Sitting With Our Emotions

Certain emotions can be unpleasant and uncomfortable to experience, especially if the emotions are new or different than what we may typically experience.  Some of us may also experience certain emotions at high levels of intensity, which can feel overwhelming and seem challenging to deal with.  Therefore it is a common human response to want to avoid, minimize, or suppress emotions that we consider to be undesirable such as fear, hurt, anger, sadness, depression, or anxiety.  Pushing these emotional experiences down or pretending like they are not happening may be a temporary fix to promote our ability to function in the short term however these reactions just prolong the inevitable: the need to deal with the root of our emotions.  In fact, efforts to avoid or minimize feelings can have the opposite effect by actually intensifying symptoms or emotions.

In order to resolve negative and uncomfortable emotional experiences in a healthy manner, we need to be able to acknowledge in a non-judgmental manner any emotion that we feel in the moment.  This requires us to practice awareness of what happens for us emotionally, physically, and mentally at any point in time.  I commonly recommend for clients to create a ritual of checking in with him/herself throughout the day in which the following questions are answered:

·      What mood or feelings am I currently experiencing?

·      What physical sensations do I currently notice in my body?

·      What type of thoughts am I currently experiencing?

Once we are able to establish awareness of what happens for us from moment to moment, we can then practice the skill of acknowledging our experiences without placing judgment on them or trying to change them in any way.  For example, “I am feeling sad and don’t want to do anything.  I feel an emptiness in my heart and have no appetite.”  Instead of becoming critical of ourselves by thinking we should not be feeling sad and need to change it, which just adds to our sadness, we can learn to simply recognize our experience for what it is and allow ourselves to sit with it for as long as it occurs.  Even though it may not seem like it in the moment, sitting with our emotions can lead to healthy resolution, as it requires us to embrace and deal with our experiences.  This skill takes practice and patience but can be extremely rewarding and healing.

~ Cory Stege, M.S., LMFT

Suicides In The Military: On The Rise

Sadly the number of self-inflicted deaths for active duty military members, reservists, and members of the National Reserve continued to increase in 2016.  Although the statistics for suicides in the military are not yet out for the entire year of 2016, the Department of Defense reported 110 suicides in the first quarter and 103 suicides in the second quarter of 2016 (DOD Defense Suicide Prevention Office), which means that there could be close to 400 military suicides just last year.  These statistics are significantly more than any training or combat-related deaths in the military in 2016.

So how do we make sense out of these rising numbers?  It is an understatement to say that suicide continues to be a critical public health issue, both in the military and in the civilian communities.  Although there is not a single or clear cause or precipitant to suicide, there are patterns and trends associated with suicides in the military that have been identified over the years.   According to research conducted by the DOD DSPO (2016), some of the common factors linked to suicide include exposure to combat and life threatening situations during deployments and challenges with managing the significant transitions that active duty service members experience when they join the service as well as leading to and following deployments.  More emphasis is being placed on the latter as a risk factor of suicide since it has been found to result in substantial disruptions in service members’ interpersonal relationships.  Along these same lines, an individual’s degree of experiencing feelings of connection and belongingness to others within their community during times of transition can influence level of risk. 

It is important to acknowledge that a number of individuals in the military enter the service with pre-existing stressors and mental health issues that place them more at risk for suicide, especially after they experience some of the demands and stressors associated with military life. 

So what can we do to begin to reverse this trend?  For one, everyone can take accountability for knowing that we each have a critical role in preventing suicide, regardless of who we are or what we do for a living since suicide affects everyone.

Other steps we can take are:

1.     Recognize the warning signs to suicide in those around you. This includes listening and looking for:

•      an increase in substance use; isolation or withdrawal from support network
•     a significant change in behavior, especially after a loss, trauma, or life transition
•       reckless behavior
•       insomnia or sleeping too much
•       giving away personal belongings
•       calling/writing to people to say goodbye
•       researching or looking for ways to die
•       aggressiveness and rage
•       depression
•       Irritability/anger
•       Humiliation/embarrassment
•       Decreased involvement in activities and hobbies
•       Anxiety
•       Talk of severe hopelessness or being a burden to other people
•        Expressing pain and not having any reasons to live
•       Expressing suicidal ideation that the individual wants to kill themselves 

