Psychotherapy

Millions of people are diagnosed with depression every single year, but what is it? It is more than just normal emotions and occasional feelings of sadness. Major Depressive Disorder is defined by the DSM-5-TR, must include 5 of the following symptoms that last longer than a period of 2 weeks. These symptoms must interfere with your ability to go about your daily life:

• Depressed mood (sadness, hopelessness, emptiness) most of the day, almost everyday
• Decrease in interest or pleasure in doing things you loved to do, almost every day
• Significant unintentional weight loss or weight gain. A decrease oran  increase in appetite
• Change in sleep patterns (too little or too much)
• Agitation or moving more slowly than normal
• Fatigue/loss of energy
• Feelings of worthlessness or excessive guilt
• Decreased ability to concentrate or make decisions that interferes with everyday life
• Recurrent thoughts of death

If you have 5 or more of these symptoms that have lasted more than 2 weeks, please fill out this screening form and feel free to schedule an appointment.

I am sure you have heard that when someone prefers things to be extra clean, that they have OCD. Well, they may or may not have an actual diagnosis of OCD. Let me explain what OCD actually looks like. As the name suggests, OCD has a component of obsessions, which are defined by the DSM-5-TR, recurrent and persistent thoughts, urges, or images that are intrusive and unwanted causing anxiety and distress that interferes with functioning. The person that is experiencing the obsessions, or intrusive thoughts, attempts to suppress them by performing some action or thinking about something else.

Thinking of repetitive words or performing repetitive actions, are known as compulsions. They are aimed at reducing the stress caused by obsessions. The person believes that performing the acts or thinking the thoughts will prevent bad things caused by their obsession. For instance, someone may turn the light off and on 5 times (compulsion) because they believe if they don’t, something bad will happen to their loved ones (obsession). These are time consuming and disruptive to their everyday lives.

Anxiety can be a normal part of life. It can actually serve a purpose to motivate us to complete tasks or protect us from danger. It is when anxiety interrupts your daily life that it becomes a problem.

Excessive worry that you experience more days than not for at least 6 months.

The worry or anxiety is difficult to control

The worry is associated with one or more

• Restlessness
• Tires easily
• Difficulty with concentration
• Irritability
• Muscle tension
• Sleep difficulties

These signs and symptoms can overlap with other mental health issues. Remission Health is here to help you. Together, we can discuss your symptoms and come up with a treatment plan. If you feel like this applies to you, please fill out the survey below and feel free to schedule an appointment:

In American culture, body shape popularity changes every few years. One minute being thin and frail is considered stylish and chic. The next minute a more curvy or thicker physique is all the rage. It can be very discouraging and cause serious issues trying to keep up with the fads. At Remission, I hope to help you change your relationship with food and get on the path of healing your self-image. We all can use some help with our food choices, especially in America. With the hustle and bustle of everyday life and easy access to unhealthy choices, it is no wonder that many Americans are obese. On the flip side, societal standards and various stressors may force some people into feeling like they should have an unrealistic body size.

Serious health problems can come from disordered eating. Anorexia can cause bone loss, cardiac arrythmias, electrolyte derangements, and death. Bulimia can cause tooth decay, esophageal erosion and electrolyte imbalances, amongst other things. Binge eating disorder can contribute to obesity, diabetes and other metabolic disorders. Orthorexia can cause psychiatric distress. So you see, disordered eating doesn’t exist in a vacuum. Let’s navigate this tough subject together and heal relationships with food.

In recent years, ADHD has gained more awareness, and people are falling into the trap of self-diagnosis. I want to give clear and concise diagnostic criteria but be cautious because ADHD symptoms have some overlapping symptoms with other mental health issues. ADHD, or Attention-Deficit/ Hyperactivity Disorder, can be defined as a persistent pattern of inattention, and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by either inattention or hyperactivity and impulsivity. Both can be co-occurring and is referred to as a combined presentation.

The inattentive type can be characterized by five (for adults) and six (for children) of the following symptoms: Lacks attention to detail, difficulty sustaining attention, does not listen when spoken to, does not follow through on instructions, difficulty organizing, avoids or dislikes tasks that require sustained attention, loses things, easily distracted and forgetful. These symptoms must be severe enough to interfere with everyday life.

The hyperactive and impulsive type must have 5 or 6 of the following diagnostic criteria: fidgets or taps feet, leaves seat in situations when remaining seated is necessary, runs or climbs in inappropriate situations, unable to play in leisure activities, on the go as if driven by a motor, talks excessively, blurts out answers, excessive talking, interrupts and has difficulty waiting their turn.

If you think you may meet these criteria, feel free to contact me for an evaluation.

