{"id":687,"date":"2021-01-09T00:00:00","date_gmt":"2021-01-09T00:00:00","guid":{"rendered":"https:\/\/www.cmmhealth.org\/about\/news\/understanding-the-why-behind-behavioral-health\/"},"modified":"2026-05-06T20:10:47","modified_gmt":"2026-05-06T20:10:47","slug":"understanding-the-why-behind-behavioral-health","status":"publish","type":"post","link":"https:\/\/www.cmmhealth.org\/es\/about\/news\/understanding-the-why-behind-behavioral-health\/","title":{"rendered":"Understanding the &#8216;why&#8217;\u00a0 behind behavioral health"},"content":{"rendered":"<p class=\"wp-block-paragraph\"><em>This article was first printed in Vail Health Magazine 2020, written by Katie Coakley.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What makes someone healthy? Is it the numbers measured in blood pressure, heart rate, cholesterol and body weight? Or is it the wellbeing of the body, mind and spirit? Increasingly, patients are seeking treatment for conditions related to behavioral health \u2014 issues that can include depression or anxiety, weight loss or diabetes management and quitting smoking, drinking or drugs. As a result, healthcare is moving beyond the numbers, and integrated behavioral healthcare is becoming the gold standard.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Mental health is a key component in this puzzle. Though we all have \u201cdown days\u201d or \u201cfeel blue\u201d now and then, some people experience persistent, debilitating and devastating depression, anxiety or mental illness.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">While there isn\u2019t one reason why people experience metal health challenges, most can be traced back to a combination of factors, both biological and environmental, including genetics and biology, life experiences and external factors. However, by understanding the causes, behavioral healthcare providers can work to unlock the right treatment, or combination of treatments, for each person.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>How genes can impact mental health<\/strong><br>Does mental illness run in families?&nbsp;Is there a gene that determines whether or not an individual will suffer from mental health problems? Yes and no.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cEven though we have lots of research on the root causes of mental illness, whether it&#8217;s depression or anxiety, for instance, it\u2019s almost impossible to link it to one thing,\u201d explains Dr. Casey Wolfington, licensed psychologist and community behavioral health director for Eagle Valley Behavioral Health (EVBH). \u201cWe\u2019re such complex creatures and so much of who we are is a combination of both our genetics and what we experience as humans.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Genes may play some part in mental health disorders, but it\u2019s not as straightforward. Instead, mental health disorders like depression and anxiety are what Dr. Marshall Thomas, director of the Johnson Depression Center at the University of Colorado and the medical advisor to EVBH, calls a polygenic disorder: There are multiple effects based on multiple genes. To add to the mix, there\u2019s also a gene environment interaction that doctors believe starts even before you\u2019re born \u2014 a mother\u2019s stress hormones can actually trigger certain things in a baby\u2019s genes prenatally.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cYour genes aren\u2019t static. They\u2019re turned on and turned off by the environment, especially by trauma and stress,\u201d Dr. Thomas explains. \u201cSo there\u2019s a huge role that the environment plays on who ends up depressed, who ends up with certain chronic diseases.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In other words, there may be genes that indicate mental health issues like depression, bipolar disorder or schizophrenia, but just because those genes exist doesn\u2019t mean that those illnesses will manifest.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There is also some indication that families can have a predisposition for certain mental illnesses, like depression or bipolar disorder.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cFor example, with depression, if you have a first-degree relative (like a mother or sibling) with major depression, you\u2019ve got a 10% chance&nbsp;<br>of having major depression yourself,\u201d Dr. Thomas says. \u201cIt\u2019s not 100%, it\u2019s 10%. If you look at the general population, that&#8217;s probably 5%. So that genetic predisposition puts you&nbsp;at increased risk.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As a result, the ability to reduce or alleviate stressors in the environment can play a major factor in preventing depression, or mitigating the effects of depression, if you\u2019re genetically predisposed to the condition. &nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cIf you take appropriate care and practices to help mitigate environmental stressors like early loss and trauma, you\u2019re less likely to actually manifest depression,\u201d Dr. Thomas says.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is positive news. Just because there are genetic indicators or family history, experiencing a mental health challenge is not a foregone conclusion. Instead, our environment and our connections to other people can not only make a difference in our own lives, but we can make a difference in other people\u2019s lives.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cThat should be where a lot of our attention is: How do you get upstream with this and create nurturing environments either in the family or in the community that mitigate stress in kids and help them not walk into adolescence or adulthood with a body that&#8217;s already had all the stress genes turned on to set them up for anxiety and depression and substance abuse?\u201d Dr. Thomas questions.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Nurture versus nature<\/strong><br>These environmental stressors \u2014 everything from loss to trauma and abuse \u2014 can play a huge role in behavioral health.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cThere are studies where they count how many adverse childhood events someone has,\u201d Dr. Thomas says. \u201cAnd the research shows there\u2019s a direct correlation between the high number of adverse events that happened in childhood and the instances of medical illness and psychiatric instances.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As a result, creating nurturing and supportive environments, both in the home and in the community, is crucial for creating positive behavioral health. This is where the importance of relationships comes in.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Research has linked the number of connections that one person has to his\/her resilience and ability to overcome difficult times or obstacles in &nbsp;life. This goes beyond the early years. In addition to having strong relationships at home, it\u2019s important to have other connections \u2014 at school, in the workplace and in your social life. Your support group doesn\u2019t only help when uncontrollable situations occur, but it can also create positive influences throughout life.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cEven if genetics show a predisposition for anxiety or depression or learning disabilities, for instance, our social connections and strong relationships with other people are our biggest predictors of health,\u201d Dr. Wolfington says.