What Is the Difference Between Psychiatrists and Psychologists?

If you have mental health concerns — whether that’s anxiety, depression, or turmoil in your relationship — you should seek help. But who do you need to see? How do you know what type of mental health care provider you should talk to? Do you need a psychiatrist or psychologist? The answer might be: both.

Part of what makes Next Step unique is that we are a multidisciplinary team. In our case, a multidisciplinary team is a group of mental health care professionals who are members of different professions (e.g. psychiatrists, psychologists, pediatricians, coaches, etc.). Each provider offers specific services to you. A multidisciplinary team coordinates their services as the team works together towards a specific set of goals.

If you’re unsure which type of provider would benefit you, you’re not alone. There’s a lot of confusion out there! In this article, we’ll explore the differences and similarities between psychiatrists and psychologists — and why seeing both providers might be the right solution for you.

What Are the Differences Between Psychiatrists and Psychologists?

For those researching mental health care providers, this is a common question. There are a lot of differences, but also many similarities between these two types of providers. We talked to Dr. Brian Briscoe to gain a deeper understanding.

Similarities

Both psychologists and psychiatrists have a strong background and understanding of mental health conditions.  Both providers:

• Have completed extensive (6 years or more!) doctorate-level graduate study and training after undergraduate studies
• Receive extensive training in evaluating, managing, and treating a broad variety of mental illnesses

The Big Difference

Dr. Briscoe says, “The primary difference between the two tends to be the scope of practice ‘in the real world.'” He continues, “Psychiatrists attend medical school as part of their training, and hence have the ability to conduct lab work and other medical tests to rule out medical causes of physical symptoms that are often associated with mental health conditions (e.g. lack of energy, insomnia, excessive sweating, etc.).  And, given their medical background and license, psychiatrists may prescribe medications when necessary.”

PSYCHIATRY
Many psychiatrists have been extensively trained to provide psychotherapy, and a few psychiatrists provide hour-long psychotherapy sessions on a routine basis.  However, due to the demands of the “real world” (e.g., lack of insurance coverage for psychiatrists to provide psychotherapy, paucity of psychiatrists vs. therapists, demand for medication management, etc.) most psychiatrists in the “real world” tend to provide shorter sessions, specialize medication management, and provide oversight of their patient’s comprehensive treatment plan — a plan that ideally involves a dedicated team of psychologists, therapists, and/or coaches.”

Psychologists do not have a medical degree, and hence are unable to prescribe medications.   Dr. Briscoe continues, “However, psychologists tend to receive more training in neuropsychological testing than many psychiatrists — a tool that can be helpful in certain cases.  Because psychologists end up providing more psychotherapy in the “real world” than some psychiatrists, their skills in psychotherapy are often perfected over time — and this skill can be of great service to persons struggling with anxiety, depression, OCD, and other forms of mental illness.”

Seeing a Psychiatrist and Psychologist Offers the Best of Both Worlds

If you are struggling with a significant mental health condition, it is generally best to see BOTH a psychiatrist and a psychologist (or therapist).

Dr. Briscoe highlights a key fact: “Good professionals (that includes both psychiatrists and psychologists) should be willing to collaborate with each other in order to do what is best for your health and wellbeing. If you are seeing a professional that does not seem willing to collaborate with other mental health professionals, we would advise some caution.”

Benefits of Multidisciplinary Treatment

Numerous studies have shown that multidisciplinary approaches to treatment tend to lead to better outcomes than medication alone or psychotherapy alone.”

WHAT MULTIDISCIPLINARY TREATMENT MIGHT LOOK LIKE
If you’ve never received mental health care from a multidisciplinary team, that’s okay. Dr. Briscoe explains what treatment might look like:

“Multidisciplinary treatment does not have to be extremely expensive.  Once a medication has been started and the dose dialed in, your visits with the psychiatrist (M.D.) may only have to occur once every 2-3 months — or even less than that if the medication dose is going to stay the same.  Visiting a psychiatrist can be a little more expensive at first because you have to do the initial evaluation and then the first few follow-up sessions every few weeks as you are getting the medication adjusted.  But after that, the cost goes down quite a bit.”

On the other hand, “Psychotherapy generally works best if it is provided on a weekly basis.  Some people do okay with every other week, but I generally recommend it once a week if possible.   In my experience once a month does not work,” Dr. Briscoe says.

Consider this analogy:

Think of going to the gym.  It doesn’t do any good to go to the gym or exercise once a week.  If you are going to make any progress you really need to exercise every other day or at least three times a week.    If you just go once a week, you won’t get anywhere.  It’s just like that with psychotherapy — except that the frequency of psychotherapy needs to be once per week — not every two days.

