All posts by Dr. Andrew Rosen

Loneliness: A Public Health Concern?

Loneliness is an emotion that can be difficult to pin down because it often means different things to different people. It can be a perception of isolation because we feel that we aren’t being heard and valued. It can be caused by feeling that there is no one we can turn to for emotional support. Also, in many instances, a lonely person is actually physically alone through the loss of a spouse or loved one. Regardless of how we define loneliness, however, researchers have concluded that feeling so alone can affect not just our mental and emotional well being, but our physical health, as well. And, they are finding that loneliness can be as contagious as a virus.

Feeling Lonely is Becoming a Public Health Concern

It may be hard to believe, but loneliness is also becoming a public health issue in the United States. When people were asked how many close confidants they had during a poll taken back in 1984, the average answer was three. When a follow-up poll was taken again in 2004, however, the average response from people was that they had no close confidants: zero!

Not only is loneliness on the upswing, but studies are now suggesting that loneliness can be contagious and can spread through groups of people via negative social interactions. One such study asked more than 5,000 people to complete a loneliness questionnaire. Participants were also asked to supply researchers with a medical history and go through a physical examination every two years to four years over the ten year study period. The participants also listed relatives and friends and referred them to the study: many of these referrals also took part in the study. By looking at the social networks of the participants and the number of lonely days they experienced each year, scientists were able to see how loneliness spread throughout the groups.

Additionally, researchers are finding that social isolation actually changes human DNA. In 2015, a study done by UCLA School of Medicine psychologist Steve Cole and his colleagues revealed that complex immune system responses are at work in lonely people. Their investigation found that feelings of loneliness or actually being socially isolated created more activity in the genes responsible for inflammation and reduced the activity of genes that produce antibodies to fight infection. They found that monocytes, a type of white blood cell that forms the first line of the body’s infection response system, are dramatically changed in people who are socially isolated.

Even if you overlook this change in infection-fighting cells, we know that “lonely adults consume more alcohol and get less exercise than those who are not lonely,” says John Cacioppo, co-author of the book Loneliness: Human Nature and the Need for Social Connection in an interview with U.S. News and World Report. “Their diet is higher in fat, their sleep is less efficient, and they report more day time fatigue. Loneliness also disrupts the regulation of cellular processes deep within the body, predisposing us to premature aging.” Their study showed that the cellular damage that can be caused by these genetic changes appears to be similar to that which comes from smoking, diabetes, and obesity.

Coping With Loneliness

So, how do you cope with being lonely? First, understand that loneliness is a normal part of being human, but it can make you feel like you are abnormal. Second, move forward by trying these suggestions:

  • Get a pet – they provide companionship and unconditional love and can be a way to meet other people through activities that get you up and out of the house. Dog-walking in the park is a good example of this type of activity.
  • Volunteer – helping others is often done as group. Volunteering can give you a new sense of purpose, can make you feel more positive about yourself, and will allow you to meet others who are working toward the same goal.
  • Take a class – classes also allow you to join a group of people with at least one common interest of yours. Additionally, classes give you something to look forward to and can provide you with the sense of ‘belonging’ that comes from being in a group.
  • Try to strengthen your existing connections and relationships with family and friends by calling them more or going out with them more often. Take the initiative to ask the person out, be yourself, and be a good listener.
  • Consider joining an online community because it can be easier to connect with people online than connecting with them in person if your loneliness comes from being shy or socially anxious. Do keep in mind, however, that online interaction is not a substitute for connecting face-to-face.
  • If you have tried some of the ideas above and are still having difficulty with feelings of loneliness, it might be time to try Cognitive Behavioral Therapy (CBT). CBT can give you the power to cope with your situation and can help you take action to deal with feeling lonely. Past studies have shown that changing how a person perceives and thinks about themselves and their social interactions with others was the most effective intervention for loneliness.

Learn More

It may be hard to figure out why you feel lonely and how to move past those feelings. A licensed mental health professional at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help you to understand and work through your loneliness. For more information, call them at 561-496-1094 or email The Center today.

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How to Beat the Post-Holiday Blues

The holidays have come and gone and a new year has begun. You should be feeling inspired and happy to start working on your New Year’s resolutions and doing what you can to make this year better than the last…right? Maybe not.

