counseling

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.

The aftermath of an affair, 4 ways to tell, ‘Should I Stay or Go?’

Repair or Run the Other Way? My partner had an affair, Should I Stay or Go?

If you or your partner has recently discovered an affair has been happening in your relationship, in this moment you are likely trembling, a blurry fury of agonizing hurt, the entire relationship now may feel foreign to you. As a couples counselor affairs and their tempestuous aftermath are ironed our my office couch. Both parts of the couple struggle to make sense of the betrayal and its costs, couples seek aid and asylum to find the answers to questions such as; should we stay together or separate, will our relationship ever regain a sense of normalcy, ‘am I weak or foolish for thinking of staying?’ ‘how can we fix this?”

A relationship is founded and grows upon a platform of trust, without the reinforcement that trust provides, the person who was victimized by the affair will be thrust into a state of panic, questioning every action and motive of their life and partner. An affair is a trauma to the relationship, often people who have learned of, or been told about an affair from their partner, suffer from symptoms similar to PTSD or Acute Stress Disorder. Sleeplessness, anxious and intrusive thoughts and images, fear of it happening again. Within the wake of this mountain of emotional upheaval they create their next course of action, remain together or disassemble their lives. Use this guideline to weigh the options, keeping in mind the decision is one that must be made by ones self, as it is personal, intimate, and an infinitely complex choice to make.

• Is the partner who committed the affair being accountable? There must be a high level of accountability if the relationship will be repaired. This means that the cheating spouse accepts responsibility for his or her actions. If instead your partner is blame shifting or gaslighting, by saying that the affair is your fault or someone else’s fault, or if he or she is trying to minimize the impact or the hurt this will not work. The relationship must have truth to begin the healing process. It can be very frightening to own up, and some personality types that are antisocial, psychopathic, or narcissistic will likely use more defensiveness when met with the truth and or will struggle with empathy for their betrayed partners hurt. Under these circumstances it won’t be possible to work thought what happened in a healthy way.
• Has communication been cut off with the paramour? If communication is on going with the alternate partner there is no chance that the relationship can heal from the betrayal. There are people who will try to stick it out and court their partner while he or she tries to figure out which partner to choose. This is not a recipe for healthy connection, jumping around doing the “pick me dance” will likely lead to a major impact on self esteem and an internal sense of anxiety and profound sadness. Many couple’s therapists will not treat a relationship when there is an active affair happening.
• Is your partner willing to have greater transparency with you? This means giving you the codes to his or her phone, email, and social media accounts. Even with the codes and access to your partners interactions, it will take a herculean effort to restore any sense of safety or trust. This is a good first step in letting ones partner in and pushing the affair partner out.
• Do you want to do the work or forgiveness? While it is true that the affair is often symptomatic of deeper issues, the aftermath puts a tremendous strain on both parties. Deciding to work through and forge forgiveness is a toll which most heavily gets heaped upon the person who has experienced the betrayal. If you have learned that an affair has happened in your relationship and that you want to work on repairing it, you will simultaneously actively be committing to forgiving, this will be exquisitely difficult. After enough time has passed, you will be required to work through the process of handling anger, hurt, sadness, resentment, jealously, insecurity, all in the name of staying with your partner. Keep this in mind as it may not be for everyone which is ok!

All of these grim facts in mind, there is hope, if the above questions can be answered with certainty then there is a path to be forged toward forgiveness. Not an easy one but it is possible to have a connection which is stronger after an affair. Trust is a formula of consistency over a time, trust can be rebuilt if the formula is followed. With understanding, truth, and commitment, love is a robust and golden vessel which proudly contains the tender blossoms of our lives. A vessel that is able to withstand complete annihilation and be recreated to become gleaming and full again, or sometimes it is best to pluck our precious contents and replant somewhere anew…

In love and care,

Counseling and Wellness Center of Pittsburgh and Monroeville

Stephanie Wijkstrom MS, LPC, NBCC

Acupuncture, Mini Retreat Spring Detox Led By Dr. Truncali, D.C, L.a.C, Monroeville

Acupuncture, Mini Retreat Spring Detox Led By Dr. Truncali, D.C, L.a.C

March 20th 

2539 Monroeville PA, 15146

6pm-7pm

Spring Acupuncture Detox

Transitioning from winter to spring is a challenge for our bodies and a time to do some spring cleaning for our physical, and emotional selves. This is a group acupuncture session focused on cleansing and cleaning, boosting immunity, and calming the spirit as we let go of winter and move toward spring’s light, warmth, hope, and growth. Dr. Truncali, D.C, L.a.C, our centers new licensed acupuncturist, will be leading the workshop sharing practical tips to cleanse and care for yourself using his knowledge of Traditional Chinese Medicine (TCM) and Holistic Health to reinforce our bodies ability to be healthy and strong as we come into the new spring season. If you have always wanted to try acupuncture this is your chance to do so at a special community rate. You will also be welcome to enjoy complimentary snacks from our “Brain Bar” and sip some “Be Well” herbal tea.

