Dr. Nicki

It is quite common to experience sleeplessness every once-in-a-while, but insomnia is a condition that occurs when you have trouble sleeping on a regular basis. If you have trouble falling and/or staying asleep almost every night then it is probably time to see a psychiatrist. Chronic insomnia can be a sign of another condition such as anxiety disorders, manic depression and clinical depression so it is important to seek help as soon as possible.

A psychiatrist may suggest the following natural remedies to help you sleep more soundly:

Melatonin

Melatonin is a natural remedy that is used to help people fall asleep when their sleep/wake cycle has been interrupted (such as: people who work night shifts and those who experience jet lag). Your body naturally produces melatonin, a hormone. In other words, at night, when light exposure declines, your body converts serotonin into melatonin. Melatonin, in supplement form, is usually taken approximately 30 minutes before bedtime to help you sleep more soundly.

Some medical professionals (physicians and psychiatrists) caution against melatonin if you suffer from schizophrenia, depression and/or autoimmune disorders because it can interact with prescription medications used to treat those conditions. In addition, you should also avoid melatonin if you are pregnant or nursing.

Relaxation Techniques

Your psychiatrist may recommend you partake in relaxation techniques to help you sleep. Relaxation techniques can help you sleep more soundly, fall asleep more quickly, stay asleep throughout the night and feel rested in the morning. In order for relaxation techniques to be the most effective in preventing insomnia, you should practice then at least 20 minutes before you go to bed.

The following relaxation techniques may help prevent insomnia:

·       Visualization – This relaxation technique consists of imagining a relaxing and/or calming scene. Practice visualization as you lie in bed. Make sure to use all of your senses. For example, if you imagine that you are walking on a sandy beach, try to feel the ocean breeze and the sand beneath your feet, listen to the ocean waves crash against each other, taste the salt water on your lips and smell the ocean water. The more graphic the image, the more likely it will relax you and help you sleep.

·       Mindfulness – This relaxation technique involves mediation. Mindfulness focuses on centering your mind so that it connects with your body. When you are mindful, you reframe from getting caught up on feelings and emotions that prevent you from living a calm existence. Mindfulness can relax you and help you disconnect from negative emotions like stress, anger, frustration, etc. so that you get a good night’s sleep.

·       Yoga – This is popular relaxation technique combines deep breathing exercises with stretching and mediation. Practicing yoga for 6 weeks straight can actually improve your ability to fall asleep and stay asleep.

Light Exposure

Your psychiatrist may also recommend that you add a light sunshine into your day. If you have a hard time falling asleep at night, you may not be getting enough light during the day. Light exposure plays a significant role in how your body functions. In fact, the amount of light you receive each day alerts your body as to when it is time to go to sleep and wake up. Taking a brisk morning walk each day or taking several 5 minute walks throughout the day may help regulate your wake/sleep cycle.

Valerian

Valerian is a popular herb that has been used to prevent and/or treat insomnia for centuries. It is unknown exactly how it works in your body, but it appears to work like traditional sleeping pills. In other words, this herbal sleeping aid may work by regulating your moods so that you feel calmer and sleep better at night. Unlike prescription sleep aids, valerian does not appear to be addictive. It also does not appear to cause drowsiness upon waking.

It is important to note that this herb is not effective for everyone and even though studies have been supportive, the final verdict on this alternative treatment is still uncertain. For maximum effectiveness, you should take valerian approximately one hour before bed.

Valerian takes several weeks to become fully effective. In addition, you should not take it more than twelve weeks at a time. You may experience some of these common side-effects when you first start taking valerian: dizziness, hot flashes, indigestion, palpitations and/or mild headaches. This herb is offered in capsules, liquid extracts and teas.

Valerian should not be mixed with other medications without doctor’s authorization. This is especially true for medications like antihistamines and sedatives because they slow your nervous system. Furthermore, you should not take this alternative medication if you are scheduled to have surgery and/or if you suffer from liver disease.

Music

Your psychiatrist may suggest that you listen to music to calm your nerves and help you sleep. Slow, soothing music is a natural way to improve your sleep without the use of prescription sleep aids. In fact, music not only improves the quality of your sleep and prevents you from waking prematurely, it also helps you sleep throughout the night and helps you awaken refreshed and rested.

Antihistamines

Child psychiatrists are medical doctors who treat children and adolescents with mental health issues. A child psychiatrist begins his/her career as a general or family physician, but these medical professional go to school for a longer amount of time in order to specialize in pediatric mental health. A child psychiatrist attends school for approximately 10 years following high school. It is important not to confuse a psychologist with a psychiatrist. Although a child psychologist is considered a “doctor,” he/she holds a doctor of philosophy (PhD), while a child psychiatrist holds a medical degree (MD).

In addition, a child psychologist attends graduate school, while a child psychiatrist attends medical school.  Furthermore, a child psychologist focuses on therapeutic services and therefore cannot prescribe medications unlike a child psychiatrist, who can write any prescription a pediatrician can. There is also a difference between your child’s pediatrician and a child psychiatrist. A pediatrician’s job is not only to attend to your child’s bumps, cuts, scrapes, colds, flu, and simple illnesses, but also to know when it is time to refer your child to a specialist.

Sometimes children, like adults, benefit from mental health services (therapy and/or medications). You may notice changes in your child that prompt you to take him/her to his pediatrician for care. Once you arrive at the appointment, your pediatrician may assess your child’s behaviors, emotions, physical abilities and psychological status to try to determine what is causing the changes.

Your child’s pediatrician may also pay close attention to medical, genetic, educational, social, developmental and/or family factors that could be causing a change in your child’s demeanor, attitudes, moods and/or behaviors. If your child’s pediatrician feels that your child needs further examination, he/she will refer your child to a psychiatrist for additional examinations and assessments.

Your child’s pediatrician may also refer your child to a child psychiatrist, if he/she has already been diagnosed with a mental illness and/or psychological disorder like developmental disorders, mood disorders, anxiety disorders, behavior disorders, adjustment disorders and/or attention deficit disorders. It is the responsibility of your pediatrician to refer your child to a child psychiatrist if he/she suspects that your child needs more advanced services and he/she does not feel properly equipped to treat the condition.

Once your pediatrician refers your child to a child psychiatrist, he/she will continue to work with you and your child’s psychiatrist to provide the best care for your child. In addition, in some cases, depending on the diagnosis, your child’s pediatrician may be able to manage his/her condition, with consultations with his/her psychiatrist, but this typically only occurs after your child has been seeing a psychiatrist for a long time and is considered stable.

Other reasons why your child’s pediatrician may recommend that your child see a child psychiatrist include:

·       When your child’s pediatrician believes that your child may need psychotropic medications (anti-depression medications, anti-anxiety medications, mood stabilizers, etc.).

·       If your child frequently sees his/her pediatrician, but does not appear to be getting better and/or worsens.

·       If your child has tried two or more psychotropic medications and they do not appear to be working.

·       If you disagree with the pediatrician’s treatment plan.

It is important to note that a referral from a pediatrician to see a child psychiatrist does not automatically mean something is wrong with your child; rather this is a way for your child’s pediatrician to be pro-active and put your child’s health first. In other words, it is best to be safe than sorry. It is also does not mean that your child’s pediatrician is not a good doctor for your child’s medical needs.

A child psychiatrist sees children with emotional issues, psychological disorders, adjustment disorders, mental illnesses, all day long, every day, while your child’s pediatrician does not. The main function of your child’s pediatrician is to diagnose and treat medical conditions and refer patients to specialist when need be. A child psychiatrist is a specialist who treats mental and psychological conditions.

The main goal of your child’s pediatrician is to assist you and your child by referring him/her to the right person to help with his/her condition and to work with your child’s psychiatrist when evaluating and treating your child’s mental, emotional and/or behavioral issues. Once your child begins to see a child psychiatrist, your pediatrician will work with him/her to help effectively manage your child’s condition.

If your child appears to be nervous about going to school, frequently skips school or simply refuses to go to school, then he/she may be suffering from school phobia, also known as school avoidance. A phobia is characterized as an intense and/or unrealistic fear of an object, person, situation, animal and/or idea. Undiagnosed and untreated phobias can lead to anxiety, panic attacks and/or depression. A school phobia typically begins during the ages of five and seven years old, but it can also arise earlier or later then this time frame.

