an agnostic or atheistic mindset.  Science and metaphysics can work together to properly balance care of the body, mind and soul and identify afflictions that are beyond comprehension.

Professionals in healthcare as well as mental health can offer spiritual care in certain settings, as well, in particular cases with willing clients.  Christian and spiritual counselors obviously have more freedom in pastoral settings to identify these issues, but when spiritual experts and mental health experts work together, then a proper balance of care is given that avoids sick spirituality and superstitious thought with the opposite extreme of a psychology that has become blatantly hijacked and poisoned by atheistic humanism.

Differential Diagnosis

There are numerous natural explanations and differential diagnoses that explain many cases that may have formerly been consider demonic.

Within the Catholic Church, prior to any exorcism, a full medical and mental health evaluation is required.  This prevents not only a mockery of the rite, but also protects further damaging the person who is experiencing possible mental health issues.  What may appear as possession could be more so a host of various mental and physiological issues.   These differential diagnoses must be ruled out before any suspicion of a demonic possession or presence is even considered.  The mental and clinical health professional plays a key role in these cases.  The professional counselor may have a person referred by the Church exhibiting certain characteristics and the counselor’s professional diagnosis may be required to rule out all natural explanations, or discover an overlooked mental defect with natural causes.   Some counselors, whether clinical or pastoral, as well. may have clients or patients arrive without referral with stories of demons or even God speaking to them, in which the counselor must deduce if the person is in a state of psychosis, or other mental defect, or truly being spiritually afflicted.  The counselor, whether spiritual or atheistic, must carefully tread these ethical waters as not to impose one’s one religious or lack of religious faith, as well as to respect the cultural and spiritual beliefs of the person.  This does not mean, the counselor should ignore present pathology, but instead should carefully with empathy and compassion work with the person to discover the underlying issue and if without closure, refer the client to someone who can deal with these issues.

Among the possible natural explanations for spiritual voices or demonic affliction can be a host of mental issues that must be diagnosed or ruled out.

Psychosis or any type of hallucinations due to natural explanation or mental defect first need addressed.  In addition to psychosis diagnosis that includes seeing things or hearing things, the counselor needs to investigate if any psychosis may be due to drugs, substances or medications. Obviously certain hallucination type drugs need to be ruled out such as PCP or others.  Within Schizophrenia, multiple symptoms that were once considered in the pre-scientific times as demonic have mental origins.  Schizophrenia manifests not only hallucinations but also delirium, disorganized speech, catatonic behavior, numbness and stupor as well as negative symptoms including affective flattening, alogia or avolition (DSM-V-TR, 2022).  In addition, Dissociative Disorder or formerly Multiple Personality Disorder presents the existence of different personalities within the same person.  This manifestation is due to early childhood traumatic experience which cuts away from reality and terror to protect the self by a new identity (DSM-V-TR, 2022).  It is easy to understand how the pre-scientific mind could misconstrue this as a demonic presence.  In addition, physical ailments can also cause hallucinations.  This includes tumors and brain injury.  It is imperative that scans, as well as blood work is conducted to rule out these basic explanations for possible interpretation of demonic manifestations.   Finally, one needs to rule out possible malingering.  Some individuals may fake, lie or try to fabricate symptoms for attention (DSM-V-TR, 2022).  Others may want attention or have a weak sense of the spiritual or their faith.  They mistake what is demonic for natural.  Some may have a fanatic view of faith and indeed look to use supernatural activity  as a way to gather praise or sympathy from others.  Only until this due diligence of ruling out natural explanations is completed, can one begin to contemplate a spiritual issue.

This not to say a seasoned exorcist can sense the demonic far sooner, or for that matter, present individuals who face various mental disorders with also spiritual origins attached, but it is extremely important for the mental and physical safety of the person to ascertain with clarity the etiology and source of the manifestations.

Signs of the Metaphysical

Manifestations of the demonic.

