counseling pittsburgh

Nature Therapy Reduces Stress

Green & Serene; Nature Therapy Reduces Stress

Nature offers therapeutic benefits and reduces stress according to a recent study from the National Institute of Health.

Mindfulness, mantras, fitness and new age therapy are all devoted to finding ways to enhance wellbeing, joy, and alternately to decrease stress levels. Combating the effects of stress are increasingly important for all of us as we manage demanding lives. One of the best ways natural ways to enhance feelings of wellbeing is by practicing fitness or some form of exercise therapy. In many studies, cardio vascular exercise is explored and compared with placebos and even pharmacology and it is verified to significantly impact and reduce the symptoms associate with anxiety and depression. Yet, there seems to be new evidence that we can even further enhance the benefits of exercise.

Increasingly, we learn that the great outdoors may have many secrets to enhancing our wellness potential. In fact in a 2013 study published by the National Institute of Health, cortisol levels were measured in people who had taken a long walk indoors and others who had done the same walk outdoors in a green serene setting. Those who had gotten their cardio amidst the trees had significantly less cortisol in their saliva than those who were indoors. Peaceful outdoorsy people have long felt the call of the wild and reported the great benefit of getting their fitness fix by hiking, biking, and other outdoor activities. We know that we can boost endorphins and decrease cortisol levels from the experience of being outdoors. Keep in mind the Cortisol is a hormone produced in the body by the adrenal glands, its activating presence leads to the physical responses involved in “fight or flight.” When cortisol is contained in overabundance in our bodies it can lead to many forms of disease, weight gain, and chronic stress to name a few. So in short, discovering ways to reduce cortisol’s overabundance in our bodies is vital, the mental health community is ready to explore many ways to expound upon the health benefits of spending more time outdoors.

Here are a few of our therapists top 12 to be well, ways to enjoy the outdoors:

Learn to forage for wild edible plants and berries with an expert guide.

Take your lunch break outdoors, even a ten minute walk helps.

Learn how to do a walking meditation.

Create an outdoor space at your home.

Pack a picnic with your dog or your partner.

Try to go camping.

Do some star gazing.

Take a flower sniffing tour.

Plant a garden and make some farm to table meals of your own.

Pick up litter, we can even be altruistic with our wellness.

Ask your therapist to do an outdoor walking session.

Take an outdoor fitness  or yoga

class.

We love western Pennsylvania and finding ways to enhance wellness with our abundant green outdoor spaces.

This short wellness moment is brought to you by our licensed professional counselors and wellness providers at The Counseling and Wellness Center of Pittsburgh.

Be Well Pittsburgh, Monroeville, and Western Pennsylvania!

830 Western Avenue Pittsburgh PA 15233

4108 Monroeville BLVD Monroeville PA 15146

Agoraphobia

Agoraphobia

Agoraphobia is a type of anxiety disorder that can sometimes co-occur with panic disorder. Its prevalence rate in the population is low, occurring in only about 1.1% of the population. Agoraphobia is hallmarked by a fear of leaving the house or other safe place. This often cooccurs with panic attack or panic disorder because a person has experienced a panic attack and then fears that they may have one again or that they will experience some other feared situation such as traveling on a bridge, going through a tunnel, or being stuck in a crowd of people. In some situations, the person may be able to encounter the feared situation, but they do so with such dread that the activity and many other parts of life lose their joy and peacefulness, which can even lead to depression and other psychiatric disorders. In some instances agoraphobia can be diagnosed without a history of panic disorder.

The criteria for Agoraphobia are as follows:

1. A fear or anxiety about being in places or situations where escape may be challenging. This fear is often surrounding being unable to quickly escape if the sufferer has a panic attack and could become trapped or unable to leave.
2. The fear of being unable to leave leads to an avoidance of said situations which can result in restriction of travel or in some instances the situations are endured but only with a certain safe person or friend.
3. This specific phobic avoidance is not accounted for by another disorder such as social anxiety or post traumatic stress disorder.

