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Types of Problems

People seek the assistance of a mental health professional (MHP) for many different reasons. These are some of the most common:

1. You feel unhappy most of the time.
2. You worry all the time and are unable to find the solutions to your problems.
3. You feel extremely sad and helpless.
4. You feel nervous, anxious, and worried most of the time.
5. You have panic attacks.
6. You have a hard time concentrating.
7. Your emotional state is affecting your daily life: your sleep, eating habits, job, and relationships.
8. You are having a hard time functioning from day to day. Your emotional state is affecting your performance at work or school.
9. Your behavior is harmful to yourself or to others.
10. You are feeling impatient and angry with someone you are taking care of.
11.  You are having problems with your family members or in other important relationships.
12.  You or someone you care about has problems with substance abuse or other addictions.
13.  You are the victim of sexual abuse or domestic violence.
14.  You have an eating disorder.
15.  You are having trouble getting over the death of someone you loved.
16.  You or someone you love has a serious illness and you are having a hard time with it.
17.  You feel lonely and isolated.
18.  You are experiencing problems in a sexual relationship.
19.  Your family has a lot of conflict and tension.
20.  You are experiencing a divorce or marital separation.
21.  You are having a hard time coping with change.
22.  You often feel afraid, angry, or guilty.
23.  You have a hard time setting and reaching goals.
24.  Your child is having problems with behavior or school performance.
25.  Your family is stressed because someone is ill.
26.  You have a hard time talking with your partner, children, parents, family members, friends, or coworkers.
27.  You are having problems dealing with your own sexual orientation or the sexual orientation of someone you care about.
28.  You are planning to marry, and you have some concerns.
29.  You have gotten a divorce and your family needs help adjusting.
30.  You are part of a blended family and need help learning to live together.

Types of Mental Health Professionals

The most common MHPs in the United States are Psychologists, Marriage and Family Therapists, Social Workers, and Professional Counselors. Each state has its own licensing laws and standards that govern each type of professional. While all licensed MHPs can help most people with problems of living, each group has its own special training in specific areas that makes them more qualified for certain types of issues. In addition, each individual therapist has a unique set of experiences that makes him or her uniquely qualified to work with certain kinds of issues.

Psychologists generally have a Ph.D. or Psy.D. degree in psychology from an accredited school. They must complete a rigorous internship period and pass a state licensing exam. In addition to their undergraduate college degree, most psychologists spend five to seven years in education and training. They study scientific methods and the science of human behavior, building skills for working with people who have real life problems.

Marriage and Family Therapists (MFTs) generally have a master’s degree in psychology, counseling, or a related subject from an accredited school. In most states, they must complete a supervised internship period and pass a state licensing exam. Marriage and family therapists are trained to work with people, focusing on how they relate to others. While they often work with an individual client, the focus of treatment is the set of relationships that surround the client and how those relationships impact the client. MFTs are trained in psychotherapy and family systems. They are licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples, and family systems. They work in a variety of settings with individuals, couples, families, children and adolescents, providing support and a fresh viewpoint as people struggle with life’s challenges.

Social Workers have a BSW or MSW from an accredited school. They must have completed an MSW and a supervised internship before passing a state licensing exam. (Each state has its own licensing regulations.) The social work profession focuses on individual happiness and well-being in a social context. It is also concerned with the well-being of the society that surrounds the individual. Social workers are trained to pay attention to the environmental forces that may contribute to the individual’s life problems.

Licensed Counselors have a master’s degree in psychology or a related subject from an accredited school. In most states, they must complete a supervised internship period and pass a state licensing exam.

Referral to Other Health Professionals

When it is in the best interest of the patient or outside the scope of the MHP’s license, therapists collaborate with and refer to other health professionals, such as physicians or psychiatrists in the case of prescribing medication.

Confidentiality

Each group of MHPs has strict ethical guidelines governing privacy and confidentiality. Clients of licensed MHPs can expect that discussions will be kept confidential, except as otherwise required or permitted by law. Examples of times when confidentiality must be broken are when child abuse has occurred or where the client threatens violence against another person.
When you are looking for a mental health professional to help you address your issues, it is very important to ask about a therapist’s qualifications to treat your specific concerns.

Visit these web sites to learn more:

www.aamft.org (National Association of Marriage and Family Therapy)
www.apa.org (American Psychological Association)
www.naswdc.org (National Association of Social Work)
www.counseling.org (American Counseling Association)

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Angie Woodward is a Registered Nurse in Wyoming and is the founder and owner/director of Trinity Teen Solutions, Inc. TTS is a licensed Christian Residential Treatment center for at risk teen girls, young adult women, and their families.  Call 307-645-3384 for a free consultation.

