All Posts Tagged: palm beach county

Separation Anxiety and School Refusal

The summer is waning – it’s almost time for autumn to roll around again, which means school will be starting soon. While most children look forward to this time so they can see their friends and enjoy various school activities, this can be a period of major anxiety for some school-aged children. These kids are extremely unwilling to leave home or be away from major attachment figures such as parents, grandparents, or older siblings. The beginning of the new school year is often seen as a threat to them, resulting in elevated anxiety levels and possible school-related disorders, such as separation anxiety disorder and school refusal.

In some cases the separation anxiety and school refusal follow an infection or illness or can come after an emotional trauma such as a move to another neighborhood or the death of a loved one. The anxiety generally occurs after the child has spent an extended time with their parent or loved one, perhaps over summer break or a long vacation.

Anxiety Definition

A teen or child is said to be suffering from a separation anxiety disorder if they show excessive anxiety related to the separation from a parent or caregiver or from their home, or if they exhibit an inappropriate anxiety about this separation as related to their age or stage of development. School refusal and separation anxiety are not the same: school refusal is not an “actual” diagnosis, instead it is a result of the child or teen having a separation anxiety disorder, panic disorder, post traumatic stress disorder, or social phobia, among other diagnoses.

Separation Anxiety Physical Symptoms

Children with separation anxiety have symptoms which can include:

  • Excessive worry about potential harm befalling oneself or one’s caregiver
  • Demonstrating clingy behavior
  • Avoiding activities that may result in separation from parents
  • Fearing to be alone in a room or needing to see a parent at all times
  • Difficulty going to sleep, fear of the dark, and/or nightmares
  • Trembling
  • Headaches
  • Stomachaches and/or nausea
  • Vomiting

A child who exhibits three or more of these symptoms for more than four weeks is likely to be suffering from a separation anxiety disorder.

Treatment for School Refusal and Separation Anxiety

When treating a child with separation anxiety and school refusal, therapists try to help the child learn to identify and change their anxious thoughts. They teach coping mechanisms that will help the child respond less fearfully to the situations that produce their anxiety. This can be done through role-playing or by modeling the appropriate behavior for the child to see. Medication is sometimes appropriate in severe cases of separation anxiety. Additionally, the therapist encourages child to use positive self-talk and parents help with this therapy by actively reinforcing positive behaviors and rewarding their child’s successes.

Have Questions? Need Help?

To get more information and help for child anxiety, separation anxiety and school refusal, please 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.

Read More

What is Religious OCD?

Obsessive compulsive disorder (OCD) is characterized by unwanted, intrusive thoughts and anxiety (obsessions) about something and the behaviors (compulsions) that people who suffer from the condition use to relieve the anxiety. This particular anxiety disorder represents a very serious condition that often grips the victim’s mind with fear and, in a very real way, controls their lives.

OCD is a broad disorder that encompasses many subgroups: in the case of religious OCD (also known as scrupulosity), the person is fixated on obsessions that are based in religion and/or religious beliefs, or around beliefs concerning morality. People who experience this form of OCD suffer from obsessive religious doubts and fears, unwanted blasphemous thoughts and images, as well as compulsive religious rituals, reassurance seeking, and avoidance.

People with religious OCD strongly believe in and fear punishment from a divine being or deity. Experts estimate that anywhere between 5% and 33% of people with OCD may experience scrupulosity and the number likely rises to between 50% and 60% in OCD sufferers who come from within very strict religious cultures. Even people who are not particularly religious can suffer from scrupulosity because they worry about being morally compromised or unintentionally offending others. A common thread throughout the spectrum is the linking of thoughts and actions: people with scrupulosity believe their thoughts are the same as actions, so they worry not just about what they have done, but also about what they have thought.

