How Do You Know That You Have Received a Comprehensive Psychiatric Evaluation?

As I have discussed in previous blogs on this website, the practice of Psychiatry is challenging. Unlike other medical specialties there are a paucity of laboratory testing or radiologic imaging that will reveal the true nature of the problems being presented at the time of our appointment. Instead of relying on objective data I must process a wealth of subjective information; that is, the words that you use in describing your current emotional state. I view this challenge much like a good detective would tackle a mystery. To help you better understand the complexities of the evaluation I will try to outline the key components.

Firstly, I certainly recognize that a new patient coming into my office will be uneasy and not sure of what to expect. So it is important to reassure the individual that he evaluation process is straightforward and geared to better understanding what brings the individual to my office.

This brings us to what I call the “Chief Complaint”, best expressed by asking “How can I help you?” Quite commonly people present with concerns about being depressed or suffering from anxiety. The problem with the chief complaint is that what people mean by words like depression or anxiety differ tremendously among individuals. So the chief complaint must be clarified with more specific descriptions of what the person means by the words they are using. Often a perceived problem with anxiety represents a symptom of a depressive disorder. I commonly hear individuals come in concerned about “mood swings” with a fear that they could have bipolar disorder (manic depressive illness). However, after clarifying their concerns by getting a more comprehensive description, I often discover that what they are describing I a swing between feeling fine and feeling depressed, a symptom complex that can be part of a core depressive disorder.

Once the chief complaint is determined, the next step is to obtain a “History of Present Illness”. Specifically, this entails finding out how long the difficulties have been present, what does the development of emotional symptoms look like and what was the context in which the difficulties presented themselves. Since a major goal of assessment is to discover if there are underlying biological (that is, brain related) factors causing symptoms,  it is just as important to determine if there are situational factors present during symptom development. Then the challenge is to try to better understand whether there are psychological factors (coping style, attitude and belief systems) influencing or even responsible for producing the current problems bringing the person to my office.

Current problems and symptoms must be understood in the context of any “Past Psychiatric History”. Have these problems and/or symptoms been present in the past? If so, has there been a pattern of episodes? Has there been previous psychiatric treatment and what was the outcome of such treatment? It is always helpful to know if an individual had previous depressive episodes and responded to a particular antidepressant. If there is a history of prior courses of psychotherapy, what type of therapy was it and what was the outcome?

The presence of “Substance Abuse” (another section of the comprehensive evaluation) must be discovered because of the complicating role it may play in the presentation of the individual’s symptoms and concerns. The drugs, amount used and duration of use must be clarified. When substance abuse has been extensive and long term, all bets are off in determining a non-substance abuse primary psychiatric disorder. It is only after months of a brain free of the substance(s) abused can one adequately determine the presence or absence of a core mood or anxiety disorder.

A most important section of this initial assessment consists of the “Family Psychiatric History”. Knowing what the individual’s genetic pedigree is can be very telling. If mood and/or anxiety disorders are prevalent in nuclear and extended family members the possibility of an underlying biological problem must be considered when treatment planning occurs. This does not mean that biological dysfunction is the sole problem. It is quite common to discover that there has been a stress-diathesis interaction; that is, the external situational stressors are interacting with an underlying biological predisposition.

A “Childhood History” is another critical component. To discover that there is a past history of traumatic life experiences raises questions about both the nature of the present problem and aspects of treatment planning. Bullying has unfortunately become recognized as a major factor in the development of future suffering and trauma syndromes. Determining if there was any birth injury, delay in developmental milestones or school related anxiety and avoidance or academic learning difficulties is part of this section. Although a very sensitive area of investigation, learning about a history of abuse, whether it be emotional, physical or sexual, represents important albeit painful information to gather.

The person’s “Past Medical History” cannot be ignored. This section includes the presence or absence of medical system problems (involving heart/vascular, lungs, kidney. Liver, thyroid, gastrointestinal, other hormonal, and brain) that may be impacting on the individual’s current complaints. An accurate and detailed list of current medications and dosages taken is essential for treatment planning due to the varied effects of medication on mental state as well as the risk of drug to drug interactions when psychiatric medications need to be prescribed. Obtaining a history of medication-related or other allergies, surgeries, head injuries or concussions rounds out this section.

