How Do I Know If I Need Therapy?

By Annabelle Parr

Each May we celebrate Mental Health Awareness Month to draw attention to and reduce stigma around mental health issues. According to the National Alliance on Mental Illness, or NAMI, 1 in 5 people will be affected by mental illness in their lifetime. And as we discussed last May during #CureStigma, “while 1 in 5 Americans are affected by a mental health condition, 5 in 5 Americans know what it is to feel pain. The frequency, intensity, and duration can vary, but pain itself is a function of being human. When culture stigmatizes the 1 in 5 and simultaneously dichotomizes illness and wellness, the resulting message is that it is shameful to struggle and to feel pain. In essence, stigma says that it is shameful to admit our own humanity.”

Do I need therapy?

Given that all of us will at some point encounter painful experiences and emotions, this year we are discussing how to know when it might be helpful to seek therapy. Though it may be clear that those affected by a previously diagnosed mental health condition could benefit from therapy, for those who are either undiagnosed or are struggling with anxiety, stress, grief, sadness, etc. but do not meet diagnostic criteria for a mental health disorder, it may be harder to discern whether therapy is warranted.

How am I functioning in the important areas of my life?

For nearly every condition in the Diagnostic and Statistical Manual (DSM-V; APA, 2013), clinically significant impairment in an important area of functioning is a required criterion to receive a diagnosis. In other words, the presenting symptoms must be making it very difficult to function at work or school, in relationships, or in another important life domain (e.g., a person is feeling so anxious that she is not able to make important presentations at work, or so stressed that he is finding it difficult to connect with his loved ones).  When life has begun to feel unmanageable in some capacity, or if something that was once easy or mildly distressing has become so distressing it feels impossible, it may be worth considering therapy.

Could things be better?

It’s also important to note that you do not have to feel as though things are falling apart before you seek professional counseling. Therapy can be helpful in a wide range of situations. It can help you not only navigate major challenges or emotionally painful periods, but also can enhance your overall wellbeing by helping you to identify your values and lean into them. Maybe things are going fine, but could be better. A therapist can help you identify what could be going better and can help you learn to fine tune the necessary skills.

I want to try therapy, but where do I start?

Whether things feel totally unmanageable or it just feels like they could be better, it’s important to find a therapist with expertise relevant to what you would like assistance with. Working with children requires different expertise to working with adults, just as working with couples and families requires additional expertise to working with individuals. Different conditions also correspond with particular evidence based practices. For stress and anxiety disorders – including social anxiety, generalized anxiety, panic disorder or panic attacks, and phobias – evidence based practices include Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT). The gold standard of treatment for obsessive compulsive disorder (OCD) is Exposure and Response Prevention (ERP), and evidence based treatments for PTSD include Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) (all of these—ERP, PE, and CPT --fall under the CBT umbrella). So no matter what you are seeking treatment for, ensuring that the therapist you choose has expertise that aligns with the types of concerns you are struggling with is critical. For some more tips on finding and choosing a therapist, click here and here. For more information on the different kinds of licenses a therapist may have, click here.  

Though there is no right or wrong answer as to whether or not you need therapy, if you are unable to behave in ways that make life manageable and/or fulfilling because of difficult thoughts or feelings, you may find therapy beneficial.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT) for anxiety, panic, phobias, stress, PTSD, OCD, or insomnia, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Five Ways Parents Can Help Children with Political Anxiety

Guest Post by Tracy Dunne-Derrell, writer at Teach.com

One hundred years from now, America in 2017 will exist only in history books. Those future writers will have plenty of material to work with: mass shootings, terrorism fears, international turmoil, and “fake news.” But those facts probably won’t capture the anxiety that’s been generated by these events. A poll conducted earlier this year by the American Psychological Association found more than half of American adults cited the current political climate as a source of stress.  

Children are feeling anxious too. A recent UCLA survey found that 51% of teachers reported more anxiety among their students. As a parent, the past year may have presented you with unique challenges as your children grappled with a range of emotions- from general anxiety to personal stress over the impact potential policies could have on them and their friends. You may have a child who’s finding that current events are causing anxiety, and are struggling to figure out how to best provide support.

