Mental Health News Guide for Therapists

According to the U.S. surgeon general, mental health is the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and providing the ability to adapt to change and cope with adversity.

The term mental illness refers collectively to all diagnosable mental disorders—health conditions characterized by alterations in thinking, mood, or behavior associated with distress or impaired functioning.

A person struggling with his or her mental health may experience stress, depression, anxiety, relationship problems, grief, addiction, ADHD or learning disabilities, mood disorders, or other mental illnesses of varying degrees. Therapists, psychiatrists, psychologists, social workers, nurse practitioners or physicians can help manage mental illness with treatments such as therapy, counseling, or medication.

Mental illnesses are categorized as follows:

Neurosis: Also known as psychoneuroses, neuroses are minor mental illnesses like phobias, obsessive-compulsive disorders, and anxiety disorders, among others.

Psychosis: Psychoses are major mental illnesses in which the mental state impairs thoughts, perception and judgement. Delusions and hallucinations are marked symptoms. This may require the use of psychotic drugs as well as counselling techniques in order to treat them.


9 Simple Ways to Deal With Stress at Work

According to research, the percentage of Americans who are stressed at work is high, and it’s only getting higher. According to the CDC’s National Institute of Occupational Safety and Health, studies have found the number of Americans who are “extremely stressed at work” range between 29 percent to 40 percent.

Unfortunately, work stress has significant health consequences that range from the relatively benign—more colds and flus—to the more serious, like heart disease and metabolic syndrome.

But, because stress at work is so common, finding a low-stress job may be difficult or impossible for many people. A more realistic choice would be to simply adopt more effective strategies to reduce stress at work. Here are some stress management techniques to try.

Start Your Day Off Right
After scrambling to get the kids fed and off to school, dodging traffic and combating road rage, and gulping down coffee in lieu of something healthy, many people come in already stressed, and more reactive to stress at work. In fact, you may be surprised by how much more reactive to stress you are when you have a stressful morning. If you start off the day with good nutrition, proper planning, and a positive attitude, you may find the stress of the workplace rolling off your back more easily.

Be Clear on Requirements
One of the factors that contributes to job burnout is unclear requirements. If you don’t know exactly what’s expected of you, or if the requirements keep changing with little notice, you may find yourself much more stressed than necessary.

If you find yourself falling into the trap of never knowing if what you’re doing is enough, it may help to have a talk with your supervisor and go over expectations, and strategies for meeting them. This can relieve stress for both of you!

Stay Away From Conflict
Because interpersonal conflict takes a toll on your physical and emotional health, and because conflict among co-workers is so difficult to escape, it’s a good idea to avoid conflict at work as much as possible.

That means don’t gossip, don’t share too many of your personal opinions about religion and politics, and try to steer clear of colorful office humor. Try to avoid those people at work who don’t work well with others. If conflict finds you anyway, try these conflict resolution strategies.

Stay Organized
Even if you’re a naturally disorganized person, planning ahead to stay organized can greatly decrease stress at work. Being organized with your time means less rushing in the morning to avoid being late and rushing to get out at the end of the day. Keeping yourself organized means avoiding the negative effects of clutter, and being more efficient with your work.

Be Comfortable
Another surprising stressor at work is physical discomfort. You may not notice the stress you experience when you’re in an uncomfortable chair for a few minutes. But if you practically live in that chair when you’re at work, you can have a sore back and be more reactive to stress because of it. Even small things like office noise can be distracting and cause low-grade frustration. Do what you can to ensure that you’re working from a quiet, comfortable and soothing workspace.

Forget Multitasking
Multitasking was once heralded as a fantastic way to maximize one’s time and get more done in a day.

Then people started realizing that when they had a phone in their ear and were making calculations at the same time, their speed and accuracy (not to mention sanity) suffered. There is a certain kind of frazzled feeling that comes from splitting one’s focus that doesn’t work well for most people. Rather than multitasking, try a new strategy known as chunking.

Walk at Lunch
Many people are feeling ill effects from leading a sedentary lifestyle. One way you can combat that, and manage stress at work at the same time, is to get some exercise during your lunch break and perhaps take short exercise breaks throughout the day.

This can help you blow off steam, lift your mood, and get into better shape.

Keep Perfectionism In Check
Being a high achiever can help you feel good about yourself and excel at work. Being a perfectionist, on the other hand, can drive you and the people around you a little nuts. Especially in busy, fast-paced jobs, you may not be able to do everything perfectly. But striving to just do your best and then congratulating yourself on the effort is a good strategy. Your results will actually be better and you’ll be much less stressed at work.

Listen to Music on the Drive Home
Listening to music brings many benefits and can offer an effective way to relieve stress after work. Combating the stress of a long day at work with your favorite music on the drive home can make you less stressed when you get home, and more prepared to interact with the people in your life.

By Elizabeth Scott, MS

Not sure why parts of your character hold you back in your work? For Work Stress Counseling Metro NYC, Kearns Group helps individuals study the gap between goals and their achievement. Through a contextual counseling we reveal the stress that gets in the way and design strategies to better reach their achievement. Conveniently located in Greenwich Village near Union Square.

Acceptance and Commitment Therapy

The Six Core Processes of ACT

The Psychological Flexibility Model
The general goal of ACT is to increase psychological flexibility – the ability to contact the present moment more fully as a conscious human being, and to change or persist in behavior when doing so serves valued ends. Psychological flexibility is established through six core ACT processes. Each of these areas are conceptualized as a positive psychological skill, not merely a method of avoiding psychopathology.

Acceptance is taught as an alternative to experiential avoidance. Acceptance involves the active and aware embrace of those private events occasioned by one’s history without unnecessary attempts to change their frequency or form, especially when doing so would cause psychological harm. For example, anxiety patients are taught to feel anxiety, as a feeling, fully and without defense; pain patients are given methods that encourage them to let go of a struggle with pain, and so on. Acceptance (and defusion) in ACT is not an end in itself. Rather acceptance is fostered as a method of increasing values-based action.

Cognitive Defusion
Cognitive defusion techniques attempt to alter the undesirable functions of thoughts and other private events, rather than trying to alter their form, frequency or situational sensitivity. Said another way, ACT attempts to change the way one interacts with or relates to thoughts by creating contexts in which their unhelpful functions are diminished. There are scores of such techniques that have been developed for a wide variety of clinical presentations. For example, a negative thought could be watched dispassionately, repeated out loud until only its sound remains, or treated as an externally observed event by giving it a shape, size, color, speed, or form. A person could thank their mind for such an interesting thought, label the process of thinking (“I am having the thought that I am no good”), or examine the historical thoughts, feelings, and memories that occur while they experience that thought. Such procedures attempt to reduce the literal quality of the thought, weakening the tendency to treat the thought as what it refers to (“I am no good”) rather than what it is directly experienced to be (e.g., the thought “I am no good”). The result of defusion is usually a decrease in believability of, or attachment to, private events rather than an immediate change in their frequency.

Being Present
ACT promotes ongoing non-judgmental contact with psychological and environmental events as they occur. The goal is to have clients experience the world more directly so that their behavior is more flexible and thus their actions more consistent with the values that they hold. This is accomplished by allowing workability to exert more control over behavior; and by using language more as a tool to note and describe events, not simply to predict and judge them. A sense of self called “self as process” is actively encouraged: the defused, non-judgmental ongoing description of thoughts, feelings, and other private events.

Self as Context
As a result of relational frames such as I versus You, Now versus Then, and Here versus There, human language leads to a sense of self as a locus or perspective, and provides a transcendent, spiritual side to normal verbal humans. This idea was one of the seeds from which both ACT and RFT grew and there is now growing evidence of its importance to language functions such as empathy, theory of mind, sense of self, and the like. In brief the idea is that “I” emerges over large sets of exemplars of perspective-taking relations (what are termed in RFT “deictic relations”), but since this sense of self is a context for verbal knowing, not the content of that knowing, it’s limits cannot be consciously known. Self as context is important in part because from this standpoint, one can be aware of one’s own flow of experiences without attachment to them or an investment in which particular experiences occur: thus defusion and acceptance is fostered. Self as context is fostered in ACT by mindfulness exercises, metaphors, and experiential processes.

Values are chosen qualities of purposive action that can never be obtained as an object but can be instantiated moment by moment. ACT uses a variety of exercises to help a client choose life directions in various domains (e.g. family, career, spirituality) while undermining verbal processes that might lead to choices based on avoidance, social compliance, or fusion (e.g. “I should value X” or “A good person would value Y” or “My mother wants me to value Z”). In ACT, acceptance, defusion, being present, and so on are not ends in themselves; rather they clear the path for a more vital, values consistent life.

Committed Action
Finally, ACT encourages the development of larger and larger patterns of effective action linked to chosen values. In this regard, ACT looks very much like traditional behavior therapy, and almost any behaviorally coherent behavior change method can be fitted into an ACT protocol, including exposure, skills acquisition, shaping methods, goal setting, and the like. Unlike values, which are constantly instantiated but never achieved as an object, concrete goals that are values consistent can be achieved and ACT protocols almost always involve therapy work and homework linked to short, medium, and long-term behavior change goals. Behavior change efforts in turn lead to contact with psychological barriers that are addressed through other ACT processes (acceptance, defusion, and so on).

Taken as a whole, each of these processes supports the other and all target psychological flexibility: the process of contacting the present moment fully as a conscious human being and persisting or changing behavior in the service of chosen values. The six processes can be chunked into two groupings. Mindfulness and acceptance processes involve acceptance, defusion, contact with the present moment, and self as context. Indeed, these four processes provide a workable behavioral definition of mindfulness (see the Fletcher & Hayes, in press in the publications section). Commitment and behavior change processes involve contact with the present moment, self as context, values, and committed action. Contact with the present moment and self as context occur in both groupings because all psychological activity of conscious human beings involves the now as known.