Examples of Religious OCD

Religious OCD can take many forms. A CNN news article tells the story of a Jewish woman who was so consumed with obsessions surrounding exposure to pork that she spent a large amount of time each day washing her hands and cleaning items that could even have remotely had the potential to come into contact with pork. An ABC News report discusses the problems of one Catholic woman who was faced with saying hundreds of prayers a day to obtain forgiveness for her self-perceived wrongdoings. The same article recounts a story about a man who eventually stopped eating and speaking in an attempt to please God by making sacrifices similar to those made by certain biblical figures. Even pillars of religious faiths may have been victims of scrupulosity: it has been suggested that both Martin Luther and St. Ignatius of Loyola may have exhibited religious obsessions.

Symptoms of Religious OCD

Scrupulosity rituals can include such behaviors as:

  • Compulsively praying, which can involve restarting the prayer if you get distracted while saying it and/or repeating it if you didn’t feel you were concentrating properly on the prayer or on the meaning of the prayer
  • Asking others if you are behaving correctly or if you “did the right thing”or analyzing your behavior throughout the day to be sure you are acting “appropriately”
  • Reading or studying religious writings, books, and texts excessively
  • Questioning your motives in numerous situations
  • Excessively apologizing to a deity (God, Allah, etc) and seeking forgiveness for your behavior

Treatment for Religious OCD

As with other forms of obsessive compulsive disorder, treatment for religious OCD involves cognitive behavior therapy. In some cases, medicines are combined with this type of exposure and response therapy. A patient will not be asked to give up his religion when undergoing therapy, instead he are given ways to face his triggers and live within his faith and religious traditions. Additionally, those patients who may not be able to travel to a therapists’office may be able to receive treatment over the phone or on a computer-based application such as Skype or FaceTime.

Have Questions? Need Help?

To get more information and help for scrupulosity and religious OCD, please 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.

Read More

Superstitious Behavior Psychology

Let’s face it, everyone has exhibited superstitious behavior at some point: we probably can all think of someone we know who always plays a certain set of lucky lottery numbers and most of us have crossed our fingers at one time or another for luck. Believing a little superstitiously can make us feel like we have some control over various circumstances and can help us make sense of a situation. But when rituals need to be repeated over and over to avoid perceived negative outcomes and this type of behavior begins to rule someone’s life, it has spiraled out of control, causing more anxiety than it relieves. At this point, the superstitious behavior psychology can be, and often is, a form of Obsessive Compulsive Disorder (OCD).

The Difference between Superstitious Behavior Psychology and OCD

You might worry that your superstitious behavior is actually a sign that you have OCD, so here is how you can tell the difference:

  • Before running a race, do you wear a certain pair of “lucky” shorts because you won your last few races while wearing them? That is a facet of superstitious behavior. Why? Because, while wearing the shorts can help give you confidence and provide positive thoughts, you aren’t performing a ritual wherein your success in the race depends on the repetition of a certain behavior.
  • Do you attribute the outcome of a situation to the “magic” of the ritual you perform? That is a sign of superstitious OCD. As an example, if you feel that you must take a certain number of practice swings at a golf ball in order to do well on each hole, that is more in the realm of OCD. Why? Because, if you get so anxious that you can’t complete the hole if the number of swings is interrupted or if something hinders your ritual, you are obsessing about it.
  • In superstitious OCD, a “normal” superstition becomes disabling. Superstitious behavior psychology might make someone avoid booking a hotel room on the 13th floor, but a person with superstitious OCD would find they couldn’t step on a crack in the sidewalk without having to complete a certain ritual to avoid the evil that would be sure to befall them or someone they love for their perceived transgression.

What Does Religion Have To Do With It?

For people with OCD, religion can enter into their obsessions in the form of trying to pray correctly or feeling that if certain rituals aren’t followed correctly, the things that go wrong in the world around them are their fault. This type of religious OCD is called “scrupulosity”. For example, a Jewish person with this condition may feel that if they have been exposed to pork in any form and can’t get “clean enough,” and then subsequently something bad happens to a family member, it is a punishment because the OCD patient has offended God. In another example, a Catholic person may worry that if they haven’t kneeled correctly at the altar or haven’t said the rosary properly or a certain number of times, disaster will come to themselves or their loved ones.