Dr. Briscoe recalls another analogy, one that his former professor and Chair of his Department of Psychiatry once taught him: Psychotherapy is like a rubber band.  “If you engage in therapy once a week, you s t r e t c h yourself just a little and make progress each week.  But if you wait too long between sessions (say one month), the rubber band snaps back to its original shape and you don’t get anywhere.”

However, you should not have to do psychotherapy indefinitely.  Depending on the type of psychotherapy you are completing, you might expect to meet weekly on average for a few months (or maybe even a little longer), then maybe taper off.

You don’t need to go to therapy forever. Dr. Briscoe says, “Gone are the days of meeting every week for 5-10 years.  We don’t do that anymore.”

Explore Your Next Steps

Regardless of what type of mental health concerns you have, our team of skilled and compassionate providers can help you regain control of your life. At NextStep 2 Mental Health, it’s our mission to help you live a happier life, a better life.  Give us a call at our Louisville, Kentucky office at 502-339-2442, or send us a message to request more information. 

You can also request an appointment with our convenient scheduling tool here.

About Dr. Briscoe

Dr. Brian Briscoe is a board-certified psychiatrist. He also serves as the medical director of adult programs here at Next Step. He was voted a “Top Doctor” by Louisville Magazine. You can make an appointment with Dr. Briscoe here.

13 Ways to Help Children Cope with Back-to-School Anxiety

An upset stomach. Nightmares. Unrelenting desire to avoid school. Difficulty sleeping. Temper tantrums and crying outbursts. These are all examples of how anxiety can manifest in children. Sometimes, these signs of anxiety are attributed to other causes i.e., a stomachache from eating a rich meal before bed. Anxiety can be hidden in plain sight, but as we enter back-to-school season, you might start to see the signs of back-to-school anxiety.

Mental healthcare providers have noted a 17% increase in anxiety cases in children in the past decade, according to the Child Mind Institute. And the current pandemic has only contributed to the increasing spike in anxiety cases, according to the Centers for Disease Control and Prevention. Anxiety in children is treatable, but because it can be hidden or missed, as many as 80% of children aren’t getting the anxiety treatment they need.

As your child is preparing to go back to school, you might start to see signs of anxiety. Anxiety is more than just worries — it can affect your child’s personal life as well as academic performance.

Children who are worried and anxious aren’t doing it to get out of going to school. In fact, your child’s nervous system functions all on its own, especially when it comes to worry and fear. If your child senses fear, his or her nervous system kicks into action and triggers fight or flight reflexes. This is why phrases like “don’t worry” or “just relax” or “calm down” aren’t helpful — even though they seem like the right thing to say.

With a little practice and guidance from you, your child can learn to slow down his or her anxious brain. Here are a few ways you can help your child manage back-to-school anxiety this fall.

1. Practice Deep Breathing Exercise

When children feel anxious, they may subconsciously take shallow, quick breaths. These chest breaths can increase heart rate, muscle tension, and even contribute to dizziness. Taking slow, deep breaths can help you shift from chest breathing to abdominal breathing. When children slow down their breathing, it helps to shift out of flight or fight mode so their body can relax. Isn’t science cool?!  Slow, deep breaths — that’s the key!

You can do square breathing or triangle breathing, or you can follow along with guided meditations. The following videos are cute ways to introduce the idea of deep belly breathing to young children.

Rainbow Breathing

Whale Breath Singalong

Once your child learns how to belly breathe, he or she can practice deep breaths before bed — or any time during the school day when he needs a quick reset.

2. Spend Time in Nature

Nature is healing, and it can do wonders for easing anxious thoughts. Sometimes children benefit from simply changing up the scenery. This is especially helpful if your child is participating in e-learning and just needs to get out of the house. As your child breathes in the fresh air, feels the breeze rustle his hair, or listens to the birds chirp, his thoughts are gently calmed.

This is a great opportunity to practice a grounding technique. Monica Clark, LPA, explains this technique:

If you find yourself beginning to lose focus, ground yourself in the moment. One effective grounding technique is the 5-4-3-2-1 Game. In this technique, you ground yourself in the physical environment by naming:

• 5 things you can see
• 4 things you can hear
• 3 things you can feel against your skin
• 2 things you can smell
• 1 thing you can taste

Ask your child to describe the smells, find green leaves, describe the texture of a pebble.

3. Talk about What Anxiety Is

“Anxiety is often regarded as something that is bad and should be eradicated completely. However, anxiety by itself isn’t necessarily bad. Anxiety is actually an emotion that helps us take care of dangerous situations — and respond to those situations. If we are aware of a potentially dangerous situation, we can avoid harm,” says Dr. Dan Guy.

In other words, worry and fear is designed to help us avoid potentially dangerous situations. For example, a stray dog charging at your may instill fear, and it’s that fear that ignites flight or fight mode — so you can take flight to safety. Problems arise when anxiety and fear is triggered outside of dangerous situations — like feeling physically anxious even if there isn’t a dog nearby.