It is not uncommon for teenagers to experience school phobia. If your child suffers from school phobia, you may first notice it after he/she has been absent from school for a lengthy time due to an illness (chickenpox, the flu, etc.) and/or after returning from a vacation.  It is important to understand that going to school may be traumatic for your child so it important to get him/her the help he/she needs a quickly as possible. 

Causes

The exact cause of school phobia varies depending on the child, but separation anxiety (the fear of being separated from a loved one, even for brief amount of time) may play a significant role in the development and progression of this condition. In other words, your child may develop school phobia because he/she is afraid of being away from you. In reverse, if your child sees how upset you are about being separated from him/her, he/she may develop school phobia. No child wants to see his/her parents distressed so he/she may develop a fear of going to school because he/she does not want you to be upset.

Other possible causes of school phobia include:

Illnesses and Medical Conditions

Accidents and Injuries

Family-Related Deaths

Divorce

A New Baby

A Blended Family

Moving (Schools, Homes and/or Locations)

Criticism and Ridicule from Peers

Fear of Authority Figures (Teachers, Principals, Coaches, etc.)

Fear of Gym Class (Undressing and/or Showering in Front of Peers)

Warning Signs

If you child suffers from school phobia, he/she may cry uncontrollably when it is time to go to school. In fact, you may find it almost impossible to get your child out of bed, ready for school and on the bus. If you try to force him/her to go to school, he/she may sneak out of school or run away until school has competed for the day. Moreover, your child may complain of dizziness, headaches, stomachaches, body aches, heart palpitations, nausea, diarrhea, shakiness and vomiting when it is time to go to school.

School phobia is a real condition that can interfere with your child’s daily functioning. In addition, you may notice that your child becomes despondent and/or angry when it is time to go to school. He/she may isolate himself/herself from peers and have trouble focusing at school. Furthermore, it can also lead to depression, social isolation and anxiety later in life.

Other warning signs that your child suffers from school phobia:

Excessive Tardiness

Frequently Absences

Early Morning Psychosomatic Illnesses

Constant Peer-Related and/or Teacher-Related Complaints

School-Related Crying and/or Tantrums

Unrealistic Reasons For Wanting To Miss School

Treatments

A school phobia is typically treated with a combination of medication and counseling.

The following medications can help your child manage this condition:

Anti-Anxiety Medications: Anti-anxiety medications may help reduce your child’s school-related nervousness, anxiety and fear.

Anti-Depressants: It is common for children with school phobia to experience depression. Anti-depressants can reduce your child’s depression symptoms.

Mood Stabilizers: If your child has a school phobia, he/she may be happy one moment and depressed and/or angry the next. Mood stabilizers can regulate your child’s moods.

Psycho-stimulants: If your child’s school phobia causes him/her to experience inattention and/or unexplained fatigue, psycho-stimulants can improve your child’s energy and help him/her focus while at school.

Sedatives: Irregular sleep patterns can trigger a school phobia, in some children. Sedatives can be used at night to calm your child and help him/her sleep better.

The following psychotherapies can help your child manage this condition:

Family Therapy: A family therapist can help your child work through his/her school phobia. During a family therapy session, a mental health professional (counselor, social worker, therapist, psychiatrist or psychologist helps you, your child and your family understand what is causing the school phobia. He/she also teaches you how recognize the signs and how to effectively manage your child’s condition.

Group Therapy: During group therapy, your child attends counseling sessions with other children who have a school phobia. During these therapy sessions, a mental health professional helps your child, along with others in the group, come up with effective ways to cope with their fear of going to school.

Individual Therapy: Your child may also benefit from individual therapy sessions. During individual therapy, your child attends one-on-one counseling sessions with a mental health professional. The therapist, social worker, psychiatrist, counselor or psychologist teaches your child how to handle his/her school phobia so that he/she can excel at school.

I can help. Call me at 732-262-8255.

If your child deliberately injures himself/herself by cutting his/her body with a sharp object (box cutter, knife, etc.), he/she is participating in self-mutilation. When he/she cuts deep enough to bleed he/she is suffering from a type of self-mutilation called “cutting.” Cutting behaviors typically begin during the teenage years, but can arise during early childhood or late adolescence.

In some cases, cutting behaviors persist into early adulthood. If your child is self-mutilating, he/she may cut himself/herself on the arms, wrists, legs and/or lower abdomen. Some children may take it a step further and burn themselves with cigarettes, cigarette lighters and/or matches. When the cuts and/or burns heal, they often leave “battle scars” and/or marks. You may not notice your child’s cuts at first because he/she will more than likely hide the scars and/or marks from you.

Why Do Adolescents Self-Mutilate?

The reason why adolescents self-mutilate varies depending on the child. In some cases, it may be hard to understand why your child is cutting himself/herself. Your child may start cutting as a way to cope with conflicting emotions, peer pressure, a romantic break-up, frustration and/or hormones. He/she may cut as a way to release pressure and distract himself/herself from the emotional pain. Moreover, your adolescent may be experiencing a situation that he/she does not know how to resolve. He/she may be so overwhelmed that the only way he/she can get relief from the situation is to cut.

It is important to understand, that your adolescent may not know any other way to get relief from his/her emotional pain and/or conflicting feelings. Cutting may be your child’s way of coping with feelings of sorrow, sadness, rage, abandonment, rejection, hopelessness, emptiness and/or loneliness.  Your child’s urge to self-mutilate may be triggered by the inability to express how he/she really feels (scared, angry, shame, hurt, etc.) for fear of criticism, rejection and/or ridicule.

In addition, your child may cut because he/she does not feel that he/she fits in with peers, with your family or with others in the world. He/she may feel like no one cares or understands him/her or he/she may cut as a way to deal with the death of a loved one, pet or friend. In your child’s mind cutting is the only way he/she can express himself/herself and gain relief from what distresses him/her. 

What Triggers Cutting?

Cutting typically starts with an impulse. It is important to note that your child does not think about cutting himself/herself in advance, rather something happens to trigger that reaction. If your child has a psychological disorder or mental illness, emotional stress, pressure and/or anguish can trigger and/or worsen cutting behaviors.

Moreover, cutting is often linked to clinical depression, manic depression, eating disorders (anorexia, bulimia and binging), obsessive compulsive disorder, impulsivity, behavioral problems and anxiety disorders. Drug and alcohol abuse and/or addictions may also cause adolescents to cut themselves.

Furthermore, your adolescent may begin cutting as a way to deal with a traumatic experience like child abuse, child neglect, abandonment, divorce, a new baby, domestic violence and/or a natural disaster. Your child may view cutting as a way to “feel” again. In your adolescent’s mind the pain from the cutting takes away the emotional pain and physical numbness.

How Can I Get My Child To Stop Cutting?

Tell Someone: It is important for you to encourage your adolescent to tell someone when he/she gets the urge to cut. The first step, talking about the cutting, is the hardest part of the recovery process, but once your child opens up and tells someone how he/she feels, he/she will more than likely experience a sense of calmness and relief. Make sure your adolescent knows that he/she can talk to you about anything.

If your child is not ready to talk to you about his/her feelings, encourage him/her to talk to someone he/she trusts and feels comfortable with such as: a school counselor, coach, teacher, doctor, nurse, relative and/or friend. If your child has trouble verbalizing his/her feelings and/or expressing himself/herself, ask him/her to write down how he/she she feels in a journal or note. 

Identify Triggers: Your adolescent is probably cutting himself/herself as a way to cope with tension, conflicting feelings, emotional distress, anger, frustration and/or anxiety. The first thing you want to do is figure out why your adolescent feels the need to self-mutilate. What is going on with him/her? Is he/she anger, frustrated and/or confused? Does he/she feel pressure to change to fit in with peers? What is happening in his/her relationships? Is he/she having trouble with friends? Is he/she being bullied at school?

One of the hardest parts of understanding cutting behaviors is identifying the real triggers. A mental health professional can help your child figure out his/her cutting-related triggers.