How to Get Help

As with any type of OCD, help comes in the form of both therapy and medication. Cognitive Behavioral Therapy and Exposure Therapy help the person in treatment learn to face the situations that trigger their obsessions. In these types of therapy, the patient is gradually encouraged to put themselves in situations that would normally trigger their rituals and then discouraged from performing them. By taking these guided risks, the OCD patient learns that their fears are unfounded. Additionally, certain medications such as antidepressants are helpful in reducing the symptoms of OCD and religious OCD.

To get more information and help for OCD and/or superstitious behavior or religious OCD, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

HOCD

HOCD or Homosexual Obsessive Compulsive Disorder is defined as the questioning of one’s sexuality by a person who already suffers from Obsessive Compulsive Disorder (OCD). What this means is that someone with OCD who is happy in their straight, heterosexual orientation becomes fixated on the question of whether or not they are actually gay. Over time, these thoughts and worries about the possibility of being gay begin to consume their lives.

People with OCD experience their obsessions in different ways from each other, but the underlying premise is that they are dealing with disturbing unwanted or intrusive thoughts. An example would be that a person who suffers from OCD is physically healthy but begins to worry about whether they actually have cancer or another serious illness. In the case of HOCD, straight people with the disorder spend countless hours wondering if they could really be gay or if they could suddenly become gay (conversely, homosexuals with Straight OCD, constantly worry if they are, or could become, straight). People with HOCD expend a great deal of energy and countless hours trying to “know”, without a doubt, that they are straight and not gay.

The Differences Between Being Homosexual and Having HOCD

So, if you are questioning your sexuality, how do you know the difference between having HOCD and actually being gay?

Typical HOCD symptoms include:

  • Currently suffering from OCD (Obsessive Compulsive Disorder)
  • Recurring unwanted or intrusive thoughts about your own sexuality
  • Constantly reassuring yourself that you are straight
  • Avoiding people of your same gender due to anxiety or unwanted fears that you might be gay
  • Worrying that you might be sending out “signals” that will make others think you are gay
  • Homosexual thoughts are repulsive to you, rather than arousing
  • Feeling no attraction to your same sex
  • Repeating an action because you worry that you might have done something in a way that makes others think you are gay (example: a man repeatedly gets up and sits down on a chair because he worries that he takes a seat in a way that looks too feminine). Repeating the action relieves the anxiety, but you need to continue repeating the action to continue anxiety relief.

Typical Homosexual characteristics include:

  • Homosexual thoughts are enjoyable and/or arousing to the person, even if they hide their sexual orientation from others or are ashamed of it
  • Having had past sexual experiences with those of their same gender
  • Preferring to date or have sexual encounters with people of their same gender instead of with those of the opposite sex
  • Often, people who are gay report having felt differently than their same-sex peers at an early age. Additionally, researchers have found they preferred to engage in activities associated with the opposite sex from early childhood onward

HOCD Treatment

HOCD is treated in much the same way as Obsessive Compulsive Disorder (OCD). In general, cognitive behavioral therapy and mindfulness-based therapy is used to help the person reduce their response to their thoughts and help them deal with their obsessions. Additionally, these behavior therapies may or may not be combined with medications such as SSRIs (Prozac, Zoloft, etc). By changing one’s behavior and responses towards one’s intrusive thoughts, it is possible to neutralize and eliminate the fixation.

For more information about HOCD or to explore treatment options, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

Anxiety and Sexual Disorders

Recently, several small studies have suggested that there may be a link between anxiety disorders and sexual disorders. While the study of this relationship is just beginning, researchers have seen connections wherein those who suffer from panic disorder, anxiety disorder, and social anxiety disorder also have noted an increase in impairment of sexual function, arousal and desire, and a decrease in satisfaction and enjoyment of sex.

