The New Year and a New Focus on Yourself





As the holidays come to an end, this is the time of year where the minds of many people begin evaluating the past year and turn their focus, sometimes with a mix of excitement and dread, toward the New Year. It’s late December and I can almost hear the voices of clients new and old who will begin arriving in the first week of January.
There are the clients who want to spend more time with family and friends. There are others who want to lose weight and work on their physical fitness. Others still would like to quit smoking or drinking, to learn to enjoy life more, to improve their mental health, to get out debt and learn something new. It’s not uncommon to hear people talking about doing something to help others, or finding a new job and getting organized.
Each year our coaches work with people to accomplish those goals.  Our hands-on, action-oriented life coaching, career coaching and wellness coaching is results-oriented and goal-directed. It seeks to help clients to move from the stage of figuring out goals and preparing plans to actually acting on those efforts and following through until the goals are completed--or adjusted as desires and expectations change.
In the meantime, for those of you who are in the Washington, D.C. area and are looking for some do-it-yourself ideas, we’ve compiled a list of ideas below that will help get you jumpstarted:


1.    More Time with Family and Friends. Washingtonians seem to be one of the few groups that do not take advantage of the Washington area. With its wealth of resources, museums and outdoor attractions, there are plenty of healthy activities to do with family and friends. Among our top suggestions are visiting the Smithsonian museums or the National Zoo, touring the national monuments and memorials, touring the three houses of government, taking a walk through Georgetown, walking or biking through the C&O Canal, or seeing a show at the Kennedy Center or a concert at Wolftrap. Exploring Mount Vernon, taking a hike through Great Falls Park, taking a walking tour of Old Town Alexandria or visiting the Northern Virginia RegionalAuthority parks are great options for spending time with friends or family.

2.    Quitting Smoking and Drinking. Studies have shown that the best way to quit smoking involves a combination of medication, the patch and smoking cessation classes. The Inova Health System offers smoking cessation classes, personal quit coaches, smoking cessation seminars and a support group that meets the 2nd and 4th Saturday of every month from 11:00 a.m.-12:00 p.m. in Fairfax. Our wellness coaches work to help people quit smoking, while our mental health coaches work to help people trying to quit drinking or manage other addictions.

3.    Physical Fitness and Weight Loss. Goose Creek’s Wellness Coach, Sharon Craddock, and fitness consultant, Natalie Schneck, work with clients to help people improve their lives through health, fitness and other holistic wellness methods. Wellness coaches work as your encouraging partners in getting healthy, losing weight, coming up with and following through on a fitness program and other things that will improve your health.

4.    Volunteering. Our work often involves connecting clients with opportunities to volunteer their time. Helping others can provide a great sense of satisfaction, boost your self-esteem and help provide meaningful contributions to others. We’ve recently worked to people obtain volunteer opportunities with the USO, a therapeutic horse riding school for children with special needs, the Loudoun County Salvation Army and a variety of other organizations. A great source for matching yourself with volunteer opportunities is the Washington, D.C. volunteermatch.org page. It provides interactive tools to help match your profile and interests with opportunities that are out there.

5.    Career Change and Development. Our coaches use a variety of resources to help clients with career development and career change, including career coaching, career testing, resume preparation, cover letter preparation, interview preparation (including mock interviews) and job retention coaching.

6. Improving Your (Or Your Child's) Grades. Our coaches often work with people with learning disabilities, executive function problems and other academic problems to help improve their comprehension, absorption of knowledge, test-taking skills, structure, organization, prioritizing, routine, executive functioning, writing and other things that help improve grades


This is not, obviously, an exhaustive list of the resources available out there or the services that we provide. We do wish you luck in your New Year and with accomplishing your goals. Please let us know if there is anything we can do to assist you.





Redefining Help: How Can I Get Help for My Teenager?

A father named Sean and a mother named Mary come into the Goose Creek Coaching office to make an appointment with me because his teenage daughter is having difficulties attending school because of anxiety and is having emotional outbursts at school that don't fit the traditional profile of a mood disorder.

In a family session prior to my first meeting with their 16-year-old daughter, Michelle, we go through her history of performing well academically in schooling, but failing out of classes because of attendance problems. We discuss the crowd of people that she hangs out with and their drug use. We discuss the physical altercations she has been involved with over the years. We talk about the impact on her 13-year-old sister. Michelle has no history of legal interaction other than a court order stating that her parents must make sure she attends school.

Over the course of many months of treatment, we are able to work with a child psychiatrist that I have recommended to stabilize her mood and reduce her anxiety. Problems with Michelle's mood and anxiety creap up less frequently. Michelle is compliant with the doctor's orders when it comes to medications and says she sees positive results on the mood stablizing and anxiolytic medications her doctor uses. In coaching, we work on coping skills and social skills that help Michelle better manage her anxiety about school and social situations. There is no need to work on academic skills, because, as her teachers say, when Michelle is in class she does exceptionally well. Our  rapport is good and we have positive results. Michelle still struggles with getting to school, but she is doing her best. Her father is happy that the truancy officer is off his back and that Michelle is getting a better education.
A problem begins to emerge about three months into the school year. Michelle is making it to school more, but there have been several instances where she has ended up in altercations with other girls at the school and has had arguments with teachers. We notice a pattern between these altercations and arguments with teachers. In the following days, it is almost impossible for her to make it to school.

