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Insurance

Did you know that mental health providers are paid less than
primary care providers by insurance companies? A recent report
found that Insurers paid primary care providers 20%-50% more*
for care than they paid mental health care specialists,
including psychiatrists. Because of low reimbursement rates,
professionals in the mental health and substance abuse fields
are not willing to contract with insurers. Especially the
really good providers.

If you use your insurance to pay for therapy, you should be
aware that your insurance provider has the right to know why
you are going to therapy and the progress you are making. Which
is why many of the more experienced and more established
therapists have removed themselves from managed care panels.
Here are ways to get your insurance provider to work with an
out-of-network counselor.

On the back of the insurance card, there should be a toll-free
number for questions related to mental health benefit. When
calling, be sure to check coverage carefully by asking the
following questions:

  •  What or my behavioral health (mental health) benefits?
  • What is my deductible and has it been met?
  • How many sessions per calendar year does my plan cover?
  •  How much does my plan cover for an out-of-network provider
    after my deductible has been met?
  •  Is approval required from my primary care physician?
  • Insurance company may require you to meet a deductible
    prior to them paying for your sessions minus your co-pay.
    Call your insurance company to verify, so you can make an
    informed choice.
  • If you are using your insurance to pay for therapy, you
    should be aware that they have they right to know why you
    are going to therapy and what progress you are making. Your
    insurance company has the right to audit your therapist’s
    files and notes and ask questions of him/her regarding your
    mental health issues.
  • In order to access your insurance benefit, the therapist is
    required to diagnose you with a mental disorder. The record
    of this diagnosis will also become part of your Medical
    Information Bureau profile.
  • Many of the more experienced and more established
    therapists have removed themselves from managed care
    panels. This may make it difficult for someone using their
    insurance benefits to find a particular specialty or a
    certain level of experience.

How do you get your insurance provider to work with an
out-of-network counselor?

Ask for a Single Case Insurance Agreement

Insurance providers who offer single-case contracts will review
potential agreements on a case-by-case basis. It’s important to
note that the agreement is specific to the current episode of
care and does not apply to care outside of this treatment
episode.

What is a Single Case Agreement?

  • A single case agreement is a contract between a patient and their insurance company who has agreed to treat Kaleidoscope Behavioral Health as though they are in-network. With this agreement the patient pays the full session fee at time of service and when the patient files with their insurance, they are reimbursed at the higher in-network rate.

 

Insurance-What-You-Need-to-Know

A letter of medical necessity is an essential part of a request
for services, and can be used in a wide range of issues. Maybe
a physician has recommended therapy for a patient and the
insurance company denies paying for an out-of-network provider.
Or, a patient is hospitalized and his physician wants him to go
to a specific behavioral health provider post discharge but the
insurance company denies the request.

A letter of medical necessity, whether being submitted to a
private insurance company, should contain the information
needed to convince the reader that the requested service is
necessary to meet the medical needs of the person for whom the
service is being requested.

In order to be effective, the letter of medical necessity
should be written by a healthcare professional familiar with
the requesting party’s medical condition. The professional
should briefly describe their credentials and relationship to
the requesting party. This professional may be a physician, a
nurse, or other medical professional. However, note that most
funding sources, (aka insurance companies), require a
physician’s letter as part of the funding request. Therefore,
letters of medical necessity not written by a physician should
be endorsed by a physician.

When an letter of medical necessity has been written, but
services are still being denied, do yourself a favor and track
it down so that you can make sure that the important parts are
included. Most letters of medical necessity are not that well
written or compelling, so insurance companies can easily deny
the service.

Sample_Letter_of_Medical_Necessity

Request_for_Letter_Medical_Necessity_from_Your_Physician

Anxiety

Anxiety is the displeasing feeling of fear and concern. Anxiety
can create feelings of fear, worry, uneasiness and dread. It is
also associated with feelings of restlessness, fatigue,
concentration problems and muscle tension.

Anxiety is a normal human emotion that everyone experiences at
times. Many people feel anxious, or nervous, when faced with a
problem at work, before taking a test, or making an important
decision.

Anxiety disorders, however, are different. They can cause such
distress that it interferes with a person’s ability to lead a
normal life. Anxiety can be confused with fear. However, fear
is concrete, (a real danger), whereas anxiety is the paranoia
of something out there that seems menacing but may not be
menacing, and, indeed, may not even be out there.

There are many types of anxiety disorders, including:

  • Panic disorder
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • Social anxiety disorder
  • Specific phobias
  • Generalized anxiety disorder

An anxiety disorder is a serious mental illness. For people
with anxiety disorders, worry and fear are constant and
overwhelming, and can be crippling.

The exact cause of anxiety disorders is unknown; but it is
important to note that anxiety disorders – like other forms of
mental illness – are not the result of personal weakness, a
character flaw, or poor upbringing.

Like certain illnesses, such as diabetes, anxiety disorders may
be caused by chemical imbalances in the body. Studies have
shown that severe or long-lasting stress can change the balance
of chemicals in the brain that control mood. Studies also
suggest that the inability to adapt to stress is associated
with the onset of depression or anxiety.

Risk factors associated with anxiety and psychological stress

  • Acute coronary syndrome (ACS), a collection of symptoms
    that indicate a heart attack or approaching heart attack.
  • Stroke. In some people, prolonged or frequent mental stress
    causes an exaggerated increase in blood pressure, a risk
    factor for stroke.
  • Susceptibility to Infections. People who are under chronic
    stress have low white blood cell counts and are more
    vulnerable to colds or flu. And, once a person catches a
    cold or flu, stress can make symptoms worse.

Anxiety takes several forms: phobia, social anxiety,
obsessive-compulsive, and post-traumatic stress. The physical
effects of anxiety may include heart palpitations, tachycardia,
muscle weakness and tension, fatigue, nausea, chest pain,
shortness of breath, headache, stomach aches, or tension
headaches.

As the body prepares to deal with a threat, blood pressure,
heart rate, perspiration, blood flow to the major muscle groups
are increased, while immune and digestive functions are
inhibited (the fight or flight response). External signs of
anxiety may include pallor, sweating, trembling, and pupillary
dilation. For someone who suffers anxiety this can lead to a
panic attack.

Although panic attacks are not experienced by every person who
suffers from anxiety, they are a common symptom. Panic attacks
usually come without warning and, although the fear is
generally irrational, the subjective perception of danger is
very real. A person experiencing a panic attack will often feel
as if he or she is about to die or lose consciousness. Between
panic attacks, people with panic disorder tend to suffer from
anticipated anxiety – a fear of having a panic attack may lead
to the development of phobias.

