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It is easy to get grief confused with a major depressive episode (MDE) and vise versa. Both include feelings of sadness, at times hopelessness, and a state of unease or generalized dissatisfaction with life (dysphoria). So how do you really know the difference between both? Thankfully there are some clues to help you distinguish the […]
It is easy to get grief confused with a major depressive episode (MDE) and vise versa. Both include feelings of sadness, at times hopelessness, and a state of unease or generalized dissatisfaction with life (dysphoria). So how do you really know the difference between both? Thankfully there are some clues to help you distinguish the two.
Let’s start with talking about grief. Grief is typically felt in response to loss which leaves a person feeling empty. Grief also typically will decrease in intensity over a couple of days to sometimes a number of weeks, but the idea is that is does in some way begin to lift. Grief is most commonly experienced in short waves which are also accompanied by a lot of memories of the deceased. During the “waves” of grief, there come specific thoughts or preoccupations but generally speaking the person’s self-worth is preserved. Grieving people also tend to occasionally have feelings of grief that can be followed by funny stories or pleasant reminders of the deceased that may make them feel moments of happiness. If there are any questions of the bereaved’s self-worth it is most likely in response to regrets, or feelings of failure, that are directly related to the loss (I should have donated an organ, I should have visited more often etc.). It is important to note that someone experiencing grief may have feelings of taking their own life, known as suicidal ideation, but that is typically in response to a desire to join the deceased or for the pain of the loss to end.
A Major Depressive Episode (MDE) on the other hand can be quite overwhelming for an individual that can last for weeks. The main characteristic of an MDE is that a person really cannot anticipate pleasure of good things along with a persistent depressed mood. There is an unrelenting feeling of misery and unhappiness. There can be suicidal ideation but this is typically in response to feelings of worthlessness, feeling undeserving of life, or the person may feel it is the only way to stop the feelings of depression. Significant changes in diet (too much or too little), sleep (again, too much or too little), changes in weight (5% or more in 4 weeks), becoming fidgety or slowed down, loss of energy, inability to concentrate are all also important markers of Major Depression. We all have some level of depression at times, but these symptoms must really impact your daily life (work, school, relationships etc.) in order to truly be considered a part of an MDE.
According to the National Institute of Mental Health (NIMH), in 2014 15.7 million Americans 18 years (or 6.7 %) were diagnosed with at least one MDE in the last year.
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Whether it is grief or depression, the good news is that you do not have to manage the difficult feelings alone. You may not feel like reaching out to talk with someone all the time, but do not isolate yourself. Even if you just have to ask a friend or family member to come sit on the couch while you cook dinner just to be in the house with you…. start there. Grief and depression both tempt us to isolate and hurt alone but suffering in silence really is not the solution. Know that if you are struggling with grief, your journey will be unique and be patient with yourself. If you are going through an MDE, remember that there is real help out there to support you through the darker days.
If you or someone you love needs to speak with a counseling professional, we are here to help.
If you would like to scheduled a session, feel free to contact Flourish Counseling Co. at 407-630-7529 or schedule immediately with us online at www.flourishcounseling.co.
* IMPORTANT REMINDER: Please keep in mind as you read this article that this is NOT meant to be used as a diagnostic tool, but rather a simple checklist that includes common markers of both conditions. If you are experiencing symptoms, it is recommended you schedule an appointment with a professional that can provide an appropriate diagnosis.
About the Author
Cristina Ally, LMHC, is the owner of Flourish Counseling Co. in Winter Park, Florida. She specializes in women’s issues, sexual abuse recovery and diabetic lifestyle adjustment. She has helped countless individuals and families reach optimal mental and emotional health by providing counseling and trauma resolution in the Orlando area since 2015. She is currently the President of the Mental Health Counselors of Central Florida and is a passionate advocate for mental health.