The “Psychosocial History” explores childhood specifics, religious background, educational level, job history, marital status and special interests or hobbies. It helps to fill in the context of the present illness.

The “Mental Status Examination” is the psychiatrist’s equivalent of the internist’s physical examination. This examination evaluates the behavior and demeanor of the individual. Emotional experience and expression is assessed. Thinking content and process along with speech characteristics are components as well. A formal assessment of memory, attention/concentration, abstract language use, fund of knowledge and perceptual/sensory disturbances are an integral part of mental status.

Because severe mental disorders can lead to self or other destructive thoughts and urges, an evaluation of dangerousness risks is an important aspect of a comprehensive evaluation.

After all this information is obtained, a preliminary psychiatric assessment is provided. This diagnostic section utilizes the American Psychiatric Association Diagnostic and Statistical Manual, Edition V to aid in evidence-based diagnostic consistency.

The initial plan of treatment may include medication, lifestyle recommendations and psychotherapy. It is important to recognize that both diagnostic impressions and treatment recommendations need to be flexible because as the therapeutic relationship unfolds additional information becomes available which may alter treatment planning.  

 

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Signs You May be a Hypochondriac

A hypochondriac is someone who lives with the fear that they have a serious, but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them. Hypochondriacs experience extreme anxiety from the bodily responses most people take for granted. For example, they may be convinced that something as simple as a sneeze is the sign they have a horrible disease.

Hypochondria accounts for about five percent of outpatient medical care annually. More than 200,000 people are diagnosed with health anxiety (also known as illness anxiety disorder) each year.

Hypochondriac Symptoms

Hypochondria is a mental health disorder. It usually starts in early adulthood and may show up after the person or someone they know has gone through an illness or after they’ve lost someone to a serious medical condition. About two-thirds of hypochondriacs have a co-existing psychiatric disorder, such as panic disorder, obsessive compulsive disorder (OCD), or major depression. Hypochondria symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier.

Hypochondriac symptoms may include:

·         Regularly checking themselves for any sign of illness

·         Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness

·         Making frequent visits to their doctor

·         Conversely, avoiding the doctor due to fear that the doctor will find they have a dreaded disease or serious illness

·         Talking excessively about their health

·         Spending a lot of time online, researching their symptoms

·         May focus on just one thing: a certain disease (example: cancer) or a certain body part (example: the lungs if they cough). Or, they may fear any disease or might become focused on a trending disease (example: during flu season, they may be convinced that a sniffle means they’re coming down with the flu)

·         Are unconvinced that their negative medical tests are correct, then worry that they have something undiagnosed and that no one will be able to find it and cure them

·         Avoiding people or places they fear may cause them to get sick

Health anxiety can actually have its own symptoms because it’s possible for the person to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety. In fact, illness anxiety can take over a hypochondriac’s life to the point that worrying and living in fear are so stressful, the person can become debilitated.

You may be wondering what triggers hypochondria. Although there really isn’t an exact cause, we do know that people with illness anxiety are more likely to have a family member who is also a hypochondriac. The person with health anxiety may have gone through a serious illness and fear that their bad experience may be repeated. They may be going through major life stress or have had a serious illness during childhood. Or, they may already be suffering from a mental health condition and their hypochondria may be part of it.

Hypochondriac Treatment

Often, when a person repeatedly runs to their doctor at the first sign of a minor symptom, their doctor doesn’t take them seriously and may consider them to be a “difficult patient,” rather than a person who is honestly concerned about their health. Worse, some doctors will take advantage of the person’s fears and may run unnecessary tests just to appease the patient. In fact, it’s been estimated that more than $20 billion is spent annually on unnecessary procedures and examinations.

Self-help for hypochondria can include:

  • Learning stress management and relaxation techniques
  • Avoiding online searches for the possible meanings behind your symptoms
  • Focusing on outside activities such as a hobby you enjoy or volunteer work you feel passionate about
  • Avoiding alcohol and recreational drugs, which can increase anxiety
  • Working to recognize that the physical signs you experience are not a symptom of something ominous, but are actually normal bodily sensations
  • Setting up a schedule for regular appointments with your primary care doctor to discuss your health concerns. Work with them to set a realistic limit on medical tests and specialist referrals.