The truancy officer shows up at her parent's door. He is demanding that Michelle attend school or her parents face charges. In Loudoun County, two parents were charged last year with truancy, so, even though this is Fairfax County, my client is taking this seriously. We have several options to consider here, so I recommend to the father that we meet with Michelle's psychiatrist to see what he would recommend, and then get an educational advocate and a family law firm that has worked with our clients before involved in order to protect Michelle and her family.

My first recommendation is to sit down with Michelle's psychiatrist and see her recommendations. After the meeting, we see that the psychiatrist is still hopeful that Michelle will be able to attend school in a normal setting, but said she will begin working on home-bound school paperwork in case that step needs to be taken. We meet with the educational advocate so the advocate, the parents and Michelle can begin looking for alternative school options in the event that's necessary. Michelle is frustrated by now and has said she plans to run away.

I reach out to the guidance counselor at school, who has been working with us and Michelle, and also the school psychologist. We decide it would make sense to meet with school administrators, Michelle's teachers and family members for an eligibility meeting to determine whether we should consider looking at an IEP (Individualized Educational Plan) for Michelle and what steps we could all take before then.

We meet with the school officials, including the guidance counselor, the school psychologist, two assistant principals, two of Michelle's teachers who have a good rapport with her. We inform the school that we have engaged an educational advocate in the event that the county school system is unable to provide her a free public education (in that case, the school system would be responsible for paying for any alternative placement) and a family lawyer in the event that truancy charges become an issue. Another reason we have engaged the family lawyer, which we don't say here, is in the event that we need to file a Child In Need of Supervision (CHINS) petition with the Fairfax Juvenile Domestic Relations Court. A CHINS petition is a non-criminal procedure that brings the state's resources in to help manage problems with truancy, running away or behavior that may result in threat to well-being or psychical safety, and events that are prohibited but would not be criminal violations for an adult, such as tobacco possession and curfew violations.

From the school records I have gathered, I can see that Michelle scores As on virtually every in-class assignment she is present for and turns in most of her homework.  We would like an IEP on the table as a possibility for the future, but we'd like to work on less restrictive steps, including allowing Michelle to do work at home on some days when she is too anxious and me coaching teachers on how to respond when she experiences anxiety, mood swings or behaviorial problems.

We create a weekly reporting system where Ms. Dowd, the guidance director, solicits overservations from all of Michelle's teachers and the team involved in the situation once a week and then sends a report to the father, who forwards it to me and her psychiatrist. I recommend that teachers continue to encourage her in her successes and that only counselors engage her on the difficulities caused by her mental illness. I continue to work with my client on coping skills, but am able to use information received by the school officials to make adjustments to our regime and to pass on information that her psychiatrist says will be helpful to her medical treatment.

In my experience, parents and schools often work well together once the misconceptions about what is happening with a student are cleared and a uniform approach is adopted among the parent-school team. In this case, we had the family lawyer and educational advocate  lined up in case it did not work out that way or in the event that we need to revisit the situation at a later date.

In the end, we determine that the high school Michelle is attending is not the best one for her. The educate advocate has luckily lined up a placement an a therapeutic boarding school for girls in West Virginia.. But Sean and Mary are hesitant because of the costs associated with the program. We work with the education advocate to find a financing company that specifically provides parents loans for these types of schools.

Michelle heads off to spend her senior year in the West Virginia boarding school, which provides a similar level of care as the one she received at Goose Creek. She graduates with a 3.7 GPA, no academic problems and has stopped using marijuania. She plans to attend George Mason University to study psychology in the Fall.

This example highlights the benefits of a mental health coach, who can coordinate care with health providers, family members, school officials an education advocates.

Stay tuned for the next blog, which is the first in a three part series on the involuntary and voluntary mental health hospitalization process in Virginia. The blog includes what you should expect, what the legal and medical standards are for hospitalization, the impact on your job, how the family should prepare for transition, aftercare planning and even information about the impact of mental health hospitalization on security clearances.

- Jayson Blair, Certified Life Coach

To find out more information about Goose Creek Coaching, contact us at www.goosecreekconsulting.com/contact.php or (703) 574-6271, Ext. 700.

Disclaimer: Blogs in the Redefining Help series are hypothetical stories based on the experiences of clinicians at Goose Creek Coaching. They often draw from the experiences of clients and families that we work with, but are general amalgamations of several experiences. They are designed to educate you about the services we offer and realistic outcomes.

Mental Health Professionals Seek to Help Victims of Sandy

 After September 11 and Hurricane Katrina, mental health professionals from across the country further developed plans for disaster response and triage. These professionals are getting a large-scale chance to put those plans into action on the Far Rockaways in Queens, New York as they are providing mental health services to the survivors of Hurrican Sandy.

