Different Yet the Same: OCD & OCPD

For many, OCD (obsessive-compulsive disorder) means avid hand-washing, excessive organizing, color-coding and deep cleaning. Though associating OCD with these habits isn’t exactly wrong, it leaves out an important part of the picture.

You may be familiar with Jack Nicholson in As Good As It Gets who plays the part of an author with OCD. Throughout the film, he engages in ritualistic behaviors (also known as compulsions) that disrupt his interpersonal and professional life.  To avoid contaminants outside of his apartment, he wears gloves in public and warns pedestrians not to touch him. He refuses to use restaurant silverware and instead brings his own plastic utensils wrapped inside a protective bag. And upon returning to his orderly apartment, he immediately disposes of the gloves and commences a multi-step cleansing ritual by washing with scalding hot water and multiple new bars of soap.

This is a common portrayal of obsessive-compulsive disorder. You are likely familiar with this disorder, especially because it is common to joke about yourself or others being, “so OCD,” or overly tidy. In this post, I will delve deeper into OCD and explain the differences between this disorder and its closely named counterpart, OCPD.

Obsessive-compulsive Disorder

Obsessive-compulsive disorder (OCD) is an anxiety disorder defined by the presence of obsessive and compulsive behaviors. These behaviors occur together and interfere with a person’s quality of life and ability to function. Individuals with OCD have frequent, upsetting thoughts (obsessions) that they try to control by repeating particular behaviors (compulsions). This cycle sparks a great deal of anxiety because it is not only intrusive and unwanted, but also recurrent. All else gets paused until the compulsion is appeased.

OCD is a genetic predisposition and it usually makes its first appearance in childhood or adolescence. It is often triggered by a stressful or traumatic experience. The behaviors of individuals with OCD are driven by fear, anxiety, and uncertainty. They are aware their thoughts are irrational, but their fear and anxiety is the reason behind their compulsions. Many individuals suffering from OCD seek treatment to alleviate their anxiety.

Obsessive-compulsive Personality Disorder

Obsessive-compulsive personality disorder (OCPD) is a personality disorder defined by strict orderliness and control over of one’s environment at the expense of all else. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) describes OCPD as “a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.” Individuals with OCPD tend to think their way of doing things is the only way, and they are unlikely to delegate unless they know people will do things as well as they do. Their perfectionism keeps them at a high standard, so though they succeed at work, they are difficult to work with. They show unhealthy perfectionism and want to be in control of what is going on around them. They are judgmental, controlling, and stubborn. People with OCPD are difficult to live with and relationships suffer. They often feel paralyzed and unable to make decisions because they fear making the wrong one. They even struggle getting rid of items that no longer have value, which often leads to hoarding.

This disorder is usually diagnosed in late adolescence or young adulthood. It is approximated that men are twice as likely as women to be diagnosed with OCPD.

Juxtaposition

These two disorders have a few shared traits that connect them–a fear of contamination, a preoccupation with symmetry, and a nagging sense of doubt. If you are still unsure of the difference between these two disorders, allow me to further compare and contrast them:

  1. OCD is an anxiety disorder while OCPD is a personality disorder.
  2. Studies indicate that those with OCD are continually in search of immediate gratification, while those with OCPD can delay immediate reward.
  3. The symptoms of OCD tend to fluctuate in association with the underlying anxiety. Because OCPD is defined by inflexibility, the behaviors tend to be persistent and unchanging over time.
  4. Persons with OCD will often seek professional help to overcome the irrational nature of their behavior and the persistent state of anxiety they live under. Persons with OCPD will usually not seek help because they do not see that anything they are doing is abnormal or irrational.
  5. Individuals with OCPD do not experience an OCD cycle.

I want to elaborate on that final point, because it is the best way to differentiate OCD from OCPD. The key difference between the two is the cycle that sufferers experience, or the trigger. Those with OCD may constantly notice things out of place (trigger), and they will obsess over “fixing” the problem (compulsion) to the point that they are unable to focus on other tasks. If they do not appease their compulsions, anxiety will mount. Once the time is taken to “fix” things, they feel relief…until the next trigger appears. With OCPD, the behaviors are not directed by uncontrollable thoughts or irrational behaviors that are repeated over and over again. These individuals fully believe that their actions have an aim and purpose, and they consistently act this way, independent of their circumstances or surroundings. In other words, their actions are not triggered by anything, but are instead simply they way they operate.

