From Maesk Group Counseling - Emotional Support Animal (ESA) Evaluations

Maesk Group Counseling provides Emotional Support Animal (ESA) evaluations.  It is well documented through research that pets provide benefit to people suffering from anxiety, depression, PTSD, insomnia and many other conditions.  Having an ESA prescription letter allows you to have your pet in no-pets housing, and allows you to travel with your pet in the cabin on airlines at no additional cost.

There are other details/benefits.  Feel free to contact the office to schedule your consultation, and receive your ESA prescription letter today.

From Maesk Counseling in Fort Lauderdale - Anxious Depression

From Psychcentral:

Experiencing Anxious Depression

By LaRae LaBouff 
 

Depression is a part of bipolar disorder. It is, in fact, one of the poles. The question of experiencing depression is not “if” but “when.” Depression on its own is a horrible experience, but sometimes other problems pile on. More than half of people with bipolar disorder also have some form of anxiety disorder. These can include generalized anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive compulsive disorder and social anxiety. When anxiety occurs during a depressive episode of bipolar disorder it is called depression “with anxious distress.” Distress is exactly the term to describe how it feels.

When I experience anxiety, I communicate how I am feeling by comparing my mood to a pot of water. When I am feeling fine, the water is ambient temperature. The more anxiety I feel, the hotter the water becomes. Lately I’ve been sitting at a simmer with occasional panic attacks that put me into a rolling boil. This is in addition to the depressive symptoms I feel like depressed mood, loss of interest, weight gain, fatigue and feelings of hopelessness. It’s a debilitating combination.

In order to be qualified as an episode with anxious distress, you have to experience at least two of the following: 

  • Feeling keyed up or tense.

  • Feeling unusually restless. 

  • Difficulty concentrating because of worry. 

  • Fear that something awful may happen. 

  • Feeling that you might lose control yourself.

If you experience two of these symptoms, the anxious distress is considered mild. Three symptoms is moderate and four or more is moderate to severe. If physical restlessness is involved, it’s considered severe.

Having bipolar disorder with anxiety can lead to extra complications with the disorder. People who have episodes with anxious distress typically have longer episodes, don’t respond to treatment as well and have a higher suicide risk. 

Experiencing severe anxiety mingled with depression is incredibly distressing.  On the one hand my brain is telling me that all I can do is to go to bed and not do anything. On the other hand my anxiety is telling me how horrible I am for ignoring other responsibilities. The two sensations fight each other and leave me frozen, not knowing what part of my brain I should listen to. The anxiety is usually louder than the depression, but that doesn’t mean I succeed at getting out of bed. It just means I end up having a panic attack while I’m there.

I’m continuing to talk to my therapist and psychiatrist about my situation. My therapist gave me a list of ways to combat distress and my psychiatrist gave me additional medication to manage the anxiety acutely. In the meantime, I hope this is a short phase and that I will reach a level of normality soon.

From Maesk Counseling in Fort Lauderdale - Signs of Progress in Therapy

Assessing Your Healing

Do you know that you can focus on various areas in your life to see if you are feeling better in specific ways? This is a fun, informal quiz to use for this purpose. Rate your improvement from 1 to 4, with 4 being the most improved. Leave it blank if it doesn’t apply to you. Take the results to your therapist for discussion.

LIFE ISSUES*:

__Self Esteem

__Ability to reach Life Goals

__Personal Safety

__Your work or career

__Level of happiness

__Intelligence

__Use of your talents

__Sense of Humor

__Ability to care for others

__Personal self-care/Attractiveness

__Ability to make friends

__Relationships (friends)

__Relationships (family)

__Getting along with coworkers

__Taking time for you

__Treating yourself well

__Putting your needs first

__Taking care of your body

__Not getting overly tired

__Taking care of yourself when ill

__Eating well

__Sleeping enough

__Exercising regularly

__Appropriate alcohol use (or none at all)

Track your progress on a regular basis. Therapy is all about improving your life and making it the best it can be!

(Adapted from It’s My Life Now by M. Dugan)

 

From Maesk Counseling in Fort Lauderdale - Emotional Support Animals (ESA)

Emotional Support Animal Evaluations - A simple, fast process that allows you to have your pet in "no-pets" housing as well as being able to travel with you in the cabin on airlines at no additional cost.  Located in East Fort Lauderdale, we offer day and evening appointments for your convenience.  Contact us today for an appointment!

