Mental Health is the National Focus of May
This month, Miracles Counseling Centers is joining the national movement to raise awareness about mental health. Millions of Americans are currently living with a mental illness, and this number is growing. The sad reality is that many of these individuals do not receive the support they need due to stigma or a lack of understanding surrounding mental health, the resources available to them, and the importance of seeking help. Mental health is a huge part of our overall health, so we must take care of it! This is why it is so important that we take time this month to engage in intentional conversations about mental health, fight against stigma, and show our support for those in our lives who are struggling. We want to start by sharing information on the mental health resources available to you! That’s why we’ve put together a list of some of the larger mental health advocacy groups out there and how they work to support mental health in our country.
Mental Health America (MHA)
Who They Are: Mental Health America is a national community-based nonprofit that is focused on promoting mental health as a critical part of overall wellness, including prevention services for all, early identification for those at risk, early identification & intervention for those at risk, and integrated care, services, and supports for those who need them, with recovery as the goal.
What They Do: MHA provides education and outreach to help Americans of all ages to better understand prevention, early identification, and intervention through access to online screening tools, information, and events. MHA collaborates with its over 200 affiliates in 41 states to bring information and referral, support groups, rehabilitation services, as well as socialization and housing services to those struggling with mental health issues and their loved ones in communities around the country. MHA also works with these affiliates to advance policy recommendations promoting mental health.
Website: https://mhanational.org/
National Alliance on Mental Health (NAMI)
Who They Are: The National Alliance on Mental Health is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI started as a group of families around a kitchen table in 1979 and is now an alliance of more than 600 local Affiliates and 48 State Organizations who work in our communities to raise awareness and provide support and education to those in need.
What They Do: NAMI offers educational classes, training, and presentations on various mental health topics. They advocate for public policy changes in favor of mental health. The toll-free NAMI HelpLine is available to anyone in need of emotional health support. NAMI leads public events and activities to fight mental health stigma in communities across the nation. Their website has lots of information on mental health conditions and their appropriate treatments, as well as blog posts that share personal stories.
Website: https://nami.org/home
American Foundation for Suicide Prevention (AFSP)
Who They Are: The American Foundation for Suicide Prevention is a voluntary health organization that seeks to provide a national community for those affected by suicide in an effort to empower and advocate for them. AFSP’s mission is to save lives and bring hope to those in our country who have been impacted by suicide.
What They Do: The AFSP funds scientific research and advocates for public policies in mental health and suicide prevention. They also engage in efforts to educate the public about mental health and suicide prevention and provide support groups for survivors of suicide loss and those affected by suicide. Their website has information for individuals having suicidal thoughts, for those who have lost or are worried about someone, and those who have survived a suicide attempt.
Website: https://afsp.org/
Anxiety and Depression Association of America (ADAA)
Who They Are: The Anxiety and Depression Association of America strives to improve the quality of life for individuals who struggle with anxiety and depression.
What They Do: The ADAA works to find new treatments in hopes of one day preventing and curing anxiety, depressive, obsessive-compulsive, and trauma-related disorders. They offer education on these disorders, including articles, webinars, and other resources, to help individuals better understand anxiety and depression. The ADAA also offers training to help turn their research findings into practice.
Website: https://adaa.org/
Child Mind Institute
Who They Are: The Child Mind Institute is the leading independent nonprofit in children’s mental health. They are dedicated to transforming the lives of children and families struggling with mental health and learning disorders by giving them the help that they need.
What They Do: The Child Mind Institute holds workshops, talks, and conversations for parents and families. They also have a Family Resource Center on their website, with parenting guides, a symptom checker tool to inform parents about possible diagnoses, a resource finder, and an option to submit questions.
Website: https://childmind.org/
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What does high functioning anxiety or depression look like?
You may have heard people around you using the term “high-functioning” to describe themselves and their mental health. Phrases such as high-functioning anxiety and high-functioning depression are being used more and more, but what do they mean?
High-functioning anxiety and depression are not technically clinical diagnoses because they are not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a handbook used by mental health professionals. However, many practitioners and researchers recognize that people can experience symptoms of anxiety or depression and continue to be highly functioning, productive individuals. Those who have high functioning anxiety or depression may not appear to struggle with it on the surface, despite experiencing symptoms internally. To others, they may seem to have it all together or go about their days as they normally would.
What Does High-Functioning Anxiety Look Like?
People with high-functioning anxiety may experience symptoms of anxiety disorders, such as excessive worrying most days, feelings of restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or trouble sleeping. However, these symptoms do not cause significant problems across areas of their lives and do not inhibit daily functioning. Some common characteristics of individuals with high-functioning anxiety include:
- High-achieving, with a fear of failure
- Extremely organized & detail-oriented
- Engages in nervous habits, such as nail-biting, hair twirling, lip biting, leg shaking, etc.
- Perfectionist with a harsh inner critic
- Active & needs to keep “doing,” finding it hard to relax
- Appears calm on the outside, but may have racing thoughts
- People pleaser who has a hard time saying no
- Procrastinates when stressed
- Talks a lot or has nervous chatter
- Overthinks and overanalyzes everything
- Difficulty expressing emotions
- Need for repetitions and reassurance
- Tendency to dwell on the negative
What Does High-Functioning Depression Look Like?