A person who has experienced a panic disorder may state “ Before I sought treatment and recovered from agoraphobia, I rarely left my apartment for 2 years. It all started when I was walking down a crowded street in downtown Pittsburgh and suddenly I had hot flashes, I was sweating and couldn’t breathe, the pain in my chest became so bad that I ran for help and reached for the lady next to me and told her to ‘Help, call 911!’ When I was diagnosed as having a panic attack the hospital I couldn’t believe it, everything changed for me then. I wanted to avoid having another episode and the only place I felt better was at home. I avoided everyone and even did my grocery shopping online. It became so bad that I started to feel anxious when I thought about leaving home for anything.”

A person with agoraphobia suffers greatly, their ability to function in life is limited including socially, emotionally, and psychologically. Treating panic disorders can be extremely difficult because the person may not want to leave their home even to seek help, fortunately treatment using distance or online counseling is now an option. The best treatment for Agoraphobia is psychotherapy, a counseling or therapy approach which uses exposure therapy and cognitive behavioral therapy. Medication or Pharmacological therapy including anxiolytic medications and SSRI’s are often used effectively to treat Agoraphobia too, medication is often used in conjunction with counseling or psychotherapy.

Social Anxiety Therapy

Social Anxiety or Social Phobia

Social and anxiety or social phobia is a kind of anxiety disorder in which the person experiencing the anxiety is fearful of experiencing embarrassment in social situations. According to epidemiological statistics this disorder has a lifetime prevalence rate of as much as 3-13%. Researchers have also noticed a strong family component to this disorder meaning that social anxiety or social phobia occurs with more frequency in first degree relatives. The onset of this particular kind of anxiety disorder is often in the teen years and can sometimes result after having experienced humiliation an embarrassing social situation.

According to the Diagnostic and Statistical Manual IV, this fear is very marked and when a person thinks about performing, speaking, or interacting in a social situation they may notice the fear response and or anxiety onset immediately in the form of sweating, heightened heart rate, increased respiration as well as cognitive responses such as worry and fearful thoughts. The symptoms of social phobia are marked and the person experiencing them recognize that they are excessive fears. An example of social phobia or anxiety is that person is terrified that if they speak up in class that they may blush and others will then see it and laugh at them. As you can imagine this can cause impairment in academic functioning and in many instances the person will avoid the possibility of enduring such a response and could skip class or even drop out of school. Some individuals with a social anxiety may be able to face the feared situation with distress.

Treatment for Social Phobia often involves therapy with a licensed professional counselor or licensed therapist. Counseling has many clinically verified treatment methods which are scientifically validated to reduce the anxiety related to this disorder and help individuals experiencing social anxiety to live normal healthy lives. Mindfulness based stress and anxiety reduction techniques including integrative medicine, medication therapy, meditation, acupuncture, diet, and exercise may also be helpful in treating this anxiety disorder. Please talk to your medical or licensed mental health professional to see which of these would be the best option for you.

Generalized Anxiety Therapy

Generalized Anxiety

Generalized anxiety disorder is a mental health concern which brings many people into therapy each year. As many as 1/4^th of people who seek treatment in counseling centers each year do so as a result of wanting to manage symptoms related to Generalized Anxiety Disorder or (GAD). Signs and symptoms of Generalized Anxiety Disorder are free floating thoughts and worries that are not related to a real imminent danger. Those who experience generalized anxiety disorder may find it difficult to distinguish between thoughts and fears which are related to a real possible danger or threat and one that is not. The thoughts, fears, and worries of Generalized Anxiety Disorder co-occur with physical somatic responses such as elevated heart rate, fatigue and restlessness, and or difficulty falling and staying asleep. Individuals who are experiencing this anxiety disorder may also be prone to irritability and may too have a higher incidence rate of other mood and mental health disorders including other anxiety disorders, or depression and substance abuse disorders.

A woman suffering from GAD may say something like “I was always on edge, it was difficult to pin point when the worrying started but it felt like it was one thing after the next. I was worried about getting into college, then how I would manage student and work life after, each test and paper caused me endless worry. It wasn’t just with school either, everything from traffic, to my parent’s health, I wasn’t even able to see the way it was effecting me until things became so bad that I wasn’t sleeping well and started to really feel down. Then I found a therapist and started working on treating my anxiety and along with that I was able to identify how much it had taken over my life.”