General symptoms of anxiety include:

  • Feelings of panic, fear, and uneasiness
  • Uncontrollable, obsessive thoughts
  • Repeated thoughts or flashbacks of traumatic experiences
  • Nightmares
  • Ritualistic behaviors, such as repeated hand washing
  • Problems sleeping
  • Cold or sweaty hands and/or feet
  • Shortness of breath
  • Palpitations
  • An inability to be still and calm
  • Dry mouth
  • Numbness or tingling in the hands or feet
  • Nausea
  • Muscle tension
  • Dizziness

Fortunately, much progress has been made in the treatment of
people with mental illnesses, including anxiety disorders.
Although the exact treatment approach depends on the type of
disorder, one or a combination of the following therapies may
be used for most anxiety disorders:

  • Talk therapy, called psychotherapy, addresses the emotional
    response to mental illness. It is a process in which
    trained mental health professionals help people by talking
    through strategies for understanding and dealing with their
    disorder.
  • Medication: Drugs used to reduce the symptoms of anxiety
    disorders include anti-depressants and anxiety-reducing
    drugs.
  • Cognitive-behavioral therapy: People suffering from anxiety
    disorders often participate in this type of psychotherapy
    in which the person learns to recognize and change thought
    patterns and behaviors that lead to troublesome feelings.
  • Expressive Arts Therapy: Uses art and creativity to help
    people connect to their problems, give voice to their
    emotions, and learn techniques to heal. It uses a variety
    of techniques including art, drama, movement, music,
    poetry, puppetry, and sand play.
  • Animal Assisted therapy (AAT)
  • : Uses trained animals to enhance an individual’s physical,
    emotional and social well-being, thus improving
    self-esteem, reducing anxiety and facilitating healing.
  • Dietary and lifestyle changes
  • Relaxation therapy

Having an anxiety disorder does more than make you worry. It
can also lead to, or worsen, other mental and physical health
conditions, such as:

  • Depression
  • Substance abuse
  • Trouble sleeping (insomnia)
  • Digestive or bowel problems
  • Peptic ulcers
  •  Headaches
  • Teeth grinding
  • Muscular and joint pain
  • Sexual dysfunction

Parenting • Bullyproof Your Child

Children’s behavior is always communicating something to us…we
just don’t know how to interpret it for its true meaning…the
meaning behind the behavior.Parents, teachers and society need
to learn to speak the language of connecting the behaviors with
what’s behind them (i.e., “seeing the world through the child’s
eyes”) then risking self and truly touching the “soul” or sense
of the child. When we can do that, children feel whole, valued
and important.

  • I hear you
  • I see you
  • I understand
  • Equaling I CARE

STOP COMMUNICATING

  • I must make you happy
  • I always agree
  • I will solve your problems

Help your child develop an Internal Locus of Control vs. an
External Locus of Control. One way to do this is to replace
some of your parsing statements with encouragement.

Although praise and encouragement both focus on positive
behaviors and appear to be the same process, praise actually
fosters dependence in children by teaching them to rely on an
external source of control and motivation rather than on
self-motivations. Encouragement focuses on internal evaluation
and the contributions children make in the development of
self-motivation and self-control.

For Children

“Bully: A Discussion and Activity Book”
This book addresses the issue of bullies in the school and
gives helpful suggestions to both adults and children on how to
deal with the stressful situation in a positive manner.

For Teens

“Hey, Back Off! Tips for Stopping Teen Harassment”
A comprehensive teen guide to harassment prevention that
incorporates strategies and coping tips for not only teens, but
also parents and educators.

For Moms and their Daughters

“Queen Bees and Wannabes: Helping Your Daughter Survive Cliques, Gossip, Boyfriends, and the New Realities of Girl World”
A MUST read for all moms of daughters, even if your child is
not being bullied

For Women

“In the Company of Women – Indirect Aggression Among Women: Why We Hurt Each Other and How to Stop”
Bullying does not stop at high school…especially among women.
This is a good book that looks at how indirect aggression
manifests itself among women.

When parenting we need to be clear about our vision and purpose. For example, we want children to feel good about themselves from their own conclusions rather than be addicted to having their parents and teachers tell them how “good” they are. Try telling your child, “Thank you for helping with the dishes. That was very helpful,” instead of, “Good job.” Next time your son takes out the garbage without having to be asked you might say, “You noticed the garbage can was getting full and you chose to bag it up and take it out without anyone asking you to. You’re realizing this is your house too and pitching in shows that you care about keeping things nice around here.” 

The problem with praise is that children begin to expect constant acknowledgement and conversely are alarmed when they don’t get it. They come to rely on external praise rather than develop internal motivation or confidence in their emerging abilities. They stop doing things because they should or they can, and instead do them for the recognition. Children who come to rely on praise take fewer risks, because they are unwilling to lose their praise-worthy status. When children seek praise (consciously or unconsciously) they tend to avoid anything they won’t get ‘right’: which is unfortunate because mistakes, trial and error, and risk-taking are critical elements of any learning process.

SO, what should we do instead? We should offer encouragement for their efforts and attitudes. Encouragement can be inspirational and motivating – a gentle, supportive nudge that helps children meet important goals – instead of self-defining and limiting. Children who received encouragement were more likely to believe their intelligence could change and they could do better if they tried hard, whereas children who were praised felt their intelligence was fixed, even in the toddler years, avoiding experiences perceived to be challenging.

And when we do praise children, it should be genuine: praise that is specific (i.e. “That was very kind of you to clean up your toys without being reminded”) rather than generic (i.e. “You are wonderful”) and praise focused on behavior (i.e. “You came up with a very creative solution”) rather than the person (i.e. “You are so smart”).

PRAISE

ENCOURAGEMENT

You are always so beautiful.

I like the combination of patterns you chose to wear

You did it just like I told you.

You worked hard on that

Good job!

You really stuck with that – your hard work paid off.

I’m so proud of you

You did your best, and didn’t give up.

What a smart kid you are!

I can tell you’re working hard on reading because you finished a longer book.

I’m glad you know how to sit in class

You figured it out for yourself.

All A’s! I’m going to give you a big prize.

You must be proud of yourself.

You are such a good girl (boy).

I love you no matter what.

What a pretty picture.

The colors you chose for that sunset are unique.

With more work, you just might get this right

You have it just like you wanted

You sure are strong.

That was the first time you’ve jumped rope without stumbling.

You really know how to please me.

Look how far you’ve come. You can do It!

You are so organized.

I appreciate the way you organized the shelf, it makes it easier to find everything.

I am so proud of you.

You look proud of yourself! You really proved you can do it

Great! That is what I expected.

Your creative solution really worked

You always look perfect.

I appreciate your help.