Even though many people do greet the new year with excitement, there are also many who find themselves suffering from the post-holiday blues. This is understandable: the holiday season is a time of family gatherings and festive parties, which all comes to an abrupt halt right after the calendar page turns to the next year. Instead of all the merriment, we have to deal with fatigue, going back to work after taking time off, taking down those cheerful decorations, and stress from paying for all the gifts we’ve given. Additionally, the long, cold, dark days of winter, can lead some people to experience seasonal affective disorder (SAD). If you think about it, it’s no wonder many of us experience some depression after the holidays!

Symptoms of Post-Holiday Depression

The symptoms of the post-holiday blues period are similar to those of “regular” depression – headaches, insomnia and trouble sleeping, anxiety, weight gain or loss, and agitation. In general, depression related to the holidays is short-lived, though, lasting just a few weeks into the new year. For some people, however, it can be long-lasting and overwhelming: in these cases, counseling and support groups can help immensely.

Tips for Getting Over Depression after the Holidays

In order to help avoid (or climb out of) that post-Christmas depression period, many mental health professionals recommend taking a pro-active approach to the New Year. You might try:

  • Reflecting on the good times you had over the holidays. Spending some time to remember the enjoyable things that happened during the holiday season can help you focus more on the blessings you have in your life. Keeping a gratitude journal can also be helpful.
  • Getting some rest: things always look bleaker when you are tired. If you can, take some time to relax and do something just for yourself: reading the book you’ve been wanting to finish, watching a movie or two, or indulging in some “me time” can all give you a brighter perspective.
  • Starting a hobby or picking up one that you’ve enjoyed in the past. Activities you delight in will help take the focus off the end of the holiday season.
  • Starting to plan your next vacation or what you’ll do on your next long holiday weekend. There are holidays in January (Martin Luther King, Jr’s birthday) and February (President’s Day) that you can start looking forward to. Even something as simple as planning a dinner with friends over those weekends can help you refocus your thoughts away from the holidays.
  • Volunteering: if you are lonely and missing those gatherings with family and friends, this can be a great way to get out and be around people.
  • Phototherapy: If your depression is more related to the dark days of winter, phototherapy can help immensely. Seasonal affective disorder generally responds well to light therapy, in which patients are regularly exposed to bright light. In particular, fluorescent lights have been shown to significantly improve depression. People with SAD can purchase “light boxes” which are used for approximately 30 minutes daily in the morning and evening.
  • Setting realistic New Year’s resolutions. Don’t aim so high that your goals are unattainable or you may end up disappointed in yourself for breaking them.

Above all, expect to enjoy the year ahead of you. Look forward to the coming months: plan some of the things you’d like to do this year, make a list of things you’d like to accomplish, stop looking backwards at the past. Put your goals for the year down in writing or tell them to a friend, so you’ll be more likely to make them happen.

Learn More

If you’ve tried some of these tips and are finding that you’re still having a hard time kicking the post-holiday blues, it might be helpful to speak with a mental health professional. Dr. Andrew Rosen and the therapists at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help. For more information, call them at 561-496-1094 or Contact Dr. Rosen and The Center today.

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Fear of Public Speaking

We’ve all experienced it: you have to give a presentation and you’re stressing about getting up in front of a room full of people. What’s the first thing everyone always says? “Just picture your audience naked,” they’ll tell you with a chuckle. While that can work for a few people, for many, a fear of public speaking is no laughing matter. Studies have shown that some speakers can’t even calm down after beginning their speech: instead, they become increasingly more nervous as their lecture goes on. For these people, even presenting their ideas to a small group in a workplace meeting can be a harrowing experience.

It’s no secret that glossophobia or fear of public speaking is the number one fear reported by people in the United States. This anxiety comes from a worry about being judged and often has origins in social anxiety. Speech anxiety has increased in today’s cyber-world of communication where we are often “faceless” and can remain relatively anonymous by sending emails or texting instead of speaking directly to people.

