What is ERP for OCD?

Obsessive-compulsive disorder is too often misunderstood. Many folks use the abbreviation OCD as shorthand for anyone who is very organized or hygiene-focused. But it’s so much more than that. As the name suggests, OCD involves a cycle of obsessions and compulsions. The obsessions are anxiety-causing thoughts and fears. In response, someone with OCD will perform rituals meant to prevent danger from happening. These are the compulsions — some of which may involve the aforementioned bent toward order or cleanliness.

OCD’s intrusive sequence of events can interfere with daily functioning, thus making this a very serious disorder. Fortunately, exposure and response prevention (ERP) therapy has become an effective form of treatment for people with OCD.

What is ERP for OCD?

The “exposure” part of ERP is precisely what you’d imagine it is. In other words, ERP is not about avoiding obsessions but, rather, facing them and changing part two: your “response.” This is a realistic approach because distress and its triggers can never be deleted from anyone’s life. What matters most is how we react to these inevitable trials.

Yes, it can feel challenging at first to provoke intrusive thoughts, but ERP’s long-term effect is worth the initial discomfort. 

How It Works

Of course, every person is different, and every manifestation of OCD is unique. Thus, ERP will be adapted on a case-by-case basis. Be that as it may, we can still explore one form of ERP. 

You’re exposed to a trigger and, therefore, feel a powerful need to perform a compulsion to neutralize it. For the sake of this description, let’s say the compulsion needs to be performed immediately, and it involves 6 or 7 parts. Here are some steps you can take via ERP:

• Delay the first step. Challenge the immediacy by taking time (maybe ten seconds, maybe ten minutes) before taking any action. This may feel scary, but just control yourself before allowing the compulsion to take control. Over time, you will want to lengthen the duration of the delay. This weakens the power of the cycle and transfers some of that power back to you.

• Perform the compulsion, but remove one of the five steps. So yes, you still submitted to the compulsion, but not without removing a little more of its control.

From there, with your therapist’s support, you can incrementally increase the delay time while slowly removing other phases of the compulsion. Over a time frame that feels right for you, ERP will eat away at the OCD cycle until you can experience an intrusive thought but not perform the compulsion.

This is not a guarantee or a “miracle cure.” You may slide at times and go back to restart at an earlier point. What matters is that ERP causes improvement, which, in turn, infuses the entire process with hope. ERP, combined with other therapies or possibly medication, can be a game-changer for someone with OCD.

How ERP is Used

Initially, ERP is done in a clinical setting. Your therapist may use pictures or videos to expose you to a known trigger gently. As things progress and you improve in maintaining control, it may become your responsibility to envision common obsessions (with a visual cue). With the therapist nearby, you will then practice the steps of ERP. Next comes homework, e.g., the client is guided on how to practice ERP coping skills outside the therapy setting.

Thanks to ERP, you can learn more about OCD and more about what it takes to control it. OCD has no known cure but approaches like ERP offer hope when it comes to managing the symptoms and regaining control of your day-to-day life. 

Learn more about OCD Treatment.

How Long Do Bipolar Episodes Last?

When you’re struggling with a condition that causes extreme swings and shifts in mood (and more), it’s logical to ask how long these episodes will last. That’s a common concern for anyone diagnosed with bipolar disorder. Fluctuating between moods of mania and depression is a major challenge to daily functioning. 

While there is no way to accurately predict the frequency or duration of bipolar cycles, as you’ll see below, certain patterns do exist. It is also important to bear in mind that some folks experience mania and depression symptoms at the same time. For the purposes of this post, we’ll focus on episodes that are more clearly delineated. 

What Are Bipolar Episodes?

Manic

You talk more but sleep and eat less. Your thoughts are racing, but, for the most part, they are all about perceived positivity. A manic bipolar episode can leave you feeling invulnerable, and thus, it’s not unusual for the person to engage in risky behaviors — but remember very little about these choices.

Depressive

Conversely, a depressive episode will appear like a rapid downward spiral that ends in a crash. Everything slows down, and the general vibe is that of sadness and hopelessness. Sleeping and eating habits swing back to the extreme while speech slows down and thoughts are the opposite of manic elation. The person is unmotivated to do anything and can eventually slip into a place of self-harm and suicidal ideation. 

