Dr. Ala Stanford: Advocate for Health Equity & Mental Health

This year for Women’s History Month, we want to highlight women who have impacted the daily lives of Pennsylvanians and improved our world.

Dr. Ala Stanford
Photo courtesy of SpotlightPA.org’s Diverse Source Database

Dr. Ala Stanford is a distinguished pediatric surgeon who has dedicated her life to advocating for health equity and social justice. As the founder of the Black Doctors COVID-19 Consortium, she has played a critical role in providing free testing and medical care to underserved communities in Philadelphia during the COVID-19 pandemic. In recognition of Women’s History Month, we celebrate her tireless efforts to promote health equity and mental health awareness in the healthcare industry.

Dr. Stanford’s career began with a degree from Pennsylvania State University, graduating from the Penn State University College of Medicine with a residency at SUNY Downstate Medical Center and the University of Pittsburgh Medical Center. As the first Black female pediatric surgeon trained entirely in the United States, she has been a trailblazer for women and people of color in the medical field. Throughout her career, she has been a passionate advocate for healthcare reform, mental health awareness and health equity.

In response to the COVID-19 pandemic, Dr. Stanford founded the Black Doctors COVID-19 Consortium, which has been providing critical medical care and resources to Black communities in Philadelphia. The Consortium set up testing sites throughout the city and worked tirelessly through the pandemic to ensure that those who have been disproportionately impacted by COVID-19 had access to the care they needed to stay healthy and safe.

“Our mantra is access, empathy and action for the people we serve – the folks of Philadelphia.”

– Dr. Ala Stanford, Alumni Spotlight, Penn State Science Journal, Winter 2021

In addition to her work with the Consortium and mental health advocacy, Dr. Stanford has also been a vocal advocate for health equity and social justice. Her tireless efforts to promote health equity and social justice have earned her national recognition, including being named one of USA Today’s Women of the Year.


In April 2022, in recognition of her expertise and knowledge, President Biden appointed Dr. Stanford to a key role within the Department of Health and Human Services (HHS). She will be acting as the HHS Regional Director in Region 3, serving Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia and West Virginia. Dr. Stanford and the other Regional Directors will be critical to the President’s efforts to rebuild communities most impacted by the pandemic, the economic recovery and climate change.

As we celebrate Women’s History Month, we are inspired by Dr. Ala Stanford and her dedication to improving the lives of others. Her work with the Black Doctors COVID-19 Consortium and her advocacy for mental health awareness is a testament to the importance of access to care and resources for all individuals, particularly those in underserved communities. We salute her efforts to promote health equity and mental health awareness in the healthcare industry, and we are proud to recognize her as a true leader and role model for women everywhere.

Follow Dr. Stanford on Twitter to learn more about her ongoing work to improve the lives of people across Pennsylvania.

Women’s History Month

Women’s History Month was established in 1981 as a national celebration, with Congress passing Pub. L. 97-28 authorizing the President to designate the week beginning March 7, 1982 as “Women’s History Week.” Congress continued to pass joint resolutions over the next five years, designating a week in March as “Women’s History Week.” In 1987, Congress passed Pub. L. 100-9 after being petitioned by the National Women’s History Project, officially designating March 1987 as “Women’s History Month.” From 1988 to 1994, Congress passed additional resolutions requesting and authorizing the President to declare March of each year as Women’s History Month. Since 1995, each year, Presidents have issued proclamations recognizing and celebrating the contributions women have made to the United States and highlighting the specific achievements women have made in various fields throughout American history.

Learn more at WomensHistoryMonth.gov.

Dr. Rachel Levine, a groundbreaking figure in Pennsylvanian healthcare history

This year for Women’s History Month, we want to highlight women who have impacted the daily lives of Pennsylvanians and improved our world.

Admiral Rachel L. Levine, MD
Photo provided by the U.S. Department of Health & Human Services

Admiral Rachel L. Levine, MD, is a highly accomplished physician and public health expert who has significantly contributed to the medical field throughout her career. As a transgender woman and a member of the LGBTQ+ community, Dr. Levine has also been a powerful advocate for greater inclusion and diversity in healthcare.

Dr. Levine began her medical career studying pediatrics and psychiatry at New York City’s Mount Sinai Hospital. In 1993, she joined the faculty of Penn State College of Medicine and the staff at Penn State Hershey Medical Center. She later served as the Pennsylvania Physician General and was appointed as the state’s Secretary of Health in 2017. In this role, she was responsible for overseeing the state’s response to the COVID-19 pandemic and worked tirelessly to protect the health and safety of all Pennsylvanians.