2.      Be willing to listen in a non-judgmental manner.

3.      Offer hope that there are options for getting help.

4.      Seek support from others who can provide resources or treatment.

If you or someone you know is experiencing suicidal thoughts or is at risk for suicide, use these resources below to access help 24/7:

Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Veterans Crisis Line: 1-800-273-8255 press 1

Crisis Chat for online emotional support: crisischat.org

Crisis Text Line: Text START to 741-741

~ Cory Stege, M.S., LMFT

Shame Versus Guilt

When we think about feelings we experience we typically categorize them into positive or negative and on a continuum: happy, sad, excited angry, fearful, etc.  Shame and guilt are two emotions that tend to fall into the negative category, as they can be uncomfortable and unpleasant to experience.  Shame and guilt often get confused as being the same emotion however they are in fact different.  It is important to be able to comprehend how these two emotions are both similar and different in order to better understand our experiences so that we can address and cope with them appropriately.

Guilt:  A feeling of remorse or regret that is associated with something we have done.  Guilt is a response we experience that is based on our behaviors and choices which typically involves the violation of values, beliefs, or standards of ourselves or of other people.  Because we are human and make mistakes, it can be expected and normal for each of us to feel guilty from time to time.  Guilt can influence us to consider making changes in order to avoid or prevent future instances of it.   

Shame: The feeling or perception of inadequacy when we think about ourselves in relation to others.  Shame is linked to our self-esteem, or how we view ourselves, and is associated with worthlessness and feelings of failure.  Shame is typically a response we experience when we feel insulted, put down, or blamed by significant people in our lives (parents, siblings, partners, friends, etc.) and we receive messages that we are bad or not worthy.

In other words, guilt = a feeling associated with something we did and shame = a feeling associated with who we perceive ourselves to be.

Now that the primary differences between shame and guilt have been identified, hopefully it makes sense for why each emotion needs to be treated differently. 

In order to resolve feelings of guilt we can examine the behavior that caused it, seek forgiveness from others as well as ourselves, and focus on clarifying our values in order to prevent poor choices from recurring.  In order to resolve feelings of shame, we need to peel back the layers that contribute to our core beliefs about the world and ourselves.  We can then begin to challenge and reframe our perceptions so they are more in line with how we want to be perceived. 

Guilt and shame can be very powerful emotions and if we allow them to go unmanaged, it can lead to irrational and unrealistic thinking, feelings of depression and anxiety, social isolation, substance abuse, and health problems.   Therefore if you experience feelings of guilt or shame or think they are negatively impacting your functioning, don’t hesitate to reach out to others to talk or consider seeking professional help.  

~ Cory Stege, M.S., LMFT

Feeling Distressed Or Anxious? Techniques That Help You Feel Grounded

Certain thoughts and feelings can feel extremely overwhelming to us when we experience them and if we don’t learn to identify and manage them effectively, we give them the power to be debilitating.    Strong emotions, memories, or physical sensations tend to be associated with stress, anxiety, and abuse or violence and can result in flashbacks, nightmares, panic attacks, depersonalization, and derealization, which can be unsettling and frightening. 

Although we don’t always have control over aspects or triggers that cause us to experience stress or anxiety, we do have the ability to control our thoughts so that our feelings and behaviors are directly impacted.  It can take time to learn to reframe our core beliefs about who we are and how we think about the world we live in however there are some basic exercises we can implement in moments of stress and anxiety that can promote a sense of reality that often brings relief and comfort.   

These exercises are referred to as grounding techniques, as the purpose of them is to re-establish ourselves in the present moment when we find ourselves reliving a painful memory, worrying about the future, feeling panicked, or simply feeling stressed.  Research has shown a strong connection between our emotional, cognitive, and physical selves therefore changing one of these aspects of ourselves can influence the other parts.  

Here are some grounding techniques that have been found to be effective during moments of distress, stress, or anxiety:

1.     Orient yourself by identifying the current time of day, month, and year as well as your current location.

2.     Remind yourself about who you are (name, birthdate (age), occupation, close family members)

3.     Focus solely on your breathing by taking 4-5 deep breaths

4.     Use your five senses to identify what you are currently experiencing:

·      Sight: Name 1-3 objects you can see.

·      Sound: Focus on the sounds you hear.

·      Taste:  Do you notice any specific tastes in your mouth?

·      Touch: Feel something within your reach and identify the texture.

·      Smell: Pay attention to any odors you pick up on.