How Long Do Bipolar Episodes Last?

We’re back to the question at hand. Here are just a few of the factors that can influence the duration of bipolar episodes:

• Specific diagnosis

• How engaged the person is with their treatment plan (someone diligently following the protocol can have shorter episodes) 

• Use of alcohol or drugs can induce mania 

• An inevitable variance between individuals 

That said, some general trends can be observed:

• Episodes can range from hours in length to, in rare cases, years

• If symptoms become severe, hospitalization is sometimes suggested 

• Depressive episodes tend to last longer than manic episodes across the board

• In some cases, the cycling can be quite rapid  

What is Rapid Cycling?

Anywhere from 10 to 20 percent of people with bipolar disorder will experience rapid cycling. This means the time between episodes is brief enough that they can experience at least four cycles in any 12-month period. Rapid cycling is not automatically an ongoing issue and can be transient. However, it could also transition into “ultra-rapid cycling.” This occurs when an individual cycles through manic and depressive episodes in a very short time period. How short? Typically, it would be one month, but it could take place within a 24-hour window. At that point, we’re talking about a very fine line of difference between ultra-rapid cycling and a mixed episode.

What Does All This Mean For Someone With Bipolar Disorder?

It may sound disheartening not to get a straight answer on the length of episodes. But the sobering news above can be viewed as a positive motivation. It aims a person in a new direction. They can focus primarily on connecting with a compatible therapist and dedicating themselves to following the treatment plan. This has been shown to be incredibly helpful.

In addition, basic self-care is a powerful supplementary tool. Healthy habits can work to counterbalance some of the bipolar symptoms. It’s also important to have a trusted friend, spouse, or other family member to advocate for you in all medical settings. 

Remember that while your symptoms — and thus, the specifics of your episodes — are unique to you, this doesn’t mean you are alone. Connecting with a bipolar disorder support group can be a powerful source of support and solace. 

Lear more about Depression Therapy.

How to Cope with Anxiety and Panic Attacks During Divorce

Divorce is unfortunately a common occurrence. Anxiety and panic attacks during divorce are almost as common. Even when a divorce feels like the best move and brings some form of relief, it is still a major life shift. A transition this big will inevitably cause high-stress levels—especially if children are involved. Studies find that at least 40 percent of people going through a divorce report feeling extreme anxiety.

Keep in mind that we’re not talking about temporary worry or concern. An anxiety disorder can result in severe outcomes—including panic attacks. Left unchecked, these conditions can become debilitating. Fortunately, there are proven ways to cope.

What is Anxiety?

Let’s begin by further clarifying the disorders begin discussed. Anxiety is a natural part of everyone’s life, and under certain circumstances, it can keep you safe. If anxiety becomes chronic, you can get stuck in a perpetual state of vigilance. From there, you can get caught up in a cycle of life-altering physical and emotional symptoms. This includes panic and panic attacks.

What are Panic Attacks?

Fear comes on suddenly and intensely. You feel it is beyond your control as a wave of physical reactions arise, e.g., palpitations, sweating, dizziness, hyperventilating, nausea, shaking, numbness, and dissociation.

Considering the impact of a divorce, such responses are not shocking. They also illustrate the importance of developing healthy coping mechanisms.

How to Cope with Anxiety & Panic Attacks During Divorce

• Practice self-care: Protect your eating, sleeping, and physical activity patterns. Amidst the swirling changes, prioritize yourself. 

• Recognize the need to grieve: Mourning is not just for when someone dies. Do the work to process your loss, and you will feel a decrease in anxiety. Don’t let others tell you when you should “move on” or “get over it.”

• Stay connected: It’s tempting to withdraw, and yes, some solitude is helpful. But avoid the urge to isolate yourself. Slowly begin the process of rebuilding your social life. 

• Try new life patterns: This may be the ideal time to reinvent yourself—one small step at a time.

• Be patient with yourself: There is no set timetable. Allow things to move at their own pace, and be sure to ask for help when you need it.