Ask For Help: It is important that you encourage your adolescent to ask for help when he/she feels the urge to self-mutilate.Explain to your child that if he/she asks for help and that person does not help him/her, ask someone else. Sometimes adults dismiss adolescent problems by referring to their issues as a “just a phase.”

If you believe that your child is self-mutilating it is imperative that you encourage him/her to talk to a school counselor, psychiatrist, psychologist social worker or nurse immediately. If you believe that your child need needs more advanced care for the self-mutilation, you should contact a mental health professional for a child consultation.   

 I offer help at 732-383-6255. 

A critical milestone in your adolescent’s life is entering high school. High school is a time when your child is learning how to assert his/her independence, make decisions and form strong relationships with peers. However, it is also a time when your child has to adapt to a “new world” or at least a “new school environment.” It can be quite challenging for your adolescent to have to adjust to a new school system, make new friends, learn new rules and adapt to a more adult world.

Another significant milestone in your child’s life is the transition from high school to college. Transitioning from the protective environment of high school to the independent environment of college can also be a harrowing experience for your child. When your teenager enters college, he/she has to adapt his/her lifestyle and daily habits to fit the new environment he/she has entered.

Although, this is a new and exciting experience, it can also be anxiety-provoking for teenager. It is important that you make the transition from middle school to high school and high school to college as easy and stress-free as possible. Thankfully there are a variety of things you can do to help your child successfully enter into high school and later college.

Middle School to High School

You can help your middle school child successfully transition to high school by providing guidance and suggestions in the following areas:

Parental Assistance

Your middle school child may be eager to choose his/her high school classes and learn new things, but in some cases, your adolescent may not get the help he/she needs to pick the classes that will benefit him/her throughout high school. This can be confusing, upsetting and stressful for your child. You can help your adolescent peacefully transition to high school by attending a high school orientation with him/her. During orientation your adolescent learns about the new school rules (attendance policies), class choices, who to contact with questions, teachers, sample schedules, activities and expectations in an informative and non-stressful environment.

Friendships

Another way you can help your child transition from middle school to high is to encourage him/her to attend high school or age-appropriate social events. During the high school years, your adolescent’s main focus may lie with developing friendships and interacting with peers on a social level. In fact, your child may feel pressured to think, behave and/or look a certain way in order to fit in with his/her peers. Moreover, he/she may not know how to cope with these new expectations.

In addition, if your adolescent has difficulty fitting in at school, he/she may feel alone, which can lead to depression and anxiety. Friendships can provide your adolescent with confidence and sense of belonging, which will not only help ensure an easy transition, but also provide him/her with the support that he/she needs to navigate through the world of high school.

Mentors

You can aid in the transition process by connecting your teen with a mentor. Some schools offer a “peer-to-peer mentorship program,” in which high school students schedule social activities (meet-and-greets, dances, parties, etc.) for incoming freshman students. The older students act as a mentor for your freshman child by keeping in constant contact with him/her through emails, informal counseling sessions, causal activities and phone calls. The purpose of the “peer-to-peer mentorship program” is to provide support for your young teen and help him/her safely transition from middle school to high school.

High School to College

You can help your child transition to high school by providing helpful suggestions in the following areas:

Roommates

You can help your teenager adjust to college by encouraging him/her to get along with his/her roommate. Suggest to your child ideas that he/she can use to develop a friendly relationship with his/her roommate. Some of these ideas may include: going out together once a week, grabbing a lunch together in-between classes, studying together, watching a show or movie together once a week and/or establishing “roommate guidelines.”

It is important to remember that sharing a room with a complete stranger or even a close friend is new to your teenager. Stress to your teen that with an optimistic attitude and a little effort, he/she can have a positive college experience.

Homesickness

Although your teenager may lament the protective nature of living under your roof, he/she may secretly be afraid of leaving the safety of your nest for the “real world.” Once your teen actually moves into the dorm, he/she may experience some level of homesickness. Being away from you may be tough for your child, although he/she may not admit it.

The best way to help your teenager successfully transition to college is to discuss ways that he/she can cope with the new environment. Some positive ways that your teen can cope with homesickness is to email friends and loved ones on a regular basis, invite friends and family members to visit, join clubs and participate in college activities.

Money Management

You can make the transition between high school and college an easy one for your child by teaching him/her how to effectively budget his/her money. It is a proven fact that college students have a habit of accumulating large amounts of debt. You can reduce your teen’s stress, and help them develop lifelong money management skills by teaching him/her budgeting techniques like setting a weekly spending limit, looking for discount and/or using coupons when grocery shopping.  

For more info call me at 732-383-6255. 

As a parent, you are normally the first person to notice emotional and/or behavioral disturbances with your child. Although this can be quite unsettling, it is important that you talk to your child in a calm and gentle manner. Opening the door to communication can help your child express his/her feelings in a safe, secure and supportive environment.

It is true that it can be hard to decide if and when you should seek professional treatment for your child, but it is important that you contact a psychiatrist if you feel that he/she is experiencing severe and/or chronic distress.

What is a Child Psychiatrist?

A child psychiatrist is a licensed medical doctor that has successfully completed medical school and a clinical residency in general psychiatry and child psychiatry. As part of the residency requirements, a child psychiatrist must pass his/her state’s licensing and board certification examinations in his/her specialty area.

Once the child psychiatrist is licensed, he/she is given permission to counsel and prescribe medication to children (young children, adolescents and teenagers). He/she is also allowed to order lab tests and conduct diagnostic studies. Moreover, if a child is a danger to himself/herself and/or others, a child psychiatrist can admit him/her to the hospital for care.   

The following signs may signal that your child needs a psychiatric evaluation:

A significant decline in academic performance

Excessive fear and anxiety (refusal to go to school, participate in age-appropriate activities and/or go to sleep)

Recurrent complaints of aches and pains

Hyperactivity (the need to constantly move)

Constant “bad” dreams (nightmares or night terrors)

Unpredictable temper tantrums

Suicidal ideation

Promiscuity (sexualized behaviors)

Depression (chronic mood swings, a negative attitude, lack of appetite, insomnia and thoughts of suicide and death)

Alcohol and/or drug abuse/addiction

Self-destructive behaviors

Regular angry outbursts, rage episodes and/or aggressive behaviors

Hostility towards authority figures, burglaries, truancy and/or property damage

Why Should I Take My Child To a Child Psychiatrist?

There are a variety of reasons why you should take your child to see a child psychiatrist. For instance, if you suspect that your child is suffering from a psychological disorder such as: anxiety disorders, clinical depression, obsessive and compulsive disorder, eating disorders, manic depression, etc. a child psychiatrist can help your child effectively manage his/her condition. In addition, if your child is experiencing high levels of stress at home or at school, a child psychiatrist can help him/her resolve his/her issues and reduce tension.

Moreover, you may decide to take your child to a child psychiatrist because your child’s counselor, clinical social worker or child psychologist believes that medication will help your child better cope with his/her psychological disorder, elevated stress-levels, behavioral problems and/or emotional distress. A child psychiatrist can help improve your child’s life by helping him/her better cope with challenging, confusing and conflicting feelings.

What are Some Advantages to Taking My Child to See a Child Psychiatrist?

Your child’s emotional distress is real. Even though you may be unsure whether or not your child is just “acting out” and “seeking attention” or really experiencing psychological distress, it is important to consult a child psychiatrist if you notice a significant change in his/her moods, attitude and/or behaviors. There may be a chemical imbalance in your child’s brain that needs to be corrected. If that is the case, a combination of medication and psychotherapy can improve your child’s quality of life.  

It is important to understand that there is no shame in taking your child to see a child psychiatrist. A child psychiatrist is trained to treat issues that affect a child’s thought process and/or mental health. Most mental illnesses can be successfully treated with therapy and medication.

Although your child may avoid seeing a psychiatrist because of his/her fear of the psychiatric ward, it is important to make your child understand that most psychological disorders and emotional issues are successfully treated in an outpatient basis. Children are only admitted to the hospital when they are a danger to themselves and/or others.  

