Shall I Begin Psychiatry or Counseling?

While often misidentified as the same, psychiatry and counseling are actually quite different. To begin, let me try and differentiate psychiatry from counseling.

Counseling is traditionally focused on the practice of “talk therapy,” or “psychotherapy.” That is, the process of working through problem/life issues by talking them through with a professional counselor. Such a professional will help clients to process their emotions, thoughts, and behaviors, and will help clients to build strategies for improving their moods, lives and relationships.

Psychiatry (with some exceptions) is generally focused on helping individuals to overcome specific problem issues with medication.

Medication in Psychiatry Treatment

Psychiatric medications get their fair share of criticism. Critics, from licensed mental health professionals to Tom Cruise, have voiced their distrust and displeasure with psychiatric medications. Some claim that psychiatric meds are over prescribed, such as in the case of medicating to treat ADHD (Attention Deficit Hyperactivity Disorder) in children. Others claim that psychiatric medications are unhealthy, or even addictive. Still, others suggest that psychiatric medications are no more effective than a placebo!

Criticisms are so widespread and diverse that, in fact, it is logically impossible for them all to be true (a medication can’t be both highly-addictive and a placebo).

A Balanced Approach to Psychiatry

Many persons battling with life challenges, such as anxiety and depression, do not require medication. Even many psychiatrists will attest that it’s best practice for a person to try and work through such issues with counseling, and without psychiatric meds (and, to blur things a little, some psychiatrists will provide counseling or “talk therapy” in addition to psychiatric services).

However, medications are helpful in some situations. For instance, medications may be helpful in the case of a chronic problem, one in which counseling has been tried but hasn’t provided adequate relief: Chronic depression or unmanageable symptoms of ADHD, OCD (Obsessive Compulsive Disorder), or serious mental illnesses are just a few issues that can greatly benefit from psychiatry.

Second, medications can be helpful during the acute onset of severe symptoms; very commonly depression or anxiety. For instance, medication can be helpful after the loss of a loved one, or immediately following a personal tragedy or trauma, or during instances when a client/patient is so distraught that he or she cannot participate in counseling, and/or function in his or her daily life. At times like these, psychiatric medications (such as anti-depressants and anti-anxiety meds) can be of great help and relief to a client.

Getting Started

We hope this article was helpful to you, and helped you to learn a little more about psychiatry and counseling, and what differentiates the two. Buck Black LCSW wrote a good article titled “Medication Vs. Counseling,” which is available in this blog. Mr. Black also provides Online Counseling to clients across the USA. This article was written by staff writers at Thrive Boston Counseling, 872 Massachusetts Ave, Ste 2-2, Cambridge, MA 02139, a counseling practice that also offers psychiatry services. Learn more at: http://www.thriveboston.com/boston-psychiatry.html

Living Within Your Means

Keeping up with the Jones’, go big or go home, and livin’ large are all mantras of our society.  These mantras may very well sound appealing.  However, they seem to cause a great deal of pain for many.

In my office, I see people who are spending much more money than they are earning.  After the credit cards are maxed and the second or third mortgage has been taken out, people often find there is no place to turn and they are quite unhappy.

What you own is now owning you, as the old saying goes.  It is unfortunate how I see people who work excessive amounts of overtime just make the minimum payments on their credit cards and other debts.  When this happens, the excessive amount of work leaves little time to spend with family.  It often results in arguments with their partner regarding spending habits and sacrifices that may need to be made to pay for the material possessions. Sadly, when people buy these material things in hopes of improving their lives, it often causes the people so much mental anguish and long working hours that they cannot enjoy the possessions that they have.

Prevention is key.  What are you and your partner’s philosophies on money?  Do you have a budget?  Do you have a good understanding between wants and needs?  It is important to know the household income and the amount of money it takes to live for one month (utilities, rent/mortgage, food, car payment, etc.).  Once your have this amount figured, it is important to decide what you will do with the remainder of the money.  Remember to save for retirement too.  It is recommended that you see a financial advisor for detailed help in this area. Below are general spending guidelines:

Housing (rent or mortgage payment, utilities, repairs): Up to 35%

Food: Up to 25%

Transportation (car payments, mass transit, gas/oil, maintenance, insurance): Under 12%

Clothing: Under 10%

Medical (dental, prescriptions, health insurance, over the counter drugs): Up to 8%

Debt (school loans, credit cards, bank loans, etc.): Under 15%

Entertainment (movies, eating out, books, etc.): Under 5%

Emergency Fund: Minimum of 1%

Savings and Investments: At least 10%

Source: Reeta Wolfsohn, CMSW, 2004-2010  Center for Financial Social Work, Inc.  800.707.1002 www.financialsocialwork.com

 

When is financial social work counseling helpful?