What to Do When a Panic Attack Occurs

As you take steps to address anxiety, you may remain prone to panic attacks for a little while. If so, keep in mind some tips for when panic becomes overwhelming:

• Start by closing your eyes to reduce stimulation. 

• Focus on taking deep breaths. This reminds your brain that you are not in danger.

• Ground yourself. Become aware of the sensations you are feeling. This could be the feeling of your feet standing on the ground or the wind blowing on your face.

• Slowly open your eyes and find something on which to aim your gaze. Sharply focus on this item and study it.

With practice, these techniques can become your automatic response. This reduces the intensity and duration of the panic attack. At the same time, of course, you will need to find ways to identify the root causes of your anxiety—and address those causes.

Getting to the Root

You may have had simmering anxiety all along, and it was the divorce that made it obvious. Perhaps you felt abandoned as a child, and that trauma has been unearthed. The possibilities are many. That’s why it makes sense to connect with a skilled mental health professional. Together, you can navigate the divorce while also exploring ways to enhance your coping skills in a more general way. If divorce has you struggling, let’s connect soon.

Learn more about Anxiety Therapy…

What is BIPOC Trauma?

Trauma is a frighteningly common global experience. It could be caused by a high-profile natural disaster. Far more often, the underlying reason is something more personal. For Black, Indigenous, and people of color (BIPOC), trauma can take on very unique and insidious forms. This is where the concept of BIPOC trauma (a.k.a. racial trauma) becomes a reality. 

From the time they are children, BIPOC face slights, abuses, and attacks that have been normalized over the decades and even centuries. Whether they have been targeted or have bore witness to the traumatic events, Black, Indigenous, and people of color can face debilitating outcomes, e.g., Post-Traumatic Stress Disorder (PTSD).

How Does BIPOC Trauma Happen? 

The more obvious factors include physical violence or the threat thereof, micro-aggressions, invalidation, and public shaming. Because such treatment can be chronic and passed down through generations, it can qualify as complex trauma — further complicating the situation. However, another danger is how invisible the sources of trauma can be.

Long-Term Realities That Lead to BIPOC Trauma

Because we live in a world with systemic racism, many of us are blind to the trauma endured by BIPOC. Here are just a few of the daily realities of life as a BIPOC:

• Fear that you’ll be targeted by law enforcement solely based on the color of your skin.

• When moving into a new neighborhood, you cannot be sure if the locals will welcome you or even be friendly.

• In stores, you are watched and followed as you’re only there to steal or cause trouble.

• People expect you to be a “spokesperson” for others who share your race or ethnicity. 

• You wonder how often race plays a role in situations like applying for a job or a school.

This decidedly incomplete list gives you an idea of the many threads woven in the scourge of BIPOC trauma. They add up, escalate, and too often become so common as to become unseen — even by victims.

Obviously, systemic change is long overdue. However, at the same time, survivors of racial trauma need help, support, and treatment.

Addressing BIPOC Trauma

A powerful starting point is acceptance from yourself and others. Racism is a hot-button, misunderstood topic. This can lead to BIPOC feeling confused and conflicted about feeling traumatized. But healing — and ultimately, societal change — cannot happen until more folks speak out without shame. It is the abusers who should be struggling with shame, not you!

Other steps you can take:

• Connect: To avoid feeling alone or ashamed, connecting with people in your community can be a powerful tool. They get it and will validate you. This is a giant step toward healing.

• Support: Racism can temporarily make BIPOC feel powerless. This is far from the truth. Help others who are also struggling. Soothe your heart through kindness. 

• Self-Care: Traumatic racism has the potential to cause self-esteem and major stress. Self-care counters both trends. It improves your overall well-being. It also reminds you that you matter and deserve such positive attention and care.

Treatment For Trauma

Any and all types of trauma require treatment from a trauma-informed professional. In the case of racial trauma, it also requires a therapist who can handle the unique challenges involved. BIPOC need and deserve to be met where they are — with full respect for their lived experiences. 

