All Posts Tagged: broward county

distressed senior woman

Does Anxiety Get Better With Age?

It’s no secret that the elderly population is the fastest growing age group in the United States. In fact, there are now approximately 76 million baby boomers in the United States and that number is increasing daily. While some things get better with age (think of fine wines), will aging affect mood disorders? Does anxiety get better with age?

Unfortunately, that doesn’t seem to be the case. Although there are reasons we might expect a senior to have less anxiety, such as being retired and no longer living with the stress of the workaday world, for many older adults anxiety may not necessarily improve. In fact, anxiety disorders are one of the most common mental health problems among older adults.

There are a number of factors that can contribute to anxiety in older adults.

  • Many seniors experience losses such as the death of a spouse or the loss of independence.
  • There are age-related brain and neurological changes that take place.
  • There are fears about the aging process itself.
  •  Social isolation and loneliness can contribute to anxiety.
  • Additionally, chronic health conditions can mimic anxiety symptoms or lead to anxiety about pain, mobility limitations or disability, and even death.

Cognitive impairment (and the fear of it) also becomes more of a concern as we age, along with a higher potential for a diagnosis of dementia and the anxiety that often comes with the condition.

The National Institute of Health (NIH) reports that, “Anxiety has reported high prevalence rates among people with dementia. It has a negative impact on cognitive impairment and is associated with agitation and poor quality of life. The presence of excessive anxiety can be difficult to establish in people with dementia, especially when expressive or receptive speech is impaired.”

How Common Is Anxiety In Older Adults?

Anxiety is a very common problem among older adults. Depending on the resource you consult, it is estimated that between four percent and twenty percent of senior citizens experience anxiety.

This wide range is due, in part, to the fact that many elderly people will only report the physical symptoms they feel and do not talk about their worries, fears, or anxious feelings. They may shy away from reporting anything that might make them feel ashamed or “weak.” They may also feel that anxiety is an inevitable part of aging (it’s not).

What Are The Symptoms Of Anxiety In The Elderly?

Anxiety is the overall feeling of unease. Real anxiety isn’t the same as a case of nerves or worrying about an upcoming event, although those things can make you anxious. Rather, genuine anxiety takes over your life and can prevent you from functioning. It can lead to a range of different symptoms, from feeling constantly on edge and irritable to having trouble sleeping and concentrating.

In general, we can experience psychological, physical or mental symptoms of anxiety – or a combination of them.

Psychological symptoms can include:

  • Confusion or memory problems
  • Obsessive thoughts
  • Nightmares
  • Unable to sleep

Physical symptoms can include:

  • Headaches
  • Nausea
  • Heart palpitations or racing heart
  • Dry mouth
  • Muscles are tense or clenched
  • Trembling
  • Shortness of breath

Emotional symptoms can include:

  • Feeling panicked or apprehensive
  • Engaging in rituals (such as repeated handwashing)
  • Withdrawal and/or refusal to participate in activities you used to enjoy

The National Council On Aging states, “While symptoms are an important aspect of diagnosing anxiety in older adults, even more critical is how these symptoms affect day-to-day living. Anxiety is considered problematic when it interferes with your daily functioning, your quality of life, and even your health.”

How To Manage Anxiety In The Elderly

It’s natural for the fear response to kick into gear when there’s uncertainty about what might happen next. As we grow older, life changes can be more frequent and dramatic. Additionally, our resilience may be reduced, which can make it harder for us to handle those changes in a healthy way.

Thus, when changes occur, an older adult may be more likely to struggle to find ways to cope with the new situation or unexpected loss than they would have in their younger years. They might begin to respond from a more an anxious state.

Common triggers for anxiety can include such things as:

  • A change in routine (for example, maybe a senior used to enjoy playing golf twice a week, but has been ill and unable to recently)
  • Financial concerns
  • Planning for end of life care for themselves or a loved one
  • Loss of independence
  • A change in surroundings (for example, moving to a new residence or into a care facility)
  • Health concerns
  • Loss of mobility
  • Reduced ability to take care of the tasks of daily living (dressing, bathing, feeding oneself, etc)
  • The passing of a loved one
  • Medication side effects
  • Insomnia or sleep problems
  • Genetic predisposition (mood disorders run in the family)

It can help to manage your anxiety if you try to understand what triggers your symptoms. While you can’t avoid everything that increases your anxiety, you can learn coping methods to build your resilience and better allow you to deal with your distress.

It’s also helpful to have a social network to rely on. Friends and family members or support groups (in person or online) can be a great resource, especially if you are alone or isolated.

Doing something physical can help break the cycle of troubling thoughts and calm your mind. Try to set up a regular exercise routine. This can be as simple as getting outside to walk or taking a gentle yoga or tai chi class. Activities that involve the sense of touch, such as cooking, knitting, or painting, are also helpful.

Mindfulness exercises, such as meditation or journaling, can be calming, as well. There are YouTube videos and smartphone apps available to guide you through meditations or engage in deep breathing.

As much as possible, try to have balance in your life. Eat healthy foods, get enough sleep, and continue to stay socially connected. Absorb yourself in the activities you enjoy and look forward to.

Anxiety can have a devastating effect on your life, so it’s very important to speak to your healthcare provider or a mental health professional about what you’re experiencing – especially if your symptoms have been present for more than two weeks or are getting worse.

Have Further Questions?