  • The couple is not able to agree on a philosophy on money
  • The couple does not agree on what is a want vs. a need
  • A person feels that he or she has a poor or “complicated” relationship with money
  • There is a concern that there is too much emphasis placed on material possessions

Coping with Trauma

Women who have been attacked, assaulted, or have had their life threatened may have great difficulty coping with the stressors of life.

This can show up in many forms, such as relationship problems, frequent nightmares, high levels of stress and anxiety, as well as persistent irrational fears and panic attacks.

Participating in workshops to learn how to keep yourself safe is a fantastic way to empower yourself to make it much less likely that you will become a victim. These workshops often have a healing component to them. However, it is important to look at your own psychological healing and address what may have happened in the past.

Therapy is a great complement to the workshops on personal safety that you may have already taken. You will feel so much better about yourself once you have better self-confidence, sleep better, and have dealt with those negative feelings that may be holding you back. Remember, it is very important to focus on prevention and resolve past feelings that are still holding you back.

Below are some simple and powerful techniques for helping you to get through anxious times. Remember, what you tell yourself can increase or decrease your anxiety. Why not learn a few things you can tell yourself to reduce your anxiety? You are in control of your thoughts and you have the power to significantly decrease your anxiety.

COPING STATEMENTS FOR DEALING WITH ANXIETY

REBT Essentials for dealing with the “circle of anxiety”

  • My anxiety is bad, but I’m not bad.
  • I don’t always have to feel comfortable, and it isn’t awful when I don’t.
  • My over-reactive nervous system is a part of my life, but it’s not bigger than life.
  • Controlling my anxiety is important, but hardly urgent.
  • Comfort is nice, but not necessary.
  • I don’t have to be the one person in the universe to feel comfortable all the time.
  • I don’t have to hassle myself or put myself down for not coping better with my anxiety.

Source: Bill Borcherdt. REBT Resource Book for Practitioners. Albert Ellis Institute.

Summertime and Mental Health

Sunlight affects a person’s mental health.  With the lack of sunlight, usually starting in November, people often begin to feel more depressed.  The summertime usually has the opposite effect and allows for much more happiness and energy.

During the feelings of a carefree summer, are you taking care of your mental health?  Yes, it is much easier to focus on the positives.  However, it is also much more likely to slip out of your routine and go back to old habits.  What is it that keeps you on track?  What are the signs of slipping into a depression.

Remember, there are plenty of people who have a recurrence of depression, in spite of these long warm summer days.  What kind of summertime activities can be carried over to winter time?  How can you bottle some of the positives of the summer in order to carry it over to those dreary winter days?

What is Trucker Therapy?

When I first started out as a mental health therapist, I found that I had several clients who were truckers.  Quickly, I realized that my clients were unable to keep appointments because they were out on the road.  Therapy was quickly ineffective for them.

I also had clients who would take weeks off work (usually unpaid, of course) so they were able to see me for weekly office visits.  This was also not very helpful to the client.

I knew there needed to be a more effective means to help the truckers.  After a great deal of thought, I remembered my skills of volunteering at a crisis hotline (more than 500 hours).  I started networking with the trucking community by leaving business cards at truck stops and through word of mouth.  Then, Twitter and Facebook started to become more popular.  Now, I’m proud to say that I talk with truckers every day who are seeking help, as well having casual conversations over Facebook and Twitter.

Not only do truckers suffer from having great difficulty accessing therapy and other healthcare, but there are many problems related to the profession itself.  For example, truckers have a high rate of depression related to the isolation of being out on the road for days and weeks on-end.  Because most people are social creatures, the isolation of driving a truck can really take a toll on one’s mental health.  Also, relationship problems are very frequent, as well.  It is very difficult to keep a relationship going when one is away from home for extended periods of time.  As there are more arguments and/or isolation with the trucker’s loved ones, life becomes more and more stressful.  Dispatchers, receivers, and all of the four wheelers on the road only compound the stress.

What is Trucker Therapy? Trucker Therapy uses phone and Skype so the trucker can stay on the road and improve themselves at the same time. Couples can also work on their relationship, either with teams or when the trucker is on the road and the other is at home.  For couples that are away from one another, I use conference calls and/or Skype. For those who are passing through, visits are also available in my Lafayette, Indiana office.  Anger, Stress, and Relationships are the primary focus of trucker therapy, but many other issues may be discussed.