Similarly to high functioning anxiety, individuals with high-functioning depression may not meet the criteria for a clinical diagnosis of depression, but are able to function normally most of the time. Thus, their depression is often not clear to others or themselves. Typical symptoms of depression would include persistent sad mood, feelings of hopelessness, worthlessness, and/or guilt, loss of interest in hobbies or activities, fatigue, irritability, trouble sleeping, changes in appetite or weight, or thoughts of death or suicide. The following may be characteristic of an individual with high-functioning depression:
- Feeling a little down most of the time
- Poor self-esteem
- Difficulty making decisions
- Low energy and motivation
- Performs well at school or work, but has difficulty focusing on tasks
- Crying a lot without any concrete reason
- Forcing oneself to engage in social activities when they’d rather withdraw
- Feeling overwhelmed
- Feeling lonely
The Role of Stress
Before determining whether or not you have high-functioning anxiety or depression, it is important to first consider current stressors and evaluate their impact on your life. April is National Stress Awareness Month. We all experience stress in response to challenging circumstances and some times are more stressful than others. This is our body’s normal response. However, if these symptoms persist well beyond a stressful event or are consistent and unrelated to specific stressors, you may be experiencing high-functioning anxiety or depression.
This truly highlights the importance of good mental health care and scheduling check in’s with a mental health therapist. The opportunity for building insight and awareness of our emotional loads and the management of that load is done best with the help and insight of a professional who can guide you through this. Everyone should consider seeing a therapist! When you are ready to do so, you can visit our therapist’s page to find a clinician who fits you best.
Sources: nimh.nih.gov, rtor.org, psyccentral.com, waldenu.edu, health.usnews.com, washingtonpost.com
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The impact addiction has on the family
It’s true, Addictions is a family disease
Addiction is difficult, and it can take a toll on relationships with our nearest and dearest. Our families are not just a group of people who live together. The family is a living, breathing, system that adapts to change. For instance, think of the last time a close family member had a serious illness. How did other family members respond? In some circumstances some members become anxious, while others take charge. Some members delegate responsibilities. Others may feel doubt or helpless, unsure what to do. All responding in ways to cope with the situation and their own feelings. It is the same with addiction. Addiction can go on for years and behaviors associated with addiction can cause chaos, feelings of helplessness, shame and guilt. This is true not only for the addict, but also for family members. Families cope by creating unspoken rules, like – ‘Don’t talk about the addiction,’ ‘Don’t express your feelings,’ and place blame elsewhere.
These rules contribute to codependency within the family system. Research has show us dysfunction is displayed in the roles family members play to sustain as sense of normalcy in the family system. We will now review these roles.
- The Dependent is the individual that is the focus of the family. The family spends a lot of time and energy helping, controlling and protecting the dependent, to preserve the family system. If the Dependent continues with maladaptive behaviors (usually dependence on substances, gaming, sex/porn, work, etc…) family members will take on specific roles to help themselves or others in the family. This is dynamic is done over time, unconsciously and with honorable intent.
- The Enabler/Caretaker is the individual who the dependent is most dependent on. This person enables the dependent’s addiction and is usually a parent or spouse. They cover-up the Dependents behaviors protecting them from the consequences of their choices, thereby supporting their dysfunction. This “martyr” role correlates with high stress and negatively impacts the health and mental well-being of the Enabler/Caretaker. They carry all responsibility for maintaining normalcy of the family system. This occurs both in the home and outside the home.
- The Hero Child. Typically the first-born child and is the one that is the “enabler in training”. They too cover-up and protect the Dependent with the goal of maintaining a sense of normalcy in the family system. A hero child is sometimes referred to as the “Golden Child”, usually high achieving, athletic students, responsible, independent and helpful. They provide value and worth to the family. The family is proud of this person. Without help, the Hero child’s maladaptive behaviors can result in repeating patterns of codependency and enabling a partner with chemical dependence.
- The Scapegoat. These individuals are usually the only identified problem the family reports. This person may refer to themselves as the “black sheep” or “outsider” in the family. They will get into trouble at school, will avoid close relationships, having a “back-off” attitude. The Scapegoat’s role is an important one, they carry the weight of all the projected family anger and tension, they take the attention off the Dependent person. Without help, the Scapegoat runs the risk of addiction, they seek attention through negative behaviors and this increases risk of unplanned pregnancy, difficulty maintaining employment, with risk of criminal activity.
- The Lost Child: This family member flies below the radar, not wanting to be drawn into the family dysfunction. The Lost Child tends to be the creative loner, they present as withdrawn, quiet, without friends, are “followers” and struggle to make decisions. They provide “relief” for the family, “This is one child we don’t have to worry about.” They feel unimportant, lonely and high levels of anger. Without help the Lost child commonly struggles with depression, sexual identity and often die young, having a higher risk of suicide.