Tips for Overcoming Speech Anxiety

For many people, a fear of public speaking can often be helped by learning a few skills:

  • Know your topic: the more you know about your topic, the less you will stress if you accidentally lose your train of thought or make a mistake.
  • Practice your speech: go over (and over) your presentation in front of a supportive friend or coworker (videoing yourself can also be helpful). Have them ask questions about your topic so you are prepared to give answers. Also, ask them for feedback and consider making any changes they might suggest.
  • Visualize a successful outcome. Mentally picture yourself being announced, approaching the lectern or stage, smiling at your audience, presenting your slides or PowerPoint images. See yourself being congratulated for your ideas and shaking hands with the admiring people you’ve spoken in front of.
  • Be prepared – organize your slides or handouts, listen to any audio clips, and run through your presentation from start to finish so you can see how it “flows.”
  • Bring water with you to the podium in case your mouth gets dry or you need to take a quick pause to regroup.
  • Clasp your hands together or stand with your knees slightly flexed to help keep them from trembling if you are nervous and shaky.
  • Take a few deep breaths and smile (even though smiling is probably the last thing you’ll want to do!). Deep breathing helps you relax and studies have shown that smiling can help lower your heart rate and aid in physiological recovery after stressful situations.
  • Focus on your material instead of your audience.
  • Keep in mind that audiences will generally sympathize with a nervous speaker, so try not to worry about appearing uneasy or anxious.
  • After your speech, mentally congratulate yourself for putting yourself up there in front of everyone! Write down some of the positive aspects of your lecture (did you remember to make eye contact with your audience or toss out statistics without a mistake?). Focusing on the positives will help keep you from over-analyzing any slip-ups you made (even world-class speakers make mistakes!).

Cognitive Behavioral Therapy for Public Speaking Anxiety

In many cases, the apprehension we experience before giving a speech can be used as a way to focus: in our nervousness, we go over and over the points we want to make and read through our notes repeatedly which helps ingrain them in our memory. For some individuals, however, instead of focusing on the details of the presentation they are about to give, they will zero in on their own physical symptoms and won’t be able to settle in once they’ve begun to talk. They’ll turn their attention to how their hands are shaking or how nauseous they are and they’ll become progressively more anxious as their lecture goes on.

Often, they end up carrying that anxiety over after the speech ends, too, so they stay keyed up instead of relaxing – even to the point of becoming physically ill. For these people, cognitive behavioral therapy (CBT) done through a licensed mental health professional can help quickly identify and challenge inaccurate or negative thinking. CBT can often provide coping mechanisms that can help them gain confidence and overcome their public speaking anxiety.

Keep in mind that not everyone who benefits from cognitive behavioral therapy has a mental health condition. In the case of “stage fright”, CBT simply gives you the power you need to cope with a public speaking situation in a more effective and healthier way. Because CBT utilizes a goal-effective approach, it can be an effective tool to help you learn how to better manage the stress of speech anxiety.

Learn More

If these tips and tricks don’t help you when it’s time for your next public lecture, it might be helpful to speak with a mental health professional like Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, call them at 561-496-1094 or Contact Dr. Rosen and The Center today.

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Resilience Training

Why is it that some people seem to take life’s challenges in stride, while others fall apart at the least little thing? Haven’t you noticed that some people just ooze grit and determination and others give up after the tiniest failure? You might think this is because certain people have more dominant personalities or may be emotionally stronger than others, and you may be correct in some cases. Some people who seem so strong, however, have gotten that way because they have actually been taught to use coping tactics that allow them to better handle depression, stress, and anxiety. These people have gone through resilience training.

Resilience Definition

According to the Mayo Clinic, “Resilience is your ability to adapt well and recover quickly after stress, adversity, trauma or tragedy. If you have a resilient disposition, you are better able to maintain poise and a healthy level of physical and psychological wellness in the face of life’s challenges.”

When you have emotional resilience, you can look at problems as being temporary and something that can be changed. You can also perceive adversity not as catastrophic, but as something that can have positive aspects: resiliency means you “look on the bright side” of a problem. For those who don’t come by this mental fortitude easily, resilience training can be used to minimize negative thoughts and help you learn ways to bounce back effectively from life’s setbacks.

One thing to keep in mind – being resilient does not mean that you will go through your life without experiencing grief, loss, and painful events. Instead, understand that suffering and personal growth can exist side by side when you learn to work through the emotional effects of adversity.

Besides thorough training, emotional resilience can come from:

  • Having close relationships with family and friends
  • Feeling like you are in control of a situation
  • Having confidence in yourself, knowing your strengths
  • Keeping a positive outlook – looking for the positives, in spite of your difficulties
  • Not seeing yourself as a victim
  • Good problem-solving skills
  • The ability to manage strong feelings and impulses
  • Being able to let others help you and being able to help others
  • Being able to look for and use resources
  • Coping with stress in healthy ways and avoiding harmful coping strategies, such as substance abuse

What Will You Learn in Resilience Training?