It’s tempting to remove all anxiety triggers from your child because — as parents — we don’t want our child to be unhappy, but the goal is to help your child manage anxiety because  experiencing some degree of anxiety is part of what it means to be human. For example, if your child is feeling anxious about this school year, he or she may ask to skip a day of school. While skipping a day of school might temporarily ease his mind, it won’t be helpful in the long-term nor will it help him manage anxiety. Instead, it’s more helpful to teach a child how to manage anxiety.

Explore this great article of what you should (and shouldn’t) do when your child has anxiety.

4. Fit Fitness into Your Schedule

Exercise is good for your body and mind — and that’s true for children too. The above video depicts an easy at-home workout that your child can perform after work, but that’s not the only option. Other good-for-the-brain exercises include:

• Hiking
• Playing sports like soccer or basketball (even if it’s in your backyard)
• Rollerblading
• Biking
• Dancing
• Jump rope

Walking around the block or playing tag in the yard are good options too!

5. Go for a Walk Around the Block

We just talked about the importance of exercise, and this tip combines an exercise (walking) with some quality one-on-one time. If you go for a walk-and-talk with your child, you’ll experience three key benefits:

• A walk around the block removes your child from his environment ( a fresh scenery is always helpful)
• The quality time allows your child to express his or her feelings and frustrations and worries
• The exercise produces “happy” endorphins to lift your child’s mood

6. Think Positive by Introducing a Gratitude Journal

Keeping a gratitude journal is a great way to combat anxious thoughts. In fact, writing in a gratitude journal is shown to improve emotional resilience and reduce stress. There are many ways to keep a gratitude journal, but here are some tips:

• Journal first thing in the morning to start the day on a positive note
• End the day with a quick reflection about things you were grateful for over the course of the day
• If your child can’t write yet, she or he can draw pictures instead

You can download our free printable Gratitude Journal. Print out the journal and let your child explore the concept of gratitude. With 50+ pages, your child will have nearly two months of journaling!

7. Focus on Good Nutrition

Good nutrition impacts your mental health too! In fact, there are plenty of tasty brain-healthy foods, such as:

• Salmon
• Yogurt
• Turmeric

Not all kids enjoy salmon, but a yogurt-lemon-dill sauce may make the salmon more appetizing for kids. You can also make salmon loaf, which eliminates the fish texture that children might not like.

TIP: If your child has a stomachache caused by anxious thoughts, she or he may not feel like eating. If that’s the cause, offer more bland foods or a warm cup of chamomile tea.

8. Read a Story

Children can learn important life lessons through reading — plus, reading is a good bonding activity! Review this list of books via WeAreTeachers, and you might discover some great books for kids with anxiety.

9. Create a Safe Space

If your child is feeling overwhelmed, he or she may benefit from a cozy place to unwind after school. From fidget spinners to books to coloring books, this can be a great way for kids to process all of their thoughts after school — rather than jumping right into homework or chores.

10. Ask for Individual Accommodations

For some children, accommodations at school can make all the difference when it comes to anxiety. For example, if a student struggles with performance anxiety, he or she may not do well when taking tests. Some students benefit from individual accommodations such as extended time on tests. For other accommodations for kids who struggle with anxiety, check out this list from The Children’s and Adult Center for OCD and Anxiety.

11. Help Your Child Practice Good Sleep Hygiene

Poor sleep and anxiety often go hand-in-hand. Anxious thoughts can make it difficult to sleep, and poor sleep can exacerbate the symptoms of anxiety. Help your child practice good sleep hygiene, including:

• Going to bed at the same time every night
• Using warm-colored lights during his or her bedtime routine
• Sleeping in a cool, dark room

12. Go Over New Changes

Reduce back-to-school anxiety by going over any new changes with your child. Maybe your child feels unsure about the new rules at school. Be sure your child understands what the new rules are (when to wear masks, etc) to help cut back on some “fear of the unknown.” If your child is participating in e-learning, ask your child if he would like to review any of the technology. Sometimes just a quick refresher on what’s expected can go a long way in feeling confident about the new school year.

13. Reach Out to Your Child’s Mental Health Care Provider

The good news about anxiety is that it can be treated with therapy, medication, and lifestyle changes. With the right support and strategies, most children are able to develop strategies that help them manage their anxiety both in the classroom and at home.

Here at Next Step 2 Mental Health, we provide comprehensive mental health care for children (and adults too!). Whether your child is just now experiencing anxiety for the first time, or is seeing a resurgence in symptoms, we can help your child get the relief s/he deserves. Call 502-339-2442 or send us a message to request more information.

