What is Persistent Depressive Disorder?

The National Institute of Mental health estimates that such disorder affects 1.5% of the adult population in the United States and about 11.2% of the population between 13 to 18 years of age. Although it is not as severe as major depression, Persistent Depressive Disorder or dysthymia, is a chronic ongoing type of depression. Individuals who have such disorder lose interest in their daily life activities and in most cases, they also have a hard time being “upbeat” even when a happy occasion is presented. It is important to note that such feelings can last for years and that it is believed that girls are more likely to experience any type of depressive disorder than boys.

Other symptoms:

• Feel hopeless, sadness, emptiness, and are constantly feeling down
• There is a lack of energy & are tired
• Have low self-esteem, self-criticism, or may feel incapable of doing tasks, for example
• Have a hard time concentrating and making decisions
• Excessive anger and irritability
• There is a decrease in activity, effectiveness, and productivity
• Avoid social activities
• Poor appetite or overeating
• Often have feelings of guilt
• Worry over the past
• Have trouble sleeping

It is also important to note that such symptoms can cause a significant impairment on individuals and that they usually come and go over a period of years. However, systems usually don’t tend to disappear for more than two months.

What causes Persistent Depressive Disorder?

Although there is not one known exact cause, it is believed that biological differences, brain chemistry, inherited traits, and life events may have an influence in the development of the disorder.  It is believed that people who suffer from persistent depressive disorder experience physical changes in their brains. Also, an individual is more likely to develop the disorder if someone in their family has previously been diagnosed with it as well as a loss of a loved one, financial problems, or high stress can also play a role in the development. An individuals’ negativity, their low self-esteem and being too dependent of others may also contribute to the risk factors of such disorders.

What effect does it have in an individual’s life?

• Reduction in quality life
• Suicidal thoughts or actions
• Chronic pain along with general medical illnesses
• Difficulty forming relationships with family and friends
• Substance abuse
• May cause other depressive disorders

How can I reduce the chances of developing Persistent Depressive Disorder?

Although for some people there will not be a way to prevent such disorder, for others there may be. It is important for an individual to take control of the stress they experience and learn how to cope with it. Also, reach out to friends and family, start receiving treatment the moment you begin to see signs, and consider keeping such treatment for a while.

How can it be treated and what can I do for myself?

• Seek help from your primary care physical
• Keep a log of your systems for a few weeks so that your doctor can get a better understanding
• Establish a sleep pattern
• Exercise daily
• Take care of what you eat
• Practice self-care
• Medication (i.e. SSRIs, TCAs and SNRIs)
• Psychotherapy (main recommendation for children and adolescents)
  • Cognitive Behavioral Therapy (CBT)
  • Family Therapy
  • Group therapy
  • Process Oriented Talk Therapy
• Benefits of Psychotherapy:
  • Learn how to manage the symptoms and crisis
  • Identify the triggers and learn coping strategies
  • Replace negative beliefs with positive ones
  • Improve your self-esteem
  • Setting and attaining personal goals

Alcohol Intoxication

What is alcohol intoxication?

It happens when an individual consumes more alcohol than the body can handle causing behavioral or physical abnormalities. It is also known as ethanol poisoning or being drunk.

What causes such intoxication?

Ethanol, a type of alcohol, creates depressive effects in various areas of the brain that then cause the physical and behavioral abnormalities already mentioned.

What are the symptoms of alcohol intoxication?

• Breath smells like alcohol
• Enlarged pupils
• Blackouts or seizures
• Slurred or loud speech
• Nausea and/or vomiting
  • If the person vomits more than once, it may be a sign of head injury or other serious illness
• Fast heartbeats and slow breaths
• Loss of ability to maintain balance
• Confused & disoriented
• Loss of memory

What are some common behaviors of individuals who are experiencing alcohol intoxication?

• Rapid mood changes
  • An individual may feel happy one second and become easily upset the next second while engaging in violent acts
• Risky sexual behavior
  • Unprotected sex
  • Sex without the other persons consent
• Work or school trouble
  • Begin to miss class & work
  • Cannot successfully complete desired tasks

How is alcohol intoxication diagnosed?

