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How veterans with PTSD can reclaim control and improve their mental health. Prioritizing mental well-being helps veterans reduce PTSD symptoms and improve daily functioning. Small, consistent habits like movement, mindfulness, and rest promote resilience and emotional stability. Connection through nature and peer support strengthens recovery and restores a sense of purpose. Post-traumatic stress disorder (PTSD) affects nearly one in three veterans who served in Operations Iraqi Freedom and Enduring Freedom—nearly five times the rate found in the general adult population. According to the U.S. Department of Veterans Affairs, an estimated 29 percent of these veterans will experience PTSD at some point in their lives, with 15 percent affected in the past year alone. While traditional treatments like cognitive behavioral therapy and medication can be effective, they aren’t the only paths toward healing. Many veterans benefit from incorporating daily, accessible strategies that help manage symptoms and build long-term resilience. To gain a clearer picture of what this looks like in practice, I spoke with Mike Kogan, a leading mental health expert at Compel America, a nonprofit dedicated to supporting veterans. Drawing from his extensive experience, he shared powerful, actionable strategies that help veterans manage symptoms, reclaim control, and enhance their overall well-being. Relaxation as a Recovery Tool PTSD often heightens the body’s stress response, making it difficult for veterans to regulate anxiety and return to a sense of safety. Research shows that consistent use of relaxation techniques—such as deep breathing, progressive muscle relaxation, and mindfulness practices—can significantly reduce PTSD symptoms and improve emotional regulation. These techniques are particularly effective when integrated into daily routines and paired with gentle activities like walking or calming music. In fact, studies have found that relaxation-based interventions can serve as powerful complements to traditional treatments, especially for veterans who haven’t responded fully to cognitive therapies. These methods support the nervous system, reduce hyperarousal, and offer a non-invasive, accessible way to manage daily stressors. According to Kogan, “The anxiety response is one of the biggest triggers of PTSD, which makes learning and consistently practicing relaxation techniques an important step for veterans.” By making relaxation a priority, veterans can take meaningful steps toward healing, fostering a greater sense of stability and control in their daily lives. The Healing Potential of Nature For veterans recovering from trauma, nature can offer more than just fresh air—it can be a powerful tool for healing. A growing body of research supports the role of outdoor environments in reducing stress, regulating emotions, and fostering social connection—all critical factors in managing PTSD. Time spent in green spaces has been linked to improved mood , lower anxiety, and greater resilience, offering an accessible complement to traditional therapeutic approaches. In one study, veterans hiking the Appalachian Trail reported greater peace, inner reflection, and a renewed sense of purpose. Similar outcomes have been observed internationally: Group nature programs in the UK helped veterans ease anxiety and build peer support, while Danish veterans participating in a 10-week immersion at an arboretum experienced meaningful reductions in PTSD symptoms. Whether it’s a walk through the woods, time in a garden, or simply sitting outdoors, these moments in nature provide more than temporary relief—they support reconnection with self and others and a larger sense of well-being. Building Health Through Daily Habits For veterans coping with PTSD, consistent healthy habits can serve as powerful anchors for both mental and physical well-being. Research shows that even moderate physical activity, like walking or cycling, can alleviate symptoms of anxiety and depression by increasing serotonin levels and promoting emotional regulation. Good sleeping practices are just as vital. Experts indicate that poor sleep can intensify PTSD symptoms and make daily functioning more difficult. Establishing a calming bedtime routine, reducing screen time, and avoiding stimulants like caffeine and alcohol can significantly improve rest and recovery. Kogan emphasizes, “Healthy habits can help mitigate many of the symptoms that veterans with PTSD often experience. Exercise, for example, helps reduce body tension and stress, which can help manage anger and prevent outbursts.” In addition to physical health habits, engaging in creative or emotionally fulfilling activities—like journaling, art, or music—can also help veterans process emotions and reduce stress. Studies suggest that these positive distractions lower anxiety, improve mood, and support overall quality of life by creating space for expression and calm. The Value of Support Networks While isolation may feel like a way to cope, withdrawing from others can actually worsen PTSD symptoms. Research suggests that veterans with strong social connections experience lower levels of depression and anxiety while also benefiting from improved emotional regulation and overall well-being. Peer support—particularly among those with shared military experiences—can offer unique validation, accountability, and healing. Support groups offer veterans a safe environment to share their stories, learn coping strategies, and rebuild a sense of community. These gatherings reduce feelings of isolation and help participants feel more connected and empowered in their recovery journey. Organizations like the Wounded Warrior Project and Compel America provide veteran-specific support groups, ensuring participants receive guidance and encouragement from those who genuinely understand their experiences. Additionally, The Cohen Veterans Network offers accessible mental health care for veterans and their families, while Team Red, White & Blue fosters community and well-being through physical and social activities. The National Center for PTSD also provides a wealth of evidence-based resources, including mobile apps, self-help tools, and educational materials tailored to veterans navigating PTSD and related challenges. Bottom Line PTSD recovery isn’t one-size-fits-all—and for veterans navigating life after service, healing often happens through small, intentional steps. Whether it’s practicing relaxation techniques, reconnecting with nature, developing healthy daily habits, or leaning on a supportive community, these strategies work together to support long-term resilience and mental well-being. While traditional treatments remain valuable, it’s often these everyday tools that make the biggest difference. As Kogan notes, true progress comes from “finding the coping strategies that work best for them,” supported by consistent guidance and encouragement. Healing is possible—and it starts by meeting veterans where they are. References Dietrich, Z. C., Joye, S. W., & Garcia, J. A. (2015). Natural Medicine: Wilderness Experience Outcomes for Combat Veterans. Journal of Experiential Education, 38(4), 394-406. Gettings, R. D., Kirtley, J., Wilson-Menzfeld, G., Oxburgh, G. E., Farrell, D., & Kiernan, M. D. (2022). Exploring the role of social connection in interventions with military veterans diagnosed with post-traumatic stress disorder: Systematic narrative review. Frontiers in Psychology, 13. Hossain, M. N., Lee, J., Choi, H., Kwak, Y. S., & Kim, J. (2024). The impact of exercise on depression: how moving makes your brain and body feel better. Physical activity and nutrition, 28(2), 43–51. doi.org/10.20463/pan.2024.0015 Maddox, G. A., Bodner, G. E., Christian, M. W., & Williamson, P. (2024). On the effectiveness of visual arts therapy for traumatic experiences: A systematic review and meta‐analysis. Clinical Psychology & Psychotherapy, 31(4). Poulsen, Dorthe & Stigsdotter, Ulrika & Davidsen, Annette. (2018). “That Guy, Is He Really Sick at All?” An Analysis of How Veterans with PTSD Experience Nature-Based Therapy. Healthcare. 6. 64. 10.3390/healthcare6020064. Talkovsky, A. M., & Lang, A. J. (2017). Mantram Repetition Program for PTSD: A Randomized Trial. PTSD Research Quarterly, 28(2). U.S. Department of Veterans Affairs, National Center for PTSD. Wheeler, M., Cooper, N. R., Andrews, L., Hacker Hughes, J., Juanchich, M., Rakow, T., & Orbell, S. (2020). Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial. PloS one, 15(11), e0241763. Ryan C. Warner, Ph.D., - Website - Blog -