OCD During the Pandemic: What You Need to Know

Mental health experts from the Centers for Disease Control and Prevention are noting “historic rises” in anxiety and depression cases, but anxiety and depression aren’t the only two mental health conditions impacted by the pandemic. Individuals with OCD may be particularly triggered. One of the more prominent obsessions associated with obsessive-compulsive disorder (OCD) is the fear of germs and contamination, and with the increased talk and demands for increased hygiene, it’s no surprise. If you find that your symptoms of OCD are worsening, you’re not alone. Research published in a June 2020 study noted that the intensity of OCD symptoms grew during (and after) the quarantine, and relapse symptoms also intensified.

If you have OCD, now is a good time to check in with yourself to ensure your symptoms are fully managed. In the meantime, this is what you need to know about the pandemic and OCD.

Debunking the OCD Myth

OCD is one of the anxiety disorders. OCD is characterized by recurring, unwanted thoughts, ideas, or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). Unfortunately, there are a lot of myths about OCD, including the idea that OCD is just about washing your hands, but the reality is that OCD is a real disorder that can profoundly impact your life if it’s left untreated. Washing hands is just one example of a compulsion. Other examples of compulsions include frequently checking on things, ruminations, or other ritual behaviors.

OCD can affect anyone, including children, teens, and adults. According to the International OCD Foundation, 2-3 million adults and about 500,000 children currently have OCD.

• Obsessing or ruminating over thoughts or images that pop into your mind and feel unable to let go?
• Spending excessive amounts of time engaged in OCD rituals (repetitive behaviors) or checking behaviors?
• Feeling like you are losing control of your thoughts, feelings, or behaviors?
• Feeling like OCD is interfering with your life or things you have previously enjoyed?

What to Do If You Notice the Symptoms of OCD

The signs and symptoms of OCD vary depending on what your specific obsessions/compulsions are. For example, if a person has recurring thoughts about germs, compulsions could include frequent hand-washing, frequent cleaning and recleaning, and drive to keep everything orderly. For example, recurrent thoughts about injury could lead to frequent checking that the oven is off.

In general, symptoms include:

• Having unwanted, recurring thoughts
• Having disturbing thoughts
• Being unable to ignore repetitive compulsions

Note that the recurring thoughts don’t always have to be about germs. According to Mayo Clinic, OCD obsessions can have themes, like fear of contamination, unwanted sexual thoughts, or the need for symmetry.

If you notice any of these signs and are struggling to manage intrusive thoughts, it may be a good time to seek professional help.

Treatment Options for OCD During the Pandemic

Do Warm-Colored Lights Help Sleep?

Perhaps you’ve noticed that e-readers, smartphones, and other tablets have an option called “night mode” — have you ever wondered what “night mode” is and why the screen turns orange? What’s up with these warm-colored lights?

There’s a lot of discussion about warm-colored lights and how they affect your ability to get a good night of sleep. Getting a good night of sleep is critical for your physical and mental well-being. According to researchers, many conditions, including depression, anxiety, and ADHD, can interfere with your sleep so it’s essential to prioritize quantity and quality sleep.

And the big question is: can warm-colored lights really help you sleep better?

To get to the bottom of this question, we spoke with Monica Clark, LPA to get some answers.

What Exactly Is a Warm-Colored Light?

“To fully understand the role that warm-colored (red, orange, and yellow) light plays in sleep, it is important to first understand your body’s natural circadian rhythms and how various types of light affect sleep-wake cycle,” Monica says. She continues, “Circadian rhythms are basically your body’s 24-hour clock that helps you to naturally alter between sleepiness and alertness at regular intervals. It is commonly referred to as your sleep-wake cycle. Circadian rhythms are impacted by both natural and artificial light. With regard to natural light, when your brain, the hypothalamus to be more precise, receives a message from your eyes that it is dark, your brain stimulates the production of melatonin, leading to sleepiness.

In the modern-world, we are surrounded by artificial lighting 24-hours per day. A large percentage of this artificial light utilizes LED technology, which research has shown to emit blue light. LED lighting is found in many light bulbs, but also in back-lit electronics, such as televisions, computer screens, tablets, smart phones, and e-readers. Using these devices or being in a room lit with LED bulbs can serve to increase alertness and arousal in the brain and have a negative impact on sleep. ^[7] Research has supported that the brain is most sensitive to the impact of artificial light during the evening hours. ^[1] Additionally, there is some research to suggest that artificial green light, especially during evening hours, serves to decrease natural production of melatonin in the brain at similar levels to the blue light spectrum. ^[3][4][8]

As opposed to the cool-light spectrum, lighting using colors on the warm spectrum, which includes yellow, orange, and red tones, demonstrated health improvements. Research suggests that warm-light tones do not negatively impact melatonin secretion ^[6] and, in another study, Lin et al. ^[5] found that being in a room illuminated with lights on the warm light-spectrum increased production of both melatonin and glutamate, a neurotransmitter that plays an important role in learning and memory. Despite these benefits, however, there is research that suggests that exposure of high levels of any light color decreases subjective feelings of sleepiness and increases feelings of vigilance and arousal ^[2]; so, even while using beneficial warm lighting, it is important to focus on keeping the lighting low and dim.