Your healthcare provider will often examine you and ask a variety of questions such as:

• How much alcohol did you drink?
• How often do you drink?
• What kind of alcohol did you drink?
• What do you remember?

Often, healthcare providers will also take a urine sample to test the amount of alcohol in the body, for liver, kidney, and heart damage.

How is such intoxication treated?

• Medicine such as sedatives, anti-nausea medicine, glucose, or vitamin B1
• Brief intervention therapy
  • Meet with health provider to discuss ways in which you can control risky behaviors
• Breathing support such as extra oxygen or a ventilator if you cannot breathe on your own because of the intoxication

What are the consequences of alcohol intoxication?

• Puts you at a higher risk of developing a disease or an injury
• Alcohol damages not only the brain, but the liver, kidneys, and lungs as well
• Engage in violent actions
• May become a harm for yourself & other
• Alcohol intoxication can lead to a coma and may be life-threatening

How do I know if I am experiencing alcohol intoxication? How do I know when to seek help?

• You have a hard time controlling the amount of alcohol you consume
• It is disrupting your daily life activities such as work and school because you drink too much
• Engage in physical & verbal fights
• Question your condition
• Have a seizure
• Cannot stop vomiting
• Were in an accident because of alcohol consumption
• Feel upset to the point where you are thinking of harming yourself or other
• Hallucinate

How to help someone or yourself if they are experiencing alcohol intoxication?

• Get rid of all the alcohol in their home
• Remove the person from all sources of alcohol
• Provide a safe environment (i.e. keep away from driving vehicles)
• Find out what the person has consumed aside from ethanol (i.e. drugs or medications)

It is estimated that between 2 and 3% of Americans encounter panic disorder in a given year. Additionally, although it can be present in both women and men, women are twice as likely to encounter such disorder.

What is Panic Disorder?

Panic Disorder can be classified as a type of anxiety disorder. People who suffer from such disorder have sudden panic attacks and often have a strong fear that lasts for several minutes, in some cases even hours. Such attacks may derive from the fear that a disaster may occur or from the fear of losing control on a situation even though there appears to be no danger. It is important to note that such attacks can begin to develop in late adolescence and early adulthood however, children are subject to developing such disorder as well. Additionally, just because you have panic attacks does not mean you have developed panic disorder. It is believed that 1 in 10 people in the United States have a panic attack each year while one third of people have one in their lifetime however, only about 3% of adults have developed such disorder.

Panic Disorder can be affecting your daily life in the sense that it may not allow you to go to work or school for example, because of the fear that a panic attack may happen, and you may then feel embarrassed.

What are the symptoms?

• Sudden & repeated panic attacks (due to anxiety or fear)
• A sense of lack of control
• During the panic attack, an individual may experience physical symptoms such as a racing heart, sweating, chills, breathing problems, trembling, weakness, nausea or stomach pain for example
• Avoid going to places where a panic attack has occurred in the past
• Feel unreal or detached when experiencing a panic attack
• Numbness or tingling in the body

How can it be treated?

• First, talk to your doctor
• Psychotherapy (Cognitive and Behavior Therapy), which teaches you different ways of thinking, reacting, and behaving
• Medications

It is important to note that if you leave such disorder untreated, it may lead to agoraphobia (an intense fear of being outside).

What causes Panic Disorder?

There has not been true known factor as to what causes such disorder however, some of the research that has been conducted has revealed that it may be run in families. There has not been an establishment in the relationship among the disorder and the environmental factors however, it can also play a role. On the other hand, researchers have found that several parts of the brain along with the biological processes, can often play a role in both fear and anxiety.

What can I do to help myself?

• Become an expert on what anxiety is. This will help you cope with it better while allowing you to have a better understanding as to what is happening to your body.
• Learn the facts and difference between what its like to have Panic Disorder with or without Agoraphobia.