This psychological first aid, as it is known, is designed, like mental health coaching and mental health case management, to address immediate concerns as opposed to long-term issues. According to the Huffington Post, "Their work did not involve psychotherapy sessions and diagnosis but rather tending to the immediate needs of survivors".

We are well-aware that many people in the Washington, DC have relatives in the affected areas who are in need of mental health support in the aftermath of the hurricane.

For more information:
http://www.huffingtonpost.com/craig-l-katz-md/sandy-mental-health_b_2240907.html

ADHD Study Suggests Long-Time Links to Crime, and We Offer Help

A study recently published in the New England Journal of medicine suggests a link between crime and older teenagers with attention deficit disorder and attention deficit hyperactivity disorder. Past studies have suggested a link between crime and the impulsiveness problems in teenagers ADHD, ADD and other executive functioning disorders. The study suggests that treatment of ADHD and ADD with stimulants can help counteract these problems and reduce the likelihood of teenagers with ADD and ADHD committing crimes.

Dr. Imran Akram offers psychiatric medication management services to treat ADHD and ADD, and his experienced in treating individuals with AD/HD and co-morbid illnesses, such as depression, bipolar disorder, anxiety and substance abuse. Goose Creek coaches Jayson Blair and Valerie Tunks also help clients with AD/HD through AD/HD coaching designed to help teenagers with impulsiveness, prioritizing, organization, time management and other executive functions.

For more information about psychiatry and AD/HD coaching services in Goose Creek Coaching's Centreville and McLean offices you can contact us at (703) 574-6271, Ext. 700.

PSYCHIATRY

Centreville Office
http://www.goosecreekconsulting.com/psychiatrist-medication.php

McLean Office
http://www.goosecreekcoachingmclean.com/medication-management.php

AD/HD COACHING


Centreville Office
http://www.goosecreekconsulting.com/add-adhd-coaching.php

McLean Office
http://www.goosecreekcoachingmclean.com/adhd-coaching.php


Older teens and adults with attention deficit disorder are much less likely to commit a crime while on ADHD medication, a provocative study from Sweden found.
It also showed in dramatic fashion how much more prone people with ADHD are to break the law - four to seven times more likely than others.
The findings suggest that Ritalin, Adderall and other drugs that curb hyperactivity and boost attention remain important beyond the school-age years and that wider use of these medications in older patients might help curb crime.
"There definitely is a perception that it's a disease of childhood and you outgrow your need for medicines," said Dr. William Cooper, a pediatrics and preventive medicine professor at Vanderbilt University in Nashville. "We're beginning to understand that ADHD is a condition for many people that really lasts throughout their life."


Read more: http://www.foxnews.com/health/2012/11/23/adhd-medicines-may-help-curb-criminal-behavior-study-suggests/#ixzz2Dhzrqns5 
http://www.foxnews.com/health/2012/11/23/adhd-medicines-may-help-curb-criminal-behavior-study-suggests/

Preparing students with ADHD for College

USA Today presents an interesting take on the reasons many students with ADHD and ADD flounder when they head off to college.  This report contracts a body of research that students with other types of learning disabilities often perform much better in college than those with ADHD and ADD.

Children with ADHD and ADD often have average-to-high-average IQs, but their performance tends to be below their potential. The reason for the lack of success in college is that ADHD and ADD are both disorders of inattention and/or hyperactivity, but also primarily disorders of executive functioning that lead to students making more poor choices because of impulsive decisions, poor time management, disorganization and other executive functioning factors.

More alternatives for students with ADHD and ADD exist, including special colleges for people with ADHD or ADD bridge gap year programs that allow students to take more time to prepare for college and action-oriented, practical coping skills options available at Goose Creek Coaching.

Contact us by email or phone by clicking here or calling us at (703) 574-6271, Ext. 700.

Bill Collins to Offer Business Coaching in Goose Creek Offices



Goose Creek Coaching is excited to announce that Bill Collins, a certified business coach, will be available to meet with clients out of Goose Creek Coaching offices in Centreville and McLean starting on October 1, 2012.  Bill, who is an independent coach and is not a part of the Goose Creek Coaching practice, provides proactive coaching for small business leaders and executives in larger organizations. 

Bill is a business practitioner himself and coach with more than 30 years of experience managing programs, projects and improvement initiatives. In addition to running his own business, Bill has broad managerial experience in staff and line positions across multiple functional disciplines and in private industry and consulting. Bill’s key strengths include strategic thinking, mentoring and developing people, recognizing problems and implementing solutions, organizing for improved performance, researching, analysis, writing and teaching.
In his coaching practice, Bill works with business owners and executives to achieve better business results, more personal fulfillment, and less stress and uncertainty.  Often this work entails addressing issues of time, team, money, and exit.

 I’m excited to be working with the top-notch coaching professionals at Goose Creek Coaching,” Collins said.  “I’m always looking to bring more value and a better coaching experience to my clients, and the Goose Creek office locations in Centreville and McLean enable me to do that.