Professional treatments for hypochondria include:

  • Cognitive Behavioral Therapy (CBT), which is very helpful for reducing patient fears. In this type of therapy, the person learns to recognize and understand the false beliefs that set off their anxiety. Research has shown that CBT successfully teaches hypochondriacs to identify what triggers their behavior and gives them coping skills to help them manage it.
  • Behavioral stress management or exposure therapy may be helpful
  • Psychotropic medications, such as anti-depressants, are sometimes used to treat health anxiety disorder

It is worth noting that many sufferers are unwilling to acknowledge the role anxiety plays in their symptoms. This makes them less likely to seek help from a mental health professional. Often, hypochondriacs are so resistant to the idea that they have anxiety that it takes intervention from loved ones to help them understand that they need assistance.

Get Help for Health Anxiety Disorder

Being a hypochondriac and experiencing health anxiety can be debilitating. It can severely affect the lives of the people who suffer from it.  The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are experienced in helping those with illness anxiety. For more information, contact us or call us today at 561-496-1094.

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13 Ways to Overcome Travel Anxiety

The summer travel season is just kicking off. Scores of tourists are excitedly packing their luggage and consulting websites or glossy brochures as they anticipate their upcoming vacations. While the idea of seeing new places or relaxing in cozy, familiar locations is appealing to most people, there are those who find the whole idea of travel frightening. It’s hard to get excited about new adventures when the mere thought of taking a trip brings up travel anxiety.

Here’s How to Help Your Travel Anxiety

For some, just being out of their home and familiar surroundings can be enough to bring on travel anxiety, especially if you suffer from panic attacks. Meeting new people or experiencing new foods can also make people feel insecure, plus worrying about how you’ll react emotionally may trigger anxiety.

If you have travel anxiety these tips should help you feel more in control:

  • Plan for your anxiety. Brush up on your coping skills and bring along items you know will help you stay calm. For example, you might check to be sure your favorite music is downloaded to your phone or you might tuck your favorite pillow into your suitcase so you’ll be sure to get some restful sleep.
  • Practice relaxation techniques before your trip, so you can use them the minute you start to feel anxious.
    • Focus on a calming image in your mind or on an object you can physically see to take your mind off your fears. Concentrating on a book or watching a movie is distracting and can keep you from stressing over the unfamiliar.
    • Use affirmations, such as “I am safe,” to calm your thoughts.
    • Long, slow breaths have been proven to reduce anxiety and it’s worth it to learn deep breathing techniques. Breathing in slowly through your nose, then exhaling gradually through your mouth helps keep you from taking the short, hurried breaths that can trigger a panic attack.
    • Learn to meditate, which has been proven to reduce stress and boost overall health. Meditation can be done in so many ways – did you know that getting lost in music or even daydreaming are forms of meditation? Regular meditation practice can build long-term resilience.
  • Remind yourself of why you’re traveling. Picture your life a year from now – will you regret not having gone to your destination?
  • Because anxiety often stems from a feeling that you’re not in control, plan the first few days of your trip in detail. Look for photos of the airport and its terminals, explore the city’s subway system or figure out local transportation, look for your hotel on a maps website, and check out nearby restaurant and read their reviews. Having the details handy helps to keep your from worrying about the unexpected.
  • Join a community. There are many online forums or local support groups for anxiety sufferers where you can talk about your travel fears and find support.

If you’re scared of flying (also called aerophobia), these tips can help make your next flight the best you’ve ever taken:

  • Travel with a companion who is an experienced flyer. Having someone there to explain what the various sounds of flying mean or to walk you through the procedures associated with flying (security checks, boarding passes, terminals, etc), can go a long way toward calming nervousness. If they can sit next to you, they can help distract you with conversation, play games to keep your mind off of flying, or give your encouragement.
  • Be sure to talk with your travel companion before you board so they are aware of your fears and they know what you need. For example, if you don’t like to be touched, they should be told they shouldn’t try to hold your hand during a tense moment, which could increase your anxiety.
  • Avoid alcohol, which can alter the way your brain reacts and may increase your travel anxiety.
  • Practice relaxation techniques before your flight, then keep using them from the minute you reach the airport.
    • Focus on an object you can see or on a calming image in your mind.
    • Take in slow, long breaths through your nose and exhale slowly through your mouth.
    • Try tensing each part of your body for ten seconds, then slowly relax it and move on to another body part (example: tense your right hand for ten seconds, then relax and tense your right arm for ten more seconds. Repeat on your left side, then move to your legs, etc.).
  • Listen to your favorite, calming music on your phone or other device or watch a movie or television show.
  • Try the SOAR app for Android or iOS. Part of the SOAR fear of flying program, developed by Capt. Tom Bunn, a former U. S. Air Force pilot and commercial jet pilot, the app has reassuring features like a built-in G-force meter that reads your plane’s current turbulence so you’ll know the jet can sustain it. It also links to weather and turbulence forecasts and allows you to download videos of Capt. Bunn walking you through each step of the flight process so you know what’s happening in the cockpit and on the plane.
  • Exercise before you fly. The endorphins from exercise are calming and will help dissipate your nervous energy. If you can’t exercise before your trip, try walking around the terminal to distract yourself and to keep your muscles loose, which helps reduce travel anxiety.
  • Consider booking a seat towards the front of the plane and along the aisle, so you don’t feel hemmed in or like you’re in a tunnel. Seats toward the front may cost more, but the additional expense can be worth it for more leg room, making it easier to relax.

If you’ve tried some of these tips on previous trips and they haven’t worked for you, consider seeking help from a mental health professional. They may prescribe medications to help ease your travel anxiety and often have programs that teach coping techniques you can use when you’re scared of flying. Some even offer virtual reality sessions that simulate the flying experience in manageable doses in a safe office setting, so you can conquer your fears before even setting foot on a plane.

Get Help for Travel Anxiety

If you’re still facing travel anxiety after trying our tips to reduce your stress over an upcoming trip, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help. For more information, contact us or call us today at 561-496-1094.

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13 Reasons Why

13 REASONS WHY

Following the Netflix release of 13 Reasons Why in 2017, many mental health, suicide prevention, and education experts from around the world expressed a common concern about the series’ graphic content and portrayal of difficult issues facing youth. Resources and tools to address these concerns were quickly and widely disseminated in an effort to help parents, educators, clinical professionals and other adults engage in conversations with youth about the themes found in the show.

In advance of the release of season 2, SAVE (Suicide Awareness Voices of Education) brought together a group of 75 leading experts in mental health, suicide prevention and education as well as healthcare professionals (see full list below) to develop tools to help encourage positive responses to the series. In just a few short months, this group has developed a toolkit providing practical guidance and reliable resources for parents, educators, clinicians, youth and media related to the content of the series (suicide, school violence, sexual assault, bullying, substance abuse, etc.).

Using the toolkit and resources developed will help to encourage conversations, identify those at risk and prevent unexpected tragedies. Hopefully, it will also help those in need get the appropriate level of support and professional care to ensure that youth are protected, nurtured and our communities are stronger.

Dan Reidenberg

Executive Director – SAVE

SAVE especially thanks the following sub-group leaders in this effort:

Katherine C. Cowan

Christopher Drapeau

Frances Gonzalez

Sansea Jacobson

Matthew Wintersteen

ABOUT

The organizations listed below represent thousands of mental health and suicide prevention, education experts and healthcare professionals from around the world with decades of experience working with youth, parents, schools and communities.

SAVE thanks the following organizations for their participation in this effort:

  • American Academy of Child and Adolescent Psychiatry
  • American Association for Emergency Psychiatry
  • American Association of Suicidology
  • American Psychiatric Association
  • Australian Institute for Suicide Research and Prevention
  • Befrienders Worldwide
  • British Psychological Society
  • Danish Research Institute for Suicide Prevention
  • International Association for Suicide Prevention
  • International Academy for Suicide Research
  • Medical University of Vienna, Center for Public Health, Dept of Social and Preventive Medicine
  • Mental Health Foundation of New Zealand
  • National Association of School Psychologists
  • National Council for Behavioral Health
  • National Suicide Prevention Lifeline (USA)
  • National Suicide Research Foundation (Ireland)
  • Orygen, The National Centre of Excellence in Youth Mental Health, Australia
  • Prevention Communities
  • Samaritans UK
  • Stanford Psychiatry’s Center for Youth Mental Health and Wellbeing
  • School of Public Health, University College Cork, Ireland
  • Society for the Prevention of Teen Suicide
  • Suicidal Behaviour Research Laboratory, University of Glasgow, Scotland
  • Suicide Awareness Voices of Education
  • The Jason Foundation
  • The Jed Foundation (JED)
  • The Lancet Psychiatry
  • The Trevor Project
  • University of Michigan Psychiatric Emergency Services