Anxiety is something I handle with clients on a regular basis. It can be something I handle as an issue of its own or something that can be a symptom of another problem in a person’s life. The bottom line is that anxiety can really rob a person of daily peace. Sometimes I call a […]
Anxiety is something I handle with clients on a regular basis. It can be something I handle as an issue of its own or something that can be a symptom of another problem in a person’s life. The bottom line is that anxiety can really rob a person of daily peace. Sometimes I call a symptom of anxiety “bully thoughts” which is when there can be excessive worry about what could go wrong, extreme needs for perfection, and unrealistic catastrophizing (believing that the worst is going to happen) etc. So, what do you do about it?
Well, there can be a lot of unique solutions but one technique to help manage your excessive worry is what I call the worry box. This is something you can try if you feel like you need a technique to help you:
Allow yourself to worry on purpose for 15 minutes each day
Set a specific time and use a timer
Worry about anything and everything!
Tell yourself during that time all things go…
Rehearse the worst case scenarios.
This is a time when you can allow yourself to purposefully think about the worst possible case scenarios in your mind
Let your thoughts run wild!
Get creative in your processing.
You can journal, pace or just think but worry on purpose. Some people like to draw the worst case scenarios.
Use this space as a sort of BOX for your worry!
This can be a buffer during the day. Remind yourself will have time to worry about everything tonight, in an hour, in the morning etc.
Believe it or not this works for many clients! It can be a helpful way to help manage this issue rather than the issue managing you. You can have control over your thoughts. You don’t have to live with your anxiety forever. Whether there are solutions through medications to cure chemical imbalances or relaxation techniques to help you manage stress healing is possible.
If you would like to scheduled a session, feel free to contact Flourish Counseling Co. at 407-630-7529 or schedule immediately with us online at www.flourishcounseling.co.
About the Author
Cristina Ally, LMHC, is the owner of Flourish Counseling Co. in Winter Park, Florida. She specializes in women’s issues, sexual abuse recovery and diabetic lifestyle adjustment. She has helped countless individuals and families reach optimal mental and emotional health by providing counseling and trauma resolution in the Orlando area since 2015. She is currently the President of the Mental Health Counselors of Central Florida and is a passionate advocate for mental health.
What is self-care? Self-care has become somewhat of a buzz word in popular psychology. In a world filled with on-the-go professionals and families, people are finding it hard to slow down and, well, care for self. But what exactly is self-care? Simply put, it is the ability for a person to provide a measure of nurturing for […]
Self-care has become somewhat of a buzz word in popular psychology. In a world filled with on-the-go professionals and families, people are finding it hard to slow down and, well, care for self. But what exactly is self-care? Simply put, it is the ability for a person to provide a measure of nurturing for him or herself.
Self-care has become increasingly important as our society demands more of us everyday. At its best, it is used as a preventative measure that increases our capacity for handling stress so we have fewer emotional breakdowns. But self-care can also serve as a protective measure once we’ve hit rock bottom. It can be a great way to lift ourselves up after we feel destroyed.
Self-care should increase you ability to feel calm, centered and connected to the joy that lies dormant within you. As you can imagine it may look different for everyone. I would never consider golfing as self-care since it actually causes anxiety for me. However, a sports enthusiast may find it’s a great way to detox from a day in a stress-filled corporate life. I love painting my nails while watching a romantic comedy but that is far from likely going to be the choice of my husband. You get the point.
Questions to clarify what it is for you…
So here are some questions to help guide you in your pursuit:
– What brings you to life?
– What activities make you want to smile?
– What makes you want to take a relaxing deep breath when you think about it?
– What scenes or locations do you find yourself longing for?
– What is a great hobby?
– How can you care for you body?
– How can you care for your mind?
– How can you care for your spirit?
These are just a few guiding questions. If you’re having a hard time thinking about what you could do for self-care consider talking with a friend or family member. Sometimes an outside perspective can really help enlighten us! Here is also a list of common things people may like to do:
1. Breathe
2. Take a bath
3. Self-massage
4. Take a walk in nature (no phones)
5. Listen to guided imagery
6. Journal
7. Pray
8. Coffee with a friend
9. Sit in silence to enjoy a mindful moment
10. Get a good night’s rest
Consider ways you would like to “take yourself out on a date” and enjoy your own company. If you are struggling with a consistently high level of stress, feel like you may need to recover from a haunting past trauma or just need a safe place to talk, there is help. Contact a counseling professional to help walk you through this season.