Bill is a recognized expert in operations management, with more than 15 years of experience in manufacturing and distribution companies, including Mars, Incorporated and Dal-Tile Corporation.  He also has extensive experience implementing and using information systems.
Bill shares and expands his knowledge through writing, speaking, and teaching on a broad range of business subjects, including operations management, business intelligence, performance management, and information technology (IT).  He has had 12 articles published, spoken at conferences and meetings and taught for multiple associations and organizations.

Bill has been utilizing Goose Creek Coaching space for several months now. The new arrangement will allow him to become more available in the Goose Creek offices.

“We’re thrilled to have a business coach of Bill’s caliber available to clients near our Northern Virginia offices,” said Jayson Blair, the managing partner of Goose Creek Consulting, L.L.C. “As we have seen, our clients often reach out for business, career and life coaching at the same time, and we are glad that in this difficult economic times that we can recommend someone as dynamic and intelligent as Bill.”

Bill’s education includes a Master of Liberal Arts (MLA) from Southern Methodist University, an MBA from Benedictine University, and a BS in mathematics from Western Illinois University.  He is a Certified Fellow in Production & Inventory Management (CFPIM) by APICS and a Project Management Professional (PMP) by the Project Management Institute.

FOR MORE INFORMATION

For Bill Collins:
Bill Collins

For Goose Creek Consulting:
Stephanie Hassell
(703) 574-6271, Ext. 700 | stephanie@goosecreekconsulting.com

Psychological Testing Now Available at Goose Creek's Centreville Office

Mary Koralewski, PhD., an independent clinical psychologist whose primary office is in Warrenton, will be available in Goose Creek Coaching's Centreville office to provide psychological testing. Psychological testing involves using samples of behavior in order to assess the cognitive, intellectual, emotional, vocational or academic functioning of an individual. The test results can help with the diagnosis of mental health disorders, school and work accommodations and recommendations for coping skills and services to improve quality of life.

Dr. Koralewski earned her undergraduate degree in psychology from Texas A&M University, her master's and doctorate degrees in psychological sciences from Purdue University. She has worked at various inpatient and outpatient settings, including Prince William Hospital. In addition to psychological testing available through Dr. Koralewski's independent practice, Goose Creek provides career testing through its career coaches and Imran Akram, MD, provides forensic and psychiatric evaluations. For more information about psychological testing and career testing at Goose Creek, please contact us at (703) 574-6271 or info@goosecreekconsulting.com.

Time Says that one U.S.soldier commits suicide every day

Time magazine tells us in its July 23 cover story that one U.S. soldier commits suicide each day. The magazine notes that "more U.S. soldiers have killed themselves than have died in the Afghan War" and then it asks, "Why can't the Army win its war on suicide?" Part of the text of the article (for those who do not subscribe to Time) is available courtesy of Florida State University.

The article interviews two widows of men who committed suicide. One man sought help and were turned away. One  story also examines a Army doctor in Hawaii who faced depression and who was rebuffed by Army mental health. Military officials told her it was "a family problem." Soon, the doctor hung himself in the Army hospital in his full uniform. The Time correspondent concludes in this video that the "knocks on the mental health doors often go unanswered."

Stigma is only one of the problems those who are depressed or struggle with PTSD in the military face. According to a 2010 New York Times article, the Army has 3,800 therapists and psychiatrists, two thirds more than it had in 2007. In the Times article, the author notes that too few soldiers are screened for mental health problems when they return from theater.The number of mental health professionals is too low and many are devoted to the security clearance process, the disciplinary process and "force readiness" (which means, in part, making sure people complaining of mental health problems return to the field of battle).

“The military still blames the soldier, saying it’s financial stress or family stress, and it is still waiting for the service member to come forward,” told Paul Sullivan, the executive director of Veterans for Common Sense.

What Internet Anxiety has in Common with Bath Salts, Stranger Danger and Satanic Ritual Abuse

Newsweek published a recent cover story called Is the Internet Making Us Crazy whether they Internet, which has made inroads into everything Americans do, has made us more anxious. The article theorizes whether in the world of texts, tweets, emails, posts and other forms of less personal communication has made us more lonely, anxious and depression. The conclusion is based on a "Newsweek's review of findings from more than a dozen countries," including brain scan data.

According to Newsweek, the review:
... finds the answers pointing in a similar direction. Peter Whybrow, the director of the Semel Institute for Neuroscience and Human Behavior at UCLA, argues that “the computer is like electronic cocaine,” fueling cycles of mania followed by depressive stretches.
 But, in reality, the Newsweek piece seems to be a classic example of moral panic stories, where journalists and researchers identify thinly sourced trends that appear to threaten the social order but with a closer look appear more dubious   (See  human sex trafficking, bath saltsSatanic ritual abuse, "stranger-danger" and child sexual abuse, Dungeons and Dragons and Internet screen time, as well as VCR, television and radio time before them).

It comes as no surprise that Newsweek competitor Time pokes a couple of holes in the magazine's theory, attacking every platform in the story. Time notes that brain scans cannot "predict ... who will be able to regain control over their behavior and who will not" and that " there is no brain scan that can clearly determine whether certain brain changes signify addiction or simple, harmless enjoyment."

