depression – Page 6 – Licensed Mental Health Counselor

Combating Depression: 10 Tips

29 Jan 201329 Jan 2013by Torey C. Richards, LMHCLeave a Comment

Depression affects about 17. 5 million Americans and out of those, an estimated 9.2 million will have what is considered major or clinical depression.

What’s the difference between depression and major depression?

Major depression is categorized as:

a depressed mood, most of the day, nearly everyday for at least two weeks. In children, adolescence and some adults, depression may present as irritation or anger.
Marked diminished interest in or pleasure in all, or nearly all activities most of the day, nearly everyday.
Significant weight loss (when not dieting), decrease in appetite, or significant weight gain or appetite nearly everyday.
Insomnia or hypersomnia nearly everyday.
Psychomotor agitation or retardation (i.e. moving extremely slow or faster than normal) nearly everyday.
Fatigue or loss of energy nearly everyday.
Feelings or worthlessness or excessive or inappropriate guilt nearly everyday.
Decreased ability to think or concentrate, or indecisiveness nearly everyday.
Recurrent thoughts of death, suicidal thoughts with or without a plan or a suicide attempt.

A person doesn’t have to have all of these symptoms to be diagnosed as having major depression, but they have to have the majority of these symptoms for at least two weeks and they can’t be accounted for something else, such as bereavement (i.e., losing someone close to them recently).

Depression has been given a bad name and so many people who feel depressed don’t like to admit to it and may not seek help or even the comfort of a friend when they are feeling depressed. The thing about depression in general is that it is not always a bad thing.As a matter of fact, very often, depression is your minds way of telling you that something in your life is not going the way you want it to go.

Instead of ignoring that feeling or trying to make it go away immediately, it may be a good time to sit with it and evaluate your life and see what is it that is not going the way you want it to go, and if you can change it, then change it, if you can’t, then try to change the way you think about it.

More often then not, this is what depression is and it is possible for a person who is in tune with themselves, to take this self-evaluation, correct the problem(s) and eliminate their symptoms. Other times, a depressed person may need the help of a professional to help them analyze what’s going wrong in their lives and help them learn how to deal with it. And yet, still there are times when medication is needed due to chemical imbalances or if a person gets to the point where they are so depressed that they don’t have the capacity to be introspective.

While most of us have or will experience depression at least once in our lifetimes, major depression can be a very dark and dangerous place. The Center for Disease Control has intentional suicide as the number ten cause of death in the United States last year, killing an estimated 38, 364 people.

10 Tips To Fighting Depression

**First off… if you or someone you know is suicidal, don’t be afraid to call 911 or 1-800-suicide for immediate help**

Opposite Actions is a technique from Dialectical Behavior Therapy that basically says, do the opposite of what the depression is telling you to do. If you feel like staying in bed all day, get up and do something. If you feel like blowing off your friends, don’t, call them and force yourself to be out with them. One of the things about depression is that it is a self-feeding disease. It zaps a persons motivation, makes them want to isolate themselves and stop doing things like going to the gym, all of which end up making the person feel more depressed.
Set an alarm that will help you wake up, that will remind you to eat, or to do whatever it is you need to do.
Take care of yourself by getting out of your bed, making it, and taking a shower. Letting yourself go is one of the hallmarks of being depressed and will make it easier for you to start avoiding other people.
Go outside for at least ten minutes a day. It doesn’t matter where you go, or if you don’t go anywhere. Going outside, getting some fresh air, some sun even, can do natural miracles when battling depression.
Exercise. You won’t feel like it, but it will be good for you and will get your blood flowing and your endorphin and dopamine (natural feel good hormones) going.
Make a list of activities to do, hopefully some will involve other people.
Keep a schedule, that way you can stay on track during the days you don’t feel like doing anything.
Make a daily necessity schedule if needed that reminds you when to eat, take a bath, brush your teeth, etc. Yes, in the middle of severe depression, it’s easy to neglect all these things.
Visit people like healthy family and friends. Once again, you will feel like isolating yourself, but having good family and friends around will help pull you out of the fog.
Last, but not least, if all self-help fails, do not be afraid to see your doctor or a psychotherapist. 80% of people with major depression who received treatment had significant improvements.

Depression will affect us or someone we know to some degree, and it’s always good to have some idea of what you’re dealing with and how to begin fighting it.

Therapist are Humans Too

Am I An Effective Counselor? A Case Example On Counselor Effectiveness And Struggles When Working With A Client

21 Jan 201321 Jan 2013by Torey C. Richards, LMHC4 Comments

Often as a counselor, it’s not always easy to know when I am truly being effective in helping clients live better lives. This can be difficult because clients often lie, not only about their feelings, but also about their behavior, about following through with treatment recommendations and even about getting better.