One of Dr. Levine’s most significant achievements as Secretary of Health was her leadership in the fight against the COVID-19 pandemic. She was instrumental in implementing policies and protocols to slow the spread of the virus and ensure that hospitals and healthcare workers had the resources they needed to care for patients. As a result, under her guidance, Pennsylvania reduced the number of COVID-19 cases and deaths, and the state’s vaccination efforts have been among the most successful in the country.

“I’m not here to be a celebrity. I’m here to be a physician and a Secretary of Health and protect the public health of Pennsylvania.”

– Dr. Rachel Levine, 2020 interview with WNEP

In addition to her work on the pandemic, Dr. Levine has been a champion for many other public health issues. She has worked to combat the opioid epidemic in Pennsylvania and has been a strong advocate for mental health awareness and suicide prevention. She has also been a vocal proponent of healthcare reform and universal access to quality healthcare, particularly for underserved communities.

As a transgender woman, Dr. Levine has faced significant discrimination and barriers in her career. However, she has been a powerful advocate for greater inclusion and acceptance of LGBTQ+ individuals in healthcare. She has spoken openly about her experiences as a transgender person and has worked to raise awareness and understanding of the unique healthcare needs and challenges faced by LGBTQ+ patients.

In a 2022 interview with NPR, Levine said, “I’m not a political person.” But in this context, she says, when young trans people are being attacked by their own governments, she thinks medical professionals “need to stand up and be more vocal — and that’s exactly what I’m going to do.”

Dr. Levine’s accomplishments and contributions to the medical field have not gone unnoticed. In 2021, she was nominated by President Joe Biden to serve as the Assistant Secretary of Health in the United States Department of Health and Human Services. After a bipartisan vote to confirm President Biden’s nomination, she is now the first openly transgender person to hold a Senate-confirmed position at the federal level.

Dr. Levine’s success in the medical field and her dedication to improving healthcare for all people, particularly those from marginalized communities, inspire women everywhere. In addition, her achievements serve as a reminder of the importance of diversity, inclusion, and equity in healthcare and the crucial role that women play in shaping the future of medicine.

During Women’s History Month, we celebrate Dr. Rachel Levine and the countless other women who have made significant contributions to the medical field. Their accomplishments serve as a testament to the power of women and their ability to effect change in the world.

Follow Admiral Rachel L. Levine, MD, on Twitter to learn more about her ongoing effort to improve the health and well-being of all Americans.

Women’s History Month

Women’s History Month was established in 1981 as a national celebration, with Congress passing Pub. L. 97-28 authorizing the President to designate the week beginning March 7, 1982 as “Women’s History Week.” Congress continued to pass joint resolutions over the next five years, designating a week in March as “Women’s History Week.” In 1987, Congress passed Pub. L. 100-9 after being petitioned by the National Women’s History Project, officially designating March 1987 as “Women’s History Month.” From 1988 to 1994, Congress passed additional resolutions requesting and authorizing the President to declare March of each year as Women’s History Month. Since 1995, each year, Presidents have issued proclamations recognizing and celebrating the contributions women have made to the United States and highlighting the specific achievements women have made in various fields throughout American history.

Learn more at WomensHistoryMonth.gov.

Naomi Osaka: Winning Opens and Opening the Discussion on Mental Health.

The final athlete we are highlighting in this year’s Black History Month series is an athlete that some consider the first in a year that encouraged several athletes start discussing their mental health (like Simone Biles).

Naomi Osaka
Image from Associated Press

In May 2021, Japanese tennis player Naomi Osaka withdrew from the French Open to protect her mental health.

The French Open is a major tennis tournament held each year in Paris, France. The second of the four Grand Slam tournaments, it has the distinction of being the only one performed on clay courts.

This withdrawal shook the tennis world. Osaka was then 23 and ranked number two in the world. Fans would soon learn why she seemingly walked away at the top of her game.

Osaka explained, “The truth is that I have suffered long bouts of depression since the US Open in 2018 and I have had a really hard time coping with that.”

“I think now the best thing for the tournament, the other players and my well-being is that I withdraw so that everyone can get back to focusing on the tennis going on in Paris,” Osaka wrote. “I never wanted to be a distraction and I accept that my timing was not ideal and my message could have been clearer. More importantly I would never trivialize mental health or use the term lightly.”

Last year, she returned to competing. “Saying out loud that I’ll take a break and I’ll come back when I am truly in love with the sport and I know what I want to do here, it gave me time to reset.”

After sharing her struggles with depression and anxiety with her fans, she has also shared what has helped her. “Lately, I’ve been writing in my journal, and I think that it keeps my thoughts in order,” she said. “I feel like it gives me clarity on what I want to do and what I want to accomplish.”