 

 

 

Be sure to say some Encouragement statements, focusing on efforts and attitudes, along with your Praise statements.  Children who received encouragement were more likely to believe their intelligence could change and they could do better if they tried hard, whereas children who were praised felt their intelligence was fixed, even in the toddler years, avoiding experiences perceived to be challenging.

Here are some Encouragement examples:

  • I like the combination of patterns you chose to wear
  • You worked hard on that
  • You really stuck with that – your hard work paid off.
  • You did your best, and didn’t give up.
  • I can tell you’re working hard on reading because you finished a longer book.
  • You figured it out for yourself.
  • You must be proud of yourself.
  • I love you no matter what.
  • The colors you chose for that sunset are unique.
  • You have it just like you wanted
  • That was the first time you’ve jumped rope without stumbling.
  • Look how far you’ve come. You can do It!
  • I appreciate the way you organized the shelf, it makes it easier to find everything.
  • You look proud of yourself! You really proved you can do it
  • Your creative solution really worked
  • I appreciate your help.

In an effort to stop the pain, we act out poorly, in an effort to
overcome feelings of inferiority.

How you relate to your child is what will bully-proof them.

For more in-depth info on these concepts, download these helpful
brochures:

Task_of_Childhood-Nov2012

Dr.Trotters-Choices

Dr.-Trotters-Limit-Setting

Depression

Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.

True clinical depression is a mood disorder in which feelings of
sadness, loss, anger, or frustration interfere with everyday life for
weeks or longer.

In collaboration with the World Health Organization (WHO) to mark World Mental Health Day, writer and illustrator Matthew Johnstone tells the story of overcoming the “black dog of depression” via the video on this page.

The exact cause of depression is not known. Many researchers
believe it is caused by chemical changes in the brain. This may
be due to our genes or triggered by certain stressful events.
More than likely, it’s a combination of both.

Some types of depression run in families. But depression can
also occur if you have no family history of the illness. Anyone
can develop depression, even children.

The following may play a role in depression:

  • Alcohol or drug abuse
  • Certain medical conditions, including under-active thyroid,
    cancer, or long-term pain
  • Certain medications, such as steroids
  • Sleeping problems
  • Stressful life events, such as:
    + A relationship breakup
    + Death or illness of someone close to you
    + Divorce
    + Childhood abuse or neglect
    + Job loss
    + Failing a class
    + Social isolation (common in the elderly)

Depression can change or distort the way you see yourself,
your life and those around you. People who have depression usually see everything with a more negative attitude. They cannot imagine that any problem or situation can be solved in a positive way.

Symptoms of depression can include:

  • Agitation, restlessness and irritability
  • Becoming withdrawn or isolated
  • Difficulty concentrating
  • Dramatic change in appetite, often with weight gain or
    loss
  • Fatigue and lack of energy
  • Feelings of hopelessness and helplessness
  • Feelings of worthlessness, self-hate and guilt
  • Loss of interest or pleasure in activities that were
    once enjoyed
  • Thoughts of death or suicide
  • Trouble sleeping or too much sleeping
    Depression can appear as anger and discouragement, rather
    than feelings of sadness.

 In general, treatments for depression include:

  • Talk therapy, called psychotherapy
  • Medications called antidepressants
    If you have mild depression, you may only need one of these treatments. People with more severe depression usually need a combination of both treatments. It takes time to feel better, but there are usually day-to-day improvements. If you are suicidal or extremely depressed and cannot function you may need to be treated in a psychiatric hospital.

People who are depressed are more likely to use alcohol or
illegal substances.
Complications of depression also include:

  • Increased risk of health problems
  • Suicide


If you have thoughts of suicide or harming yourself or
others, immediately call your local emergency number (such
as 911) or go to the hospital emergency room.
You may also call a suicide hotline from anywhere in the
United States, 24 hours a day, 7 days a week: 1-800-SUICIDE
or 1-800-999-9999.

Teen Depression

Your teenage daughter has a tantrum screaming that no one understands her and that you, her loving parents, are ruining her life, making it not even worth living. Your teenage son tucks himself away in his room connected to technology barely surfacing to lay claim to food. How is a parent to know if these are the normal challenges of raising a teen or warning signs that depression is setting in, especially when it appears your child really has nothing to be depressed over?!

The teen years bring about a number of physical and
physiological changes, which bring with them mood swings and a
quest for independence. Social acceptance from peers and
forming an identity become developmental milestones that
become, perhaps from a parent’s perspective, consuming.
Identity formation is multifaceted and can add stressors that
may go unnoticed.

While a teen begins to align sense of self with a particular
label, with that label comes expectations…

  • The athletes must maintain the grueling schedules
  • The academic must maintain the 4.0
  • Sexual identity may be questioned
  • Religious beliefs may be questioned
  • Future career or academic paths loom ahead

. . .and the list continues, all adding to the pressures teens
face each day.
teen depression counseling

It is easy enough to Google symptoms of teen depression, which
has quite a good explanation, but how does a parent be
preventative first and know when to seek support second? Sooner
than later is the best rule of thumb, especially given the
threat of suicide which is all too real. What is a parent to
do?

As prevention, begin to view the teen years as a time for safe
exploration of decision making and learning cause and effect.
Teens need to believe you have faith in their ability to make
choices as well as accept the consequences of their actions.
Often parents become hyper guarded at a time when they really
need to start letting go. Set boundaries, curfews and
expectations with a loving acceptance that such rules are meant
to be challenged. Accept that teens will make mistakes. Allow
them to figure out how to make things better or solve their
problems. Allow them to feel emotional pain, disappointment and
exclusion. It’s when these things happen that they need you the
most, not as the prevention police.
depression

Teens need empathy, understanding and someone to listen and
encourage as they learn to move through the challenges of life
to learn the skills they will eventually need as adults. Do not
solve their problems for them; have faith that they know what
to do, even if they don’t think they do. Look at mistakes as an
opportunity for them to learn in the safety of your
guardianship rather than once they are out on their own. Tell
them you believe in them and their ability to find solutions on
their own. Even when you are begging to say “I told you so!,”
hold your tongue and respond with an empathetic statement such as “You seem so disappointed in yourself . . . What do you
think you’re going to do now?” Listen. Reflect. Support. Share
air. Acknowledge the humanness of their actions. Let them know
that its not the failure as much as what comes next that
matters. Help the teen figure out whom they want to be.

