When Should Someone Go to Counseling and What Should They Expect.

Do I Have a Mental Health Problem?

Often when people think of anxiety and depression, they think of their symptoms as being feelings/emotions and the thoughts/cognitions associated with them. However, there many physical symptoms of anxiety disorders and depression. Thus, these people go to physicians thinking they have serious medical conditions when they do not. For example, many people go to the hospital thinking that they are having a heart attack because of chest pain, racing heart and shortness of breath. However, these symptoms are also characteristics of a panic attack, a type of anxiety disorder. When a medical professional indicates that all their medical tests are negative, they think there is nothing wrong and/or their family and friends sometimes tell them that they are not actually having these symptoms, and “it is all in their heads”. Unknowingly, they do not get the professional counseling they need because of the shame they feel.

Why Don’t People Who Suffer from Mental Health Conditions Attend Counseling?

Although this blog provides knowledge to educate others on the common anxiety disorders and depression, it will hopefully help those who have a mental health condition to recognize their symptoms, and alleviate shame or fear that prevents them from initiating counseling. Thus, they are more likely seek the services they need and lead a happier, productive life. Some people think that they are crazy if they have a mental condition and that they will be treated differently. No one is at fault for being anxious or depressed. Recovery and being asymptomatic has nothing to do with will power, weakness, immorality, or competence.

Most people have sought some type of counselling in their life and sometimes more than once. Having mental health disorders/conditions does not mean that he/she cannot be a functional, socially respected and a successful person as long as professional help is received. There are people who have symptoms of depression or an anxiety disorder who do not need take prescribed medication and /or may not attend counseling. This is usually because the symptoms are not chronic in frequency, number of symptoms, duration of time and more important has not affected their functioning per health, work tasks, family obligations and social interactions. However, it is time to seek profession help when symptoms affect your life.

 Biological Causes of Psychological Disorders

Mental health symptoms are characteristic of psychological disorders that are caused by and result in physical, emotional, cognitive and social issues. Many psychological conditions have genetic factors in which they are passed down from one generation to another. Examples of these are Schizophrenia, Bipolar Disorder, Anxiety Disorders, Phobias, Depression and, yes, addiction. If you know you have one of these diagnoses and know your family history, most likely you can think of family member(s) who has/had it too. Having a relative who has your mental health condition may be good if they are or have taken steps to progress in their treatment. The professional methods that helped the anxious or depressed family members may help you reduce your symptoms. Psychological disorders can be result of an imbalance of brain chemistry that cause anxiety, depressed mood, anger, mood swings, hallucinations/delusions, and paranoia. Large amounts or depleted chemicals in the brain that create these symptoms are serotonin, dopamine, and endorphins. (Alcohol and illicit drugs have this similar effect on the brain.) Psychiatric medications prescribed by physicians, psychiatrists and APRNs take the role to balance natural body chemicals and reduce symptoms. Just because a relative who have chronic mental health symptoms does not automatically mean another will have it. Knowing you have a family history of a mental health condition, someone can take precautions such as early recognition of symptoms, medication management and/or following recommended counseling which can significantly reduce the chronicity and/or longevity or regression of your mental health condition.

Like your biological factors can affect you emotionally, the stress of prolonged psychological symptoms and conditions can cause bodily ailments. Anxiety can cause headaches, migraines, stomach aches and ulcers, and muscle pain. Depression contribute to lower immunity to medical problems, self bodily harm, injuries, and suicide/death.

Overlapping Symptoms of Different Psychological Diagnoses Associated with Thoughts and Feelings

Along with physical symptoms of a mental health condition, there are also thoughts and feelings that are associated with psychological disorders. Usually thoughts are connected to feelings and feelings are connected to thoughts. If someone is depressed, they may have thoughts of low self-worth and pessimism. Due to feelings of failure, they are unmotivated or lack the energy to make attempts to feel better. Then, this results in lack of unachieved goals reinforces their negative feelings of self-worth. If someone has past thoughts of regret and worries about certain things or most things most of the time, they will avoid some or many situations that trigger fear and become anxious when they are exposed to threatening situations. Again, this can hinder the participation in activities that would promote personal goals and happiness. Thus, anxious and depressed thoughts and feelings also have negative outcomes on behavior. Negative symptoms of anxiety and depression such as irritability, restlessness, anger and isolation can have negative impact on family and social relationships.

