Blog - OCC

Oct19

What is Mania and Hypomania?

By Kelsey Rood - blog

Mania and hypomania: although they sound similar, they differ in multiple ways. Although mania and hypomania have similar symptoms, hypomania is known to be a milder/less severe form of mania. Hypomania is seen in a diagnosis of bipolar II, while mania is seen in the diagnosis of bipolar I. Hypomania and mania differ in the length of episodes, severity, treatment, the possible need for hospitalization, and how significant it impairs function. Mania will last for a minimum of one week, where hypomania will last somewhere between a minimum of four to seven days. Mania is more severe in symptoms, severely impairing one’s functioning, and possibly leading to the need for hospitalization. Hypomania often does not greatly impact one’s daily functioning. Below are the symptoms of mania and hypomania, the key difference is hypomania’s version of the symptoms are less severe than mania.

Symptoms of Mania and Hypomania

Feeling of euphoria and feeling overly happy/silly. This can last for most if not the entire day for several days.
Higher levels of activity, excitement, and energy than usual.
Experiencing less sleep, not needing as much sleep, and still feeling rested on little to no sleep.
Not feeling hungry or the need to eat.
Reckless/risky decision making without considering the consequences of those decisions. These can include, but not limited to, purchasing large cost items, large amounts of reckless sexual activity, heavy gambling, and reckless driving.
Increased impulsivity and taking on many activities at one time.
Increased irritability and aggression.
High increase in optimism and over confidence, outside of one’s usual range.
Racing thoughts, racing speech/talking, and racing ideas.
Easily distractible by unimportant stimuli.
Hyperfocus on an activity.

The way hypomania and mania are diagnosed is through a mental health professional or healthcare professional. A healthcare professional will often rule out medical related conditions that could be causing mania or hypomania symptoms. Once an underlying medical related condition is ruled out, a mental health professional can diagnose mania or hypomania using the criteria listed in the Diagnostic Statistical Manual of Mental Health Disorders (DSM-5). Both hypomania and mania can be treated with psychotherapy and psychiatric medication. One of the most common forms of psychotherapy used to treat hypomania is cognitive behavioral therapy (CBT). Mania and hypomania can often be treated with medications such as antipsychotics, anti-seizure medications (mainly used to treat mania rather than hypomania), mood stabilizers, and antidepressants. It has been stated in multiple articles that hypomania can be treated without medication with a primary focus on psychotherapy, self-care, and healthy lifestyle choices.

If you believe you are experiencing symptoms of mania or hypomania, please contact your health or mental health care provider. If you or someone you know is experiencing severe symptoms of mania, and is a danger to themselves or others, please contact 911 or go to your nearest emergency room.

References

Cuncic, A. (Novemeber 30, 2021). Hypomania vs. mania: What’s the difference?. Very Well Mind. Retrieved October 15, 2023. https://www.verywellmind.com/hypomania-vs-mania-5208167

Cleveland Clinic (nd). Hypomania. Cleveland Clinic. Retrieved October 15, 2023. https://my.clevelandclinic.org/health/diseases/21774-hypomania

Pietrangelo, A. (September 29, 2022). What you should know about mania vs. hypomania. Healthline. Retrieved on October 15, 2023. https://www.healthline.com/health/mania-vs-hypomania

Jul10

Toxic Relationships and How to Leave

By Kim Wells - Counseling,Mental Health

Toxic Relationships are defined as an unhealthy relationship between two people where disrespect, lack of appropriate communication, dishonesty, controlling behaviors, and possibly abusive behavior that result in continued unhappiness by one or both people.

Toxic Relationships typically do not start out as toxic. In fact, most relationships that end in toxicity begin with an intense spark and connection. Many people report when first meeting this person, that they felt seen and heard for the first time in their lives and feel that they have “known this person their entire lives.”
This sense of “knowing this person” comes from unconscious ideas and behaviors you may have experienced as a child and increases the intensity of the relationship. While most people do not display overly controlling and problematic behaviors initially, these behaviors will become apparent after the “honeymoon” phase of the relationship. Unfortunately, by this point in the relationship, the partners have an intense attachment to each other thus making it more difficult to leave the relationship. Some couples may experience a “trauma bond.” A “trauma bond” is an unhealthy attachment where cycles of abuse. These bonds and relationships typically follow a pattern of increased tension, followed by abuse of some kind, then followed by a “honeymoon” stage where the toxic and abusive partner tries to apologize and make amends for their actions. Trauma bonds are seen in most abusive relationships and in some toxic relationships.