We would love to work with you! If you would like to scheduled a session, feel free to contact Flourish Counseling Co. at 407-630-7529 or schedule immediately with us online at www.flourishcounseling.co.
80+ Self-Care Activities from the Self-compassion Project
About the Author
Cristina Ally, LMHC, is the owner of Flourish Counseling Co. in Winter Park, Florida. She specializes in women’s issues, sexual abuse recovery and diabetic lifestyle adjustment. She has helped countless individuals and families reach optimal mental and emotional health by providing counseling and trauma resolution in the Orlando area since 2015. She is currently the President of the Mental Health Counselors of Central Florida and is a passionate advocate for mental health.
Expect the unexpected And just like that, he was gone. We would’ve seen it coming had it been during one of the many emergency visits to the hospital or during one of the countless surgeries he had on his skull. But no, this was unexpected, making it all the more traumatic for a nine-year-old. I […]
And just like that, he was gone. We would’ve seen it coming had it been during one of the many emergency visits to the hospital or during one of the countless surgeries he had on his skull. But no, this was unexpected, making it all the more traumatic for a nine-year-old. I was that nine-year-old. And he was my brother, Nathaniel — born with numerous special needs and undiagnosed syndromes in 1997, who just four short years later left this earth on November 11, 2001 due to a cardiac arrest.
My parents, empathetic to a community who five years prior had been strangers, decided to turn their grief and loss into a triumph and victory to bring hope and help to other families who were like us: worn out and challenged with the assignment of caregiving for a special needs child. So it was then in 2002 that Nathaniel’s Hope, a nonprofit celebrating kids with special needs (our VIP kids), was born.
Over the past 14 years we’ve had over 11,000 kids register as part of our free national VIP Birthday Club. We’ve seen hundreds (if not thousands) of families benefit from our national respite program, Buddy Break, where we partner with churches around the U.S. to bring free practical assistance to VIP families for three hours each month, so that caregivers can get a much needed break. We’ve distributed toys and goodies to thousands upon thousands of kids (and adults) stuck in the hospital on Christmas day with our Caroling for Kids program, and allowed just as many VIP families to shop for free toys at Nathaniel’s Toy Shop at Christmastime. Finally, we’ve been Making ‘m Smile since 2002 when we launched our first Make ‘m Smile Festival at Lake Eola in Downtown Orlando. Now, in 2016, we have our 14th Annual Festival, which we deem the BIGGEST party celebrating kids with special needs, with an estimated 40,000+ in attendance.
WHAT? Does this sound like something that would come from death?
Not to me. But we are grateful — I am grateful — that God uses everything for good.
So, if you have a brother, sister, son, daughter, or client with special needs, Nathaniel’s Hope is a resource for you. Join us on Saturday, June 4, 2016 for Make ‘m Smile — all VIPs and their immediate families get in FREE! Or come as a Buddy and be a friend by participating in our Friendship Stroll. It’s so much fun and packed with entertainment —just like a theme park. In fact, many VIP kids say it’s better than Disney world!You’re officially invited. To learn more about, or to register for, Make ‘m Smile or any of our Nathaniel’s Hope programs and events, simply visit NathanielsHope.org.
Oh, and in case you were wondering…that nine-year-old? Though such an early childhood death took it’s toll on her own mental health, she’s now in her master’s program to become a licensed mental health counselor to help kids process through grief, loss and trauma similar to what she experienced.
Would these unexpected GOOD events have resulted without the unexpected BAD events?
Only God knows.
But with God, I’ve learned to expect the unexpected.
Nathaniel’s Story
Learn more about Nathaniel’s Hope, the heart of the program and
get to know the Kuck Family through this video (shown above).
Brianna Kuck is currently a graduate student at Palm Beach Atlantic University pursuing her Master of Science in Mental Health Counseling. She is currently the Event & Communications Coordinator at Nathaniel’s Hope. Through Teams Commissioned for Christ International she lives out her passion for missions by facilitating & participating in trips to Guatemala.
