Tag Archives: counseling

How to Deal with the Mental Health Provider Shortage

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With mental health providers already in limited supply the increase in the need for services due to the stresses caused by the pandemic has made finding help extra difficult as of late.  If you are just starting out with problems, your primary doctor or ob-gyn might be a good place to start. In addition to doing an initial assessment, taking a history and prescribing medication, they can refer you to the appropriate mental health professional, if needed.

The obvious way to find providers is to check your health plan provider list. Consider those outside your area who offer teleheath services via the phone or computer. This could widen your options quite a bit. 

Seeing providers out of network or paying out of pocket may be other options to facilitate access to providers, which unfortunately are more costly and not possible for many people.  Although, some providers may offer a sliding-fee scale for those who are self pay that allows them to pay based on their personal income and what they can afford.

If you or your spouse are employed, you can check to see if your employer offers an Employee Assistance Plan (EAP) which is separate from the medical plan. Typically you can access counseling at no cost on a short-term basis. Check with your HR department. 

If you are a student, take advantage of any free campus or university resources.

Your local church might offer pastoral counseling from a trained clergyman or woman which is usually free.

Some teaching colleges and universities may offer low-cost therapy provided by grad students who are supervised while they gain counseling experience. If there is such a school in your area, contact the psychology or behavioral health department and inquire.

SAMHSA is a government organization that is the go-to resource for locating affordable mental health care nationwide. Contact them at 1-800-662-4357 or online https://findtreatment.samhsa.gov

Online therapy is another option with chats with actual therapists from places like Better Help, TalkSpace or 7 Cups.com.

Theravive is a resource directory you could investigate for low cost therapists by state. 

Open Counseling is another resource for attaining accessible care. The site indicates if providers are accepting new clients and many list their rates. 

Open Path connects low-cost therapists to patients. I think you pay a lifetime membership fee and then get access to discounted rates on therapy sessions in the future. 

You can also get professional help getting professional help by contacting NAMI support services. Call their helpline, 1-800-950-NAMI (6264) to find a chapter or services in your area. 

If your mental health puts you in an immediate crisis, help is always available by going straight to the hospital emergency room. All emergency rooms have access to psychiatric care. 

Are you having trouble accessing mental health services?  What are you doing about it?

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What About Counseling Works?

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Have you ever been to counseling? Did it help? I have been many times and it has helped many times and other times it has not.

I don’t know if it is where I was at or where the counselor was at, but the times it didn’t work were in particular with this one therapist who didn’t seem too confident in herself. Quite frankly, she looked like a deer in headlights which surprised me because she was an older lady so I assumed she had years of experience, but who knows, maybe she was a recent graduate.

On the other hand, I was pretty sick at the time. My symptoms were out of control with much hypomania and anxiety going on, so many of her tactics flew in one ear and right out the other. It was probably more of a “it’s me not you” thing going on.

The times that therapy works, however, oh those glorious times…like today. I went in there wound tight as a watch and left walking a little taller, out into a world that seemed a lot brighter than when I went in.

My good therapist, rephrasing my feelings back to me, validating my emotions, asking insightful questions and providing practical and logical feedback. What a grand lady!

Tell me, has counseling ever helped you?

What’s Good About Depression?

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Researchers say there are some positives to having depression. I am not so sure I agree with them. Let’s take a look at what they are saying:

  • Depression makes you a better problem-solver because you need to figure out (usually with the help of a therapist) how to deal with your existing symptoms and the problems they cause in your life.

My thought on this is if we knew how to deal with our problems in the first place, many of us wouldn’t have became depressed to begin with.

  • Depression forces you to learn how to cope, again, usually with the help of a therapist or professional of some sort. Admittedly, researchers say that those who are depressed often initially choose poor coping mechanisms such as drinking.

So what I am hearing is that many of us had poor coping mechanisms which probably increased our chances of becoming depressed in the first place. I don’t see the positive in this.

  • You have better relationships because those who are depressed become better, as part of their healing process, at prioritizing what is and who is important in their lives.

Again, this suggests that before professional help, we did not have the ability to prioritize well. I know this was the case for me as I put financial security above my relationships and my own mental health which lead to a breakdown that almost cost me my life.

  • Depression can make us more compassionate to others going through hard times.

This I totally agree with, hands down! You can’t really understand what a person is going through unless you have been there yourself.

