Anxiety Disorders:

Generalized Anxiety (GAD)

Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. Without provoking, it is chronic and exaggerated worry and tension. This disorder involves anticipating disaster, often worrying excessively about health, money, family or work. Sometimes, though, just the thought of getting through the day brings on anxiety.

People with GAD can't shake their concerns, even though they usually realize that much of their anxiety is unwarranted. People with GAD also seem unable to relax and often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, hot flashes and feeling lightheaded or out of breath.

Cognitive and behavioral therapies for generalized anxiety disorder (GAD) refer to a variety of techniques that can be provided individually or in combination. The basic premise underlying the therapy approaches is that thoughts, feelings and behaviors are inter-related, so altering one can help to alleviate problems in another (e.g., changing negative thinking will lead to less anxiety). The cognitive therapy techniques focus on modifying the catastrophic thinking patterns and beliefs that worrying is serving a useful function. The behavioral techniques include relaxation training, scheduling specific ‘worry time’ as well as planning pleasurable activities, and controlled exposure to thoughts and situations that are being avoided. The purpose of these exposures is to help the person learn that their feared outcomes do not come true, and to experience a reduction in anxiety over time.

Panic Disorder

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.Although panic attacks themselves aren't life-threatening, they can be frightening and significantly affect your quality of life.

A panic attack is really nothing more than bodily sensations of anxiety and a catastrophic misinterpretation of those sensations as dangerous. Your belief that you are in danger results in increased anxiety, which then leads to more sensations and more catastrophic thoughts, creating a vicious cycle between bodily sensations, distorted thoughts, and anxiety, which can rather quickly result in a panic attack. The real problem is actually your mistaken belief that you are in danger – not the panic itself – since panic is in fact an appropriate emotional reaction when you are convinced that you may be in danger. However, your belief is untrue, and when you understand this on a deeper level, you will master your panic.

Symptoms of a panic attack include Shortness of breath or hyperventilation, Heart palpitations or racing heart, Chest pain or discomfort, Trembling or shaking, Choking feeling, Feeling unreal or detached from your surroundings, Sweating, Nausea or upset stomach, Feeling dizzy, light-headed, or faint, Numbness or tingling sensations, Hot or cold flashes,.Fear of dying, losing control, or going crazy.

Cognitive Behavioral Therapy (CBT) has been proven the most effective way to manage and treat Panic attacks.

OCD

Obsessive-compulsive disorder (OCD) is a type of anxiety that causes repeated unwanted thoughts. To get rid of the thoughts, a person with OCD does the same tasks over and over. For example, you may fear that everything you touch has germs on it. So to ease that fear, you wash your hands over and over again.
Although it has been established that OCD has a neurobiological basis, research has been unable to point to any definitive cause or causes of OCD. It is believed that OCD likely is the result of a combination of neurobiological, genetic, behavioral, cognitive, and environmental factors that trigger the disorder in a specific individual at a particular point in time. It has also been shown that a decrease in Serotonin aids in the problem.

Symptoms of obsessive-compulsive disorder tend to come and go over time and range from mild to severe. Anxiety is the most common symptom. For example, you may have an overall sense that something terrible will happen if you don't do a certain task, such as check again and again to see if the stove is on. If you fail to check, you may suddenly feel tense or anxious or have a nagging sense that you left something undone.

There are 2 parts to OCD:

Obsessions

These are unwanted thoughts, ideas, and impulses that you have again and again. They won't go away. They get in the way of your normal thoughts and cause anxiety or fear. The thoughts may be sexual or violent, or they may make you worry about illness or infection.

Compulsions

These are behaviors that you repeat to try to control the obsessions. Some people have behaviors that are rigid and structured, while others have very complex behaviors that change.

The obsessions or compulsions usually take up a lot of time-more than 1 hour a day. They greatly interfere with your normal routine at work or school, and they affect social activities and relationships. Sometimes people may understand that their obsessions and compulsions aren't real. But at other times they may not be sure, or they may believe strongly in their fears.

Cognitive behavioral therapy (CBT) treatment for OCD may take place in individual, group or family sessions. OCD patients can experience some relief through cognitive behavioral therapy, particularly a form called exposure and response prevention. This entails gradually exposing the patient to the feared obsession. For instance, if the patient is obsessed with cleanliness, they are exposed to dirt for gradually increasing amounts of time. This helps the patient to learn new thought patterns and behaviors about their obsession with dirt. Although this form of therapy takes a lot of effort and practice, the reward is a much better quality of life for the patient.

