The Enigma of Mental Health?

Diagnosis vs Symptoms

People come to therapy for various reasons. The symptoms of individuals I see are self-reported or observable and consist of anxiety, phobia, exposure to traumatic events, symptoms of depression, obsessions, compulsions, and experiencing significant life events.

Anxiety

Anxiety which consists of worrying several times daily or throughout the day, having ruminating thoughts, (negative or catastrophic thoughts that get stuck in your head on repeat), and body sensations consisting of dizziness, trembling, increased heart rate, nausea, shortness of breath, or a sense of delusion (lack of reality).

Phobias

Phobias (fears of bridges, vomiting, needles, flying, snakes, etc.) anxiety or sensations of dizziness, trembling, increased heart rate, nausea, shortness of breath, a sense of delusion (lack of reality), triggers by objects or situations.

Trauma

Trauma consists of exposure to a big or little traumatic event that threatened death, injury, or violence to oneself or someone else that has caused problems in one’s life due to the internal re-experiencing of the event emotionally or visually, intrusive thoughts of the event, nightmares about the event or related to said event, avoidance of trauma triggers, maladaptive processing of results from event, changes in mood, changes in reactivity and arousal because of the event like hyper vigilance, exaggerated startle response, problems in concentration, sleep disturbance, and dissociative reactions.

Obsessions and Compulsions

Obsessions that are bizarre followed by internal or external compulsions that individuals cannot stop repeating with various levels of frequency. There are various subjects of obsessions: relationships, contamination, symmetry, just right, harming yourself or others, or scrupulosity or perfectionism.  Most obsessions are based on wanting certainty for subjects that are uncertain.  There are lots of compulsions that can be internal or external like reassuracne seeking, reserching, cleaning, organizing, counting, checking, and confessing.  

Depression

Depression consist of depressed mood most days, diminished interest or pleasure in activities, weight loss or weight gain, a slowing down of thought and movement, fatigue, worthless feelings and guilt, irritability, problems sleeping, decreased motivation, and sometimes suicidal ideation.  

Significant Life Events

Lots of people come to therapy to process significant life events with someone educated and someone outside of thier circle. These types of problems consist of issues with your children, husband, significant other, parent, illness, moving to a new city, or death of someone close to you.

All of the above symptoms can be diagnosable or bothersome.  They are diagnosable if these symptoms meet the criteria for the following diagnoses.  

Most Common DSM Diagnoses:

Each DSMV diagnosis contains specific number of symptoms and have to affect daily functioning.  

Major Depressive Disorder 

Major Depressive Disorder consists of depressed mood most days, diminished interest or pleasure in activities, weight loss or weight gain, a slowing down of thought and movement, fatigue, worthless feelings and guilt, irritability, problems sleeping, decreased motivation, and sometimes suicidal ideation.  

Generalized Anxiety Disorder

Generalized anxiety Disorder consists of worrying several times daily or throughout the day, having ruminating thoughts, (negative or catastrophic thoughts that get stuck in your head on repeat), and body sensations consisting of dizziness, trembling, increased heart rate, nausea, shortness of breath, or a sense of delusion (lack of reality).

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder consists of obsessions that are bizarre followed by internal or external compulsions that individuals cannot stop repeating 

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder is exposure to a traumatic event that threatened death, injury, or violence to oneself or someone else that has caused problems in one’s life due to the internal re-experiencing of the event emotionally or visually, intrusive thoughts of the event, nightmares about the event or related to said event, avoidance of trauma triggers, maladaptive processing of results from event, changes in mood, changes in reactivity and arousal because of the event like hyper vigilance, exaggerated startle problems in concentration, sleep disturbance, and dissociative reactions.

Specific Phobia

Phobias (fears of bridges, vomiting, needles, flying, snakes, etc.) anxiety or sensations of dizziness, trembling, increased heart rate, nausea, shortness of breath, a sense of delusion (lack of reality), triggers by objects or situations.

Social Anxiety Disorder

Social Anxiety Disorder consists of anxiety in social situations and these social situations are avoided. 

Panic Disorder

Panic Disorder is characterized by panic attacks that consist of accelerated heart rate, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, feeling dizzy, derealization or depersonalization, fear of losing control, fear of dying, numbness, or chills, and fear that the panic attack will occur again.  

I “treat” individuals’ symptoms in the same manner, whether diagnosable or just bothersome, by using various skill-based approaches such as DBT, Mindfulness, Guided Meditation, and Resourcing.

DBT

(Dialectical Behavioral Therapy)-provides clients with new skills to manage painful emotions, decreasing conflict in relationships, and strengthening relationships through skills building.  

DBT focuses on four areas:

Mindfulness improves an individual’s ability to accept and be present in the moment.

Distress Tolerance  increases an individual’s tolerance of negative emotions

Emotional Regulation helps individuals manage intense emotions that are causing problems in their lives.

Interpersonal Effectiveness teaches communication skills that are assertive, maintain self-respect, and strengthen relationships. 

Mindfulness

Developing a mindfulness practice helps individuals focus on the present moment, accept feelings, thoughts, and body sensations while remaining unattached to them. These practices can take 30 seconds to 30 minutes.  There are so many types that we can find to fit you.  

Guided Meditation or Resourcing

Using guided meditation or Resourcing regularly assists clients in developing skills to manage feelings, compartmentalizing difficult emotions and thoughts in a healthy way.  

And often clients participate in therapeutic processes to assist in managing their symptoms.  Some of these processes are Eye Movement Desensitization and Reprocessing (EMDR) and Exposure Response Prevention (ERP).

EMDR

Eye Movement Desensitization Reprocessing was designed to alleviate the distress associated with traumatic events through bilateral stimulation consisting of eye movement, tapping, or sound.  It facilitates the accessing and processing of traumatic memories and other adverse life experiences to bring these to an adaptive resolution or healing.  

ERP

Exposure Response Prevention is a process implemented specifically for OCD. The exposure in ERP refers to exposing yourself to the thoughts, images, objects, and situations that make you anxious and/or trigger your obsessions. While the response prevention part of ERP refers to making a choice not to engage in compulsive behavior once the anxiety or obsession has been triggered. All of this is done under the guidance of a therapist at the beginning, though you will eventually learn to do your own ERP exercises.

These approaches are evidence-based therapeutic techniques to assist clients in managing their symptoms and meeting their therapeutic goals. Therapy that is focused on evidence based approaches and is goal driven can move individuals through the most difficult symptoms or mental blocks.