A Definition of ACT
ACT is an approach to psychological intervention defined in terms of certain theoretical processes, not a specific technology. In theoretical and process terms we can define ACT as a psychological intervention based on modern behavioral psychology, including Relational Frame Theory, that applies mindfulness and acceptance processes, and commitment and behavior change processes, to the creation of psychological flexibility.

by Steven Hayes

Besma (Bess) Benali, Clinical Social Work/Therapist, MSW, RSW, Counselling Ottawa. I am trained in Cognitive Behavioural Therapy (CBT), Brief Psychodynamic Therapy, ACT, and mindfulness. Clients come to me because they are struggling and feel like they are trapped in a darkness that no matter what they have tried (and many have tried therapy before) they can't pull themselves out. I help my clients understand themselves in ways no one has ever taught them before allowing them to see positive changes.

Depression: the most common mental health issue

Adults with depression may have low self-esteem. They may display poor concentration, low motivation, and withdraw from social or recreational activities. They may respond intensely to criticism or feedback. Changes in appetite, weight, and sleep issues may occur. Depressed adults may display a decline in grades, and experience boredom and lethargy.

In terms of seeking treatment, adults who struggle with identity issues may be reluctant to identify themselves as someone who has a depressive disorder. Issues with authority and concerns about confidentiality may make seeking out help problematic. I am sensitive to these issues and make sure to validate and normalize my client’s experience. I also tailor my interventions to adapt to specific factors connected to the type of depression my client’s may exhibit. Anger, perfectionism, avoidance, and divorce are just some traits and stressors that can exacerbate depression.

Anger and Depression
Adults who have depression may present with typical symptoms such as a depressed mood and withdrawn behavior. Males who are depressed may display more anger rather than sadness. Males who feel pressure to live up to perceived gender norms may be less likely to show vulnerability. Their anger towards others may be a way to prop up their self-esteem and negative feelings about themselves. Unfortunately, their anger can serve to alienate them further. Therapy can provide a safe place to verbalize feelings and connect with deeper emotions. This can help my clients feel more connected and identify and modify cognitions contributing to their distress.

How I can help
I teach clients how to identify negative emotional states and understand the connection between thoughts and feelings. Through the therapy process they learn how to modify dysfunctional thoughts that lead to anger. They develop alternative perspectives that are more balanced and adaptive. I help my clients see underlying self-esteem issues that contribute to anger and depression. They learn how to observe difficult emotions without becoming flooded or acting on them and communicate more effectively. I strive to create a safe place where clients can increase self-understanding about who they are and what is important to them. This understanding often leads to more self-confidence and a stronger sense of self.

Perfectionism & Depression
In adolescence one of the major development tasks is developing one’s identity and independence. As teenagers experiment with discovering who they are they may place more emphasis and passion towards focusing on specific domains such as academics, athletics and peer relationships. They may develop lofty goals and ambitions as they pursue their goals. There striving and dreams of excellence is not always problematic. However, for some falling short of meeting their goals can lead them to become extremely self- punishing and punitive toward themselves. They may perceive failure or setbacks as intolerable. This can lead to depression, anxiety and irritability. Some people feel they will not live up to expectations and may avoid tasks all together, at times these expectations may be unrealistic.

How I can help
Having high personal goals and expectations is not unhealthy and can lead to success. However, problems arise if people react punitively if they fail to meet goals. Being extremely critical of oneself if goals are not met can lead to depression and anxiety. Harsh self-appraisals after not meeting goals can also decrease emotional resilience and lead to avoidance behaviors. To manage this type of perfectionism, I work with clients on skills to help develop compassion towards themselves. I utilize mindfulness and acceptance skills to help them learn to be able to define themselves in a holistic fashion rather than just by outcomes. I help them to confront issues rather than avoid them by helping them break down fears and tasks into manageable components.

Often people who have high expectations of themselves also have high expectations of others, which can leave them feeling disappointed and frustrated. I help my clients develop more realistic expectations regarding others. They learn how to see other perspectives, which can increase empathy and mitigate negative mood states.

Peer Relationships and Depression:
As teenagers transition into adolescence there is a shift away from caretakers to peers and friends as a source of social influence. For example, support, validation and encouragement, become roles that friends take on more significantly. Adolescent’s relationships with peers can greatly impact their self-esteem and mood. Teenagers who struggle with peer relationships may isolate and avoid others expecting rejection. This can further increase isolation and depression. Alternatively, a strong desire to fit in may lead teenagers to be over accommodating to their friend’s demands at the expense of their own interests. They may believe that if they don’t not accommodate, their friends will reject or abandon them. This can create resentment and hostility. The over accommodating teenager may feel that relationships are not reciprocal and that they are being taken advantage of.

How I Can Help
I employ CBT skills to help manage feelings or fears pertaining to rejection. Often my clients may view their relationships in a bias and negative fashion leading to distress. They may have inflated perceptions that others view them more poorly than is actually the case. Distress can be minimized by helping to perceive relationships more accurately. Mindfulness skills are used to help detach from others judgments or perceived judgments which can mitigate depression and anxiety. Helping identify negative patterns when selecting friends and helping to create boundaries can help establish stronger self-esteem. I explore with my clietns how their interpersonal style may impact relationships and get in the way of forming positive connections. I work with them on strategies for developing their interpersonal and communication style to improve relationships.

Divorce and Depression
Divorce can be an extremely painful process. There are different stages people experience as they go through the process. Initially, it may be hard to accept, leaving them feeling shocked and emotionally numb. They may also become withdrawn and minimize the separation. As times goes on they may blame themselves for the separation and believe if they just did better, were more easy going or more lovable the relationship would not have dissolved. Missing the family unit and adjusting to the stress of the dissolution of the marriage may lead people to feel unsafe and anxious. They may develop trust issues regarding relationships in the future.

How I can Help
I help my clients verbalize anger or depression regarding the divorce. Expressing feelings such a betrayal and disappointment can allow them to gain more clarity, insight and be less prone to internalizing negative feelings and blaming themselves. Giving them a place to process feelings can also help prevent rebellious or acting out behaviors. Mindfulness skills can be extremely helpful in navigating feelings of abandonment and rejection they may feel from one or both of their parents. Consulting with family members on setting proper boundaries and communication strategies can also be helpful.

Depression Treatment for Older Adolescents
College can be an extremely exciting time providing the opportunity for intellectual and emotional growth. However, personal freedom, self-exploration and challenging academics although invigorating, can be stressful. Being away from home, facing new demands and thinking about the future can be daunting and contribute to anxiety, depression or self-doubt. The symptoms may derive from the existential struggles that college students often face regarding who they are intellectually, emotionally, and sexually. Am I smart enough? Am I good enough? What is my purpose? are common questions college students ponder. Starting and leaving college are both significant life style shifts and may be particularly difficult for students. Fortunately, therapy can help.

How I can help
Psychodynamic therapy is a deeper dive into motivation and can create expanded awareness allowing college students to understand and resolve issues pertaining to identity, relationships and choices about meaningful careers. During the process of psychodynamic therapy college students can have the space to explore possibilities and find their authentic voice. CBT and Mindfulness skills can also help college students cope with depression, anxiety or volatile emotional states. Learning how to regulate emotions with mindfulness skills can also help with academic performance and time management.

Carolyn Ehrlich LCSW, CGP, Counseling Tribeca, specializes in Relationship Counseling NYC. In Couples Therapy Tribeca I help increase your self awareness and help you gain more insight into your inner life. We'll work together so you can get more out of every day and meet any challenge life throws at you.

Counseling in Tribeca New York City

Loneliness. Anyone can feel lonely. It doesn’t matter if you’re in a relationship or not, a social butterfly or someone who isn’t into crowds. To understand what’s making you feel alone, we’ll focus on your inner and outer experiences and work together to find useful things you can do to feel more connected to the world.

Depression. It affects the way you think and feel, it can even affect you physically. It can alter the way you think about yourself, your relationships and the people around you and the events you experience every day. We’ll work together to understand what’s going on and help you feel more positive.

Confusion. There are times when making a decision feels impossible. We’re not sure about who we are, how we live, who we love, or whether we’d be better off in a different career. But by spending some time together, we can help you find a sense of clarity and work out what’s really important to you.

I started Mindwork back in 2007 for people who want to get a better understanding of themselves and the world around them. I found InSession in 2017, InSession has been wonderful to work with, guiding my practice into a new area with their expert Marketing and SEO skills. I couldn't be happier with the results.

For Counseling Tribeca NYC, contact Therapist Carolyn Ehrlich with offices near TriBeCa in SoHo, specializing in Counseling TribecaCouples Therapy Tribeca.

Carolyn Ehrlich, LCSW,Relationship Counseling NYC

Fearing Death

How to cope with the inevitable end in a positive way.

As people age, go through life changes, or experience illness (either themselves or the illness of loved ones) the topic of death is often brought up. The idea of death is so different for so many people; it’s hard to agree on a universal definition of death. As far as we know, it can be as simple as no longer existing, or as complicated as moving from one plane of existence to the next. One thing about death can be universally agreed upon though and that is the fact that no one knows exactly what happens when you shuffle off this mortal coil. The knowledge of the unknown is scary to many people which leads to people fearing death. Some fear the act if dying: will it be painful? Others fear what happens after you die: do you move on, or just cease to be? Others fear what will happen to their loved ones once they’ve passed. Wherever your fear of dying originates from it can be lessened and controlled in many ways. Read through the list below to learn more about how to conquer your fear of death so you can get back to living your best life.