Because of the nature of different mental health disorders, many of them have overlapping symptoms of anxiety and depressed mood. Someone with escalated anxiety and is fearful of situations will also feel hopeless and depressed. Feelings of failure, negative self-thoughts and depressed mood may lead to anxiety about the future. Symptoms of Bipolar Disorder include mood swings, mania, anxiety and depression. Hallucinations or delusions of a schizophrenic of aliens attacking the world will create feelings of anxiety. Someone with social phobia will have anxiety in social situations or when meeting new people. Someone who has post traumatic disorder will be depressed when they have flash backs of past trauma and anxiety when they are triggered in the future by events reminding them of the trauma event.

Symptoms and Diagnoses

The significance being able to identify mental health symptoms and diagnosing mental health condition helps in selecting a counseling approach and modality, treatment plan, and effective medication for the individual person.

Below are the physical, thoughts, and feelings associated with Anxiety Disorders and Depression.

Symptoms of Anxiety

Cognitions/Thoughts: Worried thoughts about particular situations or many things most of the time. Unrealistic anticipation of negative outcomes of future events. Thinking many things at once. Inability to concentrate and Memory deficits.

Emotions/Feelings: Excessive worrying resulting and inability to function. Nervousness, fear, and restlessness.

Behaviors: Tapping, biting nails, nonstop talking, fidgeting and pacing

Physical or autonomic: Racing Heart, difficulty breathing, shortness of breath, stomach problems, headaches, dizziness, and/or feeling faint. Shakes, chills, trembling, numbness, and muscle tension and aches

Common Types of Anxiety

Generalized Anxiety: Excessive worrying about most things most of time.

Panic Disorder: Sudden and unrealistic feelings of pending doom.

Social Phobia: Excessive fear of being judged or disapproval from others. Fear and anxiety in groups, social events or when meeting people.

Symptoms of Depression

Cognitions/Thoughts: Negative thoughts of self, others, or outcome of events

Emotions/Feelings: Depressed mood, feelings of hopelessness & worthlessness, Guilt, low esteem, fatigue and loss of interest and pleasurable feelings.

Behaviors: Isolation, monotone & slow speech, low motivation and low activity

Physical or autonomic: Difficulty sleeping falling sleep, staying asleep and early morning awakenings or sleeping to much. Lower or heightened appetite. Weight loss or weight gain.

Common Types of Depression

Depressive Disorder (mild, moderate or severe): One episode of depression Recurrent Depressive Disorder: Two or more episode od depressive episodes Dysthymia: chronic depressed mood lasting at least several years, but not severe and individual episodes are not prolonged for severe, moderate of recurrent depressive disorder. Post Traumatic Disorder (PTSD): Difficulty recovering after experiencing or witnessing a terrifying event. Depressed mood and anxiety triggered by Flashbacks, nightmares and memories of trauma event(s).

  Medical Treatment and Psychological Counseling

Physical Exam: Medical disease, conditions are assessed and ruled out before evaluating and diagnosing for a psychological disorder by a physician.

Medication Management: Once a medical condition has been ruled out, a psychiatric evaluation is implemented by a licensed psychiatrist, social worker or counselor so a diagnosis is determined for medication. Follow up medication appointments are scheduled when medications are prescribed.

 Common Counseling Approaches I utilized in my counseling practices:

A. Motivational Enhancement Therapy (MET):

B. Cognitive-Behavioral Therapy (CBT):

1) Breathing Relaxation Exercises: Slowing done breathing that reduces the physical symptoms of rapid breathing, fast heartbeat, shortness of breath and muscle tension

2) Breathing Relaxation with Imagery: Imagery with relaxation exercise

3) Systematic Desensitization: Using relaxation exercises while visualizing being in anxiety provoking situations rated 1 low) to 10 (high) in trauma

4) Exposure in vivo: Using relaxation exercises while being in anxiety provoking situations rated 1 (low) to 10 (high) in trauma

C) Dialectical Brief Treatment

  • Mindfulness: the practice of being fully aware and present in this one moment
  • Distress Tolerance: how to tolerate pain in difficult situations, not change it
  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
  • Emotion Regulation: how to change emotions that you want to change.

If you have any of the above symptoms of anxiety or depression or wonder if you have a mental health disorder, consult with your physician and have a psychological evaluation. If you have any thoughts or feelings of harming yourself or others, notify a family member and seek immediate medical care by calling 911.

Pleases feel free to contact me ( 860) 227-7326 or my email angela.beckerman@gmail.com if you have any questions about mental health or would like a counseling appt. I also welcome any opinions, thoughts or comments. However, remember this is public forum.

Angela Beckerman, LPC, LADC

Psychotherapist and Addiction Specialist