The Time piece notes that one of the key sources, Baroness Susan Greenfield, a pharmacology professor at Oxford,"never published a study on Internet use," adding:
The logic behind her claims is often befuddling: for example, this is how she attempted to explain why she believes the Internet has something to do with the recent rise in autism, in a 2011 interview with the Guardian: “I point to the increase in autism and I point to Internet use. That’s all.” Obviously, that is not scientific reasoning, which is why her comments inspired an Internet meme (among other outrage and disdain) that trended on Twitter.
The Time article concludes that Newsweek sqaundered an opportunity with its cover story. "The Internet might indeed be a cause of our societal worries, but not necessarily because we’re addicted to it," the Time author wrote. "And creating a moral panic based on flimsy evidence isn’t going to help, no matter what the real cause of our problems."



Ex-CIA Officer Takes On Postpartum Mental Health Conditions

Valerie Plame Wilson, best known for her role as a Central Intelligence Agency operations officer who worked to fight nonproliferation before being outed in a battle between the White House and the CIA over weapons of mass destruction in Iraq, has become an advocate in an important, and much ignored, area of mental health: postpartum mental health conditions.

According to an NPR interview with Wilson:
Years before CIA agent Valerie Plame Wilson's cover was blown in a newspaper column, she faced a private struggle with postpartum depression. After giving birth to twins, she suffered from debilitating sleep deprivation and emotional strain.
In the interview with "Tell Me More" host Michele Martin, Plame Wilson, who is the honorary chair of Postpartum Support Virginia, describes the time when she found out she was pregnant.  "So, when I was happily married and found myself pregnant, I just thought that this would be just the next, normal chapter," she says. "I was absolutely thrilled"

But she adds that, for a variety of reasons, it did not work out that way, comparing the experience of postpartum depression to torture techniques used to train CIA officers:

There's a reason they use sleep deprivation as a torture device in training and, unfortunately, in real life. And - because when you have that sleep deprivation, you're who you are, and your reactions completely break down. And, of course, it's normal when you have a new baby to have everything disrupted. Everything is just tossed upside down.

I had twins, but I was - I also had them rather late in life. So the hormonal and chemical changes in my body and the sleep deprivation, I found myself spiraling down and I had no idea what was happening and...
Plame Wilson noted that she was not one of those cases where someone with postpartum mental health problems experiences sharp mood swings or psychotic symptoms.

I wasn't crying. I wasn't experiencing those extremes. What I do remember - and a lot of it is a blur - is I just wanted to go away, which made no sense, logically, because I had married the love of my life. I had two beautiful babies. We had supportive families and, you know, it didn't make any sense. Why was I feeling this way? Empty. And I had very little emotional response. It was all dulled.
 She said that she had no idea what she was "signing up for" before experiencing that depression and said she felt shame about telling her doctor that something was wrong. Plame Wilson tried to, in fact, hide it from her doctor but broke into tears during a follow up examination. It was 2000 in Washington, D.C. and Plame Wilson said it was extraordinarily difficult to find doctors who treated postpartum mental health symptoms and insurance companies were of little help in those efforts.

Plame Wilson  noted that 20 of new mothers experience anxiety or mood disorders. "For many women it does resolve itself, that's what's called the baby blues," she notes. "For others it goes further, as mine was deeper and harsher. And then for a small fraction, which we always read about in the worst possible ways, they harm themselves or harm their children."



Observations on Mental Health Epidemiology

By Jayson Blair
Certified Life Coach
 
The Washington Post examines a report from the government called the National Survey on Drug Use and Health that says that we love in an America where mental illness is common and the demand for treatment is high.  Some of the most interesting data comes from mental health statistics and epidemiology that has been so eloquently written by S. Nasser Ghaemi in his laymans guide to the topics.

The article offers this interesting observation about mental illness epidemology:
About 20 percent of American adults suffer some sort of mental illness each year, and about 5 percent experience a serious disorder that disrupts work, family or social life, according to a government report released Thursday.
And some interesting observations on the demographic profile of those who are diagnosed with mental health problems:

Mental illness is most prevalent in women, young adults, the unemployed and people with low incomes. Drug and alcohol abuse is more than twice as common in people with mental illness than those without it. About 4 percent of adults contemplate suicide each year. According to the study, slightly less than half the people with any mental illness —  and only 60 percent of those with serious, disabling ones — get treatment each year. Whites and Native Americans are more likely to get treatment than blacks, Hispanics or Asians.In all, about 14 percent of American adults receive some sort of behavioral care each year — and one in five said he or she wanted more, the survey found. Of the people reporting an “unmet need” for mental-health care, about 40 percent said they couldn’t afford it.

Prescription medicine has played an increasing role in treatment:

Prescription medicine was the most common treatment, used by 12 percent of adults. Between 2002 and 2010, the percentage of adults getting outpatient counseling fell slightly (to 7 percent), while the fraction of adults using a prescription drug went up.
The findings were drawn from interviews with about 68,500 randomly selected Americans living at homes, dormitories or shelters in 2010. It did not include people living on the street, active-duty members of the military, prisoners or hospital patients.
“This is a good picture of what the households in the country really look like,” said Pete Delany, an official of the Substance Abuse and Mental Health Services Administration, the agency that oversees the survey.