Multiracial, Osaka is the first Asian player to be ranked number one in the world. And is also a four-time Grand Slam singles champion, with two Australian Open and two US Open titles. Her seven titles on the WTA Tour also include two at the Premier Mandatory level. At the 2018 US Open and the 2019 Australian Open, Osaka won her first two major titles in back-to-back tournaments. She was the first woman to win successive major singles titles since Serena Williams in 2015, and the first to win her first two in successive majors since Jennifer Capriati in 2001.

If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.


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Chiefs Create a Culture for Better Mental Health

As we continue to highlight Black athletes open about their mental health for Black History Month, we want to also talk about the strives the other team that made it to Super Bowl LVII is making towards bettering their players’ mental health.

Dr. Shaun Tyrance
Image by Steve Sanders

Understanding the importance of mental health, the NFL and NFLPA announced a joint agreement that every NFL team must have a Team Clinician on staff before the start of training camp in 2019. However, the Chiefs, were already well down the road of bringing in someone to fill this important role a year before this announcement.

Dr. Shaun Tyrance was hired to serve as the team’s first in-house clinician, only the second full-time team clinician hired by an NFL team. As a licensed therapist who specializes in working with athletes, Tyrance joined the Chiefs with years of experience helping players and coaches perform at their highest levels personally and professionally.

“We are thrilled to add Shaun [Tyrance] and his unique experience in counseling to our team,” Chiefs President Mark Donovan said. “We pride ourselves on providing a complete package of resources to our players, coaches and staff for success both in the workplace and in life outside of work.”

Tyrance added. “I’ve talked to other professional sports organizations and clubs over the years, and this was probably the first opportunity where I said, ‘They see the value in the role, and it’s really fully integrated across the organization. That was truly the thing that really caught my eye about this position. They wanted to be on the frontend of what we’re doing in the mental health space across the NFL.”

Tyrance’s main duties are to support the Chiefs players, families and friends included. “If they’re important to our players, they’re important to me. My job is to support them with any challenges, any issues or anything that they face on and off the field. I can’t be a face that they only go to when something is wrong – that’s not how I work. I’m always around and guys are in my office all the time, even when times are good. That’s a big thing for me.”

“To me, this is an opportunity that I think makes sense for the long haul. I think this is something that we can really build on and do something special with it.”

One of the Kansas City Chiefs’ players who has been open about his mental health is linebacker Willie Gay, Jr.

In 2021, he tweeted:

Willie Gay Jr. tweet

And in interviews he has shared with reporters that he’s had issues that have dated back to high school and college.

“I was going through some things in life, and people think these NFL players are bulletproof or whatever,” Gay told reporters. “We were taught growing up to hold it in, just go on about your day and keep distractions away, but sometimes – I got to the point where I was like I can’t shake this, and I had to tell my coaches, I had to tell people that I work with. That’s when I Tweeted it, and it was just a lot weighing on me at the time. I just had my baby boy, he’s finally here, doing good, and it was just a lot going on at the time. Sometimes you just have to let that stuff out so you can move on.”

Willie Gay Jr. tweet
Getty Images

“Coming to the NFL, man, people think everything’s perfect,” said Gay. “I’m still human at the end of the day. I still have feelings. I still get angry. I still get stressed. I can [make] 10 tackles and still be stressed. You’ve just got to be sure you balance it out, man.”

Though Gay’s journey with his mental health is ongoing, his tweet was met with support from Chiefs teammates and personnel. “Everybody was checking in on me from coaches to training staff, equipment staff, of course, all my teammates just making sure I was good when I was here. They know me well. They know when I’m having one of those days, and I feel like I’m a guy that when I’m having a good day, you’re going to know, and when I’m not, you can definitely tell. But they did a real good job with just keeping me on the right track and helping me out. A simple ‘you good bro?’ it goes a long way, and they did a real good job with that.”

Gay’s situation reminds us that it doesn’t matter what level of success you achieve in life, everyone still needs proper emotional support and understanding.


If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.


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Eagles Players Tackle Mental Health

This year for Black History Month, as we highlight Black athletes who have been open about their mental health struggles, we could not help but tie it in to the big sporting event that also happens this month: Super Bowl LVII. For the first time in NFL history, two Black quarterbacks are starting: Kansas City Chiefs’ Patrick Mahomes and Philadelphia Eagles’ Jalen Hurts.

As the Eagles go on to represent Pennsylvania in the game with Lane Johnson who has been open about his mental health, a few former players have also spoken out about and advocate for mental health: Brandon Brooks, Brian Dawkins, and Malcolm Jenkins.

Brandon Brooks

Brandon Brooks
Brandon Brooks | John Jones/Icon Sportswire via Getty Images

In 2019, offensive lineman Brandon Brooks admitted he was sidelined from a game due to an overwhelming and debilitating bout of anxiety.