Plan what you can:
If you’re worried about how your family and friends will deal with your passing, planning the practical aspects of it while you’re able may put you at ease. Even if you have decades of healthy years ahead of you, the simple act of planning may be enough to help you cope with the reality of death. Create a will, purchase life insurance if you’re able and make your final wishes known to your loved ones. As a more emotional practice, tell your friends and family that you love and appreciate them whenever you get the chance, so you’re never worried about something being left unsaid.

Focus on living your best life:
Why fear death when you can be busy with life? Changing your focus from worrying about the end of your life to enjoying what’s happening in the present can be fulfilling and refreshing. Even if you’re close to the end of your life, having a positive outlook can be incredibly useful. Enjoy nature, make a bucket list, take up a new hobby. If you’re busy living, you won’t have time to worry about dying.

Talk to a professional:
Perhaps the above tips are far from useful. Maybe your fear of death is all-consuming, making it difficult to live your daily life. If the idea of death is overwhelming and makes it hard to enjoy your day to day life, talking to a therapist may be your best option. You may have underlying issues such as phobias, anxiety, depression or PSTD that make it hard to cope with the finality of death. If that’s the case, speaking to a professional will be an incredibly useful exercise that can help you work through these feelings to have a better, more positive outlook on life and death.

Mollie Busino, LCSW, Director of Mindful Power, counseling Hoboken. Mollie has had extensive training in Cognitive Behavioral Therapy, Rational Emotive Therapy, and Mindfulness. Her work focuses on Anxiety, Depression, Anger Management, Career Changes, OCD, Relationship, Dating Challenges, Insomnia, & Postpartum Depression and Anxiety.

Hypochondriasis Explained

Hypochondriasis is now more commonly known as Illness Anxiety Disorder (IAD). It is an official mental disorder that requires a diagnosis. When someone is diagnosed with hypochondriasis, it means they believe they have incredibly serious illnesses or diseases, when in fact nothing is physically wrong with them.

Someone with IAD may believe they have a life-threatening illness. They might even believe they have certain symptoms of different diseases, even if no one else sees those symptoms. Or, the symptoms they do have could be very mild to everyone else (including medical professionals) but seem incredibly severe to the person dealing with them.

It can be easy to brush off hypochondriasis as a disorder for someone who only wants attention or who might be paranoid. But, it goes much deeper than that, and can be a real problem for the people struggling with it every day.

What Are the Signs of Hypochondriasis?

The biggest tell-tale symptom of IAD is worrying excessively about having a particular illness or disease. Or, you may fear that you will eventually contract a life-threatening illness. Other common symptoms include:

Extended fear of an illness (more than six months)
Constant anxiety over health
Avoiding doctors
Obsessed with self-checking health status (checking blood pressure, etc.)
Concern for developing illness at some point is out of hand
The fear that can go along with hypochondriasis can be crippling for the individual dealing with it. Unfortunately, there isn't one concrete cause when it comes to what triggers some people to feel this way. However, certain risk factors have been identified, including:

A major life change
Stressful event
History of abuse, especially in childhood
History of physical illnesses
How Can IAD Be Treated?

IAD is diagnosed only based on what symptoms are described by the person going through it, as well as family members or friends who have noticed the symptoms as well. A mental health professional will want to know as many details as possible about what the individual is feeling, and when the symptoms started.

Management for hypochondriasis typically consists of regular office visits their primary care physician. That physician can help to ease their stress and offer peace of mind. Visits as frequently as every week may be needed. It's a good idea for the person with the disorder to stick with one doctor throughout the process.

If the fear becomes too severe for the person with IAD, they may need to seek out additional treatment and help from a mental health professional. A mental health doctor can help the individual figure out what might be causing hypochondriasis in the first place. Once that can be determined, it may become easier to treat and/or manage it.

The ultimate goal for someone dealing with IAD is to feel less mental stress and try to function and live as normal of a life as possible. Being able to understand that you don't have some serious condition can be difficult for the people who truly believe something is wrong with them. No matter what cause you to start feeling this way, it's important to find a management solution that works for you as soon as possible, so you can begin living your life freely again.

Written by, Janessa M Borges, Clinical Social Work, Therapist, LCSW, Couples Counseling Naples. My therapeutic approach is providing support to help clients effectively address personal life challenges, help them build on their strengths and attain the personal growth they are committed to accomplishing. When couples feel distressed & disconnected I integrate eclectic techniques offering a personalized approach tailored to each client.

Ketamine Infusion Therapy Benefits

Depression and anxiety affect millions of people in the United States each year. Even after an official diagnosis and treatment plan, many people don't find the relief they're looking for from traditional antidepressants or therapeutic treatments. Unfortunately, that often leads people with depression to seek different ways of self-medicating, which can lead to drinking, drug use, and more. People who can't find a treatment option that works can even begin to have suicidal thoughts and tendencies.

Ketamine is an anesthetic drug that has recently come into the medical world as a new potential type of therapy for treating depression. It has been used in the past as a powerful drug that blocks pain. In more recent years, Ketamine has become a popular 'club drug,' often known as 'Special K.' Club-users take it because it can cause people to experience a sort of 'out of body' sensation. So, why is it being tossed into the field of treatment for depression?

How Does It Work?

Unfortunately, one of the reasons this therapy is still used with such caution is because we're not 100% sure how or why it really works to treat depression. One theory, however, is that ketamine is supposed to change the way the cells in the brain talk to one another. It helps to block certain receptors that are associated with depression.

The administering of this drug is considered a type of 'therapy' because it is given through an IV directly into a vein. It's not a simple prescription pill, like most antidepressants. In most cases, you'll receive regular doses for a week or two, and follow it up with boosters every few weeks after that.

One of the biggest benefits to ketamine infusion therapy is how quickly it works. It's important to understand that there are no real 'quick fixes' when it comes to treating depression. But, most antidepressants can take weeks just to start kicking in. Ketamine only takes hours for its users to feel effects.

Is it Safe to Use?

For now, ketamine is not approved by the FDA as a treatment for depression. But, it's being used more frequently by people in the most dire of depressed states. Side effects can include feeling as though you're having an out of body experience, or it can cause a spike in your blood pressure. Unfortunately, doctors don't know much about what long-term side effects could be caused by the drug.

Do the benefits of this type of therapy outweigh the risks? That's something that should be answered by someone who has gone through the therapy, or continues to do it on a regular basis. For now, there isn't enough known about why ketamine helps with depression in order to consider it completely safe. It also isn't covered by insurance, and each treatment can cost hundreds of dollars.

But, the results for people with depression who have used this form of therapy don't lie: Ketamine is a fast and effective way to change the way your brain communicates in different areas. It provides a stronger solution than most antidepressants. If you're struggling with anxiety and depression and other treatments haven't worked, talk with your doctor about the possibility of ketamine infusion therapy. It could help to change the way you think immediately, and in the end, that could save your life.

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and specializes in issues involving anxiety depression and adult ADHD. Ketamine Infusion Therapy is one of the many treatments Dr. Ditzell offers to treat a variety of mental health issues.

Mindfulness-Based Stress Reduction (MBSR)

Everyone on the planet has felt a little out of control at times. You get angry or stressed out, tired or overwhelmed. After all, we’re all human. However, one thing as humans that we have on our side is the ability to breathe. Simply taking a deep breath and becoming aware of a moment when you feel your most stressed is profoundly helpful. The idea that breath and awareness help to cope with stress isn't all in your head either. Pausing during stressful times to become present is an incredibly powerful practice. It’s so powerful in fact that it’s been studied, organized into a program and taught around the world. This process is called Mindfulness-Based Stress Reduction (MBSR), and it can be used to help alleviate chronic pain, reduce stress, and improve your quality of life. MBSR incorporates meditation, body awareness and yoga to help people become more mindful. It was developed at the University of Massachusetts Medical Center in the 1970s by Professor Jon Kabat-Zinn and has been used since to provide calmness and stillness to those that practice it.

Despite having roots in Eastern spiritual practices such as Buddhism and Hinduism, MBSR itself is secular and can benefit anyone that chooses to learn and practice this useful skill.

MBSR teaches participants, through in-person or online courses to be present in any given moment. Noting a definitive joy, pain, anxiety or even a particular taste or smell can help you process it easier, providing you with more fulfillment or peace at any given moment.

The beauty of this practice is that it can be useful for both positive and negative experiences. MBSR can help make you more present at joyous events just as it can help you understand what’s exactly making you anxious during periods of negativity.

Try it for yourself:
Close your eyes, sit in a comfortable position, and focus on your breath for just 2 minutes. Become aware of the way your breath feels moving through your body or the way your body feels in your chair. If a passing thought comes into your mind, acknowledge it and then recenter your focus. After the 2 minutes are over, note the way you feel. Relaxed? More centered? Better poised to tackle the rest of the day? Try to do this once a day or at least when your anxiety gets the better of you. Awareness is an incredible thing, and once you learn to use it, it’s very powerful.

Who would have thought that simply being more aware of yourself can so strongly affect your well-being? Do you think that MBSR is for you? Both online and in-person trainings are available to help you learn and thrive from this technique.

Dr. Dimitra Takos is a Newport Beach Psychologist specializing in the treatment of adolescents and adults suffering from depression, anxiety, and trauma-and stressor-related disorders.

How to Get Along With Your Partner

There are a number of other skills for couples that help preserve a marriage, a friendship, and even a co-worker’s loyalty. These include:

Knowing the right time and place for everything, including arguments. For example, don’t bring up the dirty clothes strewn all over the bedroom floor this morning as soon as your significant other comes in the door after a grueling day at work. How would you know it was a grueling day?