Some of the diagnostic criteria for GAD according to the Diagnostic and Statistical Manual, are as follows; Excessive worry for at least 6 months.

The person experiencing the anxiety is not able to control the worries or change the focus of their thoughts. Additionally these worries are accompanied by physical sensations or somatic responses including at least 3 of the following; Restlessness, Fatigue, Concentration difficulties, Irritation of Mood, Tightness in the Muscles, Sleep Cycle Disruptions including Difficulty staying or falling asleep. Remember these symptoms cause significant distress in social, family, or work life and are not caused by another disorder or use of substances. Only a licensed professional counselor, psychologist, or psychiatrist can help you to discern whether you are exhibiting or experiencing the full range or concerns which may mean you qualify for a diagnosis which will then help to guide the treatment for the anxiety disorder.

Treatment for generalized anxiety disorder often involves many therapy and counseling options. Many forms of psychotherapy including, cognitive behavioral therapy, psycho-dynamic therapy, brief solution focused therapy, acceptance therapy, gestalt therapy, rational emotive behavior therapy, are all valid methods to treat anxiety disorders and manage the symptoms associated with it. In other instances, counseling may be used alongside medication therapy, integrative medicine, including mindfulness and meditiation, to achieve a significant and long lasting reduction in the symptoms of anxiety.

Counseling and Wellness Center of Pittsburgh and Monroeville

830 Western Avenue

Pittsburgh Pa 15233

4108 Monroeville Blvd

Monroeville PA 15146

Post Traumatic Stress Disorder Therapy and Counseling

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder is a form of anxiety disorder which stems from exposure to a traumatic event or situation which caused real or threatened injury to and this can also be caused by the witnessing of an event or situation which injured or threatened injury to another person. According to the DSM IV, there is a lifetime prevalence rate of about 8% for the development of PTSD. Muggings, rape, terror, hostage attacks, natural disasters, car accidents, are situations that can increase the likelihood that a person may develop PTSD.

As a therapy practice which also specializes in marriage and family counseling, we support the research which suggests that individuals who have experienced an infidelity in their relationship may also go on to develop symptoms of PTSD or Acute Stress Disorder.

There are certain occupations which put people at risk for developing Post Traumatic Stress Disorder by exposing them to frightening and dangerous situations. Those who work as military/armed forces, policeman, fireman, and detectives may be particularly vulnerable for developing PTSD. Finally, there is a second form of PTSD, Vicarious or Secondary trauma, this form of trauma is caused by exposure to information related to traumatic events and is commonly seen in therapists, social workers, attorneys, judges and persons who offer support and services to those who have had trauma.

The Diagnostic Criteria for PTSD are;

• The person has witnessed, was confronted with or in some way threatened with death or serious injury to the self or others.
• The response to this event or threat was intense fear, horror, anxiety, and or helplessness.

1. The events is then continually and persistently re-experienced in the form of imagery, thoughts, perceptions, the person may also experience frightening and recurrent dreams related to the traumatic event. The person will then attempt to avoid any associated triggers of the event and have an over all numbing and or a hyper-vigilance meaning they become hyper-aroused when exposed to triggers for the trauma. They also may have difficulty falling asleep, concentrating, regulating mood, and have an increased startle response. Individuals exposed to trauma may too are also at increased risk to develop mood disorders such as depression and are also at increased risk for developing substance abuse.

Treatment for Post-Traumatic Stress Disorder often involves Trauma Focused therapy with a licensed professional counselor or therapist as well as medication therapy in certain instances. Another form of therapy which has proven effective in clinical models is EMDR.