Clients often put up lots of psychological defenses and resistance that make it difficult to know how effective treatment is being. Many of them learn how to better mask their symptoms, while all the while their depression, anxiety, compulsions, etc. are still raging inside of them, causing marked distress.

Of course there are many ways a counselor can try to verify the effectiveness of treatment such as assessment tools and reaching goals set forth in treatment plans, but most clients know how to fake those as well.

One of the most powerful ways to verify if treatment is being effective is through my own observations of the client during sessions. Clients who are depressed or anxious for example, tend to display those affects during therapy and as they progress, those symptoms tend to decrease and the clients whole persona will seem to improve.

Of course there are the times when a client will tell me how much they have changed, how much I have helped them or how much better they feel from counseling. And times when teachers or parents will tell me about the improvements they have seen in a student I’ve been working with, but sadly, in the school based program I do most of my counseling at, that type of feedback isn’t as common as I would like it to be. Still, when it happens, it feels great.

Case Example

For a little over a year now I’ve been working with a client we’ll call Suriyan. Suriyan came to me after she lost one of her parents suddenly. She was obviously grieving so I started working with her through her grief and put her in my grief counseling group. It was obvious almost immediately that Suriyan was grieving harder than anyone else in the group which consisted of other students her age, all whom had lost a parent within the last year.

Through individual counseling I realized that one of the reasons Suriyan was grieving so hard was because she had a pre-existing issue dealing with depression and self-injury, and on top of that, unlike the rest of the grief counseling group, her grieving is what we call complicated grief. Her parent had not only died suddenly, but she blamed her parent for dying and blamed herself for allowing her parent to die, although her parent died of a disease neither one of them had any control over. They had lots of unfinished business she was internalizing.

She felt that her parent was her best friend and had chosen to abandon her.

Suriyan initially was very resistant to counseling. She rarely participated in group and in individual sessions she would cycle between talking about her feelings, to being extremely angry, to totally shutting down. On top of that, she was cutting herself to deal with the pain and anger, and had become suicidal. She wanted to be with her parent. Her thought was, if my parent didn’t want to be here with me, why should I be here.

I was extremely worried about Suriyan, especially as the weeks went by and her depression wasn’t lifting. I was throwing everything at her, counseling wise, to try to get her to understand that she needed to let go of the anger and guilt she felt for and towards her parent. I felt like I was failing her and wanted to refer her to another counselor, but she didn’t want to see anyone else. As little as I seemed to be helping her, we had built a pretty good therapeutic relationship.

I started reading academic journals on grief, referring to other counselors for clinical advice and reading books as fast as I could to try to find new techniques, but ultimately patience on my part and time appeared to be the most effective technique.

In time her depression seemed to lift and she was able to talk about her parent’s death without placing blame on herself or her parent. She started participating in group, following my recommendations and keeping a journal to write in, which also seemed to help. By the end of last school year she had stopped cutting herself, was happier and was definitely in a better place.

Then summer came.

I tried to make sure over the summer she had access to counseling and even to me if needed, but when school started back this year she was almost even more depressed and upset about her parent’s death than when I first met her.

Now she was even more resistant to therapy, often missing appointments, yelling at me in session and walking out of sessions when I tried to get her to talk about things she was trying to avoid, like her suicidal thoughts, self-injury and how she was dealing with her parent’s death.

She would always come back, always wondering if I was mad at her or upset, which I never was. I knew her outbursts and “resistance” were also ways she was testing my claim of unconditional positive regard for her. She was suicidal again however. She had once been a highly motivated student, a senior with a dream to go to one of the top university’s in Florida, but now she claimed to not care about that or even graduating high school. She saw no point in anything.

She was also cutting herself again and one day in my office, after recently cutting herself in school and saying she wanted to kill herself, I had to have her involuntarily hospitalized. She was furious with me, but I knew at the time I had no choice and it broke my heart seeing her taken away, but I was positive I had did what was best for her.

She yelled that she would never come see me again or forgive me, but a week later she was released from the hospital and we settled back into a regular counseling routine. She was angry with me, but was actually thankful and told me that had I not had her hospitalized that day, she was positive she would have went home and killed herself.

Over the next few months we had our moments of resistance, but I wanted to continue to push her and to keep her goals in mind because I knew that once she got through this fog, she could be lost without guidance. I kept reminding her of her dreams and encouraging her to focus on the bigger picture. She is a brilliant young lady with huge aspirations that tended to get lost in the darkness of her depression.