The following day he wrote on Twitter, “I’d like to address what happened yesterday. I woke up, and did my typical routine of morning vomiting. It didn’t go away like it normally does, but I figured it would calm down once I got to the stadium. It did, but I felt exhausted. The nausea came back, and I tried to battle through it and went out for the first drive,” he wrote. “The nausea and vomiting came back until I left the field, and tried everything I could to get back for my teammates but just wasn’t able to do it.”

Understandingly, his teammates and coaches had his back. Eagles coach Doug Pederson said “It’s something that he’s dealing with each and every day of his life. You never really know what triggers it. We’re here to support him, we love him. It is unfortunate that it happened, but it’s something that he deals with every single day. We’re just going to continue to support him.”

Though Brooks would end up retiring in 2021 due to injury, Eagles chairman and CEO Jeffrey Lurie, in a statement, called Brooks, “one of the most thoughtful and bravest athletes I have ever been around.

“Brandon’s willingness to openly discuss his own struggles with anxiety has served as an inspiration to so many, and helped open the door for future conversations among athletes and role models everywhere.”

Brian Dawkins

Brian Dawkins
Brian Dawkins

In 2018, during his induction speech at the Pro Football Hall of Fame, Brian Dawkins revealed his struggle with depression and suicidal thoughts. Early in his NFL career, he turned to alcohol and had to fight off suicidal thoughts.

However since then, Dawkins has found ways to deal with that depression: his faith and daily routine.

“I do specific things daily in the morning and at night to make sure that I’m operating in a place that I want to be in,” Dawkins said, “that I’m making sure I tell my body to shut up and get in line.”

Dawkins said every morning when he wakes up he spends at least 20 minutes praying, meditating and writing in a journal. He also focuses on breathing techniques, something he began doing after joining his wife at Lamaze classes. He was fascinated that breathing techniques could help women manage pain while giving birth, so he began to use those techniques himself during his football days.

“I’ve taken ownership of it,” Dawkins said. “It belongs to me.” Dawkins realizes that everyone will have different things that work for them, but he’s invested in sharing his own experiences to help anyone who might be listening. And a lot of that simply starts with a refreshing reminder that mental health shouldn’t come with a stigma at all.

Malcolm Jenkins

Malcolm Jenkins
Malcolm Jenkins

Malcolm Jenkins is a two-time Super Bowl champion with the Saints and Eagles.

Jenkins spoke at Michelle Obama’s Beating the Odds Summit at Howard University in 2019, talking to a crowd of first-generation college-bound students about the pressures they face and how to deal with them.

“I know for me, mental health wasn’t anything we talked about when I was in school. But… I am in therapy once a week at this point in my life because I recognize that I’m somebody who’s responsible for a lot of things, and I put a lot of pressure on myself, and so with that comes stress and a little anxiety,” Jenkins said.

For Jenkins, it is a combination of weekly therapy and talking to students about the psychological effects of racism that helps him cope with anxiety and depression.


According to the American Journal of Men’s Health, masculine norms among American men continue to influence behavior and a general aversion to engage in self-help for mental health, particularly compared to women. Even though depression and suicide are a leading cause of death in men, social and self-stigma restrains men from acknowledging their problems and seeking help. As stated succinctly by the Journal, “American men are subjected to a culture where the standards of masculinity are literally killing them.”

In a hopeful sign of changing culture, Pilgram reports that Generation Z is more apt to report and pursue help than prior generations – regardless of gender. Perhaps the reluctance is beginning to fade due to more people speaking out like these former Eagles players.

If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.


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Simone Biles, an unexpected advocate for mental health

Simone Biles

This year for Black History Month, we want to highlight Black athletes who have been open about their mental health struggles.

Simone Biles shocked the world when she withdrew from the team competition at the 2020 Olympics in Tokyo.

Although she was previously open about anxiety and panic attacks prior to the Olympic games, Biles hid her inner turmoil that finally hit a tipping point when she experienced “the twisties.” A term referring to a mental block when a gymnast loses control of their body in the air, no longer able to complete a twisting skill they’ve done countless times before.
“We have to protect our body and our mind … It just sucks when you’re fighting with your own head. Whenever you get in a high-stress situation, you kind of freak out. I have to focus on my mental health and not jeopardize my health and well-being,” said Biles. “I know I brush it off and make it seem like pressure doesn’t affect me but sometimes it’s hard, hahaha! The Olympics is no joke.”

Later that year, in October 2021, Biles opened up in an interview on the “Today” show, that she was “still scared to do gymnastics.” Though she has now found herself in a new role as a mental health advocate.

“See for me, that was the hardest part because speaking out on mental health, I knew that I could have the possibility of becoming an advocate for that. But it wasn’t my goal. It’s not what I really wanted,” Biles told Olympics.com in an exclusive interview prior to her Gold Over America Tour’s third stop in Anaheim.