It is true that psychiatrists can prescribe a variety of psychotropic medications (such as: anti-anxiety and anti-depression medications), but it is also true that many times these medicines can regulate your child’s moods, improve his/her behaviors and reduce stress. Your child may experience mild side-effects at the beginning, but over time they will diminish and your child will feel a whole lot better.

Your child’s medical records are confidential. Your child’s private information will not be shared with the public. You decide who knows your child’s medical history.

A child psychiatrist can really help your child have a happy and productive life. He/she can help your child recognize triggers, manage psychological disorders, resolve issues and effectively cope with life’s stresses. Moreover, a psychiatrist can offer your child a variety of medications that can help correct chemical imbalances in the brain, control moods, change negative and/or destructive behaviors and improve self-awareness.

It is true that psychiatrists are often selective when it comes to the health insurance plans that they accept. In fact, a psychiatrist may decide that he/she does not want to accept any health insurance plans. This selectivity not only allows them to control how much they will charge for services, it also gives them an opportunity to develop and adhere to their own clinical and billing standards.

Although most health insurances, like the preferred provider organization (PPO) plan offer some payment for out-of-network services, others, like the health maintenance organization (HMO) plan neglects to pay for any out-of-network services.

It is important to understand that an out-of-network psychiatrist is one that has not entered into a reimbursement agreement with your insurance. Payment is typically reimbursed at a negotiated rate. Health insurance plans like HMOs typically will not reimburse out-of-network psychiatrists. In other words, you, as the patient, are responsible for all charges associated with your office visits, counseling sessions, psychiatric evaluations and diagnostic tests.

Moreover, if you choose to see an out-of-network psychiatrist, the amount you are required to pay, as a patient, will be higher than it you were seeing an in-network provider. Although it may cost you more out-of-pocket money to see an out-of-network psychiatrist, there may be times when it is better for you to see an out-of-network psychiatrist rather than an in-network provider.

Reasons for seeing an out-of-network psychiatrist include:

Emergencies

There may be times when you experience such severe emotional distress and/or psychological turmoil that emergency psychiatric care is required. During these times, you may have to see an out-of-network psychiatrist because you are unable to see your regular provider.

Thankfully most plans do cover some out-of-network services, especially if they consist of severe mental illness (clinical depression, panic attacks, eating disorders, etc.) and/or emergency situations (suicidal and/or homicidal ideations). It is important that either you or a loved one contact your primary care physician (PCP) and health insurance company as soon as possible (within 48 hours) if you  experience an emergency that requires out-of-network psychiatric care.

Location

If you live in a rural area where there aren’t any practicing psychiatrists, you may need to see an out-of-network provider.  Moreover, if you need a psychiatrist that specializes in a certain areas such as: child and adolescent, addiction, forensic, geriatric or adult psychiatry, you may need to seek treatment from a non-participating psychiatrist. 

In addition, you may need to seek medical care from an out-of-network psychiatrist if you experience emotional and/or psychological distress while away from home. For example, if you experience a panic attack or anxiety, while working away from home, visiting relatives and/or friends or vacationing with loved ones, you may need to seek medical care from a psychiatrist that is not in your health insurance network.

In these situations, there is a good chance that your health insurance company will accept the in-network services rates, but it is important to contact your health insurance company to see how location affects service rates.

Natural Disasters

Natural disasters such as hurricanes, floods, widespread fires and tornadoes can cause you to leave home in order to seek shelter. When this occurs you may be away from home for long periods of time. If you need to see a psychiatrist for your psychological condition and/or mental illness, you may have to seek treatment with a provider that is out-of-network. Moreover, if the federal government declares that your state is in “state of emergency,” you may be able to receive in-network benefits for the services you receive from a non-participating psychiatrist.

Specialized Care

If you have a chronic and/or severe mental illness such as: clinical depression, manic depression, anxiety, etc., and your health insurance plan does not include these types of mental illnesses, seeking treatment with an out-of-network psychiatrist may be required to maintain your mental health and psychological well-being.

Consistency

If you are seeing an in-network psychiatrist for depression, anxiety, etc. on a regular basis and he/she leaves the network, it may be in your best interest to continue seeing the same psychiatrist you started with, even if it means receiving services from an out-of-network provider.

It is important to note that you may be able to receive in-network service rates, even if it is only for a set number of visits or for a specific amount of time. Contact your health insurance company for more details on how you can receive in-network coverage when your psychiatrist leaves the network.

Advantages to Out-of-Network Psychiatric Care

There are many reasons who you should seek out-of-network care such as:

You are free to seek treatment from any psychiatrist, hospital and/or facility that you choose.

You do not have to obtain a referral from your PCP to see a psychiatrist.

You are not required to get health insurance pre-authorizations for psychiatric evaluations, diagnostic tests, counseling sessions or medications.

You do not have any geographic limitations, in regards to psychiatric services.

Most health insurance plans cover some out-of-network charges.

There may be times in your life when you experience problems that you cannot successfully resolve on your

own. A medically trained psychiatrist can teach you how to effectively manage your mental illness, emotional distress, psychological issues and/or self-destructive behaviors. A psychiatrist can treat your mental health by using a variety of techniques such as: diagnostic testing, psychotherapy and psychotropic medications. Psychiatrists can be found in a variety of locations such as hospitals, mental health facilities, nursing homes, research laboratories, educational institutions, social service agencies and/or private practices.

If you suffer from severe and/or chronic mental health problems like panic attacks, manic depression, generalized or specific anxiety, obsessive compulsive tendencies and/or eating disorders, then you may need to see a psychiatrist. Your psychiatrist will not only stabilize your moods and reduce self-destructive behaviors; he/she will also improve the quality of your life.

A psychiatrist can make a difference in your life if you suffer from one of the following conditions:

Generalized Anxiety Disorder (GAD)

Psychiatry is especially beneficial if you suffer from panic attacks and/or generalized anxiety disorder (GAD). If you have GAD, you may not be able to stop fretting over your past, current or future situation. Moreover, you may feel that life and/or events are beyond your control.  Your psychiatrist can provide you with the tools that you need to reduce your anxiety, manage your condition and resolve your issues.

Manic Depression

Manic depression, also known as bipolar disorder, typically consists of fluctuating moods. For instance, if you suffer from manic depression you may experience mania (excited, irritable and/or energized moods and/or behaviors) one minute and severe depression (suicidal ideation, despair and/or fatigue) the next. Your psychiatrist can reduce the severity and frequency of manic depression symptoms by prescribing medications, conducting psychotherapy sessions and teaching you the skills that you need to regulate your moods, reduce your symptoms and effectively manage your condition. Moreover, your psychiatrist is the only qualified mental health professional that can treat your manic depression symptoms with a combination of counseling and medication.

Eating Disorders

Eating disorders such as: bulimia, anorexia, body dysmorphic disorder and food addictions can wreak havoc on both your mental and physical well-beings. An eating disorder occurs when you experience a significant change in the amount of food you eat. For instance, if you are anorexic, you may restrict your food intake until you are severely underweight and/or malnourished and if you are bulimic; you may eat large portions of foods (binging) and then immediately expel those foods (purging) by vomiting, extreme dieting and/or over-exercising.

It is important to note that your psychiatrist can restore your mental and physical health with the use of diagnostic testing, counseling and medications. Moreover, if outpatient treatment is unsuccessful and/or you become a danger to yourself, you may be admitted to the hospital for proper care.

The following psychiatric approaches can improve the quality of your life:

Diagnostic Testing

During your visit, your psychiatrist will collect and document your medical history, administer a psychiatric exam and/or psychological assessments and/or order CAT scans so that he/she can accurately diagnose your condition.

Treatment Plans

You will see your therapist at least once a week (in some cases you may see your psychiatrist multiple times a week). During this time, you and your provider will develop a treatment program that best suits your needs and helps you achieve your goals. Your psychiatrist may administer a variety of psychological assessments and diagnostic tests an effort to accurately diagnose your condition. He/she may make a difference in your life by providing you the tools and medications needed to effectively manage your psychological issues.

Medication

Your psychiatrist can help you by prescribing medications that will reduce your symptoms and restore your mental health. He/she has been trained in the area of psychopharmacology (the study of psychotropic medications and their effects on mentally ill individuals) and may use his/her psychopharmacology knowledge to decide which medications are best for you.