You may be surprised to learn what's at the heart of your emotional triggers. At the heart of our emotional triggers often lies a childhood narrative. When we overreact, we are likely triggered by present-day events, reawakening past events and their emotions. When we’re triggered, an earlier narrative gets activated so that we behave as if we're still in the past. Triggers give us the opportunity to locate and better understand our early narratives. (This post is Part 1 of a two-part post.) Everyone has emotional triggers—we’ve all experienced the sudden rush of intense feelings set off by something someone says or does. Almost by definition, when we’re triggered, we react without thinking, and afterward, when things have calmed down, we might wonder why we had such an intense reaction—a reaction so intense that we regret what we said or did. Just know that being triggered is a very common experience and that there’s a lot you can do to keep your triggers from controlling you. What's at the Heart of Emotional Triggers Triggers are often childhood wounds that never fully healed, such that they are now sensitive areas which, when “triggered” by something in the present, return us to the original hurt. At these moments, we are no longer our rational 35-year-old selves. Instead, our not-so-rational childhood feelings take over, and we react to the present as if we were still in the past. We have triggers for a reason: they helped us deal with bad things in our past. Back then, emotional triggers protected us. Now they get in our way. For example, when five-year-old Anthony hears his alcoholic father return home after dinner and start to raise his voice, he knows it’s best to sneak off to his room. This becomes a trigger for Anthony: if someone raises his voice, he wants to retreat and hide. As a child, this kept Anthony away from his father’s angry wrath. The trigger helped him survive a bad situation. As an adult, however, the trigger gets in his way: Anytime his partner gets irritated and raises his voice, Anthony walks away and avoids him. Rather than talk through their issues, Anthony fears his boyfriend’s anger , even though Anthony knows his partner—unlike his father—can control his anger. Triggers Often Point to Early Narratives At the heart of our emotional triggers often lies a childhood narrative. (For a quick review of what narratives are, check out the post, “How We Form Lifelong, Unhealthy Narratives.”) As children , we are constantly forming narratives about how things generally work. Based on our experiences, along with the feelings and thoughts that accompany these experiences, we construct narratives that form our system of beliefs. We could illustrate it like this: In this way, Anthony arrived at the narrative that he should avoid people who are angry. This Venn diagram can be rewritten to illustrate how we get triggered by present-day events: Notice how our rational, thinking mind “turns off” as we are flooded with old, childhood feelings triggered by the present-day event. In the end, we behave according to the original narrative, which is probably not the best choice for the present-day circumstances. To sum up, here’s what happens: An event creates some feelings. These present-day feelings trigger past feelings. The past feelings awaken past narratives. The past narratives determine our present-day behaviors. Here's another example: Let’s say I grew up in a military family , moving frequently so that I was always losing friends. As a result, I formed the narrative that making friends wasn’t worth it. As a child, this narrative protected me from further losses whenever we moved. But as a young adult, when my girlfriend tells me she’s ready to “step up” our relationship and be exclusive because she really likes me, I become triggered. As she asks for more intimacy, I panic with a childhood fear. The trigger has re-ignited old narratives and old ways of coping with problems. Though I can’t explain my reasons to her or myself, I break up with her. When we’re triggered, an early narrative is activated by our present situation so that we behave as if we’re still in the past. Another way to put it: Our adult self is being controlled by our little kid self. It’s as if we’re letting an eight-year-old tell us what to do and how to act. Put this way, do you want a little kid running your life? Conclusion: Moving Past Old Triggers At the heart of a trigger lies an unhealthy childhood narrative. These narratives aren’t set in stone. We can change them, and when we do, our triggers lose their power. Rather than react emotionally, we respond mindfully. Evan Shopper, LICSW, - Website - Blog -

In a world brimming with challenges and heartache, children often bear burdens that seem insurmountable. Just as the mighty oak grows strong when nurtured from seed, children flourish when provided with the right support—especially when it comes to their mental and emotional health. We will explore the essential role that play therapy can play in alleviating childhood behavioral health issues. Understanding Childhood Behavioral Health Issues Childhood is a wondrous phase filled with exploration, curiosity, and innocence. Yet, for some children, it can also be a time marked by anxiety , trauma , grief , and depression . Statistics reveal that one in five children experiences a mental health disorder, which can interfere with their ability to learn, engage socially, and build healthy relationships. These behavioral health problems may stem from various sources: environmental stressors, familial disruptions, or even the lingering effects of communal and societal trauma. It's vital that parents and caregivers remain vigilant and recognize the signs early on. This early identification allows for timely intervention, preventing these behaviors from developing into more severe issues that can persist into adulthood. A tranquil park provides a safe space for children's emotional exploration. The Power of Play Therapy Play therapy, a dynamic and engaging therapeutic approach, employs play to help children express their feelings, thoughts, and experiences. At its core, play therapy recognizes that children communicate differently than adults. “In the whispers of a child’s play, we can find profound stories waiting to be uncovered.” One might wonder, how can play therapy be effective for addressing behavioral health problems? It provides children with a safe space to explore their emotions and develop coping strategies. With trained therapists guiding them, children can navigate their feelings without the pressure of traditional talking therapies, allowing for personal discovery at their own pace. 5 Advantages of Play Therapy for Children Emotional Expression : Through art, storytelling, and creativity, children can express feelings they may not have the words for. They transform complex emotions into relatable stories, fostering understanding and healing. Building Resilience : As they engage in play, children learn resilience. They experiment with problem-solving and experience both success and failure, equipping them with the skills to manage future hurdles. Safe Environment : The playroom becomes a sanctuary. With toys, games, and playful activities, the atmosphere is non-threatening, allowing children to immerse themselves in healing without the fear of judgment. Strengthening Relationships : Therapy sessions provide a unique opportunity for parents and caregivers to learn more about their child’s emotional world. They gain insight into the child’s thoughts, thereby improving communication and trust. Coping Mechanisms : Through various play activities, therapists can teach children practical coping strategies. From role-playing to art therapy, children learn techniques they can use outside of therapy sessions, enhancing their ability to manage stress. Colorful building blocks serve as tools for children to express emotions during play therapy. The Role of Immersive Techniques in Play Therapy In the realm of therapy, one approach is not superior to another. Rather, each child is unique, and play therapy can blend various immersive techniques tailored to their needs. For instance, sand tray therapy allows children to manifest their internal struggles visually and physically. By creating scenes in a sandbox, they illustrate their feelings and stories—perhaps a representation of an ignored grief or bottled-up anger. Additionally, using puppets can facilitate difficult conversations. When a child feels overwhelmed by a topic, a puppet can become the vehicle through which they articulate their fears or desires. The separation of self from the puppet enables conversation that might otherwise feel too daunting. Immersive techniques, such as storytelling with props, can be effective in bridging the gap between a child's real-life experiences and their imagined world. This blend creates a rich tapestry, where the child feels seen and heard while simultaneously navigating their challenges. The sandbox is filled with tools for children's expression during therapy sessions. The Importance of Early Intervention Timing matters immensely. When we speak about behavioral health assessments, we emphasize the importance of early intervention. Identifying behavioral health challenges in children as soon as possible allows parents, caregivers, and educators to address issues before they escalate. Therapeutic interventions, such as play therapy, can alleviate distress and help children build essential coping skills that last a lifetime. The longer a child struggles with unmet emotional needs, the deeper the roots of their distress can grow. By acting early, we can pave the way for healthier development. To explore more about how The Resilience Center supports children and families, check out our webpage on treating children . Fostering a Supportive Environment Creating an environment where children feel safe to express their feelings is crucial. As caregivers and community members, we must cultivate environments that prioritize emotional health. Conversations about mental health should be normalized, and we can foster resilience by modeling healthy emotional expression ourselves. Moreover, schools play a significant role. Teachers and administrators should be educated in recognizing behavioral signals among students, facilitating early dialogues, and providing appropriate referrals when necessary. Closing Thoughts: Nurturing Our Children As we delve into the intricate and beautiful dance of childhood mental health, let us acknowledge: children are not just small adults. They are vibrant beings capable of profound thoughts and emotions, often expressed through the language of play. In recognizing the importance of play therapy and the early identification and treatment of behavioral health problems, we open the door to healing. By breaking down barriers and fostering supportive networks, communities can empower young minds to flourish, ensuring that the oak can grow strong and resilient. Explore more about the transformational journey of play therapy and how it can create a brighter future for our children at The Resilience Center . Let's work together to ensure every child has the support they deserve, nurturing both their emotional and behavioral health needs with compassion and understanding.