Why Do These Disorders Coincide?

While there are many more reasons that anxiety and sexual disorders occur together, the following offer a glimpse into why they might be found in patients with anxiety:

  • Just experiencing anxiety by itself can be enough to impair sexual function in some people. If a man is concerned that he may not be able to please his partner, for instance, that fear may cause him to avoid sex, it may increase the potential for erectile dysfunction or premature ejaculation, or it may weaken arousal or satisfaction.
  • Certain medications can cause sexual side effects. SSRIs (selective serotonin reuptake inhibitors) are commonly prescribed for panic disorders and social phobias (an example is Prozac) and these drugs are known to delay orgasm in many men.
  • Stress, worry, and fear can impede sexual function and the subsequent worry about one’s sexual function can create a vicious cycle of fear, worry, and stress.

What Can You Do About It?

  • Tell your doctor or therapist if you are being treated for an anxiety disorder and also have problems functioning sexually as these conditions can be treated simultaneously. Additionally, sexual problems often have a root physical origin and a medical exam will help identify and treat any physical condition that may be causing the dysfunction.
  • If you are on anxiety disorder medications, your doctor can adjust your medicine so it has less impact on or helps with your situation.
  • Other medications can be utilized to help your sexual function. For example, because SSRIs can have a side effect of delayed orgasm, prescribing them often can help men who suffer from premature ejaculation.
  • There are many therapies, such as psychodynamic psychotherapy to help reduce anxiety, fear, and negative emotions. Discussing your concerns with your therapist can help you find the way that works best for you.

Even though researchers have seen that anxiety disorders and sexual disorders often co-occur, these disorders do not coincide in all anxiety patients. For that reason, more studies will need to be conducted so we can better understand how to treat people who suffer from both conditions.

To get more information and help for a possible connection between your anxiety and sexual disorders, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

Postpartum Depression and Anxiety – How to Overcome Them

According to the National Institute for Mental Health, postpartum depression and its accompanying anxiety can affect nearly 15% of new mothers at some point during the first year after giving birth. Postpartum depression can be a very serious mood disorder and is different than having the “baby blues” that some women experience due a change in hormone levels after childbirth. In general, postpartum depression lasts longer and is more severe than the post-birth blues.

Postpartum Depression and Anxiety Symptoms

The first thing to do is recognize postpartum depression symptoms:
• Negative feelings about the baby and/or not being interested in your newborn
• Trouble sleeping
• Persistently feeling hopeless, sad, and/or despondent
Panic attacks – rapid heartbeat, feeling shaky, dizziness *(link: http://www.drandrewrosen.com/panic-disorder-therapy/)
• Decreased energy, loss of appetite
• A loss of interest in activities you used to enjoy
• Anxiety that interferes with your ability to take care of your baby

Because our society thinks that new mothers should be thrilled with their baby, we often dismiss her postpartum depression and anxiety as “just hormones” when, in fact, therapy or anxiety medication is necessary. If a woman buries her feelings because she thinks she should be happy but isn’t, postpartum depression and anxiety can become much worse over time.

Help for Postpartum Depression and Anxiety:
• Before postpartum depression and anxiety is treated, physical causes should be ruled out. A medical exam will be able to exclude hypoglycemia, thyroid deficiency, or other health conditions that can mimic postpartum depression.
• Speak to a mental health professional – many specialize in treating women with anxiety and postpartum depression. These professionals can help you develop coping strategies and can work with you and your family so they can provide further support. Additionally, therapists can determine your need for antidepressants or other medication, if your depression is severe.
• If you can’t afford a therapist, each state has county mental health facilities that can get you the help you need.
• Get as much rest and sleep as possible by sleeping when your baby sleeps.
• Eat a healthy diet and get some exercise.
• Follow your treatment plan as closely as possible.
• Don’t isolate yourself – spend time interacting with friends and family.
• Seek out a “New Mom” support group – your pediatrician or obstetrician can refer you to a nearby program if you can’t locate one on your own.