  • We are better at dealing with stress after going through the process, with a therapist, of figuring out what went wrong and how to avoid or manage future stressful times.

While this is true, again, it points to the fact that we did not deal with stress very well before the depression took over.

  • We are more realistic because we better understand what we have control over and what we don’t in life.

Again, we do now, but not before the depression took hold.

  • We can detect deception because we tend to have a more “realistic” view on life.

Realistic? How about pessimistic or cynical – those would be my choice of words.

Don’t get me wrong – I love that research is trying to say there are benefits to having depression. It is all about looking at the glass half-full, I suppose. But, if your depression is anything like mine, there wasn’t any water in the glass to begin with. What are your thoughts on this?

The Do’s and Don’ts of Mental Health Blogging

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The National Institute on Mental Health (NIMH) news reports that over 50 research studies worldwide have found that the type of news coverage on suicides makes a difference in the influence it has on the suicide rates of its viewers who are at risk for it.

The longer and the greater the coverage of a suicide story, the more likely vulnerable individuals may commit suicide themselves. Explicitly describing the suicide method and using dramatic headlines are big no-no’s as well.

However, “careful” reporting on suicides can change public misperceptions and dispel myths, thereby encouraging those at risk to seek help.

What does this mean for us mental health bloggers?

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While our audience may not be in the millions like network television stations or hundreds of thousands like those of major newspapers and internet news sites, I think we should still be responsible in how we describe our own struggles with mental illness and our own thoughts on self-harm and suicide.

I have seen bloggers on either end of the spectrum here. On one hand, some are overly cautious and post “trigger warnings” on most everything they write or vlog about. Trigger warnings are little blurbs that say, “Hey, I am getting ready to write or talk about something that could trigger negative symptoms in you, so continue reading/listening at your own risk.”

I like trigger warnings because sometimes I am in a bad space with my own mental illness symptoms to where listening to someone talk about their self-abuse habits or their detailed thoughts of suicide may cause me some sleepless nights at best, and at worst, may tempt me to entertain such ideas myself.

I have also come across bloggers who write about or post vlogs about the details of their childhood abuse, which is a huge negative trigger for me. For those of you who put trigger warnings on this type of stuff, I thank you, because I will skip those parts entirely. Maybe some people want to read about it; maybe it helps others, but for me it triggers panic attacks. In my opinion the details of such events are best dealt with in therapy or within your own private journal.

Now, I am not proposing we don’t mention the fact that the abuse happened at all. If it did, it is important to validate the horrifying affect it had on us. I am merely suggesting that the minute details of the specific acts themselves be kept out of public posts. To me, the negative effects on the reader far outweigh any positive ones.

Another hot topic in the mental health blogosphere is self-harm behaviors. Some bloggers not only name the behavior, which is acceptable in my opinion, but go on to detail why they do it, what it feels like and looks like, and the thrill or release or whatever “positive” thing they are getting out of it. I understand it works for many people (I used to be one of those individuals; I get it!) However, sensationalizing it, as the NIMH states, only encourages others to do it, and that is not what we want.

Based on NIMH’s suggestions, I propose that we bloggers:

  • Help reduce the risk of contagion by including posts or links to treatment services, warning signs and suicide hotlines.
  • Include stories of hope and recovery; information on how to overcome self-harm behaviors and cope with suicidal thinking.
  • Focus on solutions rather than just the problems.

What suggestions would you have for mental health bloggers?  Share them in the comment section below.

For a side-bar list of suicide warning signs you can include in your posts visit http://reportingonsuicide.org/warning-signs-of-suicide/

If you or someone you love is suicidal you can call the U.S. National Suicide Prevention Lifeline at 1-800-273-TALK (8255), a free, 24/7 service that can provide support, information and local resources. For those outside the U.S., visit http://www.suicide.org/international-suicide-hotlines.html to find suicide hotlines in your country.

How to Deal With Complex PTSD Triggers

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Dealing with PTSD Triggers

Current Symptoms

Racing thoughts. Obsessive compulsive behaviors, such as cleaning, organizing, exercising. Increased negative coping behaviors, such as overeating, smoking, and drinking. Physical pains, such as upset stomach, migraines, muscle aches and fatigue. Early morning waking. Increased irritability. Forgetfulness. Tightening chest. Racing heart rate – literally hearing my heart pounding in my ears. Shallow, rapid breaths. Dissociation or feelings of having an “out-of-body” experience.

