Jun24

Post-Traumatic Stress Disorder (PTSD)

By Kelsey Rood - blog,Counseling,Mental Health

June is Post-Traumatic Stress Disorder (PTSD) awareness month! We are going to look at what PTSD is, its provenance, symptoms, treatment, and listed resources. What is PTSD? Post-Traumatic Stress Disorder (PTSD) occurs following direct or indirect exposure to a traumatic event(s). These include but are not limited to personal acts of violence, assault, abuse, sexual assault, accidents (i.e. motor vehicle collisions), disasters (both human-caused and natural), combat, and mass violence/attacks. It is important to note not everyone who experiences traumatic events will develop PTSD. It is reported that 6 out of 100 people will be diagnosed with PTSD at some point in their lives. It is also reported that PTSD is two times as present in females than in males.

Symptoms of PTSD

There are multiple possible symptoms one may experience with PTSD. These symptoms can range in severity and frequency. These symptoms include avoidance, mood and cognition changes, reactivity and arousal changes, and intrusions. Symptoms involving avoidance can include avoiding triggers, thoughts, memories, conversations, or reminders of the trauma. Intrusions can include involuntary memories of the event, nightmares, intrusive thoughts, derealization, dissociation, and experiencing flashbacks of the trauma. Some of these flashbacks may be so vivid that the person may believe they are reliving the trauma. Changes in mood and cognition may include eschewed beliefs about themselves and others around them, potentially leading to them having a negative and distrustful view of themselves, others, and the world around them. It can also lead to one wrongfully assigning blame to themselves or someone else for the trauma. It may also include difficulty remembering details of the traumatic event, symptoms of depression, anger, consistent fear, shame, guilt, isolation from others, and withdrawal from activities they once enjoyed. Changes in reactivity and arousal can include being easily angered, emotional outbursts, reckless/risky behaviors, becoming startled easily, hypervigilance, and difficulty concentrating or sleeping.
Those who experience trauma may experience these symptoms shortly after the traumatic event(s), but to be diagnosed with PTSD, they must experience these symptoms for more than one month and cause significant distress and difficulty in their daily functioning. Those with PTSD may not experience signs and symptoms of PTSD until three months to six after the traumatic event(s).

Treatment

Treatment for PTSD can include psychiatric medication to address the mental and physical symptoms. Therapeutic interventions and treatment include Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Processing Therapy (CPT), Narrative Exposure Therapy (NET), Prolonged Exposure Therapy for PTSD (PE), and Eye Movement Desensitization and Reprocessing (EMDR). Treatment for PTSD can be conducted through inpatient treatment, partial hospitalization programs (PHP), intensive outpatient treatments (IOP), residential care, or outpatient treatment (i.e. outpatient therapy and outpatient psychiatric consultations). Group therapy is also offered for those experiencing PTSD.

Resources

Below is a list of several resources, including information, support, and materials for those experiencing PTSD or their loved ones.

Support for self and loved ones with PTSD: https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder/?tab=support

Suicide Crisis Hotline: Call or text 988 https://988lifeline.org/talk-to-someone-now/

Veterans Crisis Line: Call 988 and press 1 or text 838255. https://www.veteranscrisisline.net

More information on PTSD and further resource links: https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd

Find a PTSD support group: https://www.psychologytoday.com/us/groups?category=trauma-and-ptsd

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
American Psychiatric Association (n.d.). What is posttraumatic stress disorder (PTSD)?. Retrieved June 20, 2024. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
Rogers Behavioral Health (n.d.). Trauma and PTSD facts. Retrieved on June 20, 2024. https://rogersbh.org/trauma-and-ptsd-facts

Mar28

What’s the Difference Between ADHD and ASD?

By Kelsey Rood - blog,Counseling

Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have several similarities and differences in their diagnosis, symptoms, and treatment. It is not uncommon for a person to be diagnosed with both ADHD and ASD. However, until 2013, ADHD and ASD could not be diagnosed together. It is also possible for autism to be misdiagnosed as ADHD. Both ADHD and ASD are classified under neurodevelopmental disorders in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). They are often diagnosed in childhood but have also been diagnosed in adulthood. ADHD has three types: predominantly inattentive, predominantly hyperactive-impulsive, and combination type. For ASD, there are three levels of severity, where level three requires the most support. So what are the similarities and differences between ADHD and ASD?