If you or someone you love have questions or would like further information about anxiety in seniors, 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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Post-Pandemic Social Anxiety: Simple Steps To Start Living Again After Covid

My colleagues and I have noticed a dramatic increase in anxiety and anxiety-related disorders over the past two pandemic years. While apprehension is a typical response during times of strife, as we return to more normal lives, many people have been caught off-guard to realize how uncomfortable they now are in social situations – especially if they were never fearful before.

And for those who were challenged with social anxiety prior to Covid, being distanced from others for two years was a blessing in disguise. They were able to stay in their comfort zones, skip distressing situations entirely, and avoid in-person interactions. Now that everything is changing, they worry about venturing out once again.

But, if we consider that we’ve been fairly sequestered from each other for such a long time, it makes sense that social anxiety is now present in so many people. Although strict social distancing measures were necessary, they helped us feel protected and stay safe, which makes it all the harder to let go and start interacting socially now.

In addition, many people experienced a great deal of trauma, uncertainty and fear during the pandemic. They learned to associate social situations with infection. As a result, they now feel vulnerable around others, and those helpless feelings will be hard to shake as the pandemic moves into the endemic stage.

Is It Normal That I Feel Anxious After The Pandemic?

Some emotional aspects of social anxiety involve perceived feelings of judgment and disapproval by others. Physical signs include sweating, a racing heart, difficulty concentrating, and feeling nauseous. For many, simply thinking about going out socially could bring on any of these symptoms or a combination of them.

Superficial differences also contribute to social anxiety, especially now. Some people have already dropped Covid protocols, but others will continue to hold tightly to safety measures, like mask-wearing and standing away from people. Consequently, those who don’t do the same may feel judged for their own relaxed standards.

For example, if they go to a social event unmasked, they may spend the entire time feeling extremely anxious around those who are wearing one. They might become nauseous or break out in a cold sweat when interacting with a masked person – even if they are surrounded by family or friends.

They may also have problems concentrating or focusing on conversations. Feeling confident in themselves could seem next to impossible when they are convinced that everyone is staring at them.

If this happens often enough or their reaction is strong enough, their anxiety might cause them to avoid social situations entirely. While doing so brings short-term relief, continuing to evade people over time can lead to isolation and a feeling of being disconnected from others.

How To Deal With Social Anxiety After Covid

Some of us will fill our social calendars in the coming months while others will struggle emotionally with the current relaxed social standards.

If you are feeling anxious about resuming a social life, don’t accept every invitation, at first. Remember that this is a time of transition for everyone. Be choosy about which social gatherings you attend, limit yourself to the ones that enforce similar personal protocols, and give yourself a breather in between them.  

The same goes for your return to the office. If you are able to be flexible, take baby steps when going back into the workplace. Perhaps you can go into the office one day a week for the first week or two, and then slowly increase your number of days from there.

If you can’t ease your way back into the workplace, reach out to others for support. Most likely many people you know will have already been in the office for a few weeks. Ask them how they handled their nerves when they went back. What did they do to cope? No doubt, they found each successive work day a little easier to manage as they got used to their old routine.

Be kind to yourself during this transition, as well. Keep in mind that, as is frequently the case with social anxiety, the anticipation is often worse than the actual event.

Try to eat a good diet, relax and do something you enjoy, and get a good night’s sleep the day (or weekend) before you go back into the office. Above all, avoid anything that might stress you and negatively affect your first days back.

Additionally, it is crucial to stay positive and optimistic, even when social interactions are difficult or uncomfortable. With time and patience, it is possible to manage social anxiety during this difficult period and eventually regain your normal routine.

If social anxiety is still causing significant distress or impairment in your life even after trying these strategies, don’t hesitate to seek professional help. A therapist or counselor can help you explore other options and develop a treatment plan that works for you.

Did You Know? We’re a Regional Clinic for the National Social Anxiety Center

The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida is a regional center for the National Social Anxiety Center. Our certified therapists provide compassionate care and have specialized training in social anxiety treatment and virtual reality therapy. For more information, contact us or call us today at 561-496-1094.

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Lonette Belizaire

Lonette Belizaire, Ph.D. – Consult The Expert On Cognitive Behavioral Therapy (CBT) And Self-Care

Dr. Lonette Belizaire works with young adults in our Anxiety Center, as well as with children and teens in our Children’s Center. Her primary treatment approach utilizes cognitive behavioral therapy (CBT). This is a modality which helps people recognize and change their negative thoughts and behaviors. Cognitive behavioral therapy can be effective in treating many mental health conditions, including anxiety and depression.

Do negative thoughts and behaviors really contribute to anxiety? “The brain has plasticity,” Dr. Belizaire says. “Trauma, anxiety, and distressing life experiences actually create structural changes within the brain.”

She explains that when we encounter something that worries or scares us, or puts us on guard, the amygdala – a small structure within the brain – responds with a nearly instant message to our hypothalamus. This activates the release of stress hormones and heightened physical responses, along with building new neural pathways.

This is designed to keep us safe. These responses help us take action during a dangerous situation or an imminent threat, such as making us leap out of the path of a speeding car. “The fight or flight response is protective and good,” Dr. Belizaire says, “but at times we apply this response when we’re not in danger.”

“For example, someone who is anxious and facing a work project may have the thought “I can’t get this done on time and I’m going to be fired,” she explains. “The distress response from this negative thought can lead to the person stalling or avoiding the project altogether. However, with cognitive behavioral therapy, this person would learn how to challenge their negative thought and replace it with a more positive one, such as “I can do my best to complete this project on time.”