So, what does this mean? Based upon current research, the best suggestion is to use bright, cool tones during daytime hours to increase alertness. During the darker, evening hours, when melatonin production and secretion is vital, switching to dim, warmer tones of lighting may create some benefit for sleep.”

How to Implement These Suggestions into Your Life

Now that we know how cooler tones affect your circadian rhythm, what can you do to increase your quality of sleep at night?

Here are Monica’s suggestions:

1. Eliminate or decrease the use of back-lit electronics devices in the one to two hours before bed. This continues to be the strongest recommendation to minimize the impact of artificial light on sleep.
2. If you absolutely cannot unplug completely, the use of red, orange, or yellow tinted glasses or screen covers filters some, but not all, blue light. Red lenses and covers have shown to also filter some green light as well.
3. Switch some light fixtures in your home from bright, white lights to dim, warm-toned lights. Two hours before bed, switch off the white lighting and turn on warmer lighting. However, remember to use dim, not bright lights, regardless of the color.

If you’re reading on an e-reader or your smartphone, be sure to adjust the settings. It might say “Night Shift” or “Night Mode” depending on what device you’re using. See below for an example of what that looks like.

Is Something Else Affecting Your Ability to Sleep?

If you use warm-colored lights at night and practice good sleep hygiene, but still struggle to get a good night of sleep, it’s worth mentioning to your mental healthcare provider. Racing thoughts, insomnia, and anxious thoughts can keep you from a peaceful night of sleep. According to the National Alliance on Mental Health, about 50% of insomnia cases are connected to psychological distress, anxiety, or depression. If a mental health condition or past trauma is keeping you from getting the sleep you deserve, you may benefit from treating the underlying condition. Cognitive-behavioral therapy, for example, can help you control the unwanted thoughts that keep you awake at night.

Post-traumatic stress disorder (PTSD) and panic disorder are also known for causing nightmares and night terrors. According to the US Department of Veteran Affairs, as many as 96% of those with PTSD experience nightmares. Treatment for PTSD or panic disorder can also help eliminate nightmares and other sleep problems associated with the condition.

Here at Next Step 2 Mental Health, we provide comprehensive mental health care. Whether anxiety, trauma, PTSD, or other forms of psychological distress are impacting your ability to sleep, we can help you get the relief you need. Call 502-339-2442 or send us a message to request more information.

About Monica Clark

Monica Clark is a Licensed Psychological Associate who focuses on treating children and adolescents struggling with anxiety, depression, and trauma-related emotional struggles. Monica uses Cognitive-Behavioral Therapy and trauma-focused therapy to help children and teens learn to self-regulate and have greater control over their thoughts and behaviors.

You can request an appointment with Monica here.  

References

1. Blume, C., Garbazza, C., & Spitschan, M. (2019). Effects of light on human circadian rhythms, sleep, and mood. Somnologie, 23(3), 147-156.
2. Figueiro, M. G., Bierman, A., Plitnick, B., & Rea, M. S. (2009). Preliminary evidence that both blue and red light can induce alertness at night. BMC neuroscience, 10, 105.
3. Gooley, J.J., Rajaratnam, S.M.W., Brainard, G.C., Kronauer, R.E., Czeisler, C.A., & Lockley, S.W. (2010). Spectral Responses of the Human Circadian System Depend on the Irradiance and Duration of Exposure to Light. Science Translational Medicine, 2(31), 31-33.
4. Horne, J.A., Donlon, J., & Arendt, J. (1991). Green Light Attenuates Melatonin Output and Sleepiness during Sleep Deprivation. Sleep, 14(3), 233-240.
5. Lin, J., Ding, X., Hong, C. et al. (2019). Several biological benefits of the low color temperature light-emitting diodes based normal indoor lighting source. Scientific Reports, 9, 7560.
6. Morita T, Tokura H. (1996) Effects of lights of different color temperature on the nocturnal changes in core temperature and melatonin in humans. Applied Human Sciences, 15(5), 243-246.
7. Thomas, Liji. (2019). Artificial Light Exposure and Circadian Rhythm. News-Medical. Retrieved from https://www.news-medical.net/health/Artificial-Light-Exposure-and-Circadian-Rhythm.aspx.
8. Wright HR, Lack LC. (2001) Effect of light wavelength on suppression and phase delay of the melatonin rhythm. Chronobiol Int. 18(5):801-808.

5 Rules for Fighting Fair in Marriage

Fair fighting?! It might seem like an oxymoron, but the reality is that there are rules to fighting fairly. At some point, all couples experience a blip in the road of marital bliss. Whether you’re fighting about the division of chores or finances, the reality is that disagreements occur in all marriages. The key is to arm yourself with problem solving skills and conflict resolution skills.