Obsessive Compulsive Disorder OCD, Therapy and Counseling

Obsessive Compulsive Disorder

Obsessive compulsive disorder is a type of anxiety disorder which afflicts .5-2.5% of the population. The disorder greatly effects the quality of life for the sufferer and becomes a consuming pattern of anxieties and rituals which are centered around both obsessional worries and compulsive behaviors. Most of the individuals who have this disorder at one time or another acknowledge or have insight that their worry is excessive or disproportionate to the actual fear or anxiety. An example of someone who may be experiencing Obsessive Compulsive disorder is that “It started when I was in my mid 20’s, I was always worried that I would get something wrong, I made lists so I could try to manage my daily living tasks. Soon lists became my life, I would write a list of everything that I needed to do while I was in the shower, then I would check the list 3 times after writing it, to be sure that I did get everything right. Then I would reread my list again 2 times before entering the shower and read it out loud, If I didn’t perform this task I was simply unable to take my shower for the day because I would lapse into such overwhelming anxiety.”

Some examples of symptoms and behaviors association with this disorder are as follows

according to the Diagnostic and Statistical Manual;

That the individual has either obsessions or compulsions and which the definition of these are;

1. Thoughts which are recurring and persistent including images or impulses, these impulses are distressing and cause impairment including anxiety.
2. These impulses, thoughts and images are not related to a threat or worry about a real life problem.
3. There is an attempt to repress and ignore the distressing images, impulses and thoughts.
4. The person who is suffering from this disorder is in recognition that these fears are in fact a product of his or her own thought process.

Compulsions are defined as

1. Repetitive behaviors (e.g., checking, cleaning, cleaning,) and also cognitive acts such as (ie, ritualized prayer, tracing in the mind, taking count of objects or steps) the person feels compelled to enact the behavior in response to the obsession in a system of self created rules.

Obsessive compulsive disorder is a treatable anxiety disorder, the best form of therapy often involves both pharmacology including SSRI’s delivered in conjunction with long-term psychotherapy. Cognitive behavioral therapy has proven effective in managing the symptoms associated with this diagnosis as well as Behavioral Therapy such as Exposure therapy are all effective treatment or counseling models to progress beyond this disorder and take back control over life.

Panic Attacks and Panic Disorder

Panic Attacks and Panic Disorder

As many as 4.7% of people will experience a panic attack at some point in their lives, panic disorder is a form of anxiety disorder which can be extremely intense, many times individuals who have a panic attack end up going to the emergency room imagining that the rapid heart beat and dizziness are a heart attack. Symptoms and features of anxiety disorder according to the Diagnostic and Statistical Manual IV, laid forth by the American Psychiatric Association are as follows: To have experienced at least 4 of the following 13 symptoms;

Heart Palpitations

Trembling

Shaking

A feeling of smothering

Feeling of Choking

Discomfort or Pain in the chest

Nausea

Abdominal distress including a heightened need to urinate or defecate

Dizziness or Lightheadedness

Derealization or Depersonalization

Fear of losing control or a feeling that you are “going crazy”

Sweating, Chills or Hot Flashes

The symptoms of a panic attack are hallmarked by their sudden onset and intensity, unusually a panic attack has an onset in as little as 10 minutes. In example a person who has experienced a panic attack may say “I was sitting on the bus when all of the sudden I felt like I couldn’t breathe, it was like my throat closed up and I was choking but there was nothing in my mouth. I became dizzy and my heart felt like it was beating out of my chest, I started looking around and was going to cry for help. My fingers and toes felt numb and tingling, in a few minutes my heart slowed down a little bit but my stomach was really tight for hours after.”

As you can imagine someone who is experiencing a panic attack is suffering greatly. There are several different types of Panic disorder according to whether they are caused by a specific cue, such as public speaking or encountering an enclosed space such as the panic that can happen with claustrophobia. In other instances, panic attacks can be un-cued or non-specifically cued, this means that sometimes a person who has a panic attack may not understand what the trigger for their panic is until they seek treatment for the panic and uncover the deeper fears and how to manage the panic with their therapist.  A panic attack is differentiated from having a panic disorder which is to have had recurrent and unexpected panic attacks for a period of one month or more. Treatment for panic disorder are therapy, often most effectively Cognitive Behavioral Therapy, with a licensed professional counselor and also medication is sometimes the best treatment. Usually it is a combination of these two treatments which best helps to manage panic disorder. Untreated panic disorder can greatly reduce quality of life, leading to long standing feelings of guilt and shame and even agoraphobia.

