Post-Traumatic Stress Disorder

The term “PTSD” is thrown around fairly often.  People sometimes use it to describe something that was unpleasant, like “I have PTSD from standing in line for 3 hours on Black Friday”.   However, Post-traumatic Stress Disorder (PTSD) is so much more than an unpleasant experience.

Not everyone develops PTSD after experiencing a traumatic or life-threatening event, but for those who do, it is no joking matter.  The symptoms of PTSD can interfere with your ability to function on a day to day basis.  They can rob you of enjoying the small moments in life.  PTSD makes people feel as if the alarm bells are constantly on, and that they have to be on alert for danger at all times.

In order for a clinician to diagnose someone with PTSD, there are very specific criteria that have to be met.  At CBT Associates, we will evaluate your symptoms, and then use evidence-based therapies to address the symptoms of PTSD and help you learn to turn the alarms off.  

Depression

Depression is not just being down or having a bad day. Depression is not sadness. Depression is a mood disorder that affects how a person thinks, feels, and interacts with others. Depression interferes with their ability to complete daily activities such as work, sleep, eat, or study, and it can take away the joy they once felt when spending time with friends or participating in a hobby. It isn’t something you can “just snap out of."

Depression is treatable. Cognitive Behavioral Therapy (CBT) makes the same changes in the brain as medication, although it may take more time, the effects last longer. The treatment plan depends on the severity of the depression.

Depression lies, it tells us things that we believe are true, but have very little basis in facts. It says things to us that we would never say to someone else (“You’re worthless”, “No one will ever love you”, etc). Of course, that kind of self talk would make anyone feel badly. CBT teaches people how to identify the self talk, check to see how accurate it is, and if it is accurate, how to make a plan to handle the situation. If it is not accurate, we find a more realistic way (NOT a positive way) to think about things.

CBT also focuses on increasing actions that make us feel better. Depression likes to hide and withdraw from the world. Fighting that urge helps make the depression go away. In therapy, we can work on finding the things you used to enjoy and work on a realistic plan for enjoying life again.

For severe depression, a referral to a psychiatrist for further evaluation and medication may be necessary to help with treatment progress.

Obsessive Compulsive Disorder

Cognitive-behavioral therapy is the recommended treatment for Obessive Compulsive Disorder (OCD).  Before beginning treatment, we will do a thorough evaluation of the things you can't stop thinking about (the obsessive thoughts) and the things that you do to try to make the thoughts go away (compulsive behaviors).  We then take that list and work with you to rate how uncomfortable you would feel if you were stopped from doing the compulsive behavior.  We rate them on a scale from 1-10, with 1 being something you could probably change fairly easily, and 10 being the thing that you can't even imagine changing.  We start with the easy stuff, just like in lifting weights.  We never have you try to do anything that seems too hard, just like we would never hand you a 500 lb barbell and tell you to lift it.  We work together to conquer OCD.

PostPartum Depression

Babies are hard on a family, they are especially tough when you have just given birth to one.  Not every mom develops post-partum depression, but for those who do, it makes a major life change seem unbearable.  Cognitive-behavioral therapy can help with the symptoms of post-partum depression.  We begin by focusing on how much support the mom has in caring for her baby, how much sleep she is able to get, and how she is taking care of herself.  We also work on the negative self-talk of moms who are trying to be the picture of perfect motherhood and all the things a woman feels she "should" be doing to be the perfect mom.  We are both moms at CBTA, and have worked with many mothers who have experienced post-partum depression.  

Anxiety

It is common to feel anxious before a test, job interview, or if you have to give a talk in front of a group of people. This feeling usually subsides once you start and it is temporary. With an anxiety disorder, a person’s fears or worry are persistent, more severe, and interferes with their daily activities and sometimes relationships.

There are different types of anxiety disorders such as Generalized Anxiety disorder; Anxiety disorder, NOS; Social Anxiety; Panic disorder; and specific phobias. Generalized Anxiety disorder causes persons to have excessive worry for months, and they feel tense, irritable, easily fatigued, difficulty with focus, sleep, and are not able to control the worry. Panic disorder is recurrent and unexpected times of intense fear that could include sweating, trembling, increased heart rate, shortness of breath, and a feeling of impending doom. While persons with Social anxiety disorder are highly anxious around other people, and feel self –conscious in social situations. They worry they will be judged, humiliated, or rejected and this makes it difficult for them to make or keep friends. They will avoid social situations and events.

When a person avoids the thing that makes them feel anxious, they may experience temporary relief but the avoidance actually reinforces the anxiety. Making it worse over time and more pervasive. Treatment for anxiety disorders include learning coping and relaxation skills to face their fears, and CBT to learn new ways of thinking and reacting to anxiety producing situations. CBT can help a person learn to identify and challenge unhelpful thoughts that lead to anxiety. A person with social anxiety can learn and practice social skills to help them interact with others more effectively. People with anxiety disorders can manage their feelings to lead a more calm and productive life.

Oppositional Defiant Disorder

Most children and teens will test limits and argue with their parents from time to time. This can happen more frequently when kids are tired, hungry, upset, or going through a stressful change in their life. Children with ODD have a recurrent pattern of hostile and defiant behavior that has lasted at least 6 months, is directed at authority figures likes parents and teachers, and is causing disruption within the family and at school. They also have frequent temper tantrums, and will argue excessively with adults about rules and requests. They can be easily annoyed by others, and deliberately try to upset or irritate others. They also have a hard time taking responsibility for their own behavior.

These behaviors create strained relationships for the child with family, teachers and peers. This is why it is important to seek help and not wait for a child to “grow out of it”.

Short term programs such as boot camps or other scare tactics are not effective in treating ODD. In fact, trying to forcibly coerce or scare your child into behaving may increase aggressive behavior.

Effective treatment for ODD is cognitive behavioral therapy (CBT), parent training, and collaborative problem solving. Kids with ODD often interpret situations as negative or “unfair” and will act out. CBT teaches them to see things from a more realistic viewpoint so that they can better tolerate frustration and improve how they interact with others. Then parents will learn how to set age appropriate limits, follow through calmly with logical consequences, and how to reinforce positive behaviors. Finally, collaborative problem solving teaches parents and children how to actively listen to one another while working together to solve their problems.