Your psychiatrist may improve the quality of your life by treating your condition with ADHD (stimulant based) medications such as: Adderall, Ritalin and Dexedrine. These stimulants may help reduce your hyperactivity and impulsivity and increase your attention, focus and concentration.

Psychotherapy

Your psychiatrist can make a difference in your life by utilizing a psychotherapy approach to treat your emotional distress and/or mental illness. He/she will provide a safe, secure, supportive and confidential environment for you to work through your issues and learn new skills. For instance, if you have been diagnosed with post-traumatic stress disorder (PTSD), your psychiatrist will help you acknowledge, process and cope with your traumatic experiences.

Panic disorders are characterized as unexpected and frequent panic attacks (episodes of overwhelming fear) that can persist for a couple of minutes or more.  If you suffer from a panic disorder you may experience reoccurring panic attacks that prevents you from performing your daily routines such as: going to work, picking up your children at school and/or preparing meals.

You may hide your condition for fear of being stigmatized or shunned by those around you. Panic disorders can affect all areas of your life, from your relationships and self-esteem to your work performance. This condition typically arises during adolescences, but can occur later in life, for instance, during middle adulthood. Research suggests that panic disorders occur more frequently in women than men.

Signs and Symptoms

In some cases, your panic attacks may decrease or stop all together, without any other complications. You should not worry if you only have one or two panic attacks, however if you experience reoccurring panic attacks combined with behavioral changes and extreme anxiety, then you should seek counsel from a qualified mental health professional.  

You may be suffering from panic disorder if:

You suffer from chronic, recurrent panic attacks that are not associated with a specific event or circumstance.

You are worry excessively about having another panic attack

Your behavior has changed because of your frequent panic attacks. For instance, you may avoid driving because you typically have your panic attacks when you drive or you avoid social events because you tend to experience panic attacks at parties and/or social events.

It is important to note that while panic attacks may only last a few minutes, the emotional effects can persist throughout your life. For instance, a panic attack can trigger an intense fear of a certain situation. In addition, an untreated panic disorder can negatively affect your self-esteem and self-confidence, which can prevent you from having a normal life.

Panic disorder symptoms may include the following 

Defensive anxiety – If you suffer from defensive anxiety, you feel apprehensive and/or fearful because you are always afraid that you will have another panic attack. This type of anxiety can negatively affect your quality of life.

Phobia-Related Avoidance – If you suffer from phobia-related avoidance, you avoid certain environments because you are afraid that they will trigger reoccurring panic attacks. Moreover, you avoid certain situations, because you are afraid that you will not be able to get away if you need to, therefore triggering a panic attack

Cause

The exact causes of panic disorder are unknown at this time, but genetics appear to play a significant role in its development and progression. Other significant life changes and stressors such as: having a baby, getting married, getting divorced, experiencing a death in the family, starting a new job and/or graduating from school can also trigger repeated panic attacks and/or panic disorder. Furthermore, chronic medical conditions have also been known to trigger panic attacks and/or panic disorder

Treatments

The good news is that panic disorder is a treatable condition. Research suggests that a combination of psychotherapy and medication can help reduce or eliminate panic attacks, lower your risk of panic disorder and improve your quality of life

Psychotherapies that are beneficial for panic attacks and/or panic disorder include:

Cognitive Behavioral Therapy

Cognitive behavioral therapy is considered the most effective treatment for chronic panic attacks and panic disorders. This approach helps you understand how your thought processes and behaviors trigger your panic attacks. A cognitive behavioral therapist helps reduce your panic attacks by teaching you how to change how you perceive certain situations. In other words, your therapist teaches you how to identify your triggers and reframe the situation in a positive light so that you no longer feel apprehensive when coming in contact with challenging and/or stressful situations.

Exposure Therapy

Exposure therapy has also shown success when treating chronic panic attacks and panic disorder. During exposure therapy, you are repeatedly exposed to your panic-related triggers (in a safe and secure setting) with the hope that you will eventually become desensitized to them. The purpose of this approach is to teach you healthier ways to cope with difficult and challenging situations. Eventually, with repeated exposure to your triggers, you will become less sensitive to the situations and/or environments that evoke extreme fear in you. The main goal is to help you regain control of your emotions and, therefore reduce and/or eliminate your panic attacks.

Medication

Medications are often used in conjunction with psychotherapy. A variety of anti-anxiety medications, such as antidepressants and benzodiazepines, can help manage, reduce and/or eliminate symptoms associated with panic disorders.  It is important to note that medications alone cannot cure panic attacks and/or panic disorders, but they are beneficial in extreme cases of panic disorder.

References:

National Institute of Mental Health. (2012). Panic disorder: When       fear overwhelms. Retrieved from         http://www.nimh.nih.gov/health/publications/panic-        disorder-when-fear-overwhelms/introduction.shtml.

Most of time, as an athlete, you are at the top of your game, but when you start getting distracted with personal or psychological issues, it can interfere with your athletic performance. When you are no longer able to compete on a consistently high-level, it may be time for you to contact a sports psychiatrist.

A sports psychiatrist helps you identify the psychological stressors that are negatively impacting your athletic performance, assists you as your work through your problems and teaches you strategies to reduce your stress-level. The purpose of sports psychiatry is to help you clear your mind so that you can focus on the game.

A sports psychiatrist can help you unblock hidden memories and confront your fears so that you can focus on the game. During a sports psychiatry session, you are expected to participate in mental resilience and performance endurance trainings. The purpose of these trainings is to help you perform at an optimal level.

Your sports psychiatrist can help you effectively manage your relationship issues, work-related conflicts, phobias, attention deficit disorder (ADD), depression, adjustment disorders, anxiety, anger issues and substance abuse issues.

It is not uncommon for athletes, who are consistently winning, to behave aggressively outside of the game. If you feel like you are losing control of the situation or you experience depression, a change in mood and/or behavior that it is affecting your athletic performance, you should contact a sport psychiatrist as soon as possible.

How Can A Sports Psychiatrist Help Me?

The primary function of a sports psychiatrist is to help you effectively manage dysfunctional relationships, family conflicts, career-related problems, depression, psychotic disorders, anxiety, phobias, addictions and/or other life stressors. In other words, a sports psychiatrist works with you to improve your mental health and athletic performance.

It is important to note that stress and impaired mental health can interfere with your performance as an athlete. In severe cases, the stress associated with being considered a “superior” athlete can cause you to develop obsessive-compulsive rituals that must be performed several times before a game. For instance, if you have obsessive-compulsive disorder, you may fixate on a football maneuver and practice that maneuver with a teammate over and over until it makes both of you late for the game.

A sports psychiatrist can also help you identify, confront and work through aggressive behaviors, excessive gambling, infidelity and/or suicidal ideation. Research suggests that “top performing” athletes tend to exhibit higher levels of aggression and risky behaviors then non-athletes and “lower performing” athletes. 

What Does Sport Psychiatry Treatment Involve?

Sports psychiatrists utilize the systemic approach to treatment. In other words, sports psychiatrists explore how outside influences (agents, significant others, family, coaches and trainers) affect your athletic performance. In addition, a sports psychiatrist may concentrate psychological issues related to a particular sport such as: brain damage from boxing or marital arts, doping effects in the cycling world and/or spinal cord injuries stemming from football accidents.

Once a sports psychiatrist has identified your specific issue(s), he/she will help you set realistic goals. It is important to note that to effectively treat you, a sports psychiatrist must have extensive sports-related knowledge and experience. Treatment may consist of a combination of individual counseling, group therapy, marriage and family therapy, pharmacotherapy and/or support groups such as Alcoholics Anonymous.

References:

Begel, D. & Burton, R. W. (2000). Sport psychiatry: Theory and         practice. New York, NY: W. W. Norton & Company.

  Individual psychotherapy, also known as individual counseling consists of one-on-one therapeutic counseling. This counseling approach focuses on your childhood, past experiences and current problems. The main goals of individual psychotherapy are to help you understand why you feel and behave the way you do and help you successfully resolve your issues, concerns and problems. Individual psychotherapy also aids in self-growth and self-actualization.