So how do you get out of a toxic relationship? The first step is to identify that you are, in fact, in a toxic relationship by looking for red flags and characteristics of toxic relationships. Ask yourself the following:

Your needs are not being met.
You are scared to ask more from your partner.
Your friends and family do not support your relationship.
You feel obligated and/or are scared to leave your partner.
You do not like your partner or how they make you feel.
You do not like who you are when you are with your partner.
Your partner is abusive.

Once you have determined that you are in a toxic relationship and depending on the severity of toxicity, seeking support can be one of the best options. Contact friends, family members, and other support systems to provide you with emotional and physical help while you evaluate your options. With your support in place, make the decision to leave and stick to it. Leaving a toxic relationship is hard. People typically feel sadness, anger, fear, insecurity, and ambivalence about their decision. However, if a person knows the relationship is toxic, remaining firm in your decision to end the relationship is helpful. Cut off all contact with your partner, unfollow them on all social media, and focus on your own needs rather than the needs of your toxic partner. Remembering that you deserve to be treated with love, kindness, and respect. If you are fearful for your safety, you can call 911 or the non-emergency phone number, and they can direct you on how to obtain a protective order that states that your toxic partner may not come within a certain amount of feet of you. Also, seeking professional help can assist you in this transition. Seeing a therapist does not mean that something is wrong with you but rather means that you recognize that the relationship is unhealthy and you are taking action to ensure that you break any of your own patterns so you do not enter another toxic relationship or return to your past relationship.

Remember, you deserve to feel safe, secure and receive love that does not hurt.

National Domestic Violence Hotline 24/7 800-799-7233
House of Ruth Domestic Violence Shelter/Legal Advocate 410-889-7884

Jul10

How to Overcome Social Anxiety

By Kim Wells - Counseling,One on One Counseling,Stress Management

Social Anxiety affects approximately 12% of all adults sometime in their lives. This means that more than one in ten people will experience anxiety and specifically social anxiety. Will this be you?

What is anxiety, and why do we have anxiety? Anxiety is the brain and body’s way to sign that a threat is present. The primitive part of the brain goes into autopilot to assess the threat and decide whether you should FIGHT, FLIGHT, or FREEZE. A person typically experiences increased heart rate and rapid breathing. This reaction allows the body to send more oxygen to the muscles and brain in case the person needs to take action. They will also experience flushed pale skin as the body redirects the blood to major muscle groups in the event the person needs to fight or run away. Some people also experience dilated pupils that allow them to better see and observe their surroundings.

The problem with social anxiety is that the person’s body and brain react to the social situation as if there is a true threat, even when they are not in danger. The brain and body send these signals, and the person “overreacts” to the situation, thus increasing their anxiety. It is important to note that a certain amount of anxiety can be helpful, however, when a person’s level of anxiety is extreme, and the body goes into flight or fight mode, the person is less able to manage their anxiety in the social situation and may choose to leave or avoid situations that cause this physical reaction.

To overcome social anxiety, try the following:

Assess the situation prior to attending the social event.
Identify triggers that increase your anxiety and be proactive about how to address them.
Challenge irrational thinking and reassure yourself that you are in fact SAFE.
Focus on your breathing using mindful breathing exercises such as 5-7-8 breathing.
Try to view your body’s flight, flight, or freeze reaction as helpful. For example, view your increased heart rate and rapid breathing to get more oxygen to your brain and body, and as a result, you will be able to think and act faster.
Remember that your anxiety is time limited.
Practice relaxation and mindfulness techniques.
Have supportive people around you that can help you feel safer and more comfortable.
Role playing problematic situations with friends so you feel more confident.
Designate an allotted amount of time you will be at the social event. Make sure the time is short enough that you can successfully remain in the social setting before needing to leave.
Remember that getting over anxiety takes time and that facing your fears about social activities will DECREASE your anxiety in the long run.