Exploring Thinking Patterns

The longer we focus on and worry about something stressful, the more robust those neural pathways become and the stronger we respond. This is involuntary, of course, but it means the key to calming anxiety is through destroying those negative pathways and building more positive channels. In turn, our positive emotions support the building of new neural responses that suppress the old, negative reactions.

“I begin by having my clients look at their thinking patterns. I want them to explore how they see themselves, others, and how they operate within the world,” Dr. Belizaire says. “Part of our work together involves identifying these patterns and working to challenge those distortions.”

“When working with adults, we may explore how early childhood responses to early attachment figures may still be operating in adult relationships,” she says. “Are those messages still in place? How do these responses show up across relationships, in both the past and present?”

The answers to these questions can be illuminating. “Sometimes this is the first time the person has thought of it this way,” she says.

Incorporating Self-Care

Along with traditional cognitive behavioral therapy, Dr. Belizaire often integrates self-care into her therapy sessions. Grounding techniques and mindfulness exercises help to refocus anxious responses and build positive neural pathways. “These techniques are aimed at the amygdala,” she explains.

“We know that self-care and self-regulating activities engage the physical to help the mental and emotional responses, so I try to find out what the client likes to do. What are their interests? Once I know, we incorporate regular self-care strategies in our work.”

For example, Dr. Belizaire may encourage yoga, diaphragmatic breathing exercises, meditation, or progressive muscle-relaxing exercises. When using visual imagery, “I may incorporate breathing exercises with visual imagery and have the client visualize breathing in calming white light or a calming word, phrase, or memory filling their body, and then exhaling black smoke, for example…or stress, anxiety and visualize it escaping their body with every breath.”

At times, she also gives “homework,” but it’s the kind that clients want to complete. “I’m not giving out actual homework,” she chuckles.

“Along with self-care homework, I may ask them to monitor their cognitive distortions between now and our next session, or implement a new sleep hygiene, or reward themselves after achieving a step towards their treatment goal.”

This self care work doesn’t have to be time-consuming either. “Something as simple as writing in a gratitude journal can help reframe your thinking more positively,” she says.

Just as with school-based homework or working out at the gym, Dr. Belizaire says that engaging in daily self-care exercises brings results.

“If you can learn to do them when you aren’t anxious, the habit kicks in when you are fearful, which helps ease your stress response. After all, when you are in those anxious moments, you are in fight or flight activated mode and you may not readily recall the strategies that will help reduce your stress response.”

In addition, a big step in reducing stress comes from being prepared for it. “If you can anticipate a trigger, such as an upcoming anniversary, exam, or anxiety-producing situation, you can prepare for it in advance, which can help reduce the stress during the actual event.”

We Are Here For You

Dr. Belizaire is primarily seeing clients through teletherapy right now. “There are advantages to telehealth, which includes scheduling,” she says.

One thing to keep in mind: “Teletherapy may not be appropriate for everyone and for every presenting concern,” she cautions, “but many people do benefit. Young children tend to do better with in-person interaction, but ‘tweens, teens, and adults all do well with teletherapy.”

If you are concerned that your child or teen is struggling emotionally or showing signs of anxiety or depression, we can help. To schedule an appointment with Dr. Belizaire or our other clinical team members, contact the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at (561) 496-1094.

About Dr. Lonette Belizaire, Ph.D.

Dr. Lonette Belizaire is a licensed psychologist with over 15 years of clinical experience working in a variety of treatment settings. She has worked with the gifted and talented child and adolescent school population, in college counseling centers, city hospitals and in private practice. She specializes in the treatment of anxiety, adjustment issues, interpersonal concerns, stress management, and bicultural identity. Dr. Belizaire’s approach is grounded in evidence-based treatment. She utilizes an integrative model that draws upon cognitive behavioral therapy and mindfulness-based interventions tailored to meet the client’s needs. She has found that building an awareness of the neurological basis of anxiety, how it is created and maintained in the brain, has also been particularly transformative for clients.

Dr. Belizaire earned her doctoral degree in Counseling Psychology from Fordham University, Master’s Degree in Mental Health Counseling from the University of Miami, and her Bachelor’s degree in Psychology from Stony Brook University. She has worked in some of the top institutions in the New York area including the Hunter College Campus Schools, Cornell University, and Pratt Institute. She is licensed in both Florida and New York.

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young girl in mask

Covid Stress And The Pandemic’s Effects On Society: A Psychologist’s Observations

As a psychologist who treats anxiety daily, I’ve been in a unique position during the pandemic. I can distinctly see the difference the last two years have had on individuals, families, and society in general.

Right now, we are seeing so many kids in our Children’s Center, it is mind-boggling. Children have been struggling with online teaching, loss of contact with friends and peers, and the disruption of everyday routines – and it shows.

We are also seeing many more adults in our Anxiety Center. Parents are trying to juggle lost incomes, kids learning virtually at home, relationship challenges, and the illness or loss of loved ones. The family/children aspect is also a big concern for parents right now. They are very worried about their kids and the schools are, too.

I remember when the pandemic started. At the time, I told colleagues that this virus would have two parts to it. Of course, the first and most apparent part would be the medical aspect, because we knew some people would get sick from it.

The second part, however, was the mental aspect, because every one of us would be affected by it in some way. This could be due to personally contracting the virus, or a lost job, the death of a loved one, the stress of shut downs, or the upending of our normal lives. Even if we have somehow managed to escape the virus’ direct impact, we have become aware of this bigger force looming over and all around us, over which we have no control.