So what is an exorcism?  An exorcism is liberation from a diabolical entity or force that is controlling the host person (posession).  Exorcism is scripturally based and is a power given by Christ to His apostles to cast out demons in His name.  Exorcism throughout the ages has taken on the form of a rite within the Catholic Church with detailed prayers, rituals and preparations.  It involves a fasting and a holy priest who receives authorization from the local bishop to perform the rite.  In Protestant churches, it is referred to as deliverance ministry.  Deliverance ministry does not have the same prayers or rituals found in the rite of exorcism within the Catholic Church.

An exorcist or deliverance minister with experience can sense the signs usually quickly but there are some manifestations or oddities that point to something far more nefarious than only mental defect.  While the demonic can thrive within mental defect and use it, outward signs usually manifest in cases of demonic infestation, oppression, obsession or possession (Amoth, 2016).   Among these signs include unnatural strength of the possessed, unnatural contortions beyond natural explanation, fear of Christ’s name or holy objects, unknown knowledge, utilization of ancient languages, levitation, temperature within room,  and supernatural occurrences such as flying objects (Ripperger, 2022).  Another sign from a clinical standpoint is a person’s inability to heal from a potential diagnosis.  Despite multiple medications, the issues remain.   When these things manifest, it is ultimately the person’s choice for deliverance or exorcism.

Etiology of the Demonic Possession

All demonic activity is limited in scope and practice.  God allows it to exist due to free will but the actions of the demonic can only go as far as His authority permits it.  Any possession or time of liberation is based upon the time appointed by God.  Possession can occur for the greater glory of God, or occur because of one’s own mishaps and missteps.  While all mental defect and suffering is correlated with sin and the continued presence of the demonic in the fallen world, not all mental defect is directly caused by supernatural forces, but behind many forms of suffering exist multiple demonic forces.  Scripture speaks of demons of suffering and the associated temporal pain with it, as well as the demonic and its association with various vices.   Due to actual sin, the human soul weakens its union with God and opens itself to demonic influence.   Demonic influence cannot breach freewill but it can become more persuasive to the soul that walks away from God and grace. Sinful practices that become habitual and more extreme weaken the soul to demonic influences.  Souls that wander farther from God have less spiritual defenses.  Their natural spiritual immune system weakens and as their spiritual hygiene deteriorates the more easily cracks open for spiritual and demonic infection.   Bear in mind, not all extraordinary manifestations of the demonic such as infestation, oppression, obsession and possession are always due to spiritual decline.  In the case of the saints, many times, spiritual oppression occurred where God permitted the saints to heroically battle the demonic for His greater glory.

Priests many times face individuals of possession who unwittingly dabbled in the occult

Demonic influence is not always a long process, but sometimes can happen quickly or in the moment.  Individuals who dabble within the occult or witchcraft can become victims of diabolical possession.  Some may ignorantly fall under such influence through ouija boards, divinization, astral projection, spells, or occult ceremonies and then unknowingly and unwittingly become subjugated to the demonic.  Others can face daily difficulties through generational curses (Amorth, 2016).   Some voluntarily enter into demonic contracts through witchcraft and Satanism.   Through unclean rituals, they allow themselves to be possessed or overtaken for special powers or gifts.   It is important to note in any such contracts, they is not binding upon acceptance of Christ but the consequences of liberation can be difficult, not just from a supernatural element but also within the occult community which may seek vengeance.  In addition, contracts for success and power always end sourly for the individual for the demons are princes of lies (Ripperger, 2022).

Professional Standards and Approaches when Confronted with Demonic Possession

Again, there is no manual for demonic possession within the DSM-V-TR.  For many it is considered outside the scope of professional practice.  This is why it is very important, if as a believer, a mental health professional adheres to standards and protocol.  Professional ethics prevents discussions of spiritual matters unless the client addresses or asks about spiritual aspects.  Spirituality is obviously very critical to mental health.  Since it is so important, spirituality on numerous occasions filters into the counseling session. It is important that this aspect of counseling is introduced only at the interest of the client.  Furthermore, if as a counselor, sharing in different theological views, it is important sometimes to set boundaries or refer clients to other counselors who may be better equipped to discuss spirituality.   For those of faith, these conversations are not as difficult.  Most of faith integrate spirituality at an implicit level of practice.  They quietly pray to the Holy Spirit for guidance and healing of patients, while others can have a more explicit integration with clients who openly profess faith.  Obviously this is far more easy a practice for Christian Counselors, faith based ministries, or counseling organizations with a Christian mission.