One in three girls… and one in six boys… will be sexually abused before they are eighteen. I live in a well- established Orlando neighborhood; 717 registered sex offenders – many of them predators – live within five miles from my home. I scrolled through page after page of the 717 offenders, looking at the faces and asking myself “would I […]
One in three girls… and one in six boys… will be sexually abused before they are eighteen. I live in a well- established Orlando neighborhood; 717 registered sex offenders – many of them predators – live within five miles from my home. I scrolled through page after page of the 717 offenders, looking at the faces and asking myself “would I have thought that person was a sexual offender?” Of course, some of the faces looked like someone I would be leery of, but many of them would have fooled me based on looks alone. Some of the faces looked like nice young guys, some looked like businessmen and a few looked like the women I have spoken to in line at a grocery store. The point is, you can’t tell who is out to sexually abuse the children in your church just by looking at them or talking to them. The sexual abuser may look like a nicely wrapped gift from God to help in your children or youth ministry…but in reality, he is a Trojan horse sent from the enemy. The good news is churches and other youth organizations can do something to protect the children in their care! A 5 Step Screening Program can help protect your organization.
1. Six Month Rule
Require all employees and volunteers to attend regularly for at least six months in order to apply for positions that have access to minors. A predator will not want to stick around a church for an extended period of time waiting to get access to children, especially when he can go elsewhere and have almost immediate access. Do not give volunteers who are new and unknown immediate access to children.
2. Written Application
Requiring a written application for church volunteers serves the same role as it does for paid employees. The goal is to document the selection process and to be able to demonstrate that the church met the test of reasonable care. A church can be just as liable for the negligent selection of a volunteer as it can be for a paid employee.
3. Background Check
A criminal records check and Florida Department of Law. Enforcement Sexual Predator check should be REQUIRED for all volunteers who will have access to minors. Obtain a signed Consent to Background Check from the applicant first. Background checks should also be obtained for individuals who have unsupervised access to children and youth.
4. Reference Check
The volunteer should list two or more other church members as references, plus any other references that may be available from other forms of service. It is not sufficient to list only parents of children with whom the prospective volunteer may work. Predators may work at grooming the parents of potential victims. The reference list should also include other adults. These people should be contacted for input concerning the volunteer’s qualifications for working with children or youth.
5. Personal Interview
This is the last opportunity for you to find the wolf in sheep’s clothing! Only 15% of sexual offenders are arrested so the other 85% won’t have a criminal record. Dig deep to find out the person’s real motivation to work with children and as much as you can about their background.
Start protecting the children, the workers and your ministry today by implementing a 5 Step Screening Process. Closson Insurance Agency, has over sixty years experience insuring churches and schools. We’ve developed a complete program to help you protect the children in your care – a procedure manual, a training workbook, a training workshop and announcement flyers.
About the Author
Lenise Zika is the owner of Closson Insurance Agency and has over 30 years experience as a property and casualty insurance agent. The wealth of knowledge of the agency staff lead to the agency brand: Knowledge and Experience – It Matters. Recognizing the increase of sexual abuse of children within churches and schools, Closson Insurance Agency wrote a comprehensive, step-by-step Child Protection Procedure Manual and training program for churches. The agency team is passionate about protecting kids from sexual abuse. They give back to the community by conducting CHILD PROTECTION WORKSHOPS to teach churches, schools and youth organizations how to protect kids.
What is chronic hair pulling all about? Believe it or not, there’s a name for chronic hair pulling! According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) it is called “Trichotillomania”. It is a chronic hair pulling condition that leaves a person with significant hair loss or baldness in the area of pulling. […]
Believe it or not, there’s a name for chronic hair pulling! According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) it is called “Trichotillomania”. It is a chronic hair pulling condition that leaves a person with significant hair loss or baldness in the area of pulling. Everyone pulls some hair sometimes, but those with Trichotillomania most likely know the hair pulling is “different”. Areas most commonly affected by hair pulling are eyebrows, eyelashes, scalp, arms, and legs. Less common, but possible are underarms (armpits), facial, pubic and peri-rectal areas. If you or someone you know may be suffering from hair pulling this review of the DSM 5 diagnosis of Trichotillomania may help.