Pandemic Trauma Effects

The pandemic is malignant. It is evil, malicious, and malevolent. The virus infects indiscriminately. It sickens or kills the young, the old, the rich, and the poor. Knowing this does not sit well with us.

Usually, we have an inherent coping mechanism that helps us distance ourselves from a traumatic event. We are capable of feeling sad or upset about a tragedy, while being able to go on with our usual day-to-day lives. But, this virus, this pandemic, is so big and so menacing, it is impossible not to pay attention to it.

In my opinion, one of the best stories ever written about life and how we ultimately deal with tragedy’s fallout is the Wizard of Oz. In the story, the bad, malignant force is the Wicked Witch. Dorothy needs the wizard to protect her from the witch and send her back to her normal world.

After many challenges, she finds there is no all-powerful wizard, just a mere man hiding behind a curtain. Her hopes are dashed. She has to manage on her own. Like Dorothy, we are on our own as we try to cope with the upheaval of the pandemic, both as individuals and as part of society.

We entered this crisis relying on authority figures (our governmental leaders, the CDC, the World Health Organization, etc.) to help us navigate through the unknown, but this hasn’t turned out as well as we had hoped. The problem is that humans have dependency needs. As children, we relied on our parents to keep us safe. Today, our needs are not being met by those in authority.

No Escape From Covid Stress

Because we feel fearful and unsafe, we’ve begun lashing out at other targets – and finding them in our fellow sufferers.

Think of it like this: If you were lost in the forest, you’d want to be with others instead of alone. But if the group couldn’t find their way out within a reasonable time, its members would begin turning on one another. “It’s your fault we didn’t turn right, instead of left,” someone might say. Soon the group would be fighting amongst themselves and people would start doing their own thing in an effort to feel like they had some control.

This is being reflected in the infighting we’re seeing amongst ourselves lately. Unfortunately, it will continue to be a long term effect of the pandemic. Indeed, as we emerge from this crisis, we won’t suffer as much from the medical aspect of the virus, but from the societal and psychological factors that are the result of it.

I can’t stress enough how essential it is to get your head out of the news headlines. They are almost always negative, shocking, and upsetting, and that is not good for your emotional health. Dealing with so much trauma in the news and in our personal lives creates chronic stress and disillusionment. This is much like the battle fatigue we see in military personnel during a war. It wears you down.

In this case, though, we have no battlefield to come off of.

The fact that we literally have no escape only adds to the mental fatigue, apathy, anxiety and depression the world is dealing with. As in my forest analogy, it seems that no authority figure can make things better, so we’ve become defiant. As a result, there are fights on airplanes, vaccine mandate protests, trucker blockades, and mask and vaccine refusals.

Resiliency And Moving Forward

There is no easy answer for managing the emotional stress of the past two years. As we move forward and the pandemic recedes, however, the resiliency we have as humans will allow us to bounce back. People can basically recover from anything. I’ve seen it happen over and over during the past three decades as a practicing psychologist.

That doesn’t mean we’ll develop amnesia or that there won’t be long term negatives from the pandemic. Doubtless, some people will come out of this feeling kinder towards each other, while some will feel more entitled, selfish, and rebellious. Nature has a way of correcting itself, though. It is like a pendulum swinging: for every reaction, there is an opposite reaction. I am hopeful that our innate nature will help humanity to better cope going forward.

Clearly, we need to take care of ourselves during this time. As the pandemic drags on, many people have begun reevaulating their priorities. This is contributing to The Great Reset we’ve been hearing about. We’re examining the things that are important to us. We want something new in our lives, something better – be it a new career, a new relationship, or a new hobby.

So, I encourage you to take the time to do the things that make you happy. Spend time with family. Look deep inside yourself to figure out what you want going forward. Take what has happened and learn from it.

Become more spiritual in a way that is meaningful to you. Be more aware of time and how quickly it passes: use your time well. Go out and live, but don’t be irresponsible. Instead, use this experience to make your life meaningful.

Remember that the Japanese symbol for ‘crisis’ is the same as the symbol for ‘opportunity.’ So, find your opportunity and turn this crisis into something positive!

If You Are Struggling…

We can help. Whatever the difficulties you are facing, we are here to listen and offer effective solutions. For more information, contact us or call us today at 561-496-1094.

About Andrew Rosen PH.D., ABPP, FAACP

Dr. Andrew Rosen received his doctoral degree in clinical psychology from Hofstra University in New York in 1975 and completed an additional six years of psychotherapeutic and psychoanalytic training at the Gordon Derner Institute in New York, where he earned his certification as a psychoanalyst in 1983. In 1984, Dr. Rosen founded the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, where he continues to serve as Director and to work as a board-certified, licensed psychologist providing in-person and telehealth treatment options.

Dr. Rosen is Board Certified by the American Board of Professional Psychology (ABPP). He is also a Clinical Fellow of the Anxiety and Depression Association of America (ADAA) and a Diplomate and Fellow in the American Academy of Clinical Psychology (FAACP). He is an active member of the American Psychological Association (APA), the National Register of Health Service Providers in Psychology, the Florida Psychological Association (FPA), and the Adelphi Society for Psychoanalysis and Psychotherapy. Dr. Rosen was appointed a Clinical Affiliate Assistant Professor at the FAU College of Medicine in November, 2021. He is a Board Member of the National Social Anxiety Center. He has previously served as president of both the Palm Beach County Psychological Society and the Anxiety Disorders Association of Florida.