Simone Biles

“So, to kind of be put at the forefront, it’s like… I’m still going through my own thing. So how am I supposed to teach people, hey, like, you should do this or this, but everybody goes through that process differently and there are different methods that work for each individual person,” Biles continued. “I didn’t really want to, but at least we’re going through it together and I could teach them something in that.”

When struggling with mental health, it’s important to reach out for help.

“It’s really important to use that support system and know they’re there for you and not against you, because at the end of the day, us as humans, we hate asking for help,” Biles said. “We think we can do it on our own, but sometimes we just can’t. So, use every outlet given to you.”

Biles said she has many techniques to help with her mental wellness, including using the mental health app Cerebral, and is now the chief impact officer with the company.
“Getting the mental health therapy that I need has been really relieving for me, especially being on the road and on tour. I’m happy to have such a great app to help out with that,” she said. Biles also likes going on walks outside and indulges in a little retail therapy.
For Simone Biles to prioritize mental health when the whole world was watching you was a brave, inspiring, and game-changing thing. It was a courageous decision that continues to inspire millions of fans all over the world.



If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.


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Psychiatric Care for Mature Adults with Dr. Graziane

Dr. Julie Graziane

Psychiatric Care for Mature Adults with Dr. Graziane

For the past five years, Julie Graziane, MD, has been an inpatient psychiatrist at Pennsylvania Psychiatric Institute (PPI). Among other responsibilities, Dr. Graziane co-oversees the mature 55+ unit, putting her passion and fellowship in geriatric psychiatry to use.

“I co-oversee the geriatric inpatient unit with another physician, where we see seniors with a variety of illnesses like depression, psychotic disorders, anxiety and mild cognitive impairment complicating their psychiatric presentations. We have a great team of strong social service workers and nursing staff who not only help us to take care of our patients, but also really care about them too.”

Mature adults can have unique issues when it comes to mental illness. Advanced age not only increases the possibility of developing behavioral disorders like Dementia, but physical health issues and memory loss can dramatically affect a mature adult’s mental health. Conditions like anxiety disorder and depression, which are very common in the mature adults, are often overlooked because they are masked by other physical symptoms.

“Patients come in during significantly distressing times in their lives, and I am continually amazed at how the team comes together to treat them and get them back out into the community in a better state of mind. On average, patients stay two weeks for care. We treat the person as a whole, taking into account what situation they will be going back to, and doing what we can to minimize the risk of re-hospitalization. We like getting the families involved as well to help support them.”

Reflecting on the work her team accomplishes at PPI, Dr. Graziane notes: “It’s rewarding working with individuals who are struggling and then be able to see a team come together to help them.”

When asked about how COVID impacted her unit, Dr. Graziane explains, “Personally, it felt a little bit like nothing had changed, when really everything had changed. My day to day didn’t change as I still saw patients in person, but the community resources patients rely on were much more limited. Because patients could not be checked on by community support, we saw more severe stages of illness when individuals were admitted. At-risk individuals with severe mental conditions are at higher risk of having a co-morbidity or getting covid, though we were fortunately able to offer vaccinations to admitted patients at any point during their stay.”

There are three mature adult programs at PPI:

  1. The Mature Adult Outpatient Psychiatric Program is a short-term treatment option. It is a less restrictive level of care than our Inpatient Program requiring that patients come to the psychiatric clinic or facility only during treatment hours. This allows for easier maintenance of their normal life and commitments. Patients who have completed an inpatient psychiatric program often continue treatment in an outpatient psychiatric program. This program provides therapeutic and diagnostic treatment planning specific to the needs of the individual, including psychiatric evaluations, medication management, individual, group and family therapies.
  2. The Mature Adult Inpatient Psychiatric Program is designed for adults aged 55 and older who require inpatient psychiatric care due to a mental illness that has significantly disrupted their daily activities. This program also cares for individuals who require assistance with walking or daily activities and those with uncomplicated co-morbid medical issues.
  3. The Mature Adult Psychiatric Assessment Program provides comprehensive evaluations by a psychiatrist to assess for Dementia and Alzheimer’s disease. Follow up appointments for medication management are provided, as well as support and education for the family.


Apart from the geriatric unit, Dr. Graziane is involved with the education endeavors at PPI. “PPI being a main training site for Penn State, reflects their commitment to education” notes Dr. Graziane, who teaches medical students, adult psychiatry residents, and fellows in geriatric medicine.. “As a training institution, all faculty are motivated to engage learners. I spend most of my time with those in the adult residency program, help to coordinate medical student placements and serve as the Assistant Director of Education at PPI.”