The urgent need for improved care and research for treatment-resistant depression. Treatment-resistant depression (TRD) is a major but under-recognized public health concern. Many who live with TRD shift from one failed treatment to another, and some disengage from care altogether. Changes in care and coordination for TRD patients, new research shows, could improve their prognosis. Treatment-resistant depression (TRD) is a major public health concern that affects a substantial number of people, yet remains under-recognized in clinical care, policy, and research. It is associated with significant personal, social, and economic costs, as people with TRD often experience more severe symptoms, longer illness duration, and greater functional impairment compared to those with treatment-responsive depression . It also places considerable strain on healthcare systems due to frequent service use, hospital admissions, and complex care needs. Despite its prevalence and profound impact, TRD has not received the same level of attention as other mental health conditions. To help address this gap and further advance understanding in this area, we recently published a study examining the experiences, needs, and current treatment pathways of individuals with TRD. Our study drew on data from 2,461 people diagnosed with major depressive disorder (MDD) in secondary care in the UK, combining both quantitative analysis and qualitative interviews with patients and clinicians. The quantitative data provided insights into patterns of diagnosis, treatment use, and comorbidities. The interviews offered a more personal and grounded account of how TRD is experienced in real life. Characteristics of TRD TRD is typically defined as depression that has not responded to at least two different antidepressant treatments. In our sample, nearly half (47 percent) of individuals with MDD met this criterion. In addition to experiencing persistent symptoms of depression, many people with TRD were also managing other difficulties, such as comorbid anxiety , personality disorders , physical health problems like diabetes and cardiovascular diseases, and socioeconomic disadvantage. Approximately 37 percent of people with TRD had also tried four or more different antidepressants within their current depressive episode. This pattern suggests that repeated pharmacological interventions, in the absence of broader therapeutic changes, may be insufficient in addressing the complexity of TRD. Challenges Faced by Patients and Clinicians Hearing directly from people living with TRD helped deepen our understanding of these numbers. Many described the emotional toll of moving from one treatment to another without noticeable benefit. Over time, this repeated disappointment led some to disengage from care altogether. For one individual, their experience was summed up as “years lost to inactivity,” a reflection of how long-term depression can limit daily activity and connection. Clinicians voiced their own frustrations. Several described feeling that they had exhausted the available treatment options and lacked the resources or structured pathways to offer something different. Clinicians also noted that, compared to conditions like psychosis, services for TRD felt much less structured or supported. This left both clinicians and patients feeling unsupported and, at times, directionless. These observations point to broader systemic gaps in service planning and delivery, suggesting that current models may not be adequately equipped to respond to the complexity or persistence of TRD. These accounts speak to a wider problem. People with TRD were often less likely to be referred to community mental health teams and more likely to receive care in specialist or inpatient settings, typically at a point of crisis. This suggests a pattern of reactive care, where people receive more intensive support only after their condition has worsened, rather than earlier in the course of illness. Several people living with TRD described their care as a process of “trial and error” that lacked coordination and clarity. For some, this unpredictability made it harder to continue seeking help. Improving TRD Treatment Approaches These experiences suggest that we need to change how we approach and manage TRD in services. Both patients and clinicians identified key areas for improvement. Treatment plans need to be more tailored and holistic, combining medication with psychological therapies such as cognitive behavioral therapy and compassion-focused therapy, depending on individual needs. TRD should be identified earlier so that people are not left cycling through medications without other forms of support. Care pathways also need to be clearer and more consistent, offering step-by-step guidance and continuity across time and services. Perhaps most importantly, people with TRD need to be supported in ways that go beyond symptom reduction, e.g., by focusing on improving everyday functioning, relationships, and overall well-being. If adopted, these changes have the potential to reshape care for a group that has too often been overlooked. Improving care for people with TRD calls for a more coordinated and considered approach. Isabel Morales-Munoz, Ph.D., - Website - Blog - References Read the full study: Gill K, Hett D, Carlish M, et al. Examining the needs, outcomes and current treatment pathways of 2461 people with treatment-resistant depression: mixed-methods study. The British Journal of Psychiatry. Published online 2025:1-8. doi:10.1192/bjp.2024.275

ADHD, or Attention-Deficit/Hyperactivity Disorder, is often seen as something only children deal with. Yet, for many adults, the challenges of ADHD persist and manifest in various aspects of life. Navigating work, relationships, and personal growth can be overwhelming, but by embracing vulnerability and the strength found in community, those of us with ADHD can thrive. Let us explore five practical techniques that can help you manage ADHD as an adult, drawing on the wisdom of our experiences. Embrace Therapy with a Licensed Professional One of the most powerful tools in managing ADHD is therapy. Engaging with a licensed therapist can be transformative. Therapy provides a safe space where you can explore your thoughts, feelings, and experiences without judgment. It’s more than just talking; it’s about gaining insight and learning strategies that fit your unique challenges. Imagine sitting in a warm, inviting office, discussing your daily struggles and triumphs. A compassionate therapist can offer tailored coping mechanisms that resonate with your personal journey. Cognitive-behavioral therapy (CBT), in particular, is beneficial for adults with ADHD, helping you understand how your thoughts affect your behavior. If you're in Texas, consider exploring the therapy services at The Resilience Center of Houston , which offers a variety of options tailored to adults. ADHD brain waves Consider Medication as a Tool Medication can be an essential part of managing ADHD. The right medication can help improve focus, decrease impulsivity, and enhance emotional regulation. When it comes to finding the right fit, patience is key. Every individual's response to medication is different, and it often takes time to discover the most effective option. Consulting with a physician who understands ADHD can help you navigate this journey. They will work with you to monitor the effects and adjust dosages as needed. Remember, medication is not a cure but a tool to help you thrive. Adults diagnosed with ADHD often feel empowered when they find the right mix that allows them to harness their strengths. Through this medication journey, you might discover newfound confidence