If you would like to learn to be more emotionally resilient, resilience training programs can help you:

  • Identify ways to respond positively to the pressures and demands of work, finances, and other stressors
  • Learn techniques to manage risks
  • Gain tips for developing your natural strengths
  • Find ways to identify the opportunities that can come from challenges and setbacks
  • See the relationship between performance, work pressure, personal well-being, and resilience
  • Practice techniques for promoting long-term behavior and attitude for developing resilience
  • Develop creativity and problem solving methods
  • Learn relaxation and stress management techniques

Resilience training can help you learn how to have a more positive outlook in the face of adversity. It can teach you methods for doping in a healthy way when life throws you a curve ball. Without these skills, there can be a tendency to feel overwhelmed by challenges or to dwell on problems, which could lead to anxiety or depression.

For example, resilience training has recently been implemented by the United States military to help soldiers learn to analyze and overcome their emotions and beliefs about failure so they can become tough in mind, as well as body. The military program helps participants learn to look more positively at situations and not to jump to conclusions or judge others too quickly.

In other programs, humanitarian aid workers across the globe have learned to cope with the chronic stress of living in conflict or disaster zones and caring for those in traumatic situations. Aid workers often work under unique pressures and can suffer from post-traumatic stress disorder (PTSD), depression, and anxiety. Resilience training helps them build coping skills so they can better manage their stress.

Have Questions? We Can Help!

If you are someone who often dwells on problems, tends to assume the worst, or feels overwhelmed much of the time, resilience training can help you decrease your stress and give you a better quality of life. For more information, call Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or contact Dr. Rosen and The Center today.

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Insomnia and Anxiety/Depression

Most all of us have had the occasional sleeplessness night for one reason or another. Maybe you have a work project on your mind or it could be that you are worried about a family issue and can’t seem to fall asleep or stay asleep. Whatever the reason, having more than a few nights of less than quality sleep can make anyone feel fatigued and more than a little depressed. That stands to reason: after all, who wouldn’t be depressed when they are totally exhausted?

But, the combination of insomnia, depression, and anxiety may mean more than just a lack of sleep. In fact, studies have shown that at least 80% of people who suffer from anxiety and depression also have chronic insomnia. This is so prevalent that researchers are now saying that chronic insomnia may actually be a predictor of the onset of depression and/or anxiety.

Insomnia Symptoms

Chronic insomnia is defined as having trouble falling asleep or having problems staying asleep most nights during the month. Insomnia symptoms may include some or all of the following:

  • Difficulty falling asleep
  • Waking too early or waking up throughout the night
  • Being sleepy or tired during the day
  • Feeling irritable, anxious, or depressed
  • Loss of interested in social activities
  • Loss of libido
  • Difficulty in completing tasks or staying focused
  • An increase in accidents or errors
  • Physical symptoms of insomnia may include headaches, stomach or GI distress, or not feeling well, in general

Is There a Link Between Insomnia and Depression/Anxiety?

If you can’t get to sleep or can’t stay asleep, it’s easy to see why you’d become depressed from fatigue or become so tired that you might become anxious about things that might not normally bother you. Current sleep research has found, however, that “insomnia and depression are two distinct but overlapping disorders,” says Michael Perlis, Ph.D., associate professor of psychiatry at the University of Pennsylvania and director of their behavioral sleep medicine program.

“Until recently, insomnia was typically seen as a symptom of depression,” says Perlis. “Treat the underlying depression, the thinking went, and sleep problems would go away.” But, recent findings show that insomnia often shows up or gets worse just before a bout of depression. “Insomnia may serve as a trigger for depression,” Perlis says. “But it also appears to perpetuate depression.”

Treating Insomnia and Depression or Anxiety

In our practice, we find that Cognitive Behavior Therapy, used in conjunction with Mindfulness Meditation, often helps the most to relieve the anxiety experienced by having insomnia. CBT teaches people healthier behaviors and helps them gain more positive and realistic thought processes regarding their sleep. This therapy encourages better sleep habits and helps reduce the fears and replace the negative thoughts that can keep them from falling asleep or staying asleep.

Research has shown that Cognitive Behavioral Therapy has longer-lasting, more sustainable effects on insomnia and depression. This is because it teaches you a skill set that you can use for the rest of your life. CBT gives you the power to cope with your situation in a healthy way and feel better about yourself and your world.

