crucial first step towards recovery is the initial
phone call to my office to make an appointment.
I appreciate your acknowledgment that you need help
and are reaching out to say, "I'm tired of feeling
this way, I want to feel better".
offer counseling and psychotherapy to those who
suffer from depression, stress, anxiety and panic
attacks, SAD, obsessive compulsive disorder (OCD)
and other mental health issues.
do you know if you are depressed? What is the difference
between grief and depression? Is sadness and depression
the same thing? Gaining an understanding of how
each of these is similar and different may be helpful
to your healing process.
Depression often occurs when we suppress or deny
our emotions such as sadness, anger, frustration,
resentment. Emotions are meant to be felt. They
give us clues about what is comfortable and uncomfortable
in our life. Emotions are not good or bad they just
are. We are meant to listen to and feel our emotions
so that we can move on. When we hold on to emotions
and refuse to let them go, they build up inside
of us often creating health problems such as headaches,
stomachaches. We may feel numb or stuck. We often
confuse the feeling of an emotion with the action
that results. We may deny our anger because we associate
feeling anger with violence or we fear that if we
express anger others will stop liking or loving
is a natural emotion that comes with loss, disappointment,
grief. It comes and goes. It may be felt for a short
or long time, appropriate to the particular event
or circumstance- you have plans to meet a friend
and she cancels at the last minute; a pet runs away
or is lost; someone you know is hurt or dies; you
interview for a job, but do not get it. After an
appropriate amount of time the sadness dissipates
and you are ready to move on.
is a natural emotion that we experience after a
loss, trauma, or during and after a terminal illness
of someone we love. Denial, sadness, anger, loneliness,
confusion, and other emotions are typically experienced
as a part of the grief process. There is no set
time for grief to linger, but it should ease over
time. Finding supportive friends and a grief support
grief can be helpful. Trying to push through grief
too quickly and not allowing yourself to experience
the emotions of grief may turn into depression or
Post Traumatic Stress Disorder (PTSD).
are the Symptoms of Depression?
For major depression, you may experience five or
more of the following for at least a two-week period:
of guilt, worthlessness, helplessness or hopelessness
of interest or pleasure in usual activities,
concentrating and complaints of poor memory
of co-existing chronic disease, such as rheumatoid
arthritis or diabetes
gain or loss
lack of energy
of suicide or death
speech; slow movements
stomachache, and digestive problems
of the most recognized symptoms of depression include
a profound feeling of sadness or loss of interest.
You may be surprised to learn that people with depression
often experience a broad range of other symptoms.
general, if you've been experiencing some combination
of the following emotional, physical, or associated
symptoms of depression for more than two weeks,
and they clearly interfere with your life, discuss
your concerns with a professional.
let this list of symptoms scare you. Treatments and
therapies are available to help with the symptoms
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Compulsive Disorder (OCD) . . .
Obsessive-compulsive disorder (OCD)
is a psychiatric anxiety disorder that includes
distressing, intrusive thoughts and related compulsions
(tasks or "rituals") to neutralize the
obsessions. Obsessions are usually upsetting and
the compulsions lead to temporary feelings of relief.
To be diagnosed with obsessive-compulsive disorder,
one must have either obsessions or compulsions alone,
or obsessions and compulsions together, but most
people with OCD have both.
Symptoms of experiencing Obsessions include . . .
and persistent thoughts, impulses, or images
that are intrusive and inappropriate. The thoughts
cause severe anxiety or distress.
thoughts, impulses, or images are not just excessive
worries about real-life problems.
person tries to ignore or suppress the thoughts,
impulses, or images, or to neutralize them with
some other thought or action.
person recognizes that the obsessing thoughts,
impulses, or images are a product of his or
her own mind, and are not based in reality.
Symptoms of experiencing Compulsions include . .
- Repetitive behaviors or mental acts that the person feels they must perform in response to an obsession, or according to rigid rules.
- The behaviors or mental acts to prevent or reduce distress or prevent some dreaded event or situation; however, these behaviors or mental acts
either are not connected in a realistic way with what they are supposed to neutralize or prevent or are clearly excessive.
In addition, at some point during
the course of the disorder, the person must realize
that his/her obsessions or compulsions are unreasonable
or excessive, which is why people with OCD are not
considered to be detached from reality or psychotic.