Similarities between ADHD and ASD

Studies have indicated that 22 to 83% of children with autism also meet diagnosis criteria for ADHD. It has also been stated in research that about 30-65% of those with ADHD also show signs and symptoms of autism. Regarding symptoms of each, ADHD and ASD have multiple similarities and overlaps. These symptoms include difficulty with emotional maturity (such as management of distress, anger, and frustration), difficulties with sensory sensitivities, social challenges, and executive dysfunction (including challenges completing/organizing tasks and time management). Similarities also include difficulties with impulsivity, learning difficulties/disabilities, and problems with focusing.

Differences between ADHD and ASD

There are multiple differences between ADHD and ASD. Although both ADHD and ASD can cause difficulties socially, they can differ regarding the reason. Those with ADHD can have difficulty with socialization due to impulsivity, interrupting, and difficulty paying attention. For those with ASD, it can be due to difficulties understanding social cues, pretenses, and body language. Those with ASD can also experience social difficulties due to withdrawn behaviors and avoidance of eye contact. ASD symptoms can also include speech delays, lack of speaking, and difficulty with speech patterns. Those diagnosed with ADHD can experience symptoms including trouble sitting still, hyperactivity, frequent changing of tasks, and interrupting others due to blurting out things and excessive talking. While those with ADHD can have trouble with paying attention and staying on task, those with ASD can experience intense focus on an individual thing. People diagnosed with ASD can also experience repetitive movement, which can include rocking or other stimming behaviors. It has been studied that children with ADHD can have difficulty and dislike for repetition, routines, and order. However, those with ASD often like and search for repetition and familiarity.

Treatments for ADHD include psychiatric medications, counseling, skills training, and behavioral therapy. Treatment for Autism can also include behavioral therapy and psychiatric medication, as well as speech therapy, occupational therapy, and social skills counseling. Diagnosis for both ADHD and ASD can start with a conversation with one’s doctor or mental health professional. From there, further assessment, potential diagnosis, and treatment can follow.

Resources:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Arthur, S. (2023). Do I have ADHD, autism, or both?. Psych central. https://psychcentral.com/adhd/can-you-have-adhd-and-autism

Holland, K (2024). The relationship between ADHD and autism. Healthline. https://www.healthline.com/health/adhd/autism-and-adhd

Rudy, L. (2023). Autism vs. ADHD: What are the differences?. Very well health. https://www.verywellhealth.com/autism-vs-adhd-5213000

Sokolova, E., et al(2017). A causal and mediation analysis of the comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Journal of autism and developmental disorders, 47(6), 1595–1604. https://doi.org/10.1007/s10803-017-3083-7

Jul10

Toxic Relationships and How to Leave

By Kim Wells - Counseling,Mental Health

Toxic Relationships are defined as an unhealthy relationship between two people where disrespect, lack of appropriate communication, dishonesty, controlling behaviors, and possibly abusive behavior that result in continued unhappiness by one or both people.

Toxic Relationships typically do not start out as toxic. In fact, most relationships that end in toxicity begin with an intense spark and connection. Many people report when first meeting this person, that they felt seen and heard for the first time in their lives and feel that they have “known this person their entire lives.”
This sense of “knowing this person” comes from unconscious ideas and behaviors you may have experienced as a child and increases the intensity of the relationship. While most people do not display overly controlling and problematic behaviors initially, these behaviors will become apparent after the “honeymoon” phase of the relationship. Unfortunately, by this point in the relationship, the partners have an intense attachment to each other thus making it more difficult to leave the relationship. Some couples may experience a “trauma bond.” A “trauma bond” is an unhealthy attachment where cycles of abuse. These bonds and relationships typically follow a pattern of increased tension, followed by abuse of some kind, then followed by a “honeymoon” stage where the toxic and abusive partner tries to apologize and make amends for their actions. Trauma bonds are seen in most abusive relationships and in some toxic relationships.