in your abilities. Collection of medication bottles representing tools for managing ADHD. Lifestyle Modifications for Lasting Change Change doesn't happen overnight. Implementing lifestyle changes can profoundly impact how you manage ADHD. Here are some actionable suggestions to start making positive modifications: Establish a Routine : Creating a daily schedule can provide the structure many with ADHD crave. Start small by designating specific times for tasks like work, exercise, and relaxation. Mindfulness and Meditation : Practicing mindfulness can enhance focus and reduce anxiety. Simple breathing exercises can ground you in the present moment. Apps and guided meditations can be helpful companions on this journey. Healthy Diet and Exercise : Nutrition and physical activity play a critical role in mental health. Eating balanced meals and incorporating exercise into your routine can increase energy levels and clarity. These modifications, while simple, create a ripple effect in your life, leading to better emotional stability and resilience. A serene park representing the importance of physical activity and nature for mental health. Cultivate Strong Support Systems The importance of having a strong support system cannot be overstated. A reliable circle of friends and family can provide you with encouragement and understanding as you navigate the ups and downs of living with ADHD. Building these connections takes time and vulnerability, but the rewards are truly worthwhile. Engage with those who understand and empathize with your experiences. Share your journey with them, discuss your challenges, and celebrate your successes. Having someone who listens without judgment can be profoundly healing. Small group of individuals sharing experiences and supporting each other. Stay Open to New Strategies and Adaptation Managing ADHD is not a one-size-fits-all approach. The techniques that work for one person may not resonate with another. It’s essential to remain open to experimentation. Stay curious and motivated to seek out what helps you thrive. Each strategy you adopt can contribute to a tapestry of care that is uniquely yours. Regular check-ins with yourself or your therapist can help evaluate what is working and what may need adjustment. Embrace flexibility in your approach and remind yourself that progress is not linear. As you navigate this path, remember that you are not alone. Many others share this journey and struggle, and there are resources available to assist you. Exploring tools online is a fantastic way to foster empowerment, but nothing beats personal connections. Before you know it, what once felt like an insurmountable hill can become a series of manageable steps. Each small victory deserves celebration. Finding Your Thriving Self In summary, managing ADHD as an adult requires a multi-faceted approach blending therapy, medication, healthy lifestyle choices, and community support. Each of these techniques empowers you to harness your full potential and leads to a more fulfilling life. The journey may not always be easy, but it is undoubtedly rewarding. Remember that you possess the strength of a resilient individual navigating through the complexities of life. To learn more about the resources available, visit the appointment page of The Resilience Center of Houston to get started on your path to thriving with ADHD. As you continue on this journey, know that you hold the key to your thriving self. Stay curious, stay engaged, and always reach out for support when needed. No matter the challenges you face, your story is worth sharing. Please note : The content provided here is for informational purposes only and does not substitute for professional advice from a licensed therapist or healthcare provider. Always consult with a professional for customized recommendations.

How boredom uniquely impacts ADHD—and what life looks like when it’s addressed. ADHD brains crave stimulation—boredom creates emotional distress, not just restlessness. Chronic boredom leads to impulsivity , avoidance, and a drop in motivation and self-worth. Responding to boredom with structure and curiosity rewires behavior and restores focus. For most people, boredom is mildly uncomfortable. For someone with ADHD , it can feel intolerable—like being trapped in a slow-motion moment you can’t escape. But this isn’t about being impatient or distracted. Boredom is a deeper struggle for those with ADHD, and it’s rooted in how their brains process stimulation, time, and emotional urgency. Why Boredom Feels So Intense with ADHD The ADHD brain craves stimulation. Not because of laziness or entitlement, but because of how it’s wired to regulate dopamine—the brain chemical responsible for motivation, reward, and attention. When stimulation is low—during routine tasks, waiting periods, or quiet moments—the brain can feel like it’s starving. This doesn’t just lead to restlessness. It causes distress. Tasks like filling out forms, sitting through meetings, or doing laundry don’t just feel “boring.” They feel painful. And because the ADHD brain has difficulty regulating emotion and time, that moment of boredom can quickly turn into frustration, agitation, or even hopelessness. Many adults with ADHD describe it as a kind of mental itch they can’t scratch—so they jump from task to task, reach for their phone, start multiple things at once, or give up completely. What Life Looks Like When Boredom Takes Over When boredom becomes a chronic issue, life starts to look scattered and emotionally draining. People may avoid important responsibilities—not because they’re incapable, but because the task doesn't generate enough stimulation to activate their brain. They might: Leave projects half-finished. Struggle with relationships that feel stagnant. Overeat, overspend, or scroll endlessly. Experience guilt for not “pushing through.” Feel constantly underwhelmed and overstimulated at the same time. Over time, this pattern doesn’t just impact productivity—it chips away at self-worth. Many adults with ADHD internalize the idea that they’re lazy, inconsistent, or broken. But the truth is: they’re wired differently. And once they learn to work with their brain, everything can begin to change. What Life Looks Like on the Other Side When someone with ADHD learns to respond to boredom skillfully, everything shifts. They begin to understand that boredom isn’t a sign of failure—it’s feedback. And they stop waiting for motivation to show up before getting started. With the right support, they build systems that provide just enough stimulation to stay engaged without burning out. They learn how to: Schedule stimulating breaks during low-interest tasks. Use curiosity to make boring work feel meaningful. Switch between tasks intentionally rather than impulsively. Create routines that reduce decision fatigue. Over time, they don’t just feel more productive—they feel more alive. Relationships deepen. Projects get finished. Life feels richer, more balanced, and more within reach. The Path Forward This transformation doesn’t happen overnight. For most, it takes 90 to 180 days of consistency to build new habits and internal systems that support focus, fulfillment, and emotional balance. And they don’t do it alone. With coaching, structure, and accountability, people with ADHD can rewire the way they relate to boredom—and in doing so, unlock their potential to live a calmer, more purposeful life. Ugochukwu Uche MS., LPC - Website - Blog - References Malkovsky E, Merrifield C, Goldberg Y, Danckert J. Exploring the relationship between boredom and sustained attention. Exp Brain Res. 2012 Aug;221(1):59-67. doi: 10.1007/s00221-012-3147-z. Epub 2012 Jun 23. PMID: 22729457.