Treatment

Living with OCD or OCPD can be difficult and even debilitating. Symptoms can wax and wane, getting better at times and worse at others. The good news for individuals who have either one (or both!) is that help is available. With appropriate treatment, these disorders can be managed to the point that the disruption to their lives is minimized. Treatment may involve a combination of psychotherapy, medication, and mindfulness techniques. To come to an informed diagnosis and find appropriate treatment, it is important to seek the care of a qualified mental health professional, such as a psychiatrist or psychologist. My door is always open to answer questions or offer therapy sessions. Click here to schedule with me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Phobias: When Fear Becomes Debilitating

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You are probably aware of the more common phobias, such as arachnophobia (fear of spiders) and claustrophobia (fear of enclosed spaces). But did you know there are also words which describe the fear of dawn, glass, and poverty? Read on to learn the 411 on over 200 phobias in existence today.

I sometimes joke that I have arachnophobia. I hate spiders. I am honestly sheepish to admit how much they terrify me and that I often need help to get rid of them! I know that my fear is irrational, but I cannot help it. I also recognize that my small fear of spiders is nowhere near as debilitating as any of the actual phobias that an estimated 19 million Americans face. Today I want to give an overview of phobias and urge you, or anyone living in fear caused by a phobia, to get help.

A phobia is a type of anxiety disorder that causes an individual to experience extreme, irrational fear about a situation, living creature, place, or object. The way you know you have a phobia is if you are organizing your life around avoiding whatever causes your fear. The impact of a phobia can range from annoying to severely disabling. People with phobias often realize their fear is irrational, but they are unable to do anything about it. Such fears can interfere with work, school, and personal relationships.

What causes a phobia? As with most mental illness, both genetic and environmental factors can play a part. For instance, a child who has a close relative with an anxiety disorder is at risk of developing a phobia. Distressing events, such as nearly drowning, can bring on a phobia. Exposure to confined spaces, extreme heights, and animal or insect bites can all be sources of phobias. People with ongoing medical conditions or health concerns often have phobias. There is also a high incidence of people developing phobias after traumatic brain injuries. Substance abuse and depression can often be connected to phobias.

We are most familiar with a phobia connected to a specific trigger, or a specific phobia. Aside from this, there are two additional types of phobias recognized by the American Psychiatric Association (APA):

  • Specific phobia. An intense, irrational fear of a specific trigger, like snakes, spiders, or heights. Specific phobias are known as simple phobias as they can be linked to an identifiable cause that may not frequently occur, thus not significantly affecting day-to-day life.
  • Social phobia or social anxiety: The idea of large social gatherings is terrifying for someone with social anxiety. This is a profound fear of public humiliation and being singled out or judged by others in a social situation. Social phobias are complex, as it is harder to avoid triggers, such as leaving the house or being in large crowds.
  • Agoraphobia: This is the fear of a situation that may cause you to panic and make you feel trapped, helpless or embarrassed. You may fear using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd. This is also a complex phobia because day-to-day life is surely affected.

Phobias are diagnosable mental disorders. There is hope in overcoming them! In saying so, I do not wish to minimize any one phobia. Phobias are more serious than simple fear sensations. Many individuals are aware that their phobia is irrational, but they cannot control the fear reaction. Some phobias may even cause physical symptoms like sweating and chest pains.

The beautiful news is that treatment is available. Phobias are much more widely understood today, and treatment often includes medication and behavioral therapy. If you have a phobia, it is critical that you seek treatment.  You do not need to live your life at the mercy of your fear! With treatment, you can learn to manage your phobia and live the happy, free and fulfilling life you want to. Please contact me today or click here to schedule your first session. You know I am more than happy to help!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Oxford Dictionaries: “List of Phobias”

Living with Anxiety: 5 Suggestions to Thrive

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“Worry never robs tomorrow of its sorrow, it only saps today of its joy.” -Leo Buscaglia

We all experience some level of anxiety from time to time. In fact, anxiety is a completely normal reaction to a stressful situation. The cold sweat of anxiety is the fight or flight response that kept our ancestors safe from grizzly bears and other dangers. That adrenaline rush still serves us well under some circumstances today; anxiety can even be helpful in certain instances! We worry about the common things in our lives–like finances, work, friends, and family–and this worry has the potential to help us make good decisions in these areas. Anxiety can motivate us, prepare us for things we have to face, and even give us energy to take action when we need to.

It is very possible, however, for anxiety to have an unmistakably negative affect. Serious anxiety may mean procrastinating to the point of being afraid to take a step at all. You may be so nervous about going to your child’s school to talk to the teacher that you do not go at all–you miss the appointment altogether. Your anxiety becomes so overwhelming that it interferes with day-to-day activities, it keeps you from going places, and from doing things you need to do. If you are experiencing worries that are excessive, uncontrollable, or irrational, and have been experiencing these worries for an extended period of time, you may be suffering from Generalised Anxiety Disorder, or GAD.