“In my 5 years, PPI has really embraced their identity as a community psychiatric center. We do a fair amount of community outreach; we offer a community psychiatry track now through Penn State’s psychiatry residency program and PPI realizes the important role community psychiatrists play in the psychiatric community as a whole. We are also taking a broader lens when looking at patients now, taking into account social determinants of health. Sometimes they are just as important as the illness when thinking about recovery” notes Dr. Graziane.

Dr. Graziane is also passionate about civic engagement. Read more about her personal goal to increase civic health.


To learn more about the mature adult psychiatric programs at PPI, click here, or call our Admissions Department at: 717-782-6493 or 866-746-2496.

Holiday Blues

The holidays can be a time for merriment and joyous occasions, but for some it can bring stress, sadness and even depression. Pennsylvania Psychiatric Institute’s (PPI) Licensed Counselor and Unit Therapist, Nikki Fogle, educates us on the “Holiday Blues” and provides advice on how to work through it.

“The holiday blues consist of feelings of depression, sadness, loneliness or can be noticed as more anxiety or fatigue that are exacerbated during, or appear relative to, the holidays. These feelings are more temporary and connected to the holiday season” explains Fogle, LPC.

Getting further into the signs of holiday blues, Fogle describes that there are both mood and physical symptoms:

“When it comes to mood, typically there’s feeling of angst, being personally frustrated, noticing more stress or anxiety, feeling often tired or edgy and not knowing why, feeling more depressed and unmotivated or noticing an increase in sadness. Physically, we see changes in behavior patterns like an increase in headaches, more isolation, not answering the phone, over or under eating and drinking or smoking more.”

Usually, the reason for the holiday blues can be tied to loss. “Loss doesn’t necessarily mean that of a loved one. It can also mean loss of support or a breakup or non-conventional loss, such as: loss of function due to a medical condition, loss of expectations or loss of finances” notes Fogle. “It can also be connected to wanting something and not having it, whether through your own choice or life circumstances.”

“The holiday blues is not an official diagnosis, but a circumstantial time period that can be stressful. Like a death anniversary, it is a timed calendar event that acts as a routinely occurring situational stressor. Though many of us think of the holidays as Thanksgiving though the New Year, the holiday blues can be relevant to values of the person and their culture, so it can appear during other religious times of the year.”

Some people are more likely to be affected than others. “If someone already has a mental health illness, they can be pre-disposed to notice an increase, in frequency or severity of symptoms. Major life changes that happen prior to the holidays, like significant losses of people or pets, relationship statuses, or even the loss of a job or big move can also predispose someone. And it’s not always a negative experience that can bring about the blues. Sometimes having a baby – which is a wonderful thing – can exacerbate the blues for some due to the process of dealing with that change.”

If you or a loved one might have the holiday blues, what can you do?

“The best thing to do is find ways to meet your needs. We need to nurture what we need within ourselves, without punishment or judgement.”

“Isolating? Find ways to be proactive to set up social connections. Feeling sad? Find space to grieve but create space to put it away and continue to function. With loss, find time to grieve and remember them but remember to also give yourself space. With loneliness, sometimes by giving of ourselves through volunteering we can give back to ourselves. You can visit a neighbor, pet-sit, try smiling at three people a day or give someone a compliment.”

It’s the “season of giving” but the holiday blues can also happen from over-extending. Make sure to find time for yourself: create quiet time, like a couple extra minutes in the shower. Know that saying no to someone is okay and be realistic with what can be done with your time, energy and money.

Being with family can also be stressful. Having a family that is dysfunctional can put a lot of stress on someone because they don’t have what they wish they had. “If you know that your family or a partner triggers you, plan for it to keep yourself safe. Go in with your eyes open: how much time can you spend before it becomes too much or before you drink too much? Can you limit your time, limit substance intake, bring a buffer or find support after you leave?

“Therapy isn’t always needed to get through the holiday blues. Most of the time people can take care of themselves by being aware and planning for it. However, it never hurts to reach out – unfortunately the issue is the 9-month waiting list for therapists. The holiday blues is a temporary phase that most people know will suck but can work through it. But for those depressed to begin with, it can deepen to potential suicidal thoughts. If this is the case, they should reach out for help.”

Post-holiday blues can happen too. The holidays create energy, and after, in the middle of winter, when the excitement is gone, you may have overspent and are dealing with bills or overate and face the repercussions of those extra cookies and slices of pie.

The holiday blues isn’t the only seasonal disorder, “Seasonal Affective Disorder, or SAD, is often associated with the holiday blues, and they can sometimes be mistaken for each other. Because of the interplayed timeline, they could be mistaken for the other. The holiday blues typically go away once the holidays are over, when structure comes back. SAD has a correlation with light, so those living where there are shorter days and longer nights may notice the affect to their moods continuing past the holidays, until the days once again become longer.”