There were some sessions when she didn’t want to talk so we worked on her college application or essay. Other times we just talked about random things, but through random conversation, we would end up talking about whatever was bothering her. In time she stopped cutting herself and her depression started lifting again. She started to focus on school although she had giving up somewhat on her dream of going to her first choice of college. I think she was afraid that she wouldn’t be able to take getting rejected, but I kept encouraging her to have faith while also preparing her just in case she got rejected. Still, the Universe seemed to be smiling upon her. She was winning award after award and was even “Senior of the week” recently.

She still had her bad days like over the Christmas break, which was only her second Christmas without her parent, and she will have other bad days, but she is moving forward and smiling a lot more. On top of that, she told me this past Friday that she had just gotten an acceptance letter from her first choice university. Not only did she get accepted, her first semester and perhaps even more, are already paid for including room and board. She was so excited and I was one of the first people outside of her family that she called to tell.

I was so happy because I know how much she wanted this and what this would do for her self-esteem and the doors it will open for her future. She would not only be the first person in her family to go to college, but she is going to probably the top university in the state of Florida.

She was so thankful for, “All you have done for me. For not giving up on me and for to encouraging me to follow my dreams.” I was nearly in tears because I was so happy for her, but I was quick to remind her that everything she has done to get to this point is all her and not me. She did all of this and I was just there to help guide her, but she did all the hard work. It was important to me that she took credit for her achievement so that she would know she could achieve anything she set out to, by herself if she had to.

When I got through talking with Suriyan, I was able to sit back and see how far we had come together and say that counseling had been effective. Sure it’s not done, she still has some tough days ahead, but I’ll work with her through those days until she goes off to college and even then, I will make sure she is in contact with a good counselor and make sure she is aware of the great support groups they have on campus.

I don’t do this type of work for me, I do it to help people live their best lives so this is not about me being a good counselor. There are times when I am unsure of if I am a good or effective counselor, but there are days and clients like this, when I can look back and reflect and say, yes, I am a good counselor.

The End Of A Long Week

14 Dec 201214 Dec 2012by Torey C. Richards, LMHC2 Comments

I recently just heard about the shooting at Sandy Hook Elementary School and I feel so stuck in a box right now because I am still at the high school I work at and can’t get access to television.

Yes I can read it and see pictures on the internet, but it is not the same.

I’ve been busy myself this week with a number of suicidal kids, one suicide attempt and now I am watching a suicidal teenager (yes while writing this) as we wait for a sheriff deputy to come so I can brief them on what’s going on and have them take him to the local psychiatric hospital.

It’s been one of those weeks.

This particular client is hearing voices, has been so for about a year, the same amount of time he has been getting headaches, so I think it’s possible his hearing voices could be medically based.

He’s also states he’s been depressed since he was 8 years old so it’s possible his depression is causing his auditory hallucinations as well.

I don’t know, all I know is that I would like for him to get a full medical evaluation and kept safe from harming himself for the moment, which aren’t things that can be done here so I have to refer him and his family to places where that can be done.

Talking this his family on the phone, they knew that he has been complaining of hearing voices, but never thought enough of it to try to get him help.

Once again, there goes the whole denial of mental illness again.

It’s torturous, almost abusive to deny help to a kid hearing voices that are irritating him, causing him not to be able to concentrate or focus, and causing him to yell out things like “shut up” in the middle of church (talking to the voices).

So on the phone when the family said, “Oh, he’s been hearing voices for awhile”, I stressed to them the immediate importance that he get evaluated if they didn’t want to find him dead over the weekend due to killing himself.

A little shock therapy? Maybe, but I can’t take the chance on this young man killing himself because he is so depressed and can’t take hearing the voices in his head any more. Sure, many people hear voices and aren’t suicidal, but this kid is.

Many times in the school I work at, parents seem to be mis-educated or plain ignorant about mental illness and suicide. They don’t want to talk about it and definitely don’t want to get help about it most of the time, unless it’s going to get them a disability check.

Even then, they will go to the therapist/psychiatrist as needed, get on the medication if needed to fulfill the disability check status, and then either don’t get the prescriptions filled or stop giving it to their kids after the first refill or two.

So many kids I work with have been prescribed medication for depression, anxiety, ADHD, bipolar disorder and even schizophrenia, but haven’t taken medication in almost a year.

Now, I am not a big proponent of psychotropic medication, only referring families for medication evaluations when I think it is absolutely necessary, but these teenagers I am talking about, when not on their medication, are out of control.

These are the kids that are attempting suicide, so depressed that they can’t function, so anxious that they can’t go a whole week without being taking off campus in an ambulance for having a severe panic attack and driving their fellow classmates and teachers crazy with their erratic behavior.