Phobia Therapy & Treatment

Phobia

A phobia is a fear or anxiety response of heighted arousal, ie rapid heart rate, rapid breathing, and thoughts of intense worry and this most likely leads to avoidance of the situation or object. Some examples of typical phobias are fear of public speaking, fear of choking or vomiting, fear of spiders (arachnophobia), fear of enclosed spaces (claustrophobia), fear of bridges, fear of tunnels, fear of large crowds, fear of blushing, fear of water or other natural environments, fear of contamination or germs. Phobia is distinct and much more severe than a natural aversion, for instance in the example of arachnophobia, many people do not like spiders and insects but wouldn’t qualify for a disorder because this doesn’t interfere with their functioning and enjoyment of life. A person who simply doesn’t like spiders may sheik if they encounter one and quickly try to remove it from their environment. A person who has a phobia of spiders may feel anxiety if they think about a spider, they may never go into a forest or stay away from other natural environments, they may start to take precautions like spraying repellant everywhere and have continual intrusive thoughts about the possibility of encountering spiders and even stop leaving home or developing agoraphobia because their wish to avoid the spider is so powerful.

The Diagnostic Criteria for A Specific Phobia are;

1. A continual, persistent, and excessive fear caused by the presence or anticipation of the situation and or object, examples may be choking, bridges, tunnel, flying, insects, fainting, speaking, blushing.
2. When exposed to the object or situation an anxiety or hyperarousal response is invoked. This is also a different response in children.
3. In panic disorder the persona experiencing the disorder does recognize that the fear is unreasonable and the response is excessive.
4. The situation or object may be faced or endured but only with very visible and tangible fear, anxiety and distress.
5. This fear and anxiety interferes with the enjoyment and participation of life, limiting professional, occupational, social, relational, and academic performance and functioning.
6. This can be diagnosed only in individuals who are over the age of 18 and it must be experienced for longer than 6 months.

The best way to treat a phobia disorder is with psychotherapy, your licensed counselor can help you by using a very specific kind of therapy called Exposure Therapy. This is a behavioral therapy which a licensed therapist who specializes in treating anxiety disorders will be able to guide you through. In other instances, medication including anxiolytic medication, anti-anxiety and SSRI’s are best used medication therapy to treat and manage panic disorder. Other forms of therapy which may help to manage specific phobias including meditation, mindfulness, exercise and other integrative options like nutrition counseling and acupuncture.

Therapy and Counseling, Treatment For Anxiety

Treatment for Anxiety

Treatment for anxiety takes many forms, there are generally three main agreed upon and clinically verified methods to manage and reduce symptoms of anxiety. Counseling or Therapy with a licensed counselor or therapist is the first treatment route. The treatment route for this form of help can vary from short term, brief solution-focused counseling interventions as well as long term treatment including cognitive behavioral therapy and even existential therapy. Only you and your counselor or therapist can determine which method will be best for you.

Other ways to manage symptoms related to anxiety are to enhance total wellness, this includes  integrative medicine, nutrition counseling, acupuncture, fitness, meditation, and mindfulness. Some people experiencing anxiety find that a holistic approach suites their lifestyle best, in turn they explore clinical herbalism and integrative interventions to learn how this can support positive emotional health and wellness. Holistic therapy is best utilized along with counseling or psychotherapy from a licensed counselor  which is therapy which will focus on finding triggers and changing the cognitive response to anxiety. The final way to treat anxiety is to use medication therapy. Medication has many different options including SSRI’s which must be taken for several weeks before taking effect and then other anxiolytic medication which is more short acting, talk with your psychiatrist or prescribing PCP to explore which form of medication therapy is the best for you to treat your anxiety. Medication often works best to diminish anxiety when it is paired with counseling and therapy which can change the thought patterns, discover underlying causes of anxiety and mange the full way in which it effects quality of life.

Remember that the worst way to manage your anxiety is by doing nothing at all in the hope that your symptoms will disappear. Managing anxiety is done best when we treat it early and completely with solid medical and therapeutic interventions.