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The biological, psychological and social<\/strong><br>When it comes to treating behavioral health issues, it\u2019s important to look at all aspects that could be contributing to the problem.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cWhen we\u2019re talking about mental health, oftentimes we\u2019re thinking about specific diagnoses rather than all of the different systems that contribute,\u201d Dr. Wolfington says.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example, someone with diabetes may also be experiencing anxiety or depression. Instead of treating the depression as a separate, individual illness, the patient may see a better outcome if the mental aspect of dealing with the diabetes is addressed. Having tools and strategies to deal with the mental burden can ease the depression, leading to improved mental health and, hopefully, better management of blood sugar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In short, everything is connected and dealing with just one aspect of a person\u2019s condition limits overall wellness.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cIn order for us to enhance behavioral health or physical health, we have to look at all dynamics of health,\u201d Dr. Wolfington explains.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Tapping into genes for treatment<\/strong><br>Pharmaceuticals are often part of a treatment plan for mental illnesses. But what if there was a way to use your genes to create a more effective treatment?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is a question many pharmaceutical companies are trying to answer. Genes may determine some of our responses to treatment, but again, it&#8217;s not a question of addressing a single gene. And though several companies tout genetic testing as a means to guide choices for antidepressants, \u201cexperts with no financial interest in genetic testing have repeatedly recommended that genetic tests should not be used in choosing treatments for depression,\u201d wrote Dr. Bruce Cohen and Dr. George Zubenko on the Harvard Health Blog.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In fact, the FDA advised that the tests had no proven value and should not be used. The organization also stated that the use of the tests could lead to inappropriate treatment choices that might harm patients.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cSo instead of getting overly focused on genetic testing, I think the focus should be on comprehensive care that is guideline-based. Comprehensive care is care that deals with and understands the biology, the psychology and the social aspects of the mood disorder the person has,\u201d Dr. Thomas says. \u201cAt this point I would reserve genetic testing for people where a comprehensive stepped-care approach and multiple medication trials have not been successful.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Expanding and improving the quality of care<\/strong><br>Regardless of whether or not behavioral health is linked to biology or environment, having access to care can directly improve mental health.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cNot having access to appropriate medical care or health insurance has been consistently linked to poor behavioral health and physical health outcomes,\u201d says Dr. Wolfington. \u201cThat is one of the reasons that Vail Health felt it was so important to create an integrated behavioral health environment within our Colorado Mountain Medical clinics.\u201d &nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One challenge that both rural and mountain communities face is creating better access to ongoing care. This manifests not only in affordability and access for patients, but also having the behavioral health professionals available to help. Until recently, there were no training opportunities for prospective psychologists or clinicians in the mountains.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">However, in 2014, Bright Future Foundation, a community fundraising partner of EVBH, created the Colorado Psychology Internship Consortium, also known as CO-PIC, which prepares interns to meet the needs of rural and underserved populations.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cIt\u2019s a really big deal because the vast majority of people who are in practice as psychologists, doctors or physicians typically practice in close proximity to where they finished their residency,\u201d says Dr. Wolfington, who helped establish CO-PIC. \u201cThe lack of pre- and post-degree training opportunities is one of the reasons that Eagle County struggled to effectively recruit providers.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Eagle Valley Behavioral Health has now been established as part of CO-PIC, creating partnerships with prospective psychologists and clinicians from schools like the University of Denver to try and create a pathway for the behavioral health workforce in our community.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cWithout a formal pathway, we\u2019re just relying on clinicians with high student loan debt to take the risk of moving to our high cost of living, low housing availability community, and it\u2019s not going to happen,\u201d Dr. Wolfington says. \u201cWe have to be really intentional in making these partnerships. Otherwise, we\u2019re always going to have a behavioral health provider workforce shortage.\u201d&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">By increasing access to care, which includes both mental and physical care, the community as a whole will be healthier.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Mood and anxiety disorders are not like a virus \u2014 treating them is not a \u201cone and done\u201d situation, Dr. Thomas says. Instead, they require ongoing interventions, including lifestyle interventions, psychological interventions and sometimes biological interventions. The earlier you intervene, the better the outcome.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Approaching behavioral health with a wholistic approach early on helps mitigate the unavoidable life stressors and trauma that can lead to mental health issues. So don\u2019t ignore your behavioral health \u2014 it\u2019s just as important as those other numbers on the doctor\u2019s chart.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/www.cmmhealth.org\/es\/services\/behavioral-health\/\">Learn more about Colorado Mountain Medical&#8217;s behavioral health services &gt;.<\/a><\/strong><\/p>","protected":false},"excerpt":{"rendered":"<p>This article was first printed in Vail Health Magazine 2020, written by Katie Coakley. What makes someone healthy? Is it the numbers measured in blood pressure, heart rate, cholesterol and body weight? Or is it the wellbeing of the body, mind and spirit? Increasingly, patients are seeking treatment for conditions related to behavioral health \u2014&#8230;<\/p>","protected":false},"author":1,"featured_media":688,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-687","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Understanding the &#039;why&#039;\u00a0 behind behavioral health - Colorado Mountain Medical<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Understanding the &#039;why&#039;\u00a0 behind behavioral health - Colorado Mountain Medical\" \/>\n<meta property=\"og:description\" content=\"This article was first printed in Vail Health Magazine 2020, written by Katie Coakley. 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