These are common occurrences for those of us with anxiety disorders. This week, I experienced all of them (except for the drinking.) Only after forcing myself to sit down long enough to do some journaling was I able to identify the source of my anxiety…

Triggers

There is always a cause for anxiety. Did you know that? It just doesn’t come because “we are crazy.” There is always a root cause, and it serves me well to sit down and face the fear of finding out what it is, because once I realize what is causing it, I can deal with it, and the symptoms will subside.

Sometimes finding the cause isn’t as simple as it can be with straight-forward Post Traumatic Stress Disorder symptoms, which are caused by specific events such as accidents and natural disasters. Sometimes the events are actually an accumulation of events occurring over a period of months or years, where the person is subject to long-term, repeated trauma as in the case of child abuse. In such cases, the term “Complex PTSD” is often used even though it is not officially a diagnosis included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) (at the time of this writing.)

This week my three-day anxiety attack which culminated into a full-blown panic attack was triggered by a few things. First of all, I shared my BPD story last weekend, which set my anxiety level higher than normal, but in and of itself didn’t cause me too much stress. However, add that to the fact that on two different occasions last week I unexpectedly ran into different individuals with whom I went to high school, and then the kicker was an unplanned evening of looking through my high school yearbooks (at my daughter’s request.) She wanted to see what her dad and I were like back in the day, and I didn’t think twice about taking a trip down memory lane. Next time I will.

Past Trauma

High school was a very traumatic time for me. My parents’ alcoholism was at its peak; dysfunction and emotional neglect were at an all time high in our home. Memories of those years are clouded with my own drunken states filled with self-harm behaviors and untreated bipolar and borderline personality disorder symptoms.

Before going to bed that evening, I made a passing comment to my husband about feeling a little anxious after looking through those yearbooks, and then I thought nothing more of it.

Three days later, I had my first panic attack in many, many months.

After quickly figuring out the cause of my anxiety (due only to writing about my feelings, which is why “Write into the Light” is my mantra) I began to ask myself many questions:

  • Is knowing the cause of my anxiety enough to make it go away?
  • Do I need to worry that these memories triggered me the way they did?
  • Is this a sign that I need to work out some more stuff in therapy with my counselor, who I haven’t needed to see in six months now?
  • Does this mean I am not healed all the way like I thought I was?

Healthy Coping Skills

I was a mess at this point. But, here are the skills I used to cope with my state of mind at the time. My hope in sharing these is that it will give you some ideas to try when you find yourself experiencing extreme anxiety.

First, I left messages for two friends who I knew would understand, and I also left a message for my therapist.

Next, I tried sitting with and observing my feelings, thoughts, and body sensations without judgment; trying not to push anything away nor hang onto anything. Just noticing and observing as if I was an outsider looking in.

I tried soothing myself by rubbing scented lotion on my arms and hands, which didn’t help much.

Then I decided to call my doctor to get an emergency refill of my PRN anti-anxiety medication. Luckily, the pharmacy filled it in ten minutes, and also luckily, my husband was due home for his lunch break and was able to pick it up on his way.

While waiting, I wrapped myself in a warm blanket and sat in a fetal position on the couch in a quiet room. This helped calm me immensely.

I also said some simple prayers.

I took my medication at the same time my therapist called back. After telling her what happened, she said that I might need to try some “exposure therapy” meaning that I look at the yearbooks when I am in a good place emotionally and mentally, and even then only for a short time, and maybe not with my young daughters.

Integration

I made the comment to her that I thought I had gotten past this part of my life, that my negative feelings about it were gone. She said they are always going to be there; that the goal is not to get rid of the bad memories, which is impossible, but to instead integrate them. Integration is the goal. (Integration: The organization of the psychological traits and tendencies of a personality into a harmonious whole.)

She also said that I should try to dig up a few good memories from that time. She said they are probably there, but are just overshadowed by the bad ones. At first I didn’t think she was right, but then I made a conscious effort to get out of my black and white/all or nothing thinking, and started thinking dialectically – where good and bad memories can co-exist. And guess what? She was right!

Discussion Questions:

When you’re anxious do you dig deep to find out what the root cause is? It may be something more than what it appears to be on the surface.

What physical symptoms do you have when you are feeling anxious? Do you take the time to sit and notice your body’s sensations and your mind’s thoughts during these times? Why or why not?

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Until next time…