Racial trauma requires resilience to navigate. In your weekly therapy sessions, you can develop the coping skills to help create resilience. Like all trauma, BIPOC trauma can be processed and resolved. This will not only help you live a life of self-empowerment, but it will also position you to do the work to help reimagine the world we live in. 

Learn more about Trauma Treatment.

Psychotic Depression: What It Is and How to Treat It

Depression is a term with many definitions. In everyday usage, we might use it if we feel down or blue. Clinically, the word “depression” is shorthand for many types of major depressive disorder (MDD). This is much worse than being sad. It’s a diagnosable disorder with potentially serious consequences and outcomes. A sub-form of MDD is psychotic depression. 

As the name implies, psychotic depression features a blend of MDD and psychosis. In other words, it goes beyond depression to losing touch with reality. It is possible that as many as 20 percent of adults who experience MDD also experience psychotic symptoms. 

MDD and Psychotic Depression Symptoms 

The presence of certain symptoms (hallucinations, delusions, etc.) is what enables a mental health practitioner to discern psychotic depression from MDD. These signs of psychosis might be connected with typically depressive themes or not. What matters is that they co-exist with classic MDD symptoms. Let’s get familiar with both sets of signs.

Major Depressive Disorder Symptoms 

To be diagnosed with MDD, you’d have to display several of the following symptoms for at least two weeks: 

• Feeling relentlessly sad, worthless, and guilty 

• Hopelessness and pessimism 

• Losing interest in activities that once excited you (including sex)

• Irritability and angry outbursts 

• Inability to focus, concentrate, and make decisions 

• Physical signs like sleep disturbances, unexplained aches and pains, sluggish movement, slow speech, low energy, and drastic appetite shifts

• Thoughts of death, dying, suicide, and self-harm

Psychotic Depression Symptoms

There are two big ones, of course: hallucinations and delusions. But there are more subtle red flags to watch for, e.g.: 

• Feeling numb and like you lack emotions

• Inability to keep up at work or school 

• Not taking care of yourself in terms of hygiene or how you present yourself

• Social isolation 

• Confused speech

• Behaving in a way that looks or feels paranoid or overly suspicious 

• Struggling when it comes to differentiating between reality and your inner world

Diagnosing Can Be Tricky

Despite the ominous list of collective symptoms above, it can take a while to recognize that MDD has advanced to include psychosis. This is due to the fact that people with psychotic depression can be quite aware that what they are feeling and thinking is unusual. Hence, they keep it to themselves. This is where talk therapy can be very helpful in shining a light on psychotic depression symptoms.

Treatment For Psychotic Depression

Before we get into specific clinical options, it is vital to understand that lifestyle changes can be powerful in tandem with whatever treatment plan you pursue. It’s important to commit to such a self-help regimen to manage symptoms and increase your quality of life. Some steps to consider:

• Getting sufficient sleep while maintaining a steady sleep schedule. 

• Making healthy eating and drinking choices (e.g., avoid alcohol) 

• Engage in daily exercise and physical activity.

• Stay connected to others and lean on your personal support system.

With this running parallel, here are some common approaches a professional might suggest: 

• Medication: For psychotic depression, a combination of antipsychotics and antidepressants might be prescribed. Be sure to talk about all your options, possible side effects, and dosage.

• Electroconvulsive Therapy (ECT): ECT may be suggested when a person’s response to medication and therapy is limited. This is a serious decision involving hospital admittance, anesthesia, and an electrical current. Needless to say, this is not to be considered except as a last resort.

• Talk Therapy: Approaches such as Cognitive Behavioral Therapy, Acceptance & Commitment Therapy, Experiential Psychodynamic Therapy, and Internal Family Systems have been found to be very important sources of support while a person tries medication. 

Psychotic depression must be addressed. This process can begin soon with a free and confidential consultation. 

Learn more about Treatment for Depression.

5 Distinct Sources of Anxiety For People With Autism

Anxiety is a necessary part of everyone’s day. In its healthy form, anxiety can guide and protect us. Then, of course, there are instances when something truly frightening occurs. It can shape our mindset for a while, but ideally, we recover once the threat has passed. For someone with autistic spectrum disorder (ASD), things are trickier.