- The Mascot: This person is typically the youngest child in the family. They provide respite from the family tension representing comic relief and fun. A mascot presents as hyperactive, immature and need to be the center of attention, may have learning disabilities and needs protection. They feel insecure, lonely, confused, and fear not belonging. Without help, they can’t handle stress, resulting in ulcers or other stress related health conditions. They continue to use humor to cope, can be compulsive and will frequently marry a caretaker.
- -Adapted from work of Sharon Wegscheider-Cruse
Why is this important?
Dysfunctional codependent roles initially appear to be solving the problems instead they are hiding the problem and enabling the dependent to continue their unhealthy behaviors. Without help, family members will identify with their roles, and continue these maladaptive patterns in future relationships and model them for the next generation. Mental health Counseling can help reduce dysfunctional cognitive-behavioral patterns and teach healthy boundaries and coping skills that will go a long way to reducing risk for substance use, mental illness and improving quality of life now and for future generations. For a myriad of resources including hotlines to help you or family members get connected visit the Substance Abuse and Mental Health Services Administration.
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Supporting Teens Mental Health
A Guide to Supporting Teen Mental Health
If you are a parent of a teenager, you may be wondering how to best support your teen’s mental health, especially at a time when we are bombarded with stories about suicide, depression, Tik Tok trends, threats of school shootings, and so on. Parenting a teenager can often feel like trying to decode a complicated algorithm without the formula for doing so. While there is a myriad of resources available to assist parents in this journey, there are also some basic tenants to keep in mind which you can begin to apply today.
The Roller Coaster of Teen’s Emotional World
First of all, I want to encourage all parents and teens alike that these do not have to be the worst years of your life. True, adolescence involves a great deal of transition and growth, but it is not all negative and you are not doomed to years of heightened chaos and emotionality, as many believe. Second, it is crucial to understand what is happening during the teenage years so that you can keep your eye on the end game and not become lost in the daily process. Remember the reference to decoding your teen? Well, a huge part of that is recognizing the function of adolescence so that you as a parent do not misinterpret the ups and downs of behavior. In her book about the development of the teenage brain, Dr. Frances Jensen (2015) describes the process that goes into “building a brain” (p. 24). An adolescent brain possesses “an overabundance of gray matter (the neurons that form the basic building blocks of the brain) and an undersupply of white matter (the connective wiring that helps information flow efficiently from one part of the brain to the other)” (p. 26). Jensen likens the result of this developmental journey to that of obtaining “a brand-new Ferrari: it’s primed and pumped, but it hasn’t been road tested yet” (pp. 26-27). In other words, a teenager may look like an adult physically, but his/her brain is far from being fully prepared to make adult decisions or navigate adult emotions.
This information is important to keep in mind when trying to determine whether your teen’s behavior is the result of normal development or may be a warning sign of something deeper, such as a mental health concern. Admittedly, it can sometimes be difficult to discern the difference, which is why consistent communication and interaction is key. Assuming your teenager is fine or isn’t struggling because they are not acting out or vocalizing their struggle is not necessarily accurate. The reverse can also be true, however: not all teenage rebellion is the biproduct of anxiety or depression. The following paragraphs will attempt to outline symptoms and behaviors to pay attention to, as well as offer suggestions for providing support to your teen.
Signs and Symptoms of Teen Depression or Anxiety
This is by no means an exhaustive list and may vary in presentation from one individual to the next; however, here are some general signs or symptoms to be aware of in your teenager:
- Sudden changes in behavior or habits that cannot be explained by a medical condition or other identifiable stressor
- Increased conflict between peers or family members
- Increased withdrawal and isolation
- Excessive sleeping or an inability to sleep
- Substance abuse
- Promiscuous activity
- Binge eating, purging or restriction of food
- Excessive exercise
- Lack of motivation or procrastination
- Decreased performance in school or other activities
- Self-harm or suicidal thought/ideation
- Inability to focus or complete tasks; forgetfulness
- Frequent lashing out in anger or heightened emotion
- Frequent crying or an inability to stop crying
Understanding Your Teen’s Behavior
In order to know if these behaviors are new or unusual for your teen, it is necessary to keep tabs on their daily habits and activities and have a general awareness of their friends and the influence their peer group has on them. You don’t have to know all the details or micromanage (in fact, I advise against that), but you do need to take a regular pulse. Not only does this allow you to track patterns and notice possible problems, it also sends the message to your teen that you care and are interested in their life. Although many teens protest parental involvement, they actually do want to know you care. I cannot tell you how many teens tell me their parents are checked out, don’t care or don’t monitor their activities—they don’t say this with satisfaction, by the way; rather, it’s with a sad awareness that the adults in their life are not paying close enough attention.