5.     Use your five senses to promote soothing and a sense of comfort:

·      Sight: Visualize a place or picture that is calming/comforting.

·      Sound: Listen to your favorite song or play music that is relaxing.

·      Taste: Eat or drink healthy food/drink options that have a calming

       effect.

·      Touch: Feel fabric or material that is soothing. 

·      Smell: Use essential oils or others scents that promote relaxation.

These techniques may seem pretty basic but the effect they can have on someone who is feeling out of control can be very powerful.  I always encourage my clients to practice these techniques during moments when they are not in distress for practice but also to have them experience how powerful being mindful can be. 

~ Cory Stege, M.S., LMFT

Stress: Understanding The Different Types

According to the Merriam-Webster’s dictionary, stress is “a state of mental tension and worry caused by problems in your life, work, relationships, etc.” Even though the word stress can be described as a state of being, stress is experienced differently from individual to individual and is often the result of a person’s perception about their ability, or lack thereof, to cope with specific triggers and situations.  In other words, stress can be thought of as negative emotional and psychological responses as a result of feeling unable to manage the demands being placed on an individual. 

However, what one person finds to be stressful may not be the case for someone else.  Even though stress is not experienced the same by all of us in the same manner, stress does tend to be experienced in some common forms: acute, episodic, and chronic.  Being able to identify the type of stress you are experiencing can be helpful in knowing how to best manage it. 

Acute stress:  This is the most common type of stress and is not necessarily associated with negative triggers.  Acute stress is short in duration and can often be intense.  At times, acute stress can be beneficial to us when it motivates us to take action on something.  However, when acute stress persists, it generally promotes short-term anger, irritability, depression, and anxiety.  An example of acute stress is preparing for a job interview or a work presentation.  Once the event is over, the stress associated usually subsides.

Episodic Acute Stress: This type of stress is associated with individuals who experience acute stress often and regularly.  This type of stress is also associated with chronic worriers and promotes irritability, short-tempers, tension, and anxiety.  Episodic acute stress is correlated with physical symptoms including headaches, stomachaches, high blood pressure, and heart disease.  Individuals who suffer from episodic acute stress tend to be Type A personalities and worry warts who are always running late and have a tendency to take on too much at one time.  Since this type of stress is often associated with a specific personality, effective management of it can be difficult and is often faced with resistance.

Chronic stress: This type of stress is the most damaging because it is experienced as long-term and never-ending.  Chronic stress is associated with situations in which people believe that there is no end in sight due to ongoing and demanding pressures that are too much to cope with.  Chronic stress can be deadly as a result of the impact it can have physically, emotionally, socially, and psychologically and is associated with severe depression, heart disease, suicide, violence, cancer, and stroke.  Chronic stress depletes an individuals resources and is can be very difficult to treat as a result of the long-term impact it carries.  

Whether you experience stress on a short-term or never-ending basis, being able to identify the triggers to it as well as engage in self-care activities are paramount to getting a handle on it.  Sleeping and eating well, engaging in physical exercise, connecting with friends and family, and participating in enjoyable and pleasurable activities can go a long way with stress management.  Professional help may be indicated, especially in the case of episodic acute and chronic stress.

~Cory Stege, M.S., LMFT

Baby Blues or Postpartum Depression?

One of the most significant life changing events a woman can experience is the birth of a child. Almost every part of a woman’s life is affected by childbirth, from physical and hormonal shifts to emotional, psychological, and identity changes…most of which happen within a very short period of time and all at once.  Childbirth comes with a bag of mixed emotions, some of which are unexpected while others show up unannounced.  Joy, excitement, fear, worry, and feeling overwhelmed are common emotions felt among new moms.  Within the first couple of days of childbirth, women often go through what is termed “baby blues”, which can be experienced through insomnia, mood swings, crying spells, irritability, lack of concentration, appetite issues, and anxiety.  “Baby blues” are typically short-term and subside within two weeks.  

However, about 3 million moms each year develop a more severe form of the “baby blues” after giving birth that mimics the symptoms of a major depressive disorder.  Postpartum depression should not be viewed as a sign of weakness in a female because a handful of the common causes are outside of a woman’s control.  For one, women’s bodies go through a substantial drop in estrogen and progesterone levels, which can lead to feelings of depression.  Secondly, the stressors that comes with caring for a newborn baby (lack of sleep, anxiety, decrease in feeling attractive, a sense of loss of control, and an identity crisis) can be very daunting and difficult for some women to manage effectively. 