Anxiety is not considered a symptom of ASD. However, comorbid anxiety is a big factor in the ASD experience. As many as 40 percent of people with ASD display anxiety levels high enough to warrant a diagnosis of an anxiety disorder. Left unchecked and untreated, this can hamper a person’s ability to navigate life with ASD.

5 Distinct Sources of Anxiety For People With Autism

1. Certain Social Scenarios 

It’s not as if social situations are ever easy for someone with autism. But this happens in degrees. There’s an example that dovetails with source #2 below. This is when a social plan either arises unannounced or an existing plan is changed. Other anxiety-invoking experiences might be:

• Large gatherings

• Dealing with the unpredictability of pets or young children

• Doing things outdoors 

• Starting a conversation with almost anyone

• Juggling personal plans with social plans

Any of the above can provoke versions of social anxiety. A person with ASD may already feel self-conscious. The introduction of social anxiety can feel twice as daunting. They feel watched, judged, and negatively evaluated. Another factor is separation anxiety. Children with autism, in particular, come to rely on certain people to serve as go-betweens.

2. Changes in Routines

Most people aren’t very excited about sudden changes. Someone with ASD is often quite dependent on routines as a form of calming. This could relate to:

• Chores and tasks

• Work or school (e.g., homework) 

• Household rhythms like mealtime and bedtimes 

• Personal hygiene 

Anxiety is frequently the result when forced to operate outside the realm of such routines. It can even escalate to panic.

3. Unstructured Time

A certain amount of structure is important in everyone’s life. With ASD, any form of structure can feel like a lifeline. Unlike most others, people with autism do not necessarily look forward to what is euphemistically called “free time.” In school, this means recess or lunchtime is a cause for discomfort. At any age, anxiety can rear its ugly head during any transition from one activity to the next. 

4. Sensory Overload

This is a big one. There can be no way of knowing when a sensory challenge is looming. That alone causes anxiety. When any of the following occurs, it can be instantly overwhelming:

• Large crowds

• Bright lights

• Loud noises

• Strong smells 

• Food with an unusual texture

• Tight or scratchy clothing 

• Hygiene tasks like showering or tooth-brushing 

• Medical appointments 

There can be times when sensory overload intersects with a specific phobia (another form of anxiety disorder). A specific fear can trigger both ASD symptoms and anxiety responses at the same time.

5. Academic Scenarios 

Schools have a tendency to be perplexing. All the organizing, reading, writing, answering questions, assignments, and more — all of which can be a source of dread for someone with either ASD or an anxiety disorder. When both conditions are present, a person can be left feeling in a permanent state of high alert.

How to Cope with Autism and Anxiety

Studies find that a blend of talk therapy and self-help can positively and powerfully impact this challenging scenario. Depending on the severity of either disorder, an experienced therapist will provide a blueprint for managing the comorbidity. If you or someone you know is struggling with a blend of autism and anxiety, I urge you to reach out for professional guidance.

Learn more about Anxiety Treatment…

How Does Bipolar Depression Differ From Traditional Depression?

In the age of search engines, the average person knows more about medical conditions than ever before. But things are not that simple. Even professionals can misdiagnose. A big reason for this is that some conditions are very similar. For example, the depressive episodes of bipolar disorder can easily be confused with traditional depression. 

Of course, it is essential that the correct diagnosis is found in every situation. In the case of bipolar depression and traditional depression, this begins with understanding the differences. A big part of this is accepting that the person in question may not be best positioned to perceive how the disorders diverge.