  • Apathy
  • Complaints of pains, including headaches, stomachaches, low
    back pain, or fatigue
  • Difficulty concentrating
  • Difficulty making decisions
  • Excessive or inappropriate guilt
  • Irresponsible behavior, (e.g., forgetting obligations,
    being late for classes, skipping school)
  • Loss of interest in food or compulsive overeating that
    results in rapid weight loss or gain
  • Memory loss
  • Preoccupation with death and dying
  • Rebellious behavior
  • Sadness, anxiety, or a feeling of hopelessness
  • Staying awake at night and sleeping during the day
  • Sudden drop in grades
  • Use of alcohol or drugs and promiscuous sexual activity
  • Withdrawal from friends

Teens have so many expectations placed upon them in this era;
pressures from all sides pushing and pulling for them to be
something in the moment and the future. Accept the few days
they tumble and withdraw, scream and cry, but become concerned when the teen you know and love doesn’t bounce back within aweek or so. Provide space, yet check in. Trust that parental
voice that says “something is off,” and if you can’t figure out
what, seek professional support. Look for changes in hygiene,
eating habits, motivation and zest for life. Take note when
your extrovert becomes sullen and your introvert is suddenly
full of energy. Be direct in asking about drugs, alcohol and
thoughts of suicide. Be direct, yet concerned. Be calm. Listen
to the behavior, rather than the words, as words are easy to
fake. Err on the side of caution, as a life is not something
you want to wait on to see what happens.

Spirituality in Counseling

Spiritual beliefs are now recognized to be a part of a person’s healthy coping skills, offering a social support system, the ability to find meaning and purpose in life, providing comfort in times of grief, and a strong ethical code. Incorporating spirituality in counseling positively affects healing, supports a sense of hope, and is a source of comfort along the way. Therapists may inquire about a client’s spiritual beliefs and encourage clients to connect with their spiritual communities. They may also point out areas where spiritual beliefs, practices or relationships seem to be causing, not relieving, unnecessary suffering or seem to contradict a value, goal or belief the client has expressed. Therapists are also able to assist clients seeking to clarify or discover their spiritual selves. This is not a matter of a therapist teaching a particular spiritual or religious model. Rather, the process of therapy involves the client in an ongoing inquiry into his or her own nature and their spiritual life.

Mission

Our mission is to be a compassionate place for hope and healing for all people in the North Texas area; and to contribute to the overall health and well-being of the community in which we work and live by providing the best care to every client through Christ-centered, integrated clinical practice and education.

Primary Value

We are a client-focused, Christ-centered organization that believes, with Divine intervention, the foundation of wholeness and healing can begin.

CORE PRINCIPLES

Research

Kaleidoscope Counseling will become a part of the leading edge of conducting basic and clinical research programs to improve patient care and to benefit society.

Practice

Practice therapy as an integrated team of compassionate, multi-disciplinary clinicians who are focused on the needs of clients from our communities, regions, and the nation.

Goal

To facilitate the prevention or resolution of emotional and behavioral difficulties with individuals and groups in a Christ-centered, safe and secure environment that nurtures inner healing and encourages optimal growth and development.

Therapy deals with the client’s emotions, senses, spirituality and thinking to help him or her understand what he or she is experiencing in his or her life.

Education

Educate both internal and external clinicians, Christian leaders, physicians, scientists and allied health professionals and be a dependable source of health information for our clients and the public. To train the next generation of therapists through an on-going commitment and dedication to providing supervision to post-graduate professionals.

Mutual Respect

Everyone within our organization has a valuable role to carry out in the fulfillment of our mission; and will be committed to demonstrating both the highest level of professionalism toward one another and to treating everyone in our diverse community with respect and dignity.

Commitment to Quality Continuously improve all processes that support client care, education and research.

Work Atmosphere

Foster teamwork, personal responsibility, integrity, innovation, trust and communication within the context of a clinician-led institution.

Finances

Allocate resources within the context of a system of care rather than its individual entities; Operate in a manner intended not to create wealth, but to provide a financial return sufficient for present and future needs.

Societal Commitment

Benefit humanity through the highest of quality, Christ-centered client care, education and research; Support the communities in which we live and work; Serve appropriately clients in all financial circumstances.

Eating Disorders

Disordered eating means eating in a way that could or does harm you physically or psychologically. The disordered eating can be a result of a desire to lose weight, control weight, and to manage emotions.

By definition, an eating disorder is a misuse of food to
resolve emotional problems and eating to manage emotions is
probably the most common type of disordered eating.

When people use food to resolve underlying emotional issues,
there is a problem. When the decision about what and how to eat
is based on compulsive and inflexible emotional needs, they
have become a slave to the food ritual.

There are two main reasons why people develop disordered
eating. One is because the individual is trying to achieve
unrealistic body ideals portrayed in the media, including
thinness. The second is using food and/or restricting to try
and manage emotions and control stress. Often times both are
present in the individual.

Emotional eating is very socially acceptable. Society tell us
that if we are sad we should eat ice cream and chocolate and
that if we are celebrating we should eat chocolate and ice
cream. Most people emotionally eat at one time or another.
However, when emotional eating is taking place frequently, or
with large quantities, disordered eating may be taking place.

Eating disorders – such as anorexia, bulimia, and binge eating
disorder – include extreme emotions, attitudes, and behaviors
surrounding weight and food issues. Eating disorders are
serious emotional and physical problems that can have
life-threatening consequences for females and males.

 The most effective and long-lasting treatment for an eating
disorder is some form of psychotherapy or psychological
counseling, coupled with careful attention to medical and
nutritional needs. Ideally, this treatment should be tailored
to the individual and will vary according to both the
severities of the disorder and the patient’s particular
problems, needs, and strengths.

  • Talk therapy, called psychotherapy, addresses both the
    eating-disordered symptoms and the underlying
    psychological, interpersonal, and cultural forces that are
    contributing to the eating disorder.
  • Medication: Medication can’t cure an eating disorder.
    However, medications may help individuals control urges to
    binge or purge or to manage excessive preoccupations with
    food and diet. Medications such as antidepressants and
    anti-anxiety medications may also help with symptoms of
    depression or anxiety, which are frequently associated with
    eating disorders.
  • Cognitive-behavioral therapy: People suffering from
    disordered eating often participate in this type of
    psychotherapy in which the person learns to recognize and
    change thought patterns and behaviors that lead to
    troublesome feelings.
  • Expressive Arts Therapy: Uses art and creativity to help
    people connect to their problems, give voice to their
    emotions, and learn techniques to heal. It uses a variety
    of techniques including art, drama, movement, music,
    poetry, puppetry, and sand play.
  • Animal Assisted therapy (AAT): Uses trained animals to
    enhance an individual’s physical, emotional and social
    well-being, thus improving self-esteem, reducing anxiety
    and facilitating healing.
  • Dietary and lifestyle changes
  • Relaxation therapy
  • Hospital-based care (including inpatient, partial
    hospitalization, intensive outpatient and/or residential
    care in an eating disorders specialty unit or facility) is
    necessary when an eating disorder has led to physical
    problems that may be life threatening, or when it is
    associated with severe psychological or behavioral
    problems.