The obsessions or compulsions must be time-consuming,
taking up more than one hour per day, cause distress,
or cause difficulty in social, work, or school functioning.
Having OCD is stressful and can lead to feelings
of hopelessness and depression.
Therapy (BT) - Cognitive Behavioral Therapy (CBT)
is the first line treatment for OCD. The specific technique used in BT/CBT is called exposure and ritual prevention (also known as "exposure and response prevention") or ERP. This involves
gradually learning to tolerate the anxiety associated
with not performing the ritual behavior.
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- Seasonal Affective Disorder (Winter
Depression) . . .
daylight during the fall and winter causes depression
(sometimes called the "winter blues")
in some people. This disrupts our internal body
clock leading to depressive symptoms. If you have
had episodes of depression that clearly have an
onset in fall or winter followed by remission of
symptoms in the spring or summer, you may have SAD.
Other factors contributing to seasonal affective
disorder (SAD) may include genetics and age. We
know that neurochemicals are involved in the regulation
of our mood and functioning. Melatonin and serotonin
levels are thought to be contributing factors.
are the Symptoms of SAD - Seasonal Affective Disorder?
The symptoms of SAD (winter depression - winter
blues) can closely mirror the symptoms of clinical
depression with the exception that they come on
with the shortening winter days and go away with
the lengthening days of spring:
(feeling like you want to hibernate)
of interest in activities you normally enjoy
changes, especially a craving for foods high
in carbohydrates such as pastas, rice, bread
concentrating and processing information
counseling and therapy techniques used for depression
are also used for the symptoms of depression in
SAD (Seasonal Affective Disorder). If you are experiencing
symptoms, it is important to take good care of yourself
and not ignore the symptoms. Self-care includes
doing all the usual things: healthy diet, avoiding
too much alcohol (a depressant) and exercise such
as getting out in the fresh air for a walk. You
also may want to investigate full spectrum lighting
- tanning is recommended by some doctors. Increasing
your intake of Vitamin D is helpful. If you are
typically a person who takes care of everyone else
it may be time to take better care of yourself and
stop worrying about everyone else.
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- Panic Attacks and Stress . . .
affects everyone at some level. We get stressed
and we rush around. In spite of our technological
advances that make our life "easier,"
we don't seem to be free from the stress factor.
Stress and anxiety can really move in a direction
than can be quite scary. We may not even know that
we are experiencing anxiety. A third of everyone
will suffer from some kind of anxiety disorder.
Traumatic experiences can lead to Post Traumatic
Stress Disorder (PTSD) - often more severe and chronic
than occasional anxiety and stress. How do we know
we have an anxiety disorder?
are the Symptoms of Anxiety?
and over-analyzing too much
sensations of rapid heart-beat, difficulty breathing,
sweating, breaking out in cold sweat and shakiness
the worst and "future tripping" (what
if?. . .)
and obsessive thoughts, usually about safety
issues, or horribly embarrassing thoughts
and not being able to think positively
of "out of control" and that one is
going lose one's mind
Anxiety - Fear of going out into "public"
may experience some of these symptoms or possibility
all of them. Feelings of embarrassment and shame
come up for people as they talk about their thinking
and episodes. Sometimes we can have bizarre or irrational
thoughts. This sometimes compounds the issue making
it a private problem and keeping us from reaching
out for help and support.
is a Solution to Anxiety . . .
If you are suffering from panic attacks and anxiety,
you need to know you can and will get better if
you take certain steps. When we are spinning in
the vortex of self-doubt and losing control, it
is important to know there is something you can
do. Recovery comes with time. Before we look at
the steps from recovery, let us look at the mental,
emotional and physiological sides of anxiety.
Emotional Side of Anxiety . . .
Fear is a good thing. It is a God-given emotion
that tells us something is dangerous in our environment.
It can be used to help keep from poor choices. It
is when our lives are ruled by fear that is when
it becomes a problem. With Generalized Anxiety Disorder
Physiology of Anxiety . . .
While anxiety has a lot to do with one's thinking
and spirituality, it also has to do with our bodies.
physical aspect of anxiety involves centers in the
brain called basal ganglia. These centers deal with
fear and fine motor skills. When we experience panic
or extreme anxiety, these centers become over-active.