Depressive Disorders:

Clinical Depression

Do you have symptoms of clinical depression? Sure, most of us feel sad, lonely, or depressed at times. And feeling depressed is a normal reaction to loss, life's struggles, or an injured self-esteem. But when these feelings become overwhelming, involve physical symptoms, and last for long periods of time, they can keep you from leading a normal, active life.

Symptoms of depression include: Feelings of sadness, tearfulness, emptiness or hopelessness, Angry outbursts, irritability or frustration, even over small matters, Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports, ideations and/or past attempts of self-harm such as cutting, burning, scratching, punching, etc. Sleep disturbances, including insomnia or sleeping too much,Tiredness and lack of energy, so even small tasks take extra effort, Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people,Anxiety, agitation or restlessness, Slowed thinking, speaking or body movements, Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that aren't your responsibility, Trouble thinking, concentrating, making decisions and remembering things
Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide, Unexplained physical problems, such as back pain or headaches.

The CBT (Cognitive Behavioral Therapy) approach to treating depression can be divided into its cognitive and behavioral components. In the cognitive component of treatment, therapist and patient learn to identify the distorted negative thinking that causes negative emotions. Then they question the truthfulness of these thoughts and come up with alternative balanced thoughts. They also learn about the patient's core beliefs underlying the daily automatic negative thinking, and begin to change their core beliefs about themselves.

In the behavioral component of treatment, the therapist helps the patient assess how the different daily activities have an impact on the patient's mood and how some of them can improve symptoms of depression. Therapists usually help patients develop an action plan, where they create a list of activities and then they order them from less to more difficult to achieve. As the patient goes from easier to harder activity his feeling of mastery improves as depression lessens.

It is believed that when a patient changes their core beliefs or cognition's about themselves the behaviors will naturally follow on their own.

Persistent Depressive Disorder

Persistent depressive disorder, also called dysthymia, is a continuous long-term (chronic) form of depression. You may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy. These feelings last for weeks, months, or even years and may significantly interfere with your relationships, school, work and daily activities.

If you have persistent depressive disorder, you may find it hard to be upbeat even on happy occasions. you may be described as having a gloomy personality, constantly complaining or incapable of having fun. Though persistent depressive disorder is not as severe as major depression, your current depressed mood may be mild, moderate or severe.

Childhood and Developmental Disorders:

ADHD

ADHD or attention-deficit hyperactivity disorder, is a behavioral condition that makes focusing on everyday requests and routines challenging.

People with ADHD typically have trouble getting organized, staying focused, making realistic plans and thinking before acting. They may be fidgety, noisy and unable to adapt to changing situations.

Children with ADHD can be defiant, socially inept or aggressive.

There are 3 different types of ADHD: Inattention, Hyperactivity, and Impulsivity.

Inattention

The child might procrastinate, not complete tasks like homework or chores, or frequently move from one uncompleted activity to another. They might also:,Be disorganized, Lack focus, Have a hard time paying attention to details and a tendency to make careless mistakes. Their work might be messy and seem careless. They Have trouble staying on topic while talking, not listening to others, and not following social rules. They may Be forgetful about daily activities (for example, missing appointments, forgetting to bring lunch), Be easily distracted by things like trivial noises or events that are usually ignored by others.

Hyperactivity

It may vary with age. You might be able to notice it in preschoolers. ADHD symptoms nearly always show up before middle school. Kids with hyperactivity may:Fidget and squirm when seated, Get up frequently to walk or run around, Run or climb a lot when it's not appropriate. (In teens this may seem like restlessness.) Have trouble playing quietly or doing quiet hobbies, Always be "on the go"

Talk excessively. Toddlers and preschoolers with ADHD tend to be constantly in motion, jumping on furniture and having trouble participating in group activities that call for them to sit still. For instance, they may have a hard time listening to a story. School-age children have similar habits, but you may notice those less often. They are unable to stay seated, squirm a lot, fidget, or talk a lot. Hyperactivity can show up as feelings of restlessness in teens and adults. They may also have a hard time doing quiet activities where you sit still.

Impulsivity

Symptoms of this include: Impatience, Having a hard time waiting to talk or react, Having a hard time waiting for their turn, Blurting out answers before someone finishes asking them a question.

Frequently interrupting or intruding on others. This often happens so much that it causes problems in social or work settings. Also Starting conversations at inappropriate times.

Impulsivity can lead to accidents, like knocking over objects or banging into people. Children with ADHD may also do risky things without stopping to think about the consequences. For instance, they may climb and put themselves in danger.