But what skills exactly do you need? If you Google it, you’ll find 30 rules (or 15 or 10) for fair fighting. There are dozens of good ideas out there, and many of them are worth reading, but in the heat of the moment, it’s difficult to remember 30 rules for fair fighting.

Thankfully, Dr. Dan Guy, a licensed clinical psychologist, has compiled the 5 rules for fair fighting in marriage.

Rule #1: Nothing Physical

“No abuse is a no brainer,” Dr. Guy reminds us. However, there’s more to this rule than just avoiding physical abuse. Dr. Guy explains, “When something is thrown, or a door is slammed, or a hole is put in a wall, it sends the non-verbal message/warning that ‘I am so out of control that this could be you.’ This type of intimidation can only serve to make the problems worse, and damage the relationship further.”

In other words, while it might seem not-so-bad to throw a book at the wall or slam a door (since you’re not physically harming the other), it sends a threatening message, even if that’s not your goal.

Rule #2: No Name-Calling

Name-calling only adds tension to an already tense situation. Dr. Guy likens it to “throwing gasoline on the fire, with the obvious result of making things worse than when you started.”

So what counts as name-calling? The answer might surprise you.

“Remember, name calling is not limited to the ‘B-words’. If you tell your spouse, ‘You are just like your mother’ or ‘You act just like your father’, it can be just as cutting as that singular expletive,” Dr. Guy says.

Rule #3: Take a Time-Out

Time-outs have a bad reputation as something you are forced to endure if you break a rule. The idea of a time-out may conjure the image of a child sitting in the corner after hitting a sibling, but the reality is that a time-out can be a good thing. Time-outs allow you to regroup and retain self-control. Instead of imaging a naughty child, think of a football or basketball team. They call time-outs so that they make a game plan and regroup.

You too can call a time-out to regroup.

Dr. Guy provides the guidance on calling a time-out: “You must maintain self-control. If you are about to lose control, say ‘I love you and I feel like I am about to say something hurtful, and because I love you, I don’t want to do that, so I need a few minutes to calm down.'”

Calling a time-out isn’t the same thing as avoiding the conflict. Taking a few minutes to calm down isn’t the same thing as saying, “I’m losing, so I quit.”

If you take a time-out, there’s a catch: You have to come back to finish the argument in a controlled way. Dr. Guy expands on the baseball analogy:

“When a coach calls a timeout, the team does not go to the locker room, shower, get dressed, and get on the bus.  They take a break, get a drink of water, regain control of their emotions, and re-enter the game with a renewed sense of hope and determination to win the game.”

Note that when it comes to couples therapy, “winning the game” is equivalent to resolving the issue.

By the way, you can’t call a time-out for your spouse — only for yourself.

Rule #4: Only Fight About One Thing at a Time

It’s a common situation. You’re arguing about who’s turn it is to empty the dishwasher, when suddenly you’re arguing about something that happened two months ago.

Why does this happen? Dr. Guy explains, “When somebody finds that they are losing an argument, they will often “go back into the history books” to find an argument that they won or was justified in, and bring it into this new argument, in an attempt to win.” It’s tempting to bring up old issues, but it doesn’t help the argument at hand.

“The problem is now you arguing about two things, then three things, and it becomes almost impossible to have something positive come out of the argument. It becomes a jumbled mess of issues,” Dr. Guy explains.

If you have several unresolved issues, it’s best to address them separately, not while you’re trying to solve the most current issue. In this case, you might consider the benefits of couple’s therapy to help you sort through issues and strengthen your conflict resolution skills.

Rule #5: Don’t Argue to Win; Argue for Resolution

This is probably the toughest rule. It is human nature to want to win, and win at any cost.

Winning doesn’t mean that you’ve seen the end of this argument. In fact, it’s more likely that you’ll be having this same argument again. Why? According to Dr. Guy, “Maybe you can win the argument through force/intimidation, manipulation, or cunning, but you will have the same argument again in a week, because it has not been ‘resolved.'” If you have a hard time with conflict resolution, couple’s therapy can help you develop these skills.

Think About Your “Opponent”

Remember that you are arguing with somebody you love.  You aren’t arguing with your enemy. You’re arguing with your spouse, and you’re not in a boxing ring (which is a square by the way). You’re not on a basketball court, a soccer pitch (not baseball by the way), a debate podium, or a football field, where you want to DOMINATE your opponent.

This is somebody that you want to build a life with — that is exciting.

If Following These Rules Isn’t Enough…Should You Consider Couple’s Therapy?

Sometimes, a couple can follow the rules for fair fighting and overcome a squabble here and there. Sometimes, though, there are serious issues (like trust issues, etc.) and additional help is needed to resolve the conflict(s). Couple’s therapy and counseling isn’t just for couples on the brink of divorce. Therapy can strengthen relationships in all phases.