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stop omicron image

An Omicron Infection Is Not A Failure

For nearly two years, the country has tried their best to dodge the coronavirus. We have submitted to lockdowns, hidden ourselves away at home, and shunned gatherings with friends and family. When vaccines rolled out last year, many Americans lined up to get the jab. Millions more have gotten a booster and vaccinated their children as soon as they were eligible. Despite our vigilance, the Omicron variant is ripping through the country, infecting both the vaccinated and unvaccinated in record numbers. After being so careful for so long, how have we failed to stay safe?

In part, some of our distress at the high number of Omicron cases is due to a misunderstanding of what vaccines do. When they were first rolled out, both the Pfizer and Moderna mRNA vaccines reported above 90-percent efficacy rates against the virus. If you got the feeling that you were pretty much invincible after being fully vaccinated, you’re not alone. Vaccination, combined with mask-wearing and social distancing, made it seem as if we were golden.

Not so much.

Then, at the beginning of the summer of 2021, the CDC loosened mask-wearing restrictions. They told us that it was fine to gather in small groups, as long as everyone was vaccinated. We began to feel like we were climbing out of the valley and catching tiny glimmers of hope that the pandemic might be nearing an end.

But then Omicron replaced the Delta variant across much of the world, and suddenly everyone is either sick or knows several people who are.

The timing of the new variant was awful, coming right around the holidays. Many people were forced to cancel plans to see loved ones, or to travel, and all the trauma of the past two years came flooding back to us.

After all, the pandemic has been very traumatic for countless people. Anxiety, depression, loneliness, and post-traumatic stress syndrome (PTSD) have now become part of our daily lives.

By definition, a post-traumatic stress disorder can occur when someone has “experienced, witnessed, or been confronted with a terrible event.” Although facts and figures are still emerging, mental health professionals are now recognizing that factors associated with the pandemic have given rise to what is being called “Covid PTSD.”

“We are seeing more and more traumatized people in our clinic and many express a feeling of being hopeless and disheartened now that Omicron is here,” says Andrew Rosen, Ph.D., psychologist and Clinical Director of The Center for Treatment of Mood and Anxiety Disorders in Delray Beach, FL. “If they catch it, they feel as if they have failed themselves and everyone around them.”

But, is catching Omicron really a “failure”?

Absolutely not. In reality, we have succeeded. What we need to do now is revise our way of thinking about the pandemic’s trajectory.

When the virus began, our arsenal was designed around “flattening the curve.” It was never intended that we could completely stop the virus. We only hoped to slow the spread so we wouldn’t overwhelm our resources and wouldn’t have more sick people than hospitals and staff could handle.

Now, we have Omicron, which Dr. Anthony Fauci says, “with its extraordinary, unprecedented degree of efficiency of transmissibility, will ultimately find just about everybody.”

Scientists have determined that Omicron has “upwards of 50 mutations in its genome, 30 of which exist in the gene encoding Spike,” according to the American Society for Microbiology. With an unprecedented rate of transmission (it replicates 70 times faster than Delta), we aren’t going to be able to outrun it or hide from it.

Instead, right now it is very important to find a calm “center” – something that can help to shield you from the stress. After all, you may not be able to change the larger picture, but you can definitely control your personal environment and work towards attaining a small measure of peace.

Making time for self-care can help you regain a sense of control, which reduces anxiety and soothes your emotions. “Above all, make sure to break away from what you fear if it is something you are focusing on too much,” says David A. Gross, MD, a psychiatrist and the Medical Director at The Center. “When we are in the grip of fear, it is sometimes hard to stop the catastrophic “what if” thoughts that come along with those emotions.”

If you are highly focused on something that is creating stress for you, that laser-focus creates more stress and anxiety. Redirecting your attention to something else can break that destructive pattern. Things that require the sensation of touch – like knitting, kneading dough, folding laundry, or exercising – are very helpful in allowing you to turn off and let go of your distressing thoughts.

“Know that it is okay to ask for help,” says Dr. Rosen. “We all have days when we feel sad, stressed, or angry, but it is best to seek help if you can’t shake those feelings after a reasonable period of time. Think of it like you would if you had a wound on your arm that won’t stop bleeding or a headache that won’t go away. You would go to a doctor for help in those cases and you should do the same for the Covid trauma that is troubling you now.”

“Remember that mental and emotional trauma create changes in brain function, which means your distress is not your fault. In many cases, you can use self-care to reduce your anxiety, but if your symptoms continue for more than two weeks or seem to be increasing, we encourage you to seek therapy.”

Dr. Rosen and Dr. Gross are co-authors of Covid Trauma, Healing From The Psychological Impact Of The Coronavirus Pandemic.

Learn To Feel Safe Again

If you are struggling with coronavirus anxiety, reach out and get the help you need. By working with a mental health professional who specializes in trauma, you can experience recovery from your PTSD relating to the pandemic. For more information, please contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 today.

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Jerome Siegmeister, MD, MaED – Consult The Expert On How Virtual Schooling Is Affecting Children

The Center’s newest clinician, Dr. Jerome Siegmeister, MD, MaED, is an expert on the psychiatric concerns of children and adolescents. A former high school teacher, he has a unique perspective on how children learn and the societal skills they can only develop through social interaction with peers. Since the pandemic, what he has seen has left him genuinely concerned.