These are the kids that need medication, because no amount of counseling can correct something that is largely chemically based. Yes I can work with them and help them learn to cope better, but if they are so out of it that they can’t take in or practice what I teach them, then counseling won’t work alone.

I guess I should have been prepared for this week and next week. Unfortunately, along with all the blessings of the season, this is also the time of year when we see an increase in student suicidal ideation (thoughts) and child abuse.

My clients, your kids, your students need us to be vigilant and responsive to their signs of distress.

This is not the post I attended on writing today, but maybe I just needed to vent a little. After multiple suicidal kids and just a frantic week of tense, emotionally and mentally unstable clients, I’m looking forward to the weekend.

It’s my time to recharge myself, refill my emotional energy so that I can stay healthy myself, be there for those around me and give it all up again next week.

Popular Psychology

On Jovan Belcher, Murder-Suicide and Chronic Traumatic Encephalopathy in NFL Players

3 Dec 20123 Dec 2012by Torey C. Richards, LMHC6 Comments

Like a lot of people, I was shocked when I first heard the tragic news that National Football League (NFL) player Jovan Belcher had shot and killed his girlfriend, 22 year old Kasandra Perkins, before killing himself in front of the stadium his team played and practiced at last week.

Shocked at first because here was a guy, 25 years old, in the the prime of his life, making millions of dollars and yet for whatever reason, got to a point where he thought the only way out was to take the life of his 22 year old girlfriend and the mother to his infant child.

I don’t have any intimate details about Jovan Belcher or his relationship with his girlfriend, but I think it’s safe to say that Belcher was not in his right mind when he committed this tragedy and that the biggest victim of this incident is the orphaned child left behind.

I also think it’s safe to say that this was an act of domestic violence, even if the couple had no history of domestic violence, because killing your spouse, even in a fit of rage, is the ultimate act of domestic violence.

In my area, there has been a rash of domestic violence situations that have lead to homicide or murder-suicides lately. Most of these men were mentally/emotionally disturbed individuals.

A lot of times this type of incident comes from the desire to control other people and situations that we cannot control.

Sometimes when someone feels like they have exhausted themselves of every rational choice, they resort to very irrational and in this case, permanent choices that are destructive.

Also, many people who commit suicide often do not plan it, but do so impulsively.This seems to be the case often, especially when it comes to men.

In a fit of anger, irrational thinking, and/or sadness, picking up a gun and pulling the trigger probably wasn’t thought out completely, put an impulsive reaction.

Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease that is seen in some people who have had multiple concussions or head injuries.

CTE and many similar conditions strike numerous NFL players, boxers, wrestlers, hockey players and soldiers, often leading to poor memory, coordination, depression and impulsive behavior.

Signs of CTE were seen in former NFL player Junior Seau, who shot himself in the chest in 2012. NFL player Dave Duerson, who before committing suicide, sent a text message to his family asking that his brain be donated to the Boston University research center because he felt as if his brain was “sick”.

Other recent NFL suicides include former NFL player Ray Easterling who shot himself in April, and 25 year old NFL player O.J. Murdock who shot himself in July.

Signs of CTE were also seen in an University of Pennsylvania Football player, who abruptly committed suicide in 2010.

Signs of CTE and other degenerative brain conditions are also showing up in Afghan and Iraq war veterans, many of them have committed suicide and other tragic, impulsive acts as well.

I’m not saying that CTE or any other brain condition was the cause of this tragedy, but I think it has to be taken into consideration as well as Belcher’s mental state.

Like in the military, in the NFL and other male professional sports, it’s often not popular to talk about feelings or problems, so men don’t. They hold it in and deal with them in the best way they know how, often ending up in situations where the only way they see out is through destruction of some type (violence, alcohol, drugs, etc.).

Maybe if Belcher had someone he felt he could talk to about what was going on, this wouldn’t have happened, who knows.

I do know that our society discourages men in most cases from talking about how they really feel and that in turn often leads to angry, depressed, damaged, frustrated, and hurt men who sometimes go on to hurt themselves and/or others.

I don’t want to speculate too much on this situation, but I do want us as a society to talk more about men dealing with their feelings and breaking through the stereotypes of manhood and letting men know it’s okay to ask for help.

Six current or former football players have killed themselves in the last two years, four in the last eight months.

Maybe this goes along with the CTE and impulse control theory or with men not talking about their problems theory. In my opinion, in many circumstances it may be a combination of both.

This is disturbing. Even without looking at CTE, this gives us a quick glimpse into the state of men in general when it comes to mental/emotional health.

Popular Psychology

Observing Body Language: A Quick Glimpse Into One Patient

16 Nov 201216 Nov 2012by Torey C. Richards, LMHCLeave a Comment

I have a patient who is emotionally unstable, at times unpredictable and erratic. She suffers from depression, mostly due to tragic events that have happened in her past including a family history of drug abuse, sexual abuse and incest.

