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Blog Articles and Resources

Through our Eyes: Children, Violence and Trauma

4/28/2016

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This video was found on youTube.com.  It was published by the Office for Victims of a Crime on February 27, 2013.  Keep in mind when watching this video that trauma is experienced by children differently than adults and that trauma can be big, obvious issues and less obvious experiences that are experienced traumatically by the child. 
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Depression

4/26/2016

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The following article was found on the National Institute for Mental Health website which is a government sponsored site.  This site offers information and research opportunities to those interested in participating in trials related to treatment of mental health conditions. 
Depression
Definition
Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.
Some forms of depression are slightly different, or they may develop under unique circumstances, such as:
  • Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
  • Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.
  • Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
  • Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.
  • Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”
Examples of other types of depressive disorders newly added to the diagnostic classification of DSM-5  include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).
Signs and Symptoms
If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:
  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.
Risk Factors
Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.
Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.
Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.
Risk factors include:
  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications
Treatment and Therapies
Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.
Quick Tip: No two people are affected the same way by depression and there is no "one-size-fits-all" for treatment. It may take some trial and error to find the treatment that works best for you.
Medications
Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.
Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.
Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.
If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding, talk to your doctor about any increased health risks to you or your unborn or nursing child.
To find the latest information about antidepressants, talk to your doctor and visit www.fda.gov .
You may have heard about an herbal medicine called St. John's wort. Although it is a top-selling botanical product, the FDA has not approved its use as an over-the-counter or prescription medicine for depression, and there are serious concerns about its safety (it should never be combined with a prescription antidepressant) and effectiveness. Do not use St. John’s wort before talking to your health care provider. Other natural products sold as dietary supplements, including omega-3 fatty acids and S-adenosylmethionine (SAMe), remain under study but have not yet been proven safe and effective for routine use. For more information on herbal and other complementary approaches and current research, please visit the National Center for Complementary and Integrative Health  website.
Psychotherapies
Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy. More information on psychotherapy is available on the NIMH website and in the NIMH publication Depression: What You Need to Know.
Brain Stimulation Therapies
If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research:
  • ECT can provide relief for people with severe depression who have not been able to feel better with other treatments.
  • Electroconvulsive therapy can be an effective treatment for depression. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention.
  • Once strictly an inpatient procedure, today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks.
  • ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Advances in ECT devices and methods have made modern ECT safe and effective for the vast majority of patients. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT.
  • ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert.
Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. You can learn more about these therapies on the NIMH Brain Stimulation Therapies webpage.
If you think you may have depression, start by making an appointment to see your doctor or health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses if you are unsure of where to start.
Beyond Treatment: Things You Can Do
Here are other tips that may help you or a loved one during treatment for depression:
  • Try to be active and exercise.
  • Set realistic goals for yourself.
  • Try to spend time with other people and confide in a trusted friend or relative.
  • Try not to isolate yourself, and let others help you.
  • Expect your mood to improve gradually, not immediately.
  • Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
  • Continue to educate yourself about depression.
 
"Depression." NIMH RSS. National Institute of Mental Health, Mar. 2016. Web. 13 Apr. 2016.

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4 Tips to Change the Way You Deal with Stress

4/21/2016

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This article comes from the PsychCentral.com website, which has numerous articles on coping with stress from professionals.