Daniel J. Carlat, a Massachusetts psychiatrist whose 2010 book “Unhinged: The Trouble With Psychiatry” criticized the profession’s overreliance on prescription drugs,“that there is a kind of alarmist quality to these reports.” The Post gives examples of the disorders found could include spider-phobia and staying upset for a long time after arguing with one’s spouse.

“There is a stigma about ‘mental illness’ that as soon as you hear the term people assume that it’s something quite severe. The nuances of this type of data tend to be lost on people,” he said. He added, however, that he doesn’t doubt that 5 percent of the population has a serious mental disorder. 
 Allen Frances, a professor of psychiatry at Duke University, makes an interesting observation about the survey. "I am skeptical that rates this high make sense,": he says. Frances oversaw the revisions of the Diagnostic and Statistical Manual of Mental Disorders from 1987 to 1994.  It echoes some of the thoughts of others.

Jayson Blair is a certified life coach and he can be reached here.


Now that the Elf on the Shelf is Gone…


By Valerie Tunks, Board Certified Coach

Congratulations! 


You made it through the holiday season.  Remember back in October when you had a strange mix of excitement and dread about all the work ahead of you preparing, shopping, wrapping, cooking, gifts and parties?  Well, now that there’s no elf on a shelf keeping the kids in line, the glitter and lights are boxed up and in the attic and the kids are back at school, you kind of miss it don’t you?  Your neighborhood no longer twinkles and glows at night when you drive home from work. The holiday magic is gone and it’s back to business as usual.  While there are a lot of stresses involved with the holidays, it is a magical time of year and when it’s over, we miss it; now it’s just plain old winter.   

Although we tend to have a love-hate relationship with the holiday season, when it’s over we’re left with somewhat of an empty feeling.  So, what can you do to spice up the rest of the season while we wait for Mr. Groundhog to tell us how long we have to wait for spring?
 
Get Out of the House


It is important to get out of the house during the winter months to avoid cabin fever.  It is easy to fall into a winter depression, so do your best to get out and be active.  Look around – sometimes it’s nice to walk in a winter wonderland.


Make the Best of it


While colder and shorter days can be tough to get through, they will go faster and be more enjoyable if you try to embrace them.  If you have a fireplace, use it; sit by the fire and enjoy the warmth and glow.  When it snows, get out there and make a snowman or go sledding with some friends.  If that isn’t your thing (or you live someplace where it doesn’t snow or you hate snow), get out your camera and take some scenery photos; you may just come to appreciate the winter landscape.


Try Something New Every Week


Cooking is great way to try something new every week.  Search for recipes online and invite a friend over to cook with you.  Your inner Julia Child will thank you.  Plus, having friends and loved ones over is fun – it makes us feel less cold and lonely.  It’s a great way to pass the time and doesn’t require going outside when it is too cold.


Plan Something to Look Forward To


If your budget allows now is a good time to plan that vacation you’ve been dreaming of.  It will give you something to look forward to and something to plan for a while.  You can book the trip now and spend the next couple of months planning your itinerary.  If a vacation isn’t a possibility, map out some day trips or outings you would like to do once the warmer weather reappears. Or, plan a winter trip if you can.  Go skiing, head someplace tropical, wherever you feel good – just give yourself something to look forward to.

Whether the Groundhog says we have 6 more weeks of winter or an early spring, don’t worry – you can beat the post-holiday blues by keeping yourself busy.  Who knows, winter may become your favorite season!

Valerie Tunks is a board certified life coach and can be reached here.

DiffDx: Anxiety About Anxiety


By Jayson Blair, Certified Life Coach

It’s a jungle out there.

And one of the hardest forests to untangle your way through is the differences between stress and anxiety, and the differences between the many anxiety disorders. It’s enough to make you anxious. But no worries, we’ve put together a little guide.

Anxiety disorders have one of the longest differential diagnosis lists of all psychiatric disorders.

One of the biggest problems is that clients with anxiety disorders also have anxiety about their disorders, and anxiety about treatment, making self-reports and diagnosis a difficult thing to work your way through. No worries, though. It might take time, but a careful clinician can often differentiate for you, and help improve your quality of life.

The importance of these differences is a key to selecting the most effective therapeutic and medical treatments.

One of the most important issues is the difference between anxiety and plan old stress.

Stress vs. Anxiety

Wikipedia puts it this way: “Stress is a term that is commonly used today but has become increasingly difficult to define.”

How true.

The Mayo Clinic puts it better than I ever could: “Its normal to feel anxious from time to time, especially if your life is stressful. However, severe, ongoing anxiety that interferes with day-today activities may be a sign of” anxiety disorders.

The key differences: severe, ongoing and inferring with living a healthy day to day life.

The same goes for fear. Gavin de Becker pines about the gift of fear in his excellent book by the same name. Fear and institution go hand and glove and as de Becker puts it, “Intuition is always right in at least two important ways: It is always in response to something. It always has your best interest at heart … Denial is a save now, pay later scheme.”