Do not argue in the heat of battle. In fact, don’t battle, because you know you will likely say things that can never be forgiven, even if the other person never brings them up again.

Make sure you have the other person’s attention. This can be as simple as eye contact, and as firm as asking that person to sit down and look at you while you explain something.

Frame all complaints and comments using the word “I”. Don’t say “You always leave you dirty clothes on the floor!” Instead say “I work late, and it’s no fun to wake up to a mess in the bedroom.” This simple reversal changes blame to need – the exact location from which to negotiate change.

Don’t sweep relationship issues under the carpet. There will come a time when you reach the breaking point, and every angry, hurtful thing you ever thought spews out of your mouth. If you can’t talk to your life partner about issues, why are you even in a relationship?

Keep the message simple – no more than three items at a time. These can be promises or problems, but it’s always best to keep the message short.

Repetition is key. The more often we hear something, the deeper it penetrates into that grey matter between our ears.

Another way to reinforce any communication is to have the other person repeat the essence of what we have said back to us. This can take the form of a verbal summary or a written one, and neither one has to sound like a kindergartner’s lesson.

Be truthful about your own needs without purposely being hurtful. If the other person is talking, learn to listen without interrupting or getting upset every time he/she says something that you would rather not hear.

If you can master these rules of communication with your husband/wife, life partner, or significant partner, you will be well on the road to an ideal partnership, which includes: being able to talk honestly about each other’s faults; being able to make each other laugh; agreeing to disagree; taking time away from each other without guilt or fear; and always having each other’s backs.

Christy Weller, Psy.D., Couples Counseling Boulder. I bring a genuine curiosity, a kind appreciation of where you have been, and a non-judgmental stance so that you feel comfortable exploring your story and making sense of it. I tailor my work to each client and I'm trained in both short-term and long-term therapies.

My Irrational Moral Superiority

It's easy to judge someone for thinking they are 'better' than us in just about every aspect. But, looking in the mirror and saying the same thing can be a little more eye-opening. The reality is that most of us tend to think we are better than others, whether we say it out loud or not. We're smarter, we work harder, we have more to offer, etc.
The biggest area of self-superiority that we tend to hold against others, though, is that of our morals. The illusion of moral superiority affects more people than you might expect (and it probably affects you, too!). A study published in Social Psychological and Personality Science found that moral superiority is unique in just how prevalent of a positive illusion it is for so many people.

Why Do We Feel Our Morals are Better?

Through this particular study, researchers quickly found that most people are eager to give themselves high scores on the more positive areas of life. We all want to think we have better-than-average intelligence, for example. It's not hard to put that on a piece of paper when you're doing a study.

But, why was moral superiority so high for so many people? There is no concrete answer – at least, not yet. The researchers' theories suggest that we want to downplay the morals of others and boost up our own as a survival mechanism. We live in a world where we are so convinced that others are untrustworthy, that we give ourselves moral superiority over almost everyone else; even people close to us.

The next step is to research what aspects of these inflated beliefs about morals really mean the most to people. Morals can mean different things to different participants, and one person may be focusing on something like virtue, while another may be thinking about honesty.

Some of our superiority thoughts aren't so irrational. They give us an ego boost, make us feel better about our overall wellbeing, and for the most part are generally harmless. Even downplaying the strong traits of others isn't always a bad thing as long as it doesn't start to affect relationships.

But, moral superiority seems to be an unexplained phenomenon of sorts when it comes to how irrational it really is. Without more research to officially back up the reasoning behind it, we're left guessing as to why we're so concerned with feeling and looking morally better on paper than our neighbors.

Are There Dangers to Irrational Moral Superiority?

The idea of thinking we're somehow more righteous than others might seem harmless. But, if these ideas grow and gain momentum in all of us, it could lead to potential problems for the future. Conflict is bound to arise when we all think we have higher moral standards than those around us.

There are two sides to every debate, and if both side thinks they are more righteous than the other, it can make any argument turn even more heated. This could lead to a snowball effect for many different conflicts, and could even lead to more violent behavior in the future.

Carolyn Ehrlich LCSW, CGP specializes in Relationship Counseling NYC. I increase your self- awareness and help you gain more insight into your inner-life. We'll work together so you can get more out of every day and meet any challenge life throws at you.

Recognizing Your Stress – Where it Comes from and How to Manage It

A little bit of stress in everyday life is normal. It's nearly impossible to avoid. Sometimes, a little stress can even be a good thing! But, when you're overly-stressed, your life can feel like a battle field on a daily basis.
There are different types of stress to consider. The most common are 'acute stress,' which is an immediate reaction to a situation, or 'chronic stress,' which feels like a constant, longer-lasting problem. It is chronic stress that can take over your life, and even cause your health to suffer if it isn't managed correctly.

What Are Your Common Stressors?
Everyone has different 'triggers' that can cause stress in their lives. Some of the most common triggers include things like:

* Big life changes
* Sudden events
* Workplace environment
* Social situations
* Underlying fears
* Lack of control

Again, triggers are different for everyone and aren't limited to this list. But, it's important to know what makes you feel stressed. The more you can understand your personal stressors, the easier it can be to manage your stress levels, and reduce the chance of experiencing chronic stress. When you recognize what's causing you stress, you've already taken the first step toward getting it under control.

The good news? You don't have to figure it out on your own. We can help you sort out what might be triggering your stress, so together, we can figure out the best management solution.
How to Manage Your Stress

Stress can't be fully 'treated.' There will always be different stressors throughout life. But, knowing how to effectively manage it can make a big difference in how you're able to live your life. There are lifestyle changes and choices you can actively make that can help you get your stress under control. Just like there are different triggers for everyone, there are different management options for everyone, too. Some of the most popular solutions include:

* Changing your diet
* Getting more exercise
* Meditation/Breathing exercises
* Time management
* Talking to someone

Different relaxation techniques can make a big difference in how you're able to manage your stress levels. Finding a technique that works for you is the most important thing. Sometimes, just talking to someone or journaling your experiences can help to bring your stress to the forefront. Again, recognizing what triggers it is the first step in managing it.

It's not always easy to recognize our triggers, especially when stress becomes less acute and more chronic. But, if it isn't properly managed, it can do everything from ruin your relationships and career, to take hold of other aspects of your health.

Stress Management Help

Even though stress is a part of everyday life, it can become a problem for some people. Don't feel as though you have to deal with it alone. Even though it's common, it's not something that should be ignored when you find it affecting your life in negative ways.

Let us help you when it comes to recognizing what might be causing the most stress in your life. Sometimes, recognizing your triggers can be one of the biggest factors in reducing the amount of stress you experience on a regular basis. Stress itself might be normal, but it doesn't have to consume your life, your relationships, or your health. Together, we'll find ways to manage your stress levels, so you can take your common stressors and work through them in a healthy way.

Counselling Burnaby Vancouver, Via Counselling & Consulting. Burnaby Counsellor Shari Wood, M.Ed., R.C.C. dedicated to helping clients begin their personal therapeutic journey. A Clinical Counsellor, specializing in Individual and Relationship Counselling by helping people overcome self-doubt to build healthy relationships.

Anxiety Disorders

According to the Anxiety and Depression Association of America, Anxiety disorders are the most common mental illness in the in the United States, affecting 40 million adults, or 18.1% of the population each year. Despite the fact that it’s so common in the U.S and highly treatable, less than 40% of suffers get help for their condition.

Anxiety disorders develop from a complex set of risk factors. Genetics, brain chemistry, personality traits, and life events all contribute to the onset of anxiety disorders. In our world of constant stimulation, tight deadlines, hectic schedules and never-ending to-do lists, it’s easy to see why anxiety is so ubiquitous. Anxiety is a blanket term for a number of specific occurrences that can affect your daily life significantly. Anxiety can present itself in General Anxiety Disorder, Panic Disorder, Social Anxiety Disorder or Specific Phobias. Individuals can also suffer from conditions like Obsessive Compulsive Disorder, Major Depressive Disorder and Post Traumatic Stress Disorder. Generally, most of these conditions develop in adolescence and are more prevalent in women than men. Symptoms include an overall sense of dread, nervousness in social situations, rapid heartbeat and inability to control worry and negative thoughts. For some people, anxiety can be a small yet controllable issue throughout their day, but for others, it can take over their existence and cause extreme problems in all areas of their lives.

You often hear anxiety and depression being mentioned together and there is a good reason for this. Almost 50% of those diagnosed with depression are also diagnosed with anxiety. It’s a combination that can contribute to substance abuse issues and higher instances of divorce and even suicide.

So, what do you do if you believe that you have anxiety? As mentioned before, it’s a common problem but relatively under-treated. The best way to start treating your anxiety is to document times when you feel overwhelmed, nervous, full of dread or worried. Having documentation about your feelings and how often they happen is a great way to begin a dialogue with a medical professional. Your therapist will ask you about when you feel anxious and how it affects your daily life, so having a good record of it will help facilitate a smooth conversation. After you’ve been diagnosed with anxiety, you may be asked to employ various methods to reduce your anxiety like breathing exercises, visualization, journaling, physical exercise, or meditation. These exercises are a great way to help train yourself to better navigate anxious episodes so you can learn how to react to stress in a positive way. Various methods of talk therapy may also be used as a way to understand the underlying cause of your anxiety and work towards a resolution.

The most important thing to remember when you’re thinking about your anxiety is that it’s a treatable condition that can get better. Implementing therapy, journaling, meditation, breathing exercises and medication are all great ways to help combat this common condition. With consistency and a little work, your anxiety is an easily treatable condition that will get better.