Explore Your Next Steps

At NextStep 2 Mental Health, we provide comprehensive and compassionate mental health care — and that includes couples therapy and marital counseling. Whether you’ve been struggling with multiple issues or you just can’t seem to resolve a conflict, we can help you get your relationship back on track. Give us a call at our Louisville, Kentucky office at 502-339-2442, or send us a message to request more information. 

About Dr. Dan Guy

Dr. Guy specializes in the treatment of ADHD, depression, anxiety, mood swings, relational problems, and issues pertaining to self-doubt and self-value. He is skilled in the use of cognitive behavioral therapy (CBT), solution focused therapy, and reality therapy. He also provides psychotherapy for individuals with bipolar disorder and some addictive behaviors. Dr. Guy has helped hundreds of individuals, couples, and families establish loving relationships, healthy communication, and effectively address mental health issues. As a trusted professional, Dr. Guy will walk beside you as you face challenges in your life and will guide you toward healing and fulfillment.

You can now book an appointment with Dr. Guy here or give us a call at our Louisville, Kentucky mental health clinic at 502-339-2442 .

6 Uncommonly Thought Of Depression Symptoms That Shouldn’t Go Unnoticed

When people think of depression, they commonly think of someone who feels sad, lonely, has a bleak outlook on the future, and experiences thoughts of death, dying, or killing themselves. However, depression is a complex mental illness and, while these symptoms are valid and true, there are a host of other ways that you or someone you love may present that also indicates a potential problem with depression.

In this post, we’ll explore the lesser known signs of depression.

Lesser Known Signs of Depression

Below, these symptoms will be explored further:

1. Anger, Irritability, and Mood Swings

While the relationship between anger and depression is complex and not easily understood, research has supported a close relationship between depression and increased feelings of anger, as well as poor ability to regulate emotions, which leads to rapidly changing moods. ^[1] As a result, the individual may experience subjective feelings of irritability and annoyance and may even describe themselves as grouchy or touchy. Loved ones may observe the outward signs of this irritability through increased conflict and argumentativeness. Depressed individuals are biased toward negative information and, as such, will constantly point out the negatives in any situation. Furthermore, they are more likely to ruminate on negative information and thoughts, further exacerbating irritability and anger. ^[1] A person with depression may also experience rapid and unexpected changes in their mood throughout the day, or even rapid changes within the same hour.

They may go from happy to irritable to sad, often without any clear event to provoke the change.

Along with these rapidly changing moods, outbursts of emotions, especially angry outbursts, are not uncommon. ^[2]

2. Feelings of Inferiority and Guilt

Depression can lead to feelings of inferiority and guilt, which leads to anxiety about being unable to cope with day to day life. People with depression worry frequently and may experience recurrent feelings of tension and subjective stress.

Additionally, people with depression may experience other symptoms consistent with anxiety, such as poor concentration and focus, restlessness or difficulty sitting still, ruminating or intrusive thoughts, and difficulties making decisions. An individual with depression may have frequent worries about being a burden to loved ones or may fear being negatively perceived by others for their depression. Frequently, someone with depression may feel unable to identify if they feel depressed or anxious, as the feelings are so closely aligned.

3. Trouble Making Decisions

We all make thousands of decisions each day, often times without even thinking about it. These decisions may involve simple tasks ⁠— such as when to wake up or whether to take a shower ⁠— to more complex decisions, such as what route to take to drive to work. However, despite the automatic nature of these decisions, many people with depression will struggle to make them.

For more complex decisions, such as deciding where to go as a group for dinner, a person with depression may feel paralyzed by an inability to decide. Difficulty making decisions may be related to either internal or external fears. For instance, an external fear may be that their decision would disappoint or create hardship for someone else. Internal fears may include being afraid of making the wrong decision or that they will later regret their decision. People with depression may attempt to relegate as many decisions to others as possible as a defense against their indecisiveness.

4. Loss of Interest

While sadness is most prevalently known, loss of interest in pleasurable activities is a core symptom of depression.

Someone with depression may feel that they have lost the ability to feel joy or pleasure. As a result, they may no longer care about hobbies, social activities, or sex. When presented with opportunities to engage in social activities or hobbies, they will decline, leading them to become isolated or withdrawn. Friends may notice that someone with depression suddenly stops attending group functions or engaging in regular social activities.

5. Alcohol or Drug Use

According to the National Institute on Drug Abuse ^[3], people with depression or other mood disorders are twice as likely to abuse substances as those without these disorders. For someone struggling with depression, they may often feel that there is no end in sight and no relief for their symptoms. As such, they oftentimes turn to substances in an effort to self-medicate, combat the symptoms, and find some temporary relief; however, the use of these substances may actually lead to a worsening of depression over time. Other complications may also exist, including becoming addicted to the chosen substance.

6. Physical Pain

Depression is not just in your head.