Yet, there still can be many pitfalls.  First, many spiritual people can sometimes have distortions of faith.  While faith experiences are exempt from delusionary behavior in the DSM-V-TR, many can experience spiritual events that need to be properly discerned for their authenticity.  Some counselors are better equipped to handle these situations, while others should refer a client to a Christian or faith based counselor or a minister or spiritual director or priest.  These individuals can help clients better discern spiritual communication from God, or for that matter, spiritual discernment regarding demonic manifestations.  In addition, deliverance prayers, or pray healing can present serious issues for purposes of billing.  Since they are not a recognized medical therapy (Note: prayer needs to be carefully integrated into any session for those who desire it) Finally, deliverance and exorcism is far different than mere prayers but involves deep emotional, psychological, mental and spiritual goals and aims.  Only trained professionals who are approved should ever pursue these types of spiritual exercises.  First, it is extremely dangerous for the person if mishandled both mentally and spiritually.  Secondly, the possibility of malpractice sky rockets.  Third, it is not recognized within norms of care.  And finally, it is extremely dangerous for the counselor to perform exorcism or deliverance.  Exorcism not only involves intense training, but it also requires spiritual preparation dictated in Scripture.  It involves faith and it involves a calling.  Thus, anyone manifesting symptoms of diabolical possession should be referred to the appropriate religious professional.  Counselors should have a list of adjunct professionals they can contact regarding these extraordinary issues. Obviously, before anything can be referred or conducted, the person must grant full consent and give permission.

Christian Counselors can help an individual discern spiritual experiences, help lead in prayers, advise and offer solutions.  Spiritual cleaning and spiritual direction can help the soul face issues, but if diabolical presence is more than temptation and simple obsession or infestation, a trained exorcist will be required for more serious matters.   When matters are more serious, they seem to keep returning, especially if the person is unwilling to change certain life styles that have attracted the presence, or refuses to take the proper spiritual care at home, protecting it and self.

Christian Counselors can offer binding prayers, sacramentals of protection, moral guidance and references, but sometimes, a soul needs liberation at the hands of a qualified religious professional.  Again under no circumstance, should a counselor, or even a Christian Counselor attempt to exorcize a person.

Conclusion

Helping individuals with spiritual issues involves balancing superstition against atheism. It involves a middle ground that accepts the spiritual aspect of humanity. Please also review AIHCP’s Christian Counseling Certification as well as its Christian Spiritual Direction Program

Demonic possession is a reality that many deny.  Understanding the the presence of Satan in the world and its many levels is important because it affects all levels of humanity.  Mental health and spiritual health are integrated realities and many times both affect each other.  While not every issue is demonic or directly correlated, it is very dangerous to dismiss this reality.  Mental health professionals play a key role in diagnosing mental disorders and helping religious professionals dismiss fake possession for true mental defect, or by ruling out all natural differential diagnoses.  This helps the religious professional or exorcist understand if he is dealing with a true demonic case.  Many Christian counselors or even clinical counselors may come across cases of the supernatural and must follow their own ethical standards.  In cases of possession, clients should be referred to the appropriate religious and pastoral professionals.  Clinical counselors or even Christian counselors should never attempt to perform an exorcism.

Please also review AIHCP’s Christian Counseling Certification.

 

Additional Blogs

Types of Demonic Activity.  Access here

References

Amorth, G. (2016). “An Exorcist Explains the Demonic. Sophia Institute Press.

DSM-V-TR, 2022

Rippeger, C. (2022). “Dominion: The Nature of Diabolic Warfare”. Independently published.