Anna M. Hickey, Counseling Macomb, works with couples and families struggling with relationship issues

More On Cognitive Behavioral Therapy (CBT)

Your mind is an incredible thing. Every moment of your life is processed and analyzed almost instantaneously so you can react accordingly. Your brain is so reactive and sensitive to stimuli that the way you frame stressors and respond to issues can positively or negatively affect your well-being in incredible ways. Essentially, the way you react to your daily life can be either good or bad for your mental health.

If your thoughts lead to anxiety or depression or you suffer from conditions like PTSD, disordered eating, OCD, or borderline personality disorder, using a technique called Cognitive behavioral therapy may be the way to break from your negative thought patterns and forge ahead.

Cognitive behavioral therapy (CBT) is a psychosocial intervention technique used for improving mental health. It’s the most widely used evidence-based practice due to its ease of implication and general effectiveness. Guided by empirical research, CBT focuses on developing personal coping strategies that aim to change detrimental patterns in beliefs, behaviors, and emotions. It was originally designed to treat depression and is now used to help individuals with various other mental health conditions.

The primary distinguishing factor of CBT over other approaches to psychotherapy is that it is more problem focused and action oriented. CBT actively works to combat an individual's negative thoughts, feelings, and actions to help them achieve a stronger sense of self-worth and confidence. The beauty of CBT is that it looks at a person as a whole being and not just as a condition that needs to be fixed. It helps identify maladaptive thinking and changes it to help modify behaviors in ways that will positively influence all parts of a person’s life.

How it works:
When using the CBT technique, a therapist will first identify critical behaviors in a patient and then determine the frequency and intensity of these reactions to obtain a baseline. Once behaviors are determined, the positive ones are fostered to increase their rate, and the negative ones are discouraged to lessen or eliminate them. These behaviors are molded through various therapies including positive behaviors distraction, motivation, self-talk, and positive reframing.

Try it now: Change your mindset.
Some aspects of CBT can be done on your own as a way to help positively affect your mindset. By simply talking negative thoughts and turning them into positive statements, you can help alleviate stress and change your outlook for the better.

For example:
Instead of complaining about rush hour traffic, say “I’m grateful for being able to wake up each morning and be gainfully employed.”

Or, instead of stressing over a mess that your kids made, reframe it in a positive light: “I have healthy, happy kids that are capable of playing.”

Making small changes to your thoughts will help you to react better to difficult situations and find the value in every day.

However, despite your mind’s inherent power, it doesn’t change over night. It needs to be exercised just like a muscle in order to get stronger. The best outcomes from CBT take time and dedication. After all, you’re retraining your brain to work through negative stimulus more healthily. That’s hard work and when it comes to CBT, slow and steady wins the race.

Dr. Takos is a Newport Beach Psychologist specializing in the treatment of adolescents and adults suffering from depression, anxiety, and trauma-and stressor-related disorders.

What Are the Causes of ADHD?

The symptoms of Attention Deficit Hyperactivity Disorder (ADHD) often found in children lead many people to believe those particular kids aren't disciplined, or that they are given too much control at home. Those same symptoms in adulthood can lead others to believe that person is lazy or unmotivated, and even immature.

Unfortunately, there are many myths associated with ADHD in all ages. This is usually because most people don't take the time to learn the underlying causes of the disorder to begin with. ADHD is not about a lack of discipline in childhood or being lazy as an adult. It is a real disorder with real factors attached.

While most research suggests that ADHD is largely caused by genetics, there are more studies being done about possible external factors that could play a role in the disorder. Let's take a look at some of these potential causes.

While more research needs to be done, a 2010 study in Pediatrics discovered a possible link between certain pesticides and this disorder in children. If you are concerned about this link, there are two easy ways to fight back against the risk: Either choose organic produce for you and your children (even when you are pregnant), or gently scrub any non-organic produce that may have residue from pesticides.

Pregnancy Choices

It's common knowledge that the choices you make during pregnancy can have a lasting effect on your child. When it comes to ADHD, smoking and drinking have been linked to the disorder. In fact, children who have been prenatally exposed to tobacco or alcohol are nearly 2.5 times more likely to have ADHD than those who were not.


The most important factor to consider when looking at ADHD is genetics. There are multiple other myths and factors associated with the disorder. This includes everything from too much sugar, to too much time in front of the television. While many of these 'myths' are continuing to be studied, there simply isn't enough evidence to showcase a strong correlation.

Genetics are the main cause of this disorder, as touched on earlier in this article. That means that it is passed on through the genes of parents, and not how they raise their child.

It has been shown that a child is more likely to have ADHD if a close relative has it, but more research needs to be done to determine which type of genes cause the disorder. As of now, it is believed that ADHD is caused by a missing gene or duplicated DNA segments.

Is It Possible to Prevent ADHD?

Because ADHD is mostly based on hereditary factors, it's very unlikely that you can prevent it from happening. Until more research is done on external factors, there aren't many ways in which to 'protect' your child from the disorder.

What is important is to recognize the symptoms for what they are. If someone in your family has the disorder and you notice your child showing similar symptoms, it's a good idea to get an official diagnosis.

No matter the official cause of a child or adult's disorder, getting it diagnosed quickly and recognizing that there is treatment available is the most important thing. Always be sure to stay up to date with the latest research being done on this disorder. The more studies and tests doctors and scientists are able to perform to determine a specific cause (or even a specific gene), the better treatment will become.

Marcy M. Caldwell, Psy.D. is a licensed clinical psychologist who specializes in the treatment and assessment of adult ADHD Psychologist Philadelphia.

The Good Ways to Argue

For most people, arguments are a way of settling disputes without anyone getting injured.

For some, however, arguing actually includes the getting hurt portion, and the winner is the one who can stay upright longest.

It doesn’t have to be that way, nor does anger have to be a “bad” thing. Counting to 10 while holding one’s tongue can lead to peace, but equally as often it leads to the kind of festering resentment and lingering bad feelings.

So let’s define some good and bad ways of arguing. Starting with the good ways:

First person please. “I feel hurt” is a lot less threatening than “You hurt me”, and – like a good wine – it also goes down more easily.

Own your anger. Don’t keep shoving it down and smiling as though everything was perfectly fine, until it seriously and irreparably isn’t.

Something else you need to own is the fact that you knew, before you said or did it, that your spouse/mate/life partner would be upset. And you knew this because you have said or done it before. Past the one-year mark, almost all arguments are repeat performances that haven’t been resolved yet.

You are not “in it to win it”. An argument with a loved one or friend is designed to find common ground, not a trophy. So put it all in perspective and try to see the bigger picture.

Stay focused on the issue at hand, and don’t bring a list of all the other things your significant other has done in the past 10 years to hurt you. If you must, write the problem down, with input from both sides. If it still seems too overwhelming, by all means give it some time, at least a short break. After which both of you might realize how silly the argument was, and how much you really like one another.

Different habits for different life partners. Some couples enjoy arguing and others are appalled by raised voices and harsh words. Whichever type your relationship is, factor temperament into your fight rules.

The good ways to argue? Well, there are never going to be any good ways, but there are fair ways – or should we say “non-righteous” ways. defines righteous indignation as: retribution, retributive justice; anger and contempt combined with a feeling that it is one's right to feel that way (i.e., anger without guilt).

So, a few rules. A good argument follows a script. Couples who learn the script can avoid hurting each other too badly, but first they need to agree on their lines – and what type of behavior crosses that line. For many, these are specific words, like “always”, and “never”.

Going forward, imagine that these words have been redacted from your script, as have such trigger words as “chill”, “fine”, and “never mind. Also draw a marker through the words “seriously?”, and “whatever”. This latter, in the hands of your very angry significant other, comes out sounding extremely dismissive. Remember, being heard is the goal for both parties.

Carolyn Ehrlich LCSW, CGP specializes in Relationship Counseling NYC

Do I Have Postpartum Depression?

You came home from the hospital three weeks ago, a proud mom after eight grueling months of pregnancy.

You should feel on top of the world. Your baby is perfect: ten little fingers and toes, and the softest skin. The effects of labor – the tiny red spots all over your face and neck from pushing, the aching belly and back muscles, the sting of the stitches – are mostly gone. All the hormones that rushed into your blood during pregnancy have leveled off. Life is no longer an emotional roller coaster, just a rainy day.

You could probably get past – or at least get used to – the “new baby blues”: up every four hours to change and feed your little one as the laundry piles up, the floors need sweeping, the dishes threaten to overflow the sink, and dinner is pizza or whatever else can be delivered.

What you are having trouble getting used to is the fact that you are no longer the center of attention. Your friends – who used to call once a day to make sure you weren’t in labor on the basement floor – don’t call as often. Your husband or significant other jokes that you look like a zombie, albeit without the blood.

You know he (or she) is right, so you set aside a half-hour a day to shower, run a comb through your hair, and put on lipstick and blusher. Or at least you try to, but it seems baby has other ideas, and invariably starts crying the moment you step inside the shower. Your reaction is “oh, shit!”, and you wonder if maybe having a baby was a bad idea. A very bad idea.

Your mood plunges – to a place you have never been before. You feel excessive fatigue, decreased sex drive, loss of appetite (or the desire to gorge), and frequent changes in your response to others. Worse, you feel them far more often, and more intensely, than seems warranted. Even your gorgeous, extremely sexy husband or significant other is puzzled by your lack of interest, because you used to be the hottest thing since habanero chili peppers.

You may have postpartum depression, or PPD. Because the symptoms so readily mimic the feelings and behaviors of women who have recently given birth, it’s sometimes hard to tell. However, if the behaviors persist beyond the first two weeks, and get stronger rather than fading, you probably have PPD.