Regardless of the level or intensity of anxiety you are experiencing, it is important that you manage it properly. Anxiety can take a serious toll on your mind and body. You may have trouble sleeping, eating, and concentrating. You may get headaches or have an upset stomach. You may even have a panic attack, a pounding heart, and/or a feeling of lightheadedness. So what can you do when you are feeling anxious? Here are five simple suggestions that you can do anytime, anywhere:

  1. Label your emotions. Figure out exactly what is bothering you by giving a name to what you are feeling. Naming an emotion is the first step in being mindful of it. This activates your prefrontal cortex and can help you balance and self-regulate by creating a relationship with the experience.
  2. Drop the story. Emotions are often driven by the stories you tell yourself. For example: You have an important presentation in class. Your anxiety escalates this assignment into a fantastically worrisome story where you mess up, everyone laughs at you, you fail the class, never graduate college, have to live with your parents forever… and on and on. My suggestion here is to drop the story. Separate the real risks and dangers that a situation presents and those your imagination is making worse. Cut out negative thoughts. No need to worry unnecessarily!
  3. Focus on the task at hand. What can you control? In the class presentation example, what you can control is your preparation and delivery. Try not to stress about peripheral factors–like how others may react or respond. It is a twist on the old adage: “Take control of the things you can, and accept those you can’t change.”
  4. Relax. Stop what you are doing and take deep breaths. Meditate. Do yoga or get some exercise–this is a terrific outlet for anxiety! As you focus on calming your mind and body, you will become more proficient with managing ongoing anxiety.
  5. Be kind to yourself. Feeling anxious is uncomfortable. A good dose of self-care can go a long way to bringing relief and perspective. This may mean practicing a hobby like painting, hiking, singing, baking, exercising, reading, taking a long bath or even sleeping. Whatever self-care looks like for you, make the time to take care of yourself.

Very often, it is possible to get past an anxiety cycle with the help of friends or family to help you sort out your problems. But when anxiety becomes overwhelming, it may be time for you to consider seeing a therapist, taking medication, or both. Anxiety is the most common mental illness among American adults–with women experiencing it at roughly twice the rate as men–and only half of those affected receive treatment.  Please do not be part of that statistic. Get the help you need and deserve in order to find happiness. Many of my clients face some form of anxiety, and I have been able to help them overcome the negative effects that come with this mental illness. If you or someone you care about could use help living with the effects of anxiety, please contact me today. Additionally, you can click here to schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Making Room for Grief During the Holidays

This topic of grief and/or loneliness always seems to be increasingly relevant for many during the holiday season. In this post I will focus on these feelings, and how to let your grief have a healthy place in your life“Grief is two parts: The first is loss. The second is the remaking of life.” -Anne Roiphe

Last month I wrote about what I referred to as the “trauma of surviving”–or learning to live life after losing someone dear to you. Such loss may be due to divorce, a move, death, or any other change that results in a separation from loved ones. This topic of grief and/or loneliness always seems to be increasingly relevant for many during the holiday season. In this post I will focus on these feelings, and how to let your grief have a healthy place in your life.

A friend of mine recently told me about a movie on Netflix called the Babadook. A widowed mother is plagued by the death of her husband and simultaneously battles with her son’s fear of a monster lurking in the house. Although this is supposed to be a scary movie, the ending is applicable and relatable to the topic at hand. As the mother in the film avoids facing the reality of her husband’s death, the presence of the monster grows, and the complications in her life amount. In the end we see the mother well put-together and clearly in a different, more positive state as she takes food down to the “monster” that has been banished to live in the basement.  She is feeding or acknowledging the monster–or her grief–and by so doing, it is appeased. It stops tormenting her. Its malevolent presence diminishes and she is able to figure out how to live a balanced, happy life even after the loss of her husband. She lets grief have a place in her life.

While I have not personally seen this movie, I love the parallels that can be made between the monster and grief. Avoiding grief and acting like it is not there can wreak havoc on our life. It can and will weaken us and our important relationships. We must first, acknowledge it and second, work through it.

Acknowledge it.

The “monster” in the Babadook terrorizes the mother right up until the end of the film. She struggles sleeping, maintaining friendships, holding a job, and even keeping the basic elements of her life together. In the same way, grief can eat away at you if it is given the chance. A person who is dealing with grief will most likely display some of the following emotional symptoms: Increased irritability, numbness, bitterness, detachment, preoccupation with loss, and inability to show or experience joy. While these emotional symptoms are normal in the days and weeks after a traumatic event, they can be indicators of a more serious disorder if they do not fade over time.