Additional Resources

Fragomeni, R. (2023). “What is an exorcism?”. U.S. Catholic.  Access here

Somers, J. (2023). “What Actually Happens When You Request An Exorcism” G.  Access here

“What is deliverance ministry, and is it biblical?” Got Questions.  Access here

 

 

 

Crisis Intervention Skills for the Fentanyl Era: Responding to Overdose Emergencies

Posted on by Joseph Gerard

Tablet pc and medical stuff with OVERDOSE inscription, prevention conceptWritten by Jessica Downs,

Over the past decade, the opioid epidemic has changed dramatically, with illicitly manufactured fentanyl now responsible for the majority of overdose deaths in the United States. The current wave of the opioid crisis presents unique challenges for emergency responders, nurses, physicians, behavioral health professionals, crisis intervention specialists, and other healthcare professionals. The extreme potency, rapid onset, and prevalence of fentanyl in counterfeit medications and polysubstance use have changed the way in which overdose emergencies must be identified and treated.

Healthcare professionals who work in emergency departments, behavioral health settings, addiction treatment programs, and community outreach services need specific crisis intervention skills that go beyond traditional overdose response. In today’s opioid epidemic, the ability to recognize a problem, respond promptly, communicate efficiently, and provide coordinated care following an overdose has become a staple of clinical practice.

This article addresses the effects of the fentanyl epidemic on crisis intervention in the United States and identifies evidence-based approaches healthcare providers can take to improve patient outcomes.

The Fentanyl Epidemic in the United States: A New Clinical Paradigm

The Centers for Disease Control and Prevention (CDC) reports that synthetic opioids—mainly illicit fentanyl—are the primary cause of the majority of the nation’s opioid overdose deaths. Fentanyl is approximately 50 times more potent than heroin and up to 100 times more potent than morphine, meaning even a small amount can be lethal.

Unlike the prescription opioid misuse that characterized earlier phases of the opioid epidemic, today’s crisis is increasingly driven by illicit fentanyl mixed into heroin, cocaine, methamphetamine, counterfeit prescription pills, and other street drugs, and many individuals who experience overdose are unaware they have consumed fentanyl.

This changing landscape requires a broader clinical perspective for healthcare professionals. Patients that present with stimulant intoxication, altered mental status, or polysubstance use may also be experiencing opioid-induced respiratory depression and require rapid assessment for fentanyl exposure.

Behavioral health professionals and crisis intervention specialists should also be aware that multiple overdose events are often occurring along with trauma, homelessness, severe mental illness, and social instability and require integrated medical and psychosocial intervention.

The American Institute of Health Care Professionals (AIHCP) offers certification programs in crisis intervention and other healthcare specialties for healthcare professionals seeking to continue their education in crisis response and behavioral health intervention with a focus on evidence-based practice and professional development.

Geographic Hotspots: Fentanyl Crisis Varies by State

Fentanyl has reached every corner of the country, but overdose trends differ significantly by state.

States along the East Coast were among the first to see widespread fentanyl infiltration into heroin supplies. More recently, western states have seen dramatic increases as fentanyl became prevalent in counterfeit pills and stimulant supplies.

California has experienced dramatic increases in fentanyl-related overdose deaths in recent years, with thousands of opioid-related emergency responses each year in Los Angeles County. Public health officials have reported that counterfeit pills, sold as oxycodone, Xanax®, and other drugs, are a major driver of accidental overdoses in adolescents and young adults. Demand for fentanyl addiction treatment in Los Angeles has risen alongside these numbers, straining an already limited network of providers.

Communities with high rates of homelessness, untreated mental illness, and poor access to addiction treatment often suffer disproportionate overdose burdens. Healthcare organizations that serve these populations must prepare for opioid emergencies.

Why Fentanyl Overdose Needs a Different Approach to Crisis Response

Fentanyl overdose can happen quickly, far more rapidly than overdoses associated with many other opioids. Critical respiratory depression can occur within minutes, leaving little time for effective intervention.

