Therapy That Works...

Suicide - The Rising Rate of Teen Suicide - By Chris Gearing

Wednesday, June 05, 2013

Watch Dr. Sylvia Gearing discuss the rising rate of teen suicides, why American teens need more help than ever, and some of the warning signs of teen suicide - click here.

According to the CDC, one in five US teenagers considers suicide every year.

The American Psychological Association reports that teen suicide is the third leading cause of death for people who are 15 to 24 years old. So why would a teenager with every thing to look forward to in life choose a permanent solution such as suicide?

Most teen suicides begin with a perfect storm of upsetting events, like getting dumped by a significant other or losing a family member, that leads to overwhelming depression. If they lose hope and think that their life will never change for the better, they may begin to think about committing suicide. At a basic level, these adolescents lack the necessary coping skills to think accurately about temporary setbacks and how to overcome adversity.

There are several factors that can lead to teen suicide:

No Hope For The Future:

Suicide becomes an option for a young person when all hope is lost. In fact, hopelessness is the best predictor for a suicide attempt. Hopelessness is the most common emotion in those who attempt to end their lives.

Escaping Unsolvable Problems:

The motivations for either attempting or completing suicide are complex. In most cases, they are trying to escape depression and loss, debilitating anxiety, or a situation they regard as being unsolvable such as being bullied or abused. The older the child is, the greater the likelihood that their suicide is connected to interpersonal conflicts.

Hidden Mental Illness:

Mental illness, such as clinical depression or general anxiety disorder, is the top risk factor in suicide and accounts for 90% of all suicides. Clinical depression is the most common disorder linked to suicide. Children and adolescents are particularly skilled at hiding their mental health challenges since they do not know how to fully describe their thoughts and feelings. Since they are confused about what is going on inside of their minds, they don’t know when they need to ask for professional help.

Masking Their Pain:

Adolescents will not always articulate their pain because they often don’t understand the serious nature of their feelings. In fact, they may even present a happy façade. Psychologists describe this condition as a “smiling depressive” since they are hiding their clinically depressed thoughts behind a mask.

A lack of emotional coping skills combined with overwhelming situational stress can drive children and teens toward suicide. If you are worried about someone you know, please seek the assistance of a clinical psychologist.

Sources:

"Learned Optimism" by Martin Seligman, Ph.D.

"Unraveling the Mystery of Suicide" by Tori DeAngelis, American Psychological Association

"Suicide Among Pre-Adolescents" by Michael Price, American Psychological Association

"Teen Suicide is Preventable" published by the American Psychological Association

American Association of Suicidology, www.suicidology.org

National Institute of Mental Health, nimh.nih.gov

Anxiety - What Is Generalized Anxiety Disorder? - By Chris Gearing

Wednesday, May 15, 2013

Watch Dr. Sylvia Gearing describe what Generalized Anxiety Disorder looks like and what you can do to help - click here.

Generalized Anxiety Disorder affects over 6 million Americans every day.

They live with constant worry, unending concerns, and ongoing apprehension about the future. To escape their crushing anxiety, they withdraw from other people and avoid the things that make them anxious.

Generalized Anxiety Disorder, or G.A.D., grows over time and is built on every negative experience in a person’s life. Since it often begins in childhood, most sufferers wait 25 years before reaching out for professional help.

Here are a few important points about Generalized Anxiety Disorder:

Paired Disorders:

Ninety percent (90%) of G.A.D. sufferers have some kind of co-existing mental health disorder. Around 42% of people suffering with G.A.D. also have issues with depression, and one disorder usually is more prominent than the other.

Double Trouble:

Women tend to develop generalized anxiety at twice the rates of men. The rates of depression and anxiety double for girls around puberty, so their anxious thinking habits are more likely to take root in their teens and grow over time.

Suspicious Minds:

One of the principle features of generalized anxiety disorder is the tendency to worry and ruminate. Worry is a prominent characteristic of G.A.D. and occurs in 40 to 60% of cases. The worry creates a vicious cycle - we worry to soothe our own anxiety, which only makes the fear grow. If your mind is tied up with worrying all the time, you have little energy to rest, learn, or implement more effective ways of coping.