From Maesk Counseling in Fort Lauderdale - Kids at Risk for Addiction

A great article written by MAIA SZALAVITZ of the New York Times:

The 4 Traits That Put Kids at Risk for Addiction

Drug education is the only part of the middle school curriculum I remember — perhaps because it backfired so spectacularly. Before reaching today’s legal drinking age, I was shooting cocaine and heroin.

I’ve since recovered from my addiction, and researchers now are trying to develop innovative prevention programs to help children at risk take a different road than I did.

Developing a public antidrug program that really works has not been easy. Many of us grew up with antidrug programs like D.A.R.E. or the Nancy Reagan-inspired antidrug campaign “Just Say No.” But research shows those programs and others like them that depend on education and scare tactics were largely ineffective and did little to curb drug use by children at highest risk.

But now a new antidrug program tested in Europe, Australia and Canada is showing promise. Called Preventure, the program, developed by Patricia Conrod, a professor of psychiatry at the University of Montreal, recognizes how a child’s temperament drives his or her risk for drug use — and that different traits create different pathways to addiction. Early trials show that personality testing can identify 90 percent of the highest risk children, targeting risky traits before they cause problems.

Recognizing that most teenagers who try alcohol, cocaine, opioids or methamphetamine do not become addicted, they focus on what’s different about the minority who do.

The traits that put kids at the highest risk for addiction aren’t all what you might expect. In my case, I seemed an unlikely candidate for addiction. I excelled academically, behaved well in class and participated in numerous extracurricular activities.

Inside, though, I was suffering from loneliness, anxiety and sensory overload. The same traits that made me “gifted” in academics left me clueless with people.

That’s why, when my health teacher said that peer pressure could push you to take drugs, what I heard instead was: “Drugs will make you cool.” As someone who felt like an outcast, this made psychoactive substances catnip.

Preventure’s personality testing programs go deeper.  They focus on four risky traits: sensation-seeking, impulsiveness, anxiety sensitivity and hopelessness.

Importantly, most at-risk kids can be spotted early. For example, in preschool I was given a diagnosis of attention deficit/hyperactivity disorder (A.D.H.D.), which increases illegal drug addiction risk by a factor of three. My difficulty regulating emotions and oversensitivity attracted bullies. Then, isolation led to despair.

A child who begins using drugs out of a sense of hopelessness — like me, for instance — has a quite different goal than one who seeks thrills.

Three of the four personality traits identified by Preventure are linked to mental health issues, a critical risk factor for addiction. Impulsiveness, for instance, is common among people with A.D.H.D., while hopelessness is often a precursor to depression. Anxiety sensitivity, which means being overly aware and frightened of physical signs of anxiety, is linked to panic disorder.

While sensation-seeking is not connected to other diagnoses, it raises addiction risk for the obvious reason that people drawn to intense experience will probably like drugs.

Preventure starts with an intensive two- to three-day training for teachers, who are given a crash course in therapy techniques proven to fight psychological problems. The idea is to prevent people with outlying personalities from becoming entrenched in disordered thinking that can lead to a diagnosis, or, in the case of sensation-seeking, to dangerous behavior.

When the school year starts, middle schoolers take a personality test to identify the outliers. Months later, two 90-minute workshops — framed as a way to channel your personality toward success — are offered to the whole school, with only a limited number of slots. Overwhelmingly, most students sign up, Dr. Conrod says.

Although selection appears random, only those with extreme scores on the test — which has been shown to pick up 90 percent of those at risk — actually get to attend. They are given the workshop targeted to their most troublesome trait.

But the reason for selection is not initially disclosed. If students ask, they are given honest information; however, most do not and they typically report finding the workshops relevant and useful.

“There’s no labeling,” Dr. Conrod explains. This reduces the chances that kids will make a label like “high risk” into a self-fulfilling prophecy.

The workshops teach students cognitive behavioral techniques to address specific emotional and behavioral problems and encourage them to use these tools.

Preventure has been tested in eight randomized trials in Britain, Australia, the Netherlands and Canada, which found reductions in binge drinking, frequent drug use and alcohol-related problems.