So how do you get out of a toxic relationship? The first step is to identify that you are, in fact, in a toxic relationship by looking for red flags and characteristics of toxic relationships. Ask yourself the following:

Your needs are not being met.
You are scared to ask more from your partner.
Your friends and family do not support your relationship.
You feel obligated and/or are scared to leave your partner.
You do not like your partner or how they make you feel.
You do not like who you are when you are with your partner.
Your partner is abusive.

Once you have determined that you are in a toxic relationship and depending on the severity of toxicity, seeking support can be one of the best options. Contact friends, family members, and other support systems to provide you with emotional and physical help while you evaluate your options. With your support in place, make the decision to leave and stick to it. Leaving a toxic relationship is hard. People typically feel sadness, anger, fear, insecurity, and ambivalence about their decision. However, if a person knows the relationship is toxic, remaining firm in your decision to end the relationship is helpful. Cut off all contact with your partner, unfollow them on all social media, and focus on your own needs rather than the needs of your toxic partner. Remembering that you deserve to be treated with love, kindness, and respect. If you are fearful for your safety, you can call 911 or the non-emergency phone number, and they can direct you on how to obtain a protective order that states that your toxic partner may not come within a certain amount of feet of you. Also, seeking professional help can assist you in this transition. Seeing a therapist does not mean that something is wrong with you but rather means that you recognize that the relationship is unhealthy and you are taking action to ensure that you break any of your own patterns so you do not enter another toxic relationship or return to your past relationship.

Remember, you deserve to feel safe, secure and receive love that does not hurt.

National Domestic Violence Hotline 24/7 800-799-7233
House of Ruth Domestic Violence Shelter/Legal Advocate 410-889-7884

Jul10

How to Overcome Social Anxiety

By Kim Wells - Counseling,One on One Counseling,Stress Management

Social Anxiety affects approximately 12% of all adults sometime in their lives. This means that more than one in ten people will experience anxiety and specifically social anxiety. Will this be you?

What is anxiety, and why do we have anxiety? Anxiety is the brain and body’s way to sign that a threat is present. The primitive part of the brain goes into autopilot to assess the threat and decide whether you should FIGHT, FLIGHT, or FREEZE. A person typically experiences increased heart rate and rapid breathing. This reaction allows the body to send more oxygen to the muscles and brain in case the person needs to take action. They will also experience flushed pale skin as the body redirects the blood to major muscle groups in the event the person needs to fight or run away. Some people also experience dilated pupils that allow them to better see and observe their surroundings.

The problem with social anxiety is that the person’s body and brain react to the social situation as if there is a true threat, even when they are not in danger. The brain and body send these signals, and the person “overreacts” to the situation, thus increasing their anxiety. It is important to note that a certain amount of anxiety can be helpful, however, when a person’s level of anxiety is extreme, and the body goes into flight or fight mode, the person is less able to manage their anxiety in the social situation and may choose to leave or avoid situations that cause this physical reaction.

To overcome social anxiety, try the following:

Assess the situation prior to attending the social event.
Identify triggers that increase your anxiety and be proactive about how to address them.
Challenge irrational thinking and reassure yourself that you are in fact SAFE.
Focus on your breathing using mindful breathing exercises such as 5-7-8 breathing.
Try to view your body’s flight, flight, or freeze reaction as helpful. For example, view your increased heart rate and rapid breathing to get more oxygen to your brain and body, and as a result, you will be able to think and act faster.
Remember that your anxiety is time limited.
Practice relaxation and mindfulness techniques.
Have supportive people around you that can help you feel safer and more comfortable.
Role playing problematic situations with friends so you feel more confident.
Designate an allotted amount of time you will be at the social event. Make sure the time is short enough that you can successfully remain in the social setting before needing to leave.
Remember that getting over anxiety takes time and that facing your fears about social activities will DECREASE your anxiety in the long run.