Intolerable Uncertainty:

Anxious minds cannot tolerate uncertainty or ambiguity. They have difficulty with leaving loose ends or having a lack of closure. They lack confidence in their ability to handle adversity or the unexpected, so they worry constantly to prepare for anything.

Generalized Anxiety Disorder can be a very serious condition. If you are worried that someone you know may be living with an anxiety disorder, please seek the assistance of a clinical psychologist.

Sources:

Treatment Plans and Interventions for Depression and Anxiety Disorders: Robert Leahy, Stephen J.F. Holland and Lata McGinn, Guilford Press, 2012.

Wittchen, H. U., Zhao, S., Kessler, R. C., and Eaton, W.W. 1994, DSM III-R Generalized Anxiety Disorder in the National Comorbidity Survey, Archieves of General Psychiatiry, 51/(5), 355-364

Rubio, G. and Lopez-Ibor, J.J. 2007, Generalized Anxiety Disorder: A 40 year follow up study. Acta Psychiatrica Scandinaviaca, 115 (5), 372-379

Blazer, D., George, L., and Winfield, I. 1991, Epidemiologic data and planning mental health services: A tale of two surveys. Social Psychiatry and Psychiatric Epidemiology, 26, 21-27.

Breslau, N and Davis, G.C., 1985, DSM-III generalized anxiety disorder: An empirical investiagation of more stringent criteria. Psychiatry Research, 15, 231-238.

Kessler, R.C., Walters, E.E. and Witchen, H.U. 2004, Epidemiology. In R.G. Heimberg, C.L. Turk, and D.S. Mennin (Eds) Generalized Anxiety Disorder, Advances in research and practice (pp29 to 50). New York: Guildord Press.

Butler, G, Fennerll, M., Robson, P and Gelder, M. 1991, Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxity disorder. Journal of Consulting and Clinical Psychology, 59, 167-175.

Rapee, R.M. 1991, Psychological Factors involved in generalized anxiety. In R.M. Rapee and D. H. Barlow (Eds.) Chronic Anxiety: Generalized Anxiety disorder and mixed anxiety depression (pp. 76-94). New York: Guilford Press.

Intolerance of Uncertainty and Problem Orientation n Worry, Michael Dugas, Mark Freeston, Robert Ladouceur, Cognitive Threrapy and Research, Vol 21, no 6, 1997, pgs. 593-606

Anxiety - The Differences Between Normal Anxiety and Anxiety Disorders - By Chris Gearing

Friday, May 10, 2013

Watch Dr. Sylvia Gearing describe how to tell whether your anxiety is normal or when it might be time to seek professional help - click here.

Anxiety is an appropriate reaction to situations that are negative and unexpected.

Normal anxiety is present during and shortly after an adversity. However, once the situation resolves, the tension should dissolve and the mind should return to a calm state of being. There should be no lingering anxious thoughts or after effects. You simply move on.

If anxiety persists for days or even weeks after an event, it may be indicative of an anxiety disorder.

Anxiety disorders differ from normal anxiety in specific and important ways including the following:

A Way Of Life:

Anxiety disorders don’t give up easily. They are tenacious and can become a way of life. Anxious thoughts can define the way we look at life, how we act, how we view other people, the way we think about ourselves, and much more.

Missing Evidence:

An anxious mind is always searching for evidence to support its anxious thoughts. Entrenched anxiety disorders cause us to discount evidence that disputes our negative thoughts and to only encode what confirms our pessimistic view.

People Problems:

Chronically anxious people seem to have a lot of trouble getting along with those around them. Anxious and distorted thoughts interfere with our ability to relate realistically and effectively to those around us. They cause us to misinterpret others and inappropriately react to their actions.

Quick Triggers:

Anxious minds can go from calm to a full-blown anxiety attack within minutes. The symptoms can be brief or progressive waves of tension that are overwhelming.

Brain Freeze:

High levels of anxiety can disrupt your ability to think clearly and accurately. While small amounts of normal anxiety may mildly compromise the person’s effectiveness, severe and chronic anxiety may render the person unable to function. They literally freeze and fail to react at all when an immediate response is important. The mind is locked up in wave after wave of debilitating anxiety.

