Specializing in PTSD, Anxiety, Depression, and Borderline Personality Disorder

PTSD
 

While everyone will experience trauma in their life, not everyone will subsequently develop PTSD. It is unclear why some individuals develop the disorder while others experiencing the same event do not. However, listed below are certain factors known to increase the likelihood of developing PTSD.

  • Experiencing trauma as a child: The younger the child when the trauma occurs the more likely they are to develop PTSD.

  • Severity and type of trauma: Being the victim of or witness to life threatening violence (or threat of violence), toward self or a loved one can be extremely traumatizing. Sexual abuse or assault, at any age, is known to result in a high vulnerability to the development of the disorder.

  • Multiple traumas: An individual who experiences multiple or sustained traumas has a higher likelihood of developing PTSD.

  • Community and personal support system: A strong personal group of compassionate family members and friends can help reduce the impact of a traumatic experience.

  • Individual temperament: We are all born with our own unique temperament. Those more sensitive, with an inherent tendency toward excitability, are more susceptible to the development of the disorder.

 

Common PTSD Symptoms: A number of distinct symptoms are common to this disorder. Trauma is known to affect our neurobiology and the way we process information. The most common symptoms of PTSD are described below.

  • Difficulty with concentration.

  • Sleep disruption and nightmares.

  • Flashbacks and intrusive thoughts when moments of the traumatizing event can feel as if they are occurring in the present.

  • Emotional numbness and a tendency to avoid places or situations where memories of the experience may be triggered.

  • Hyperarousal and alert state where you may consciously or unconsciously monitor the perceived safety of the current location and people present.

  • An exaggerated startle response to unexpected touch, sound, or movement.

  • A seemingly irrational “fight or flight” response to non-life-threatening situations. This can be one of the most perplexing and disruptive symptoms to the individual, and to those around them.

 

Ways PTSD May Affect Daily Life & Relationships: The development of PTSD often creates disruption in key relationships and with employment or education.  This disorder can cause a significant change in personality which can be confusing and feel overwhelming to you and to those closest to you. You may have experienced or be experiencing some of the following changes.

 

  • Agitation: You may frequently experience hyperarousal and find yourself easily agitated and angry.

  • Loss of interest, isolation, and depression: In the aftermath of trauma you may find yourself losing interest in activities you previously enjoyed, begin to distance yourself from others, and experience extended periods of depression.

  • Employment/Education: You may experience intrusive thoughts and have problems with your ability to concentrate. This can make even the most mundane tasks challenging to complete. People often report difficulties when attempting tasks, they could easily accomplish before the trauma. You may find yourself making more mistakes and struggling to meet deadlines in areas where you previously excelled. 

  • Relationships: Even the most caring friends and family members may be confused by the affects the trauma has had on you. It is important that those closest to you understand this condition and how it can affect everyone touched by the traumatic experience and its aftermath. You may hear comments like, “It’s time to move on. What’s in the past is in the past. Quit obsessing about it.” Whether well-meaning or not these comments can be very demoralizing and increase your tendency toward isolation and depression. We know that time does not necessarily heal all wounds. Without treatment PTSD can result in significant changes to one’s ability to function and maintain important relationships.

  • Self-image: The wide range and unpredictability of PTSD symptoms can be frightening. Some people feel like they have lost their sense of self and may even think they are “losing their mind.” These thoughts and feelings are completely normal. It can be helpful to talk about these feelings with those closest to you who are knowledgeable about this disorder.

 

Treatment Options: The good news is that PTSD can be successfully treated. There are a number of therapies that have been shown to be effective in alleviating and even eliminating the most disruptive characteristics of PTSD. Treatment, individualized to your needs, can help you regain a sense of safety and control in your life, and help you rediscover joy in the things you used to love.

What Else Should I Know? If you suspect you may be suffering from PTSD, or have been diagnosed with the disorder, seek treatment. Be patient and kind to yourself as you work through your treatment journey. Share this information with those around you so they can better understand what you are experiencing and support you through this process.

Learn more about PTSD by contacting our office or visiting the National Center for Posttraumatic Stress Disorder.  http://ncptsd.va.gov/ncmain/index.jsp

Anxiety
 

Anxiety is an uncomfortable feeling of fear or impending disaster, and reflects the thoughts and physiological reactions a person has when they are presented with an event or situation they feel they cannot manage or undertake successfully. When a person experiences anxiety their thoughts are actively assessing the situation, sometimes automatically and outside of conscious awareness, and developing predictions of how well they will cope based on past experiences. Although some anxiety is normal in response to a stressful situation, when the anxiety level is excessive a person may not be able to identify an effective way of managing the stressful or threatening situation. They might "freeze", avoid the situation, or even fear they may do something that is out of character. This response can occur when the assessment of the situation is accurate or when the assessment is distorted, resulting in a disproportionately extreme response resulting in panic.