4 Tips To Change the Way You Deal with Stress
By Donna M. White, LMHC, CACP
 
Dr. James C. Dobson once said “there are very few certainties that touch us all in this mortal experience, but one of the absolutes is that we will experience hardship and stress at some point.” Stress may be inevitable, but how we handle it is our choice.
Stress is different for all individuals, so there is no “cookie cutter” solution to manage it. You may have to experiment to find what works best for you. Finding healthy, positive ways to deal with stress will add to your overall well-being.
When dealing with stressful situations, consider the four points below. They may aid in decreasing the amount of stress and changing the way you view it.
  1. Nothing and no one can “make” you feel anything. How you feel and the way you deal with a situation is a choice. I’m reminded of a counselor who would often state “no one can drive your car unless you give them the keys.” You cannot control others’ actions, but you can be responsible for your reactions.
The serenity prayer states “God grant me the serenity to accept the things I cannot change, the courage to change the things that I can, and the wisdom to know the difference.” When applied, this can be a great stress reliever. Look at the situation and ask yourself “is this something I can change?” If so, start exploring positive ways to change the situation.
If the situation cannot be changed, such as an illness or the economy, accept it for what it is. Accepting does not mean giving up. By accepting the situation and finding ways you can cope with what cannot be changed, stress can be drastically reduced.
  1. Exchange attitude for gratitude. Our attitude has a profound effect on how we deal with situations. Negative attitudes affect our physical, spiritual, and mental wellbeing.
When in a particularly stressful situation, try exchanging attitude for gratitude. When you are running late for a meeting because you are stuck in traffic, change your attitude. Instead of being frustrated about the traffic, find some gratitude. Look around and think of all the things you can be thankful for. Sometimes you can find gratitude in the smallest things. You can be thankful for life, health, strength, friends, family, nature, etc. Focusing on gratitude can definitely change your attitude.
  1. Relax, relax, relax. Amidst the hustle and bustle of everyday life, sometimes we forget to take care of ourselves. If we do not help ourselves, how can we effectively help others? Relaxation rejuvenates the body, mind, and spirit and leaves us better equipped to handle stressful situations when they come.
Try to find something that you enjoy and do it every day. If you can set aside time for relaxation, do it. Try to set aside a designated, uninterrupted time and stick to it. Many people state they don’t have time to relax, but relaxation does not have to be time-consuming. Relaxation can include periodic 5-10 minute breaks of breathing exercises or watching your favorite show for 30 minutes. Relaxation can also include connecting with positive people.
  1. Look at the big picture. Evaluate your stressful situation from a “big picture” point of view. Ask yourself “how important is this?” and “will this matter in the long run?” If the answer is no, it’s likely not worth your time and energy.
Stress does not have to be a part of life. Success stress management is all about learning how and when to take control. It’s important to remember that you control how stress affects you. You can control the stress or let stress control you.
 
White, Donna M. "4 Tips To Change the Way You Deal with Stress." Psych Central. Psych Central, 2015. Web. 13 Apr. 2016.

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The Impact of Stress

4/18/2016

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This article comes from a site called psychcentral.com which has several quick resources on stress, what it can do to the body and different ways to cope with it.  Stay tuned later this week for an article from this same site on stress management techniques.
The Impact of Stress
By Steve Bressert, Ph.D.
 
Stress often is accompanied by an array of physical reactions. These symptoms can be characteristic of other physical or mental disorders. A health care professional can rule out other causes after you have undergone a physical examination. Signs of stress can include the following:
  • sleep disturbance (insomnia, sleeping fitfully)
  • clenched jaw
  • grinding teeth
  • digestive upsets
  • lump in your throat
  • difficulty swallowing
  • agitated behavior, like twiddling your fingers
  • playing with your hair
  • increased heart rate
  • general restlessness
  • sense of muscle tension in your body, or actual muscle twitching
  • noncardiac chest pains
  • dizziness, lightheartedness
  • hyperventilating
  • sweaty palms
  • nervousness
  • stumbling over words
  • high blood pressure
  • lack of energy
  • fatigue
Cognitive signs of stress include:
  • mental slowness
  • confusion
  • general negative attitudes or thoughts
  • constant worry
  • your mind races at times
  • difficulty concentrating
  • forgetfulness
  • difficulty thinking in a logical sequence
  • the sense that life is overwhelming; you can’t problem-solve
Emotional signs of stress include:
  • irritation
  • no sense of humor
  • frustration
  • jumpiness, overexcitability
  • feeling overworked
  • feeling overwhelmed
  • sense of helplessness
  • apathy
Behavioral signs of stress include:
  • decreased contact with family and friends
  • poor work relations
  • sense of loneliness
  • decreased sex drive
  • avoiding others and others avoid you because you’re cranky
  • failing to set aside times for relaxation through activities such as hobbies, music, art or reading
Recently, much has been reported about stress and its relationship to other health problems, such as heart disease, blood pressure and depression. While research has not confirmed that having a hostile or aggressive personality (so-called “Type A”) directly causes cardiovascular disease, it may place you at greater risk, especially if your heart rate or blood pressure rise dramatically in response to everyday stress.
Stress also has been linked to suppression of the immune system, increasing your chances of becoming ill or altering the course of an illness if you already have one. In particular, it has been implicated as playing a role in cancer and gastrointestinal, skin, neurologic and emotional disorders, and even the common cold. Some studies have shown that relaxing while listening to soothing music can improve immune system functioning and, we can assume, help with our long-term health.
Elevated blood pressure is another response to stress. Too much stress with little or no coping skills keeps the body “revved up.” Learning to relax can help lower your blood pressure. Elevated blood pressure always should be discussed with your family physician, who can help you sort out whether your elevated blood pressure is due to a medical or genetic condition or a reaction to uncontrolled stressors.
If you do not end up identifying a method to handle your stress then it eventually can lead to a heightened sense of dysfunction. This may result in increased anxiety or a sense of depression because you’re not mastering your world. Feeling depressed (for example, sad, pessimistic, hopeless or helpless) is a common reaction to stress. When these symptoms are temporary, they may simply be a reflection of life’s normal ups and downs. But if they persist for long periods of time, especially after the stressful situation has passed, you may have a problem that could benefit from professional help.
When stress and anxiety escalate without a means to cope with the stress, they often are linked to many troublesome psychological and physiological conditions. Oftentimes, psychological distress accompanies and/or produces these conditions, which include:
  • amnesia
  • sleepwalking
  • multiple personality
  • obsessive-compulsive disorders
  • phobias
  • generalized anxiety disorder
  • hypochondriasis (fear and excessive complaints of bodily disease)
  • high blood pressure
Since prolonged stress can impact your health, it’s important to develop positive coping mechanisms to manage the stress in your life.
 