As an adult, you might be experiencing negative feelings too, but you have the advantage of being able to channel them productively by contacting elected officials and engaging in activism and service. And you’re more likely to have developed meaningful ways to help yourself get through uncertain, difficult times. But your children might not be able to grasp the concepts that are troubling and confusing to them, and they may lack the skills they need to identify and cope with their feelings. Here are some ways to help them.

1. Listen, but accept that you might not always have good answers. 

As a parent, you may be tempted to help by dismissing and downplaying the concerns and worries of your anxious child. But this approach, while well-intentioned, isn’t helpful. Validating kids’ concerns and making sure they understand that it’s ok to feel what they’re feeling is important.  And unfortunately, you can’t magically erase the sources of stress for them. But you can be a sympathetic ear, and make a point to spend a little time each day talking to them about their concerns. Help them develop coping skills, which won’t eliminate the sources of negative feelings, but will help them learn to work through them. The ability to cope with challenging times is a necessary life skill.

2. Help them take action.

With so much beyond their control, your kids may find themselves feeling powerless. They might want to do something to distract them from their fears and help them feel like they’re contributing to the world in a positive way. Some adults are channeling their concerns into helping others, and there are ways children can do the same. Talk with them about some of the needs they observe in your community, and help them think of ways to address them. Young children can choose items from the grocery store to donate to a local food pantry, while older ones can join service-oriented local organizations, or look for a project to support, like a winter coat drive. Even small actions help students feel like they matter, and lead to a life-long involvement with community service.

3. Connect with the school counselor.

Kids spend a substantial amount of time in school, and their counselors are a valuable resource. School counselors are already trained to help students learn to manage a wide range of situations and challenges. And they’ve got ample materials to help them work with students who are living with political anxiety. Last year the American School Counselor Association published a guide for counselors, with suggestions for supporting children experiencing post-election stress. Sitting down with a school counselor could be a great opportunity for your child to share his or her fears with a trained professional. Ask for ideas and strategies to use at home to talk about current events, and the feelings these events generate.

4. Examine the impact of technology.

News and social media might play a role in fostering negative feelings. Escaping bad news used to be as easy as turning off the television and radio. Now, with 24-hour cable channels, mobile apps, and social media, it’s almost impossible to get a break from current events. Consider the role screen time with televisions and gadgets may be playing in your child’s politics-related stress. Evaluate the amount of time your child spends watching and reading news, and discuss alternative activities which may help them manage their stress.

5. Talk about previous times our country experienced turmoil and got through it.

It feels like we’re going through unprecedented uncertainty, but America has faced crisis before, more than once. Our country has survived wars, recessions, and natural disasters. Your children likely have some awareness of challenging times in our history, but events of long ago probably feel abstract to them; they may not be able to connect past and present. Depending on your age, you may have your own personal stories to share which might resonate with your anxious children and help them feel more optimistic. For example, during the 1970s, Watergate dominated the news, and led to concerns about government. In the 1980s, the Cold War between the United States and the former Soviet Union generated fears as both countries and their allies engaged in an arms race, generating legitimate concerns over the possibility of nuclear war. Share your stories and take this opportunity to talk with your kids about America’s resilience.

Providing support for anxious kids is challenging, but it is possible. As a parent, you know your child better than anyone, and are the best person to help them manage stress and anxiety. However, if you need some outside support to help your child, you can check your child’s school for resources, and reach out to outside resources, like local therapists, as well.

CSAM IS HERE TO HELP

If you or someone you love might benefit from cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), or biofeedback for anxiety, depression, stress, or PTSD, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at info@csamsandiego.com

Anxiety in Children

Have you noticed that your child seems to be experiencing a significant amount of anxiety? Learn more about the anxiety disorders that can develop at a young age and the support that is available. If you would like to seek the help of a professional, contact us to schedule an appointment with our child anxiety specialist now.