Remember, the goal of overcoming social anxiety is to ensure a person’s safety by assessing a threat. In social anxiety, the person’s “assessment meter” is going off when no threat exists. If you or your child continues to struggle with social anxiety after trying these suggestions, seeking help is a good option. Yale researcher, Eli Lebowitz, Ph.D., developed a special program called SPACE. SPACE stands for Supporting Parents of Anxious Childhood Emotions, where the parents learn how to decrease their role in their child’s anxiety by either inserting something or removing something from their child’s life to decrease their anxiety. If you think your family may benefit from the SPACE program, Kim Wells of Olney Counseling Center has been trained in this approach.

Apr11

How to Find a Counselor for Your Teenager

By Kim Wells - Teen Therapy

how to find a counselor for your teenager

Making the decision to take your teen to therapy can be a stressful decision, especially if your teen is resistant to therapy. Here’s how to find a counselor for your teenager and what things to look for:

Therapist makes you feel heard, understood, and connected. Rapport, the connection between the therapist and client, is essential in developing a strong therapeutic alliance.
Therapist is a licensed professional that has specialized training and experience in the area that you are seeking assistance.
Therapist works collaboratively with you, your teen and other providers.
Ask friends and family for recommendations for therapists.
Trust your gut as a parent. If you feel a connection with the therapist and you think your teen will likely connect with them this is a great sign. Remember, some teens may not want to be in therapy and may say they don’t feel a connection, so check in with the therapist about their perspective. A good therapist will be honest and tell you what they think.

How do you present the idea of therapy to your teen?

Now that you have decided on a therapist, how do you present the idea in a way that your teen will be more likely to participate? I am lucky that many clients I see want and/or request therapy; however, it is “normal” for anyone, including teens, to not want to participate in therapy. Even if your teen begins therapy not wanting to be there, they can still gain positive skills Try the following to help your teen accept therapy:

Explain that therapy can be seen as a “fast track to mental health.” Get in, learn skills, and get out of therapy.
Therapy is time limited and can be a place to learn skills and how to express your feelings.
Therapy is a confidential space, even from your parents, except in the case of child abuse, harm to self or others.
Explain that lots of people seek therapy to gain skills, even some people that you may already know. (Because of confidentiality, the therapist can’t confirm or deny the attendance of any client).
Explain to your teen that you are requesting that they participate in 5 therapy sessions and after that, everyone will evaluate to see if therapy is still needed.
Define therapy goals so they are easier and quicker to achieve.

Remember, therapy may be a new experience for you and your teen. Now you know how to find a counselor for your teenager. It is common for everyone involved to experience several feelings at the same time. So keep in mind that finding the best therapist for your teen, presenting the idea of therapy in a positive way, and having some patience, is likely the best plan for helping your teen get help and enjoy their time in therapy!

Jan3

What are Personality Disorders?

By Kim Wells - Counseling

A personality disorder is a deeply ingrained, unhealthy pattern of thinking, feeling, and behaving. Personality disorders usually begin to form in the teenage years when the person is experiencing significant problems maintaining or initiating relationships and social activities at work, school, or home. If these patterns persist, the person may struggle to function in society in a healthy way. Most people who have a diagnosed personality disorder are not even aware of the impact of their entrenched think and behavior. They view their struggle as the fault of others and are resistant to accepting responsibility for their actions. This thinking perpetuates the personality disorder, and the person typically continues to struggle.

The following is a list of the most common personality disorders, and it is important to note that approximately 10 percent of the population suffers from these disorders:

Antisocial
Borderline
Histrionic
Narcissistic
Obsessive Compulsion

What causes personality disorders?

Researchers believe that personality disorders are influenced by genetics and the environment in which the child grew up. Other studies indicate a link between anxiety, fear, aggression, and some of the personality types.

Significant childhood trauma such as:

Sexual abuse
Physical Abuse-in extreme cases these traumas can lead to borderline personality disorders
Verbal abuse
High Reactivity Environment-more likely to develop an anxious personality disorder
Inconsistent Parenting-children are three times more likely to suffer from a narcissistic personality disorder
Intense bullying

What is the best way to treat personality disorders?