Bressert, Steve. "The Impact of Stress." Psych Central. Psych Central, 2015. Web. 13 Apr. 2016.
 
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Teen Suicide Prevention

4/13/2016

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6 Bad Habits That Will Sabotage Your Success

4/4/2016

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This article was found on the Psychology Today website.  Psychology Today is an excellent resource to help find therapists near you and to find helpful articles that may address what you are experiencing as well.

Amy Morin What Mentally Strong People Don't Do
6 Bad Habits That Will Sabotage Your Success
Your thoughts not only affect your emotional state, but also influence your behavior. When you think positively, you'll likely feel better and perform better. When you think negatively, that despair will be reflected in how you feel and behave.
Everyone experiences unhelpful, unrealistic, and exaggeratedly negative thoughts at one time or another. Allowing cynicism to become a habit, however, will limit your potential. No matter how much talent or experience you possess, if you can't gain control of your mind, you'll never achieve great things, because you can't reach the next level unless you believe you're capable of accomplishing more.
That's why sport psychologists work with aspiring Olympians and other elite athletes to help them eradicate the negative self-talk that interferes with their ability to perform. But it's not just athletes who can benefit from changing their mindset: Learning to think productively can help you as well. Learning to recognize the thinking habits that rob you of mental strength is the first step in changing your mindset. Here are six bad mental habits that will sabotage your success.
1. Making excuses.
Blaming other people or external circumstances for your lack of achievement harms your performance. Saying things like, "My boss is holding me down," or "All this paperwork makes it impossible to do my job" will only keep you stuck.
Stop making excuses: Focus on all the things you can do rather than on what you can't. When you pay attention to the positive, you'll put more effort into your performance. 
2. Catastrophizing the future.
Negative predictions easily turn into self-fulfilling prophecies. If you step up on a stage to deliver an important speech thinking, "I'm going to mess everything up," you'll be distracted—and that distraction may cause you to forget the words.
Stop catastrophizing: Unless you're creating productive plans to deal with potential worst-case scenarios, don't explore "what if?" questions. Predicting disastrous outcomes will cause a spike in anxiety that could cause you to choke.   
3. Seeking approval.
Your attempts to gain approval from others could backfire. Trying to decipher how an interviewer is perceiving your answers, for example, could cause you to stumble over your words. Worse, thinking about the other person's response could cause you to tune out the conversation altogether.
Stop trying to gain approval: While it may sometimes be important to gauge your audience's reaction—like in the middle of a sales pitch—every second you spend seeking reassurance is a second you aren't focused on the task at hand. Keep the focus on doing your best and recognize that you can't control how other people respond.
4. Believing self-doubt.
Insecurity can kill your dreams. If you walk into an interview thinking, "I'll never get hired," your self-doubt will shine through and you'll be less likely to land the job. Rejection will only fuel your self-doubt and create a negative cycle that's hard to break.
Stop doubting yourself: Create a list of your skills, talents, and achievements. Read the list regularly and when you're plagued by self-doubt, remind yourself of all the reasons you're "good enough." 
5. Putting yourself down.
It's impossible to perform well when you're telling yourself "You're stupid" or "You can't ever do anything right." Negative self-talk will discourage you from putting in your best effort and it will drag you down fast.
Stop the put-downs: Talk to yourself like a trusted friend. If you wouldn't use such harsh words with someone else, don't allow your inner critic to say them to you.
6. Second-guessing yourself.
While reflecting on past choices can be healthy, second-guessing each choice you've made make will impair your performance. Questioning whether you said the right thing, or second-guessing your choice in attire for a cocktail party, wastes a lot brain power.
Stop second-guessing yourself: Practice mindfulness so you can learn how to be fully present in the here-and-now.


Morin, Amy. "6 Bad Habits That Will Sabotage Your Success." Psychology Today. AMyMorinLCSW.com, 3 Mar. 2016. Web. 30 Mar. 2016.

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    Michelle Stewart-Sandusky

    I write articles based on my experience as a therapist or a training or conference attendee.  Many of these articles are written by others who are experts in their field and I share their information as resources for others.

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