Maintaining Connection
You may be wondering how to maintain this connection without your teen pushing you away or feeling you have to stock them on social media. For starters, establish some kind of regular check-in. I tell my teenage daughter to “keep me in the loop,” so this might take the form of a conversation over dinner, after school, in the car on the way to an activity, or, more often than not, late at night. As a parent to teens, we have to be available when they are ready to talk, even if their timing doesn’t match with ours or is inconvenient. If you can’t make the time when they are ready to talk, assure them you will make it a priority and follow through with them. It is also advisable to occasionally monitor their on-line activity and discuss parameters of how to utilize social media. For example, Snap Chat is not the place to post pictures of self-harm or a cry for help. Not only can these messages negatively impact others who view this material, it often won’t result in intervention. Other kids are not equipped to help their friends, nor should they have to, so it is critical your teen knows of at least one adult they can go to in a crisis.
Communicating With Your Teen
In addition to establishing a regular check-in or monitoring social media, make your home a place where your teen’s friends are welcome to hang out. This can provide you with a wealth of information about your child and allow you to truly assess their state of mind. Finally, never underestimate the power of a good old-fashioned question about how your teen is doing. Not everything has to be clandestine with adolescents. In fact, it is perfectly acceptable to ask your teen how they are doing. If they don’t feel comfortable talking, ask them to write you a letter or encourage them to talk to a counselor. The goal is to get them talking about their feelings and to create a safe space for them to process. In my experience, most teens would rather have a root canal than talk about their feelings, so your child may not get super deep with you, but at least they will know they can when push really comes to shove.
Additional Tips for Maintaining Strong Mental Health
Some final suggestions for helping to support your teen’s mental health include making sure they get adequate sleep, eat regular meals, engage in some form of regular movement or exercise, have down time without being on a device, and have an open-door policy to talk with you whenever they choose to do so.
You and your Teen can Solve anything Together
Keep in mind that not every difficult or dramatic behavior from your teen is a sign of dysfunction. Part of their brain development includes learning to emote in healthy and constructive ways. They don’t always know what they are feeling or how to describe it, so it can be challenging for them to communicate the reason behind tears, eye rolls, angry outbursts, etc. Sometimes an adolescent’s acting out is trying to tell you something deeper and they aren’t necessarily trying to be difficult or disrespectful. By the way, one of the biggest complaints I hear from teens is that their parents demand respect but often yell at or criticize their teen, in return. While their brain may still be developing, they do see this for the double standard that it is. Keep your cool, Parents. Believe it or not, teenagers are capable of fairly high-level conversations and are often logical in their thinking—it just may not be the same as your way of thinking. Again, fostering an environment where conversation is invited and productive is key.
References
Sarah Groff, LCMHC has worked in the mental health field for over 20 years in a variety of settings that have included the nonprofit and 
private practice sectors. This work has ranged from providing counseling and support to birth parents, adoptive parents and adoptees in the adoption field, to working with those infected with HIV/AIDS, to teaching undergraduate psychology courses, and now to private practice where she works with adolescents, individuals, couples, and families. Sarah truly loves her work and counts it as a privilege to come alongside clients in their most painful and celebratory moments of life. She has three children and has lived in the Lake Norman area for eight years.
Self Love February!
Focus on Self-Love this Valentine’s Day
Valentine’s Day can bring up many different emotions for both singles and couples. However, regardless of relationship status, one thing we can all focus on this Valentine’s Day is self-love! Self-love involves showing yourself the same love and kindness that you’d show others and accepting yourself for who you are. It’s about putting some energy and effort into the relationship that you have with yourself. The concept may sound self-indulgent or narcissistic, but it is more about getting in touch with ourselves and our well-being, which can have great benefits for our mental health! So how can you love yourself this Valentine’s Day, no matter how much love you receive from others? Here are 10 tips for practicing self-love:
- Treat yourself like your best friend: This is a great rule of thumb. You deserve the same kindness and care that you’d give to a friend, so give that to yourself! Listen to your needs and desires by taking time to check in on yourself then following that lead on you need more of next.
- Challenge your inner critic: It’s easy to listen to your negative thoughts and become your own worst critic. Be mindful of the way you talk to yourself. When you start to feel self-criticism coming on, press pause, take a step back, ask yourself “Is this true?” and then consider what you’d tell a friend who was thinking that about themselves.
- Engage in positive self-talk: Once you recognize and challenge a negative thought, replace it with something more positive. Take time to consider your positive qualities and the things you love about yourself. Write them down when you think of them to have when you need them most.
- Celebrate your accomplishments: No matter how big or small of a win, celebrate them all! Allow yourself to take time after a victory to be proud of yourself and your accomplishment before moving on to your next goal or challenge. You absolutely have something to celebrate about yourself!
- Practice good self-care: Regular self-care is an act of self-love. Take care of your hygiene to let yourself know that you are worthy. Take care of your physical needs with a nourishing diet, exercise, and proper sleep. Practice self-care not because you have to, but because you care about you.
- Spend time doing things that bring you joy: Make time each day for something that makes you happy or makes you laugh. This will increase your self-esteem, mood, & energy, and give you a sense of purpose. Try not to put pressure on yourself to instantly feel better, but just be fully present in what you’re doing.
- Surround yourself with supportive people: Spend time with those that help you feel safe in being yourself and leave you feeling good. These people will help lift you up when you have self-doubts and encourage you to take chances in order to grow. Identify those in your life who are mostly negative and consider spending less time with them.