So what are the symptoms of postpartum depression?
 
•    Sad or depressed mood
•    Excessive tearfulness
•    Difficulty bonding with your baby
•    Isolation from family and friends
•    Loss of appetite or eating much more than usual
•    Inability to sleep (insomnia) or sleeping too much
•    Fatigue or loss of energy
•    Reduced interest and pleasure in activities you used to enjoy
•    Feelings of irritability and anger
•    Feelings of worthlessness, shame, guilt or inadequacy
•    Diminished ability to think clearly, concentrate or make decisions
•    Severe anxiety and panic attacks
•    Thoughts of harming yourself or your baby
•    Recurrent thoughts of death or suicide
•    In some severe cases, psychosis (hallucinations, delusions, or paranoia) 
 
Often new moms assume that their symptoms are just the “baby blues”, especially in the days and weeks following childbirth; however once symptoms continue to last longer that two weeks and start to affect a woman’s ability to function and care for herself and her child appropriately, postpartum depression is likely a more appropriate case.  Postpartum depression can actually be experienced up to six months following childbirth, even if it is not felt immediately.  

Women who notice any of these more severe, longer lasting symptoms should be treated by a professional, whether it is through medication prescribed by an OBGYN or by a skilled therapist through counseling.  In less common cases, women who experience postpartum psychosis or thoughts of harm themselves or their child need to seek immediate treatment in order to ensure safety.  Women are encouraged to call the National Suicide Prevention Lifeline at 1-800-273-TALK; 911; their mental health or medical provider; or a family or friend. 

Regardless of whether new moms go through the “baby blues” or postpartum depression, self-care can go a long way.  This means getting enough rest, eliciting help from support systems, connecting with other moms, and avoiding substances that can alter moods.  

~ Cory Stege, M.S., LMFT

Stress In The Workplace

The workplace is one of the most common sources of stress in the United States and many of us struggle with being able to manage this stress without it negatively impacting our emotional, physical, and mental health.  Whether work-related stress is short-term or chronic, it can impact us in various ways if we don’t get a handle on it.   For example, unmanaged short-term stress can cause headaches, stomachaches, difficulty focusing, sleep problems, anger and irritability whereas unmanaged chronic stress can contribute to anxiety, depression, high blood pressure, insomnia, heart disease, obesity, and a weakened immune system.   When we begin to experience some of these negative effects of stress, we often turn to unhealthy coping skills that include alcohol or tobacco use, unhealthy diet, lack of exercise, and isolation, which just compounds the negative effects of work associated stress.  Take a look at some of the triggers to work-related stress and steps we can take to cope with them:

What are some common factors associated with the workplace that contribute to stress?

1.     Increasing and demanding work loads

2.     Lack of opportunities for growth or advancement

3.     Low salaries or lack of benefits

4.     Lack of social support

5.     Conflict with supervisors/managers or co-workers

6.     Lack of boundaries

7.     Unclear or unrealistic job-related expectations

8.     Lack of decision-making power or ability

9.     Lack of challenge or engagement in job-related tasks

In order to combat work-related stress so that our physical, mental, or emotional functioning is not impacted, we can develop and implement some healthy and effective coping skills. Here are some helpful tips to consider:

1.     Increase awareness of your specific stress-related triggers at work.  This includes identifying what situations/factors cause the most stress and acknowledging how you are responding to them.  It can help to identify thoughts, feelings, and behaviors associated with the specific stressors so that any patterns can be identified. 

2.     Replace unhealthy habits and coping mechanisms with healthy choices.  Instead of grabbing alcohol, junk food, or engaging in isolation, try engaging in physical activity, healthy eating habits, and activities with friends and family. 

3.     Develop healthy sleep hygiene habits.  This includes avoiding caffeine or physical activity 3-4 hours within sleep as well as any stimulating devices such as T.V. or cell phone activity in bed.  Maintaining a consistent sleep-wake cycle also helps promote good sleep quality. 

4.     Establish boundaries.  This not only includes setting boundaries between your work and personal life but also involves setting limits at work.  Identify your limits and learn to be okay with saying no to tasks that you know will increase your stress level.

5.     Identify factors that are both within and outside of your control.  It is easy to focus on aspects of our jobs that we have no control over however that just increases our stress. Instead, focus on the things at work that you are able to manage or control and let go of or learn to accept those factors that you simply cannot change.