A 2013 study published in JAMA Psychiatry included over 2,600 13- and 14-year-olds in 21 British schools, half of whom were randomized to the program. Overall, Preventure cut drinking in selected schools by 29 percent — even among those who didn’t attend workshops. Among the high-risk kids who did attend, binge drinking fell by 43 percent.

Dr. Conrod says that Preventure probably affected non-participants by reducing peer pressure from high-risk students. She also suspects that the teacher training made instructors more empathetic to high-risk students, which can increase school connection, a known factor in cutting drug use.

Studies in 2009 and in 2013 also showed that Preventure reduced symptoms of depression, panic attacks and impulsive behavior.  For kids with personality traits that put them at risk, learning how to manage traits that make us different and often difficult could change a trajectory that can lead to tragedy.

 

Maia Szalavitz is the author of “Unbroken Brain: A Revolutionary New Way of Understanding Addiction.”

From Maesk Counseling in Fort Lauderdale - Lower your stress

1. Turn off the TV news.  Instead, light candles and put on music.

2. Notice even the smallest of your daily accomplishments instead of what you DIDN’T get done. Keep a “success list!” 

3. Remember that we get what we focus on in life. Focusing on good points in yourself and others will bring MORE of them.

4. Take a “senses walk” for 20 minutes, 4 times a week. Notice the breath in your lungs, the smell of the air, the change of the seasons. Outdoor light and exercise both stimulate serotonin production, lifting mood.

5. Take a few minutes daily to “hibernate.” Close your door, remove your shoes, dim the lights, and focus on what makes you happy.

6. Breathe in to the slow count of four. Hold it four slow counts. Release in four slow counts. Repeat until you feel the muscles relax all over!

7. Stay aware of your thoughts. 

8. Don’t take on another person’s bad mood. Guard yourself, removing yourself from their company if necessary.

9. Find freedom by letting go of criticizing and complaining about yourself or someone else.

 10. If you need to make changes, act NOW. Don’t put off health or happiness! 

From Maesk Counseling in Fort Lauderdale - Panic Attack Help

Tips for Coping with Panic Attacks

Always begin with a visit to your doctor or health care provider to ensure that there is not an underlying medical cause to your symptoms. Don’t self-diagnose.  Panic symptoms include:

  • Shortness of breath

  • Tightness in the chest

  • Rapid heartbeat

  • Inability to relax*

*(NOTE): since these can be symptoms of other medical emergencies, DON’T self-diagnose. Seek emergency medical care if this is the first time you’ve experienced this)

What Can I Do To Cope?

  • RATE the panic on a scale of 1 to 10, 1 meaning not bad at all, up to 10 meaning, call an ambulance! Anything we can MEASURE we can start to control.

  • ACCEPT, don’t fight. Fighting increases the bodily symptoms.

  • ASK yourself: what’s the worst that could happen here? How would I handle it?

  • BREATHE normally and naturally. Pay attention to your breath.

  • FOCUS on an object in the room. See it, describe it to yourself. This helps orient you in the present moment reality.

  • TIME the attack (measuring again). Note how little time it actually lasts.

  • NOTICE if the attacks are happening in a certain location or at a certain time (“cued” attacks.) When it passes, get out a piece of paper and write about that place or time. BE A SCIENTIST about your panic—objective, measuring, curious.

  • TAKE your writings to your counselor to further explore the causes of the panic.

  • REMEMBER that overcoming panic is not a matter of willpower. It is a malfunction of brain chemistry which can be helped by cognitive-behavioral therapy and/or medication.  Medication takes away the SYMPTOM but not the CAUSE. Therapy helps get to the root of the problem.

Remember that a panic attack won’t hurt your physically. Although it’s very uncomfortable, your body will continue to breathe and function through it.   And we are here to help - don’t hesitate to contact us.  

From Maesk Counseling in Fort Lauderdale - Childhood Emotional Neglect

This is a great article about emotional neglect from childhood by Dhyan Summers, MA, LMFT:

How to Recognize and Overcome Childhood Emotional Neglect

Because it’s mostly silent and invisible, childhood emotional neglect is largely an overlooked phenomenon in psychology. Unlike physical neglect or abuse, where there are signs such as bruises or children coming to school underfed, emotional neglect is difficult to identify as there are frequently no observable signs. More importantly, emotional neglect is generally unrecognized by the child until symptoms begin to appear in adulthood.