Some features that set fentanyl overdose emergencies apart from other opioid overdose emergencies include:

  • Rapid onset of respiratory failure
  • Increased risk of recurrent respiratory depression after naloxone administration
  • Frequent polysubstance involvement
  • Increased risk of cardiac arrest
  • Multiple overdose victims during contamination events

Healthcare professionals should also be aware that standard assumptions about opioid dosing or expected response may not apply.

Knowledge of local epidemiology allows healthcare professionals to predict emerging trends, to allocate resources effectively, and to design community-specific prevention approaches.

Repeated doses of naloxone with continued airway support may be required until emergency medical services arrive or definitive care is established.

Equally important is a cool, organized response to crisis intervention. Families, bystanders, and even medical personnel can be emotionally overwhelmed during overdose incidents, and effective communication is a critical component of successful crisis mitigation.

Clinical Identification of Suspected Fentanyl Overdose

Early recognition is the single most critical factor influencing survival.

Healthcare providers should immediately evaluate for:

  • Severe respiratory depression or apnea
  • Pinpoint pupils (though not always present)
  • Cyanosis of lips or fingertips
  • Unresponsiveness
  • Bradycardia or absent pulse
  • Gurgling or snoring respirations
  • Reduced oxygen saturation

Not all fentanyl overdoses present classically.

In those exposed to fentanyl and stimulants, initial agitation may rapidly progress to a decline. Diagnosis may be more challenging in patients who are co-intoxicated with alcohol or benzodiazepines.

Medical personnel should maintain a high index of suspicion for altered mental status in any patient with known or suspected substance use.

Current guidelines recommend immediate activation of emergency medical services, airway management, administration of naloxone, and continued monitoring until advanced care is available.

Evidence-Based Crisis Intervention Protocols

Current best practices emphasize the necessity of rapid, coordinated intervention, with emphasis on airway management and restoration of adequate ventilation.

Key elements include the following:

Immediate Scene Assessment

Medical personnel should rapidly assess responsiveness, breathing, circulation, and environmental safety.

Call emergency response systems

Call emergency medical services (EMS) without delay for all suspected opioid overdoses.

Naloxone Administration

Administer naloxone according to current clinical guidelines. Because fentanyl has a longer duration of action than naloxone, multiple administrations may be necessary.

Airway and Ventilatory Support

Rescue breathing and bag-valve-mask ventilation are potentially lifesaving steps while awaiting definitive care.

Continuous Monitoring

Patients who awaken are still at risk for recurrent respiratory depression and need continuous monitoring.

Post-Overdose Engagement

Surviving is only the first step in the intervention process.

Healthcare providers should provide compassionate, nonjudgmental substance abuse counseling, determine readiness for treatment, initiate medication-assisted treatment as appropriate, and make warm handoffs to addiction treatment providers.

This transition from emergency stabilization to long-term recovery represents one of the most important opportunities to reduce future overdose mortality.

Challenges Facing Healthcare Professionals During the Fentanyl Era

The fentanyl epidemic is creating tremendous strain on healthcare systems across the country.

Repeat overdoses in the same patients are rising in the ER, adding to provider fatigue and burnout.

Healthcare providers also face the following:

  • Increasing rates of polysubstance use
  • Limited behavioral health resources
  • The stigma of substance use disorders
  • Barriers to follow-up care
  • Growing community overdose rates
  • Compassion fatigue of frontline staff

Trauma-informed care is more critical than ever.

Individuals suffering from overdose often have complex histories of trauma, adverse childhood experiences, psychiatric illness, or housing insecurity. The empathetic, person-centered approach increases engagement and decreases barriers to continuing treatment.

Continuing education, simulation training, interdisciplinary collaboration, and organizational support are essential for maintaining provider resilience during this evolving public health crisis.

Prevention Strategies Beyond Emergency Response

While emergency response saves lives, a public health approach must address the problem long-term.