Impulsive Distractions:

Anxiety disorders can provoke a wide variety of impulsive self-destructive behaviors. These behaviors often represent their desperate efforts to escape their overwhelming anxiety and to be calm even if it is for a little while.

Anxiety can be a very serious condition. If you are worried that someone you know may be living with an anxiety disorder, please seek the assistance of a clinical psychologist.

Sources:

"The Anxiety and Phobia Workbook" by Edmund Bourne Ph.D.

The Anxiety and Depression Association of America, www.adaa.org

Anxiety - What Is Anxiety? - By Chris Gearing

Monday, May 06, 2013

Watch Dr. Sylvia Gearing describe what clinical anxiety is and how it can happen to you - click here.

Anxiety disorders are the number one diagnosed mental health disorder in America.

Forty million Americans regularly experience high levels of anxiety but only one third of sufferers ever receive treatment. Anxiety is extremely expensive for our country’s healthcare system and it accounts for close to one third of all mental health costs in the United States.

Anxiety causes us to feel high amounts of tension, uncertainty, and fear often without any specific threat or problem.

Anxious individuals feel like their mind cycles in a continuous loop of speculation, worry, and confusion about what is going to happen next. Despite their best efforts, they just cannot seem to give their mind a break. The endless nervous thoughts are disruptive to sleep, work, and their sense of wellbeing.

Anxiety disorders can develop for many reasons, but here are some of the most common:

In Your Genes:

Anxious thinking and anxiety disorders may run in the family. If you have an anxiety disorder, then one out of ten people in your family may also have anxiety issues.

Trauma Sequence:

Trauma is often deregulating and interrupts our ability to effectively manage our emotions, especially anxiety. Before trauma, we may have handled adversities with ease. However once our minds have been deregulated by the traumatic event, we may be waging constant battle against our anxious thoughts.

Begins In Childhood:

When there is child abuse, excessive uncertainty, change and struggle with difficult parents, or unpreventable trauma in childhood, anxiety may gain a foothold. Although most of us develop higher rates of anxiety in our twenties, many anxious adults began dealing with their anxious thoughts in childhood.

Loss of Relationships:

Traumatic breakups that leave us feeling confused, lost, and helpless can start the cycle of anxiety. Our positive beliefs about other people can be shattered and we may develop serious trust and anxiety issues.

Anxiety can be a very serious condition. If you are worried that someone you know may be living with an anxiety disorder, please seek the assistance of a clinical psychologist.

Sources:

"The Anxiety and Phobia Workbook" by Edmund Bourne Ph.D.

The Anxiety and Depression Association of America, www.adaa.org

The Violent Influence of Siblings - By Chris Gearing

Monday, April 29, 2013

Watch Dr. Sylvia Gearing describe how siblings can make each other more extreme in their views and more violent toward the world - click here.

Two brothers planned, built, and detonated multiple bombs at the 2013 Boston Marathon.

Many people are wondering how one brother with a promising future could allow himself to be lead astray by his troubled and angry older brother. What would lead him to abandon and attack the city that had celebrated and rewarded him?

Absent Parents

Parental absence in late adolescence can be highly damaging with certain children. Without their parents around, they may have no one to keep them in line and remain a positive influence. A teenager can become involved in social movements and militant causes without fully understanding the motivations and implications of such activities. It is easy to overestimate the maturity of a late teen or early twenties child who is still mentally developing and defining who they are.

A Convincing Sibling

An older sibling who champions extreme or militant causes may be impossible to resist. They can be a strong influence on an insecure younger sibling who lacks immediate parental guidance and insight into the older sibling’s troubles. The younger teenager may be mesmerized and convinced by a sibling out of control.

Tests of Love and Loyalty

Particularly when there is a specific cause or injustice to be avenged, a trusting and naïve teenager can be convinced by the irresistible arguments of their older, more experienced sibling. Older siblings often frame the cause as a test of the younger sibling’s love and loyalty.

The Bond of Violence

Violence can be an alluring bond for young men who are lost. Anger and violence are unfortunately a legitimate way to connect for boys and men. If there is a common goal to avenge a perceived injustice, any prohibitions against violence or murder may diminish and fade away.