There was a huge increase in the holiday blues during the pandemic. “People had change thrust upon them without their permission. There was lots of depression, isolation and loneliness from not having social connectiveness. There was a change in the routine and structure that provides us safety; it was removed. Though waiting lists have grown as a residual from the pandemic, we’re moving back towards pre-pandemic levels.”

Unlike many who focused on the negatives, Fogle noticed good things from the pandemic as well. “Sometimes we stay in our comfort zone as much as we can. People learned adaptive skills. There was time for self-reflection and reassessing values. People reconnected with hobbies and interests, found more creative and expressive explorations, reconnected with those in their lives and found more creative ways to be social and to connect.”


At PPI, Fogle works as a therapist in the inpatient unit, providing group and individual counseling as a member of the multidisciplinary treatment team. She has been at PPI for 23 years, starting out as a psych tech before going back to school and getting her degree allowing her to provide therapy for the past 12 years. She also runs trainings and does drug and alcohol work for the commonwealth of PA on the side as a CADC certified (drug and alcohol) counselor.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.

Patient Transfers: PPI’s Relationship with Local Hospitals

Dr. Mormando

Patient Transfers: PPI’s Relationship with Local Hospitals

Charles B. Mormando, DO, is Pennsylvania Psychiatric Institute’s (PPI) Medical Director for Admissions. He is also the Associate Director for neuromodulation, PPI’s lead on electroconvulsive therapy (ECT) services and research and he plays a role in improving PPI’s access to local hospitals.

Previously a resident of New York, Dr. Mormando came to PPI in 2018 looking for a change from New York City living. Another driving force: his mentor, Andrew Francis, MD, PhD, an internationally recognized expert in catatonia, who leads the ECT department at PPI.

Apart from Dr. Mormando’s passion for ECT research and therapy, his role as PPI’s Admissions Medical Director has brought on other responsibilities.

Dr. Mormando further explains, “As the director for admissions, I receive referral requests from hospitals for the patients they think need the services of PPI. When a patient is in the emergency room (ER), they are either assessed by a doctor, or a psychiatrist is called in for consult. In general, providers only have basic training on psychiatric conditions, so they reach out to PPI for recommendations on care. This is where I step in to help to determine if admission is needed for treatment, and if PPI is the appropriate place for the patient.”

Because of the number of calls, texts and virtual consultations between Dr. Mormando and the various emergency departments, he has built good relationships with the referring doctors.

“Good psychiatric and ER doctor relationships help patient access to care. Through the relationships I’ve built with those in local ERs, I can access more information which helps to decide what is best for the patient. These relationships also help to make decisions for treatment without needing to see the patient in person, as the providers learn to help with screening. For everyone involved, these relationships bring a positive experience” notes Dr. Mormando.

As the medical director for the past two years, Dr. Mormando has been able to improve the admission process at PPI and adapt to changes, mainly brought on by the pandemic.

“During the pandemic, we saw several difficulties. Patient acuity significantly increased, and we saw an increase in involuntary admissions. Because of the increased acuity, we also saw the increased need for the use of restraints and medications. Not to mention, the increased need for care coupled with safety protocols made access to care difficult, overwhelmed emergency departments, and impacted our communication.”

Though the pandemic brought challenges, Dr. Mormando and his colleagues did not let it get the better of them. “Through everything, we have been able to improve the relationships with our parent hospitals.”

When asked about his goals to improve patient access, he responded: “Access to care is extremely limited. There are three things that I would love to see. First, we need enough staffing, mainly nurses. Second, improved community resources. And lastly, as a community, we are extremely limited when it comes to where patients can go, and if there’s enough room to admit them. We can deal with the acuity, if we are fully staffed and have proper resources to treat them.”


Please note, PPI is not a walk-in facility. Patients as well as referring physicians must begin the admissions process by calling 866-746-2496 or 717-782-6493.

If you are a person in need of immediate assistance, please go to your nearest Emergency Department or dial 911.

Click here for more information on our Admissions Department

Depression: Signs, Treatment, And How to Help

Dr. Jain

Depression: Signs, Treatment, And How to Help

October is National Depression and Mental Health Screening Month. During this month, Pennsylvania Psychiatric Institute (PPI) hopes to bring more awareness to this disorder, and with the help of one of their psychiatrists, educate on the symptoms, treatment and how family members can help.

Ankit Jain, MD, is an outpatient psychiatrist at PPI, and regularly treats patients with depression among various other mental health problems. “Depression is a common term, but medically, it’s known as major depressive disorder, or MDD” clarifies Dr. Jain.