Effective prevention strategies include:

  • Community distribution of naloxone
  • Harm reduction education
  • Medication-assisted treatment (MAT)
  • Routine screening for substance use disorders
  • Integration of behavioral health in primary care
  • Peer recovery support services
  • Public education on counterfeit pills
  • Prescription drug monitoring programs

Healthcare professionals also should advocate for the reduction of stigma around addiction. To maintain provider resilience in this evolving public health crisis, we must provide continuous education, simulation training, interdisciplinary collaboration, and organizational support.

Treating opioid use disorder as a chronic medical condition, rather than a moral failing, increases treatment retention and patient engagement. Increasing access to evidence-based treatment is one of the most effective ways to prevent future overdoses.

Preparing Healthcare Organizations for Future Overdose Trends

The fentanyl epidemic is not static—as synthetic opioids rise and polysubstance use becomes more complex, health care systems must be nimble to respond to changing clinical needs.

Preparedness efforts should include standardized overdose response protocols, regular simulation training, increased availability of naloxone, cross-disciplinary collaboration between emergency medicine, behavioral health and addiction specialists, and ongoing workforce education in trauma-informed care. In addition, health care systems should collaborate with public health agencies, community organizations, and recovery programs to improve the continuity of care after overdose events. Data surveillance is another necessary component.

Organizations can monitor local overdose rates, emerging synthetic drugs, and patient outcomes to help anticipate changes in staffing, training, and resource needs.

Ultimately, the best response to the fentanyl crisis is more than just emergency stabilization and is aimed at health care providers who can save lives during overdose emergencies and connect patients with compassionate, evidence-based treatment that supports long-term recovery. As the opioid epidemic continues to shift and evolve, skills in crisis intervention will remain a vital part of high-quality health care across the United States.

Author’s Bio

Jessica Downs

My name is Jessica Downs and I currently serve as the Primary Counselor and Admissions Counselor at House of Life. I earned my bachelor’s degrees in Psychology and Chemistry from Nova Southeastern University in 2004, graduating with honors. Since 2003, I have worked in the mental health field supporting individuals struggling with severe and persistent mental health disorders, co-occurring conditions, complex trauma, and substance use disorders.

When clients and their loved ones walk through the doors at House of Life, my goal is for them to feel safe, supported, understood, and never judged. Recovery is difficult, but no one should have to face it alone. If there is one thing I hope people take away from learning about me, it is that I am a passionate, compassionate, and nonjudgmental advocate who genuinely cares about helping others heal and reclaim their lives.

References

  1. Centers for Disease Control and Prevention. Drug Overdose Deaths in the U.S. https://www.cdc.gov/overdose-prevention/
  2. National Institute on Drug Abuse (NIDA). Fentanyl DrugFacts. https://nida.nih.gov/publications/drugfacts/fentanyl
  3. Substance Abuse and Mental Health Services Administration (SAMHSA). Opioid Overdose Prevention Toolkit. https://store.samhsa.gov
  4. California Department of Public Health. California Overdose Surveillance Dashboard. https://skylab.cdph.ca.gov/ODdash/
  5. Los Angeles County Department of Public Health. Substance Abuse Prevention and Control. https://publichealth.lacounty.gov/sapc/
  6. American Institute of Health Care Professionals. Crisis Intervention Certification. https://aihcp.net/crisis-intervention-certification/
  7. American Institute of Health Care Professionals. https://aihcp.net/

 

 

Workplace Ergonomics Starts at Your Feet: How Proper Support Reduces Fatigue During Long Shifts

Posted on by Joseph Gerard

Nurses standing in a line posingWritten by Kim Hobbs,

If you go to a hospital or to the mall, you see all the people working there walking around all the time. And all of them seem like they’re okay doing it. The sales associates aren’t limping, the nurses aren’t holding their backs because they’re in pain; it doesn’t seem that bad. Yes, they spend all their shift on their feet, but it seems like they’re used to it.

But can you ever get used to it, though? Well, you can’t (and you shouldn’t). 

Spending the vast majority of your shift standing up can’t be comfortable, and the shoes you wear usually make the whole situation worse.