        

Before diagnosing a teenager with depression, it’s important to recognize the physiological changes occurring within her body. The maturation process is marked by an influx of hormones, which contribute to the teen’s mood swings. Add onto this the stress of transitioning from childhood to adulthood, and it’s not uncommon for youths to display characteristics of depression.

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But there are other factors that could contribute to teen depression. The death of a loved one, breakups with girlfriends or boyfriends, or even failure at school can weigh heavily on the psyche. These circumstances, coupled with growing pains, can result in a depressed state of mind.

Sad vs. Depressed

Sadness is part of the human condition, just as happiness is. Some situations call for us to be sad, such as the loss of a love. It’s when we’re unable to break out of this sadness that help is needed, and this is how you decipher sadness from depression.

While it’s normal for teenagers to experience mood swings, it’s important to notice when sadness evolves into depression. Chronic depression can be identified by a persistent, melancholy state. Strained relationships with family and friends, substance abuse, and other negative behaviors also indicate a need for professional assistance. Other signs of teen depression include:

• Excessive Sleeping
• Change in Eating Habits
• Criminal Behavior
• Obsession with Death
• Isolation

Do not take any of these signs lightly, or excuse them as “normal teenage behavior.” If your teen is consistently displaying one or several of these depression indicators, it’s time to get involved.

Treatments for Teen Depression

Teenage depression is a sensitive matter. Adolescents are emotional, and respond to depression more angrily than adults. For this reason, it’s important that parents remain open-minded and patient.

Prior to seeking professional help, parents should:

• Listen to their child;
• Don’t criticize;
• Make sure their teen knows he or she can speak to them;
• Don’t pressure their teen to talk;
• Take notice of positive things their teenager does;
• Suggest to their teen to visit the family doctor.

Most importantly, parents should keep their eyes and ears open. If (after trying to help their teen) nothing seems to work, it’s time to take charge. Talk to your family doctor, and begin the depression screening process. You’re the parent, and you know what’s best.

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Angie Woodward is a Registered Nurse in Wyoming and is the founder and owner/director of Trinity Teen Solutions, Inc. TTS is a licensed boarding school for troubled teens. Call 307-645-3384 for a free consultation.

        

But millions of people (an estimated 15% of the population) suffer from devastating and constant anxiety that severely affects their lives, sometimes resulting in living in highly restricted ways. These people experience panic attacks, phobias, extreme shyness, obsessive thoughts, and compulsive behaviors. The feeling of anxiety is a constant and dominating force that disrupts their lives. Some become prisoners in their own homes, unable to leave to work, drive, or visit the grocery store. For these people, anxiety is much more than just an occasional wave of apprehension.

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Types of Anxiety Disorders

An anxiety disorder affects a person’s behavior, thoughts, feelings, and physical sensations. The most common anxiety disorders include the following:
Social anxiety or social phobia is a fear of being around other people. People who suffer from this disorder always feel self-conscious around others. They have the feeling that everyone is watching them and staring at them, being critical in some way. Because the anxiety is so painful, they learn to stay away from social situations and avoid other people. Some eventually need to be alone at all times, in a room with the door closed. The feeling is pervasive and constant and even happens with people they know.

People who have social anxiety know that their thoughts and fears are not rational. They are aware that others are not actually judging or evaluating them at every moment. But this knowledge does not make the feelings disappear.

Panic disorder is a condition where a person has panic attacks without warning. According to the National Institutes of Mental Health, about 5% of the adult American population suffers from panic attacks. Some experts say that this number is actually higher, since many people experience panic attacks but never receive treatment.
Common symptoms of panic include:

• Racing or pounding heart
• Trembling
• Sweaty palms
• Feelings of terror
• Chest pains or heaviness in the chest
• Dizziness and lightheadedness
• Fear of dying
• Fear of going crazy
• Fear of losing control
• Feeling unable to catch one’s breath
• Tingling in the hands, feet, legs, or arms

A panic attack typically lasts several minutes and is extremely upsetting and frightening. In some cases, panic attacks last longer than a few minutes or strike several times in a short time period.

A panic attack is often followed by feelings of depression and helplessness. Most people who have experienced panic say that the greatest fear is that the panic attack will happen again.
Many times, the person who has a panic attack doesn’t know what caused it. It seems to have come “out of the blue.” At other times, people report that they were feeling extreme stress or had encountered difficult times and weren’t surprised that they had a panic attack.
Generalized anxiety disorder is quite common, affecting an estimated 3 to 4% of the population. This disorder fills a person’s life with worry, anxiety, and fear. People who have this disorder are always thinking and dwelling on the “what ifs” of every situation. It feels like there is no way out of the vicious cycle of anxiety and worry. The person often becomes depressed about life and their inability to stop worrying.