But when fear becomes irrational it can interfere with functioning and its safe bet you should be checked out for anxiety.

It’s true that many of the things that help with managing day-to-day stress – mindfulness, exercise, cognitive behavioral techniques, deep breathing, guided imagery and meditation – can be beneficial for some people who have anxiety disorders. But the reality is that therapy, coping skills and medications are key parts of addressing anxiety disorders that are not usually needed in managing stress.

Some good questions to ask yourself before you write off your anxiety as a not needing intervention are: do you feel tense and wound up for a significant amount of the time? Do you feel numbness or tingling? Do you feel hot when stressed? Are you unable to relax? Do you feel a sense of dread? Dizziness? Is your heart racing? Do you have to do routines that interfere with your function or drive those around you batty? Do you feel fear of losing control or death when the possibility does not seem realistic? Do you feel ridicule, rejection or abandonment when there is not real evidence that its coming? If you answer yes to an of those, I would suggest you see a therapist, a coach, a psychiatrist or your primary care physician and ask them to administer the Beck Anxiety Inventory (treatment providers should try to rule out the impacts of drug abuse, other mental health conditions, migraines, folic acid deficiency, seizures, caffeine-related disorders, CND-based sleep disorders, pregnancy and diabetes mellitus, among other potential disorders) .

The scores on the inventory not only guide clinicians on the question of whether you have anxiety but also what’s the best treatment. Being unable to relax suggests cognitive issues while feeling hot suggests autonomic symptoms. Feeling dizzy or lightheaded suggests nueromotor issues, while feeling like you are choking suggests a panic attack. These facts help clinicians design the most effective treatment for you.

Generalized Anxiety vs. OCD

Obsessive-compulsive disorder is an illness that is defined by intrusive thoughts that produce uneasiness, apprehension, fear or worry, that are most commonly demonstrated through repetitive behaviors aimed at reducing the driving wave of anxiety.

It often works. But it often, also, screws up the lives of people who suffer from the disease. As one client puts it, “It’s a monkey on my back, one that I can’t survive with and I cannot survive without.”

One of the common misconceptions about OCD is that those who suffer from it are ridiculously clean. In fact, may people who are OCD are hoarders – the behaviors are repetitive and are designed to help them manage their fears and anxiety. Others have trouble doing things like walking on cracks in the sidewalks or other strange behaviors that sooth them but can interfere with their lives (think, Mr. Monk). Often, like Mr. Monk, the symptoms come on or come on stronger after a severe emotional or financial crisis. It can border on paranoia and even psychotic in its presentation, if not its true symptomology.

Despite people with OCD being out of the norm, it’s not as rare as it might seem. It is the fourth most common mental disorder, diagnosed nearly as often as asthma and diabetes. 

Luckily, there are some excellent medical treatments for OCD.

OCD vs. OCPD and Autism Spectrum Disorders

Not everyone who presents with the symptoms of OCD have the illness. Many actually have autism spectrum disorders or the perhaps even more tortuous illness of obsessive compulsive personality disorder or, frankly, no pervasive or persistent disorder at all.

 Autism spectrums disorders are illnesses of executive functioning. The resulting social skills problem, difficulties with nonverbal cues, time management problems, organization problems and prioritizing problems often lead to a lot of anxiety. People with autism spectrum disorder also often have restricted and repetitive symptoms.

OCPD is, frankly, the same nightmare as OCD with the added twist built on top. As one National Institutes of Mental Health publication puts it, “OCPD has some of the same symptoms as [OCD]. However, people with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct.”

This belief complicates relationships, often leading to significant outbursts and serious  disinterest in seeking help. These often leads to painful battles with friends and family, who walk on eggshells with people who have OCPD. People with OCPD are more likely than people with OCD to have an obsessive need for cleanliness and over-attention to details. Thing to get black-and-white really fast and there is often little room for other opinions.

Several other disorders, including bipolar and avoidant personality disorder and dependent personality disorder, have significant symptoms of anxiety, but in bipolar it tends to be affective – mood related – and avoidant anxiety tends to play out in, well, obviously, avoidance, and dependence tends to be focused on fears of being abandoned.

It’s worth checking out other anxiety disorders, such phobic disorders (specific fears of spiders, water, wholes, or anything else), panic disorders (focused on full-blown panic attacks), agoraphobia (fear of panic attacks that are so great that people avoid people, places and things). Personality disorders should also be examined, such as paranoid personality disorder (delusional anxiety) and borderline personality disorder (fears of abandonment).

If there is a point here, if you are feeling that stress is impacting your functioning, and it’s a jungle out there for you it is worth it to find an expert to guide you through the vines and the trees.

Jayson Blair is a certified life coach and can be reached here.


DiffDx: The Importance of An Accurate Diagnosis

By Jayson Blair, Certified Life Coach

The importance of a good diagnosis has become even clearer as pharmaceutical companies have further refined their biological silver bullets for mental illness. Medicines like, for example, serotonin reuptake inhibitors can be targeted to treat depression, obsessive compulsive disorder and a variety of other illness. But they can have dramatically harmful effects on those with bipolar disorder. All things considered, its amazing that doctors are not more attentive to the symptoms faced by their clients. But increasing demands of the economy and insurance companies have made it harder, to potentially devastating consequences, for psychiatrists and psychologists to effectively diagnosis.