There’s a strong link between prolonged standing (at work) and increased lower-limb fatigue, lower back pain, as well as low blood circulation. – CDC / NIOSH

There’s not enough talk about the amount of stress a doctor’s or a warehouse worker’s feet put up with every day, and there’s certainly not enough talk about how to help them. That’s because they think they have no other choice but to suck it up and live with it.

That makes no sense. How can you even work properly if your entire body, starting with your feet, hurts? Because that’s exactly what happens – first your feet start to ache, and by the time you go home, everything up to your neck is in pain. 

Let’s see why and what to do about it.

Every Shift Starts With Your Feet

Whenever you decide to move somewhere, it starts with the floor. 

Take nurses, for example. You don’t see them hanging around their desk all day, do you? They’re always going somewhere, and it all happens on that awful hospital floor. 

That’s not easy on their feet, especially if you take into account the fact that their shifts sometimes last for half a day. What people usually don’t think of is how much everything they do depends on their feet. The feet are the base of your body, and when they don’t feel good, nothing else does. That might seem like an overstatement, but believe it or not, that burning pain you feel on your heel could cause your back to hurt a couple of hours later.

And let’s talk about the floors a little because those sure don’t help. 

Wherever you look, you see tiles and concrete, which aren’t exactly known for absorbing impact. But that impact has to go somewhere, and if the floor doesn’t absorb it, your body has to. That’s why every step you take sends a little shock right through your heel and up into the rest of your body. And don’t think that you have to take a hit in order to have problems because you don’t.

Each human step generates approx. 1.2-1.5x body weight ground reaction forces. This force travels through the foot into the knees, then hips and disperses at the spine. – National Library of Medicine

You’re not aware of it, but your body takes tens of thousands of hits over time, and when you add those up, it becomes painfully obvious why it wears you down at some point.

So, what do people do in order to help themselves? 

They look for the fluffiest-looking shoes because cushioning seems like the obvious answer. And it is, for about an hour. 

After that, the weight of your body compresses all that cushioning, and it becomes pretty much useless. Instead of cushioning, you should be looking for support.

Supportive insoles help reduce perceived fatigue and lower-limb discomfort, especially dutring prolonged standing tasks. – Applied Ergonomics Journal Study on Insoles

If you’re dealing with plantar fasciitis, flat feet, high arches, metatarsalgia, bunions, or just deep heel fatigue, orthotic shoe insoles – such as those produced by PCSsole Insoles – can be of great help. This is because orthotic insoles combine firm arch support and shock absorption, which is exactly what you need to stay both stable and comfortable. 

The idea for these soles is to give your feet a good base because that’s what prevents your body from working against itself.  

Where Long Shifts Cause the Most Problems

You’ll hear everyone complain about back pain and sore shoulders, but what they don’t know is that most trouble starts lower than that. Your feet take a real beating during long shifts, but the problems that come from that aren’t obviously rooted in the feet.

Standing Is Harder Than It Looks

Standing produces more muscle fatigue and venous pooling than walking does, because muscle contractions are being limited. – National Institute for Occupational Sagety and Health (NIOSH)

You’d think walking is harder on your body than standing, but that’s not really true. If you stand for hours in one spot, the muscles in your legs stay tense so that your body can stay upright. When you walk, however, the movement gives your muscles a break, whereas standing doesn’t give you the chance to shift the weight from one foot to the other.

At the same time, the soft tissue under your feet gets squashed flat from the weight of your body, which cuts off circulation and presses on the nerves. 

That’s why you get that hot, tingly feeling after you’ve been standing for a few hours.

Small Changes in the Position of Your Feet Affect Every Step

Here’s something that probably never crossed your mind. 

Do you know that the arches of your feet are supposed to hold their shape as you walk? Without good support, though, that can’t happen. Your arches get flat, and your ankles roll in. To be clear, it’s only a little roll, but it changes so much.

Because of this, the knees twist off their natural track, the hips drop to balance things out, and the lower back has to curve so that your torso can stay steady. Sometimes, even the shoulders round forward. 