Mindfulness Meditation is also used to help the patient learn self-awareness. It teaches that our inaccurate view of the world is what triggers our negative emotions. Through practicing Mindfulness Meditation, the person trains their mind to overcome their worries and painful emotions, so they can be free of their suffering.

Other Ways to Treat Insomnia

There are also other schools of thought about ways to treat both insomnia and depression or anxiety. One idea is to specifically treat the insomnia by itself: research indicates that the treatment of sleep problems can help relieve and prevent a recurrence of depression and anxiety. In fact, several studies have found that depressed people who also had insomnia and were treated with both an antidepressant and a sleep medication did much better than those who were treated just with antidepressants. They slept better and their depression scores improved significantly over people who were just taking antidepressants alone.

Another method for treating insomnia is to actually wake a depressed insomniac early. This boosted mood in 30-60% of cases, but the cure is short-lived: the sufferer often becomes depressed again after they sleep once more.

Chronotherapy has also been used – in this type of therapy, those who have trouble falling asleep reset their internal circadian rhythm by adjusting the time they go to sleep over a period of days. Light therapy can also help: it exposes the insomniac to bright lights to help change their sleep cycles.

We Can Help

Are you or a loved one fighting chronic insomnia? It may be time to talk to a professional to see if there is an underlying condition that is contributing to your sleep problems. Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are ready to take your call and make getting help easier. Contact Dr. Rosen at 561-496-1094 or email Dr. Rosen and The Center today.

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Emetophobia: The Fear of Vomiting

There are a number of mental health anxieties out there that most people are familiar with: panic disorder and post-traumatic stress disorder are great examples. In general, many people have at least heard of these conditions and most could somewhat understand them if they came up as a topic of conversation. That being said, however, there are a number of fears or anxieties that you’ve probably never heard of before. And, because you don’t know they exist, you may believe you’re struggling alone through concerns no one else will understand.

If you’re one of these people and you suffer with a fear of vomiting, first know that you are not alone. In fact, the fear of vomiting, officially known as emetophobia, is a phobia that affects millions of people. And, the good news is that help is available.

Understanding Emetophobia

It might be helpful to understand a little of what emetophobia entails. The fear of vomiting can present itself in a number of different ways:

  • Fear that you will throw up.
  • Fear that you will see someone else vomit.
  • Fear of the loss of control that can come with getting sick.
  • Fear that if you begin to vomit you won’t be able to stop.
  • Fear of death from throwing up.

It is interesting that most people who struggle with emetophobia do not actively worry about throwing up. Instead, the phobia rears up when they are put in a position where they feel like vomiting may occur. Here are a few examples of triggers that can exacerbate this fear:

  • Someone else vomiting: seeing this in person, watching it in a movie, or even hearing about it can have a negative effect and trigger their fears.
  • Hearing that a coworker is home with the flu.
  • Thinking of food or seeing or smelling a food item that has made them vomit before.
  • Seeing or hearing things that can be associated with throwing up, like a toilet or the sound of someone gagging.

Life Impact

The truth about vomiting is that none of us are very happy to talk about it or think about it. In fact, most of us will also do whatever it takes to avoid throwing up, just the same as someone who struggles with emetophobia. The difference between these types of people comes in two important areas: the level of worry involved and the impact that worry has on one’s life. When faced with the triggers noted above, the average person might flinch or groan, unhappy to be hearing about them. On the other hand, someone who struggles with emetophobia may have the following reactions:

  • They may do an analysis of themselves and how they’re feeling: Is my stomach hurting? Could that gas lead to something worse.
  • They may begin digging into the details of someone else’s illness to determine their own risk of getting sick.
  • They may search for signs of impending trouble: Did that coworker cough or gag? Did they (or I) eat the same thing as someone else who just got sick?

When a person has convinced themselves that their risk of throwing up is high, there are a number of ways it can impact their life. They may find themselves avoiding:

  • People they know are sick or who look sick.
  • Food they think could lead to vomiting
  • Eating in restaurants.
  • Drinking alcoholic beverages.
  • Friend’s babies or even their own baby, based on a concern that the baby is bound to throw up at some point.