Trucker Therapy is only part of what I do.  I also work in private practice where I see people in my office for anger management, anxiety, and couples therapy.  I am also active in the community by giving trainings to other healthcare providers and the general public on these topics.

What to Expect from Counseling

Many people are afraid to come to a counseling session because they find it too intimidating. I can’t blame them. Heck, I find it difficult to go to the doctor when I am feeling sick and can’t go to work. So, it is a new experience and often provokes some natural anxiety.

Your first session is the hardest and it gets easier from there!

Here are some of the questions I’ve been asked:

* Am I any less of a man for coming to counseling?
No. If counseling weren’t manly, I wouldn’t be doing it! I’ll tell you that its much more manly to deal with your problems, compared to being too proud and trying to handle everything yourself. This way of thinking usually makes things a lot worse.

* Are you trying to find a mental illness?
No, I’m not. I want to talk with you in order to gain an understanding of both the problems you want to work on, where those problems are coming from, and what is going RIGHT in on your life. Yes, its important to talk about the successes in your life and not just dwell on the negatives.

* Will you want to spend all the time discussing my childhood.
No, I want to help you work on what you came here to address. I find it to usually be a waste of time to have an emphasis on the past. It is over and done with. There may be times that it needs to be understood, but having a primary focus on the past is often frustrating on the client and does little good. Lets focus on the here and now, which will likely help you feel better quickly!

* Do I have to be mentally ill in order to go to Counseling?
What? No. Counseling is to help people work though problems. If you had to be mentally ill to have a problem, then we’d all be crazy as loons. There is no shame in seeking an outsider’s view on a problem you have. Actually, its a sign of good mental hygiene!

* How long will this take? Will I be in therapy for years?
Most people finish up their counseling sessions within 10 sessions or less. This is because we focus on the here and now. I also give homework assignments, so people can get more value out of their counseling. That is, they are able to work on their counseling when they are outside my office. This means that you will obtain quicker results and have less money invested. If you happen to take more than 10 sessions, don’t worry about it. It goes back to how everybody is different and not everyone moves at the same pace.

* Are you a mind-reader?
No. I wish I was! You’ll have to tell me why you are coming in and a little bit about yourself. 🙂

* Is this confidential?
Yes. What we discuss does not go beyond you and I, unless you give written permission for me to disclose information about your sessions, such as if you are referred by probation, a lawyer, and so on. The only time I can tell anyone your business is if you are going to kill yourself, you are going to hurt someone, there is child abuse, or a judge orders me to disclose your information.

* Is this anonymous?
No. Others may see you walk into my office. So, you could be seen. No one would know your business, though. If you feel that you could not risk being see at my office, some coaching via telephone or email is an option. That is pretty anonymous.

* What types of counseling do you do?
I specialize in anger management, anxiety, and sexuality of various types (such as transgender, sexual orientation, sexual dysfunction, sexual harassment, sexual addiction, and sexual questions in general). However, I also work with depression, bipolar disorder and a variety of issues. I do individual, group, family, and couples counseling.

* Do I need medication?
Counseling is the primary focus. A high number of people get better by therapy alone. Changing your thinking and your behavior usually is enough for people to return to functional lives. However, if therapy is not working, then we will discuss referring you to have a medication evaluation. Medication alone often masks symptoms and does not get at the root of the problem.

* Will you fix me?
No, I will not. However, I will help you fix yourself. I can give you ideas, you can bounce things off me, we can work together to find solutions. However, I cannot make things better for you. Remember, you are the one who needs to do the hard work and I can help.

* What is your primary focus on therapy?
I want to talk about what is on your mind. You are the one that guides the conversation. I can provide some information and direction and information, if needed. However, I really want you to be the one who is running the show.

Do you have any additional questions that I have not answered? Leave a comment and I’ll respond.

Bipolar Disorder

What do you think of when you hear the term “Bipolar Disorder?” Many people use this term as a derogatory remark and don’t think twice about it.

It is very important to realize that this is a mental illness that can be quite serious in nature. It is not ok to refer to this diagnosis when you do not like someone’s behavior.

Bipolar Disorder consists of episodes of depression (lack of energy, feelings of hopeless), followed by episodes of mania (having too much energy, difficulty with concentration, irritability, intense anger, acting impulsively, taking risks). Sometimes, the mood swings are less pronounced and it is demonstrated by a great deal of irritability and agitation. Ultimately, Bipolar Disorder can be difficult to diagnose.