Do you have trouble falling asleep or staying asleep? Insomnia is a sleep disorder that has been found to affect millions of individuals worldwide. In fact, about 30 to 40% of Americans every year share that they have experiences insomnia. It is often easy to tell someone who has shared they cannot sleep at night to just take some medication or just fall asleep however, people who have insomnia cannot fall asleep even if given the opportunity or if they are immensely tired. If you experience insomnia a day or two there’s not to much to worry about however, if it is constant and continues to happen for a couple of days, it is strongly recommended to see a doctor.

Now, what causes insomnia?

Often, it is common to find that there is another medical condition that is causing the insomnia however, other factors that influence such disorder can be any disruptions in the circadian rhythm, psychological issues, hormones, or other factors such as sleeping with a snoring partner, genetic conditions or pregnancy, for example. Environmental noise, job shift changes, bipolar disorder, depression, psychotic disorder, anxiety disorder, chronic pain, Parkinson’s and Alzheimer’s diseases, or estrogen have shown to influence such disorder as well.

How long can insomnia last?

Acute Insomnia:

Such insomnia is often brief and is caused by life circumstances. For example, an individual may experience acute insomnia when they are too worried or stressed on a given mind because they have a final the next day or after receiving some bad news. This type of insomnia tends to be short and it tends to resolve without the need of going into treatment.

Chronic Insomnia:

In this case, individuals experience sleep disturbances for at least three nights a week and may often last up to three months. With chronic insomnia, it is recommended for individuals to seek therapy and may be cause by environmental factors or other medical conditions, for example.

What are the symptoms?

• Trouble falling & staying asleep at night
• Constant wakening during the night
• Irritability, depression, or anxiety
• Have a hard time socializing
• Excessive worry about being able to sleep
• Daytime fatigue or sleepiness
• Low energy 7 difficulty concentrating
• Decreased performance in daily life activities

Insomnia Facts:

• Most common sleep disorder in the United States
• Increased prevalence rate in women and older adults

How can insomnia be treated?

There are non-medical treatments such as:

• Relaxation training (teaches individuals different techniques to relax all muscles from different areas of the body)
  • Breathing exercises
  • Mindfulness
  • Meditation techniques
  • Guided imagery
• Stimulus control (build association between bedroom and sleep)
  • For example, going into the bedroom only when feeling sleepy
• Sleep restriction
• Cognitive Behavioral Therapy
  • Maintain a bedtime & eliminating afternoon naps, for example

Medical Treatments include:

• Benzodiazepine hypnotics
• Non-benzodiazepine hypnotics
• Melatonin receptor agonists

How can I battle my insomnia?

• Make sure your bedroom is dark, cool, and quiet
• Maintain & stick to a sleep schedule
• Turn off all screens at least an hour before your bedtime
• Avoid stressful situations before your bedtime
• Avoid naps, drinking too many liquids, alcohol, big evening meals, and caffeine before bedtime

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD is typically developed after an individual has experienced a shocking, scary, dangerous, or unexpected event. However, not all people who develop PTSD have experienced such traumatic event. Some people have developed it after an unexpected death of a loved one. In fact, the National Center for PTSD estimated that about 8 out of 100 people will experience PTSD at some point in their lived.

What are the risk factors that influence the development of PTSD?

• Getting hurt
• History of either mental illness or substance abuse
• Dealing with additional extra stress after the traumatic/dangerous event or trauma
• Seeing people being hurt or killed
• Lack of social support after the event
• Experiencing atraumatic event yourself including an abusive relationship

What resilience factors can reduce the development of PTSD?

• Social support
• Support group
• Having a coping strategy
• Effective reactions to an event despite the fear

What are the symptoms for adults?

• Feeling a great distress
• Disruptions in daily life activities
• Negative beliefs and feelings
• To be diagnosed with PTSD, they must have experienced ALL of the following for a period of at least 1 month:
  • At least one re-experiencing symptom (flashback, bad dreams, frightening thoughts)
  • At least one avoidance symptom (staying away from place or object for example, that remind you of traumatic experience)
  • At least 2 arousal and reactivity symptoms (easily startled, difficulty sleeping, angry outbursts)
  • At least 2 cognition and mood symptoms (negative thoughts about oneself/world, feelings of guilt or blame, loss of interest in enjoyable activities)
• Symptoms mentioned have to last for about 3 or more months for diagnosis

What are the symptoms for children under age 6?