Binge Eating Disorder
Binge eating disorder often results in many of the same health
risks associated with clinical obesity. Some of the potential
health consequences of binge eating disorder include:

  • High blood pressure.
  • High cholesterol levels.
  • Heart disease as a result of elevated triglyceride levels.
  • Type II diabetes
  • Gallbladder disease

Anorexia Nervosa
In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally.
Thus, the body is forced to slow down all of its processes to
conserve energy, resulting in serious medical consequences:

  • Abnormally slow heart rate and low blood pressure, which
    mean that the heart muscle is changing. The risk for heart
    failure rises as the heart rate and blood pressure levels
    sink lower and lower.
  • Reduction of bone density (osteoporosis), which results in
    dry, brittle bones.
  • Muscle loss and weakness.
  • Kidney failure as a result of severe dehydration.
  • Dry hair and skin; hair loss is common.

Bulimia Nervosa
The recurrent binge-and-purge cycles of bulimia can affect the
entire digestive system and can lead to electrolyte and
chemical imbalances in the body that affect the heart and other
major organ functions. Some of the health consequences of
bulimia nervosa include:

  • Irregular heartbeats and possible heart failure due to
    electrolyte imbalances, which are caused by dehydration and
    loss of potassium, sodium and chloride from the body as a
    result of purging behaviors.
  • Gastric rupture during periods of bingeing.
  • Inflammation and possible rupture of the esophagus from
    frequent vomiting.
  • Tooth decay and staining from stomach acids released during
    frequent vomiting.
  • Chronic irregular bowel movements and constipation as a
    result of laxative abuse.
  • Peptic ulcers and pancreatitis

Grief and Loss

Grief is the normal and natural response to the loss of someone
or something important to you. It is a natural part of life.
Grief is a typical reaction to death, divorce, job loss, a move
away from family and friends, or loss of good health due to
illness.

Grief reactions may include:

  • Feeling empty and numb, as if you are in a state of shock
  • Physical responses such as nausea, trouble breathing,
    crying, confusion, lack of energy, dry mouth, or changes in
    sleeping and eating patterns
  • Anger—at a situation, a person or in general
  • Guilt about what you did or did not do
  • Withdrawal from family, friends and common activities
  • Difficulty focusing, working or making decisions
  • Questions about faith or spirituality; challenges to the
    meaning, value and purpose you find in life

Grief lasts as long as it takes to adjust to the changes in
your life after your loss. This can be for months, or even
years. Grief has no timetable; thoughts, emotions, behaviors
and other responses may come and go.

Loss is an inevitable part of life, and grief is a natural part
of the healing process. The reasons for grief are many, such as
the loss of a loved one, the loss of health, or the letting go
of a long-held dream. Dealing with a significant loss can be
one of the most difficult times in a person’s life.

Examples of loss:

  • Loss of a close friend
  • Death of a partner
  • Death of a classmate or colleague
  • Serious illness of a loved one
  • Relationship breakup
  • Death of a family member

Subtle or less obvious examples of loss:

  • Leaving home
  • Illness/loss of health
  • Death of a pet
  • Change of job
  • Move to a new home
  • Graduation from school
  • Loss of a physical ability
  • Loss of financial security

These types of loss can also cause strong feelings of grief,
even though those around you may not know the extent of your
feelings.

The process of grieving in response to a significant loss
requires time, patience, courage and support. The grieving
person will likely experience many changes throughout the
process, often beginning with an experience of shock, followed
by a long process of suffering, and finally a process of
recovery.

  • Shock. Shock is the person’s emotional protection from
    being too suddenly overwhelmed by the loss. The grieving
    person may feel stunned, numb, or in disbelief concerning
    the loss. While in shock the person may not be able to make
    even simple decisions. Friends and family may need to
    simply sit, listen, and assist with the person’s basic
    daily needs. Shock may last a matter of minutes, hours, or
    days.
  • Suffering. Suffering is the long period of grief during
    which the person gradually comes to terms with the reality
    of the loss. It is often the most painful and protracted
    stage for the griever, but it is still necessary. The
    suffering process typically involves a wide range of
    feelings, thoughts and behaviors, as well as an overall
    sense of life seeming chaotic and disorganized. The
    duration of the suffering process differs with each person,
    partly depending on the nature of the loss experienced.
    Some common features of suffering include sadness, anger,
    guilt, anxiety and changes in sleeping and eating patterns.
  • Recovery. Recovery, while the goal of grieving, is not the
    elimination of all the pain or the memories of the loss.
    Instead, the goal is to reorganize one’s life so that the
    loss is one important part of life rather than the center
    of one’s life. As recovery takes place, the individual is
    better able to accept the loss, resume a “normal” life, and
    to reinvest time, attention, energy and emotion into other
    parts of his/her life. The loss is still felt, but the loss
    has become part of the griever’s more typical feelings and
    experiences.

Grief is a misunderstood and neglected process in life. Because
responding to death is often awkward, uncomfortable, even
frightening for both grievers and helpers, those concerned may
avoid dealing with grief. This can make the experience more
lonely and unhappy than it might be otherwise.

In addition, society promotes many misconceptions about grief
that may actually hinder the recovery and growth that follow
loss. For example, many believe it necessary to try to change
how a grieving friend is feeling and may do so by making
statements such as, “You must be strong,” “You have to get on
with your life,” or “It’s good that he didn’t have to suffer.”
Such cliches may help the one saying them, but are rarely
helpful to the griever. Society also promotes the misconception
that it is not appropriate to show emotions except at the
funeral, and that recovery should be complete within six
months. A helper needs to avoid these and other ways of
minimizing a person’s grief. Those in grief need to be
encouraged to recover in their own ways.

Talking about death at a party or social gathering, or bringing
up the topic at a family dinner, is socially inappropriate for
most people – if not extremely uncomfortable.
Yet the fact that most of us avoid this topic at all costs is
what makes it so hard when we lose someone close, whatever the
age or circumstances. By not talking about death, it makes it
hard to process when it actually takes place.

Grief therapy provides a safe and understanding environment for
an individual to work through any cognitive or behavioral
problems associated with complicated grief. And, the process of
talking through the fears, regrets, anger and guilt with a
counselor trained in how to listen without having “quick fixes”
brings a great amount of comfort to many individuals.

Many interventions will be the same as those for other mental
health disorders. For example, individuals suffering with
generalized anxiety disorder will often receive a range of
cognitive-behavioral therapies designed to re-structure
irrational beliefs and thoughts.