First it is important to find a mental health professional that has experience treating personality disorders. Evidence-based therapies such as Behavior Therapy/Behavior Modification, Cognitive Behavior Therapy (CBT), Dialectical-Behavior Therapy (DBT) as well as support groups and medication have been found to the most effective treatments for personality disorders. It is important to know that personality disorders are typically difficult to treat as the entrenched thinking, feeling, and acting have become a way of life for many people so be patient with yourself and family members.

Jan3

What is the Difference between Psychotherapy and Counseling?

By Kim Wells - Counseling,Psychotherapy

Deciding between psychotherapy and counseling can be difficult, especially when you need help. Rest assured that both psychotherapists and counselors can be helpful in meeting your therapeutic goals but taking some time to understand the difference between the two disciplines may produce better outcomes. Psychotherapy and Counseling terms have been used interchangeably for some time but there are important differences between psychotherapy and counseling.

PSYCHOTHERAPY	COUNSELING
Long-term solutions for past or recurring problems	Short-term solutions for present problems
Treatment is typically longer in duration	Treatment is typically shorter in duration
Feeling and experience focused	Action and behavior focused
Primary Process (addresses the event)	Secondary Process-(meaning attached to event)
May include talk therapy & testing & other modalities	Typically, is talk therapy

Most trained therapists use a combination of both psychotherapy and counseling techniques with the goal being to “start where the client is.” Based on the client’s goals and treatment needs, the therapist and the client will develop a treatment plan that will likely incorporate all the above techniques.

Counseling:
Means to “advise” and it generally involves the counselor and patients to use critical thinking to solve a problem. Counselors tend to provide advice, planning and guidance and are very active in the process. This process is typically short term and is present oriented with very specific goals.

Psychotherapy:
Generally, focuses on increased insight into chronic physical or emotional pain, where thoughts and feelings from the past and present are analyzed and changed so the person feels emotional relief.

Similarities:
Both counseling and psychotherapy are built on trust. Trust is the building block for all therapeutic interactions and with trust, the person feels emotional, and physically safe to share their story.

If you are unsure about seeing a counselor or a psychotherapist, reach out to these professionals and ask questions. A qualified professional should be able to provide you with their own process, their credentials, how they work with clients, explain the difference between counseling and psychotherapy and most importantly provide you with a sense of connection.

Jan3

How to Deal with Traumatic Memories

By Kim Wells - One on One Counseling

Most of us can remember a time when something uncomfortable and unpleasant happened to us. We wish that event did not happen, but despite the event, we can still go on with our lives, and that event does not impact our daily lives. This is an example of our brain and nervous system being able to manage or tolerate uncomfortable events. However, traumatic memories impact the body and nervous system very differently and continue to impact our daily thoughts, beliefs, and at times our bodies. It’s important to learn how to deal with traumatic memories.

Traumatic memories are best dealt with by a licensed mental health provider who understands the complexities of traumatic experiences. You, along with your therapist, will likely begin by talking about the traumatic memory, the pre, and post-issues that surround that memory, and how that trauma continues to impact you today. Understanding trauma typically involves these steps:

1. Understanding of the trauma response
2. Psychoeducation of the brain and body during trauma
3. Grounding techniques to use when the memory is overwhelming
4. Identification of the memory
5. Triggers that initiate the traumatic memory
6. Body sensations during the traumatic memory
7. Negative beliefs about self during the trauma
8. Positive beliefs about self that the client who rather feel about themselves
9. Processing the traumatic memory
10. Decreased emotional “charge” when the memory occurs
11. Improved overall functioning in body, mind, and soul

A trauma informed therapist should always teach the client emotional regulation and grounding techniques to use during and after the memory has been processed and will likely check on the client to make sure that they are able to tolerate the reprocessing sessions.

Memories have a beginning, middle and an end, while traumatic memories can have these parts, traumatic memories tend to get “stuck” in one side of the brain and the memory is more easily triggered. Many people with traumatic memories have Post Traumatic Stress Disorder (PTSD) diagnoses and suffer from some the following:

1. Reoccurring and distressing thoughts and beliefs about the event
2. Reoccurring dreams about the event
3. Acting or feeling that the memory is reoccurring (flashback)
4. Intense psychological impairment due to the traumatic event

The goal of the therapist is to allow the client to “revisit” the traumatic memory in a safe, secure manner so that the client can experience all parts of the memory (beginning, middle and end) and as a result, the emotional “charge” is decreased, and the client’s level of functioning is increased.