Symptoms

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook widely used by clinicians and psychiatrists in the United States to diagnose psychiatric illnesses. According to the DSM-5, some of the symptoms include:

  • A period of sad or depressed mood
  • Loss of interest or pleasure in activities
  • Sleeping too little or too much
  • Variation in appetite
  • Variation in weight
  • Moving too slow or fast
  • Having little energy/easily feeling fatigued
  • Poor focus or concentration
  • Feeling unworthy of good things in life
  • Extremely hopeless
  • Feeling guilty or self-critical
  • Repeating/fleeting suicidal thoughts


Dr. Jain notes: “Some or all these symptoms are required for diagnosis. The World Health Organization estimates that MDD is the 11th greatest cause of disability and mortality in the world, meaning that there are over 265 million that suffer from depression worldwide. In the US especially, it is extremely common – almost at epidemic levels – affecting 1 in 10 Americans. Depression also greatly increases the risk of suicide, at a rate 27 times more likely than the general population.”

“We see the highest rates in individuals 18-25, with women being twice as likely than men to have depression. Depression also has a genetic component, meaning those with a family history are more at risk. If you have a family history, it’s important to be aware of the symptoms of depression and seek the help of a mental health provider if you think you might be depressed.”

Diagnosis and Treatment

When discussing how he treats patients with depression, Dr. Jain states, “I first give them an assessment and psychiatric evaluation, before recommending psychotherapeutic techniques. Then I look at their medical conditions, if they’re taking any medications and if they might need adjusted. I mostly see patients in an office setting, though sometimes if any of their conditions are so severe that functionality becomes limited, or they pose a danger to themselves or others, I’ll refer them to impatient care for appropriate treatment.”

In addition to mental status examinations, Dr. Jain also does physical exams and medical evaluations, and will refer patients to other providers if he finds other conditions that need treatment. “Depression is a common comorbidity, meaning a medical condition that is also present with one or more other conditions in a patient. Common comorbid conditions are diabetes, high blood pressure, cancer, stroke, rheumatological diseases and chronic illness like lupus and MS. Unfortunately, when associated with another condition, outcomes are worse than having that condition alone.”

Depression can be experienced at different stages. “There are three levels – mild, moderate and severe. For mild to moderate depression, we typically treat with psychotherapy, individual counseling, cognitive behavioral therapy (CBT), interpersonal therapy and/or psychodynamic psychotherapy. For moderate to severe cases, in addition to therapy, we also use medication. Common medications include anti-depressants like selective serotonin reuptake inhibitors (SSRIs), SNRIs, atypical antidepressants, mood stabilizers, anti-psychotics, stimulant and non-stimulant medications.

“No matter the severity, I always recommend lifestyle changes like exercise, maintaining a healthy diet, socialization and avoiding substances. These behavioral modifications are an important part of any treatment plan.”

Helping a Friend or Loved One

If you have a friend or family member who has depression, know that there are things you can do to help their recovery. With a 50% chance that a patient’s depression will reoccur, having supportive friends and family can help prevent recurrence.

Dr. Jain explains, “Knowing the symptoms is important. Feeling sad off and on is different from feeling heavy and experiencing changes in appetite or sleep. You can help a loved one by talking with and supporting them, taking them to their mental health professional for assessment and by asking them if they have any thoughts of self-harm.”

“Those with depression can be hypersensitive, so being more sensitive to their emotions and offering support and encouragement can go a long way. MDD causes poor psychosocial relations so they may have problems with personal relationships or issues dealing with their employment. If you notice them isolate or withdrawal, encourage them to socialize. Other things to look out for are any worsening symptoms, like not sleeping or eating. If you notice worsening symptoms, increase your encouragement for them to get evaluated.”

The median time to recovery is 20 weeks and though sometimes episodes can resolve more quickly, it can be a long process. Support groups are available for family members who may need help and support as well.

Pandemic Impact

“Many are now aware that COVID-19 had a huge impact on mental health. There are lots of studies showing how it worsened anxiety and depression symptoms in patients. In a study I wrote during Covid, those who already had MDD experienced worsening conditions due to its unexpected nature, not having enough information initially, the reduction of services and institutes running at lower capacities.”

Read more from Dr. Jain’s article linked below.
Impact on mental health by “Impact on mental health by “Living in Isolation and Quarantine” during COVID 19 pandemic

Dr. Jain has authored numerous other studies and papers in renowned journals and has written book chapters related to psychiatric and neurological conditions. He is also an Assistant Professor of Psychiatry and Behavioral health at Penn State College of Medicine and an Attending Psychiatrist at Penn State Health where he routinely teaches medical students, PA students and Psychiatry residents.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

If you would like to speak to someone about better managing your stress and anxiety, or to make an appointment, please call (717) 782-6493 for more information.