Emotional neglect can take many forms, from a parent having unrealistically high expectations or not listening attentively, to invalidating a child’s emotional experiences to the point he or she begins to feel self-doubt. When a parent is not emotionally attuned to a child, there is no mirror held up, no positive reflection being shared with the child. Developing a positive sense of self, then, becomes more challenging for the child.

Symptoms of Emotional Neglect

Symptoms of childhood emotional neglect that show up in adults may include (but are not limited to):

  • “Numbing out” or being cut off from one’s feelings

  • Feeling like there’s something missing, but not being sure what it is

  • Feeling hollow inside

  • Being easily overwhelmed or discouraged

  • Low self-esteem

  • Perfectionism

  • Pronounced sensitivity to rejection

  • Lack of clarity regarding others’ expectations and your own expectations for yourself

  • While having these symptoms doesn’t necessarily mean you were emotionally neglected, if you identify with more than one symptom, it may be worthwhile to talk with a therapist about the possibility.

What Kinds of Parents Tend to Emotionally Neglect Their Children?

First, let me say most parents are well-intentioned and well-meaning and generally do the best they can. Some may have experienced emotional neglect themselves as children, and therefore may not have a lot to give emotionally. However, there are some parenting styles and characteristics that lend themselves to emotional neglect.

Authoritarian parents want their children to follow the rules, and have little time or inclination for listening to a child’s feelings and needs. As adults, children raised by an authoritative parent may either rebel against authority or perhaps become submissive.

Permissive parents have a laissez-faire attitude about child rearing and may let children pretty much fend for themselves. Children raised by permissive parents may have a tough time setting boundaries and limits for themselves in adulthood.

Parents with narcissistic qualities feel the world revolves around them. It’s typically all about the parent’s needs instead of the child’s. As adults, these children may have difficulty identifying their needs and ensuring that they’re met. They may even feel that they don’t deserve to have their needs met.

Perfectionistic parents tend to believe their children can always do more or better. These are the parents who may complain when a child brings home a report card with all A’s and one B. Children of such parents may grow up to be perfectionists, and set unrealistically high expectations for themselves, resulting in anxiety around feelings of never being good enough.

Absent parents can be removed from a child’s life for a variety of reasons, such as death, illness, divorce, working long hours, or frequent travel for work. Children of absent parents end up raising themselves to a large extent, and if they are the oldest child may also raise their younger siblings. These children tend to be overly responsible, which may carry over to adult life. As children, they seem like little adults, overburdened with worry about their families.

Tips for Recovering from Emotional Neglect

So what can you do if you think you may have been emotionally neglected as a child? Here are some tips:

1. Learn to be aware of positive and negative emotions when you’re experiencing them.

If you’ve spent your adult life being disconnected from your feelings, the first step is to learn to identify positive and negative emotion. It’s important to acknowledge just good and uncomfortable feelings to begin with.

Once you have that down, you can focus on noting subtler nuances of feelings. You may not even have words for how you feel, which is perfectly normal if you didn’t grow up in a home where people talked about their feelings.

2. Identify your needs, and take steps to meet them.

Many adults who experienced emotional neglect as children are often unaware of what they need and typically don’t feel deserving of getting their needs met. Develop your emotional vocabulary by researching emotions and needs online or at the library. Once you know what you need, it’s time to take action.

3. If you believe you don’t deserve to have your needs met, acknowledge the belief and see it as just that—a belief, not a fact.

It can be helpful to begin to deconstruct old beliefs you’ve held for a long time that may no longer hold true. Like everyone else on the planet, you have emotional needs that you deserve to have met, no matter what you experienced in childhood.

4. Be gentle with and take good care of yourself, starting with small steps.

Adults who experienced emotional neglect as children often have difficulty with self-care. Unaware of their feelings and needs, they frequently don’t know where to start. Try treating yourself with the same care and gentleness you would give a child who wasn’t able to take care of themselves. Be tender and compassionate with yourself, especially if you tend to be self-critical or judgmental.

And remember: Rome wasn’t built in a day! This is a process. When you skin your knee, you need to clean out the wound and expose it to the light of day; the same holds true for emotional wounds. Dare to bring the wound out of hiding, give it some light and air, and you’ll be on the road to healing.