- Establish boundaries: Learn to say no. Before committing to anything, pause and check in with yourself. Think about the implications. Taking on something that you can’t follow through on or do to the best of your abilities can lower your self-esteem. Setting personal limits will help to prevent you from overcommitting to people and experiences that are not aligned with your values or interfere with your self-acceptance.
- Do something kind for someone else: Kindness releases serotonin (the “feel good” hormone). Though it might seem contradictory, engaging in acts of kindness or volunteering can actually boost your self-esteem and overall happiness, making it an act of self-love.
- Give yourself compassion & forgiveness: Don’t believe the lie that you must do everything right. Give yourself grace to make mistakes and move on from them. Dwelling on mistakes allows negative thoughts to build up and consume you. Normalizing struggles, missed opportunities as being human and authentic is the most healthy and truthful thing you can say to yourself.
However you might be feeling this Valentine’s Day, all of us at Miracles want you to know that you are special. There is no one else in this world like you. You deserve to be loved, not just by others, but by YOU! If you would like further guidance with self-love or self-acceptance, contact us about scheduling an appointment with one of our therapists.
Sources: psychcentral.com, psychologytoday.com, lifehack.org, forbes.com
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How to build good relationships that support your mental health
How to build good relationships that support your mental health
Managing family relationships when you struggle with mental health issues can be a strain as we balance what we have been told to do by our therapists, and facing real life circumstances. When dealing with a mental health struggles, it is important to surround yourself with people who are supportive and understanding. Unfortunately, this is not always possible, especially during the holidays. Many family members are not understanding of depression, anxiety, or other mental health challenges. Unsupportive loved ones may blame you for your symptoms, make cold and thoughtless comments, or even try to “solve” your mental illness, which can make coping with it even more difficult. So what can you do when the people who are supposed to be your greatest supporters are not? How can you survive holiday gatherings with these people? Here are some tips:
- Acknowledge the situation- Not everyone will understand and there may be a reason behind their feelings and behavior that has nothing to do with you. It is possible that their behavior is deeply ingrained based on beliefs that they were taught growing up (e.g. weakness in vulnerability; stigma around mental health)
- Engage in positive self-talk- When seeking support, start with yourself. Practice treating yourself with kindness and compassion. Pay attention to your inner voice and what it’s telling you, challenging negative thoughts as they arise.
- Understand that other people struggle too- Some family members may be unable to support you because they are dealing with their own mental health struggles. It’s not that they don’t care, they just might not have the internal resources to do more than take care of themselves at this time.
- Don’t believe misconceptions or myths about your mental illness- You may have family members who say hurtful things to you that are far from the truth. (e.g. calling you lazy or attention seeking). Listen to mental health professionals and don’t lose sight of the facts.
- Ask for help explicitly- Don’t be afraid to be direct and ask for what you really need. Some family members may actually be willing to support you, but they aren’t sure how or may not even realize that you need help.
- Control what you can- You may not be able to control where family gatherings take place or who will be there, but you can control whether you go or how long you plan to stay. Do whatever feels comfortable for you. Don’t force yourself into an uncomfortable or triggering situation.
- Establish healthy boundaries- Unfortunately, some people may be negative and hurtful no matter what you do. If you have tried some of these tips and things do not change with a certain family member, you may need to distance yourself from this person or even cut ties. Although this may be very hard to do, it is likely having negative effects on your well-being and hindering your progress.
- Prioritize self-care- Make time for activities that improve your mood, especially during the holidays or times when you’re planning to be around family. Doing something positive for yourself will help take the focus off unsupportive people and place it back on your personal wellness.
- Reach out to others for help- When your loved ones cannot provide you with the support that you need, don’t hesitate to seek outside help. Schedule an appointment with a mental health professional or join a support group. You may find that talking about your struggles with a stranger is easier than doing so with a family member, as you don’t have to worry about being judged. Feel free to check out our therapists at Miracles here to see who might be a good fit for you.
What to know about Obsessive Compulsive Disorder now
Have you wondered what truly qualifies as having Obsessive Compulsive Disorder? We hear this phrase very commonly now, and many people like to make light of their selves or routines by saying “I’m OCD,” but are they actually? It’s important to clear up any misconceptions regarding this so you can know when you actually need to seek help. Early intervention is critical for your health and to live a full life. Read on below to fully understand what having OCD means.
What is Obsessive Compulsive Disorder or OCD?
Obsessive Compulsive Disorder (OCD) is a common mental health condition characterized by repetitive, unwanted thoughts (obsessions) and excessive urges to engage in behaviors related to these thoughts (compulsions). OCD affects both children and adults and is typically diagnosed by late adolescence or early adulthood. OCD can be a very life limiting disorder, but with proper treatment a health and fulfilling life can be achieved.
What are the Symptoms of OCD?
- Obsessions: These are unwanted, disturbing thoughts, images, or urges that won’t go away, despite causing severe distress or anxiety. Individuals with OCD know these thoughts are irrational, but feel like they have no control over them. Obsessions are typically accompanied by feelings of fear, disgust, or doubt.