Left untreated, postpartum depression and anxiety can lead to postpartum psychosis in which you consider harming your baby, yourself, or contemplate suicide. If your symptoms do not improve or if they get worse, call a medical professional without delay.

For more information about anxiety after giving birth and postpartum depression, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

Anxiety During Pregnancy

While most women are thrilled to be pregnant and eagerly look forward to the arrival of their little bundle of joy, those women who already suffer from mood disorders may see an increase in their anxiety during pregnancy. Indeed, several studies have shown that mood problems are more likely to happen during pregnancy than postpartum. Hormone fluctuations, the stress of an impending and significant life change, and fatigue can all increase anxiety symptoms, so it is important to find ways to deal with pregnancy anxiety.

Managing Anxiety Symptoms During Pregnancy

There are several ways to cope with anxiety during pregnancy:

  • Share your fears with your spouse, significant other, family or friends, or join a support group. Talking about your worries and getting other perspectives helps you feel better and more able to deal with the changes you are going through and your concerns about the future.
  • Share your worries with your obstetrician. When you experience physical changes or have concerns about your growing baby, he or she can help calm your fears. Additionally, if your anxiety or depression becomes overwhelming, your doctor can assist you with getting the professional help you need.
  • Take care of yourself. This is the time to start saying “no”, to learn to relax, and to stop being an overachiever if you tend to be Superwoman.
  • Get more rest. Mediation, reading, or taking a warm bath can help you shed the stress of the day and unwind.
  • Get more sleep. When you are tired, your stress level increases. Trying to get seven to eight hours of sleep a night can go a long way toward reducing your anxiety during pregnancy.
  • Try prenatal yoga to help calm your mind and reduce aches and pains. Concentrating on the different postures and listening to the tranquil music can help take your focus off the things that are making you anxious.
  • Along with yoga, exercise can help you feel more energized and less anxious or depressed.
  • Eat healthy, nourishing foods to keep your energy levels up and help you stay strong.
  • Seek professional help if you feel like your anxiety during pregnancy is becoming too much for you to handle. Severe and untreated anxiety during pregnancy can result in premature births and low birth weight babies, among other problems. It also can affect how your care for yourself and your baby, so it is very important that you begin therapy as soon as possible if you are feeling overwhelmed.

To get more information and help for anxiety during pregnancy, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

Opioid Abuse Linked to Mood and Anxiety Disorders

Pain, both chronic and acute, is often treated with prescription opiods, such as oxycontin, morphine, codeine, fentanyl, hyrocodone, and other similar drugs. These drugs are extremely addictive and can create a psychological dependence after long-term use.  The medical community has long thought non-medical opioid abuse and anxiety and mood disorders might go hand-in-hand and recent studies have, indeed, shown a positive correlation between the two. Researchers discovered that people who suffer from mood disorders or anxiety disorders such as bipolar disorder, panic disorder and, major depressive disorder are more likely to abuse prescription opioids than those who do not have these disorders.

Study author, Silvia Martins, said, “Lifetime non-medical prescription opioid use was associated with the incidence of any mood disorder, major depressive disorder, bipolar disorder and all anxiety disorders.” She also notes that, “Early identification and treatment of mood and anxiety disorders might reduce the risk for self-medication with prescription opioids and the risk of future development of an opioid-use disorder.”

In recent years, non-medical use of opioids has spiked (it is considered non-medical use if a person uses these drugs without a prescription or in greater amounts, or for a longer duration than normally prescribed). Opioids are now the one of the most abused illicit drugs in the United States: in fact, they are second only to marijuana. This is concerning because the study also linked opioid abuse with the future development of mood and anxiety disorders.

It found that using or withdrawing from opioids can bring on anxiety and mood disorders in those who are vulnerable to developing them. This means that those who use prescription opioids need to be closely monitored, not only for potential abuse of the drugs, but also for the development of anxiety or mood disorders. Future studies will explore whether genetic or environmental risk factors increase the chance of mood disorders or anxiety disorders occurring with non-medical opioid abuse.