For those struggling with anxiety, most thoughts that run
nonstop through their minds cause stress and mental distress,
and those who have these thoughts can’t stop them without the
help of a therapist.

In the same way, individuals struggling with problematic grief
often have thoughts about the deceased or the death of the
deceased that are irrational, or not based on accurate
perceptions.

The goal of the therapist is to target these thoughts and teach
individuals how to think differently about loss.

In cases of complicated grief, behaviors become dysfunctional,
such as turning to alcohol or drugs to treat the emotional
pain, or simply refusing to socialize or engage in enjoyable
pastimes or activities.

Grief therapy addresses behavioral issues through cognitive
behavioral interventions as well. These interventions often
involve getting individuals to acknowledge their unhealthy
coping patterns, and work toward healthier behaviors.

How to Guide Teens Through Grief and Loss

Many parents are at a loss as to how to help our children cope with the loss of 17-year-old Max Schwolert, who died from
complications of the flu during a holiday vacation. Those who knew Max, and those who have never had the pleasure of meeting a Schwolert, have many questions. Only one being: “How can I help my child through this?”

Dr. Kay Sudekum Trotter, a local counselor and advocate in Flower Mound, recently gave a presentation on how to help guide your teens through loss and below is some helpful information.

As a parent or support person, you have the opportunity to
gently guide your teenager in living with the loss, as I do not
know one ever truly “gets over it.” (BUTTON) ×
A loss of a friendship can be hard on a teenager just as it can
be on adults. It is important to validate your teen’s feelings
of loss. In validating those feelings, you make it easier for
him or her to share with you stories about the friendship, the
memories of happy and sad times. Bereaved children and
teenagers will need ongoing attention, reassurance and support.
It is not unusual for grief to resurface later on, even well
after the death. This can happen as they move through different
life milestones, and develop as individuals.

As a parent or support person, you have the opportunity to
gently guide your teenager in living with the loss, as I do not
know one ever truly “gets over it.” Many teenagers feel guilty
because their friend died; yet they have a chance at life and
graduation, and romance, and experiences, and even new
friendships.

Teen-Grief-Parental-Support

  • be honest and let them know what’s happening
  • be willing to listen, and available to talk about whatever
    they need to talk about
  • acknowledge the emotions they may be feeling—fear, sadness,
    anger
  • it can be helpful for parents, or other adults, to share
    their own feelings regarding the loss
  • frequently reassure them they are safe, who is caring for
    them, and which adults they can trust to ask for further
    support
  • keep routines and normal activities going as much as
    possible
  • talk to them about grief – what it is, that it’s normal,
    that everyone is different
  • avoid expectations of adult behavior – allow them to be the
    age and stage they are encourage them to express their
    thoughts and feelings – give them ideas of things they
    could try, such as doing physical activities, writing,
    singing, listening to music, talking with friends, reading
    etc.
  • allow questions and provide honest answers
  • comfort them with hugs, cuddles, holding their hand, and by
    encouraging them
  • speak calmly and gently to them – and be calm around them
  • talk about death together; answer any questions they may
    have
  • let them help in planning the funeral or something to
    remember the loss

It is important to recognize when your teenager is struggling with
the loss more than what is normal.

Recognizing the symptoms is one way of helping your teenager
deal with the loss such as:

  • Teenagers can experience symptoms of depression and have angry outbursts.
  • They can also be at the opposite end of the spectrum by
    showing a lack of emotions and feeling numb.
  • there can be problems in school with failing grades or
    delinquent behaviors.
  • Further symptoms showing difficulty processing the loss
    might include personality changes, self-destructive
    behaviors (drinking, drugs, etc.), withdrawal and
    isolation, or even suicidal thoughts.

While this is not an all-inclusive list of symptoms, it does
give you an idea of how hard the loss of an important
relationship can be on a teenager. If you are concerned about
any extreme reactions, or if you think the young person may
have become depressed, contact your doctor or other trained
adviser, such as a counselor, senior staff member from their
school, social worker, community or youth worker or a local
family support agency.

Internet Addiction

More than 5 million kids may be addicted to video games. 31% of males and 13% of females report that they have felt “addicted” to video games.

Do you know someone spending too much time playing video games or on the Internet? It may be a sign of technological
addiction. Our helps clients identify the source of stressful
situations or unpleasant feelings that are luring addicts to
escape into a fantasy world of cyberspace. He will help
participants turn off the games and get a real life, with
healthier outlets to bring balance and happiness.


SYMPTOMS OF INTERNET ADDICTION

  • Sense of euphoria while at computer
  • Inability to stop the activity
  • Craving more and more online activity
  • Neglect of family and friends
  • Lying about online activities
  • Problems with school
  • Feeling empty, depressed and irritable when not at the
    computer

Treatment focuses on identifying the source of stressful
situations or unpleasant feelings while recognizing how
problematic usage is affecting the individual’s life. After
doing so, the goal is to create new and healthier outlets of
expression or enjoyment in place of technology.

DrTrotter-InternetAddictions

1. Do you or your child feel preoccupied with the Internet
(thinking about previous online activity or anticipate next
online session)?
2. Do you or your child feel the need to use the Internet with
increasing amounts of time in order to achieve
satisfaction?
3. Have you or your child repeatedly made unsuccessful efforts
to control, cut back, or stop Internet use?
4. Do you or your child feel restless, moody, depressed, or
irritable when attempting to cut down or stop Internet use?
5. Do you or your child stay online longer than originally
intended?
6. Have you or your child jeopardized or risked the loss of
significant relationship, job, educational or career
opportunity because of the Internet?
7. Have you or your child lied to family members, therapist,
or others to conceal the extent of involvement with the
Internet?
8. Do you or your child use the Internet as a way of escaping
from problems or of relieving a dysphonic mood (e.g.,
feelings of helplessness, guilt, anxiety, depression)?

*If you answered Yes to five of the above symptoms you need
help NOW. If you answered YES to 3 or more you could be headed
towards full blown addiction.

Parenting Teenagers During Divorce

While your teen is busy trying to exert independence,
parents still need to lay some ground rules to make sure
that both parents stay involved in their child’s life. The
key is to have a mutual understanding between you and your
teen. In other words, take your teen’s life seriously and he
or she will take both parents seriously as well.

The first thing to remember is that teens may look and act a
lot like adults, but they aren’t yet completely mature. They
still need to have two parents and they still need to have
those parents involved in their lives. Teens are working hard
at learning to be independent, and this means that they do need
special consideration, but it does not mean that you and the
other parent should throw up your hands and say, “There’s
nothing we can do.” It can be difficult to continue to parent
someone who doesn’t want to be parented, but that’s your job
right now.