She holds tightly onto her tragic past, often choosing to become a victim, rather than a survivor or a thriver.

Because she carries around all this emotional baggage that she refuses to deal with and start letting go, mostly because she is comfortable in the role of playing the victim where everyone is to blame for all of her problems except her, she often feels miserable, cuts her self and can not enjoy the present, because she is stuck in the past.

She also always carries around an over sized book bag stuffed with books so heavy that when she walks, she has to walk hunched over, although she has a locker. She also carries around even more books, usually books she checked out from the library in her hand, yet doesn’t read any of them.

I think subconsciously she just likes carrying things around.

The other day when talking to her, I told her that I was worried about her posture and asked if there was a way she could minimize the amount of stuff she carried in her book bag and in her hands.

I gave her a task to try to de-clutter herself so that she didn’t have to carry so much stuff around.

And then it hit me, the way she was carrying so much stuff physically, reflected how she was carrying around so much baggage emotionally, and the way she walked, hunched over, head down, slow as if she was carrying the world on her shoulders, was exactly how she was feeling inside.

Her outside appearance and body language were representative of her emotional and mental states. This isn’t uncommon, we all due this to some extent, but hers was a prime example.

Amy Cuddy did a great Ted Talks lecture on body language where she discussed how when we carry ourselves (or sit) in certain postures, it no only affects our mood, but also our hormones, raising or decreasing testosterone and cortisol.

I can only imagine how this girl, walking around all the time, hunched over, looking small, is making her feel inadequate and disconsolate. I am wondering if I can get her to improve her posture, will that also improve her mood.

Now I am sure there is a fancy psychological term for this that is eluding me right now, but I found that insight fascinating and wondered if I could get her to stop carrying so much junk on her persons, would she start letting go of some of that emotional baggage that is holding her down as well.

So far, she has been resistant to letting go of some of her physical baggage just like she has been very resistant in letting go of some of her emotional baggage, but I will keep working with her.

It’s important that we pay attention to our body language. It’s something as a psychotherapist I do all the time, pay attention to other people’s body language, and if you have 20 mins, it’s worth listening to Amy Cuddy drive home the importance of body language and how changing it can affect your mood.

Popular Psychology

Inside The Thoughts of a Cutter: A Poem

9 Nov 2012by Torey C. Richards, LMHC2 Comments

The other day one of my students who used to cut herself, but hasn’t cut in several months, shared a poem with me she wrote that I thought would be beneficial to share.

I think it gives a quick glimpse into the mind of those who self-injure.

Although she and most of everyone else who was a part of her group I treated for self-injurious behavior have stopped cutting, many of them still fight with the urge to do it when they are faced with certain stressors.

With her permission, I share this poem that has no title.

Depressed and suicidal

Need to escape the misery

Not caring to continue this life

Blood loss has me weary

Scars show my painful past

As the stained blade opens up

Areas of my skin torn and scarred

To be a reminder of a dark past

Mind torn between love and hate

Will I ever be free?

Everyday is a struggle

To be free from this depression

Lost in darkness and misery

Puddles of dried blood stains

From every deep cut that is made

Full of depression and misery

Not worth saving this life of hate.

Abnormal Psychology, Popular Psychology

The Most Commonly Diagnosed Mental Disorders

17 Oct 201217 Oct 2012by Torey C. Richards, LMHC1 Comment

We are bombarded all the time with the depressing number of people diagnosed with illnesses such as cancer and heart disease, but did you know that mental illness is even more prevalent?

Like cancer and heart disease, mental illness is a medical condition that does not discriminate by age, sex, race/ethnicity or socioeconomic status.

Mental disorders often strike people when they less expect it, when they are in the prime of their lives and are often associated with other high risk behaviors such as gambling and substance abuse.

Like any other illness, they also vary in degree from mild, moderate and severe. In developed countries, these are the top 10 diagnosed mental disorders:

10. Autism Spectrum Disorders (Pervasive Developmental Disorders)

I’ve written a previous post on pervasive developmental disorders. They start when children are very young and are often difficult to diagnose. As a matter of fact, I know a parent who has just acknowledged (after much denial) that her 17 year old son has Asperger’s, something he should have been tested for and began treatment for years ago.

9. Schizophrenia

To me, schizophrenia is one of the most interesting mental illnesses. I used to enjoy working with schizophrenic patients when I worked in the mental hospital, although I did feel very bad for them.

Imagine being tormented by voices telling you bad things about yourself, thoughts that someone is trying to poison you, or seeing visions of dead bodies everywhere. That’s just some of the things people with schizophrenia I’ve worked with were tortured by.