A Developing Mind

In late adolescence, many adolescents still lack consistent, critical thinking skills necessary to reason their way through an ambiguous situation. They simply may not understand how irrational and extreme ideas can sound plausible and logical at first. Faulty, paranoid assumptions can sound reasonable to an inexperienced mind that is impressionable and naïve. Our fully developed frontal lobes and our critical thinking skills restore reality by reminding us of alternative explanations that are more realistic and often more accurate.

In the end, sibling bonds often last a lifetime and most of the time only lead to benefits for both parties. The crimes in Boston teach us once more that misplaced loyalty can be one of life’s greatest mistakes.

Sources:

The work of Gavin de Becker

The work of Dr. James Masterson

The work of Dr. John Exner

How Gearing Up Treats Eating Disorders - By Chris Gearing

Wednesday, March 06, 2013

Watch Dr. Sylvia Gearing describe how Gearing Up treats eating disorders and some of the most effective therapies for eating disorders - click here.

Eating disorders affect millions of people every year and despite valiant efforts, many patients remain mired in unhealthy eating habits. At Gearing Up, we are committed to coaching our patients to maximum success.

We believe in evidence based treatments and utilize well executed approaches to eating disorders including:

Cognitive Behavioral Therapy:

This approach focuses on the relationship between core beliefs and thoughts, and negative emotions and behavior. By evaluating and challenging negative thinking, we can achieve an improved accuracy that leads to healthier eating and more effective living. CBT helps people with eating disorders to correct larger misperceptions about their body and their unhealthy lifestyle.

Dialectical Behavior Therapy:

This approach emphasizes skills building in the face of strong, negative emotions. Managing strong emotions often requires a set of skills to distract, sooth, and tolerate emotional distress. Developed by Dr. Marsha Linehan, DBT teaches clients that dysfunctional behaviors must be replaced by more effective skills. Since many eating disorders thrive with impulsivity and distressed minds, DBT can be a critical intervention to stop unhealthy eating cycles.

Maudsley Based Family Treatment:

This treatment approach recognizes the parents’ central role in guiding and leading their child back to health and is one of the most effective therapies for eating disorders. In addition to intensive individual therapy, we work closely with parents in family therapy and in nutritional counseling to plan and support their child’s recovery. Hopefully, interventions throughout the home and family will create an atmosphere for recovery and healing.

Psychological Testing:

We often utilize personality testing to evaluate psychological resources at a deeper level including cognitive style, emotional and informational processing approaches, affective features, self-control and willpower, the ability to tolerate stress, tendencies toward impulsivity, and self-sabotaging behaviors. Testing gives us a kind of psychological x-ray so we can pinpoint the issues that we need to address and direct treatment effectively.

Coordinated Care:

To effectively address an eating disorder, we coordinate with other professionals including a nutritionist and a physician to round out our understanding of diet, nutrition, and physical health. With every professional coordinating treatment, we have the best chance at effectively treating the eating disorder.

Sources:

The New Maudsley Approach (http://thenewmaudsleyapproach.co.uk/Home_Page.php)

The National Institute of Mental Health (www.nimh.nih.gov)

The work of Dr. Marsha Linehan

Eating Disorders: Not Otherwise Specified - By Chris Gearing

Monday, March 04, 2013

Watch Dr. Sylvia Gearing discuss the "Not Otherwise Specified" diagnosis for eating disorders and what they mean - click here.

Anorexia nervosa, bulimia, and binge eating disorder are the best-known eating disorders and among the most lethal. However, Eating Disorder, Not Otherwise Specified is also a dangerous, persistent eating disorder that can disrupt an otherwise successful life.

This eating disorder diagnosis is reserved for those patients who do not meet all the criteria of the previously mentioned eating disorders. For example, a patient may severely restrict her diet but not to the point where she experiences an absence of menstruation.

According to some experts, approximately 70% of eating disorders fall under the “Not Otherwise Specified” diagnosis.

The presence of this type of eating disorder suggests several important points:

Progressive & Evolving:

Eating disorders are dynamic illnesses and do not always follow one, strict course of development. For example, a young girl may begin her eating disorder by restricting food and then move on to bulimia in which she regularly binges and then purges. The “Eating Disorder, Not Otherwise Specified” diagnosis indicates that the eating disorder is responsive to the environment and to the developmental and life changes that often come during adolescence and early adulthood.