Friends, school, sports, activities, dating, and jobs are
essential to teens. If you have a visitation schedule that
severely restricts your child’s ability to enjoy those
essential activities, all you’ll end up with is resentment.
Instead, you need to try to create a balance in your teen’s
life. He or she should have plenty of time to do the things
that matters to them, but they also have to make some room for
spending time with their parents.

As the divorced parent of a teen, you’ve got to flex the
parenting schedule to incorporate the things that make your
child who he or she is. If your spouse has visitation this
weekend, but your teen has a dance to go to, the parent whose
scheduled time it is should take the teen to and from the
dance, and spend the rest of the available time with them. You
need to find a balance between your teen’s need to be a kid and
the need for him or her to have time with both parents.

Since teens schedules are busy, and both parent’s schedules are
also probably pretty packed, it’s important to agree to some
kind of minimum time per month with the non-custodial parent.
For example, decide that you’ll try to arrange things so that
the non-custodial parent sees your child for at least four
overnights per month and four other evenings or afternoons.

Be creative with your time sharing. Take turns taking your
daughter to basketball practice. Have one parent commit to
teaching him how to drive. Have the other parent be involved
with weekend band or cheerleader activities. Some parents have
a hard time being flexible because it feels like a loss of
control. In fact it is just the opposite – you set a minimum
and then work with your child to make it work for everyone. It
takes a bit more cooperation, but in the end, you will both
have a better relationship with your child and he or she will
feel more fulfilled and connected.

  Teens are big on technology, so the non-custodial parent can
maintain a close relationship with text messaging, cell phone
calls, and instant messaging. Non-custodial parents can have a
difficult time staying connected during the teen years – teens
certainly aren’t known for being open with their parents! And,
if a family divorced when the daughter was 7, she’s a very
different person at 15 and it can be hard to stay in the loop.
Find out about her interests and activities and make yourself a
part of them – either by showing up to cheer, by offering help,
or just by asking friendly, non-intrusive questions.

Social Anxiety/Stress

Shyness is the tendency to feel awkward, worried or tense during
social encounters, especially with unfamiliar people. There are many degrees of shyness. Stronger forms are usually referred to as social anxiety or social phobia. Shyness may merely be a personality trait or can occur at certain stages of development in children.The primary defining characteristic of shyness is a fear of what other people will think of a person’s behavior, which results in the person becoming scared of doing or saying what he or she wants to, out of fear of negative reactions, criticism, or rejection, and simply opting to avoid social situations instead.

Severely shy people may have physical symptoms like blushing, sweating, a pounding heart or upset stomach; negative feelings about themselves; worries about how others view them; and a tendency to withdraw from social interactions.Most people feel shy at least occasionally. Some people’s shyness is so intense, however, that it can keep them from interacting with others even when they want or need to— leading to problems in relationships and at work.

A chronic and disabling form of shyness is called social phobia
or social anxiety disorder, and is a chronic problem that can
result in a reduced quality of life.

The difference between social anxiety and normal shyness is
that social anxiety involves an intense feeling of fear in
social situations and especially situations that are unfamiliar
or in which one will be watched or evaluated by others. The
feeling of fear is so great that in these types of situations
one may be so worried that he or she feels anxious just
thinking about them and will go to great lengths to avoid them.

Like many other mental health conditions, social anxiety
disorder likely arises from a complex interaction of
environment and genes, including inherited traits, brain
chemistry, brain structure and negative experiences (e.g.,
bullying, rejection, sexual abuse).

Left untreated, social anxiety disorder can be debilitating.

Social anxiety disorder can cause:

  • Low self-esteem
  • Trouble being assertive
  • Negative self-talk
  • Hypersensitivity to criticism
  • Poor social skills

Social anxiety disorder can also result in:

  • A poor work record
  • Low academic achievement
  • Isolation and difficult social relationships
  • Substance abuse
  • Excessive drinking, particularly in men
  • Suicide

Emotional and behavioral social anxiety disorder signs and symptoms include:

  • Intense fear of interacting with strangers
  • Fear of situations in which you may be judged
  • Worrying about embarrassing or humiliating yourself
  • Fear that others will notice that you look anxious
  • Anxiety that disrupts your daily routine, work, school or
    other activities
  • Avoiding doing things or speaking to people out of fear of
    embarrassment
  • Avoiding situations where you might be the center of
    attention
  • Difficulty making eye contact
  • Difficulty talking

Physical social anxiety disorder signs and symptoms include:

  • Blushing
  • Sweating
  • Trembling or shaking
  • Fast heartbeat
  • Upset stomach
  • Nausea
  • Shaky voice
  • Muscle tension
  • Confusion
  • Diarrhea
  • Cold, clammy hands

Overcoming social anxiety depends on the person and the
situation. In some cases it can be relatively easy—just a
matter of time for many individuals—yet for some people social
anxiety can become a very difficult, painful and even disabling
problem. The reasons are unknown. Recovery from chronic social
anxiety is possible in many cases, but usually only with some
kind of therapy or sustained self-help or support group work.

Types of Treatment

  • Cognitive Behavorial Therapy (CBT) can be one of the most
    effective treatments available. The goal of CBT is to guide
    the patient’s thoughts in a more rational direction when
    faced with anxiety; it helps the person to stop avoiding
    situations that once caused anxiety and teaches people to
    react differently to the situations that trigger their
    anxiety. Cognitive behavior therapy may include systematic
    desensitization or controlled exposure to the feared
    situation. With systematic desensitization, the person
    imagines the anxious social situation and works through
    their fears in a safe and controlled environment. CBT may
    also include role-playing to practice social skills and
    gain the comfort and confidence in order to relate to
    others.
  • Relaxation techniques include breathing methods and muscle
    relaxation strategies. Calm breathing or ‘diaphragmatic
    breathing’ is a breathing technique used to slow down and
    control one’s breathing when they start to feel anxious or
    even stressed.
  • Medication such as antidepressants like Paxil or
    benzodiazepines such as Xanax, Librium, Valium, and Ativan.
    Beta-blockers, which are often used to treat heart
    conditions, may be used to mitigate some of the physical
    symptoms of social anxiety, such as reducing heart rate or
    blood pressure.

Suicidal Thoughts, Signs & Symptoms

Suicide, taking your own life, is a tragic reaction to stressful life
situations — and all the more tragic because suicide can be
prevented. Whether you’re considering suicide or know someone who feels suicidal, learn suicide warning signs and how to reach out for immediate help and professional treatment. You may save a life — your own or someone else’s.

Warning signs aren’t always obvious, and they may vary from
person to person. Some people make their intentions clear,
while others keep suicidal thoughts and feelings secret.