People who have generalized anxiety usually do not avoid situations, and they don’t generally have panic attacks. They can become incapacitated by an inability to shut the mind off, and are overcome with feelings of worry, dread, fatigue, and a loss of interest in life. The person usually realizes these feelings are irrational, but the feelings are also very real. The person’s mood can change from day to day, or even hour to hour. Feelings of anxiety and mood swings become a pattern that severely disrupts the quality of life.
People with generalized anxiety disorder often have physical symptoms including headaches, irritability, frustration, trembling, inability to concentrate, and sleep disturbances. They may also have symptoms of social phobia and panic disorder.
Other types of anxiety disorders include:

Phobia, fearing a specific object or situation.

Obsessive-compulsive disorder (OCD), a system of ritualized behaviors or obsessions that are driven by anxious thoughts.

Post-traumatic stress disorder (PTSD), severe anxiety that is triggered by memories of a past traumatic experience.

Agoraphobia, disabling fear that prevents one from leaving home or another safe place.

Treatment Options

Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. It can be difficult to identify the correct treatment, however, because each person’s anxiety is caused by a unique set of factors. It can be frustrating for the client when treatment is not immediately successful or takes longer than hoped for. Some clients feel better after a few weeks or months of treatment, while others may need a year or more. If a person has an anxiety disorder in combination with another disorder (such as alcoholism and depression), treatment is more complicated and takes longer.

While a treatment plan must be specifically designed for each individual, there are a number of standard approaches. Mental health professionals who specialize in treating anxiety most often use a combination of the following treatments. There is no single correct approach.

Cognitive Therapy

The client learns how to identify and change unproductive thought patterns by observing his or her feelings and learning to separate realistic from unrealistic thoughts.

Behavior Therapy

This treatment helps the client alter and control unwanted behavior. Systematic desensitization, a type of behavior therapy, is often used to help people with phobias and OCD. The client is exposed to anxiety-producing stimuli one small step at a time, gradually increasing his or her tolerance to situations that have produced disabling anxiety.

Relaxation Training

Many people with anxiety disorders benefit from self-hypnosis, guided visualization, and biofeedback. Relaxation training is often part of psychotherapy.

Medication

Antidepressant and antianxiety medications can help restore chemical imbalances that cause symptoms of anxiety. This is an effective treatment for many people, especially in combination with psychotherapy.

The treatment for an anxiety disorder depends on the severity and length of the problem. The client’s willingness to actively participate in treatment is also an important factor. When a person with panic is motivated to try new behaviors and practice new skills and techniques, he or she can learn to change the way the brain responds to familiar thoughts and feelings that have previously caused anxiety.

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Angie Woodward is a Registered Nurse in Wyoming and is the founder and owner/director of Trinity Teen Solutions, Inc. TTS is a licensed Christian Residential Treatment Center for at risk teen girls and their families. Call 307-645-3384 for a free consultation.

        

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Out of all the pills at their disposal, many teens are being prescribed anti-depressants that were unknown 10 years earlier. Why the sudden need? What changed from one generation to the next?

The short answer is the media.

What Today’s Media Does

Compared to a mere 10 years ago, today’s media puts astounding pressure on youth, especially girls. Flip on the television, and you’re fed images of super-skinny women with perfect hair and fake body parts. Their barely-there clothing is the finishing touch on their seductive attire, and they always get their man. What message does this send to our teenage girls?

Put plainly, it tells them they’re not good enough. They’re brainwashed into believing that the only way to be valuable is to look and act like the images on screen. When they’re unable to do so, their self-esteem takes a hit, and teen depression kicks in.

What Parents Can Do

While it’s impossible to shelter your teen daughter from the influences surrounding her, there are some steps you can take to instill within her a sense of value and worth:

• Utilize the parental controls on your television and Internet. You won’t be able to block every piece of racy material, but you’ll have some effect.
• Tell your daughter she looks nice, and do it often.
• Compliment her accomplishments, big and small.
• Keep her active. If all she does is sit in front of the television or computer, give her some chores to do, or sign her up for an activity. From there, require her to participate.
• Take some one-on-one time with you and your teen daughter. Go see a movie, or grab some lunch together.
• Take a vested interest in her life. Ask her how school’s going, even if she acts as though she doesn’t want to talk.