Call us at 412-856-WELL with questions!

https://www.eventbrite.com/e/spring-cleaning-detox-with-acupuncture-dr-truncali-dc-lac-tickets-43654203899

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What is Nutrition Counseling?

Be Your Own Beloved: Cultivating Self-Care

Be Your Own Beloved: Cultivating Self Care

Counseling and Wellness Center of Pittsburgh, 830 Western ave, Pittsburgh 15233

Saturday Feb 10, 10am

Being your own beloved means treating yourself with the same love and kindness as you would to a dear friend. Just like you cannot fill from an empty cup, you cannot fully love someone else until you love yourself. This Valentines Day, give yourself (and your partner) the gift of self-care.

Join Kayla Hersberger, yoga instructor, essential oil lover, and advocate for natural living in this seminar which will include;

• A guided heart-opening meditation

• A writing exercise (bring your journal!)

• Tips for starting and maintaining a self-care practice

• Instruction to self-massage with essential oils

We kindly ask for a $5 love donation to cover the cost of oils, but no one will be turned away due to lack of funds.

Jackie Mandock, LPC, NCC

Jackie Mandock, LPC, NCC, LBSC, MH is a counselor at Counseling and Wellness Centers of Pittsburgh- Monroeville. She provides therapy to children, adolescents, families, couples, and adults. Jackie approaches therapy from a holistic perspective, always staying mindful of how the body, mind, and spirit are interconnected. Jackie is certified in trauma focused cognitive behavioral therapy and is trained in parent-child interaction therapy.  She has worked with many different concerns in these specialized populations ranging from attention-deficit hyperactivity disorder to trauma, as well as anxiety and depression. Jackie is also a licensed behavioral specialist with a strong background in autism.  Jackie was a school-based therapist and is familiar with school concerns and supporting educational issues. She is a graduate of University of Pittsburgh with a Bachelors in Psychology and Neuroscience and  from Chatham University with a Masters in Counseling Psychology. Jackie also has a Master Herbalist diploma from American College of Health Sciences.

Melissa Taylor, LMFT

Melissa Taylor, LMFT

Melissa Taylor, LMFT, MS is a very enthusiastic and compassionate professional that believes in the power of combining counseling and physical activity when working through personal issues. As a marriage and family therapist, Melissa works through family system issues that may influence a person’s current life situation, relationship issues, and emotional instability. As individuals, we have grown up with different family dynamics, viewed many family relationships and observed different ways of communicating that influence present time relationships and how we cope with issues. Family patterns exist, so Melissa helps people identify and understand those patterns, and then learn how they influence current problems. Melissa has worked for years with adults and adolescents that have been abused, abandoned, felt depression and anxiety, or struggle with current relationships; therefore, she is very comfortable working with individuals, couples and families that are dealing with past and current difficulties. She encourages self-care practices through counseling and exercise to build self-esteem, trust, communication and coping skills, to improve their own lives. Melissa is a psychoanalytic therapist that also provides CBT and other family system theories in her work. She encourages clients to trust her and themselves in the counseling process to work together towards healing and personal goals.

Melissa has lived in multiple states to complete her education and build her career while learning different cultures. She received her Bachelor’s Degree in Psychology at the University of Kentucky, and completed her Master’s Degree in Marriage and Family Therapy at Drexel University in Philadelphia. She also had the privilege of completing a Master’s degree in Kinesiology at LSU in Baton Rouge, which allows her to integrate physical activity for clients in their therapeutic treatment process. She has provided therapy in Kentucky, Indiana, Louisiana, Texas and now Pennsylvania. She has worked with Rape Crisis Centers, FQHC’s, Inpatient and Outpatient locations, integrated healthcare centers, and group practices. Melissa has experience in different levels and types of mental health care and has learned how mental health symptoms affect all populations.

Melissa recently moved to Pittsburgh from Texas and enjoys exploring her new city with her husband and two young children. She enjoys playing and teaching her children, Zumba and other exercises, and cooking with her family. Melissa is very energetic and is always seeking new experiences for herself and her family.

 Mindful Parenting Workshop