What happens during an individual psychotherapy session?

This approach to therapy can take many shapes and be applied to a wide array of issues such as: depression, anxiety, phobias, personality disorders, adjustment issues, etc. During therapy, your psychotherapist may ask you to share your thoughts, feelings and beliefs in an effort to help you understand how your negative thought processes have influenced your behavior. In addition, one of the main goals of the individual psychotherapist is to provide a safe, secure and supportive environment for you to confront and work through your issues.

Individual psychotherapists can help you confront the obstacles that have been interfering with your mental health and preventing you from enjoying a healthy and fulfilling life. Contrary to popular belief, you may actually enjoy learning more about yourself, your relationships and the world around you. Individual psychotherapy encourages positive thoughts and behaviors so it is not uncommon to experience a newfound sense of peace, empathy, self-esteem, happiness, relief, love and spirituality during and following therapy. 

What psychological issues does an individual psychotherapist treat?

Individual psychotherapists treat wide variety of psychological disorders such as: attention deficit hyperactivity disorder (ADHD), depression (clinical and manic depression), personality disorders, eating disorders, substance abuse, psychosis, schizophrenia, anxiety disorders, etc. It is important to note that although individual psychotherapists primarily treat mental health issues, many people who seek treatment do not have a diagnosed mental illness and simply need help with adjustment issues such as divorce problems, stress management, relationship problems, blended family issues, work-related concerns and/or the grieving process.

An individual psychotherapist actively listens to your concerns, provides support, helps you work through your issues and teaches you the coping mechanisms and techniques that you need to reframe your thoughts and change your behaviors.

What type of education, training and experience does an individual psychotherapist need in order to treat people with psychological issues?

Although a number of mental health professionals (clinical psychologists, family psychologists, school psychologists, social workers, etc.) can provide individual psychotherapy to clients, an individual must be licensed and/or certified in psychotherapy in order to be classified as a psychotherapist. The requirements are determined by your state’s licensing board, but most of the time, psychotherapists must have an advanced degree in psychotherapy or a related-field. 

In some cases, master-level students may be able to counsel clients under the direct supervision of a licensed psychologist or advanced mental health professional. A licensed marriage and family therapist (M.M.F.T), social worker, psychologist, psychiatrist and/or professional counselor (LPC) may utilize individual psychotherapy techniques during their therapy sessions.

Your state’s educational board determines what is required to be a psychotherapist. Individual psychotherapists may be required to complete continuing education courses, take additional knowledge-based exams and/or complete a certain number clinical hours at an approved social service agency, clinic, hospital psychiatric hospital or mental illness treatment center before being licensed and/or allowed to treat individuals. Fortunately, most health insurance plans either partially or fully cover psychotherapy sessions.

References:

Corey, G. (2008). Theory and practice of counseling and           psychotherapy. Belmont,      CA: Thomson Brooks/Cole.

Approximately 20 million adults are diagnosed with a specific phobia each year (National Institute of Mental Health, 2013). The exact cause is unknown at this time, but genetics appear to the play a significant role in its development and progression. The complete list of specific phobias is boundless, but this article highlights the most common specific phobias that individual experience.

The most common specific phobias include:

·       Acrophobia

Acrophobia is an intense fear of heights. This specific phobia can cause panic attacks, breathing difficulties, accelerated blood pressure and heart rate, nausea, vomiting and/or dizziness. If you suffer from acrophobia, you may be afraid of high places such as: cliffs, mountains and/or the top floor of buildings. Acrophobia is sometimes mistaken for vertigo, can cause vertigo, a debilitating condition that causes dizziness and disorientation when peering down from a high place. Acrophobia and vertigo are two different conditions

·       Claustrophobia

Claustrophobia is an extreme fear of enclosed spaces. This condition can range, in severity, from mild to severe.  If you suffer from claustrophobia, you may experience a panic attack simply by walking through a hallway. You may also discover that your fear of enclosed spaces is triggered by certain situations such as: traveling in an airplane or riding in an automobile.

·       Arachnophobia

Arachnophobia is an intense fear of spiders. This is the most common specific animal phobia. If you suffer from arachnophobia, you may be deathly afraid of spiders and anything related to spiders such as cobwebs, spider props and/or photographs of spiders.

·       Ophidiophobia

Ophidiophobia is an extreme fear of snakes. This phobia revolves around snakes only. If you suffer from ophidiophobia, you may become ill (nausea, vomiting, tremors, chills, hysterical crying and generalized weakness) simply from looking at or thinking about snakes. You may also experience panic attacks when someone mentions snakes.

·       Nyctophobia

Nyctophobia is a severe fear of the dark. This phobia is most common in children who often move from place to place. If this condition persists long then 6 months and causes panic attacks and/or anxiety, six months and causes extreme anxiety, then it is important that you seek treatment for your child. It is important to note that this phobia is uncommon in adults.

·       Trypanophobia

Trypanophobia is an extreme fear of medical-related needles and injections. This condition is considered a medical specific phobia. If you suffer from this phobia, you may experience a decrease in blood pressure and faintness when providing a blood sample or when receiving a vaccination or shot. In severe cases, this phobia may prevent you from getting the medical care that you need.

·       Astraphobia

Astraphobia is an excessive fear of thunder and lightning. This phobia is common amongst small children, but if it persists longer than 6 months, you should seek treatment for your child. If you suffer from astraphobia, you may be able to ease your fear by seeking shelter in an enclosed space, sans windows, until the storm passes and you feel safe enough to emerge.

·       Nosophobia

Nosphobia is an irrational fear of having a disease. When you suffer from this phobia, you are terrified that you have a chronic or fatal disease. This phobia is related to the hypochondriasis, another condition that causes an unrealistic fear of an illness or disease. If you have either condition, you may constantly go to the doctor’s office because you think you are ill or you may avoid going to the doctor’s office for fear that your doctor confirm that you have a chronic or fatal illness or disease. In some cases, a medical student may start to believe that he/she has the symptoms that he/she is learning about in class and/or at their internship.

·       Germophobia

Germophobia is the unrealistic fear of germs. If you suffer from germophobia, you have an extreme fear of being contaminated by germs. This condition is related to obsessive–compulsive disorder (OCD), a psychological disorder that is characterized by obsessive thoughts and repetitive behaviors. The only difference between the two conditions is that OCD focuses on the act/behavior itself, while germophobia focuses on removing something that is causing the behavior, which in this case is germs.

·       Triskaidekaphobia

Triskaidekaphobia is an extreme fear of the number 13. If you suffer from this phobia, you are afraid of seeing or hearing the number 13. You may also be afraid to leave your home of the 13th day of the month and/or live or work on the 13th floor. Although many researchers do not believe that this condition is an actual phobia, many people experience phobia-related symptoms when coming in contact with the number 13.

References:

Bourne, E. J. (2011).The anxiety and phobia workbook (5th ed.).        Oakland, CA: New Harbinger Publications.  

National Institute of Mental Health. (2013). Specific phobias.         Retrieved from         http://www.nimh.nih.gov/health/publications/anxiety-        disorders/specific-phobias.shtml 

A poor economy, war, hurricanes, tornados and tsunamis, oil spills, family dysfunction and personal conflicts are only some of the reasons why you may feel stressed and overwhelmed.  Focusing on the bad things in your life can negatively affect your thought process, drag you down physically and emotionally and interfere with your quality of life. In addition, unhealthy and/or self-destructive thoughts can influence how you view your life and your future – resulting in psychological distress, anxiety and/or depression.

What is Mindfulness?

Mindfulness is a process that encourages you to take an in-depth look at yourself. This process promotes self-awareness and provides you with the tools that you need to reap both short-term and long-term rewards. Mindfulness teaches you how to look within yourself for the answers you seek, instead of turning to outside influences for those answers.

This process suggests that once you have gained a complete self-awareness then your inner confidence will shine through. This leads to interconnectedness between your inner self-awareness and your outer social self. Mindfulness not only helps you achieve self-awareness, it also helps you understand the world better so that you can reach your full potential in life.

How Can Mindfulness Strategies Help Me?