Increasingly it is fallen on clients to rapidly self-report symptoms in 15-minute to 30-minute initial evaluations and then the question of diagnosis never return. In the best practices of the profession, diagnosis is thoroughly evaluated and constantly re-evaluated. Clients, for better are worse, have become their now diagnosticians. 

Gregory House, the fictional doctor on the show House MD, is in some ways a joke about the trend that doctors rarely have time for accurate diagnosis (his fictional Department of Diagnostic Medicine makes no money and runs up huge bills for the hospital). This article is designed to help clients identify and self-report their symptoms.

This article examines differential diagnosis of bipolar disorder and other illnesses. Subsequent articles will look at ADHD, anxiety disorders and personality disorders.

Bipolar Disorder and Depression

Bipolar disorder and depression are often the toughest differential diagnosis for the most seasoned mental health professional. Clients most often come in from the rain of depression to seek treatment and rarely seek a helping hand when they are manic or hypomanic. This means that those with bipolar, whose illness includes the symptoms of depression and mania, are often misdiagnosed with major depression.

This would hardly be a big deal if the front-line treatments for depression didn’t cause mania (often rapid cycling), which often includes high risk, life-changing behaviors that can be harmful and mentally painful to clients and their families.

Epidemiologists say that bipolar disorder effects 1% to 2% of the population and that about 10% of those with major depression will later develop mania. The first occurrence is often in childhood, teenage years or early adulthood. There is no gender difference when it comes to the prevalence of the illness.  

The symptoms of mania, which can used to differentiate from depression, vary from person to person. They can include eutrophia, irritability, agitation, inflated self-esteem, poor judgment, rapid and pressured speech, aggressive behavior, increased goal-directed activity, risky behaviors, spending degrees, delusions an increased drive to perform and frequent work and social problems.  A helpful Mayo Clinic article on mania can be found here.

ADHD and Bipolar

Steriods and stimulants can have the same effects, so it’s very careful for bipolar to be differentiated from bipolar and attention deficit hyperactivity disorder. Atypical antipsychotics that can be used to calm manic storms can exasperate inattention. A preteen or a teenager with mood swings may be going through a difficult but normal development stage. They could be suffering from actual bipolar disorder with periodic mood changes going from depression and mania.

In addition, symptoms of ADHD often mimic symptoms of bipolar disorder. With ADHD, an individual may have rapid or impulsive speech, physical restlessness, trouble focusing, irritability and, sometimes, defiant or oppositional behavior. There are some similarities.

While ADHD is characterized by inattention and most often some distractibility and hyperactivity, bipolar disorder is characterized by mood swings between high energy and activity and feelings of sadness. People with ADHD may feel sad or even depressed, but rarely with the persistence and cycling of bipolar. Another sign is that hyperactivity and inattention symptoms persist in people with ADHD while they don’t always in bipolar.

Borderline and Bipolar Disorder

Borderline personality disorder is a persistent and pervasive illness that causes emotional instability, leading to stress and other problems, including temper tantrums, self-mutalization, elevation and devaluation of people, fast and furious relationships that crash and burn, frequent feelings of inadequacy and fears of abandonment. 

From a medical perspective, differentiating between bipolar and borderline personality disorders is not relevant for medical treatment. The two diseases are often treated with the same medications to stabilize a person’s mood. It is helpful because atypical antipsychotics can have added effect with bipolar disorder and anti-depressants can be more readily utilized with borderline personality. But the medical consequences of a misdiagnose are not enormously negative. 

The differential is important, however, for therapeutic options. Bipolar disorder can be treated with a variety of psycho-therapeutic modalities, while borderline is most effectively treated with dialectic behavioral therapy and transference-focused therapies. These later treatments are some of my favorites; they focus on the relationship between the client and the therapist, helping clients understand emotions and the difficulties that develop in therapy. The relationship between the two often serve as a model for future relationships outside the safety of the therapeutic room.

Schizoaffective Disorder and Bipolar Disorder

I would be remiss if I did not address the difference between bipolar disorder and schizoaffective disorder. Despite the designs of some in the scientific community to eliminate schizoaffective disorder from the next Diagnostic and Statistical Manual of Mental Disorders, it is real, live and present. The essentially difference between bipolar and schioaffective disorder is that while people with bipolar can have psychotic symptoms, such as delusions and hallucenations, during mood swings, those symptoms don't usually persist when their mood is normal. People with schizoaffective disorder have mood swings and can have psychotic symptoms at anytime, whether their mood is good or not. The importance is the appropriate use of atypical antipsychotic medications and therapeutic treatments that recognize that the psychotic symptoms can emerge when the client's mood is fine. Take it out of the DSM, but it won't make it go away. It is also important to note that families with a loved one with schizoaffective disorder will face very different challenges and the outcomes are sharply different.

Jayson Blair is a certified life coach with Goose Creek Consulting and can be reached here.