 

From Maesk Counseling in Fort Lauderdale - Depression and Exercise

A great article from the NY Times on the connection between exercise and relief from depression:

How Exercise Might Keep Depression at Bay

By  GRETCHEN REYNOLDS NOV. 16, 2016

Exercise may be an effective treatment for depression and might even help prevent us from becoming depressed in the first place, according to three timely new studies. The studies pool outcomes from past research involving more than a million men and women and, taken together, strongly suggest that regular exercise alters our bodies and brains in ways that make us resistant to despair.

Scientists have long questioned whether and how physical activity affects mental health. While we know that exercise alters the body, how physical activity affects moods and emotions is less well understood.

Past studies have sometimes muddied rather than clarified the body and mind connections. Some randomized controlled trials have found that exercise programs, often involving walking, ease symptoms in people with major depression.

But many of these studies have been relatively small in scale or had other scientific deficiencies. A major 2013 review of studies related to exercise and depression concluded that, based on the evidence then available, it was impossible to say whether exercise improved the condition. Other past reviews similarly have questioned whether the evidence was strong enough to say that exercise could stave off depression.

A group of global public-health researchers, however, suspected that newer studies and a more rigorous review of the statistical evidence might bolster the case for exercise as a treatment of and block against depression.

So for the new analyses, they first gathered all of the most recent and best-designed studies about depression and exercise.

Then, for perhaps the most innovative of the new studies, which was published last month in Preventive Medicine, they focused on whether exercise could help to prevent someone from developing depression.

The scientists knew that many past studies of that topic had relied on people providing reports about how much they had exercised. We human beings tend to be notoriously unreliable in our memories of past workouts, though.

So the researchers decided to use only past studies that had objectively measured participants’ aerobic fitness, which will rise or fall depending on whether and how much someone exercises. Participants’ mental health also had to have been determined with standard testing at the start and finish of the studies, and the follow-up time needed to have been at least a year and preferably longer.

Ultimately, the researchers found several large-scale past studies that met their criteria. Together, they contained data on more than 1,140,000 adult men and women.

Among these million-plus people, the links between fitness and mental health turned out to be considerable. When the researchers divided the group into thirds, based on how aerobically fit they were, those men and women with the lowest fitness were about 75 percent more likely to have been given diagnoses of depression than the people with the greatest fitness. The men and women in the middle third were almost 25 percent more likely to develop depression than those who were the most fit.

In a separate study (some of the scientists were involved in each of the reviews), researchers looked at whether exercise might be useful as a treatment for depression. In that analysis, which was published in June in the Journal of Psychiatric Research, they pooled data from 25 past studies in which people with clinically diagnosed depression began some type of exercise program. Each study had to include a control group that did not exercise and be otherwise methodologically sophisticated.

The pooled results persuasively showed that exercise, especially if it is moderately strenuous, such as brisk walking or jogging, and supervised, so that people complete the entire program, has a “large and significant effect” against depression, the authors wrote. People’s mental health tended to demonstrably improve if they were physically active.

The final review offers some hints about why. Published in February in Neuroscience and Biobehavioral Reviews, it took on the difficult issue of what happens within our bodies during and after exercise that might affect and improve our moods. The researchers analyzed 20 past studies in which scientists had obtained blood samples from people with major depression before and after they had exercised. The samples on the whole indicated that exercise significantly reduced various markers of inflammation and increased levels of a number of different hormones and other biochemicals that are thought to contribute to brain health.

But the researchers also caution that most of the physiological studies they reviewed were too small and short-term to allow for firm conclusions about how exercise might change the brain to help fight off gloom.

Still, the three reviews together make a sturdy case for exercise as a means to bolster mental as well as physical health, said Felipe Barreto Schuch, an exercise scientist at the Centro Universitário La Salle in Canoas, Brazil, who, with Brendon Stubbs, a professor at King’s College in London, was a primary author on all of the reviews.

Many more experiments are still needed to determine the ideal amounts and types of exercise that might help both to prevent and treat depression, Dr. Schuch said.

But he encouraged anyone feeling overwhelmed by recent events, or just by life, to go for a run or a bike ride. “The main message” of his and his colleagues’ reviews, he said, “is that people need to be active to improve their mental health.”