- Compulsions: These are repetitive behaviors or rituals intended to counteract the obsessions or make them go away. Individuals with OCD know that these behaviors are not realistic, but they feel like they must do them to relieve the anxiety caused by obsessions or prevent something bad from happening. Compulsions do not bring pleasure and provide only temporary relief. They are time consuming and get in the way of daily activities.
How is OCD Diagnosed?
Although you may hear people say that they have OCD because they occasionally experience an impulsive thought or compulsive behavior, OCD is an ongoing cycle that severely interferes with normal, daily functioning. Lightly using the phrase “I have OCD” can bring misconceptions to the significant impact and struggles of what having Obsessive Compulsive Disorder is like. There are very specific criteria that must be met in order to receive an OCD diagnosis. To be diagnosed with OCD, you must have:
- Obsessions, compulsions, or both
- An inability to control your obsessions (thoughts) and compulsions (behaviors), even when you recognize that they are irrational
- Obsessions and compulsions that last at least an hour each day and cause significant problems with work, relationships, or other parts of life
- No gain of pleasure from compulsions aside from a brief relief from anxiety caused by the obsessions
What are the Subtypes of OCD?
Though there are many types of OCD, individuals’ obsessions and compulsions tend to fall into one of the following five main subtypes.
- Contamination Obsessions & Washing/Cleaning Compulsions- Individuals with this subtype fear discomfort related to dirt & contamination and will engage in excessive washing or cleaning to relieve their stress. (e.g. Washing your hands repeatedly for hours after touching a door knob)
- Harm Obsessions & Checking Compulsions- Individuals with this subtype worry about possible harm to themselves or others and engage in constant checking rituals to relieve their distress. (e.g. Worrying about your house burning down and repeatedly driving by your house to make sure there is no fire; Worrying that you are increasing the likelihood of something bad happening just by thinking about it)
- Symmetry Obsessions & Ordering/Arranging/Counting Compulsions- This subtype involves the urge to arrange and rearrange things to prevent feelings of discomfort from things not feeling “right” or symmetrical (e.g. Wanting to write the exact same number of words in each line on a page). Sometimes these compulsions are used to prevent potential harm or danger. (e.g. “Something bad will happen if the pillows on my bed are uneven.”)
- Hoarding- Individuals who hoard are unable to discard possessions with little value due to the fear of losing items that may be needed one day. This subtype is associated with higher depression and anxiety than other subtypes.
- Obsessions Without Visible Compulsions- Individuals with this subtype will ruminate over unwanted thoughts, particularly related to sexual, religious, or aggressive themes. Instead of engaging in compulsions, mental rituals may be used, like reciting words, counting in one’s head, or praying for relief. (e.g. Intrusive thoughts about attacking someone)
How is OCD Treated?
Treatment for OCD typically involves medication, psychotherapy, or a combination of the two. Antidepressants are the most common medications used to treat OCD, and must be prescribed by a medical doctor or psychiatrist. Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention Therapy (ERP) are also highly effective in treating OCD symptoms. CBT is focused on recognizing and changing negative thoughts that cause distress and lead to compulsive behaviors. ERP involves exposing individuals with OCD to the cause of their anxiety and prevents them from engaging in compulsions.
If some of the symptoms above sound similar to your life situation, it’s important to begin taking the steps to seek help for this. Symptoms can become worse over time and sometimes will evolve into other issues if left untreated. If you’re interested in psychotherapy for OCD, reach out to us!
Source(s): National Institute for Mental Health , International OCD Foundation, Mayo Clinic, National Association for Mental Illness, The Very Well Mind
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Getting help as an adult with ADHD
Get the help that works for Adult ADHD
For adults with ADHD, or attention-deficit/hyperactivity disorder, impulsive behavior can become persistent. Some examples of impulsive behavior may be frequently interrupting conversations or saying things that you regret later, jumping from one activity to another or trying to handle three at once, and becoming impatient while driving and cutting in front of everyone. Impulsive behaviors are generally improvised or unpredicted choices that are based on emotions, rather than logic. Adulthood ADHD can lead to feelings of guilt and shame, anger toward others, and can sometimes cause harm to oneself or others. Seeking help as an adult with ADHD is incredibly important, and many simple skills incoporated into your day can be life changing!
Your impulsiveness Can be Managed
Managing impulsivity can be challenging, but it is possible. Along with seeking help from a mental health professional, here are some strategies you can try:
Become aware of your reactions
ADHD is different for everyone. What does your impulsivity look like? Try making a list of behaviors you think are impulsive. Ask others what behaviors they’ve observed. Which ones might be more harmful? Think about the times or places in which your impulses most frequently occur. Consider both the positive and negative consequences of your impulsivity.
Practice mindfulness
Mindfulness increases our self-awareness. It involves bringing your attention to the present moment and observing what is happening without judgement. Mindfulness can help you begin to recognize urges before acting impulsively, as well as distance yourself from them. Practice focusing on your thoughts, emotions, and how your body feels when you feel the urge to be impulsive.