Navigating the stormy seas of adolescence can be a daunting task. For many teens today, social media acts like both a compass and a windstorm, guiding their perceptions while simultaneously wreaking havoc on their mental health. With the rise of social media comes a consequential battle with depression that many young people face in silence. In this heartfelt journey, we will explore the intersection of teen therapy, social media, and depression, delving into why licensed mental health therapy is not just important, but essential for our teens. Understanding the Landscape of Social Media and Teen Mental Health In a world where likes and shares often dictate self-worth, it’s crucial to consider the impact of social media on our teens. Data shows that nearly 95% of teens have access to a smartphone, and 45% say they are online almost constantly. This connectivity provides incredible opportunities for connection and creativity; however, it can also lead to overwhelming feelings of inadequacy and loneliness. Social media apps provide constant connectivity for teens. Research indicates that excessive use of social media is linked to anxiety and depression in adolescents. Studies reveal that teens who spend more than three hours a day on social media may be at a greater risk for mental health issues. It’s easy to see why: the curated lives we see linked with likes and hearts can create unrealistic expectations, isolating many from the genuine connections they desperately need. The Silent Struggle: Understanding Teen Depression As a parent or educator, it can be heartbreaking to witness a teen struggling with depression. Often, they may seem withdrawn, irritable, or indifferent, and may even mask their internal battles with a brave face. Depression in teenagers can manifest as fatigue, changes in sleep patterns, and a lack of interest in activities they once enjoyed. Statistics show that teen depression is alarmingly common, with about 20% of adolescents experiencing depression before they turn 18. From mounting academic pressure to the heart-wrenching comparisons generated by social media, it’s easy to understand how these influences can contribute to ongoing emotional battles. Many teens might feel powerless, believing their feelings are something to be managed alone. However, this is where the importance of licensed mental health therapy comes into play. When teens have access to a supportive space, such as therapy, they can not only express their feelings but also begin to understand and manage them. Why Licensed Mental Health Therapy Matters for Teens Genuine support from a licensed mental health professional can make a world of difference in a teen’s life. Here are five compelling reasons why therapy is a vital resource: 1. Professional Insights and Techniques Licensed therapists are trained to understand the complex emotional landscape that teenagers face. They have the expertise to provide tailored strategies and insights, helping young people navigate their feelings and learn coping mechanisms. 2. Safe Space for Expression Therapy offers a judgment-free zone where teens can share their thoughts and feelings without fear. This safe space encourages authentic expression, enabling them to confront their challenges head-on. 3. Building Resilience Therapists can work with teens to foster resilience. Through exercises and discussions, kids learn how to bounce back from adversity and strengthen their emotional muscle, equipping them for future challenges. 4. Improved Social Skills Engaging with a therapist allows teens to develop better communication and interpersonal skills. These skills are vital not only in therapy but also in their day-to-day relationships, both online and offline. 5. Reducing Stigma around Mental Health When seeking help becomes a normalized topic, it paves the way for others in their circles to think about their mental well-being. This reduces stigma, encouraging emotional openness and creating an environment where seeking help is viewed as a strength, not a weakness. Therapy is not just a resource for those in crisis; it's a proactive approach for promoting mental wellness and overall happiness. As parents and educators, we must encourage our teens to embrace therapy as a positive step in their lives. Can Teens be Vulnerable Online? In our digitally-centric world, teens often find themselves trapped in a web of comparisons. Social media can lead them to portray perfect, filtered images of life, disconnecting from their true selves. It can amplify feelings of envy or inadequacy, leading to isolation and deeper emotional struggles. However, there is an empowering side to this vulnerability. Many teens have turned to online platforms to share their stories, connect with each other, and promote mental health awareness. These exchanges can be fueling a transformative movement, helping them discover they are not alone in their struggles. Parents and educators can support this movement by guiding teens in how to use social media thoughtfully, helping them recognize the difference between reality and the highlight reel portrayed online. Empowering Teens Towards a Healthier Mindset So, how can we as a community, parents, and educators foster a healthier mentality in our teens? Encourage Open Conversations : Create a warm environment where emotions can be shared freely. Ask teens how they feel about social media and their emotional well-being. Normalize Therapy : Discuss therapy openly. Share that just as we take care of our physical health, emotional health is vital too. Teach Mindfulness : Simple mindfulness techniques, such as meditation and deep-breathing exercises, can be beneficial. Apps like Headspace or Calm can offer teen-friendly resources. Limit Social Media Time : Encourage breaks from social media, particularly during emotionally taxing times. Establish 'tech-free' zones or hours in your home. PromoteHealthy Activities : Advocate for involvement in activities that nourish the soul, whether that’s sports, arts, or community service. These outlets can provide positive alternatives to screen time. At The Resilience Center, we understand the unique struggles teens face in today’s social media age. Our dedicated team offers various therapy services tailored specifically for adolescents. If you’re seeking support for a teen in your life, learn more about our teen therapy services and consider taking the first step towards helping them thrive. Embracing Hope and Recovery Despite the challenges social media can pose, there remains hope. Licensed mental health therapy can unlock a path to recovery and resilience for many teens. By addressing the issues at hand, encouraging dialogue, and providing support, we can create an environment that nurtures emotional health and well-being for our youth. Ultimately, recognizing the signs of distress and seeking intervention can empower our teens to navigate their unique challenges more effectively. Together, we can foster a supportive community dedicated to the mental well-being of the next generation. Therapy rooms provide a peaceful space for healing. If you’re ready to provide your teen with the support they deserve, it’s an excellent time to reach out. Contact us for an appointment request here and let’s work together to guide our teens toward a brighter and more resilient future. Remember, it’s okay to reach out for help; it’s a vital step towards wellness. By embracing understanding, creating open dialogues, and supporting our young people as they embark on their journeys through this complex world, we can help them discover their strengths, cultivate resilience, and find joy amidst the chaos of adolescence.

Move from arguments to productive conversations about raising your children. Parents may argue about parenting due to different childhood experiences, stress, and parenting philosophies. Parenting arguments get stuck because of the "Four Horsemen" communication patterns. Help everyone regulate first, validate feelings, and offer simple solutions that respect both parents. Do you and your partner have the same fights over and over about parenting? Maybe one of you wants a more intentional approach while the other trusts their intuition. Or perhaps you clash over discipline, screen time, or bedtime routines. These conflicts might sound familiar: You: "I wish you wouldn't yell at the kids." Partner: "I don't yell at them as much as you do!" or "Yeah, because you're such a perfect parent with all your reading and podcasts..." Maybe you don't even bring up these topics anymore because they're too triggering, leaving you in uneasy silence. If you're nodding, you're definitely not alone. In this post, we'll examine why parents argue, common disagreement areas, and strategies to work through these challenges together. The goal isn't to eliminate disagreements but to handle differences in ways that strengthen your relationship and model healthy conflict resolution for your children . Why do parents argue about parenting? Different childhood experiences shape expectations. How we were raised strongly influences our parenting beliefs. If you grew up in a strict household while your partner was raised to express opinions freely, you might disagree about children's roles in family decisions. These effects intensify when either parent has experienced childhood trauma , which can influence how they respond to their child's challenging behavior. Stress amplifies parenting tensions. When parents are exhausted, stressed, or overwhelmed, small differences can quickly escalate. Sleep deprivation with a new baby or financial pressure can turn minor disagreements into major conflicts. Parenting philosophies often clash. Some parents value structure and clear rules, while others emphasize freedom and child autonomy. These fundamental differences in approach can create friction in everyday decisions. 