Mindfulness encourages you to focus on the present – not the past. It teaches you how to see things as they really are, not how they should be or how you want them to be. They also help you identify and understand how you really feel. This process teaches you how to be true to yourself, even if it means acknowledging that there are parts of yourself that need improvement. Mindfulness also teaches you how to process the situation before you respond to it. In other words, it teaches you how to respond to challenging or stressful situations in a healthy, positive way.

What Are Some Mindfulness Strategies?

·       Visualizing

A beneficial mindfulness strategy that can simulate your mind, awaken your imagination and motivate you to take the first step is visualizing

Take a minute to visualize your future by asking yourself these questions: Now that five years have passed - are you satisfied with your life? Have you accomplished your short-term and long-term goals? What parts of your life are you most happy about? What areas of your life need improvement 

Once you have a clear picture of how you see your life in five years, write your thoughts down and refer to them when you feel overwhelmed, stressed, unsatisfied and/or out-of-control.

·       Taking Several Deep Breaths

Taking several deep breaths is an effective mindfulness strategy that can help reduce your stress level, loosen your tight muscles, increase your self-awareness and help you focus. Go to a quiet room and take several deep breaths. Make sure that you breathe from your diaphragm instead of your upper chest and try to inhale through your nose and exhale through your mouth. For this exercise to work, you must block out distractions and focus solely on your breathing. This mindfulness strategy is especially beneficial if you are upset, angry or stressed.

·       Turning on the Radio

Turning on the radio and listening to music is another mindfulness strategy that has shown promise. In fact, music therapy has proven effective in treating people with a variety of psychological and physical conditions.  Classical, instrumental, soft jazz and slow-tempo songs can calm your nerves when you are under pressure, upset, anxious and/or angry.

Turn the radio or your mp3 player on something that relaxes you (not something depressing or jarring) and focus on the notes, lyrics and beats. Let the music consume you and allow yourself to experience the emotions that arise in you while you listen to the songs. If you start to get distracted, refocus your attention or change the song and start all over again. 

·       Cleaning House

“Cleaning house” is another mindfulness strategy that has proven successful in reducing stress and encouraging self-awareness. “Cleaning house” has two meanings when it comes to your life. It can refer to actually cleaning your house or it can refer to getting rid of emotional baggage (friends, family, associates, jobs or situations that are distracting or emotionally and/or physically draining).

Removing unnecessary, negative and/or harmful distractions from your life can relieve your stress and help you focus on yourself and your future. Cleaning out the “clutter” in your life can break the emotional restraints that have been preventing you from reaching your full potential. Make a list of all of the “clutter” in your life and slowly remove them from your life.

References:

Goldstein, E. (2010). Mindfulness strategies for anxiety and         depression. Huff Post Healthy Living. Retrieved from

        http://www.huffingtonpost.com/elisha-goldstein-        phd/mindfulness-strategies-fo_b_631664.html.

Queen’s University. (2013). Mindfulness-based stress reduction.         Retrieved from

Medication management consists of monitoring your medication regimen to guarantee that you are taking the correct dosage of medication at the prescribed times. It also used to protect you from harmful drug interactions and dangerous side-effects. If you take multiple medications for various chronic illnesses, injuries, psychological disorders and/or diseases, it is important that you effectively manage your medication intake.

Medication management is extremely beneficial for older adults, who take a variety of medications for an array of psychological and medical conditions. Some hospitals, clinics, psychiatric hospitals, mental illness treatment centers, drug and alcohol treatment centers and nursing homes provide medication management services to those who need it. These services are beneficial if you have a lot of medications to take at various times of the day.

Medical Managers

Medication managers can help you effectively manage multiple drugs and prevent you from missing a dose, taking too much of a medication, and ingesting a drug that may interact with another drug that you are already taking. Medication managers organize and manage your medication regimen for you.

Medical managers are also responsible for keeping up-to-date with your new medications, informing you of any possible drug interactions and side-effects, answering any questions that you may have concerning your medications, ensuring that you are taking the proper dosage for you age and condition, discussing medication-related options and offering guidance and support.

Medical managers are responsible for the following tasks:

Keeping Track of Medications: An important part of medication management is accurately documenting your medications (prescribed, supplements and over-the-counter). Your medical manager writes down the dosages, frequency, possible side-effects and dangerous drug interactions. The documentation is then placed in your patient record.

Monitoring Medications: Medication management also consists of supervising your medications. You may need to take your medications at certain times of the day and if you miss a dose or you take too much, it can cause serious side-effects and complications. Medication managers remind you to take your medication at the correct times, place your medications in daily reminder containers and/or observe you as you take your daily medications. In some cases, medical devices can remind you to take your medications at the proper times.

Checking for Drug Interactions: Medication management also consists of checking for dangerous drug interactions and making sure that you are taking the correct medications for your condition(s). This may include reminding you when to take your medications with food, what foods or supplements must not be taken with your medications and what medications may cause drowsiness or impaired functioning. 

Keeping Detailed Patient Records: Another key component of medication management is keeping detailed patient records. A variety of integrated databases help manage your medications. Your doctor’s office records your medical history including your medications in their computer system, while your local pharmacy monitors your prescriptions and informs you of any possible drug interactions and/or side-effects. Your physician, pharmacist and medication manager work together to ensure that you will not be harmed by the medications.

Medication Management Appointments

Medication management appointments are typical brief (lasting between 15-30 minutes). During the appointment your physician asks you a variety of medication-related questions such as: What side-effects have you experienced? Do you think that the medication is working? How do you feel treatment is progressing? In addition, you may be asked to schedule follow-up blood tests to make sure that the medications are working properly within your body.

References:

Curry, W., Linney, B. J. & Curry, W. (2011). Essentials of medical    management (2nd ed.). Tampa, FL: American College of     Physician Executives.

Your perception of yourself can determine how well you feel and function. Your self-esteem is based on how you see yourself. For instance, do you think you are valuable and worthy? In other words, it is the extent in which you like and respect yourself. If you have a healthy self-esteem, you respect yourself and have feelings of self-worth and value. On the other hand, if you have a low self-esteem, you constantly doubt and criticize yourself. You may also suffer from anxiety, anger issues, aggressive behaviors, social isolation and embarrassment. 

Self-esteem typically develops during adolescence, but it can also develop during early childhood. Certain experiences and events can negatively affect your perception of yourself, thus leading to low self-esteem. For instance, if you are constantly degraded and criticized by a parental figure, you may start to believe that you have little to no self-worth or value. In addition, if you are bullied or picked on by classmates, you may develop low self-esteem because you feel like no one likes you.

Other factors that can affect your self-esteem include: being discriminated against because you are of a different race, culture, religion, weight, height, sexual orientation and/or economic class. You may also suffer from low self-esteem if you are made fun of because you have a chronic illness or disability. Thankfully, there are ways to improve your self-esteem. You are not alone and there is help for you. All you have to do is tell someone you trust how you feel.

·       Self-Esteem Issues

Challenges can cause a drop in self-esteem, even if you have a healthy self-esteem. Being fired or laid-off, divorcing, addictions (drugs, alcohol, gambling and/or food), financial difficulties, mental illnesses, chronic health conditions, debilitating disabilities, child-rearing problems, etc. can cause you to question your value and self-worth. Psychotherapy not only helps you process your situation clearly, it also teaches you how to improve your perception of yourself. A psychologist can help you understand the root of your low self-esteem, acknowledge your positive qualities, work through your issues and improve your sense of self-worth and value.

·       Psychotherapy and Self-Esteem

Although you have a high risk of developing low self-esteem, if you  have experienced child abuse, domestic violence, child neglect and/or addiction, you are also at risk if you are perfectionist, overachiever and/or extremely competitive. Perfectionists, overachievers and highly competitive individuals tend to feel that they must be “perfect” all of the time and therefore set unrealistic goals for themselves. When these individuals cannot accomplish these unattainable goals they blame themselves and view themselves as failures. Moreover, if you have recently lost a loved one, your job and/or acquired a new medical condition, you may experience a decline in your self-esteem. Many times, a low self-esteem stems from a loss of control over your life and situation.