Identify the challenges underlying your impulses and make changes accordingly
Pay attention to your inner dialogue right before you act impulsively and challenge these thoughts. For example, if you had a task to complete, but browsed social media for an hour instead, ask yourself questions like, “Did the task feel doable?” “Was it interesting?” “Did you have any resistance regarding the task?”
Make it harder to act on impulses
If you engage in impulsive spending, leave your credit/debit cards at home when you go shopping and pay with cash only. Stay away from places where you tend to spend too much money. Throw away catalogs and block emails from retailers. If you struggle with impulsive speech, carry a notebook with you and jot down thoughts when they come to mind. You can return to them later and decide if it is a more appropriate time to say them.
Pay attention to body language and social cues from others
You can learn a lot about how others receive you through their facial expressions, tone of voice, and gestures. Spend time watching before speaking.
Establish healthy habits
Exercise and spend time outdoors. Stick to a regular sleep schedule with a predictable bedtime routine. Eat smaller meals throughout the day that include protein and fiber-rich whole grains. Avoid sugar and junk food when possible.
Try calming activities
Impulsivity is often the result of feeling stressed. Some calming activities include guided imagery, listening to music, deep breathing techniques, exercise, and progressive muscle relaxation.
Plan ahead strategies
Make a list of tasks that have to be completed, decide what to prioritize, and break them down into smaller steps. Use a timer to help you stay on task. Check your calendar before saying yes to commitments.
Talk to someone you trust
Talking to someone about your struggles can provide you with a healthy outlet and a safe space to work through impulsive behaviors. Ask them to help you become aware of your impulses.
Learning to manage impulsivity takes time and practice. Though impulsivity may always be a struggle for individuals with adulthood ADHD, these strategies can help to improve daily functioning and life satisfaction. For further assistance managing impulsive behaviors consider seeing one of our therapists.
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Maintain a Healthy Body Image this Summer
Summer is a season that many love for its warm weather, long sunny days, slower pace, and relaxing vibes. However, the feelings of joy and carefreeness that summer brings are often also accompanied by feelings of anxiety, depressed mood, dread, self-criticism and shame over our body. Body image is the way we view our bodies, as well as how we perceive others to view our bodies. Summer is a trigger for anyone who struggles with body image, but it can be a challenging time for even those who are more confident about their bodies. This is partially due to an increase in body-focused headlines and advertisements during the summer season. These ads promote unrealistic and unhealthy standards for achieving the ‘perfect beach body’ that is tan, thin, and toned. Sometimes these messages come from family or friends who have their own dysmorphic ideas around healthy bodies. Because we hear these messages on repeat during the summer months, many people, regardless of age or gender, experience body dissatisfaction, which is one of the biggest risk factors for eating disorders. So how can we maintain a positive body image this summer when the negative thoughts begin to take over?
First, let’s identify some of the triggers for body dissatisfaction during the summer months:
Lack of structure– We often find ourselves with more free time during the summer, which can be nice and relaxing. However, the lack of structure can disrupt our routines, leading to an increase in emotional dysregulation and unhealthy behaviors. It is more common to skip meals or over exercise when you are not on your normal routine. More free time also gives us the opportunity to overthink how we look and get stuck in negative, spiraling thought patterns.
Greater social obligations– More free time allows for more social events and vacations with friends and family, which can increase stress. Stress can trigger negative thought patterns and unhealthy habits, especially for those who struggle with eating disorders and body image. We sometimes take stress out on our bodies.
You aren’t as covered- It’s harder to hide our bodies under lots of clothing during the hot summer months. Wearing shorts and bathing suits make many people feel vulnerable and insecure, especially when they can readily compare themselves to others around them also showing more skin.
Social media- When the weather is warm, we consistently see people in bathing suits or less clothing on our social media feeds. This is an instant invitation to start comparing and critiquing ourselves. We don’t stop to consider the fact that many of these posts are posed, edited, or filtered.
Here are some tips to help you maintain a positive body image:
Identify negative self talk- Body image is deeply ingrained in our minds from a young age, making it difficult to break free from distorted thoughts about ourselves. Try to pay attention to the comments you make about your body and how those make you feel. Challenge yourself to ban negative comments for a day or a week. Separate feeling bad from feeling unattractive. Sometimes, when we feel distressed, we allow it to take the form of negative thoughts about our bodies. This is often the beginning of anxious or depressed moods – our thoughts are within our control and we can stop this in its tracks by changing these negative thoughts.
Engage in body positive talk- Once you identify those negative statements, replace them with more realistic, positive ones. For example, turn the negative thought “Everyone will judge how I look in my swimsuit” into “People aren’t looking at me; they’re enjoying their own day.” Engaging in regular body positive talk will take time and practice. Consider writing out body positive statements and placing them around your home to serve as reminders.
Limit mirror time- Many of us repeatedly spend long periods of time in front of the mirror, focusing on the parts of ourselves that we don’t like and looking for evidence to confirm our negative thoughts about them. This only magnifies our flaws. Don’t avoid the mirror, but use it in a functional way, like to see if your clothes match. When looking in the mirror, focus on your body as a whole, instead of on the parts you don’t like.