If you are suffering from a traumatic memory and that past memory is currently impacting your life, there is help. Learn how to deal with traumatic memories with one our a licensed therapists. Look for a trauma informed therapist, one that is trained in EMDR and other modalities used to treat these memories.

Oct3

How to Set Boundaries with Family

By Kim Wells - Family Therapy

With the holiday time upon us, we are pulled in several directions, from holiday parties, to baking, to having friends and family over, all the while juggling our jobs, kids, and relationships. So why are the holidays such a stressful time?

Many of us over commit, overindulge, and over EVERYTHING to make sure that those around us are happy and healthy. The problem with this approach is that when we do not set limits, we begin to feel overwhelmed, resentful and at times angry. Setting limits and boundaries is an effective way to manage our emotions and to set realistic expectations for all.

Here’s how to set boundaries with family during the holiday season.

What are boundaries? Boundaries are invisible lines that we place around ourselves that communicate to ourselves and others what is Ok with us and what is not OK with us. Effective boundaries are ever evolving and changing depending on the situation with the core limit being what is appropriate for me and what is not. Boundaries build TRUST. Nonexistent, lose or rigid boundaries decrease trust. Boundaries can come in many forms, including physical, mental, emotional, financial, moral, sexual, and spiritual. Our parents have taught us about boundaries whether they realized it or not. For example, if a teenager sees his mother saying “yes” to several commitments despite feeling overwhelmed, she may inadvertently teach the teenager that saying “no” can be seen as rude, unkind, or not caring of others. On the other hand, another mother who “always says no” to events may be teaching her children that rigid, inflexible boundaries are a better way to set limits.

I think that Brene’ Brown explains boundaries in a clear and easy to understand how to evaluate a situation and when to apply limits and boundaries…..she calls this BRAVING. BRAVING is described as:

B Boundaries-without boundaries there is no trust; must have appropriate limits

R Reliability-I can only trust you if you consistently do what you say

A Accountability- I can only trust you when you 1) own it 2) apologize for it 3) make amends

V Vault-I will keep what you say in confidence; I will not share other people’s stories

I Integrity- Choose 1) courage over comfort 2) what is right over what is fun, fast, & easy 3) practicing values not just professing values

N Non-judgement- Must be reciprocal and non-judgement towards other and self; cannot judge self for something and not judge others for the same

G Generosity-Assume the most generous words, intentions & behaviors and check in with me

It’s important to learn how to set boundaries with your family during the holidays. So, before you go into the holiday season, ask yourself if saying “yes” to the situation leads to BRAVING or breaking. Your friends and family will thank you for changing your approach and increasing their trust in what is OK with you and what is not OK with you.

Apr12

Does Group Therapy Work?

By Nicole McAnally-Turner - Group Therapy

Let’s start from the top, what is group therapy? Group therapy is a small group of people with at least one common issue or experience (personal, relational, societal) that gather to share their related thoughts and feelings. With the help of a group leader (therapist) or two, a safe and confidential space is provided where members give each other support, validation, suggestions, and ideas. Groups are either open or closed. Open groups allow members to join at any time, whereas closed groups begin with all their members.

Now that we know what group therapy is, you may be thinking “would group therapy work for me”? Thinking about being vulnerable in front of a group of strangers can be intimidating. Having some concerns and questions about the group is normal. Group therapy can offer members: a rewarding experience, camaraderie, accountability from members, empowerment, practice in sharing your thoughts/feelings with others, relief from the feelings of being the only one, self-discovery, and alternative points of view.

Can group really be just as helpful as individual therapy? Most participating members find that group therapy is in fact very helpful due to the interactions with other members that allow you to practice what you are learning both in and out of the group. Expect to get out of it what you put in, the same as you would for individual therapy. Mashinter, 2020 states, “The power of group therapy is in the recognition that the sufferer is not alone. An admission that other people have similar thoughts is one of the first steps to feeling healthy again”.