Remember, the goal of overcoming social anxiety is to ensure a person’s safety by assessing a threat. In social anxiety, the person’s “assessment meter” is going off when no threat exists. If you or your child continues to struggle with social anxiety after trying these suggestions, seeking help is a good option. Yale researcher, Eli Lebowitz, Ph.D., developed a special program called SPACE. SPACE stands for Supporting Parents of Anxious Childhood Emotions, where the parents learn how to decrease their role in their child’s anxiety by either inserting something or removing something from their child’s life to decrease their anxiety. If you think your family may benefit from the SPACE program, Kim Wells of Olney Counseling Center has been trained in this approach.

Jan3

What are Personality Disorders?

By Kim Wells - Counseling

A personality disorder is a deeply ingrained, unhealthy pattern of thinking, feeling, and behaving. Personality disorders usually begin to form in the teenage years when the person is experiencing significant problems maintaining or initiating relationships and social activities at work, school, or home. If these patterns persist, the person may struggle to function in society in a healthy way. Most people who have a diagnosed personality disorder are not even aware of the impact of their entrenched think and behavior. They view their struggle as the fault of others and are resistant to accepting responsibility for their actions. This thinking perpetuates the personality disorder, and the person typically continues to struggle.

The following is a list of the most common personality disorders, and it is important to note that approximately 10 percent of the population suffers from these disorders:

Antisocial
Borderline
Histrionic
Narcissistic
Obsessive Compulsion

What causes personality disorders?

Researchers believe that personality disorders are influenced by genetics and the environment in which the child grew up. Other studies indicate a link between anxiety, fear, aggression, and some of the personality types.

Significant childhood trauma such as:

Sexual abuse
Physical Abuse-in extreme cases these traumas can lead to borderline personality disorders
Verbal abuse
High Reactivity Environment-more likely to develop an anxious personality disorder
Inconsistent Parenting-children are three times more likely to suffer from a narcissistic personality disorder
Intense bullying

What is the best way to treat personality disorders?

First it is important to find a mental health professional that has experience treating personality disorders. Evidence-based therapies such as Behavior Therapy/Behavior Modification, Cognitive Behavior Therapy (CBT), Dialectical-Behavior Therapy (DBT) as well as support groups and medication have been found to the most effective treatments for personality disorders. It is important to know that personality disorders are typically difficult to treat as the entrenched thinking, feeling, and acting have become a way of life for many people so be patient with yourself and family members.

Jan3

What is the Difference between Psychotherapy and Counseling?

By Kim Wells - Counseling,Psychotherapy

Deciding between psychotherapy and counseling can be difficult, especially when you need help. Rest assured that both psychotherapists and counselors can be helpful in meeting your therapeutic goals but taking some time to understand the difference between the two disciplines may produce better outcomes. Psychotherapy and Counseling terms have been used interchangeably for some time but there are important differences between psychotherapy and counseling.

PSYCHOTHERAPY	COUNSELING
Long-term solutions for past or recurring problems	Short-term solutions for present problems
Treatment is typically longer in duration	Treatment is typically shorter in duration
Feeling and experience focused	Action and behavior focused
Primary Process (addresses the event)	Secondary Process-(meaning attached to event)
May include talk therapy & testing & other modalities	Typically, is talk therapy

Most trained therapists use a combination of both psychotherapy and counseling techniques with the goal being to “start where the client is.” Based on the client’s goals and treatment needs, the therapist and the client will develop a treatment plan that will likely incorporate all the above techniques.

Counseling:
Means to “advise” and it generally involves the counselor and patients to use critical thinking to solve a problem. Counselors tend to provide advice, planning and guidance and are very active in the process. This process is typically short term and is present oriented with very specific goals.

Psychotherapy:
Generally, focuses on increased insight into chronic physical or emotional pain, where thoughts and feelings from the past and present are analyzed and changed so the person feels emotional relief.

Similarities:
Both counseling and psychotherapy are built on trust. Trust is the building block for all therapeutic interactions and with trust, the person feels emotional, and physically safe to share their story.

If you are unsure about seeing a counselor or a psychotherapist, reach out to these professionals and ask questions. A qualified professional should be able to provide you with their own process, their credentials, how they work with clients, explain the difference between counseling and psychotherapy and most importantly provide you with a sense of connection.