As parents, you possess a medicine that’s better than any anti-depressant, and that’s the medicine of love. Use it to make sure she knows how wonderful she already is.

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Angie Woodward is a Registered Nurse in Wyoming and is the founder and owner/director of Trinity Teen Solutions, Inc. TTS is a licensed Christian Boarding School for troubled teen girls and their families. Call 307-645-3384 for a free consultation.

        

This is the second of a two-part series on depression. In this issue, I will describe how depression is treated and prevented. If you or someone close to you suffers from depression, it is important to educate yourself about it and seek treatment from qualified mental health professionals.

There are three basic ways to treat depression: psychotherapy, self-help, and medication. Many people respond best to a combination of two or more methods.

1. Psychotherapy: Exploring one’s beliefs and ways of thinking, and learning new ways of thinking and behaving, with the guidance of a professional.
2. Self-help: Exploring one’s beliefs and ways of thinking on one’s own.
3. Medication: Altering one’s brain chemistry by taking antidepressant medication.

A physician may recommend medication when four conditions exist:

1. The patient’s depression is severe.
2. The patient has suffered at least two previous depressive episodes.
3. There is a family history of depression.
4. The patient asks for medication only and refuses psychotherapy.

There are four types of antidepressant medication available today:

• Tricyclic antidepressants (TCAs)
• Monoamine oxidase inhibitors (MAOIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Structurally unrelated compounds

The TCAs and MAOIs have been used for decades. The SSRIs (such as Prozac) and structurally unrelated compounds are newer and are being prescribed more and more frequently. They have fewer and less pronounced side effects than the TCAs and MAOIs.

Treatment without Medicine

Teen Girls Can Be Susceptible to Depression

One of the leading methods for treating depression is cognitive therapy. Cognitive therapists help depressed clients feel better by identifying how faulty ways of thinking are making him or her feel bad. The client analyzes his or her thoughts and beliefs, and learns to substitute more healthy ways of thinking and believing.

Many mental health professionals believe that the ideal treatment of clinical depression is medication in conjunction with psychotherapy.

Prevention of Depression

Depression can often be prevented. It is especially important to take preventive action if you are aware that you have predisposing factors such as those mentioned in Part I of this series on depression.

1. Identify your risk factors and be aware of where you are vulnerable. Each of us has unique risk factors, such as things we were taught in our families of origin, values we have learned, and the presence or absence of a family history of depression. Anything that has been learned can be unlearned and replaced with something healthier.
2. Learn to manage stress. You can learn proven techniques for calming and relaxing yourself. Consider taking a stress management class or buying a set of relaxation tapes.
3. Learn problem-solving skills. Many people who develop depression never learned problem-solving skills. They need to develop the ability to see problems from many viewpoints and to look for a variety of solutions.
4. Build your life around things you can control. Learn to recognize what you can control and what you can’t. Avoid spending much effort on situations that won’t pay off for you.
5. Learn self-acceptance. Instead of rejecting the parts of yourself you don’t like, learn to manage them more productively.
6. Become aware of selective perception. Observe how you generate ideas and opinions about people and events. Remember that these are just your views, not necessarily objective facts.
7. Focus on the future, not the past. Depressed people tend to be focused on the past. People who set goals and focus on the future tend to be more positive about life.
8. Develop a sense of purpose. Many depressed people lack a sense of purpose or meaning. This means they have no goals and nothing in the future drawing them forward. To prevent depression, develop your sense of purpose and meaning.
9. Strengthen your emotional boundaries and set limits. Boundaries define your role in a social situation. They determine how you will or won’t behave in a given situation. Having clear, strong boundaries is empowering, while boundary violations make you feel victimized and helpless. Setting limits means having and enforcing rules for the behaviors you expect in a relationship.
10. Build positive and healthy relationships. Think about what you need from others in relationships. Learn to read people and trust your instincts about which people are good for you.
11. Avoid isolation. Talk to others about what’s going on with you. If you keep your thoughts to yourself, you may be unaware that your thoughts are distorted. If you share them with another person, you can become more objective.

Signs That Professional Therapy Is Needed:

1. Thinking about death or suicide. This is always dangerous and you should see a professional therapist immediately.
2. When symptoms of depression continue for a long time, you may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.
3. Your ability to function is impaired by your depression. Seek help before your life situation deteriorates to a serious level.
4. You have become so isolated that you have no one with whom to test reality. Seek someone out to share your thoughts and feelings with.
5. Depressive symptoms have become severe.

Suggested Reading

David D. Burns, M.D., Feeling Good: The New Mood Therapy. New York, Avon Books, 1980.
Michael Yapko, Ph.D., Breaking the Patterns of Depression. New York, Doubleday, 1997.