Although the reactions can be similar, teens and children may have other reactions such as:

• Wetting the bed even though they have already been taught on how to use the toilet
• Forgetting/unable to talk
• Being clingy with caregiver
• Acting out the traumatic event during playtime
• Thoughts of revenge

How is PTSD treated?

• Medications
• Psychotherapy
  • Exposure Therapy
    • Helps individuals face & control their fear
  • Cognitive Restructuring
    • Allows people to make sense of their bad memories

How can I help someone with PTSD?

• Help them get the right diagnosis & treatment
• Encourage them to get treatment & to stick with it (i.e. accompany them to the doctor)
• Offer them emotional support
• Gain knowledge yourself of what it’s like to have PTSD and what it is
• Listen carefully
• Never ignore their comments (i.e. death or desire to wanting their life to end)

How can I help myself?

• Accept the fact that you may have PTSD and that it may be a slow process of healing, but you can get better
• Talk to your doctor about your options
• Set goals
  • Prioritize
• Engage in activities with your loved ones
• Know what to expect
• Communicate with others what you are feeling (i.e. your trigger symptoms)

Is there something about your appearance that you may not like? Or are you in constant worry about such “flaw” that it causes you a significant distress? Body Dysmorphic Disorder (BDD), formerly known as dysmorphophobia, is a mental disorder in which an individual is preoccupied with an imagined or minor physical defect that is not apparent to others. For example, in most cases individuals are concerned with their skin imperfections, hair, and their facial features such as their nose. However, it is possible that they also express concern with a “flaw” in their teeth, weight stomach, breasts, legs, chin, eyebrows, or genitals for example. All of us, if not the majority of us, have something about our appearance that we do not like however, individuals with BDD cannot control their negative thoughts and often see themselves as “unattractive,” “ugly,” or looking “like a monster,” for example. Their preoccupation for their physical appearance is so extreme that it may begin to interfere with their daily lives and spend hours thinking about such “flaw.” For example, individuals may begin to isolate themselves and begin to miss school, work, social situations, and they may even isolate themselves from their loved ones because they fear that others may notice their flaws.

What are the symptoms of BDD?

• Excessive grooming
• Skin picking
• Constant mirror checking or avoiding mirror checking
• Reassurance seeking
• They begin to compare their appearance to those around them
• Seek plastic surgery, for example
• Excessive exercise
• Change clothes excessively

How can it be treated?

• Psychotherapy, a type of individual counseling where the focus is on changing the thinking and behavior of an individual
• Medication such as antidepressants
• Group and family therapy. Family support can be crucial and important to treatment success.

Who is affected by BDD?

BDD affects both men and women equally. It is believed that in the United States, there is a 2.5% prevalence in females and a 2.2% in males estimating that about 1 in 50 people are affected by such disorder. However, people who suffer BDD may also tend to suffer from other anxiety disorder such as Social Anxiety Disorder as well as Obsessive-Compulsive Disorder and Depression. It is important to take note of this but be cautious for a misdiagnosis.

What causes BDD?

Often, BDD begins to develop in adolescent years however, there is no clear diagnosis of what the causes of such disorder are. Moreover, there are believes that there may exist environmental and biological factors that may influence the development, including genetic predisposition, neurobiological factors, personality traits, and life experiences (i.e. peer-abuse, sexual assault, or child mistreatment).

What can I do to help myself cope with BDD?

• Train yourself to make positive evaluations of yourself
• Know your personal triggers
• Understand that way you perceive your appearance
• Think of what you have to offer for yourself and others
• Have a daily routine
• Engage in extracurricular activities
• Teach yourself about BDD
• Seek professional and family support

What is an Eating Disorder?

An eating disorder is characterized by irregular eating habits, severe distress or an excessive concern regarding your body weight or shape. An individual can either have an altered consumption or absorption of food and as a result it impairs the individuals’ physical health and psychosocial functioning. While there are a variety of eating disorders, the most common forms of such disorder include Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder.