You won’t notice your body doing any of this, but your muscles sure will, and by lunchtime, your back will be in pain.

Repetition Causes Most Fatigue

You won’t get wiped out from one bad step. The real issue is in doing the same thing again and again. 

Look at a nurse; they can walk 4 or 5 miles during a single shift. A warehouse worker will easily hit 10,000 steps without even thinking about it. As healthy as walking is, every single step sends a shock through your body, and those shocks add up after a few hours.

Hospital nurses walk approx 4-5 miles (7,000-12,000 steps) each shift. – American Journal of Nursing

You start to feel pain in your knees, your heels feel like they’re bruised, your lower back gets tight, and overall, you start to feel drained and achy all over. 

The worst part about this is that it’s relentless. That’s what exhausts you.

Fatigue Doesn’t Stay in Your Feet

If your feet hurt, your body will change how it moves so it can avoid pain as much as possible. You might start to walk with a little limp or shift the weight outside the edges of your feet.

Your hips could start to rock more than they should, your shoulders could lean forward, and so on. The point is, your body starts making little changes that take the pressure off your feet, but that causes issues at the same time because they make your body stop moving in a natural way. 

The exhaustion started at your feet, but after a couple of hours, it spread throughout your entire body.

The Workers Who Depend Most on Proper Foot Support

Even if you haven’t been diagnosed with any foot problems, you still need proper support. 

Anyone who spends hours on their feet every day absolutely must have footwear with good support; otherwise, your whole body will pay the price.

Medical Staff

Nurses, doctors, nursing assistants, surgical techs – these people spend almost entire shifts on their feet. 

A shift can last for 12 hours, and during that time, they’ll walk miles of tile corridors, stand at bedside monitors, and so on. They have hardly any chance to sit down, and those floors are not kind to their feet. They’re always moving around, and when you combine that with hard surfaces, it becomes obvious that healthcare workers put a tremendous amount of stress on their feet, and it’s even more obvious why proper footwear is an absolute necessity. 

Good arch support not only absorbs the shock, but also keeps everything from the ankles up aligned.

Workers in Distribution and Warehouses

Working in a warehouse involves a whole lot more than just lifting boxes. It’s not rare that the workers end up walking several miles during every shift between aisles, pulling orders, staging products, and you guessed it – lifting boxes. There’s absolutely no cushioning on that concrete floor, and with the fast pace, who has the time to slow down?

Supportive insoles can obviously be a big help here because they can take that annoying sting out of each step.

Retail Associates

Retail workers are on their feet all day, too, and their floors aren’t exactly comfortable. The stores are always busy, so there’s never enough time to sit down and rest properly. By the middle of the shift, their heels are burning, and arches are hurting like crazy.

Once again, proper support to the rescue. Good arch support will keep the feet in their natural position, and it’ll also help with posture.

And better posture means less pain in the shoulders and the neck.

Conclusion

Workplace ergonomics is actually a topic that gets a decent amount of attention, but the problem is that everyone focuses on pretty much everything except feet. That’s your real starting point, though. Every step you take starts with the feet, as does every pivot and every moment of standing up. 

So, it makes sense to think twice about what type of footwear you’re wearing to work every day.

Look down right now. What’s on your feet? Is it something that supports them or just covers them up?

Author Bio

Ms. Kim Hobbs an accomplished writer, storyteller, and creative thinker whose passion for the written word has captivated readers worldwide. With a keen eye for detail and a gift for weaving compelling narratives, Kim explores themes of resilience, transformation, and the human experience.She believes that every story has the power to change perspectives and spark meaningful connections.

 

Please also review AIHCP’s Health Care Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

What is Psychopathology? Video Blog

Posted on by Mark Moran

Understanding psychopathology is critical to understanding a large portion of human health.  This video takes a closer look at psychopathology and the importance of acknowledging one’s own mental health minus any stigmas.  Please also review AIHCP’s Behavioral Healthcare Certification Programs including Grief Counseling, Trauma Informed Care, Anger Management, Spiritual Counseling and many more!