We may predict the worst, become shaky and become
too sensitive to body functions. We feel and experience
too much. We feel our heart beating. We are too
aware. This is useful if we were in a situation
where we need to escape from a real danger. People
who have had a panic attack will do everything they
can not to experience another one. It feels like
certain death and loss of control. It is the over-control
that can actually make the condition worse.
can also be triggered by obsessive thinking. These
thoughts usually are repetitive and difficult to
redirect. We might worry about our health, germs,
or disease. We might experience intrusive thoughts
about hurting someone or ourselves. Fear of what
people are going to think about us and worry about
losing control are also classic symptom of anxiety.
is important to know that people do and recover
from anxiety. The first step is to find someone
"safe" to share your feelings and what
has happened. Talking with someone can help us gain
perspective and realize that this will pass.
Breathing and Meditation . . .
Illusion of Control . . .
Believe it or not, deep breathing and relaxation
are very beneficial to recovering from panic disorder
and anxiety. It is very difficult for the person
who already experiences anxiety to "calm themselves
down." It usually takes a counselor or someone
who knows the process of progressive relaxation.
Just by giving yourself something else to think
about, can be the beginning steps to walking out
of a panic attack. How many people feel the relief
in just knowing they have Xanax (an anti-anxiety
medication) to take. It is knowing what to do that
helps. Progressive relaxation involves counting,
breathing and tightening/relaxing certain muscle
groups. For Christians, having a certain prayer
or passage from the psalms to meditate is not only
connecting with God, but also gets the mind off
of the panicky thoughts.
that people with anxiety struggle with is the need
to feel in control. The irony is that the more they
think that they control, the more out of control
they are. We try to control people, places, and
The irony is that we often try
to control the things we don't have control over,
which are "people, places and things"
and yet we have learned to control what we can.
We can change how we respond to live, rather than
"re-act." Many who have been traumatized
in their past, have structural differences to overcome
in their brains. Brain scans demonstrate this. We
can train ourselves to think differently and more
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and Therapy . . .
recovery from anxiety, we work on "letting
go," and changing irrational belief systems.
The process of counseling can be helpful to help
the client let go of negative beliefs and to think
more healthy thoughts. Cognitive Behavioral Therapy
which involves changing negative beliefs or irrational
beliefs into more healthier beliefs. This is a process
and once the thinking has changed, the panic usually
doesn't come back. One can learn about themselves
in this process. The whole crisis once it is over
can become a real blessing which has developed muscles
to handle life better by letting go more.
can be useful for debilitating anxiety to help a
person begin to feel better so that they can work
on their thinking and lifestyle patterns that are
causing the anxiety. It is important for the person
to go beyond just wanting to "feel" better,
but to "get" better. Pain can motivate
us to work on our salvation process. Unfortunately,
once the pain is gone, sometimes so is the motivation
to "get" better, that is to really have
a change of heart.
may need to prioritize and not do too many things.
One may need to look at what is happening in their
spiritual life. Letting go of fear is the beginning
of wisdom. Perfect love can cast out fear. As we
progress in our healing from fear through love,
we gain freedom from fear.
Therapy typically means that you spend
about an hour a week talking with a mental health
professional. Treatment can continue for several
weeks or up to one to two years. Every person's
situation is different. Depression and anxiety can
negatively affect the way you think and feel. Talk
therapy can help you learn to treat your depression
and anxiety to help relieve your symptoms.
Behavioral Therapy (CBT) can help
you identify and change the thought and behavior
patterns that contribute to depression and anxiety.
People who are depressed and anxious tend to think
negatively, and cognitive behavioral therapy teaches
you how to identify and challenge the negative thoughts.
Behaviour therapy, or Behavior Therapy (BT)
- behavior modification is an approach
to psychotherapy based on learning theory which
aims to treat psychopathology through techniques
designed to reinforce desired and eliminate undesired
behaviors. Cognitive Behavioral Therapy
(CBT) is a psychotherapeutic approach that
aims to teach the person new skills, on how to solve
problems concerning dysfunctional emotions, behaviors
and cognitions through a goal-oriented, systematic
procedure. The title is used in diverse ways to
designate behavior therapy, cognitive therapy, and
to refer to therapy based upon a combination of
basic behavioral and cognitive research. This approach
is usually done in short-term therapy, and has been
found to be particularly helpful for depression