All Posts Tagged: the center for treatment of anxiety and mood disorders

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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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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child wearing mask in school

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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woman wearing mask

Are You Struggling With Covid Stress Syndrome Or Covid PTSD?

Those with mental health concerns often feel like they can’t control the world around them. Sometimes they may feel like they, themselves, are spiraling out of control. Now that we’ve gone through the last year and the challenges brought by the coronavirus pandemic, I think most of us can relate to those feelings in some way.

For many people, going through this pandemic means that trauma and post traumatic stress disorder (PTSD) has now become a part of their life. This can be for a variety of reasons.

Maybe you’re a front line worker who is burned out and mentally exhausted. You may have had the personal experience of having had Covid-19. Or, perhaps you’ve had to face the illness and/or passing of someone close to you, due to the disease. Even going through lock downs, losing jobs, and being separated from friends and family for long periods can wreak havoc on our mental health.

No matter the reason, anyone who witnesses or goes through the events surrounding a traumatic, life-threatening illness like Covid-19 may find they have anxiety, depression, or post traumatic stress afterwards.

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virtual therapy

Will Teletherapy Continue After Covid?

Before the Covid 19 pandemic, the potential of telehealth and virtual therapy was just starting to be recognized as an option for the treatment of mental health disorders. Then, the world shut down and remote care exploded into universal acceptance.

In the months since, people (and insurance companies) have learned to navigate the ins and outs of virtual therapy. Once we are free to resume our normal lives, however, will this option go away?

What Is A Telepysch Appointment For Mental Health Care During The Covid-19 Pandemic?

In a nutshell, a telepsych appointment for mental health care is pretty similar to an in-person session – with a few convenient differences.

With telemedicine, the client talks to their licensed mental health professional from the comfort of their own couch, instead of going in to the office.

Clients can choose to see their therapist via an online platform like Skype or Zoom or they can take part in an online chat session via their phone or computer. They don’t have to worry about traffic or commuting to the office in bad weather – and don’t even have to change out of their pajamas!

Because there was often no other option during the pandemic shut downs, individuals who had been in therapy before covid-19 quickly adapted to virtual and online teletherapy. This allowed them to safely continue treatment at a time when stress levels were through the roof.

How Effective Is Teletherapy?

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book cover for Hope for OCD: One Man’s Story of Living and Thriving With Obsessive Compulsive Disorder

Hope for OCD: One Man’s Story of Living and Thriving With Obsessive Compulsive Disorder

Millions of Americans go through each day tormented by the uncontrollable thoughts (obsessions) and compulsive rituals and behaviors that characterize OCD. Difficult to understand and even harder to experience, Hope for OCD – One Person’s Story of Living and Thriving with Obsessive Compulsive Disorder is a profoundly courageous inside look at navigating life with the challenges of this anxiety disorder.

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HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder

HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder

HOCD (Homosexual Obsessive Compulsive Disorder) is a debilitating condition that attacks without warning in those who already struggle with classic OCD. It leaves its victims reeling with uncontrollable doubt about their sexual orientation (despite never having questioned it before), while igniting a vain pursuit of certainty over the question of whether they are truly straight.

In this HOCD primer, Andrew Rosen, Ph.D. draws on more than forty years of clinical practice to give readers insight into the disorder, as well as offering practical help to those who are fighting against a sexuality they know deep down really doesn’t exist for them.

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What Is Harm OCD?

Studies show that the vast majority of us occasionally have unwanted violent thoughts about injuring ourselves or others. For example, we might briefly fantasize about harm befalling the guy who just cut us off in traffic and then scared us even more when he immediately slammed on his brakes to avoid other cars. Although we don’t like to acknowledge them, about 85 percent of people do experience some type of random harmful thoughts, but they are fleeting and don’t disturb our normal lives.

For people who have obsessive compulsive disorder (OCD), however, having unwanted thoughts about hurting someone may not be able to be dismissed so easily. In fact, these thoughts can become frequent enough to become intrusive, taking over the person’s life. When this happens, the individual is dealing with Harm OCD.

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Counseling Adults with Autism

Our very own Dr. Ali Cunningham recently released a book, Counseling Adults with Autism. The cover art for the book was produced by a local man with autism, Michael Vidal (pictured here with Dr. Cunningham).

Counseling Adults with Autism is a practical guide for counselors, psychologists, and other mental health professionals looking to improve their confidence and competence in counseling adults diagnosed with mild to moderate autism spectrum disorder (ASD). Organized into 11 chapters based on key areas for guiding assessment and treatment planning for this population, this book highlights evidence-based practices and therapeutic interventions through case examples to demonstrate how assessment and treatment can be applied. Replete with insights from a variety of disciplinary approaches, this is a comprehensive and accessible resource for practitioners looking to support and empower clients struggling with social and behavioral challenges. Buy the book here.

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toddler with social anxiety

Social Anxiety in Toddlers

Toddlerhood is defined as the age range from 12 to 36 months. During this period, a child’s emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddler’s social anxiety begin to emerge.

Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the “shy” child who quietly observes and doesn’t interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.

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