6 common parenting disagreements Managing children's digital device use: Screen time has become a major source of parenting conflict. One parent might view technology as educational and necessary for the future, while the other worries about compulsive use and social development impacts. Both might want their child to transition from screens without meltdowns but disagree on methods. Bedtime boundaries: Parents frequently clash over bedtime enforcement, weekend exceptions, routine length, and handling resistance and night wakings. Food and nutrition concerns: Food choices often cause disagreements between parents. One parent might allow occasional treats while another maintains stricter nutritional standards. Food disagreements often feel intense because they touch on deep values around health, cultural traditions, and childhood memories. Parents may disagree about trying new foods, handling picky eating, using food as rewards, balancing nutrition at social events, and sugar consumption. Homework and academic expectations: Different definitions of success can lead to disagreements about homework help, academic pressure, and balancing achievement with enjoyment. These differences often reflect parents' cultural backgrounds and personal academic experiences. Discipline approaches: Discipline disagreements touch our deepest values and trigger strong emotions. Parents frequently argue about physical punishment, handling tantrums, when to enforce consequences versus show leniency, and whether to use rewards and incentives. When parents disagree on discipline, children quickly learn to play one against the other, undermining authority and creating confusion about boundaries. Conflicting parenting styles: Parenting styles reflect our core beliefs about raising children, and disagreements can turn everyday decisions into conflicts. According to Diana Baumrind, the four main parenting styles are authoritative, authoritarian, permissive, and uninvolved. When partners use different styles, conflict often follows, though these four categories aren't our only options, despite their popularity. Why do we get stuck in the same arguments? According to John and Julie Gottman, four communication patterns make resolution impossible. They call these the "Four Horsemen of the Apocalypse": Criticism: Attacking character rather than addressing specific behaviors ("You always..." or "You never...") Defensiveness: Protecting yourself when criticized ("I let him have screen time because I needed to make dinner!") Contempt: Showing disrespect through sarcasm, name-calling, or eye-rolling Stonewalling: Withdrawing completely from the conversation Most arguments begin with criticism, triggering defensiveness, which may escalate to contempt or stonewalling, leaving everyone feeling discouraged and hopeless. How to resolve parenting arguments Strategy 1: Manage "in the moment" conflicts. When your partner disciplines in a way that concerns you, try: Help everyone regulate first: Move closer, perhaps placing a hand on your partner's shoulder to help de-escalate. Validate feelings all around: "It sounds like you're frustrated about the toys not being picked up" (to partner) and "It seems like you weren't ready to stop your game" (to child). Offer a simple solution: "What if we set a timer for five minutes to finish the game and then clean up together?" Strategy 2: Focus on feelings and needs, not judgments. Instead of "I feel like you're not taking parenting seriously," try "When we disagree about discipline, I feel worried because I need consistency in how we respond to challenging behaviors." Strategy 3: Use the validation ladder. Practice different levels of validation: Be present with full attention. Accurately reflect what you heard. Contextualize or equalize their experience. Make a proposal about their feelings. Express genuine empathy. Take action to support them next time. Strategy 4: Listen to understand, not to respond. Give full attention, reflect back what you heard, and validate their perspective, even when you disagree. Strategy 5: Take breaks when needed. If either of you becomes too emotionally activated, take a 20-minute break before continuing the conversation. Strategy 6: Create a culture of appreciation. Regularly express appreciation for what your partner does well in parenting and other areas. This builds goodwill and counters contempt. Strategy 7: Build a support system. Parenting books, classes, family therapy , or a community of trusted parents can provide valuable perspective when disagreements become entrenched. Strategy 8: Remember you're on the same team. Despite differences, remember that you both want what's best for your children. Approach disagreements as teammates with different perspectives, not opponents. Final thoughts The goal isn't to solve every parenting disagreement but to discuss differences without major conflict. Try different approaches, evaluate results, and adjust as needed. Even the most compatible parents disagree sometimes. The difference between struggling and thriving couples isn't the absence of conflict—it's how they navigate it together. What parenting disagreement would you like to approach differently with your partner? Jen Lumanlan, M.S., M.Ed., - Website - Blog - Book - References Lumanlan, J. Parenting Membership. Your Parenting Mojo. Greene, C. A., Haisley, L., Wallace, C., & Ford, J. D. (2020, July 23). Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence. Clinical Psychology Review. Durtschi, J. A., Soloski, K. L., & Kimmes, J. (2017). The Dyadic Effects of Supportive Coparenting and Parental Stress on Relationship Quality Across the Transition to Parenthood. Journal of Marital and Family Therapy, 43(2), 308–321. Gallagher-Squires, C., Isaacs, A., Reynolds, C., & Coleman, P. C. (2023). Snacking practices from infancy to adolescence: parental perspectives from longitudinal lived experience research in England. Proceedings of the Nutrition Society, 1–9. doi:10.1017/S0029665123003592 Lumanlan, J. (2025, April 20). Parent Conflict Over Discipline: How to Get on the Same Page. Your Parenting Mojo. Baumrind, D. (1966). Effects of Authoritative Parental Control on Child Behavior. Child Development, 37(4), 887–907. Gottman, J.M., Cole, C., Cole, D.L. (2019). Four Horsemen in Couple and Family Therapy. In: Lebow, J.L., Chambers, A.L., Breunlin, D.C. (eds) Encyclopedia of Couple and Family Therapy. Springer, Cham. Lumanlan, J. (2024, April 14). How to get on the same page as your parenting partner. Your Parenting Mojo.

Depression can feel like an ever-present shadow, hovering above us, casting doubt and sorrow into our lives. You might be facing it yourself, or you may know someone who is. In a world that often emphasizes hustle and success, it's crucial to pause and acknowledge how our mental health impacts everything we do. Therapy with a licensed therapist is one of the most empowering steps you can take towards healing. Today, let’s explore the importance of mental health therapy and how it can nurture our well-being. Understanding Depression A strong understanding of depression is the first step toward treatment. This condition can manifest in numerous ways, and its effects can linger long after its onset. People often associate depression with feelings of sadness, hopelessness, or constant fatigue. However, it can also present as irritability, anxiety, withdrawal from social interactions, and physical symptoms like changes in sleep and appetite. According to the National Institute of Mental Health, approximately 19 million adults in the U.S. experience a major depressive episode each year. That's a staggering number! Yet, acknowledging that you're not alone is the first triumph on this journey. Depression can be debilitating. The Role of a Licensed Therapist Engaging with a licensed therapist can create a safe haven to express your thoughts and feelings without judgment. These professionals bring a wealth of knowledge, skills, and empathy to their practice. They guide you in exploring the roots of your depression and help you develop coping strategies tailored to your needs. Therapists often utilize different approaches—some might lean towards Cognitive Behavioral Therapy, while others might steer you into mindfulness practices. The beauty of therapy is that it is not one-size-fits-all; it’s an opportunity for you to find what resonates most and supports your healing journey. Five Compelling Reasons to Seek Therapy Personalized Care and Support No two experiences with depression are identical. A licensed therapist takes the time to understand your situation, emotions, and challenges. This tailored approach enables them to create a treatment plan that feels just right for you. You'll have a trustworthy ally who works with you, building a foundation for your recovery. Improved Coping Mechanisms One of the most invaluable gifts therapy offers is teaching you how to manage stress and anxiety effectively. Therapists provide practical tools that empower you, such as mindfulness exercises and deep breathing techniques. You’ll learn how to navigate the everyday challenges, turning potential triggers into opportunities for growth. Access to Professional Expertise Therapists are trained professionals who have a deep understanding of mental health issues. They stay updated with the latest research and techniques in the field. When you seek therapy, you’re not just gaining an ear to listen but expertise that contributes to your healing. This knowledge can make all the difference in your journey. Creating a Safe Space Therapy is a confidential space where you can discuss topics you may never share with family or friends. It’s a sanctuary for vulnerability. This sense of security allows you to express yourself freely, deepening your self-awareness and emotional resilience over time. Encouragement for Personal Growth Engaging in therapy means embarking on a journey of self-discovery and growth. You'll start to recognize patterns of thought and behavior keeping you stuck in despair. A therapist helps illuminate these areas, nurturing the courage to embrace change, fostering hope, and igniting the drive for a better tomorrow. Close-up view of a bookshelf packed with self-help books in a calming therapy environment. Finding the Right Therapist for You Finding a licensed therapist who aligns with your needs can be a transformative step. Consider factors like their experience, approach to treatment, and whether you feel a sense of connection during your initial meetings. In Houston, Texas, resources like The Resilience Center provide a wide range of services to support individuals coping with depression and other mental health challenges. Begin your journey by researching therapists in your area. Reading online reviews can offer insight, and don't hesitate to reach out for a conversation before committing. You deserve to find someone who feels right for you. Empowering Yourself and Others It’s essential to remember that seeking therapy does not denote weakness; on the contrary, it signifies strength and a desire to evolve. In a society that often stigmatizes mental health struggles, choosing to prioritize your well-being can inspire others to do the same. Share your story, break the silence. Together, we can create more open conversations around mental health, paving the way for collective healing. Eye-level view of a journal and pen placed on a wooden desk, suggesting personal reflection. Embracing the Journey As you embark on your path to healing, it’s important to acknowledge that recovery from depression is not linear. There are ups and downs; however, therapy with a licensed therapist provides you the necessary tools to navigate life’s challenges with resilience and courage. Whether you’re ready to seek help or supporting someone who is, understand that this journey begins with compassion—first for yourself and then for those around you who may also be struggling. Remember, every step taken towards understanding mental health contributes to a brighter future—not just for you, but for your community as well. If you're interested in exploring mental health services, visit The Resilience Center for more information about their comprehensive approach to therapy. You can also request an appointment here , taking that vital step toward nurturing your mental wellness. By fostering an open dialogue about mental health and dispelling the myths that surround it, we can begin to shift perspectives, ultimately building a more compassionate world. Let’s cherish and nurture our mental well-being together because, “We are the change we have been waiting for.” (B. Obama) Prioritize your mental health today—it might be the most beautiful gift you give yourself.