Anxiety generally causes people to experience the following responses:

  • An intense physical response due to arousal of the nervous system leading to physical symptoms such as a racing heartbeat.

  • A cognitive response which refers to thoughts about the situation and the person's ability to cope with it. For someone experiencing high anxiety this often means interpreting situations negatively and having unhelpful thoughts such as "This is really bad" or "I can't cope with this".

  • A behavioral response which may include avoidance or uncharacteristic behavior including aggression, restlessness or irrational behavior such as repeated checking.

  • An emotional response reflecting the high level of distress the person is experiencing.

 

When anxiety is pervasive, or disproportionate to actual circumstances, and interferes with daily functioning, treatment can be helpful in quieting the nervous system, developing effective self-regulation strategies, and resolving underlying beliefs that trigger thought distortions.

 
Depression

People experiencing depression may not experience all of the following possible symptoms, or any symptoms all the time. However, if you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

  • Persistent sad, anxious, or “empty” mood.

  • Feelings of hopelessness, or pessimism.

  • Irritability.

  • Feelings of guilt, worthlessness, or helplessness.

  • Loss of interest or pleasure in hobbies and activities.

  • Decreased energy or fatigue.

  • Moving or talking more slowly.

  • Feeling restless or having trouble sitting still.

  • Difficulty concentrating, remembering, or making decisions.

  • Difficulty sleeping, early-morning awakening, or oversleeping.

  • Appetite and/or weight changes.

  • Thoughts of death or suicide, or suicide attempts.

  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Depression robs the individual of the ability to enjoy or pursue relationships, career, education, or other life goals, and suppresses the natural immune system. Sometimes medication can be helpful and appropriate to balance brain chemistry, while learning coping skills, and exploring underlying beliefs and past painful experiences that may be contributing to depressive symptoms.  Seek treatment to alleviate depressive symptoms and begin living the life you deserve.

* Sometimes medications can be helpful in balancing mood while receiving counseling services. We do not prescribe or advise client's on use of medication. If you need advice or assistance with medications, please contact a medical professional (PCP, nurse practitioner, psychiatrist).

 
Borderline Personality Disorder and
Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) was first developed and introduced by Marsha Linehan in the 1980’s, as a treatment for borderline personality disorder (BPD). DBT is a form of cognitive-behavioral psychotherapy, combined with Eastern philosophy that includes mindfulness and meditative practices. Previous to the introduction to DBT, no meaningful treatment was available to effectively treat those suffering from BPD. Following the introduction of this modality, for the first time, people suffering from BPD began to experience measurable improvement in life functioning and overall life satisfaction. Following initial introduction, DBT has also been shown to be effective for the treatment of mood disorders, including PTSD, anxiety, and depression, often resulting in stabilization of symptoms and improvement in overall functioning.

 

Common characteristics of BPD:

  • Extreme mood swings.

  • View the world in black and white (right/wrong, never/always, love/hate).

  • Experience intense fear of abandonment.

  • History of unstable personal relationships.

  • Unstable and shifting sense of self.

  • Impulsive, urge driven behaviors (self-harm behaviors, suicide attempts, substance abuse, promiscuity, gambling, lashing out verbally/physically, and others).

  • Intense bouts of anger followed by guilt and shame.

  • Dissociative symptoms.

  • Periods of intense depressed mood, irritability or anxiety, lasting a few hours to a few days.

Nearly all those suffering from BPD have a history of childhood trauma, neglect, and/or invalidation. The child's frantic efforts to have their emotional, and sometimes physical, needs met in childhood can result in maladaptive strategies that help the child survive their childhood environment, but those same strategies become barriers to effective functioning in adult life. 

DBT includes individual and group therapy. Group dynamics deepen learning, reinforce consistent acquisition and use of learned skills, and provide an additional level of support during treatment. The 4 modules included in DBT are: 

  • Mindfulness

  • Emotion regulation

  • Distress tolerance

  • Interpersonal effectiveness

We are not currently offering the full DBT program (with weekly group services), but expect to in the near future. If you are enrolled in a DBT program and are seeking an individual DBT therapist, please contact us today for help. Once we begin offering the full program, to include weekly group sessions, this information will be updated on our site.