Seeking Help

Though a fear of vomiting would seem to be a part of Health anxiety disorder (hypochondria), emetophobia is not the same thing. Treatment for emetophobia can even be a little more challenging at times, mostly because everyone who struggles with this type of anxiety has thrown up before or has been around their triggers without having their worst fears confirmed. Despite this, their anxieties continue and often strengthen over time.

That being said, there are plenty of ways that a psychotherapist can help sufferers learn to cope with this fear and reduce its impact on their life. As an example, Cognitive Behavior Therapy can help them recognize and understand the false beliefs that are triggering their phobia and anxiety. Exposure Therapy can also be useful to reduce the fears associated with their triggers.

Could you or someone you know benefit from professional assistance with emetophobia? Take action today to overcome your fears! For more information on treatment for emetophobia, Contact Dr. Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

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Online Therapy and Internet Counseling

In today’s stressful world, approximately 20% of Americans suffer from mental health concerns. While many of us have experienced occasional periods of anxiety or a feeling of being overwhelmed, most of us have just come to accept the tension and demands in our life. But for the 1 in 5 Americans who have true depressive or anxiety disorders, everyday stresses represent something more intense. These burdens begin affecting their home life and relationships and start impacting their work; all clear signs of an anxiety disorder.

The best way someone with an anxiety disorder can help themselves is by seeking therapy. Licensed therapists can evaluate your concerns and determine the best treatment options available for your situation. The only problem with this, until recently, is that all types of therapy have required a visit to the therapist’s office, making it difficult for certain people to obtain the help they need. Those who may not have been able to easily seek help in the past are:

  • People who live in rural areas, where the nearest office could be hours away from their home
  • Agoraphobics – those people with a phobia of going outside
  • People with social anxiety disorder
  • People with mobility constraints

 Internet Therapy

Enter the virtual therapist. This is psychotherapy that’s done electronically via resources like Skype and FaceTime. The emergence of online therapy and phone therapy has revolutionized the way counseling is performed. In addition to making treatment more accessible to people, there are a number of positive reasons to consider internet counseling as the preferred way to seek professional help:

  • Increased comfort: imagine being able to complete your therapy from your very own couch in the safety and comfort of the familiar surroundings in your home.
  • Increased options for therapists: if the therapist you want to see or need to see isn’t conveniently located near you, you can still use their services.
  • Increased availability to continue therapy while traveling for work or while on vacation.
  • Increased privacy: there’s no concern that you’ll run into someone you know while sitting in the waiting room of your virtual therapist.
  • Time saved from having to drive to and from the psychologist’s office.

 Is Online Therapy Right For You?

Just like anything else, there are important things to consider before jumping into phone therapy or internet counseling:

  • Ask your therapist about HIPAA compliance to ensure your electronic communications will be kept confidential.
  • A physical doctor’s office guarantees solitude and quiet to discuss your concerns: can your virtual therapist ensure they will provide a similar environment when engaging in therapy at your convenience?
  • State licensure: while internet therapy does offer more convenience, you will most likely still need to use a therapist who is licensed in your state. Don’t be surprised if this becomes a topic of conversation.
  • It may not be possible for your therapy to be 100% electronic. Some concerns may require visits to local clinics for in-person assessing.

What to Expect

So how does online therapy appointment differ from a regular in-person appointment? The short answer is, it doesn’t – for the most part. Aside from the fact that you’ll be talking to your therapist through a device, your internet therapy appointment should be very similar to a typical appointment in a physical office.

Your psychotherapist will work with you to go through the same exercises and analysis as they normally would if you were sitting in their office. Additionally, some therapists may periodically assign videos to watch or “homework” assignments that can be submitted electronically, but even these won’t be much different than what an in-person therapist might ask of you.

So how do you get started? Not every therapist is equipped to administer online therapy or provide internet counseling. But Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida is ready to receive your call and make getting help easier. Contact them at 561-496-1094 or contact Dr. Rosen and The Center today.

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Hoarding and OCD

We all know someone who has a collection of some items that has special meaning to them. You probably have a friend who loves turtles, for example, and has a shelf full of whimsical turtle statues. Often, men will have sports-related memorabilia tucked into several corners of their home or hunting trophies hanging in their den. While these collections are generally harmless, there are people who compulsively collect “stuff” and have accumulated so much that their possessions have literally taken over their home or yard. When a person’s life begins to be so affected by their items that they can no longer safely live in their home or they aren’t able to give up even a tiny portion of their collection, they’ve crossed over into the realm of hoarding.