Fluid Symptoms:

This type of eating disorder also demonstrates how difficult it is to classify this illness within one static category. The fundamental problem in eating disorders is the effective management of the self, both emotionally and cognitively. While the symptoms may vary, the basic problem often remains the same.

Processing Issues:

Since eating disorders can be such stubborn mental health issues, psychologists and neuroscientists are beginning to explore the neurological aspects of eating disorders. For instance, people with eating disorders tend to have difficulty with more abstract thinking and executive functioning – they tend to notice the details and miss the greater picture. At other times, they may be show a lack of cognitive flexibility which means that they struggle to be less rigid and adaptable in handling food and how they feel about themselves.

Eating disorders are very serious conditions, and they can even be lethal. If you think you or someone you know may have an eating disorder, please seek the assistance of a clinical psychologist.

Sources:

http://thenewmaudsleyapproach.co.uk/Home_Page.php

The work of Dr. John Lock

The National Institute of Mental Health (www.nimh.nih.gov)

Eating Disorders: Binge Eating - By Chris Gearing

Friday, March 01, 2013

Watch Dr. Sylvia Gearing describe what Binge Eating is, what it looks like, and signs of when it's time to get help - click here.

Eating disorders are serious emotional and behavioral mental health conditions that disrupt the individual’s ability to handle food appropriately.

Food becomes an “emotional thermostat” and is used by the individual to control emotions and to lower stress. Routine eating disorder habits include food restriction, excessive consumption of food, purging of food usually by laxatives or vomiting, and compulsive overeating in a short amount of time.

The most common of all eating disorders, binge eating disorder can be a chronic and painful problem.

It affects women more than men and it can last hidden for years by a veil of shame, secrecy, and stress. Since this eating disorder does not involve purging behaviors or excessive exercise, the people suffering with the disorder present with either average weight or are overweight. As with other eating disorders, binge eating involves a central focus on food and the power of food to modulate stress and adversity.

Binge eating disordered patients tend to have higher levels of depression.

In one study, researchers found that these patients had about twice the risk of depression over their lifetime. In addition, these patients struggle with feelings of inadequacy interpersonally, often due to the distress about their body and their disordered eating. Many sufferers reported the disorder affecting their work and impairing their regular activities. It is difficult to be your best when healthy eating is a challenge.

Rapid Consumption:

Frequently, rituals of food consumption are built into daily schedules. The food is most often purchased, either through an impulsive or scheduled visit to the store or fast food outlet and is consumed rapidly in a short amount of time. Rapidity of consumption is usually one of the main clues to this disorder.

Emotional Seesaw:

Following the binge, the individual often experiences an uptick in mood. The food is calming and soothing in the short run. There are usually momentary feelings of control or satisfaction. However, they are soon followed by feelings of shame, self loathing, and depression as they begin to deal with the realities of overeating. Clothes don’t fit, bodies are bloated, energy is sluggish, and any possible weight goals are compromised or eliminated.

Here are some other signs to watch out for:

  • Excessive eating when they don’t feel hungry
  • Eating until there is discomfort
  • Eating rituals that emphasize isolation, secrecy, and control
  • Anger and resentment if any eating ritual is interrupted
  • Depression, negative mood, and feelings of being out of control following the binge cycle
  • Ineffective dieting caused by the caloric overload of binging

Eating disorders are very serious conditions, and they can even be lethal. If you think you or someone you know may have an eating disorder, please seek the assistance of a clinical psychologist.

Sources:

"Dialectical Behavior Therapy for Binge Eating and Bulimia" by Debra L. Safer, Christy F. Telch, and Eunice Y. Chen

The National Institute of Mental Health (www.nimh.nih.gov)

How Parents Can Overcome The Empty Nest - By Chris Gearing

Friday, March 01, 2013

Watch Dr. Sylvia Gearing on CBS 11 discuss how parents can cope with the empty nest - click here.

Talking To Your Children About The Sandy Hook Elementary Shooting - By Chris Gearing

Saturday, December 15, 2012

Watch Dr. Sylvia Gearing on CBS 11 discuss how to explain to your children about the terrible school shooting at Sandy Hook Elementary in Newtown, CT - click here.


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