In order to quality for the diagnosis of Trichotillomania, the following criteria must be met:
Hair is being pulled and is result in hair loss
Attempts to quit or decrease unwanted behavior have failed
The hair loss must affect a person’s life in a significant way causing distress or impairment in social circles, work/employment, or other import at areas of function
Hair pulling is not caused by any other medical condition like a skin condition etc.
Hair pulling isn’t due to another mental disorder (like Body Dysmorphic Disorder)
Although the cause of the the disorder is not currently known, it is listed in the Obsessive and Compulsive disorders in the DSM. Typical onset is from age 11-13 years of age and can be a lifelong condition. (Mayo). Hair pulling can happen either as an automatic (involuntarily) or as a focused (conscious) coping skill.
* Important Note: If you read over this criteria and believe that you or a loved one is suffering from chronic hair pulling, Trichotillomania, it is important that you meet with a trained professional who can provide an official diagnosis and help you with appropriate treatment.
Most of the time hair pulling is associated with either anxiety or boredom. Other emotions that may come with hair pulling include tension (urges) or extreme desire for control just before the hair pulling. After the hair is pulled a person may feel pleasure, relief, and gratification.
There can also be a lot of shame associated with this disorder and it is not uncommon for Individuals to try to hide the hair loss in some way or make significant attempts to hide the hair loss. Hair pulling can cause a person to feel out of control, embarrassed and so the distress or impairment requirement (diagnostic Criterion C) is met with this aspect of the disorder. Sometimes a person will even deny the hair pulling to others.
Some hair pulling can be accompanied by certain types of preparation behaviors or preferences. This could include picking certain types of hair like only a certain color or texture. It could be pulling the hair out in a specific way perhaps twisting it out or pulling it out with the root. Other behaviors may happen after the hair has been pulled. This could be twisting the hair between fingers, twirling hair around fingers, putting the hair in between teeth, eating the hair, or biting it into pieces. These are just some of the examples included in the DSM 5 and you, or someone you know, may have others unique rituals.
During times of hair pulling there may be various types of behaviors. Trichotillomania is characterized as an obsessive (recurrent thoughts) and compulsive (recurrent behaviors) disorder that affects 1-2% of adults and adolescents. The behavior can really take on two faces:
Focused – a conscious pulling of the hair
Hair pulling happens in response to tensions, urges, and desires the person is aware of at the time.
Automatic – unconscious pulling of the hair.
Hair pulling happens without awareness and it may be hard to track when it’s happening.
Many times people state they have mixed behavior types but one may be a more dominant style.
Check it out: ABC News about Trichotillomania
Trichotillomania may have consequences such as:
Carpal tunnel or back, neck and shoulder pain (from pulling at strange angles)
Stomach pain, nausea, and vomiting from swallowing hair
Dental damage from chewing hair
Social or emotional distress
Hair pulling can be accompanied by other body-focused repetitive behaviors like (but not limited to): skin picking, nail biting, and lip chewing.
More females suffer than males in a ratio of 10:1
Some hair pullers may also enjoy pulling out hair from animals, toys, or fibrous materials like clothes, blankets or carpets.
Typically, hair pulling comes with or just before puberty (ages 11-13)
Genetic components may play a factor; it is more common in those with a first-degree relative that has OCD (Obsessive-Compulsive Disorder)
Biting hair only doesn’t qualify a person for the diagnosis
Trichotillomania varies greatly in just how long it lasts. It can last from weeks to years at a time. Some start the habit and then stop without any other episodes occurring. Interesting isn’t it?…
Behavioral log
For those who are not so lucky to have it go away quickly, a behavioral log of when the hair pulling happens may be helpful to see patterns of behavior (times, activities, locations etc.). If the hair pulling happens as an automatic behavior, then it may be helpful to have another person help you observe the behavior for your log.
Relaxation Techniques
If your issue is due to anxiety, some relaxation tips may be helpful. Try breathing, meditating for a few minutes a day, or even taking a walk outside (leave the phone at home!). Others may enjoy affirmations around anxiety, or guided imagery. Try some of the affirmations or guided imagery from Belleruth Napterstek or Kaiser Permanente.