Listen to your body- Shift your attention from the outside- how you look, to the inside- how you feel. Remember that your body is a living, breathing being that communicates with you. Practice intuitive eating and movement. Choose foods that feel good for your body without judgement and listen to the type of movement your body needs, rather than listening to what others say our bodies should be doing.
Practice self-compassion- Would you speak about a friend’s body the way you speak of yours? Be kind toward yourself. Engaging in self-care is a great practical way to do so. Working on self-acceptance and seeing ourselves on a journey through life, rather than as our anxious or depressed thoughts about one snapshot in time is very helpful.
Express gratitude toward your body- Focus on what your body can do, rather than how it looks. When we get caught up in what’s ‘wrong’ with our bodies, we take what they do for us on a daily basis for granted. Practice writing down things you are grateful to your body for in a journal and really feeling the appreciation.
Limit social media- As we mentioned earlier, social media is a trigger for body dissatisfaction. If you find that scrolling through social media tends to leave you with negative thoughts about yourself, set limits on your usage and take breaks.
Sometimes the societal messages we receive about body image, combined with our negative thoughts about ourselves can be too much, leading to body dysmorphic disorder or eating disorders. Eating disorders are more common than you might expect. Around 8 million people in the United States struggle with an eating disorder. The good news is that up to 80% of people who seek proper treatment will see significant improvement. Our therapist, Kathleen Fetter, LCMHC-S, specializes in the treatment of eating disorders. If you are struggling with body image issues and would like more individualized help, contact us or call us at 704-664-1009 to schedule with Kathleen! At Miracles, we want you to know that you have a beautiful body that was designed to carry you through life!
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How to help your student overcome test anxiety
For most students, the end of the school year is exciting because it means that the freedom of summer break is right around the corner. However, before students can begin to enjoy summer break, they must get past the one thing that many dread the most… testing! For our 3rd-12th grade students, it’s the end-of-grade tests and state exams. For our college students, it’s finals. With the end of the school year fast approaching, many of these students are likely already experiencing test anxiety. This is a term we hear a lot, but what exactly is test anxiety? What causes it? And how can we overcome test anxiety? Read below to learn how to help your student overcome test anxiety.
Test anxiety is a type of performance anxiety that we experience when pressure from high expectations or the fear of failure interfere with our ability to perform well when taking tests. Having some nervous feelings before a test is normal. In fact, these feelings are helpful because they keep our minds alert and focused. However, too much test anxiety can have the opposite effect, making it difficult to recall information or think clearly. Serious test anxiety can also lead to physical symptoms, such as, increased heart rate, shortness of breath, sweating, dry mouth, sweaty palms, headaches, upset stomach, nausea & vomiting, shaking, fainting, or even panic attacks. In addition to physical symptoms, those with test anxiety may experience emotional symptoms, like low self-esteem, frustration, irritability, fear, or helplessness. If this sounds like you or your child, then how can you begin to manage your test anxiety?
Here are some test taking tips to help you during this exam season:
- Prepare Well- Feeling prepared for a test ahead of time can help reduce your anxiety on test day, while cramming only increases it. Consider joining a study group or finding a tutor if the material is challenging. Also, be sure to learn all you can about the format of the test beforehand, such as how many or what types of questions will be on it.
- Be Mindful of Self-Talk – Watch out for unrealistic or negative thoughts. It can be easy to go down this road, but try to think about what you are telling yourself, how rational it is, and if there’s something better you could say. For example, if you find yourself saying “I have to do well on this exam,” challenge that thought with “Even if I don’t do well, it’s not the end of the world.” Or, if you say “I’m gonna fail this exam,” remind yourself of all the times you’ve successfully taken exams in the past.
- Visualize Success- Picture yourself on exam day feeling confident and doing well on the exam. If you visualize successful completion of the test, it can help you make it happen in real life!
- Use Relaxation Techniques– While studying for your test, practice deep breathing exercises, progressive muscle relaxation, or mindfulness meditation and be sure to take breaks! Some of these strategies can also be used during the test when you start to feel overwhelmed!
- Stay Healthy- Students often neglect their physical health when preparing for exams, which can worsen test anxiety. Be sure to get adequate sleep, eat nutrient-rich foods, regulate caffeine intake, and make time for physical movement during the time leading up to the test. On test day, remember to eat an adequate meal and avoid excess caffeine.
- Have Grace for Yourself- Remember that a little bit of anxiety before a test is healthy, so don’t be upset with yourself for this! Accept this feeling and realize that it helps you stay motivated. Try to let go of perfectionism. Remember that it is impossible to know everything! When studying, focus on the major concepts first and then return to the less important information if you have time.
- Reward Yourself- Plan something to look forward to after the test to celebrate your completion. This does not have to be big, and elaborate! Just make sure to take some time to relax and debrief afterward. You worked so hard! Be proud of yourself! If you have multiple exams, try to allow at least a small break before studying for the next one.