During these last two years, parents and kids have had to adapt to shut downs and periods of online learning. While some students do just fine with virtual classes, many more are struggling – not just with learning through an online format, but with the loss of the in-person connection with classmates. “Covid has really devastated these kids,” he says. “Though some children can do well in this environment, virtual learning causes an issue for most.”

“The virtual learning modality is basically a lecture modality,” he continues – and therein lies part of the problem. “What do you and I do when listening to a lecture? If we are honest, most of us listen to it in the background while doing other things, so we miss a lot of the information.”

“Children are no different,” he says. “From a developmental standpoint, it is clearly better for kids to attend in-person schooling, but the unfortunate reality is that we need to be worried about public health, as well. In many cases, virtual learning is all we have right now, but this isn’t workable for many kids.”

Loss of knowledge isn’t the only side effect the pandemic has had on the nation’s children. “Virtual classes have their place because kids need to be learning, one way or another, but it comes at a price,” he explains. “It is very obvious that our children’s socialization has been affected and will be for a long time to come.”

“At this point, we have lost at least eighteen months of socialization,” he says. “Society pushes the idea that we need others to validate us, so kids rely on social acceptance for much of their self-worth. Covid took away much of that.”

Even older teens are being challenged by this new world. “The pandemic has been very hard for kids who are transitioning to college,” he notes. “Life is drastically different for them, especially if they are having to do their first year of college virtually. They are missing out on the social aspects that help them adjust to college life.”

He is optimistic, though. For most kids who are struggling, “it isn’t too hard to stabilize them and they can do really well,” he says. “Counseling and working one on one with kids will make things better in the majority of cases.”

When working with children, Dr. Siegmeister believes in treating the whole person. Depending on the child’s individual needs, this may mean combining two or more treatment methods, such as using cognitive behavior therapy along with medical treatments if there is an underlying psychiatric concern. He also likes to take a team approach to treatment and frequently involves parents, teachers, or college faculty, so the child can achieve the quickest resolution of their symptoms.

As unlikely as it may sound, Dr. Siegmester says there is actually a silver lining to the pandemic. “Mental health is often swept under the rug,” he says, “but depression is now pretty pervasive in both children and adults and people recognize this. In fact, many so called “sick days” happen because the person is depressed and really needs to take a mental health day. The positive outcome from covid is that people are now much more aware of anxiety and depression because they’ve experienced it themselves. This means it has become much more acceptable to seek help.”

About Jerome Siegmesiter, MD, MaED. (Child And Adolescent Psychiatry / General Psychiatry)

Jerome Siegmeister, MD, MaED, is a South Florida Native. He has worked with clients of all ages, and believes that the whole person needs to be treated. Consequently, he evaluates all aspects of the situation, from medical to situational, to determine the best initial course. He has a background in both individual and group therapies, employing supportive, behavioral, and insight oriented approaches, as appropriate to best fit his client’s needs, as well as comfort with medical treatment of any underlying conditions that might manifest psychiatrically. He has significant experience in all forms of psychiatric issues, including mood symptoms, thought disorders, anxiety, phobias, attention deficits, behavioral issues, insomnia, compulsive disorders, emotional lability, substance abuse, and trauma.

Dr. Siegmeister graduated with his Bachelor’s from Florida International University, after which he spent a number of years teaching, and obtained a Masters from the University of South Florida in Career and Technical Education/Adult Education. Upon deciding to pursue medicine, he initially completed a Post Baccalaureate Pre-Medical Certificate program at the University of Miami, and then obtained his MD from the University of Miami Miller School of Medicine, staying there afterwards for his specialty training in Psychiatry, followed by a fellowship in Child and Adolescent Psychiatry, where he served as Chief Fellow, and was awarded with a Research Distinction. After training, he has worked providing Emergency care, with additional work in inpatient settings, both in mental health and as a consultant to medical units at multiple hospitals. He is currently Board Certified by the American Board of Psychiatry and Neurology in both general Psychiatry, and Child and Adolescent Psychiatry, and by the National Board of Physicians and Surgeons in Psychiatry.

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Marsha Glines, PHD

Marsha Glines, Ph.D – Consult The Expert On Overcoming Learning Challenges

Marsha Glines, Ph.D is the only person on the Center for Treatment of Anxiety and Mood Disorder’s team who is not a therapist or behaviorist – she is an educator who brings a diagnostic standpoint to the Center. Her role is best defined as that of an academic coach. “I believe very strongly that learning should be empowering and meaningful,” she says. “Everyone learns differently and not everyone can learn through traditional classroom methods.”

The frontal lobe of our brain synthesizes and organizes information. “We have more than 100,000 neurons in our brains, so we each receive information differently than anyone else,” Dr. Glines says. “This means we also process the information we receive differently from each other.”

These information reception and processing systems are called metacognitive skills. Figuring out someone’s metacognitive skills tells how the person thinks, which then can help determine their learning strengths.

When an individual has challenges with learning through traditional classroom methods, “My role is how to find the appropriate path to learning for this person. Part of that is really getting to understand the student. This involves analyzing how they look at a problem and adjusting my strategies to help them learn and understand.”

To better recognize how each client learns, she begins by observing the individual and asking questions to help figure out their learning process. In addition, Dr. Glines takes an informal “inventory” of the skills and methods the person has successfully used in the past. Putting this information together gives her a good indication of where the student is in terms of learning.

The process then turns to modifying and experimenting with this information to see what works for the student. “If they are struggling in algebra, for example, we need to figure out how to change up the way they study algebra to make it useful for everyday skills.”