What is Anorexia Nervosa?

Individuals who are suffering from Anorexia Nervosa typically have an extremely low body weight considering their height and body type. Individuals often see themselves as ¨fat,” even though their weight is considered a significant low weight, meaning their weight it less than minimally normal.

What are the symptoms?

• Chronic restrictive eating or dieting
• Rapid weight loss
• Obsession with calories and fat contents of food
• An abnormal absence of menstruation (or loss of 3 consecutive menstrual cycles)
• Loss or thinning of hair
• Intense fear of gaining weight or becoming fat

What is Bulimia Nervosa?

Bulimia Nervosa is characterized by repeated binge eating when attempting to compensate for the overeating that the individual may have engaged in. For instance, individuals may force their vomit, exercise excessively, or engage in extreme use of laxatives or diuretics in order to get rid of everything that they just consumed. Individuals with bulimia nervosa often have feeling of guilt and shame when they consume excessive amount of food. Unlike anorexia nervosa, individuals with bulimia nervosa are often considered normal weight or slightly overweight.

What are the symptoms?

• Social isolation
• Have an excessively negative body image
• A preoccupation with ones’ body shape and weight
• Eating larger amounts of food than most people would eat in such situation (within 2 hours or less)
• Feeling loss of control over how much you eat
• The thoughts of food, dieting, and your body are so extreme, it distracts you from completing other tasks
• Engage in purging behaviors

What is Binge Eating Disorder (BED)?

Unlike individuals with Bulimia Nervosa, individuals with BED do not engage in compensatory behaviors such as vomiting or excursing excessively, but rather consume large amounts of food for example, and as a consequence, they may be obese and may be at a higher risk of developing other health conditions such as cardiovascular disease.

What are the symptoms?

• Lack of control over what you are eating
• Eating rapidly
• Eating until feeling uncomfortably full
• Feeling ashamed and disgusted with oneself
• Eating alone because you feel embarrassed to eat in front of others
• Never experience satiation. No matter how much food you eat, you are not satisfied

What causes Eating Disorders?

Although the cause is not really known, it is believed that the combination of biological, psychological, and environmental abnormalities influences the development of such disorders. For example, poor self-esteem, irregular home functions, genetics, professions and careers (i.e. ballet and modeling), cultural pressure, and family traumas to mention a few.

It is important to note that it affects both men and women.

How can it be treated?

• Seeking help from a nutritionist
• Therapy
• Medical Care and Monitoring
• Medications

What can I do for myself or someone I know?

• Admit you may have a problem
• Listen to your body
• Listen to your feelings
• Accept and love yourself for who you are
• Seek professional help

What is Attachment Theory and how does my attachment style affect my interpersonal relationships?

Have you ever stopped to think how the relationship you may have had with your caregiver for example, may be affecting your relationships now? Do you ever encounter difficulties when forming interpersonal relationships and don’t know why? Attachment theory aims to describe how and why an individual may or may not handle an interpersonal relationship (both short-term and long-term). It is believed that an individuals’ experience with a caregiver for example, can play an influence on how an individual will react when separated from the caregiver or when hurt. Additionally, to describe the interpersonal relationships that an individual may form, four different types of attachment styles have been developed.

The following attachment styles have been identified as the primary styles:

• Secure Attachment
• Avoidant Attachment
• Ambivalent Attachment
• Disorganized Attachment

Now, what are some characteristics of each?

Secure Attachment:

• Tend to have a positive view on relationships, including personal interactions
• Feel secure with or without companion
• Are able to give and take emotional expressions
• Tend to discuss an issue rather than attacking the person

Avoidant Attachment

• Tend to distance themselves from relationships
• May often come off as if they were only focused on themselves
• Often shut-down emotionally
• Express little interest in a relationship and are usually unwilling to share thoughts & feelings with others

Ambivalent Attachment

• May become greatly distressed when their loved one leaves
• There’s often a constant worry that their partner for example, does not live them
• Hesitate on becoming close to others
• Extremely suspicious of strangers

Disorganized Attachment

• Often show a mixture of avoidant and resistant behaviors
• May seem confused or apprehensive when the caregiver is present
• Often take on the parental role

How does such attachment influence the interpersonal relationships I have today or may have in the future?