Let’s Start With The Basics

Bipolar Disorder

Known for its alternating extreme episodes of mania and depression, bipolar disorder can also include periods of no symptoms. These swings are typically not related to a life event and often interfere with one’s ability to function on a daily basis. The condition has two sets of symptoms: 

Mania Symptoms

• Operating on very little sleep

• High energy, high activity, general euphoria

• Restlessness

• Unrealistic ideas

• Racing thoughts

• Quick to anger

• High sex drive

• Poor judgment because you don’t recognize that you have a problem

Depression Symptoms 

• Sadness and despair almost all the time

• Losing interest in activities that once excited you (including sex)

• Low energy 

• Inability to concentrate 

• Sleep disturbances 

• Appetite changes

• A general mood of hopelessness, pessimism, guilt, emptiness, or self-doubt

• Unexplained aches and pains

• Thoughts of self-harm or suicide 

Depression 

This is a mood disorder that does not have episodes of mania or symptomless periods. Its hallmark is despair and stifling sadness. To be diagnosed with depression, you must present with five or more of the following signs for at least two weeks:

• Sadness and despair almost all the time

• Losing interest in activities that once excited you (including sex)

• Low energy 

• Inability to concentrate 

• Sleep disturbances 

• Appetite changes

• A general mood of hopelessness, pessimism, guilt, emptiness, or self-doubt

• Unexplained aches and pains

• Thoughts of self-harm or suicide

How Are Depression And Bipolar Disorder Diagnosed?

If someone is in the midst of a bipolar disorder depressive episode, it can be virtually impossible to distinguish it from traditional depression. Since people with bipolar disorder often cannot recognize mania in themselves, they may not report those symptoms. 

Therefore, an accurate diagnosis will require firsthand input from someone who has witnessed both types of episodes. From there, the medical profession can engage in further observation to make a determination. This will include taking a medical history and being made aware of any medications the persona may be taking. 

A treatment plan can only be chosen once a diagnosis is agreed upon.

Treating Bipolar Disorder or Depression 

Both conditions can be managed via talk therapy and medication. Typically, it would be mood stabilizers for bipolar disorder and antidepressants for depression. In both cases, the protocol is flexible and subject to change — based on results and response to the medications. Become active participants in your treatment and never underestimate the importance of your input when it comes to making decisions. 

Through it all, individuals with either disorder are encouraged to supplement treatment with self-care and the cultivation of a support system. 

Suggestions include: 

• Diligent self-education 

• Identifying your triggers and having a plan in place for extreme situations

• Do not self-isolate 

• Connect with support groups in person and/or online 

• Avoid alcohol and other substances

• Make healthy eating choices

• Partake in daily exercise and physical activity 

• Maintain regular sleep patterns 

Depression, in any of its forms, is nothing to tackle alone. If any of the above resonated with you, please reach out to get the help you need and deserve. 

Learn more about Depression Treatment…

Genetic or Environmental: Where Do Anxiety Disorders Come From?

It can feel paradoxical to talk about the causes of psychological disorders. On one hand, we’ve come so far and have a vast supply of resources. That said, there is still so much to learn when it comes to pinpointing how and why anxiety disorders arise and take hold. Emotional issues are complex. They are the result of many intertwining factors.

In the case of anxiety disorders, it’s important to note that there are several types. Therefore, there are a variety of possible elements to consider. With all that in mind, let’s explore what we know about the causes of anxiety disorders. 

Possible Genetic and Environmental Causes For Anxiety Disorders

Genetic

Here is where the bulk of work remains. Researchers currently believe that environmental factors are more likely to cause anxiety. But work dating back to 2002 suggests possible genetic sources. More recent studies include:

• 2015: The presence of a gene called RBFOX1 could increase the risk of developing Generalized Anxiety Disorder (GAD). 

• 2016: In addition, both Social Anxiety Disorder and Panic Disorder could be linked to specific genes. 

• 2017: GAD might be inherited by some people, but it is accepted that you can have an anxiety disorder even if it doesn’t run in your family.

Environmental

Some of the environmental factors believed to play a role in anxiety include:

• Childhood trauma

• Family composition 

• Cultural tendencies 

• Religious upbringing 

• Underlying medical conditions (or a side effect of prescribed medication)

• The presence of substance abuse in the home

Gender and Sexuality 

Researchers have found that non-heterosexual participants in studies reported anxiety at a higher rate. More specifically:

• Bisexual people seem to experience anxiety disorders more often than gay and lesbian people. This could be connected to a sense of exclusion and marginalization. 

• For transgender people, gender dysphoria can be a risk factor for anxiety.