OCD's sneaky role in modern dating, from limerence to overanalyzing. Limerence can lead to obsessive thoughts, idealization, and missing red flags. OCD may cause overthinking about compatibility, leading to mental compulsions and disconnection. Fear of disclosing OCD can create anxiety around being misunderstood or judged while dating. When people talk about OCD and dating, we often hear about Relationship OCD (ROCD), which involves intrusive thoughts and compulsions centered around the relationship itself. However, what frequently goes unspoken is how OCD can show up before you’re even in a committed relationship. Dating in today’s technological world can feel overwhelming enough, but adding intrusive thoughts, difficulty with uncertainty, frequent feelings of doubt, and perfectionistic standards can make dating with OCD feel impossible. Let’s talk about a few ways OCD can impact dating before you even graduate from the “situationship” stage. Limerence: The Obsessive High Limerence, that intense, infatuated feeling early in dating, can be especially confusing for someone with OCD. This intense feeling can lead to obsessions and idealization. You may hyper fixate on the person and romanticize them, while ignoring red flags. Limerence can also lead to compulsive behaviors like constant texting, checking their social media or dating profile, or seeking reassurance from friends. However, like any emotional high, there is always a crash to follow. This may be intense feelings of disappointment if they are no longer interested, or your perception can shift to devaluation once they do something “wrong,” leading you to cut things off without thoughtful consideration. Compatibility Over analysis We know the OCD brain loves to overanalyze, so it makes sense that this would appear early in dating. If you're constantly scanning for flaws, comparing your connection to others, or ruminating on whether the person "checks all the boxes," you may be engaging in compulsive behavior. This mental checking loop can lead to feeling more disconnected from the person you’re dating, which will impact your ability to see if there is a genuine connection. Fear of Disclosing OCD A common theme among individuals with OCD is fear of being misunderstood or judged if they share their diagnosis and/or the content of their obsessions. I always validate this for my clients because it is true that OCD is hugely misunderstood, and there are harmful stereotypes associated with it. You might worry that you’ll seem like "too much," or fear the person will leave if they know this part of you. I always tell my clients it is their choice what, how, and when they share, and disclosure looks different for everyone. Perfectionism in Dating Many folks (not all) with OCD often also struggle with perfectionism, and this can show up in numerous ways in dating. Perfectionism leads us to have many “should” statements about others. For example, they “should have this kind of job” or “should look this way.” We are all allowed to have standards and preferences; however, with perfectionism, there tends to be less flexibility. This can lead to a smaller dating pool and a never-ending search for the “perfect” partner. On the other hand, there may also be a belief that you must show up as your perfect self on dates. This pressure can lead to self-judgment, shame, or even postponing or avoiding dating altogether. Intimacy and Vulnerability Fears Whether it's emotional or sexual intimacy, OCD can show up at inopportune times. When intrusive thoughts and obsessions are taboo in nature, this can also lead to feelings of anxiety and shame. Many individuals with OCD will avoid intimate moments due to the fear of intrusions popping up, which can get in the way of building an intimate connection with someone. Uncertainty About the Future "What if this doesn’t work out?" "What if I waste their time?" "What if I fall out of love?" These questions might start innocently, but they can quickly pull us into the OCD cycle. OCD lives in uncertainty, and dating inherently requires tolerating the unknown. For someone with OCD, this uncertainty can be difficult, triggering mental compulsions to predict, analyze, and prepare for every possible outcome. So, What Do You Do? Dating with OCD doesn’t mean you’re broken or unlovable—it just means you may need more self-awareness and compassion as you navigate it. It’s essential to speak to your mental health provider if you notice OCD getting in the way of dating. The goal isn’t to get rid of OCD so that you can date; it’s about understanding how your OCD can show up so you can respond skillfully, allowing you to develop that genuine and authentic connection you're looking for. Melissa Jermann, Ph.D., - Website - Blog -

Practical steps for finding core fears. Core fears drive OCD. Even when clients present with similar obsessions, underlying fears can be different. Effective ERP targets the core fear. Use tools like the CBT Downward Arrow technique to uncover core fears. You have a few new clients coming in today, all with OCD . The first client describes fears of contamination, sharing in detail their rituals and worries about contracting germs. You gather a lot of information during the intake and begin formulating a treatment plan in your head. Then, your second client arrives and describes the exact same concern. You pause for a second, thinking, what are the chances of the same symptom presentation back-to-back? Again, you gather information, validate the distress, and start building a plan in your mind. Finally, your third and last new client of the day comes in. And again, you hear the same obsessive fears. Same rituals. Same worries about germs. By now, you’re thinking, these symptoms are weirdly identical. It would make sense to assume you could apply the same treatment plan across the board, right? What if I told you I’d bet that all three of these clients are actually presenting with distinctly different cases of OCD? You might bet against me, thinking it would be an easy win. But here’s the catch: while each of these individuals are describing contamination fears on the surface, we haven’t yet uncovered what’s underneath. The rituals may look similar, or even identical, but the driving force behind them can be worlds apart. This driving force is what we refer to as the core fear. What Is a Core Fear in OCD? The core fear represents a client’s “worst-case-scenario,” the deeply held fear that drives all the ways their obsessions show up on the surface. Think of it like peeling back the layers of an onion. The outer layers are the obsessions: the “what if” questions, the intrusive thoughts, the doubts. But, as we peel those layers away, we eventually reach the center which houses the worst possible feared outcome the person imagines would happen if those thoughts were actually true. Let’s revisit the example from earlier in this post: three clients presenting with contamination concerns. On the surface, the outer layers of their “onions” look nearly identical. But as we start peeling back those layers, we begin to uncover what’s truly driving each of them. For the first client, the core fear is being responsible for spreading germs to loved ones and causing harm, or worse, death. For the second client, the deeper worry is that they might contract germs, become ill themselves and die, leading them to miss out on living a full and meaningful life. And, for the third client, the fear centers around experiencing intense feelings of disgust, a sensation so overwhelming and aversive that they feel compelled to do whatever it takes to avoid it. Core Fear Breakdown: Client A: I’ll be responsible for spreading germs to loved ones causing harm or death. Client B: I might become ill or