Research shows that behavior therapy is an important part of treatment for children with ADHD. ADHD affects not only a child’s ability to pay attention or sit still at school, it also affects relationships with family and other children. Children with ADHD often show behaviors that can be very disruptive to others. Behavior therapy is a treatment option that can help reduce these behaviors. It is often helpful to start behavior therapy as soon as a diagnosis is made.

The goals of behavior therapy are to learn or strengthen positive behaviors and eliminate unwanted or problem behaviors. Behavior therapy can include behavior therapy training for parents, behavior therapy with children, or a combination. Teachers can also use behavior therapy to help reduce problem behaviors in the classroom.

In parent training in behavior therapy, parents learn new skills or strengthen their existing skills to teach and guide their children and to manage their behavior. Parent training in behavior therapy has been shown to strengthen the relationship between the parent and child, and to decrease children’s negative or problem behaviors. Parent training in behavior therapy is also known as behavior management training for parents, parent behavior therapy, behavioral parent training, or just parent training.

In behavior therapy with children, the therapist works with the child to learn new behaviors to replace behaviors that don’t work or cause problems. The therapist may also help the child learn to express feelings in ways that do not create problems for the child or other people.
While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome.

Autism Spectrum Disorders

Autism spectrum disorders include social, communication, and behavioral challenges. These problems can be mild, severe, or somewhere in between. Early diagnosis is important, because early treatment can make a big difference. The 3 major spectrum disorders are:

Asperger's syndrome

This is on the milder end of the autism spectrum. A person with Asperger's may be very intelligent and able to handle daily life. They may be really focused on topics that interest them and discuss them nonstop, but have a much harder time socially.

Autistic disorder

This older term is further along the autism spectrum than Asperger’s. It includes the same types of symptoms, but at a more intense level.

Pervasive developmental disorder, not otherwise specified (PDD-NOS)

This mouthful of a diagnosis included most children whose autism was more severe than Asperger's syndrome, but not as severe as autistic disorder.

While there is no “cure” to Autism spectrum Disorder, there are many ways to help minimize the symptoms and maximize abilities. People who have ASD have the best chance of using all of their abilities and skills if they receive appropriate therapies and interventions. The most effective therapies and interventions are often different for each person. However, most people with ASD respond best to highly structured and specialized programs. Some of these interventions include:Behavioral management therapy , Cognitive behavior therapy, Early intervention, Educational and school-based therapies, Joint attention therapy, Medication treatment, Nutritional therapy , Occupational therapy, Parent-mediated therapy ,Physical therapy, Social skills training, and Speech-language therapy.

Research shows that early diagnosis and interventions, such as during preschool or before, are more likely to have major positive effects on symptoms and later skills.

Oppositional Defiant Disorder (ODD)

Even the best-behaved children can be difficult and challenging at times. But if your child or teen has a frequent and persistent pattern of anger, irritability, arguing, defiance or vindictiveness toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). Sometimes it's difficult to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's normal to exhibit oppositional behavior at certain stages of a child's development.

Signs of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. These behaviors cause significant impairment with family, social activities, school and work.

ODD is characterized by the frequent occurrence of at least four of the following behaviors: losing temper, arguing with adults, actively defying or refusing to comply with the requests or rules of adults, deliberately doing things that will annoy other people, blaming others for his or her own mistakes or misbehavior, being touchy or easily annoyed by others, being angry and resentful, or being spiteful or vindictive.Negativistic and defiant behaviors are expressed by persistent stubbornness, resistance to directions, and unwillingness to compromise, give in, or negotiate with adults or peers. Defiance may also include deliberate or persistent testing of limits, usually by ignoring orders, arguing, and failing to accept blame for misdeeds.Hostility can be directed at adults or peers and is shown by deliberately annoying others or by verbal aggression.

The cornerstones of treatment for ODD usually include:

Parent training. A mental health provider with experience treating ODD may help you develop parenting skills that are more positive and less frustrating for you and your child. In some cases, your child may participate in this type of training with you, so that everyone in your family develops shared goals for how to handle problems.

Parent-child interaction therapy (PCIT). During PCIT, therapists coach parents while they interact with their children. As a result, parents learn more-effective parenting techniques, the quality of the parent-child relationship improves and problem behaviors decrease.

Individual and family therapy. Individual counseling for your child may help him or her learn to manage anger and express feelings in a healthier way. Family counseling may help improve your communication and relationships, and help members of your family learn how to work together.

Cognitive problem-solving training. This type of therapy is aimed at helping your child identify and change thought patterns that lead to behavior problems. Collaborative problem-solving — in which you and your child work together to come up with solutions that work for both of you — can help improve ODD-related problems.

Social skills training. Your child also might benefit from therapy that will help him or her learn how to interact more positively and effectively with peers.