To be diagnosed with schizophrenia, a person has to have two or more of the following:

Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Emotional flatness

Contrary to popular believes, most people with schizophrenia are harmless.

8. Bipolar Disorder

Most people with bipolar disorder are diagnosed by age 25, although different things can bring out underlying bipolar symptoms, such as pregnancy.

“Bipolar” is a term loosely used these days, usually to describe someone who seems to have mood swings, although in most cases, people with bipolar disorder don’t change their moods from moment to moment, and if you ever get to meet someone with severe bipolar disorder and they are not on their medication, you will know it and probably never forget it.

I’ve seen grown men swinging from trees and women drop from exhaustion after running ragged for four days straight, partying, sleeping with half a dozen men and charging thousands of dollars on credit cards they can’t afford.

7. Panic Disorder

Sweating, rapid heart beat, nausea, shortness of breath, dizziness, fear, loss of control, chest pains, tingling, smothering sensation, these are all symptoms of panic disorder.

Panic disorder and panic attacks are common, and can be triggered by certain events such as riding in an elevator, being in a crowd, having to give a speech or being in a place where there is no easy escape (agoraphobia).

1 out of 3 people with agoraphobia become housebound and are basically held hostage in their own homes by their illness.

6. Anxiety Disorders

Anxiety disorders include obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD).

OCD is a combination of reoccurring thoughts (obsessions) and actions (compulsions) that a person performs because they believe it gives them control. For instance, a person may believe they have to take 50 baths a day or they aren’t clean and they may lose their job, friends and family to this behavior.

PTSD occurs after a person experiences a terrifying even in which they face great bodily harm, death, fear or helplessness. They may then have reoccurring thoughts, nightmares, heighten fear and avoidance behaviors. Many rape victims and soldiers coming back from war experience PTSD, but so do people who have been robbed, beaten or in a car accident.

GAD is basically when someone has anxiety, stress and worry for at least 6 months period for no specific reason. Some of these people are considered “worry worts” in layman terms, but their anxiety can cause them to have a host of physical systems and a decreased quality of life.

5. Phobias

Phobias are related to anxiety disorders and there is almost a phobia for everything although social phobia is one of the more common phobias.

In social phobia, everyday situations causes the person to become self-conscious and nervous, often leading to physical responses such as sweating which then causes the person to become even more self-conscious and nervous.

Children with social phobia often go through great lengths to avoid going to school and once at school may either be super anti-social or go to extremes to avoid other students by skipping, or staying in the clinic and feigning and illness.

A person can pretty much have a phobia of anything. Check out http://www.phobalist.com

4. Attention Deficit/Hyper Activity Disorder

This is another one I’ve written about previously. ADHD is very common and most children learn to manage their illness or outgrow it altogether, but some will have ADHD throughout their adult life.

3. Eating Disorders

Anorexia nervosa, bulimia nervosa and binge-eating are common illnesses, usually affecting females.

People suffering from anorexia, when a person looks in the mirror, no matter how thin they are, all they see is a fat person. They then go through great lengths to restrict their food and burn calories until often they are on the verge of starving themselves to death, and sadly many do just that.

People suffering from bulimia are often of normal body weight, but binge on large quantities of food, then feel guilty about it and then may try to vomit it back up, exercise obsessively, or use laxatives to try to get rid of the food and calories.

People who suffer from binge-eating are caught in a vicious cycle of over-eating, feeling guilty about the over-eating, and then over-eating to try to self-soothe themselves, which all of course leads to weight gain and shame.

2. Personality Disorders

All humans have personality traits, most which are relatively fluid, based on our culture, upbringing and experiences. Many of us even have some traits of personality disorders, but people with true personality disorders have traits that are so rigid that they impair their ability to function and get along with people in their everyday life.

Some of the most common personality disorders diagnosed include:

Antisocial personality disorder– these people don’t follow rules of society, often care little about other people unless they can use them for their own gain, they can’t empathize or feel sorry for people, they generally show no remorse. They often have criminal behavior.
Avoidant personality disorder– these people are anxious, usually over-controlled and fear criticism, making them hesitant to become involved with other people. There for, they tend to avoid people as much as possible.
Borderline personality disorder– these people are generally impulsive, unstable, suicidal at times, fear abandonment while at the same time they tend to push people away from them, resulting in tense, unstable relationships.

1. Mood Disorders

Mood disorders are the number one most diagnosed mental illness in developing countries and something that nearly everyone can relate to in one form or another.

Mood disorders are sustained emotions that go beyond the usual, normal feelings of sadness, to deeper feelings such as dysthymic disorder and major depression.