Childhood Anxiety Disorders

Generalized Anxiety Disorder

Learn more about GAD.

Things to look out for:

·      Excessive worry about a variety of things in your child’s life

·      Perfectionism and self-criticism

·      Constant need for approval or reassurance

Obsessive-Compulsive Disorder (OCD)

Learn more about OCD.

Things to look out for:

·      Obsessions: Experiencing unwanted and intrusive thoughts

·      Compulsions: Repeatedly perform rituals and/or routines in order to ward off anxious feelings

Panic Disorder

Learn more about panic disorder and panic attacks.

Things to look out for:

·      Panic/anxiety attacks that come on for no reason or out of the blue

·      If your child is concerned about or afraid of having another panic attack in the future

Posttraumatic Stress Disorder (PTSD)

Learn more about PTSD.

Things to look out for:

·      Experiencing or witnessing a traumatic or life-threatening event

·      Intense fear/anxiety

·      Emotional numbness

·      Easily irritable

·      Avoidance of places, people or activities

Separation Anxiety Disorder

Learn more about separation anxiety disorder here.

Things to look out for:

·      Your child is slightly older (common in ages seven to nine)

·      Unable to be separated from loved ones or takes significantly longer to calm down compared to other children

·      Experiences extreme homesickness/misery at being separated from loved ones

Social Anxiety Disorder

Learn more about social anxiety disorder.

Things to look out for:

·      Intense fear or anxiety related to social interactions

·      Anxiety about performance and activities

·      Extreme shyness or inhibition

·      Difficulty making new friends or speaking with peers

Selective Mutism

Visit online: Selective Mutism Group

Things to look out for:

·      Refusing to speak in situations that make your child anxious

·      Standing motionless/expressionless

·      Avoiding eye contact, chewing/twirling hair, turning heads

Specific Phobias

Learn more about phobias.

Things to look out for:

·      Intense irrational fear of a specific object or situation (such as animals, storms, blood, needles, medical procedures, etc.)

Treatments Offered at CSAM

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is an empirically supported treatment that focuses on modifying problematic thoughts & behaviors that contribute to & maintain emotional problems like anxiety, stress, & depression. Like traditional forms of therapy, CBT emphasizes a warm, safe, & empathic therapeutic environment. CBT is different from some approaches in that it focuses on present-day problems & learning skills to overcome symptoms. It teaches children to identify thoughts & behaviors that are keeping your child stuck, so your child may develop more adaptive ways for navigating life.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy is an empirically supported treatment that focuses on reducing experiential avoidance and accepting internal experiences (thoughts and feelings) in the service of living a valued, vital, meaningful existence.  Mindfulness, metaphors, and experiential exercises play a central role in ACT.

Biofeedback

Biofeedback is an empirically supported treatment that focuses on balancing the nervous system. Biofeedback is shown to be extremely effective at helping patients reduce anxiety and stress, lower blood pressure, reduce chronic pain (including migraines), increase focus and attention, and reduce hyper-vigilance commonly experienced after trauma.

How Can I Respond to My Child?

ADAA provides the following suggestions in their article “Tips for Parents and Caregivers”

Source: http://www.adaa.org/living-with-anxiety/children/tips-parents-and-caregivers

Here are things you can do at home to help your child manage his or her anxiety disorder:

Pay attention to your child’s feelings.

Stay calm when your child becomes anxious about a situation or event.

Recognize and praise small accomplishments.

Don’t punish mistakes or lack of progress.

Be flexible and try to maintain a normal routine.

Modify expectations during stressful periods.

Plan for transitions (For example, allow extra time in the morning if getting to school is difficult).

Keep in mind that your child’s anxiety disorder diagnosis is not a sign of poor parenting. It may add stress to family life, however. It is helpful to build a support network of relatives and friends

Resources:

The Anxiety and Depression Association of America, ADAA

www.ADAA.org

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Are you interested in scheduling an appointment with our child specialist? If you'd like to speak with a professional at the Center for Stress and Anxiety Management for help with anxiety, please click here.

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