“The goal of my work is to find meaningfulness and purposefulness in how we learn. I help individuals find what their strongest cognitive pathways to their brain are, how to understand these pathways, and how to learn with them,” she explains. Does the client do better by hearing a lecture? Are they a visual learner? Do symbols or colors combine with what they are hearing to help them learn? Uncovering these unique methods makes a huge difference in the person’s understanding and retention of information.

Once Dr. Glines knows these strengths, she creates personalized education plans for what would be helpful for this person’s learning method. To do this, she uses repetition, challenge, novelty, and movement. “Our brains are wired to respond to new things, so changing up our learning method helps us learn and retain information,” she says. “I might teach them how to use symbols to remember something. Tools like mind maps and graphic organizers work well for a visual learner, for example.”

Similar to mnemonics, using tools, such as color coding the papers that students take notes on, can help with processing and retention.

At one point, Dr. Glines worked with students in a Psychology class to help them remember the differences between the pioneers in the mental health field. “These historical figures can all blur together,” she says, “so we discussed what color they thought of when they learned about Freud. Let’s say it was red. They assigned the color red to everything about Freud, even down to taking lecture notes on red paper.”

“Maybe Jung was the color brown”, she continues. “So his information was keyed to everything brown. At test time, when they saw a question about Freud, they recalled that he was red, not brown.” This allowed the students to “see” their lecture notes section in their notebook, which jogged their memory and often allowed them to correctly come up with the answer to the test questions.

Along the same lines, spatial models, symbols, and even acting out the information can function like a mnemonic. “Instead of just thinking in language and words, this is a different way of processing information and memory. It taps into different pathways of the brain’s retrieval system.”

Dr. Glines might also incorporate technology into the student’s learning process. “There are devices like smart pens that can record a lecture as the student takes notes, then lets the student replay that lecture,” she says.

This can be especially helpful for individuals who have learning disabilities. The person may not be able to visualize a spoken word in a text form, for example, which makes taking notes extremely challenging.  A smart pen can record oral notes, however. Later, the student can replay the lecture and even transform it from oral form to written text with the touch of a button. “A student can even tap a word in those notes, which then comes up to show them the meaning of words they find challenging,” she says.

Before any of these non-traditional learning plans can help an individual, though, they need to take ownership of what they value and what is important to them.

“What have you achieved and what do you hope to achieve? These are things you value and every decision we make is based on what we value,” she says. “These answers are empowering. Many people don’t take their school knowledge and think of how to apply it in real life, yet this is what gives ownership to the information we learn. If you can give the topic or subject meaning, you can learn and recall it much better.”

About Marsha Glines, Ph.D. (Academic Coach / Learning Specialist)

Dr. Marsha Glines has a national reputation in teaching and learning theory, special education, non-traditional program design and higher education curriculum development. Prior to joining the Lynn University community in 1991, Dr. Glines was the founding president of Beacon College and in October 2021 she was awarded an Honorary Degree Of Humane Letters from Beacon. While at Lynn University, Dr. Glines created and provided oversight of many academic alternative, innovative programs including: an undergraduate human service degree, the Advancement Program, the Lynn Educational Alternative Program and the “nationally recognized” Institute for Achievement and Learning.

Among her many achievements, Dr. Glines has published several pieces on post-secondary learning opportunities for students with learning disabilities and her work has been discussed in several books. In addition, she has conducted numerous training workshops both nationally and internationally and is a frequent presenter at various conferences on learning and higher education. She continues to teach remotely in Regis College’s undergrad and graduate education departments.

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Help For School Anxiety During Covid

School is starting up again and many school districts have gone back to in-person learning. While back to school anxieties are typical during any given year, COVID-19 is still with us, which has added more uncertainty and stress for everyone involved.

Since virtual, at-home learning took place during the previous school year, many kids may now find it difficult to adjust to being away from the safety of their home and parents. Add to that the fear that others around them may unknowingly be sick and you may find that even well-adjusted children are experiencing heightened stress. For children who already suffered from anxiety, however, the return to physical classrooms may mean their anxiety worsens when they return for the first day of class.

What Signs Of Stress Can Be Observed In Children During The COVID-19 Pandemic?

In general, children are resilient. Many kids will manage this transition just fine with help and support from their parents. Those who already struggled with anxiety or emotional problems or who had behavioral or developmental concerns before the pandemic may need additional assistance, though. It’s important that you keep a watchful eye on them, as they might be at risk for increased or severe depression and anxiety.

Signs of stress to watch for include (by age group):

Preschool age – Children in this age group may be more whiny or clingy than usual. They may have problems sleeping, have nightmares, or become afraid of the dark when they weren’t before. You may also find that they withdraw or their behavior may regress. They may lose their appetite or become picky eaters.

5 – 9 – Children who are in elementary school also may be clingier. They may be angrier or more irritable and cry or otherwise resist to going to school. They might have nightmares and sleep problems, along with poor concentration. In addition, your child may stop showing interest in friends or activities they used to enjoy.

10 – 19 – Adolescent children may show everything from sleeping and eating disturbances to agitation or arguments with others. They may have physical complaints such as headaches or stomach aches. They may also exhibit poor concentration or engage in some type of delinquent behavior.

Parent Anxiety About School During Covid

The uncertainty surrounding the pandemic makes in-person schooling nerve-wracking for some parents. Obviously, they are apprehensive about their child’s health and well-being, but they also have to address their child’s concerns and reassure them that they will be safe in school. For many, it’s a balancing act of trying to be supportive while also telling the child to be careful, wear their mask, and social distance. Talk about stressful!