Other symptoms of PPD include:

Loss of pleasure in things you once loved
Feelings of worthlessness, hopelessness and helplessness
Persistent depression
Thoughts of death or suicide
Thoughts or hurting someone else, including those closest to you

A number of risk factors can influence whether you get PPD. These are:

A history of depression
A history of premenstrual dysphoric disorder, or PMDD
Your age at the time of pregnancy (the younger you are, the greater the likelihood)
A pregnancy that runs contradictory to your plans for life
The more children you already have, the greater the probability you will develop PPD
Having few friends or family, and no husband or SO to offer support and encouragement
Living alone
A conflicted relationship

The most important fact a woman undergoing PPD should take to heart is that the problem can be resolved. Between regular therapy sessions and antidepressant medicines – some of which can be taken while nursing – new moms stand a better-than-average chance of beating PPD.

Most therapists will also recommend joining a support group, because there is strength in numbers and problems seem smaller when you can talk them out with like-minded new moms!

Dwan Reed, PhD, LCSW, DTM, of Tallae Counseling & Wellness Center is a therapist specializing in Depression Counseling in Houston, TX.

How to Argue Effectively

Fighting is a part of almost every relationship. Even couples with the healthiest of relationships argue from time to time, whether it be about something simple and silly, or something more concrete and serious. For the most part, those in relationships get through fights eventually, and move on. But, if you've ever felt as though the arguments you have with your partner are unproductive, and they continue to linger in the air for days on end, you may not be arguing effectively.

Yes, there are several ways to 'fight a good fight,' and turn your disagreements into something that can actually be beneficial for your relationship. Let's take a look at a few simple tactics you can use during an argument to get through it successfully.

Don't Run Away From It

Far too often, arguments get swept under the rug. Or, maybe you brought up a subject once that was important to you, but it triggered a disagreement, so you have decided to avoid it ever since. Ignoring potential arguments is bound to build up frustration in one, or both of you. Ask the big questions, share your genuine opinions and feelings, and talk it out before it becomes an even bigger issue. The longer you sit on something that's bothering you, the larger it can become.

Take it Slow

Heated arguments rarely end well. In fact, they make it easy to say things we might later regret. To really argue effectively, you both need to agree to take things slowly, and start the conversation in a calm, collected tone. Think of it as an understanding, open conversation, instead of a disagreement.

If you're able to take things slowly, and respect each other's turn to speak, the disagreement is likely to have a better outcome for both people involved. Plus, feelings are less likely to get hurt.

Make Rules Beforehand

If each person goes into an argument not knowing what to expect, there are no boundaries. That's when things can easily get out of hand. Set ground rules for your disagreements during a more neutral time. Rules could be anything from trying to come to a 'big picture' solution, to agreeing not to name call or dig up certain subjects from the past. They will be different for every couple, so suit them to fit your needs together.

Don't Forget You're On the Same Side

It's so easy to consider your partner an enemy during an intense argument. Unfortunately, that usually doesn't end well. Instead, go into a fight mentally acknowledging the fact that you're on the same team. Ultimately, you both want what's best for your relationship, you may just have a different approach to getting there.

Arguments typically happen because one person is struggling with some aspect of the relationship. As partners, you should do what you can to come to a solution regarding that struggle. You may have different ideas as to how to do it, but using these tools and techniques, your disagreements don't have to feel so hostile. Instead, they can be productive and thought-provoking. You can actually accomplish your goals as a couple.

By remembering that you're in this relationship for the long haul, it's easier to look at your partner and want to figure out a solution, rather than lash out at them. Don't forget the commitments you've made to them, and yourself, and your arguments can be far more effective.

Written by Kin Leung, MFT, providing couples therapy Burlingame

How to Handle Depression After a Breakup

Break-ups are never easy, no matter how amicable they may be. Dealing with a broken heart isn't just some old tale. The fact is, going through a hurtful break-up can have real psychological effects, including depression. It can also be a trigger into deeper anxieties and depressive actions, if you're prone to the condition.

While curling up with your favorite movie and a pizza might be the stereotypical remedy for getting over a bad break-up, there are better coping mechanisms to help pull you from the depression it might cause. Follow the tips below to help you get through this rough time, and know that what you're feeling right now doesn't have to be permanent.

Give Yourself Time

Many people might tell you to jump right back into the dating scene after a break-up, to take your mind off things and find someone new. Unfortunately, that's likely to do more harm than good, and you won't be giving yourself the time needed to fully get over what happened. It's important to understand that you don't need to get over a relationship overnight. Work through things at your own pace, and don't expect to feel better right away.

Additionally, give yourself the chance to be emotional. It's okay to cry, or feel angry, or even feel sad for a week or two. Suppressing your real feelings will make it harder to truly get over the split. These feelings won't last forever, so don't be ashamed to give yourself a release.

Keep Up With Your Routine

Sometimes, a split from your significant other can throw a huge wrench into your life – including something as simple as your daily routine. Sometimes, even having meals regularly and getting enough sleep can become chores after a break-up.

Try as best as you can to follow your regular routine after your relationship ends. This will be harder to do at first, but if you keep putting in the effort, the familiarity of that routine can provide comfort and help to reduce stress.

Spend More Time With People You Love

After a relationship ends, It's easy to feel as though you're all alone, or that no one cares about you. In reality, that's likely very far from the truth. Don't be afraid to tell the people closest to you what happened, and how you're feeling. A strong support system is crucial after a break-up. Let them be there for you. They'll help to take your mind off of things, and give you reassurance that you have some incredible people in your life.

Accepting the Truth

Accepting any hard truth is never easy. But, it's important to think about what the end of this relationship means for you, and to realize that it wasn't a waste. Being bitter about the end is only going to make it easier for depression to creep in. Instead, try to focus on things you may have learned, and what you can take with you into future relationships throughout your life. Moving on and moving forward, after giving yourself enough time to do so, is the best way to get through a break-up and fight back against depression that may want to linger because of it.

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and specializes in issues involving Anxiety & Depression.

Happiness – Cause or Effect

Is happiness a joyful state of being? How about a pleasurable experience? Or possibly a positive emotion? Merriam Webster says it’s actually all three. Even with multiple definitions, words cannot really capture the idea of happiness. Psychologists refer to emotion as “procedural knowledge”; a skill such as riding a bike. Procedural knowledge cannot be learned or fully explained in words. Only experience can lead to a true understanding. And so it goes with happiness.

Psychologists tell us that happiness has three components:
1) an overall satisfaction with life
2) satisfaction with life domains (work, relationships, etc.)
3) for the most part, higher levels of positive emotions and lower levels of negative emotions

Even so, happiness as an experience changes throughout a person’s life span. Researchers studied twelve million blogs to extrapolate words that related to happiness. Younger writers, those in their teens and early twenties, used the words “ecstatic” or “giddy.” On the other hand, older writers in their forties and fifties conveyed happiness through words like “content, satisfied, relaxed.”

Happiness comes from three distinct sources:
1) 40% from intentional activity (self controlled)
2) 10% from circumstances (outside of self control)
3) 50% from “set point”

Set points appear to be genetically influenced and are a result of certain personality traits. People who rank high on the extraversion scale may find they experience more happiness. While people who rank high on the neuroticism scale may find they experience less happiness. A life event, whether triggered by an intentional activity or an outside circumstance, may create waves of happiness, but over time, the set point will take the person back to their innate level of happiness.

Returning to the relationship of age and happiness, people between the ages of thirteen and fifty or sixty, enjoy a rise in happiness throughout life. A fast descent occurs thereafter. Another important factor discovered in research is that attitudes and actions affect happiness; examples are:
1) having a positive attitude and seeing a silver lining in any dark cloud
2) prioritizing activity such as spending time with friends and family
3) completing an important life goal

Is too much happiness a bad thing? Psychologists say yes, in some cases. The risks of too much happiness are as follows:
1) being too happy may lead to not recognizing risky situations
2) being overly happy may be expressed at an inappropriate time
3) trying to be happy all the time in not authentic behavior. The risk of offending or confusing others with too much happiness is high.

Happiness is associated with many positive life outcomes: good problem solving skills, a creative, helpful image to the world, greater professional accomplishments and good decision making capabilities. There is an association between education, successful marital status and financial success; all three are associated with happiness. Some psychologists believe that these life outcomes are “effects” of happiness while other psychologists take another position. They believe that positive life outcomes are not “effects” of happiness, but that happiness is the “cause” of the positive life outcomes. Stop for a minute and think about this concept. It is very empowering to believe that choices, attitudes and actions are paramount to circumstances that “appear” to be out of our control. This concept in no way suggests that we should fake happiness in order to achieve a life goal. Instead we have the option to create coping skills. When life circumstances become obstacles, reframe those circumstances as opportunities, see the silver living and hold on to the positive outlook. You might find that happiness is a natural result regardless of outside circumstances.

Polly Sykes, Registered Psychotherapist, MEd, RP, is a Toronto Psychotherapist with extensive post-graduate training and experience in the treatment of Trauma, and the use of Emotion-Focused Therapy for both Individuals and Couples. The support of an experienced and highly-skilled Psychotherapist can be a powerful tool to help you face the challenges of life with more hope, more self-acceptance, and stronger relational bonds.

Depression in Seniors

Often we sense a sadness among the members of a senior care facility. We might also feel that same sadness around a widow or widower who is living alone. Sadness or an occasional “blue day” is about as normal as those same emotions experienced by a younger person. But when occasional sadness morphs into a longer term condition, the person may be experiencing geriatric depression, a mental and emotional disorder affecting senior citizens.

If a senior citizen is female, there is a higher risk of developing geriatric depression. Other risk factors include being single, divorced or widowed without the support of a social network. Stressful life events may also contribute. Many times seniors are forced into early retirement because of health reasons or even corporate downsizing. Ensuing financial insecurity creates a risk for geriatric depression. Further, as seniors advance in age and develop physical illnesses such as heart disease including invasive procedures for these illnesses, the door is open for geriatric depression.