Hoard Definition

A hoarder is defined by the American Psychiatric Association as a person who “excessively saves items that others may view as worthless and has persistent difficulty getting rid of or parting with possessions, leading to clutter that disrupts their ability to use their living or work spaces.” This isn’t to say that someone is a hoarder simply because they have an assortment of specific items like model cars: collectors focus on something specific and will often display them or organize them somehow. When people hoard items, however, they generally save random, unrelated items and store them haphazardly.

In most cases, a hoarder saves things that they feel:

  • they may need in the future
  • are/will be valuable
  • have sentimental value
  • make them feel safer when they are surrounded by the things they save

The APA says those with the condition – and their families – suffer negative social, emotional and physical effects to the point where there is a disruption of normal life. People who hoard, however, often don’t see the problem: many will live in unsafe and unsanitary conditions in order to maintain and add to their collection of items.

Hoarding Symptoms

Hoarding symptoms may include some or all of the following:

  • A persistent inability to part with any possession, regardless of its value or ability to be used
  • Feeling excessive discomfort if others touch or borrow items or distress at the idea of losing an item or getting rid of it
  • Inability to use an area of the home for its intended purpose (for example, being unable to cook in the kitchen or use the bathroom to bathe)
  • Keeping stacks of newspapers, magazines or junk mail
  • Allowing trash or food to build up to unusually excessive, unsanitary levels
  • Limited or no social interaction
  • Difficulty organizing items, sometimes losing important items in the clutter
  • Difficulty managing daily activities because of procrastination and trouble making decisions
  • Moving items from one pile to another, without discarding anything
  • Shame or embarrassment

Are Hoarding and OCD Related?

Hoarding has long been thought to be a form of OCD or Obsessive Compulsive Disorder because of the victim’s fixation on their items. Often, it can be traumatic for them to discard even one or two items because of their strong need to save things.

Recently, however, some researchers have come to believe that hoarding disorder isn’t the same for all people: they think hoarding may be related to ADHD and/or dementia in certain people.

Hoarding Therapy

Treatment of hoarding disorder can be challenging because many people either don’t recognize the negative impact that hoarding has on their lives or they don’t believe they need treatment. When they do seek out a therapist, hoarding therapy generally follows a similar path as treatment for OCD. Often, the most effective means is a combination of medication and therapy.

Cognitive Behavior Therapy is used to help the person become aware of their thoughts, emotions, and beliefs about their hoarding and help them identify and challenge inaccurate thinking. Certain anti-depressants have been found to be effective in treating the disorder. Frequently, family or group therapy is encouraged. Over time, the need to hoard can be overcome and learning to take small steps can lead to big changes.

We Can Help!

If you or a loved one has symptoms of hoarding disorder, talk with a doctor or mental health provider as soon as possible. Additionally, some communities have agencies that help with hoarding problems. Check with your local or county government for resources in your area.

For more information or to talk to a mental health professional about hoarding, contact Dr. Rosen or call The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094.

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LGBT Anxiety

It is said that it is human nature to fear things or people who are different. For centuries, society has pointed to this as justification for judging and discriminating against people who fall into “non-traditional” categories.

Every day our society is becoming more and more accepting of the differences we see in each other. Despite this progressive acceptance, people who identify as lesbian, gay, bisexual, or transgender still face a number of social stigmas and discrimination. It’s no wonder that this can lead to stress and anxiety for those in the LGBT community.

Potential Issues

If you are a member of the LGBT community and you’ve experienced anxiety tied to your identity, you’re not alone. Thousands of people just like you experience the same concerns every day. Let’s consider the facts:

  • According to a 2007 survey, students who identified themselves as lesbian, gay, bisexual, or transgender were almost ten times as likely to experience bullying and victimization at school.
  • LGBT people were also twice as likely to have considered suicide as their heterosexual, non-transgender classmates.
  • People who identify themselves as homosexual or transgender face a number of common issues:
    • Discrimination and oppression at work or school
    • Stress and anxiety based around coming out to friends and family members
    • The struggle to identify your “true” self despite social expectations
    • The anticipation of potential discrimination or harassment even in situations where it hasn’t occurred yet