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Angie Woodward is a Registered Nurse in Wyoming and is the founder and owner/director of Trinity Teen Solutions, Inc. TTS is a licensed Christian Boarding School for at risk teen girls and their families.  Call 307-645-3384 for a free consultation.

        

Angie Woodward, RN-Director and Owner of Trinity Teen

Depression is a serious illness, not a harmless part of life. It is a complex disorder with a variety of causes. It is never caused by just one thing. It may be the result of a mix of factors, including genetic, chemical, physical, and sociological. It is also influenced by behavior patterns learned in the family and by cognitive distortions.

Depression affects millions of people in this country. It is always troubling, and for some people it can be disabling. Depression is more than just sadness or “the blues.” It can have an impact on nearly every aspect of a person’s life. People who suffer from depression may experience despair and worthlessness, and this can have an enormous impact on both personal and professional relationships. In this newsletter, I will describe many of the factors that may cause depression, and I will explore strategies for preventing it.

Depression Is Pervasive

When a person suffers from depression, it can affect every part of his or her life, including one’s physical body, one’s behavior, thought processes, mood, ability to relate to others, and general lifestyle.

People who are diagnosed with clinical depression have a combination of symptoms from the following list:

• Feelings of hopelessness, even when there is reason to be hopeful


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• Fatigue or low energy
• Much less interest or pleasure in most regular activities
• Low self-esteem
• Feeling worthless
• Excessive or inappropriate guilt
• Lessened ability to think or concentrate
• Indecisiveness
• Thinking distorted thoughts; having an unrealistic view of life
• Weight loss or gain without dieting
• Change in appetite
• Change in sleeping patterns
• Recurrent thoughts of death
• Suicidal thoughts
• A specific plan for committing suicide
• A suicide attempt
• Feelings of restlessness or being slowed down

When a person is suffering from depression, these symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. This means that the person’s family and social relationships, as well as work life, are impaired.
When a person is suffering from depression, symptoms such as these are not the result of a chronic psychotic disorder, substance abuse, general medical condition, or bereavement.

Grief, Sadness, and Depression

Depression may include feelings of sadness, but it is not the same as sadness. Depression lasts much longer than sadness. While depression involves a loss of self-esteem, grief, disappointment and sadness do not. People who are depressed function less productively. People who are sad or disappointed continue to function.

Depression and Socioeconomic Factors

Depression does not seem to be related to ethnicity, education, income, or marital status. It strikes slightly more women than men. Some researchers believe that depression strikes more often in women who have a history of emotional and sexual abuse, economic deprivation, or are dependent on others. There seems to be a genetic link; depression is more common among parents, children, and siblings of people who are diagnosed with depression. The average age at the onset of a depressive episode is the mid-20s. People born more recently are being diagnosed at a younger age.

Physical Causes

Many physicians believe that depression results from a chemical imbalance in the brain. They often prescribe antidepressant medication, and many people find relief as a result. However, there is no reliable test to identify such a chemical imbalance. It is unknown whether life experiences cause mood changes, which create changes in brain chemistry, or whether it works in reverse.
Depression may be associated with physical events such as other diseases, physical trauma, and hormonal changes. A person who is depressed should always have a physical examination as part of the assessment process to determine the role of physical causes.

Signs That Professional Treatment Is Needed

If you or someone you know is depressed and exhibits any of the following signs, it is extremely important to seek the assistance of a medical or mental health professional.

1. Thinking about death or suicide. This is always dangerous and you should see a professional therapist immediately.
2. When symptoms of depression continue for a long time, you may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.
3. Your ability to function is impaired by your depression. Seek help before your life situation deteriorates to a serious level.
4. You have become so isolated that you have no one with whom to check reality. Seek out someone to share your thoughts and feelings with.
5. Depressive symptoms have become severe.

In part 2 of this series, I will discuss the treatment and prevention of depression.

Suggested Reading
David D. Burns, M.D., Feeling Good: The New Mood Therapy. New York, Avon Books, 1980.

The American Psychiatric Association, Diagnostic and Statistical Manual, 4th Edition. Washington, D.C., The American Psychiatric Association, 1994.

Michael Yapko, Ph.D., Breaking the Patterns of Depression. New York, Doubleday, 1997.

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Angie Woodward is a Registered Nurse in Wyoming and is the founder and owner/director of Trinity Teen Solutions, Inc. TTS is a licensed Christian Residential Treatment center for at risk teen girls and their families.  Call 307-645-3384 for a free consultation t