Seniors who are prescribed powerful medications may find that mood alterations, including depression, are a side effect of the medication. Blood pressure medications, antibiotics, antiarrhythmics and steroids are only a few drugs that may influence mood and cause depression.

One might summarize from the information above that illnesses actually bring on bouts of depression; in other words illness is the cause and depression is the effect. However, that premise was challenged in research conducted by Lynanne McGuire, Ph.D. at the John Hopkins School of Medicine. McGuire and her colleagues findings supported the opposite premise; persistent mild depression in older adults may lower immunity and impair the ability to fight off disease. Depression is actually first cause. It is interesting to note that the length of the depression, not the severity, actually impairs a senior citizen’s immunity. Therefore depression can accelerate immunological declines.

What then are strategies to hold depression at bay, maintain immune strength and hold on to good health as one ages? One strategy involves activity, especially in retirement. Retirement need not be thought of as obsolescence and a rocking chair. Retirement is an opportunity for personal reinvention. Activity includes travel, joining a gym, thinking of all the things that one wanted to do while working but could not. Retirement is the time to do those things if resources are available. Volunteer work is always an option to create a reason to rise early and engage in the world. If, for example, a retiree is a pet lover, they could volunteer at a pet rescue organization. If a retiree is good at working with people who are in need, hospital work is an option.

Another strategy is to conduct a self assessment on lifestyle. Review all life habits such as diet, exercise, sleep patterns, even sociability. Most everyone can make improvements in some areas. As part of retirement reinvention, lifestyle changes can make a difference in attitude as well as mental and physical well being.

Probably the most important self assessment for senior citizen is personal attitude. How much time is spent during a day thinking sad thoughts instead of happy thoughts. Remember, thoughts are choices. How many times during a day are events or situations perceived through the “half-empty” glass perspective instead of the “half-full” glass perspective. Regardless of a person’s age, an occasional attitude adjustment may help ward off mild depression. Laughter is greatly underrated for its therapeutic benefits.

These strategies are suggested to manage mild bouts of occasional depression. If depression persists and is perceived as more severe, professional help should be sought. A trained certified therapist can make a diagnosis, develop a treatment plan and put the senior citizen on a more productive and fulfilling life path.

Copyright © 2015 Directory for Therapists

Teens & Smartphones, The Downside

It’s not an unfamiliar scene. Teens huddled in groups tenaciously clutching their smart phones while checking social media sites and appearing to be mesmerized by Instagram, Facebook and thousands of other apps. Teens have replaced conversation at family meals with smart phone use; some of them following the lead of their parents. The source of the compulsion to spend up to nine hours per day with smart phones or tablets is a psychological study unto itself. The effects are another. The purpose of this article is to examine proven and speculated effects.

Most people will not question the practical advantages of being connected via smart phones. Smart phones have become a body appendage feeding us with news, weather, driving directions, traffic reports, instant communication via text or email not to mention thousands of quite useful apps. Few would argue with these practical benefits. However, practical benefits aside, how do parents respond when cell phone abuse begins to negatively affect teens physical, emotional and mental health.

Sleep Deprivation: Many argue that cell phone use has become an addiction for many teens. They feel social pressure to remain constantly available to receive and reply to text messages and other communication. This pressure created by cell phone addiction increases stress, anxiety and sleep deprivation for many teens. Extended sleep deprivation may lead to drowsiness, irritability, fatigue and poor performance at school. One study showed that for each ten minutes later a teen went to sleep, there was a 6% chance they’d used drugs or alcohol in the past six months. If you notice your teen is sleeping with their cell phone on, try to instill a habit of turning off the phone before bed to allow for a full uninterrupted night’s sleep.

Brain Chemistry: Dopamine is an important chemical substance created by our bodies. Because of dopamine we are able to experience pleasure and reward. If dopamine production is interfered with due to addiction (even addiction to smart phones), the parts of our brains that impact executive control and emotion processing are impacted. Science has noted that teens (and adults) addicted to smart phones have a reduced amount of dopamine receptions in their brains. In order to experience continued pleasure, more cell phone use is required such as downloading new apps or receiving more notifications from various platforms.

Reduced Physical Activity and Mobility: If on average teens spend nine hours per day on their smart phone that means they are spending less time engaged in physical activity. Nine hours per day spent in a particular stationary position negatively affects physical development, back and spine pain and stiffness as well as soreness in wrists, fingers and elbows. There are now terms to described wrist, finger and elbow pain from habitual texting; “text claw” and “cell phone elbow”.

Cancer Risk: Cell phones do emit radio-frequency energy or electromagnetic radiation. This energy is absorbed by human tissues where the phone is held. However, there is no conclusive research or evidence that cell phones cause cancer. Speculation is a different matter. It is speculated (not proven) that if cell phone use causes cancer, it is likely to be more probable with people who begin cell phone use in their teens. Younger people are speculated to be at greater risk since their nervous systems and brains are still in a developmental stage. Making your child aware of this risk and encouraging cell phone use of no more than twenty minutes daily may help mitigate the risk. Further, using a land line for longer conversations could be helpful.

If parental intervention does not help curb the use of cell phones with your teen, and if you believe the use of cell phones has become abusive or addictive, the help and guidance from a professional certified psychologists trained in teen behavior may help.

Colin B. Denney, Ph.D., is the Director of the Pacific Psychology Services Center in Honolulu, Hawaii, he is a Child Psychologist Honolulu.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder, more commonly referred to as PTSD, is a disorder that develops in individuals who go through horrifying, dangerous, scary experiences. It is natural for people to feel afraid after traumatic events and this fear triggers many split-second changes that help the body avoid or defend itself against danger. While most people recover from traumatic events fairly quickly, there are those who continue to experience problems and these are sometimes diagnosed with post-traumatic stress disorder. People with PTSD often experience fear even when they don’t face any danger.

Causes of PTSD
The range of events that can trigger PTSD include natural disasters, terrorist attacks, being held hostage, military combat, witnessing violent deaths, severe neglect, prolonged violence and sexual abuse, violent personal assaults as well as serious road accidents just to name a few. PTSD can manifest immediately after a scary event. It can also take a while i.e. days, weeks, months or even years, to develop. And while it’s not clear why it develops in some people and not everyone, at least one out of three people who have traumatic experiences develop PTSD.

Signs and symptoms of PTSD
Not everyone who goes through a traumatic experience develops acute or chronic PTSD. It’s also important to note that not everyone who suffers from PTSD has necessarily gone through a traumatic event. Some experiences like the death of a close family friend can trigger PTSD. Symptoms develop within a period of three months but may take several years to develop in some individuals. For symptoms to be considered PTSD-related, they have to persist for at least a month and so severe that work or relations are interfered with. The severity of these symptoms varies, with some people developing chronic PTSD. The following symptoms must be experienced for one month before an adult can be diagnosed with PTSD.

At least one re-experiencing symptom - frightening thoughts, flashbacks, and bad dreams.

At least two cognition and mood symptoms - disinterest in fun activities, negative thoughts about the world or oneself, distorted feelings like the guilt of blame.

At least two arousal and reactivity symptoms - trouble sleeping, angry outbursts, feeling on edge or tense, being easily startled.

At least one avoidance symptom - staying away from people, places, and events that remind one of the traumatic events, avoiding feelings or thoughts related to the event

Treatments and therapies
There are various types of psychotherapy that are utilized to help treat patients struggling with PTSD. Such include stress inoculation training, cognitive restructuring where people learn to make sense of bad memories, as well as exposure therapy patients, are safely exposed to their trauma events to help cope. Those experiencing PTSD due to on going trauma such as abusive relationships, feeling suicidal, drug abuse and depression are encouraged to seek treatment from experienced medical professionals. It is important to note that not every treatment works for every patient as PTSD manifests uniquely in each person.

Miriam Gold, LCSW, PLLC
Springboard Therapy
Therapy Services for Children, Adolescents, Adults, Families, and Groups

Miriam Gold specializes in trauma PTSD therapy in Raleigh, North Carolina. Her treatment specializations also include childhood and adult Trauma, adult survivors of trauma, both recent and past. Treating children and adolescents; Neglect/Sexual Abuse/Physical abuse, Community/War/Political Violence, Natural Disasters, Life Threatening Medical illness, Serious Accidents, School Violence, Traumatic Loss, Foster Care and Adoption, Attachment Concerns. Miriam is Rostered in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) through the North Carolina Child Treatment Program. TF-CBT is an evidence-based treatment for children, adolescents, and their parents or caretakers who have experienced trauma or loss. Extensive training in Cognitive Processing Therapy (CPT), an evidence-based therapy for adults.

Mental Health Bill, lawmakers tackle federal policies

Mr. Murphy, a clinical psychologist, had been tapped by House leaders to investigate mental health treatment in the U.S. in the wake of the Sandy Hook shooting in 2012. He and other advocates of changing the system have cited the obstacles family members faced in caring for people with serious mental illness, including privacy laws and provider shortages. These issues were also highlighted in a Wall Street Journal investigative series in 2013.

In the years since, Mr. Murphy and other backers of the law have agreed to soften some portions of the legislation in an effort stave off opposition. The bill has a Democratic lead co-sponsor, Eddie Bernice Johnson of Texas, and was unanimously approved by the House Energy and Commerce Committee.

Earlier iterations of the bill had sought to change the privacy rules in a law known as HIPAA so that providers could share details of a patient’s diagnosis, prescriptions and appointments with a known caregiver, require states to pass laws that compelled treatment for certain people as a condition of getting federal funding, and restrict advocacy groups that receive federal health funding from helping patients bring legal challenges to their treatment.