A psychologist will not only help you identify the cause of your distress, he/she will also help you develop realistic goals that will make you feel inspired and in control of your life. For instance, if you are not satisfied with your job, a psychologist will work with you to develop a plan that helps you gain a new job or he/she will work with you to develop a plan that helps you advance at your current job. If you have low self-esteem as the result of a failed marriage, a psychologist will work with you to develop a plan that allows you to figure out who you are (as an individual) and what you want.

The most effective treatment for low self-esteem is goal-directed therapy. A goal-directed therapist may treat you individually by teaching you how to change your thought processes and behaviors or he/she may treat you in a group setting with a brief therapy approach. In addition, if you have recently acquired a medical condition, disability or illness, your therapist’s approach may include animals. Animal-assistance therapy has shown success in treating those who suffer from low self-esteem as a result of a chronic illness and/or disability. Animals do not recognize differences (medical conditions and physical impairments) and are associated with unconditional love, which can improve self-worth, self-value and self-esteem in some individuals.

References:

Schiraldi, G. R. (2001). The self-esteem workbook. Oakland, CA: New          Harbinger Publications.

It is normal to experience stress when confronted with difficult and/or challenging situations. Increasing demands at home and at work can alert your brain’s alarm system that something is wrong. When your brain’s alarm system is tripped, it causes your body to release cortisol and adrenaline, hormones that evoke a “fight or fight” reaction in your body. Once the threat has passed, your brain “turns off” its internal alarm system and your hormones decrease. Due to the continual stress of everyday living, your brain rarely “shuts off” its internal alarm system therefore you almost always have some level of cortisol and adrenaline in your body.

It is important to reduce your stress level and reset your brain’s alarm system. When your body is constantly on high alert it can cause a myriad of psychological and physical health problems such as: high blood pressure, headaches/migraines and/or depression. In addition, high levels of stress can damage your relationships, interfere with your work performance and/or negatively affect your quality of life. It is imperative that you effectively manage your stress levels. It is important to note that while stress will always be a part of your life, a variety of stress management techniques can help you gain control of your emotions, reduce your stress level and cope more effectively with life’s trials and tribulations.

·       Stress Relief Techniques

Make a Change

The first step you should take when trying to manage your stress levels is to make a change. Next, you will need to identify your stress-related triggers (relationship conflicts, work issues, financial problems, child-rearing challenges, medical concerns, etc.) and avoid them, remove yourself from the situation and/or learn ways to cope with them. It is important to note that positive experiences such as: a new marriage, baby and/or job can contribute to your stress levels. When you evaluate your stress-related triggers, take those factors into consideration as well. 

Breathe Deeply

A beneficial way to reduce and/or manage your stress is to breathe deeply. Deep breathing consists of taking deep breaths from your diaphragm (below your chest). This technique reduces stress by relaxing your muscles, clearing your mind and improving your focus. The next time you feel stressed, walk away from the situation, if possible, and take two or three deep breaths. If it does not work the first time, continue to take deep breaths until you feel calmer and more relaxed.

Meditate

Another stress management technique that has shown success when reducing tension is meditation. Meditating removes stress from your body by calming your mind, balancing your moods, regulating your blood pressure, revitalizing your body, strengthening your immune system, increasing your flexibility, endurance and stamina and preventing bodily damage caused by toxins, diseases and viruses. Meditating also improves oxygen flow to your organs (heart, lungs, kidneys, brain, etc.). When you feel overwhelmed, tense and/or anxious, go to a quiet, free-from-distractions location and sit in a comfortable position. Once you are relaxed, think of a pleasant sound, word or thought for ten to twenty minutes. If you cannot think of a sound, word or thought, focus on your breathing patterns. At first you may have trouble focusing, but with continued practice, it will become easier for you and therefore, more effective at reducing your stress levels.

Write in a Journal

Writing in a journal also known as journaling, is an effective way to manage your stress levels. Writing in a journal or keeping a diary can help you identify your stress-related triggers and explore past and present feelings, emotions and/or thoughts. Journaling helps reduce stress by aiding in self-awareness, self-reflection and self-exploration. It helps you express your feelings in a way that you cannot, for some reason, do in your everyday life. If you are in therapy, your psychologist may ask you to document stressful events and experiences in a journal or diary. You and your psychologist will discuss your entries at your next session.

Exercise

Exercising is a proven stress management technique.

Skating, jogging, working out at a gym, walking, swimming, martial arts, boxing and/or weight training can effectively boost your mood, release harmful toxins from your body, remove oxidative stress from your body, motivate you to be healthy and improve your mental, emotional and physical well-being. When you exercise, your body reduces its production of cortisol and adrenaline and increases its production of endorphins, therefore making you feel good and giving you a jolt of energy.

References

Jefferson, D. K. (2012). Stress relief today: Causes, effects, and          management techniques that can improve your life. Create Space          Independent Publishing Platform.

Mayo Clinic. (2013). Stress management. Retrieved from          http://www.mayoclinic.com/health/stress-management/MY00435.

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is a psychological condition that is characterized by uneasiness, excessive worry, anxiety, obsessions, compulsions and the need to eliminate the triggers that are causing your angst. Obsessions are described as troubling beliefs, feelings, images and/or impulses that cause unwanted anguish and do not subside on their own, while compulsions, also known as “rituals,” are the coping mechanisms that you use to ease your anxiety and reduce your obsessive impulses.

It is important to remember that compulsions only relieve your obsessions temporarily. In fact, compulsive behaviors can actually increase your risk of experiencing re-occurring obsessions and compulsions. In other words, your compulsive behaviors reinforce your obsessions in a positive feedback loop sequence.

What is Exposure & Response Prevention Therapy?

Exposure & response prevention therapy is a type of cognitive-behavioral therapy that is often used in the treatment of obsessive compulsive disorder (OCD). This type of therapy gradually exposes you to the source of your obsession and encourages you to refrain from the compulsive behavior associated with it. For instance: during exposure & response prevention therapy, your therapist may help you determine why you are obsessed with making sure the door is locked and encourage you not to check the door 15 times before you go to work.

The first thing you will do during therapy is confront your minor obsessions and compulsions. Once you have successfully worked through these issues, you will then advance to more challenging obsessions and compulsions. Research suggests that this approach to OCD treatment is highly beneficial for relieving OCD symptoms.  Exposure & response prevention therapy is typically combined with medication, family therapy and educational instruction.

How Can Exposure & Response Prevention Therapy Help You Manage OCD?

Exposure & response prevention therapy is considered the most effective OCD treatment because it not only helps you identify, understand and confront the triggers that are causing your obsessions; it also teaches you how to refrain from committing the compulsive behaviors associated with them. Response prevention is needed to help you stop the positive feedback loop sequence commonly associated with OCD. In order for this treatment approach to be successful, you must expose yourself to situations that trigger your obsessions and refrain from behaving compulsively in response to them.

During exposure & response prevention therapy, you will begin to notice a decrease in your OCD symptoms. This approach to OCD treatment consists of counseling sessions and outside homework, which is beneficial for helping you confront and conquer you OCD both in session and in the real world. As your anxiety decreases, your urge to perform compulsive behaviors will also decrease.

For instance: if you normally check the door 15 times before you leave for work, your therapist will be assign you outside homework (a weaning schedule), in which you only check the door 14 times for the first month, 13 times the next month and so on until you are only checking the door once before you leave for work. The purpose of exposure & response prevention therapy is to retrain your brain so that you no longer have obsessions and compulsions. This treatment approach teaches you how to trust your instincts and conquer your fears.

Once you finish exposure & response prevention therapy, your obsessions will decrease in frequency and strength because they will no longer be reinforced by your compulsive behaviors. In addition, when you expose yourself to the things you fear, your obsessions will weaken until you no longer experience anxiety when you are confronted with challenging situations. Furthermore, with time, practice and therapy, you will no longer be triggered by the same stimulus that you once were and you will be able to better manage your OCD symptoms.

References:

Foa, E. B., Yadin, E. & Lichner, T. K. (2012).Exposure and response (ritual)           prevention for obsessive-compulsive disorder: Therapist guide (treatments   that work). New York, NY: Oxford University Press.