It is important to keep in mind that your children look up at you for guidance on how they should react during times of stress. You want to show them that they need to take the situation seriously, but without panicking.

We all do better when we have a sense of control over something that worries us. Children are no different. Discuss their fears and help them find positive ways to deal with their stress.

Ensure they know how to wear a mask correctly (it should cover their nose and mouth). Teach them to carry and use hand sanitizer and how to wash their hands (wash for the time it takes to sing the birthday song). Make sure they understand how social distancing helps to reduce the spread of the virus. Teach them to cough into their elbow or a tissue and to throw a used Kleenex away immediately.

Lastly, protect your child’s health by encouraging them to eat well, get plenty of sleep and exercise daily. This will help build their immunity so they can fight off illness in the future.

Helping Students Return To School After Covid

Going back to in-person learning is a transition and, as with any big change, there will be upset and stress for a couple of weeks until the child settles into the new routine. This is particularly true during the pandemic, when kids are having to adjust to so many new things.

You may find that your child is overly tired during the first few weeks of school. They may be more emotional than usual or act out more often. But if there are major shifts from their normal behavior – such as withdrawing from friends or refusing to take part in things they usually enjoy – and this behavior doesn’t go away after a couple of weeks, this could signal problems and you should consider seeking help.

This is the time to sit down and talk to your kids. Encourage them to tell you what’s bothering them; acknowledge their concerns even if you don’t agree with them. When you know what is concerning your child, work with them to come up with a plan for addressing it. What can you, as the parent, do to help? What can the child do? Does the school need to get involved?

Remember that you also need to take care of yourself. What helped you before the pandemic? Was it calming to work on crafts? What about yoga or engaging in exercise? Maybe listening to calming music or reading reduced your stress? Whatever worked in the past should help you now, but you must take the time for self care.

Keep in mind that even just taking a small break can help you mentally regroup and make you feel less overwhelmed. Take a short walk around the block or indulge in some deep breathing exercises. You don’t have to take a long break – a little bit goes a long way!

Pandemic Anxiety? We Are Here For You

If you are experiencing pandemic fatigue and anxiety, we are here to help. Contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Andrew Rosen and The Center today.

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What We Have Learned From 2021

No one can deny that 2021 has been a momentous year. It has had a mixture of the good, the bad and the ugly for sure. It has at times been frightening, confusing, comforting and educational. We have witnessed a very unusual presidential election, a subsequent denial by some of the validity of the election and an unheard of polarization of our peers and lawmakers. Most critically, we have endured a gift that keeps on giving; the novel coronavirus that has killed countless people world-wide and more fellow Americans than we would have ever anticipated. We have had to learn the meaning of the word epidemiology as it relates to health and wellness. Unfortunately, we now know explicitly what a spike protein is and looks like. More than ever before we have been influenced (for good and bad) by the internet and social media. Although we have been witness to conspiracy theories in the past, but this year has certainly been a boon time for them.

So it is important for us to sit back and take stock of the emotional and psychological impact of these events. A major fallout has been the confusion over what is fact and what is fiction. We have seen the major news networks disagreeing on many important issues. Who to believe? Proponents of networks that broadcast their unique take on the news may be diametrically opposite of the proponents of the “other” networks. To avoid getting into trouble I will leave the network names blank, but I am sure you know what I am talking about. There was a time in the 1950s and 1960s when veteran newscasters like Walter Cronkite, Huntley and Brinkley, Douglas Edwards educated us nightly on national and world events. Marshall McLuhan’s “the medium is the message” conveyed the power and influence of the media. Somewhere during the subsequent decades all this has changed. It became apparent to television and radio that communicating news is basically a form of entertainment. Like most popular entertainment venues it becomes essential to be able to sell the programs to the masses. Media outlets have always been for profit businesses (exceptions being Public Radio and Public Television) but it seems that profitability became linked to the entertainment value of their shows. Newscasters and news commentators became the entertainers that we see today. Walter Cronkite would not succeed as a newscaster in 2021.

Along comes the world wide web and internet bringing to us the 24/7 experience of social media. Humanity has not been the same since. Due to the openness of social media to anyone with internet access, a huge amount of content has appeared on the screens and podcasts of this world. An interesting paradox has developed. Most social media participants should realize that what they see and hear reflects subjective information. However, at the same time, we are witnessing the tremendous influence of social media on the minds of attendees. It is as if misinformation has become the norm. Conspiracy theories have had a heyday. Part of the problem is that human beings have a strong tendency to be voyeurs. They like to be entertained. We are drawn to the unusual, fantastic and bizarre. Hence the success of reality TV no matter how strange or sensationalistic it can be. Consider the popularity of horror movies going back to the days of black and white silent films. It does appear that what we have been witnessing is the natural evolution of multimedia fueled by both the profit motive and the change in its audience. 

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How Too Much Screen Time Affects Your Kids (And How To Set Limits)

As pandemic restrictions begin to ease, we’re emerging with new addictions to our devices. For many families, lock downs meant turning to virtual entertainment and increased online communications with friends and loved ones.

The result is that we’re more comfortable with the virtual world than ever before – and many children are finding it hard to break their screen time “habit” now. How can parents restrict their kid’s online time and do they really need to?

How Long Much Screen Time Do Kids Get?

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