Trauma can affect anyone, at any age and leaves lasting effects on the body. The criteria that must be present for the diagnosis of PTSD in persons older than 6 years are as follows facing exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways according to the DSM-5-TR:

• Directly experiencing trauma
• Witnessing the events that occurred
• Learning that the violent or accidental events happened to close family or friend
• Repeated or extreme exposure not through media sources unless the exposure is work related

Presence of one or more of the following symptoms associated with the traumatic event, beginning after the event occurred must be present:

• Distressing memories, or repetitive play reenacting event
• Distressing dreams
• Dissociation
• Intense distress when exposed to internal or external cues that remind the patient of the event
• Physiological reactions

Avoidance of triggers is also a common sign. Negative mood or changes in cognition may also be present. With these things comes negative self-perceptions and negative thoughts. One may feel detached and have little interest in things they once enjoyed. Positive emotions can be difficult to experience. Some people may be hypervigilant and self-destructive. Some may startle easy.  As you can see, PTSD may be very nuanced and difficult to navigate. If you feel like you or a loved one may be experiencing some signs of PTSD, Remission can help. Please reach out for an appointment today.

Bipolar Disorder affects approximately 5.7 million Americans. The signs and symptoms may not always be obvious. Like many mental health issues, bipolar disorder symptoms overlap with other processes. It is important to ask the right questions and to have a provider that listens. At Remission, that is exactly what I do. It can be quite freeing to have an answer about what is happening. Here is some general information about bipolar disorder:

There are two types of bipolar disorder: Bipolar 1 and Bipolar 2

Bipolar disorder 1 is characterized by ONE manic episode that is preceded or followed by a hypomanic or depressive episode. You may ask what is “manic” or “mania”? As defined in the DSM-5-TR, it is a “distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally and persistently increased activity or energy, lasting at least a week, present most of the day, every day.

During this time of increased energy, you must have at least 3 of the following symptoms:

• Inflated self-esteem or grandiosity
• Decreased need for sleep; ex- you feel good after 2-3 hours
• More talkative than normal, pressured speech
• Flight of ideas, racing thoughts
• Easily distracted
• Increased goal directed activity
• Excessive involvement in painful activities regardless of the consequences

As with any diagnosis, these symptoms have to severely impact one’s life. It is only necessary to experience one of these expansive episodes in conjunction with hypomania or a depressive episode. Most people seek help when they are depressed so the mania may be missed by the clinician. It is very important to get an accurate diagnosis to effectively treat.

Bipolar 2 is similar to bipolar 1 in that it is characterized by at least 1 hypomanic episode precipitated or followed by a depressive episode. The differences in bipolar 1 and 2 are the time frame, bipolar 2 hypomania lasts 4 days or less, and the intensity of the mania. If you think you may meet these criteria, feel free to contact me for an evaluation.

Alcohol can disrupt lives and kill. According to the Centers for Disease Control, 178,000 people die each year due to alcohol. It causes behavioral changes, liver issues, increases risk for cancer, amongst other things. Recent research has indicated that there is no safe amount of alcohol one can consume. The old advice was drinking a glass of red wine every night can help with cardiovascular health. This is no longer considered to be true.

Alcohol use becomes disordered when it causes significant impairment, distress, and problems as evidenced by at least two of the following in a 12 month period:

• Alcohol is consumed in larger quantities over a longer period of time than intended.
• There is a consistent and unsuccessful effort to decrease consumption.
• A large period of time is used obtaining, using, or recovering from alcohol.
• Craving, or a strong desire to use alcohol.
• Use interferes with obligations at home, work, or school.
• Using alcohol even though it causes problems in personal or professional life.
• Important social, occupational, or recreational activities are given up or decreased due to alcohol being a priority.
• Even in hazardous situations, alcohol use continues.
• Alcohol use is continued despite knowledge of having persistent psychological or physical problems that likely is exacerbated or caused by alcohol.
• Tolerance
• Withdrawal symptoms

If you or loved one is experiencing trouble with alcohol and feel like you may need some help, please reach out as soon as possible. Feel free to take the questionnaire below to see if alcohol use is a problem.

Since the beginning of history, there have been instances recorded of humans identifying as a gender that is different than their assigned gender. Gender dysphoria has only recently been recognized as effectively treatable. It is defined as a “marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least six if the following” in children according to the DSM-5-TR:

• A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from the one assigned at birth.)
• Clothing that represents the opposite gender preferred and worn
• A strong preference for cross-gender roles in play
• A strong preference for activities engaged in by opposite gender
• A strong preference for playmates of gender that one identifies with
• Rejection of typical activities and toys associated with assigned gender
• A strong dislike of one’s sexual anatomy
• A strong desire for primary and secondary sex characteristics that match their identity.

These symptoms must cause significant distress or impairment in everyday life.

A gender dysphoric disorder varies in the number of necessary symptoms for diagnosis for adolescents and adults compared to children. The required symptom manifestation is two out of 6 listed below as listed in the DSM-5-TR:

• A huge difference between one’s experienced/expressed gender and (or anticipated) primary and/or secondary sex characteristics
• A strong desire for the primary and/or secondary sex characteristics of the other gender
• A strong desire to be treated as the other gender
• A strong desire to be of the other gender
• A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with experienced/expressed gender
• A strong conviction that one has the typical feelings and reactions of the other gender
• The condition is associated with significant interference in daily life. After treatment of gender affirming care including at least gender reassignment and/or hormone replacement therapy, the individual is considered post transition. This transition process can be extremely expensive and life altering. If you need supportive mental health care, Remission is here to help. Please schedule an appointment with a compassionate, educated, and supportive practitioner today.