For more information and help for anxiety disorders, mood disorders, or anxiety treatment, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

Hypersexuality

Hypersexuality or sex addiction is a dysfunctional obsession with sex. The disorder is characterized by:

  • Compulsive sexual behavior consisting of extreme sudden or frequent sexual urges or activity
  • Patterns of negative outcome (examples include emotional and physical health concerns, broken relationships, and legal and career troubles)
  • Attempts at self-correcting and failing to stop unwanted behavior despite repeated promises to themselves and others

The obsessive thoughts and behaviors of hypersexuality are considered to be a process addiction (for example, gambling is a process addiction) instead of a substance addiction (such as a drug addiction). Additionally, hypersexuality is usually classified as an obsessive compulsive disorder (OCD) and can be a symptom of OCD, as well as being a symptom of drug abuse, bipolar disorder and attention deficit disorder. The DSM IV for Psychiatric Disorders describes sex addiction as a “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship”.

This psychosexual behavior often begins with the sufferer subconsciously trying to manage emotional triggers in their life and alleviate distress. As the disorder progresses, the behavior develops into compulsive and uncontrollable impulses as the person becomes addicted to the pleasurable neurochemical changes in their brain that produce a “high”. This is similar to how drug or alcohol addicts constantly crave their next high. And, as with other addictions, because the underlying issues aren’t being addressed, the sex addict finds themselves locked in an endless cycle of inappropriate behavior, frustration, and unhappiness.

Often, those who exhibit hypersexuality will not look for therapy and treatment until they have hit rock bottom and have experienced significant negative consequences to their relationships, health, finances, and careers. In order to heal, a sex addict must take ownership of their behavior and will need to undergo intensive psychotherapy. Additionally, any spouse or partner of the sex addict will feel victimized and will need to work as hard as the addict in order to learn to trust them again. Still, with time and hard work, those with hypersexual disorder can overcome their unhealthy sexual compulsion and can look forward to a healthy future.

For more information and help for the treatment of hypersexuality, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More

Hypersexual Disorder (Sex Addict)

There are two current movies making the rounds in theaters that are centered around the topic of hypersexual disorder (sex addiction): Thanks for Sharing and Don Jon. Even though both movies present the subject with a comedic undertone, sex addiction is no laughing matter. Those who suffer from it end up confused, obsessed, and endlessly looking for a “fix” that becomes increasingly difficult to achieve.

A sex addict is not simply a person who loves sex or one who acts in a sexually inappropriate way. Hypersexual disorder is characterized by:

  • Patterns of negative consequence, such as anxiety, depression, and legal problems
  • Risky behavior and a loss of control
  • Attempting to stop unwanted behavior and failing

Hypersexual disorder is often thought to be a form of obsessive-complusive disorder. According to the DSM IV for Psychiatric Disorders, sex addiction is a "compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship". Those with hypersexual disorder seek the endorphins and enkepline chemicals that are released through orgasm, producing feelings of satisfaction and relaxation. In this way, a sex addict is similar to an alcoholic or drug addict. And, just as with an addiction to drugs or alcohol, hypersexual disorder usually begins with a more harmless activity that is used as a coping method to fill a void (for example, an emotional loss, social issues, or other stressors) and develops into uncontrollable impulses as the disorder progresses. This physiological aspect reinforces the psychological void, turning it into a vicious cycle that never addresses the underlying issue.

In order to heal, a sex addict needs intensive therapy and must assume responsibility for his/her behavior. If the addict is in a relationship, the partner/spouse will understandably feel victimized and will need to work as hard as the addict in order to learn to trust again. With time, hard work, and patience, however, the sex addict can learn to overcome their unhealthy sexual behavior and create a healthy future.

For more information and help for hypersexual disorder, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

Read More
Call Us (561) 496-1094