Race 

According to the American Psychological Association (APA), socioeconomic deprivation and racial discrimination are major predictors of anxiety. This can be related to, for example, exposure to discrimination and micro-aggressions. Fear of policing (personal experience or witnessing incidents) is also believed to raise the risk factor. 

Life Stressors

Acute or chronic stress in one’s life is a clear component of developing anxiety. Concerns and worries about your health, finances, relationships, etc., can lead to you feeling “stuck” in a stress response. This can be exacerbated by being called upon to perform publicly or any other act that triggers social anxiety.

So, Are Anxiety Disorders Genetic or Environmental?

Based on the information above, it would be easy to assume that your environment is the primary factor. When your environment is a huge element in your mental health, we just don’t know enough about genetics and anxiety to rank one factor above the other. What we can most definitely do is take active steps to address what is known.

You may be experiencing anxiety symptoms like:

• Excessive worrying 

• Sleep disturbances 

• Fatigue

• Sweating 

• Palpitations

• Racing thoughts

• Loss of focus

• Sense of impending doom

• Avoidance of social situations 

• Nausea 

• Shakiness

• Hyper-vigilance 

If so, before deciding if all this is genetic or environmental, why not assess yourself? An experienced therapist is ideally positioned to talk with you about what you’re feeling and why. Committing to regular sessions puts the power back into your hands. Working together, you and your therapist reveal underlying causes, counterproductive patterns, and triggering factors.

From there, you can focus on developing new approaches and solutions that can free you from anxiety’s control. After all, whether the source is environmental or genetic, anxiety disorders are treatable. You can recover and thrive again. Let’s get you started on this healing path. 

Learn more about Anxiety Therapy.

Complex Trauma: What it is and How it Affects People

There’s a lot more awareness about trauma today than ever before. But it’s a complex topic with plenty of nuance. In fact, the word “complex” factors directly into this discussion. Generally speaking, conversations about trauma revolve around a specific, terrible event. It might be, for example, an accident or the death of a loved one. Such experiences can result in Post-Traumatic Stress Disorder (PTSD).

Complex Trauma, however, is similar but arises when a person endures ongoing, relentless traumatic experiences. About three percent of people in the U.S. struggle with Complex Post-Traumatic Stress Disorder (C-PTSD)

Examples of Complex Trauma

The ongoing events listed below typically occur during childhood but can happen to anyone at any time. The criteria are that the person is subjected to long-term abuse or suffering and is unable to escape from it. Such complex traumatic events include:

• Sexual abuse or incest

• Physical and/or emotional abuse

• Medical abuse

• Human trafficking and being prostituted 

• Living in a war zone

• Living in a place besieged by campaigns of genocide 

• Torture

• Kidnapping

• Ongoing neglect or abandonment

• Child forced into the role of an adult, caretaker, or parent 

C-PTSD is more likely if:

• The ongoing trauma happened during your childhood 

• You had a real or perceived lack of escape or rescue

• The abuser was someone close to you

• More than one trauma was occurring at the same time

How Does Complex Trauma Affect People?

Any intense stressor can activate the body’s fight-or-flight response. Under typical circumstances, it serves to shut down non-essential systems and prioritize survival. All things being equal, this stress response dissipates once the threat has passed. But what if the stress doesn’t pass?

People struggling with complex trauma remain in a state of hypervigilance. Everything feels like danger, putting their minds and bodies at high risk of further problems. Like all trauma survivors, they are subject to the following:

• Flashbacks, nightmares, and intrusive thoughts 

• Memory loss and dissociation 

• Sleep disturbances 

• Being easily startled 

• Unexplained aches, pains, and bodily tension 

• Digestive issues

• Trouble regulating your emotions

• Social isolation and avoidance 

• Low self-esteem

When C-PTSD is Present

If complex trauma causes C-PTSD, in addition to the symptoms listed above, a person may:

• Display angry outbursts

• Lose trust in others and the world, in general

• Believe no one understands them or what they’ve been through 

• Avoid making any kind of connection with others

• Feel permanently damaged 

• Feel different from others and find it difficult to deal with anyone else

Self-Help For Complex Trauma 

A lot of the common relaxation techniques you’ve probably heard of are useful in easing C-PTSD symptoms. For example:

• Journaling 

• Breathing exercises

• Meditation 

• Tai chi, yoga, and dance 

• Maintaining regular sleep patterns 

• Making healthy eating choices 

• Daily exercise and physical activity

• Being in nature 

Also, it can be incredibly helpful to talk with loved ones about your triggers. Let them know what you’re going through and how they can help. All of this adds up to excellent complementary care while you work with a therapist.