6.     Disconnect in order to recharge.  This involves taking time for yourself away from work to re-energize.  This can involve taking a vacation (don’t let your accrued time off go to waste) or just turning off your cell phone or computer for some time so that you aren’t tempted to think about work. 

7.     Practice relaxation exercises.  When you feel triggered or your stress is elevated, try focusing on your breath or engage in a quick meditation exercise to help clear your mind and ground you.

8.     Engage in assertive communication with supervisors and co-workers.  Remind yourself that solely airing complaints is never productive but rather the intention of addressing concerns should be to identify potential solutions or plans that may improve stress-related situations.

9.     Seek out support.  This can include talking with friends and family members to help you vent and process your stress.  Professional help, whether it is through your employer’s EAP program or something you seek on your own, can be very beneficial in addressing concerns and developing new and effective coping skills.

Healthy employees tend to be associated with high levels of productivity and job satisfaction, which are some of the goals we seek to obtain in the workplace. However, stress at work is often unavoidable for the reasons previously mentioned therefore it is critical that we learn to develop healthy and effective strategies for managing it.  

~ Cory Stege, M.S., LMFT

Understanding the Emotional Cycle of Deployment

There are numerous challenges that military couples and families face however one of the most trying experiences includes long periods of separation associated with deployments. Deployments can range anywhere from 1 month up until 2 years and can often be experienced as a significant disruption and trauma to service members and their significant others.  Over the years of wartime and humanitarian efforts that are typical missions of military deployments, common emotional experiences have been identified that have allowed us to better understand the stages that service members and their families go through.  Knowing and understanding the five distinct stages of deployment can help everyone involved learn about what they can expect and can promote normalization of emotional experiences.  The ability to negotiate and navigate these stages is crucial in order to prevent crises as well as to minimize the need for command/unit involvement and mental health services.

Stage 1: Pre-deployment
The first stage of the emotional cycle of deployment begins when a military unit first learns about the plan to deploy and lasts up until the unit actually deploys.  This stage can last as little as a few days up to months depending on the mission.  During this stage, service members and their families begin to anticipate the loss of being away from one another and can be experienced through denial that the service member is leaving as well as an increase in conflict associated with tension, fear, clinginess, and distance.  Once the deployment is near, service members and family members may begin to detach and withdrawal from one another, which may manifest through aggression, bitterness, fear, and worry. 

Stage 2: Deployment
The second stage in the emotional cycle of deployment begins once the service member leaves their family for deployment and can last up until the first month of being separated. This stage is described as disorganization and is characterized as confusion that is associated with expectations which can be exhibited through mixed feelings (fear, pride, anxiety, anger, relief, despair).  This stage also involves challenges related to maintaining family roles, responsibilities, and routines for the family members left at home due to the need to compensate for the deployed service member’s physical absence 

Stage 3: Sustainment
The third stage in the emotional cycle of deployment begins around the second month into deployment and typically lasts until a month or two prior to the service member’s return home. This stage is characterized as stabilization as a result of the family members’ reorganization of roles and routines that are effective in meeting the family’s needs.  This stage can also involve increased communication between the deployed service member and the family, which can promote reassurance that everyone is okay.

Stage 4: Re-deployment
The fourth stage in the emotional cycle of deployment begins about a month or two prior to the deployed service member’s return home. This stage involves everyone’s anticipation and preparation for the service member’s return and can be experienced through excitement, apprehension, and nervousness about what things will be like once the family is reunited. Oftentimes individuals focus on questions about the changes everybody has experienced during their time apart as well as question how one another will feel about each other. 

Stage 5: Post-deployment
The final stage in the emotional cycle of deployment begins once the service member has returned home and can last 3 to 6 months after deployment. This stage is all about reunification of the service member and their family members and involves renegotiating the roles, responsibilities, and routines within the home.  This process can be associated with conflict however it is the most significant stage since it can greatly influence the long-term wellbeing of the service members’ relationships with their families. 

~ Cory Stege, M.S., LMFT

Suicide Prevention: Understanding the Warning Signs and Risk Factors

According to the American Foundation for Suicide Prevention (2016), 117 suicides occur on a daily basis and suicide is the 10th leading cause of death in the U.S. Unfortunately these statistics may actually be less than the reality of the occurrence rate of suicide due to underreporting as a result of the negative stigma associated with it.  Suicide rates have continued to rise over the years, which indicate the importance of increasing our awareness of it so that we can start to decrease these statistics.  Suicide can be 100% preventable and knowing the warning signs and risk factors can help us save lives. 