https://www.13reasonswhytoolkit.org/

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Midlife Anxiety

When someone goes through dissatisfaction with their job or marriage and they are in their forties or fifties, the first thing everyone says is that they must be having a midlife crisis. We hear about this phase of life as people transition from young adult to middle age so often that it almost feels like a crisis is a “given”. And, on some level, it may be. As people go from being the young, carefree person of their twenties who is just getting established in a career or marriage, to the responsible person who is expected to have gotten their lives together by the time they reach their forties, it is inevitable that people will look back and second guess decisions or wonder “what if.” For many people, this emotional jolt can bring on midlife anxiety.

Midlife Crisis Symptoms

Unlike a medical condition, midlife anxiety doesn’t have specific symptoms. Instead, it’s a mixture of emotions, feelings, and body changes that lead to the strong sense that something needs to change.  Among other things, it can be triggered by factors such as an event that reminds you that you are aging, the death of a parent, children leaving home for college, or a health scare of your own.

Things that might be signs of midlife crisis are:

  • Unexplained annoyance or anger
  • The desire to get in shape or surgically modify your body
  • Coveting that shiny new sports car or wanting to try something daring, such as skydiving
  • Feeling trapped – whether it’s financially, career-wise, or in your relationships
  • Becoming preoccupied with death
  • Constantly wondering where your life is heading or regretting your life choices
  • Losing sleep or changing your eating habits
  • Dissatisfaction with the things that used to make you happy

Additionally, keep in mind that the feelings of helplessness or worry aren’t just confined to midlife anxiety. These emotions can come up anytime during a period in which you are transitioning to a new phase of life. Leaving the teen years and becoming a college student, a parent’s empty-nest syndrome, or an elderly person who moves from a beloved home into a senior-care apartment are all examples of situations that can bring on the same symptoms as those of midlife anxiety. Even being diagnosed with a medical illness or condition can make you feel vulnerable and may bring up these symptoms.

How to Cope if You’re Having a Midlife Crisis

When you’re faced with midlife anxiety, the urge to do something – anything – can be very powerful, so the first thing to do is: nothing. Despite how you feel, this really isn’t the time to make major changes in your life that you may find yourself regretting when your anxiety has diminished.

Instead:

  • Mourn your losses, but don’t dwell on them. Try to reframe the negatives by looking at them in a different way.
  • Take some space away from your daily routine to pause and think about the next phase of your life. What new ambitions do you have? What would you like to accomplish over the next few years? Ignore the little voice in your head that tells you that you are being selfish or should stop daydreaming.
  • Count your blessings. Recognize and write down the things in your life for which you are grateful, then reread your list when you are feeling regretful about something.
  • Do something that will refocus your thoughts – volunteer, take a class, or get involved with a mentoring program.
  • Let go of the things that aren’t serving you and embrace the positives. Challenge your negative thinking (for example, make a list of the trials and pitfalls you went through to get where you are today to remind yourself that the “good old days” weren’t always carefree and wonderful).
  • Be gentle with yourself. Don’t try to stuff your emotions or judge yourself for having them.
  • Talk to someone. Psychotherapy for phase of life anxiety can help lessen or alleviate the ongoing symptoms that come with a midlife crisis before they get out of hand. For some, group therapy is a great way to interact with others who are going through the same issues so you can see that they have the same concerns and problems as you. If therapy isn’t an option, reach out to supportive friends, read books on how to help a midlife crisis, or turn to your clergy for support.

Can Midlife Anxiety Actually Help You?