Popular Psychology

On Teenage Suicide

3 Oct 20126 Oct 2012by Torey C. Richards, LMHC15 Comments

Suicide is definitely one of those unpleasant subjects that many people would like to pretend doesn’t exist or at least can’t happen to someone they know and love.

As a matter of fact, one of the most depressing and yet helpful books I’ve ever read was entitled: Psychotherapy with Suicidal People.

On Suicide

Suicide is the second leading cause of death for people between 14 and 25, and about 30,000 people in the United States commit suicide each year.

Since I’ve been working in the mental health field I’ve counseled literally hundreds of people who have either attempted suicide or have thought about suicide seriously enough that they needed hospitalization to keep themselves safe from themselves.

I’ve also assisted in crisis counseling at various schools. It’s extremely depressing to walk into a huge auditorium filled with grieving students and staff after a young person has taken his or her life.

Why Do People Commit Suicide?

This is a question I get asked very often and the answer is simple, yet complex. According the American Foundation for Suicide Prevention, 90% of people who commit suicide had a diagnosable mental illness, but there are other reasons including:

Psychological Disorders (i.e., depression, bi-polar disorder, agression, schizophrenia)
Bullying
Stress
Work
Money
Relationships

For teenagers, bullying seems to be an increasing reason to why teens commit suicide. It’s truly tragic that we live in a society that today is so connected that bullying takes on a whole new life.

Kids are now not only getting bullied at school, but in cyberspace where everyone can see, and yet no one seems to be doing anything.

On December 27th, 2011, Amanda Cummings, a 15 year old, stepped in front of a bus and killed herself after being tormented mercilessly by her bullies. A suicide note was found in her clothes.

I recently starting counseling a teenage girl who’s 20 year old brother hung himself with a dog leash last week. I didn’t know him, but from what she’s said it sounds like he may have had some struggles with depression.

He had gotten into a fight with his girlfriend and told her he was going to kill himself, something he apparently had threatened many times so she didn’t take him seriously. They found him less than an hour later hanging from a tree in the backyard.

And not too long ago here in Orlando, a man killed himself after getting in a fight with his girlfriend, telling her he was going to kill himself, and then drove the wrong way on the interstate killing himself and another motorist in a head on collision.

Other times, there may seem to be no precipitating events.

Two years ago I went to assist in suicide counseling at a high school where a popular and seemingly happy lacrosse player took his own life.

His friends and family were all blaming themselves for not knowing that he felt so sad and alone, but there weren’t many signs as far as I could tell, he seemed to be hiding his emotional pain and struggles very well.

However, in most cases there are signs to look at for.

Suicide Warning Signs Include:

withdrawal from friends and family members
trouble in romantic relationships
difficulty getting along with others
changes in the quality of schoolwork or lower grades
rebellious behaviors
unusual gift-giving or giving away personal possessions
appearing bored or distracted
writing or drawing pictures about death
running away from home
changes in eating habits
dramatic personality changes
changes in appearance (for the worse)
sleep disturbances
drug or alcohol abuse
talk of suicide, even in a joking way
having a history of previous suicide attempts

Sometimes the reasons people don’t recognize the signs of suicide is because they are in denial, especially when it comes to those close to them. When dealing with suicide, denying that someone is in need of help can cost them their life.

Suicide Prevention

If you know someone who is thinking about, talking about or you think may be at risk for suicide don’t ignore them. Often times there is a misconception that people who talk about suicide don’t end up killing themselves, but this is untrue.

Many people who end up killing themselves have mentioned suicide to someone directly or in directly, so take them seriously.

If you believe there is an immediate threat call 911, they may need emergency hospitalization. Otherwise they can seek individual and family therapy and there is always the suicide hotline (1-800-SUICIDE).

Abnormal Psychology, Popular Psychology

One Mother’s Experience with Bipolar Disorder and the Importance of Support Groups for Caregivers

18 Sep 201217 Sep 2012by Torey C. Richards, LMHC2 Comments

The other day I was fortunate to have the opportunity to speak with a former client’s mother about her experiences dealing with her now 19 year old daughter, who was diagnosed with bipolar disorder at the age of 8.

This girl from what I knew of her was extremely unstable, as could be expected from a teenager suffering from bipolar disorder.

Unlike other people suffering from bipolar disorder, teenage girls tend to be even more fickle when you factor in the normal hormones of teenagers as well as social pressures that make even some non-bipolar teens act and feel erratic.

This girl was prone to bouts of depression, mania, impulsivity and explosive anger.

At home her mom had done everything she was supposed to do to support her child including psychotherapy, family therapy and medication, but her daughter was still a hand-full.