Personal Techniques
Try anything YOU may think will work to help with your unwanted behavior. Do you notice the pulling happening when your inside too long? Not doing it when your hair is wet? When your nails are painted? Don’t underestimate the power of a simple change that is unique to your lifestyle!
Treat underlying anxiety
Although there may be a genetic component associated with this body-focused repetitive behavior, other underlying anxiety issues may exacerbate the issue. Meet with a counselor who can help you work through issues with perfectionism, stressful relationships, social issues or anything that may cause your anxiety to worsen and provide you with a safe place to work out some issues. A counselor can also work with you to try different coping skills when you feel the urge (if it’s a focused behavior).
There’s a whole world of support for those who are struggling with Trichotillomania. As a matter of fact the community has coined a term form themselves, “Trichs” (sounds like tricks)! There is a documentary called, Trichsters by Jillian Corsie that shares the struggles and stories of a few Trich survivors. There are a number of support groups online and locally. Try finding a local group for Trichotillomania or obsessive-compulsive recovery atPsychologytoday.com. Groups in person are ideal but online groups may also be helpful.DailyStregnth.org provides one of many online discussion and support groups. It’s important you find a group of people that you feel understand your isolating, and sometimes secret, issue. Even though you may feel like no one understands there are people out there who do. Connect with them, share your story to encourage others, and allow others to encourage which while you each work through the pulling.
Trichotillomania is not who you are….
Trichotillomania sufferers are people you may know! Just as with any diagnosis it is just one aspect of a person and should not be the person’s identity. I hope that those who have read the article and identify with it understand they are not alone! There is a community of people who also have the same issues.
If you believe you, or someone you love, has Trichotillomania it is important to receive help from a trained professional. He or she can help you rule out any other diagnosis and provide appropriate treatment.
We would love to work with you! If you would like to scheduled a session, feel free to contact Flourish Counseling Co. at 407-630-7529 or schedule immediately with us online at www.flourishcounseling.co.
Additional Helpful Resources
Mayo Clinic Article on Trichotillomania
Trichster.com – Trichsters documentary
TrichJournal – YouTube channel
About the Author
Cristina Ally, LMHC, is the owner of Flourish Counseling Co. in Winter Park, Florida. She specializes in women’s issues, sexual abuse recovery and diabetic lifestyle adjustment. She has helped countless individuals and families reach optimal mental and emotional health by providing counseling and trauma resolution in the Orlando area since 2015. She is currently the President of the Mental Health Counselors of Central Florida and is a passionate advocate for mental health.
In 1992, Judith Herman wrote a classic book titled Trauma and Recovery. Since that time, her book has continued to be an honored classic in field of psychology. She masterfully outlines the recovery process for both the client and therapist as the journey of recovery is undertaken. Traumatologists like Bessel Van der Kolk and Ruth […]
She outlines three major stages of effective trauma therapy; Safety & Stabilization, Remembrance & Mourning, and Reconnection. She gives case examples and really makes the recovery process easy to understand even as complex as it can be.
This is one of my favorite books about trauma recovery. For clients, it can provide a comforting sense that he or she is a part of a community of survivors. For therapists, it is an invaluable tool to effectively work with clients imprisoned by traumas.
If you have not had a chance to check it out yet, don’t wait any longer. It’s a fairly short read. If you are more of an auditory learner, you can check it out at audible.com or click the image to catch a hard copy on Amazon.com.
We would love to work with you! If you would like to scheduled a session, feel free to contact Flourish Counseling Co. at 407-630-7529 or schedule immediately with us online at www.flourishcounseling.co.
About the Author
Cristina Ally, LMHC, is the owner of Flourish Counseling Co. in Winter Park, Florida. She specializes in women’s issues, sexual abuse recovery and diabetic lifestyle adjustment. She has helped countless individuals and families reach optimal mental and emotional health by providing counseling and trauma resolution in the Orlando area since 2015. She is currently the President of the Mental Health Counselors of Central Florida and is a passionate advocate for mental health.