Remember that midlife anxiety doesn’t have to be something that leads to a crisis! You can channel your concerns into new opportunities and bring greater meaning to your life. This can be a time to:

  • Set new goals to replace your outdated or less relevant objectives. For example, if you’re no longer aiming to climb the corporate ladder, try mentoring a younger colleague.
  • Start that hobby you’ve been thinking about pursuing. After all – if not now, when?
  • Learn a new language or acquire a new skill.
  • Give back through volunteering or community work, such as coaching a team sport or helping out at a soup kitchen.
  • Renew or consider beginning a spiritual life to help you find strength outside yourself.
  • Begin stress management strategies. Take up yoga or learn meditation. Practice mindfulness. Keep a gratitude journal. Start an exercise program.

Professional Help for Midlife Anxiety

If you or a loved one is experiencing midlife anxiety, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help. For more information, contact us or call us today at 561-496-1094.

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ADAA Session Recording -Treatment Resistant Panic Disorder

Our team presented at the 2018 ADAA Conference on Treatment Resistant Panic Disorder: A Multidisciplinary Multimodality Approach. You can access the audio recording of our session here with the below login credentials.

Username: arosen1980@aol.com

Password: 1667947

We hope you find the recording of our presentation helpful and informative!

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LGBTQ Mental Health

Studies have shown that people who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) suffer from higher levels of anxiety and depression than the general public. In fact, approximately 30 – 60 % of the LGBTQ population have anxiety and depression and, as a whole, the LGBTQ community faces disproportionately high rates of suicide, self-harm, substance abuse and addiction. While there are many things that can influence a person’s mental and emotional wellbeing, prejudice and discrimination add additional trauma to LGBTQ mental health concerns.

Factors that Affect LGBTQ Mental Health

In and of itself, simply being LGBTQ does not affect a person’s mental health condition. Identifying against a cultural norm, however, exposes an LGBTQ person to prejudice and discrimination that their heterosexual counterparts don’t generally face. Some factors that affect LGBTQ mental health are:

  • Bullying
  • Homophobic societal attitudes
  • Hate crimes against LGBTQ people
  • Minority stress, which is a constant need to be “on guard” and to watch out for potential threats
  • Negative self-image and self-loathing due to societal attitudes
  • Lack of awareness of where to find positive role models
  • Media coverage that is beginning to embrace the LGBTQ culture on one hand, but shows detrimental news stories about the treatment of the community on the other
  • Worry about showing their true selves at work for fear of losing clients or promotions
  • Fear of being denied housing
  • Discrimination against transgender people within the LGBTQ community

Despite the fact that society is slowly becoming more accepting of the LGBT community, an uphill battle still remains. LGBTQ people have heard from birth that being something other than heterosexual or identifying with the gender you were born into is wrong. For example, although gay marriage was recently legalized, federal law still allows for legal discrimination in the workplace because it doesn’t protect people based on sexual orientation or gender identity. People can still legally be evicted from housing, fired from their job, or refused public or private services because of their LGBTQ status. Additionally, it is all too common for family members to reject someone who comes out to them.

Up to 65% of LGBT people suffer from some level of homophobia themselves (the belief that being LGBTQ is wrong). Hearing throughout their lives that they are somehow flawed causes many people to internalize those negative thoughts. Those who don’t have family or peer support have a harder time, as do those individuals who tend toward more negative personalities or have gone through adverse experiences, such as rejection or bullying.

On the other hand, even LGBTQ people who have supportive family and friends can end up feeling that their sexual or gender identity is somehow wrong. Often, people who love them want to help, but have no idea how to do so, and end up suggesting “cures” or a laundry list of worries (“you’re going to get AIDS”). These things contribute to the person’s feeling of being unworthy or hopeless. When the individual internalizes this shame from a young age, it often leads to long-term mental and emotional consequences.

Compassionate Care is Needed

For LGBTQ people, talking about their problems can feel like they are reinforcing the damaging stereotype against the gay and transgender community. Many individuals have been kicked out of their homes or shunned by family members and friends after they’ve come out. As an example, it’s estimated that about 40% of the homeless population in Southern California consists of homeless LGBT youth.

Compassionate care is needed to help the LGBTQ community recover from its serious mental health issues. Obviously, mental health providers should approach and treat their LGBT patients in the same manner as they would any other patient. However, they also need to understand how oppression and other factors contribute to anxiety and depression in these patients.

We Can Help

Our mental health professionals provide caring, compassionate LGBTQ mental health services. For more information, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Call us today at 561-496-1094.

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