die, meaning I’ll miss out on a living a full and meaningful life. Client C: Disgust. Why the Core Fear Matters in Exposure and Response Prevention (ERP) Therapy If we accept the symptoms at face value and only treat them as they appear without digging deeper to unmask OCD, we risk developing an ineffective hierarchy with exposures that miss the mark. ERP becomes more about checking boxes than helping clients face what truly matters to them. OCD is as clever as it is sinister. It relishes when its victims remain entangled in the web of obsessional content (a place where it would love for us clinicians to get stuck too). But if we follow its lead, we are often doing nothing more than tugging at strands of the web while the spider remains hidden at the center. The anxiety might shift or morph into a new obsession, but the underlying fear continues to drive the cycle. By identifying the core fear, we can ensure exposures are tailored to our clients’ unique fears, helping them to confront what truly feels most threatening. This allows the work to be more meaningful and more likely to lead to lasting progress and greater treatment outcomes. How to Identify the Core Fear One of the most effective ways to uncover the core fear is by using the CBT Downward Arrow technique. To stay consistent, let’s go back to our contamination examples. We might ask each client a series of questions like: “If it were true that you got contaminated and contracted germs, what would that mean to or about you?” or “What would be so bad about that?” The client responds, and we follow up with: “If that were true, what would it then mean?” We continue this process, peeling back layer after layer until we land on a worst-case scenario, a deeply personal belief or feared outcome that feels especially uncomfortable to confront. That’s when the real work begins. It can also be helpful to listen for themes. For example, does this person often feel afraid of being irresponsible? Of being rejected? Of causing harm? Or losing control? These patterns often guide us toward the core fear that is fueling the cycle. Conclusion Helping clients identify their core fears can be a transformative step in therapy. It opens the door for clients to gain deeper insight into their symptoms and the behaviors that follow. It also allows therapy to fulfill its true purpose: targeting the dominant fear that is interfering with the client’s quality of life and daily functioning. When we address these fears at their root, we empower clients to face their triggers, build resilience, and ultimately regain independence in the face of OCD.

Identifying bipolar disorder's "softer side" can be a challenge. It’s true. Bipolar disorder has a “softer side,” and that’s what makes the condition's diagnosis all the more challenging in people who have a wide array of what might be considered “finer symptoms.” Classic bipolar disorder is characterized by dramatic, extreme mood swings—from high “highs” (mania and hypomania, “I can do anything”) to low “lows” ( depression , suicidal thoughts, anxiety , paranoia). But what about people with symptoms considered more “common,” like periods of anxiousness, sense of uneasiness, irritability, boredom, poor decision-making, and feelings of meaninglessness intermingled with moments of energy and intensity, euphoria, a spurt of ideas, focus, brilliance, vision, and achievement? These are often missed in psychiatric examinations because they are not viewed as a connected whole. They fall beneath what might be called the “threshold of diagnosis,” failing to fit neatly within standard clinical tools like the Bipolar Spectrum Diagnostic Scale or the Mood Disorder Questionnaire. As a discernible condition, bipolar disorder is considered rare, affecting only about 1 percent to 2.8 percent of the population. However, if the softer forms of this mental condition are considered, its prevalence may be as high as 7 percent or 8 percent, some experts contend. Implications of Bipolar ‘Light’ Having “bipolar light” does not necessarily exempt one from both the negative and what some might call “positive” aspects of the disorder; as well as from the impact the condition can have on normal, day-to-day activities, including problems with intense anxiety; insomnia and wakefulness; substance abuse; and problems similar to those of autism spectrum disorder. As many as 50 percent of patients with bipolar disorder have abused drugs at some point in their lives. In more simple terms, bipolar disorder on any level, severe or moderate or mild, can be described as an energy imbalance; too much or too little during any given time period, that time period often lasting for several days in a row. With its elevated moods, the condition can spark tremendous productivity, speed of thinking and movement, obsessiveness, a flurry of new ideas, enhanced self-awareness, a drive for perfection, even over-excitement. Some of history’s greatest thinkers and artists—painter Vincent van Gogh, writer Virginia Woolf, composer Robert Schumann, actress Vivien Leigh, and author Edgar Allen Poe—are believed to have suffered from bipolar-related symptoms, accomplishing their greatest works during energy peaks. On the downside, the psychiatric disorder’s “highs” can lead to compulsive behaviors such as binge buying, poor judgment, irritability, and a general sense that people are moving much too slowly and, frankly, are in the way; this can result in a variety of life problems like aggressive driving and road rage. The patient is mentally moving at 100 miles per hour when everyone else is doing the speed limit of 55. Even more impactful is the condition’s “lows,” leading to feelings of hopelessness, disinterest in normally enjoyable activities, fear and paranoia and a gnawing, overall belief that what was achieved during the patient’s state of high energy was simply not good enough. A fear of falling short of perfection can stymie action, and activity. Patients with the disorder also may experience problems in personal and family relationships, exhibiting over-sensitivity to comments and situations and becoming estranged from loved ones. Treatment Approaches In its mildest forms, bipolar disorder can still leave people with an array of symptoms that no simple diagnosis will explain or standard therapy can address. Patients are left blaming their personality, childhood and family life, other medical conditions or even what some religions refer to as a “sinful nature” for their range of moods and reactions. To find peace, they oftentimes seek unconventional treatments such as ketogenic diets, ketamine infusion therapy for depression, LSD micro-dosing, cold showers, even spiritual retreats. When the condition causes difficulties in a person’s personal, professional, or work life, then medical assistance is needed. In analyzing these cases, physicians must go beyond what appears to be, at its surface, generalized anxiety or depression, because many of the medications for these more common psychiatric conditions actually can worsen the agitation in bipolar disorder. Psychotherapy also can prove helpful in managing mood swings, although the approach is much more effective with an accurate diagnosis. Meanwhile, tools that go beyond current diagnostic scales and questionnaires are needed to help practitioners recognize bipolar disorder’s less pathological, finer symptoms. That’s why we are developing a “Rockstar Bipolar Questionnaire,” which hopefully will prove clinically useful in illuminating the softer nuances of bipolar disorder. Greater awareness of “bipolar light” should give us increased understanding of what is normal, what is too little, what is too much, and what makes a person an incredible “Rock Star.” Alex Dimitriu M.D. - Website - Blog -