It is important to realize that it is natural to have mood swings. Environmental stressors, the typical “bad day,” and a variety of life events may cause these mood swings. It is a concern when the mood swings are causing family problems, difficulty with daily functioning, problems at work, legal problems, or using alcohol or other drugs to control mood.

Bipolar Disorder is treatable with therapy and medication. Often, you cannot identify a person with Bipolar if they are working to maintain their mental health. Unfortunately, there are people who do not respond well to therapy and medications and struggle on a daily basis. Basically, the severity of Bipolar Disorder is on a continuum.

If there is a concern that you or your loved one has intense mood swings or simply intense moods, for that matter, it would be beneficial to have a mental health assessment to closer examine the situation.

Is Counseling or Therapy Right for Me?

Counseling or Therapy in Lafayette Indiana is about working though life’s problems. You might be thinking that you can handle all of these problems yourself. Well, most of us need someone to bounce ideas off of.

This is even more helpful when that person is someone who is impartial, outside of the situation, and does not have an emotional investment in you. If you rely on friends, they will likely not tell you how it is because of fear that they will offend you!

So, you might be wondering if you have to be mentally ill in order to go to counseling. Not at all. Most of the people who come to see me are not mentally ill. Rather, the people who come to counseling are those who feel like they need some guidance, consultation, or education on a particular subject (often something related to how to manage teenagers, anger, anxiety or sexuality).

If you are still wondering if counseling is right for you, contact me to discuss things further.

Medication vs. Counseling

There is seldom a day that goes past where I don’t have a client who comes to me with a great concern that their medications are not working. Often, when I ask what they are doing for themselves, they develop a rather puzzled look on their face. Most of the time, they say that they just wait for the medication to take effect.

More and more, society is putting focus on medications while ignoring personal responsibility. It is very easy to blame a chemical imbalance in the brain when one becomes angry and harms someone, or when a person does not have enough motivation to get a job or leave the house. When people have these problems, an overwhelming number of them focus on the perceived need for medications and then are displeased to find that these medications often do not fix the problem. Really, I can’t blame a person for feeling that they should take a medication when they have such a problem. We have a society that has a huge focus on medications and there are frequent prescription drug commercials on TV.

I want everyone to realize that there is a need for medication in many cases. The current prescription medications are helpful for many people and lets them function. I think it is important to point out that people who take meds also need to take care of their mental health by looking at their thinking, how they interact with others, and their level of physical activity.

If people continue to place themselves in stressful environments, isolate themselves, have a lot of negative thinking, and get little exercise, they will likely have minimal benefit from a medication only approach. How can one attain significant changes if they do not change their thinking and behaviors?

What does counseling have to offer that medication does not? Well, medication helps to decrease symptoms so that a person can function. Counseling helps a person identify the causes of these symptoms. Often, these causes are a result of some sort of a relationship problem. Sometimes feelings of depression and anger are stemming from ourselves because we concentrate on negative things and continue to be ourselves up. How can a person feel good if there is continued negative self talk and continued relationship problems which cause very stressful environments?

I want everyone to realize that there are chemical and behavioral (thinking and doing) sides to our problems. Not everyone needs medications. Many people can manage their emotions by participating in therapy and changing their thinking and behaviors.

I urge everyone to first give therapy a try. If that doesn’t work, or has little success, then there may be a need for medication in addition to therapy.

Is Online Coaching Right for Me?

Online coaching is different from counseling or therapy because it is not face to face and cannot provide that high level of care. However, online coaching is great for those who have questions or want to learn how to manage anger, anxiety, depression, or learn how to have a better relationship.

Online coaching can be done via email, chat, webcam, or telephone. Any of these methods can be a great alternative to an office visit. The benefits include working around your schedule by utilizing sessions of an evening and late night. There is also increased privacy as a result of not having to come to a clinic and be seen by others. Online coaching is also very beneficial for people who are not yet ready to come to therapy or are unable to do so because of their busy schedule or a disability. The cost of online coaching is significantly less than that of a traditional therapy session because of lowered rates and the amount of travel time that is saved.

Online coaching is a fantastic way to see if you like what I have to offer. If you like what you get, you might want to come in for a face to face session. If you don’t like how things are working out, then I can provide you with another therapist who could be of help.

You might be wondering about long distance charges. I will call you if you live in the US or Canada. If you have an ATT cell phone, I will use my ATT phone to call you so that it does not count against your anytime minutes.