Suicide warning signs or suicidal thoughts include:

  • Talking about suicide — for example, making statements such as “I’m going to kill myself,” “I wish I was dead,” or “I
    wish I hadn’t been born”
  • Getting the means to commit suicide, such as buying a gun
    or stockpiling pills
  • Withdrawing from social contact and wanting to be left
    alone
  • Having mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying or violence
  • Feeling trapped or hopeless about a situation
  • Increasing use of alcohol or drugs
  • Changing normal routine, including eating or sleeping
    patterns
  • Doing risky or self-destructive things, such as using drugs
    or driving recklessly
  • Giving away belongings or getting affairs in order when
    there is no other logical explanation for why this is being
    done
  • Saying goodbye to people as if they won’t be seen again
  • Developing personality changes or being severely anxious or
    agitated, particularly when experiencing some of the
    warning signs listed above

If you think you may hurt yourself or attempt suicide, get help right now!

  • Call 911 or your local emergency number immediately.
  • Call the National Suicide Prevention Lifeline at
    1-800-273-TALK (1-800-273-8255) to reach a trained
    counselor. Use that same number and press 1 to reach the
    Veterans Crisis Line.

If you’re feeling suicidal, but you aren’t immediately thinking of
hurting yourself

  • Reach out to a close friend or loved one — even though it
    may be hard to talk about your feelings
  • Contact a minister, spiritual leader or someone in your
    faith community
  • Call a suicide crisis center hotline
  • Make an appointment with your doctor, other health care
    provider or mental health provider

Helping a loved one with suicidal thoughts

If you have a loved one who has attempted suicide, or if you think your loved one may be in danger of doing so, get emergency help.

If you have a loved one you think may be considering suicide,
have an open and honest discussion about your concerns. You may not be able to force someone to seek professional care, but you can offer encouragement and support. You can also help your loved one find a qualified doctor or mental health provider and make an appointment. You may even be able to go to an
appointment with him or her.

Supporting a loved one who is chronically suicidal can be
stressful and exhausting. You may be afraid and feel guilty and
helpless. Take advantage of resources about suicide and suicide
prevention so that you have information and tools to take
action when needed. Also, be sure to take care of yourself by
getting support from family, friends, organizations and
professionals.

Suicidal thinking doesn’t get better on its own — so get help.

Suicidal thoughts have numerous causes. Most often, suicidal
thoughts are the result of feeling like you can’t cope when
you’re faced with what seems to be an overwhelming life
situation. If you don’t have hope for the future, you may
mistakenly think suicide is a solution. You may experience a
sort of tunnel vision, where in the middle of a crisis you
believe suicide is the only way out.

Although suicide attempts are more frequent for women, men are more likely than women to complete suicide because they
typically use more effective methods, such as a firearm.

You may be at risk of suicide if you:

  • Feel hopeless, socially isolated or lonely
  • Experience a stressful life event, such as the loss of a
    loved one, military service, a breakup, a significant
    medical illness, or financial or legal problems
  • Have a substance abuse problem — alcohol and drug abuse can
    worsen thoughts of suicide and make you feel reckless or
    impulsive enough to act on your thoughts
  • Have suicidal thoughts and have access to firearms in your
    home
  • Have an underlying psychiatric disorder, such as major
    depression, post-traumatic stress disorder, bipolar
    disorder, personality disorder, anxiety or detachment from
    reality (psychosis), or paranoia
  • Have a family history of mental disorders, substance abuse,
    suicide or violence, including physical or sexual abuse
  • Have a medical condition that can be linked to depression
    and suicidal thinking, such as chronic disease, chronic
    pain or terminal illness
  • Are bisexual, homosexual or transgender with an
    unsupportive family or in a hostile environment
  • Attempted suicide before

Suicide in children and teenagers often follows stressful life
events. Keep in mind that what a young person sees as serious
and insurmountable may seem minor to an adult, such as problems in school or the loss of a friendship. In some cases, a child or teen may feel suicidal due to certain life circumstances he
or she may not want to talk about.

Some life circumstances that affect children and teens:

  • Having a psychiatric disorder, including depression
  • Loss or conflict with close friends or family members
  • History of physical or sexual abuse
  • Problems with alcohol or drugs
  • Becoming pregnant
  • Having a sexually transmitted infection
  • Being the victim of bullying
  • Being uncertain of sexual orientation

In some cases, people who are suicidal are at risk of killing
others and then themselves. This is known as a homicide-suicide
or murder-suicide. The types of feelings that trigger this
tragic behavior can stem from a number of sources.

Some common risk factors for murder-suicide include:

  • History of conflict with a spouse or romantic partner
  • Current family legal or financial problems
  • History of mental health problems, particularly depression
  • Alcohol or drug abuse or addiction
  • Having access to a firearm — nearly all murder-suicides are
    committed using a gun

Treatment of suicidal thoughts and behavior depends on your
specific situation, including your level of suicide risk and
what underlying problems may be causing your suicidal thoughts
or behavior.

EMERGENCIES
If you are at risk of harming yourself, or if you have made a suicide attempt and you’re injured:

  • Call 911 or your local emergency number
  • Have someone else call if you’re not alone

At the emergency room, you’ll be treated for any injuries. The
doctor will ask you a number of questions and may examine you,
looking for recent or past signs of suicide attempts. Depending
on your state of mind, you may need medications to calm you or
to ease symptoms of an underlying mental illness, such as
depression.

Your doctor may want you to stay in the hospital long enough to
make sure any treatments are working, that you’ll be safe when
you leave and that you’ll get the follow-up treatment you need.

NONEMERGENCY

If you have suicidal thoughts, but aren’t in a crisis situation, you
may need outpatient treatment.

This treatment may include:

  • Talk therapy, called psychotherapy, is where you explore
    the issues that make you feel suicidal. You and your
    therapist can work together to develop treatment plans and
    goals.
  • Medication: Antidepressants, antipsychotic medications,
    anti-anxiety medications and other medications for mental
    illness can help reduce symptoms, which can help you feel
    less suicidal.
  • Cognitive-behavioral therapy: People suffering from
    suicidal thoughts often participate in this type of
    psychotherapy in which the person learns to recognize and
    change thought patterns and behaviors that lead to
    troublesome feelings.
  • Expressive Arts Therapy: Uses art and creativity to help
    people connect to their problems, give voice to their
    emotions, and learn techniques to heal. It uses a variety
    of techniques including art, drama, movement, music,
    poetry, puppetry, and sand play.
  • Animal Assisted therapy (AAT): Uses trained animals to
    enhance an individual’s physical, emotional and social
    well-being, thus improving self-esteem, reducing anxiety
    and facilitating healing.
  • Hospitalization is necessary when suicidal thoughts have
    become life threatening