As a therapist who has facilitated group therapy before, I can say from experience that I have been able to witness the value that group therapy provides. I have seen members grow, learn, share, support each other and even look for more opportunities for group sessions in the future. Join us for group therapy and see for yourself if group therapy would really work for you.

References:

American Psychological Association. (2019, October 31). Psychotherapy: Understanding group therapy. American Psychological Association. Retrieved April 4, 2022, from https://www.apa.org/topics/psychotherapy/group-therapy

Kerslake, R. (2021, June 25). Better together? 5 benefits of group therapy. Psych Central. Retrieved April 4, 2022, from https://psychcentral.com/lib/benefits-of-group-therapy

M counseling and psychological services. University of Michigan Counseling and Psychological Services. (n.d.). Retrieved April 4, 2022, from https://caps.umich.edu/article/strategies-group-success

Mashinter, P. (2020). Is Group Therapy Effective? BU Journal of Graduate Studies in Education, 12(2), 33–36. https://doi.org/https://files.eric.ed.gov/fulltext/EJ1263014.pdf

Apr6

How to Take a Mental Health Day

By Kelsey Rood - Mental Health

A mental health day consists of taking a day off work, school, or daily responsibilities in order to give yourself a mental break. This can include focusing on your mental health, relieving stress, and working towards preventing potential burnout. It has also become clearer over the years that mental health holds as great of importance as physical health.

It is standard practice in many fields of work to take days off when feeling sick. This gives your body time to rest, heal, and reset. The same should be said for mental health. Research has shown that our mental state can have a direct impact on our physical health. Studies have shown that poor mental health can increase the risk and severity of chronic illnesses, sleeping difficulties, and developing health complications. Studies have also found that having overall positive mental health can decrease the risk of heart attacks, strokes, and various medical conditions. Mental health days are vital because by prioritizing mental health, we are also taking care of our overall well-being.

So now that we know why mental health days are so crucial, how do we take one and what should we do during that time? Mental health days can come in all shapes and sizes, fitting the mold of a person’s individual needs. Mental health days can be taken by calling out sick, taking time off work, or planning one in advance for a day you are already free. As previously stated, the overall goal of a mental health day is to decrease stress, process and evaluate your emotions, rest, relax, and reset. Doing so can help give a new perspective and a clearer mind to face the responsibilities that are ahead.

Below are some suggestions on what to do during your mental health day:

Pampering yourself: this can include (but not limited to) getting a massage, going to a spa or salon, taking a relaxing bath/shower.
Going for a run, walk, swim, or drive
Planning a fun activity out of the house, especially one you enjoy doing. This can be done alone or with a friend/loved one. Some examples include going shopping, visiting a museum, going to a park, attending local events, going to the movies, seeing a play, attending a concert, etc.
Taking time to do hobbies you enjoy doing. This can include video games, crafts, sports, dancing, puzzles, gardening, cooking, reading, watching TV/movies, drawing etc. This is one that is primarily dependent on what you like to do and are passionate about.
Exercising/doing yoga
Setting time to get a good night’s sleep/taking a nap
Eating regularly throughout the day & staying hydrated
Setting and evaluating goals you have for yourself and positive changes you would like to make.
Getting outside and moving around
Journaling
Meditating and practicing mindfulness techniques
Socializing, calling, facetiming, and communicating with friends and loved ones.
Nothing: sometimes what you may need most is to do nothing and give yourself the okay to not do anything. This day does not have to be productive in the traditional sense.

It is important to note that this is not an exclusive list of recommendations, and everyone will have their own idea and ways of having a positive mental health day. If you feel like you are overwhelmed, reaching a level of burnout, or just need time to decompress, take a mental health day. Make it your own and don’t forget to practice self-compassion and kindness!

References

WebMD Editorial Contributers (n.d.). Mental health: How it affects your physical health. WebMD. Retrieved April 3, 2022, from https://www.webmd.com/mental-health/how-does-mental-health-affect-physical-health

Scott, E. (July 30, 2021). When you should take a mental health day. Very Well Mind. Retrieved April 3, 2022, from https://www.verywellmind.com/when-and-how-to-take-a-mental-health-day-3144754

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