When she was in her manic states she tended to have anger directed towards her mother and would at times try to get physical with her and had to be hospitalized several times for suicidal/homicidal ideations.

Her mother tried all she could to pacify her daughter, including painting her room the pretty purple she wanted, only to come home one day and find nearlyevery inch of that wall covered in permanent marker with words directed towards her mother such as “bitch”, “whore” and “I hope you die”.

On top of that she was extremely needy, wanting to be up under her mom 24/7 to the point that she got angry whenever her mom left her and would tear up the house or refuse to go to school.

When she was depressed she would self-mutilate and attempt to kill herself. Her mother would be afraid to leave her alone.

“My biggest fear, even today, is that I will come home and find her dead”, the mother told me.

The biggest thing this mother did that made the most difference was getting educating herself on her daughter’s illness and counseling for herself and joining a support group.

Support groups are invaluable resources that often aren’t utilized enough by those living with or taking care of people with mental illnesses or substance issues.

Through counseling and the support group she learned that she was not alone, that many other parents were on the same roller coaster ride she was on.

She also learned how to change the way she had been dealing with her daughter.

If what you are doing isn’t getting you the results you desire, you have to try something different.

She started accepting that her daughter was going to have good days and bad days, and sometimes within the same day. She also had to understand her role and limitations as the mother of a child with bipolar disorder.

She had to accept that some days she might feel like giving up, or not care when her daughter threatens to hang herself, and that doesn’t make her a bad mother, but it is a sign that she needs to take a break, regroup and seek support herself.

At the end of our reunion I was happy to see that a mother, who just a couple of years ago who was so flustered, angry and exhausted, had turned into a woman not only surviving, but thriving with a daughter suffering from bipolar disorder.

Her and her daughter are doing better, but they are still taking it one day at a time.

Taking Control of Your LIfe

Cognitive Behavioral Therapy, A Brief Primer Part 3: Ignoring Negative Thoughts

28 Aug 201229 Aug 2012by Torey C. Richards, LMHCLeave a Comment

As we discussed in part 2 of this series, according to cognitive behavioral therapy, our thoughts control our behaviors and thus control our feelings, but sometimes it is very difficult to control our thoughts for a number of reasons.

On average, we have about 50,000 thoughts a day! Some of them, despite our best efforts, are bound to be negative thoughts that make us angry, fearful, anxious, sad, pessimistic, etc.

Ideally we would analyze, confront and dispute each of those negative thoughts to see if they are even rational, and then use cognitive restructuring (changing the way you perceive a situation), to turn those thoughts into less harmful and even productive ones.

With 50,000 thoughts a day going through our minds, it’s not plausible to expect to be able to sit down and use the ABC’s of thoughts, feelings and behaviors on each and every one of those thoughts, we can save that for some of the bigger, more damaging ones that keep us from experiencing life fully.

So what do we do with the other dozen, hundred or even thousands of negative thoughts?

We can chose to ignore them! Yes, it’s that simple! We can chose to ignore them, pay less attention to them, dismiss them and not allow them to take over our thoughts, feelings and behaviors.

We can learn to realize that thoughts are just thoughts, nothing more.

A thought by itself is harmless until we give it power (either good or bad). The same is true with feelings. We can have a feeling enter us, acknowledge that feeling, but don’t dwell on it, and in a very short amount of time that feeling is likely to leave us.

It’s only when we ponder, over analyze and start assigning that feeling/thought meaning that we start to give it ammunition to do harm or motivation to do good.

Let’s take for an example that one day at a coffee shop writing in your blog you start thinking, “I should have been a writer. I just wasted my entire life slaving away instead of following my passion.”

If you dwell on that thought and let it torment you, you will feel like a loser and are likely to start feeling sad. Or, you can recognize that it’s just a thought and dismiss it.

This doesn’t mean that writing isn’t something you should be doing and maybe pursuing more, it just means that in this moment you are choosing not to pay attention to that thought, especially since you recognize that it’s likely to make you feel bad.

It’s not a cop out. It doesn’t mean that later on you can’t go back and apply the ABC’s of thoughts, feelings and behaviors to it, it just means that in that present moment you are choosing to dismiss it and use that mental energy more constructively.

If we paid attention to all the negative thoughts we had, we would be worn out, worthless and depressed.

It’s very important not to dwell on thoughts that have happened in the past or will may happen in the future.

It’s important to be present and dismiss those negative thoughts that come flying in about the past (even if it was ten minutes ago) or about the future.

The beautiful thing is, you’ll learn that once you start dismissing and ignoring those negative thoughts, more peaceful thoughts are likely to fill their space and you’re more likely to feel at peace with yourself and your world.