Many of us wonder what causes suicidal behavior and the answer is that there is no one cause.  Suicidal thoughts and behavior are often associated with other mental health conditions, most commonly depression, anxiety, Bipolar Disorder, psychosis, and substance abuse.  When these conditions go untreated or when the stressors we experience are beyond what we believe our coping abilities are, the risk of suicide increases.  So what can we look out for if we are concerned that someone may be considering suicide? 

Here is a list of common warning signs for suicide:

•       A significant change in behavior, especially after a loss, trauma, or life transition
•       An increase in substance use
•       Isolation or withdrawal from support network
•       Reckless behavior
•       Insomnia or sleeping too much
•       Giving away personal belongings
•       Calling/writing to people to say goodbye
•       Researching or looking for ways to die
•       Aggressiveness and rage
•       Depression
•       Irritability/anger
•       Humiliation/embarrassment
•       Decreased involvement in activities and hobbies
•       Anxiety
•       Talk of severe hopelessness or being a burden to other people
•       Expressing pain and not having any reasons to live
•       Expressing suicidal ideation that the individual wants to kill themselves

Oftentimes the warning signs of suicidal behaviors may not be obvious so understanding what factors can put individuals at risk for suicide can be helpful for increasing our awareness and promoting prevention.

Here is a list of common risk factors for suicide:

•       Stressful events such as a loss, trauma, change in job, finances, relationships, etc.
•       Prolonged stress in work or school setting (bullying/harassment) or ongoing relationship              problems
•       Having a specific plan for how an individual would kill themselves
•       Having access and the means to carry out a plan (owning a firearm and drugs)
•       Inability to contract for safety
•       Exposure to suicide
•       History of previous suicide attempts
•       Family history of suicidal behavior
•       Serious or chronic medical conditions
•       Mental health conditions (depression, anxiety, Bipolar disorder, personality disorders,                      psychosis, and psychotic disorders)     

Knowing and understanding the warning signs and risk factors for suicide can help us identify them in individuals we know and care about so that we can get them the help they need and prevent them from being apart of the growing statistics.  One myth that needs to be debunked is that if we ask or talk about suicide to those we are worried about it impacting then we will put them more at risk for attempting.  This is not the case and actually can have the opposite effect of potentially saving a life.  So if you are concerned about someone or have noticed any of the above signs or risks, don’t be afraid to directly ask if they are thinking about suicide and then offer them an ear to listen and let them know that there are options.  Since suicide can be prevented, there are many treatment options and avenues people can take to get help.  These include psychotherapy, medication, hospitalization, and other treatment interventions for associated mental health disorders like depression, anxiety, Bipolar Disorder, psychosis, substance abuse, and personality disorders.

If you or someone you know is experiencing suicidal thoughts or is at risk for suicide, use these resources below to access help 24/7:

Suicide Prevention Lifeline: 1-800-273-TALK (8255)

Veterans Crisis Line: 1-800-273-8255 press 1

Crisis Chat for online emotional support: crisischat.org

Crisis Text Line: Text START to 741-741

~ Cory Stege, M.S., LMFT

Anxiety: When It Is More Than Just A Case Of Nerves

We all experience everyday stress and anxiety about work, finances, parenting, and our relationships.  Normal anxiety can be beneficial to us because it helps us become aware of warning signs that indicate that we need to take action in order to stay out of harm’s way.  However, anxiety can also be experienced as persistent, excessive, and overwhelming which can negatively impact our daily functioning.  So how can we tell when normal, everyday anxiety is no longer ‘normal’ or expected but is considered to be an anxiety disorder? Below you can learn about the differences in the levels of severity of anxiety and understand the warning signs that may indicate treatment:

Realistic Worry                   

Moderate worry about being able to pay the bills, find a job, manage stress within a relationship, or stress of being a parent.

Realistic Fear

Feeling fearful or afraid of a threatening or dangerous person, situation, or object.

Realistic Embarrassment

Feeling self-conscious or embarrassed in an awkward or uncomfortable situation.

Realistic Reactions to Traumatic Event

Experiencing symptoms of anxiety, sadness, or sleep problems immediately following the trauma.