 Finding the Right Therapist for LGBT Anxiety

The ethics of professions tied to mental health, such as social work, psychology, and psychiatry require that therapists provide services to all people without discrimination. That being said, some therapists may be better than others when assisting with the specific needs of the LGBT community. Because of this, there are a few factors you may want to consider when seeking therapy for anxiety about your sexuality:

  • Similar experience: A therapist who is homosexual or transgender will have real-life experience similar to yours and may be able to provide more extensive assistance.
  • Professional focus: Many therapists focus their energy on specific areas of psychiatry. Finding someone who specializes in the anxieties of the LGBT community may provide you with more options as you go through your therapy.
  • The therapist’s view on reparation or conversion therapy: Decades ago, the mental health community operated on the misguided notion that homosexuality concerns were mental health disorders. During this time period it was common to find therapists who focused on “fixing” what they considered to be “improper” romantic attractions. Obviously, this practice is highly discouraged now and, in many states, has actually been banned. However, it’s still good to be aware of this so you don’t accidentally find yourself working with a therapist who has different intentions than you do.

Remember, the LGBT anxiety you face on a regular basis is not a result of there being anything wrong with you. They arise because of the environmental factors that surround you. Appropriate therapy will aim to help you understand and cope with those factors to improve your daily interactions.

Are you or someone you know facing severe anxiety as a result of your sexual or gender identity? Dr. Andrew Rosen knows the best techniques for helping you work through this anxiety and cope with difficult situations that arise. For more information, contact Dr. Rosen or call The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094.

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Compassion Focused Therapy for Social Anxiety

It’s not unusual for people to get nervous in certain social situations. Preparing to give a speech and meeting a group of people you don’t know are both great examples of situations where it’s perfectly understandable to experience a little anxiety. However, there is a big difference between small amounts of anxiety and social anxiety disorder. Social anxiety disorder develops when those little fears become so intense that you go out of your way to avoid any situations that will trigger them. And, when that avoidance begins to negatively impact your daily life or family it may be time to seek some professional help.

Cognitive Behavioral Therapy

One of the most common treatments for social phobia is cognitive behavioral therapy. This type of systematic desensitization addresses negative patterns and distortions in the way we look at ourselves and the world. There are two main components to this approach:

  • Cognitive therapy examines how your negative thoughts can contribute to your social anxiety.
  • Behavior therapy analyzes the way you behave and react in those situations that trigger your anxiety.

There are three main steps involved in this form of therapy:

  • Identifying your negative thoughts: this can include recognizing what those thoughts include, the specific situations they occur in conjunction with, and recognizing them for the harmful thoughts they are.
  • Challenging your negative thoughts: during this step you’ll question the evidence for your frightening thoughts, weigh the pros and cons associated with them, and conduct experiments to test the validity of these thoughts.
  • Replacing negative thoughts with realistic ones: as you become more adept at recognizing your anxiety-provoking thoughts, you can begin to practice converting those thoughts into positive imaging.

The Compassionate Approach

While cognitive behavioral therapy has become widely recognized as an effective treatment for social anxiety disorder, there are aspects of it that can be difficult for many people. It can be a great challenge to identify positive thoughts or to replace them with realistic ones. Oftentimes people can recognize the benefit of this systematic desensitization approach but understanding the logic doesn’t necessarily make the treatment easier to complete.

This is where compassion focused therapy comes in. People who experience social phobia are apt to be self-critical and filled with thoughts of shame and anger because of how the anxiety affects them. Compassionate-focused therapy helps individuals reverse those thoughts through compassionate engagement. The theory behind this therapy states that we are “at our most flourishing” when we:

  • See evidence that we are cared about and valued
  • Are caring, helping, and valuing others
  • Are mindful and sympathetic of our own feelings

By demonstrating the skills and attributes of compassion, the therapist instils these values in the patient. As a consequence, the patient is aided to develop an internal compassionate relationship with themselves – one that will replace the blaming, condemning and self-critical person they may feel they are.

In other words, by learning to be empathetic and non-judgmental of others it can become easier to give yourself a break, as well. While many might view compassion as a personality trait, the reality is that it is a skill you can be trained in. This therapy helps to foster the attributes of that skill.

 Need More Assistance?

It can be difficult to convert your negative thoughts into a positive mindset when you’re in the midst of social anxiety disorder. If you or someone you know is suffering from social anxiety, seeking professional help can be the most direct path to reclaiming your life.

For more information about compassion-based cognitive behavioral therapy, contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

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