An individuals’ attachment style develops in early childhood and continues throughout the lifespan as a working model for the relationships that we may be established in the future. Such attachment style influences how we maintain a relationship because often, it is what impacts the way we may perceive or react to a current situation or how we pursue our needs. For example, an individual who may have a secure attachment, as an adult they are more likely to work together with their loved one to meet both of their needs when encountering a conflict. However, someone who may have an avoidant attachment style, they may often want to engage with someone who tends to isolate themselves so that they don’t have to be faced in the need of solving something. The way our attachment style is brought about continues to influence how we engage with our peers, friends, romantic partners, co-workers, and classmate for example, today and in the future.

What can I do to ensure that my interpersonal relationship stays healthy?

Know your attachment style. When an individual knows their attachment style they can easily understand their own strengths and vulnerabilities in a relationship. It is important for you to recognize what is it that has influenced your personality today to begin to understand the reasoning for your actions and type of relationships. Once you understand yourself, you will be able to understand your loved ones and possibly reach to an agreement when encountering a conflict for example.

If you are interested in learning more about attachment styles, how they affect your daily life, or how to manage interpersonal relationships, check out our upcoming support group at https://venturacommunitycounseling.com/managing-interpersonal-relationships-support-group/

What is an interpersonal relationship?

An interpersonal relationship is an interaction between two or more people whether it is anonymously or face-to-face, for example. Such relationships occur among those who may fill each other’s explicit/implicit physical or emotional needs. It can be with a romantic partner, friend, co-worker, classmate, family, parent, sibling, daughter, or a son.

It is important to take in mind though, that just like many other things, interpersonal relationships have their highs and lows. However, it is also important to distinguish whether a relationship is “healthy” or if it has passed over to being “unhealth” possibly.

What is a “healthy” interpersonal relationship?

It is honest, there is respect, support, equality among you and your loved one, you are your own self, meaning you are independent, you compromise with each other and you communicate. In a healthy relationship it is important for both of you to not be afraid of being yourself or afraid to make decisions because of what the other may say. You simply accept each other for who you are. Also, you are truthful to one another and have no fear for rejection, for example. One is aware that it does not matter where we come from or we are going because our loved ones will accept us the way we are. Additionally, in a “healthy” relationship there is support, and encouragement for one another so that one can be a better person, there is respect for each other’s values, and most importantly, one is willing to give and take.

What is an “unhealthy” interpersonal relationship?

Often, in an unhealthy relationship, the individual may be dependent of the other or one another. For example, they may avoid certain topics for fear of their reactions and may then believe that they may deserve to be hurt by their actions. Occasionally, individuals may even feel helpless and unvalued. There is often disrespect; they humiliate you, yell at you, put you down and criticize you or they may hide things from you because there is no trust, or they have the intention of hurting you. Additionally, one, the other, or both, may be constantly checking up on you because they want to know where you are at all the time and sometimes become jealous of others who surround you. In an unhealthy relationship, one may also find pressure and an individual pushing the other to do things they do not want to do. It is also important to take in mind that there is violence, but not just physical violence. Such violence includes both verbal and emotional violence. An individual may hit you, but if they are verbally attacking you, that is violence as well and is unhealthy for the relationship.

What can I do for myself if I am in an “unhealthy” interpersonal relationship?

Seek help. Don’t be afraid. It is often easier to say something than to get it done however, it is important for you to first recognize that there is a problem in order to continue to the solution. You are not alone. Talk to someone about your current situation. Try to talk to the person you are in conflict with to attempt to reach a solution or agreement.

If you want to learn more about unhealthy and healthy interpersonal relationships and how to manage them, learn more about our upcoming support group at

https://venturacommunitycounseling.com/managing-interpersonal-relationships-support-group/