While depression is most commonly associated with emotional pain, research supports that depression can manifest as physical pain as well. ^[4] Some common physical complaints in individuals with depression include fatigue/exhaustion, decreased tolerance for pain, achy muscles all over the body, but especially muscles in the back and shoulders, headaches, vision problems, stomach pain, digestive problems, and irregular bowel movements.

If You’re Struggling with Depression Symptoms…

At NextStep 2 Mental Health, we provide comprehensive and compassionate depression treatment. Whether you’ve been struggling with depression or another mental health disorder, we can help you feel better. Give us a call at our Louisville, Kentucky office, or send us a message to request more information. 

You can also request an appointment with our convenient scheduling tool here.

About the Author

This post was written by Monica Clark, LPA.

You can request an appointment with Monica here.  

References

1. Besharat, Mohammad Ali; Nia, Mahin Etemadi; Farahani, Hojatollah. (2013). Anger and major depressive disorder: The mediating role of emotion regulation and anger rumination. Asian Journal of Psychiatry, 6, 35-41.
2. Culpepper L. The diagnosis and treatment of bipolar disorder: Decision-making in primary care. Prim Care Companion CNS Disord. 2014;16(3). doi:10.4088/PCC.13r01609
3. National Institute on Drug Abuse, US Department of Health and Human Services. December 2008, Revised September 2010. Comorbidity: Addiction and Other Mental Illness. Retrieved from https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf.
4. Trivedi, M.H. The link between depression and physical symptoms. The Primary Care Companion to the Journal of Clinical Psychiatry, 6(1), 12-16.

5 Easy Ways to Prepare Your Child for a Telehealth Visit

Is your child new to telemedicine?

Here at Next Step 2 Mental Health, we are proud to offer a variety of services through telehealth – and not just for adults. Children don’t have to miss their sessions due to social isolation.
If your child is already familiar with apps like FaceTime or Skype, he or she already has a good idea of what a telehealth session is like. Still, the idea of a virtual appointment can be intimidating for some children. If your child is scheduled for an upcoming virtual appointment, it’s a good idea to prepare your child ahead of time.

5 Tips for a Successful Telehealth Session

As your child makes the transition from in-person visits to online sessions, we want to help you make the change as seamless as possible. Before your child’s next virtual appointment, review these tips:

1. Know what type of session your child is having

At Next Step 2 Mental Health, your child can receive a variety of services remotely. This includes:

• New patient diagnosis
• Screenings
• Talk therapy
• CBT
• Coaching
• Education
• Support

When you know what type of service your child is receiving, it’s easier to answer his or her questions.

Reminder: Virtual sessions are only for non-life-threatening visits. If your child is experiencing a mental health emergency, call 9-1-1 or head to the nearest emergency room.

2. Gather important information before the session starts

Before your appointment begins, make sure you have:

• A list of your children’s current medications
• Your child’s medical history, including allergies, weight, and any previous diagnoses
• A list of questions that your child has (if any)
• A list of questions that you have (if any)

Depending on what type of session your child is having, you might want to write down a list of concerning symptoms that you want to address. Be prepared to answer a variety of questions, including how the symptoms have been occurring, when the symptoms are most severe, and any other related details.

3. Find the perfect location

This is one of the most important steps to having a successful telehealth session. The ideal location is quiet, well-lit, and free from distractions. Consider setting up on the dining room table or in a den. The camera should be eye-level for your child.

If you have pets or other children, make sure they are situated elsewhere so you can focus on the session too.

4. Start with an introduction

You might have a telehealth session with a therapist or pediatrician that you’ve seen dozens of times. But if your child is seeing a new provider, you’ll start with introductions. Let your child know ahead of time if he’ll be meeting a new doctor so he can prepare mentally for the meeting. During the meeting, one of our providers will start by sharing his or her name and title. At this time, encourage your child to introduce himself too! After your child introduces himself, you’ll be asked to confirm a few details too. You’ll already have completed a treatment consent form, but you’ll still confirm your child’s name, date of birth, etc.

Tip: If your child is nervous (which is normal!), practice introductions beforehand!

5. Know your next steps

Before your child’s virtual appointment comes to an end, make sure that you understand the provider’s diagnosis, instructions, and/or advice.

Tip: Keep a piece of paper or notepad nearby so you can take notes during the session, if needed. Don’t hesitate to ask for clarification! We want to make sure your session is valuable and helpful.

Questions? We’re Just a Call or Click Away

At NextStep 2 Mental Health, we’re happy to provide comprehensive psychiatric care and therapy for your children. Whether your child has anxiety, depression, or ADHD, we don’t want him or her to miss out on valuable sessions, and we are here to make sure your telehealth experience is successful.

We’re just a call or click away. Give our Louisville, Kentucky mental health clinic a call at 502-907-5908 or send us a message to request more information. Alternatively, you can also request an appointment with our convenient scheduling tool here.