Treatment For Complex Trauma

Trauma requires more than self-help. Conditions like C-PTSD can be debilitating. Fortunately, several therapeutic approaches have been found effective for people with complex trauma. These include:

• Internal Family Systems

• Experiential Dynamic Therapy

• Cognitive Behavioral Therapy (CBT)

• Dialectical Behavioral Therapy (DBT)

• Eye Movement Desensitization and Reprocessing (EMDR)

• Somatic therapies 

The first step is accepting the need for change and committing to a plan. These are challenging steps, but I can help you along the way. If complex trauma is impacting your life, I urge you to reach out and connect. Depending on the specifics of your situation, your therapist will present the best options so you can work together toward recovery.

Learn more about Trauma & PTSD Treatment.

Social Anxiety: Signs, Symptoms, and Treatment

Think back on a time when you felt nervous or shy. It might have been your first day at a new school or job. Perhaps, a first date or having to give a presentation of some kind came to mind. In situations like this, feeling some apprehension is normal and inevitable. You might get butterflies in your stomach or find that your hands are shaking a little. None of this is fun, but none of it is alarming, either.

What would be alarming is if such fear and anxiousness became chronic and disrupted your daily life. This could mean you are struggling with Social Anxiety Disorder.

What is Social Anxiety Disorder?

Social Anxiety Disorder is a common, diagnosable mental health condition. More than temporary worry, this disorder challenges your ability to function. While many folks chalk up to their “personality,” that often is not the case. What some call shyness can be a disorder that strikes fear in the hearts of people when they have to perform basic tasks like:

• Making a phone call

• Using a public bathroom

• Meeting new people

• Dating

• Talking in front of people

• Asking for help in a store or restaurant 

• Eating in front of someone

Such worries may be founded on a fear of being judged, embarrassed, or rejected. As a result, the person may choose extreme forms of avoidance to feel safe. That friend of yours who seems like an “introvert” or a “loner” may actually crave a social life. But anxiety has tossed a monkey wrench into this desire. Thus, it is vital that more people get familiar with the symptoms of this condition. 

Symptoms of Social Anxiety Disorder

As touched on above, a telltale sign of social anxiety is avoidance. Worrying that you might embarrass yourself causes a person to withdraw. They turn down invitations and slip into the background when they can’t evade social situations. A child with Social Anxiety Disorder will, of course, be more demonstrative about the dread they feel. This can manifest in temper tantrums or a refusal to speak.

Some with Social Anxiety Disorder may:

• Avoid eye contact 

• Fear that others can recognize how anxious they are

• Expect the worst 

• Feel frightened anticipation leading up to an event

• Analyze their performance for days or weeks after the event

In addition, physical symptoms can include:

• Shortness of breath

• Rapid heartbeat 

• Trembling and shaking

• Blushing

• Sweating

• Dizziness

• Unexplained muscle tension and aches 

• Stomach disturbances

• Feeling like your mind has gone blank

It is essential that you reach out for help if you chronically experience any of the above. Too often, people with social anxiety either don’t realize that it’s not just shyness, or they are too self-conscious to make an appointment to talk about it. The presence of such signs and symptoms is what a practitioner will use to diagnose Social Anxiety Disorder.

Social Anxiety Disorder is Treatable

Yes, it’s not easy to share what you are feeling — especially when a fear of being judged is so strong. Social Anxiety Disorder, by definition, can hamper your desire to get help. But, like all anxiety disorders, social anxiety is treatable. So, why not start with a confidential inquiry? Take one small step to learn more about your recovery. 

Learn more about Anxiety Therapy.