Realistic Nervousness

Experiencing a degree of nervousness or anxiety before an interview, exam, date, or a presentation.

Versus

Generalized Anxiety Disorder

Excessive and persistent anxiety that is uncontrollable, causing significant distress and impairs daily functioning.

Specific Phobia

Avoidance of a person, place, or object that do not pose any threats due to irrational fears.

Social Anxiety

Excessive fears of being judged, humiliated, or embarrassed resulting in avoidance of social situations.

Post Traumatic Stress Disorder

Recurrent flashbacks, nightmares, or emotional numbing in response to a traumatic event experienced several months or years prior.

Panic Disorder

Physical and emotional symptoms that appear to be unrelated to an event and result in excessive worry about experiencing more symptoms in the future.

Anxiety disorders are among the most common mental health disorders in the United States and can be related to genetic factors, brain chemistry, personalities, and life events.  Like depression, anxiety disorders are highly treatable through various treatment options including medication, psychotherapy, and alternative treatments such as lifestyle changes related to diet and exercise, relaxation and meditation practices, yoga, acupuncture, and some vitamin supplements.  It is recommended to visit your Primary Care Physician to rule out any organic causes of anxiety prior to starting any other treatment.  If you or someone you know is experiencing any of the above symptoms, don’t hesitate to take action now!

~ Cory Stege, M.S., LMFT

Are You Depressed? Know When to Get Help.

Did you know that according to the National Institute of Mental Health, 15.7 million individuals over the age of 18 in the United States experienced at least one Major Depression episode in 2014?  This helps translates to Major Depression being one of the most common mental health disorders in the U.S.  Throughout our lifetime, we will all go through periods of ups and downs in our personal lives, relationships, school, work, and physical health that may influence us to experience some form of depression.  

Knowing the signs and symptoms of depression can be one of the most significant factors in knowing when to seek help in order to receive the appropriate treatment.  So how can you tell if you are experiencing a depressive episode? If you answer yes to the following list of symptom criteria based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (2015), you should consider reaching out for help:

1.    You experience a sad or depressed mood or a lack of interest in activities for most of the day       nearly every day for at least two weeks in which there is not a time during those two weeks in       which you feel euphoric, happy, or like yourself. 
2.   You or others in your support system notice a significant shift in your typical or baseline               mood.
3.   You notice that your functioning within your relationships, work, or school is impaired.
4.   You experience at least 5 of the following 9 symptoms every day over the past two weeks:
       a.    Irritability or depressed mood
       b.    Sleep disturbance (either lack of sleep or over sleeping)
       c.    Decreased interest or pleasure in activities that you previously enjoyed
       d.    Significant change in weight (either weight loss or weight gain)
       e.    Difficulty concentrating
       f.     Strong feelings of shame or guilt
       g.    Change in activity level (either psychomotor retardation or agitation)
       h.    Decreased energy or feelings of fatigue
       i.     Suicidal ideation or thoughts of death

These symptoms can range in level of severity from mild to severe depending on the number of symptoms you are experiencing as well as the level of impairment you experience in your daily functioning.  Some examples of impairment in functioning include: 

1.    Exhibiting withdrawal, isolation, aggressiveness, and/or anger within family and peer                       relationships
2.   Deterioration or failing performance in work or school tasks and projects
3.   Minimization or denial of feelings or problems to others
4.   Vague or active suicidal ideation
5.   Thoughts of or actual self-injurious behavior (cutting, burning, etc.) 

It is important to consider whether any of the above symptoms may be related to either a medical condition, substance use/abuse, another psychiatric disorder, or bereavement (grief) in order to determine the appropriate level of treatment as depression can often mimic or co-exist with these other conditions. 

The good news about Major Depression is that it is treatable (even the most severe forms!) through a variety of treatment modalities.  When seeing clients in psychotherapy who present with symptoms of depression, a referral to their primary care physician is typically made initially in order to rule out any organic or medical conditions that could be the cause of the depressive symptoms.  Other treatment options may include psychotropic medication, psychotherapy, lifestyle changes (diet, exercise, stress reduction, social support, and sleep hygiene), and acupuncture. 

Depression can leave you feeling stuck or like you have no control over your life however there is help for it. If you or someone you know is experiencing any of the above symptoms, don’t hesitate and take action now to get your life back!

~ Cory Stege, LMFT