Read the article here.

The Denial Defense Mechanism

We all use different forms of defense when we need to. Whether we’ve been through a traumatic experience, we’re arguing with someone, or we simply don’t want to deal with something negative, our minds and bodies work to create defense mechanisms to help protect us. Unfortunately, there are instances where these mechanisms can get out of hand.

One of the most popular and widely-known defense mechanisms is denial. It’s considered to be a ‘stage of grief,’ and is apparent in many different defense mechanism research.

Believe it or not, denial is actually an unconscious defense mechanism, not a ‘lie’ or falsehood someone is doing on purpose. Quite simply, denial is the refusal to admit or acknowledge than a specific event has occurred. An example could be an alcoholic to refuses to believe they have a problem, or a wife hearing her husband was in a car accident, but refusing to believe it, etc.

Denial is used to avoid thinking about painful things, and is one of the most basic and primitive defense mechanisms we have, even from childhood. It also goes hand-in-hand with repression, or the idea of not letting certain thoughts into our heads.

Denial At Work

Denial can be both helpful and harmful, in different ways. Studies have suggested that small amounts of denial can actually be beneficial for the right situation. For example, if someone experiences a traumatic event, living in a state of denial for a short period of time can actually give their mind and body more time to process what actually happened, allowing it to come as less of a shock later. In these cases of denial, it’s almost as though reality is simply sinking in more slowly, and the person is willing to get past the denial naturally over time.

However, denial becomes harmful when someone is not able to overcome it. When they are not able to rationally talk about the issue and eventually get past ignoring it, it can simply snowball into something even bigger. A common example of consistent denial might be something like a couple facing a mountain of credit card debt, but refusing to believe it, so their bills keep adding up every month, and they don’t even look at them so they don’t have to face reality.

Finding Help

If you feel as though someone you know struggles with denial to the point where it is affecting their lives, and the lives of those around them, there can be help available from mental health professionals. The best thing you can do, however, is not to make the person struggling with denial feel forced into anything. If you can offer to see a professional with them, just to talk, it can be a great first stepping stone into beating denial. It’s never an easy journey when someone who has been using a defense mechanism finally has to face what they were hiding from, but it is the healthiest way to move past something like denial.

To read more on Denial and other mental health topics visit, therapist website design & marketing

Dissociative Disorders - A Better Understanding

Dissociative Disorders - A Better Understanding

There are different stereotypes, opinions, and subconscious thoughts that go along with the term ‘Dissociative Disorders.’ Unfortunately, those stereotypes aren’t usually fair, and the assessments people make about these types of disorders can be dangerously false. Because dissociative disorders affect a relatively small number of people (roughly 200,000), we tend not to consider them to be as serious as we might with other mental or physical health issues, but that small number packs a big punch in terms of what these disorders can do, and how they can affect those dealing with them, and the people surrounding them.

Types of Dissociative Disorders

By definition, a dissociative disorder is characterized by an involuntary escape from reality. There is a ‘disconnection’ of thoughts, identity, memory, and consciousness. Many of these disorders arise because of a prior traumatic event, but no one is immune from it. They can happen at any age, to any race, or gender. However, a common candidate for dissociative disorder can oftentimes be children, who have suffered long-term emotional, physical, or sexual abuse. The disorder allows them to escape, become someone else, and forget about/cope with the pain and trauma they’ve had to deal with. Realistically, a dissociative disorder is nothing more than an extreme defense mechanism from our own thoughts.

Types Of Dissociative Disorders

Because dissociative disorders can be different things to different people, depending on their idea of ‘escape,’ there are different categories to make the disorders easier to understand, including:

Dissociative Amnesia - Difficulty remembering important information about yourself, such as abuse, or even identity.
Depersonalization - Lasting feelings of detachment from everything personal.
Dissociative Identity Disorder - Alternating between multiple personalities/identities.

What To Look For

Even though dissociative disorders can show up differently for different people, there are a few common traits to consider, including memory loss of specific events or people, out-of-body experiences, additional mental health issues (depression, anxiety, etc.), a lack of self-identity.

Dissociative disorders oftentimes go hand in hand with other, similar issues, including PTSD, so it’s not uncommon for them to be misdiagnosed, or mistaken for something else. Treatment can include anything from psychotherapies, to rapid eye movement conditioning, or even the introduction of similar medicines used to treat things like depression.

Dissociative disorders can be terrifying for the people having to go through them, and the families and friends surrounding those people. Yes, they are viewed as a way for an individual to escape, but there’s a good chance they are only harming themselves further in the process. If you think someone you know may be struggling with a dissociative disorder, it’s ultimately up to them to seek out the kind of help they need, but don’t be afraid to gently encourage it, if the disorder has become a real problem in their everyday life.

To read more on Dissociative Disorders and other mental health topics visit, Dr. Lynn Alexander, Palo Alto Therapy & Counseling

Social Drinking vs. Alcoholism - How To Know The Differences

We live in a society where going out for a drink or two is more often than not, the norm. And there is certainly nothing wrong with having a cocktail at a party, or sipping a beer over a ballgame, etc. Drinking has always been viewed as a social event, and many gatherings cater toward the alcohol itself, but that doesn’t necessarily mean there’s a problem.

However, because of today’s open acceptance of social drinking, it can sometimes be hard to tell when someone might be going too far, or past their limit - especially on a consistent basis. There’s a fine line between social drinking and alcoholism, and it can be more of a blurred line than many of us realize.

How To Know When It’s A Problem

Alcohol affects every single person differently, so it can be difficult to tell when a problem arises. One person might be able to have three or four drinks with no issues, while another might feel a ‘buzz’ after just one drink. Unfortunately, that’s why conditions like alcoholism stay personal for far too long, before other people begin to notice. Once other people do begin to step in, it’s often at a point where the illness has really grown, and become a huge problem.

So, there are a few things to consider for yourself before letting anything get out of hand:

Do you feel sometimes as though you should cut back on drinking?
Does drinking ever make you feel guilty?
Do you think about drinking or actually drink at ‘inappropriate’ times of the day? (ie; having a drink to cure a hangover in the morning, etc.)

Another thing to consider is the social aspect of drinking itself. Can you go to a party or restaurant/bar with friends and choose not to drink without any issues? If the answer is ‘no,’ and you feel as though you either have to have a drink to enjoy yourself, or to fit in with your friends, it may be time to take a step back and consider that to be a problem, before it escalates into an even larger one. Alcoholism results from a lack of control when it comes to drinking, which, in essence, is the very opposite of social drinking itself.

Ultimately, alcoholism is a battle, and an addiction, and the signs for it can be different for every individual. Some people can go months, or even years without showing any real signs of the illness while still struggling with it, while others will open up quickly and admit they have a problem. If you, personally, have felt as though you may have a problem with this addiction, don’t be afraid to seek out help before it snowballs - friends and family are a great way to start, but support groups, life coaching, and even therapy can be a big help when it comes to kicking the addiction.

To read more on alcoholism and other mental health topics visit, Kristy Hellum therapist Santa Rosa

Married Without Children - Choosing Not To Have Kids

Marriage and children have gone hand-in-hand since the beginning of time. As a culture, we’ve been trained to think that having children is simply what you do after you get married. In the not-so-distant past, many couples would have multiple children because it was a societal norm, and because those children were ‘needed,’ to help work, manage farms, etc. Having between 5-10 children or more was normal in the early-mid 1900s, and while forms of birth control were obviously less readily-available during those times, the idea of having that many kids wasn’t only accepted, but encouraged.

Even in more recent years, children have simply been expected as a result of being married. With women especially, the conversation of getting married and having kids always seemed to be a popular one. Today, though, that conversation is changing.

More and more couples are either choosing to have children later in life, or simply choosing not to have kids at all.

Why are couples choosing not to have kids?

There are hundreds, if not thousands of individual reasons people choose not to have children, and most of them are 100% personal to the couple making that choice, however, some common reasons include: Putting career first, trouble in the marriage, fear of a sluggish sex life, the cost of a child, etc.

Again, most reasons people give for not wanting kids is strictly personal, but as societal norms have changed, so has the pressure of having kids. Granted, it’s not accepted 100% - it’s still more often than not that married couples do have at least one child, but the focus on ourselves, our careers, and our relationships with our spouses and other people have greatly affected our overall desire to have kids.

This certainly isn’t to say we live in a selfish world. In the United States alone, over four million babies are born every year. However, many of those births are not the result of a marriage, and that stigma has begun to float away as well. Many people are seeing the choice to have a child or not to be something a woman has a right to decide for herself, whether she’s with her husband, or on her own.

In marriage, many people want to put their relationship first, especially if it’s a relationship that has had hardships or struggles. Where having a baby used to sometimes be a method of ‘strengthening’ a relationship, more and more couples now realize that bringing a child into a damaged situation can only make things worse for everyone, including the baby. Still, even the happiest of marriages choose not to have kids for personal reasons, and even though it may not be the ‘norm’ as of yet, the idea of not having kids in marriage is more widely accepted than ever before, and there’s no reason to believe those trends won’t continue.

To read more on Marriage and other mental health topics visit, Donna Shanahan, LMFT couples therapy Pasadena

Does Exercise Help Keep Our Brains Young?

For most of us, our bodies begin to lose flexibility and efficiency as we enter our 40s. Running and other movements slow down and become more awkward, and something similar seems to occur within our heads. As middle age encroaches, our thinking becomes less efficient. We don’t toggle between mental tasks as nimbly as we once did or process new information with the same aplomb and clarity. Click to read more from GRETCHEN REYNOLDS.