Grief is unavoidable after loss; the only way to overcome it is to give it place in your life–face it. Popular blogger Emily Meyers, a young mother of five, lost her husband to cancer and was left to care for their children on her own. She wrote a beautiful post about grief, and I have found great truth in these words:

“There is no ‘other side’ of grief. It’s never going to pass. You don’t ever ‘move on’ from it. You just learn to live with it. You absorb it. It becomes part of you. You simply adjust and change. You slowly but surely find how to navigate through your new normal with it. It doesn’t get easier, you just get stronger. I’ll say that again: It doesn’t get easier, you just get stronger. You stop waiting for the storm to pass, and instead, learn to dance in the rain.”

I have some clients who, like the mother in Babadook, try to simply ignore their grief and “move on” without facing it. But again, just as the mother in Babadook, this does not and cannot work. As Emily Meyers said, you cannot simply move on. You must learn to live with your grief.  You must acknowledge it. Do not expect to move on from a life-altering loss without allowing yourself to bereave or grieve. Yes, I am telling you to be sad–it is okay!

Work through it.

The loss of anything important to you–a relationship, a job, an opportunity, a loved one– can cause feelings of profound grief. Sadness around the holidays–or any time of year–is okay. It is perfectly understandable and 100% normal to feel like you are not “over” your loss. What is important is what you do with your sadness. Acknowledging it is the first step, and once you have done this, you will need to work through your grief and process your emotions. For some, this may mean crying, writing in a journal, participating in a therapeutic hobby or activity (like exercise), talking with a friend, or counseling with an experienced, licensed therapist. The most important thing is that you take the time to work through your difficult emotions because they do not go away on their own. In my experience, I have seen that simply burying or ignoring grief only exacerbates the problem when it actually does surface. And it is sure to!

If the holidays highlight your loneliness or the absence of a loved one, this time of year can be especially difficult. Many of my clients find themselves in a slump around the Christmas season, and struggle to find something to celebrate. My heart aches for those who are grieving this year. I advise you to take my counsel to heart and acknowledge, then work through your grief. I know that by so doing you will find a place for your grief and will then be able to find a healthy balance of grieving and living life to the fullest. And, as always, if you need help facing or working through your grief, please do not hesitate to contact me today or schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Getting Up With the Sun: Morning Routines

Steve Jobs, the late CEO of Apple, started his days off asking himself, “If today was the last day of my life, would I be happy with what I’m about to do today?” Ensure that you are starting your day off on the right foot with a productive morning routine!

You snoozed through your alarm to work out, woke up late, had no clean underwear, got toothpaste on your shirt, grabbed a fast, non-nutritious bite to eat, and rushed into work. You meant to wake up early, hit the gym, have a protein-packed breakfast, and beat the boss into work, but–yet again–it did not happen. Does this sound all too familiar? If you feel you are stuck in a cycle of good intentions and consistently disappointing follow-throughs, this post is for you. By making a few tweaks and additions to your morning, you can be on your way to a happier, healthier life–one where you are in control.

Last month I posted about nightly routines and promised to follow-up with a post on morning routines. We all know that starting the day off on the right foot is actually quite indicative of how the rest of the day will go. A morning ritual or routine can consist of many activities; whatever you choose, consistency in those activities is the key to jumpstart your day!

The hardest part of starting a morning routine is just that, getting started–both literally and figuratively. Do you know where to start? What type of morning ritual do you want to have in place? What types of things do you want to do? I scoured the internet and read blog posts about all sorts of morning routines, and I found the following six suggestions to be the most recurring:

  • THE GYM. We all know someone who is slightly smug about the fact that he/she made it to the gym before the sun arose. While getting exercise in to start the day does come with various health benefits, there is an additional benefit we all could use:  Focus. A friend of mine who has dealt with ADHD her entire life recently told me she got through the most stressful job she ever had by waking at 5 a.m. to go to barre class. It calmed her down, helped her focus, and allowed her to wean off coffee–which, in turn, reduced her jitters. Hit the gym in the a.m., or simply get out for a walk. You will never regret it.
  • MEDITATION. I have written about the benefits of meditation. Though often used to slow down and relax (before bed, for instance), it can also be used to focus the mind and prepare oneself for productivity. Whether your meditation includes actual yoga and stretching, prayer, spiritual study or simple breathing exercises, being in tune with your psyche will start your day off on the right foot. Meditation lowers stress levels and boost productivity and creativity.
  • NUTRITION. This one will be different for all of us depending on preferences and allergies. Some may have oatmeal, chia pudding, a green smoothie, or maybe it will be eggs, toast and sausage. Give yourself nutrient-rich food and you will be sure to notice heightened energy levels. Fuel up in preparation for a productive day. Take a few extra minutes and pack some healthy snacks to take with you. And don’t forget the vitamins!
  • APPEARANCE. My dad always showers at night because he likes to go to bed clean; but then, he will shower in the morning as well. Showering in the morning wakes him up and helps him feel refreshed, awake, and ready for the day. Whatever you choose, be sure to make time to get yourself looking and feeling presentable. Shower/wash your face, brush your teeth, do any necessary ironing, coordinate your outfit and accessories, so that you can leave your house feeling good and confident.
  • GAMEPLAN. Many nightly routines include making a plan, schedule, to-do-list, etc. for the next day. The reason for that is to streamline that process in the morning. During your morning ritual, review that game plan for the day, add in any specifics, and prepare yourself for any responsibilities you may have. Plan what you will need to take with you when you leave the house, as well as anything you may need throughout the day. This may seem obvious, but taking the time to sit and plan this step will help you feel less like a chicken with its head cut off as you haphazardly grab things while rushing out the door!
  • PRODUCTIVITY. Get right to work. Instead of wasting time idly catching up on your Facebook or Instagram feed (which has been proven to decrease overall motivation and productivity when done at the start of the day), get to work. Start your morning routine immediately.  It will reduce your stress!

Here is an example of a morning routine:
5:30 AM: Wake up, put on gym clothes, contacts, drink 8 oz. ice cold water
5:40 AM: Hit the gym (M/W/F: Weights; Tu/Th: Interval Cardio; Sa/Su: Walk)
6:40 AM: Return home, eat protein shake, shower, brush teeth, get dressed, etc.
7:10 AM: 20 minutes of meditation/prayer/spiritual study
7:30 AM: Review goals and day’s schedule, prepare to leave
7:45: Leave for work

Remember, this is just an example. Your morning routine should work best for you and your lifestyle, and should incorporate your goals. I have covered the basic suggestions to fuel productivity and focus throughout the day.  While this post contains six of the most frequently occurring ideas on the internet, there are so many other options out there! Through my research in writing this blog, I found a neat website, My Morning Routine, where you can sign up to receive a brand new morning routine idea in your inbox every Wednesday. The key is finding what works best for you and implementing that into a pattern you can consistently and happily follow. Should you find yourself with questions or desiring additional help, please don’t hesitate to contact me or schedule a session. And be sure to tune in next month as I talk about ways you can use your morning and nightly routines to help you reach your New Year’s goals!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Cutting Shame Off at the Knees

Cutting Shame Off at the Knees - Cluff Counseling, Lewisville Marriage & Family Therapist“Guilt is just as powerful, but its influence is positive, while shame’s is destructive. Shame erodes our courage and fuels disengagement.” -Brené Brown

Regardless of age, gender or nationality, we all experience shame from time to time. Dr. Brené Brown, an author and researcher, explains in her book Daring Greatly, “The less we talk about shame, the more power it has over our lives. If we cultivate enough awareness about shame to name it and speak to it, we’ve basically cut it off at the knees.” And that is what I want to focus on today–cutting shame off at the knees.

Dr. Brené Brown has dedicated her career to researching shame and vulnerability. She describes shame as the intensely painful feeling or experience of believing we are flawed and therefore unworthy of love and belonging. The dictionary defines shame as a painful feeling of humiliation or distress caused by the consciousness of wrong or foolish behavior. We all feel it; in fact, it was recently found that even babies can experience shame!

It is important to note that there is a distinction between shame and guilt. While shame means, I am bad, guilt means, I did something bad. Shame is debilitating, it can shut us down or emerge in ways destructive to ourselves and others. The remorse and regret that can come with guilt, on the other hand, can motivate us to make adjustments or restitution, and create new paths.

Let’s talk about real life examples of shame. How many of us have ever scrolled through social media to see someone doing something we wish we could do–affording a luxury vacation, building their dream home, accepting a prestigious position, holding a difficult yoga pose, cooking a beautiful multi-course meal for friends, reaching 10k followers, etc? We all have. What was our next thought? For many of us it is, I could never do that, I’m not smart, rich or talented enough! This is shame. Shame holds us back and debilitates is. It tells us we are “bad,” which can prevent us from changing or doing better. Shame corrodes the very part of us that believes we are capable of change or progress. Further, it can lead to addiction, violence, aggression, depression, eating disorders and bullying. Because of the powerful implications of shame, we must identify our feelings of shame, understand them and build healthy coping skills against it! Here are five ways to cut shame off at the knees:

  • Bring shame to the light. Know what it is and what it feels like. Recognize when it sneaks into life. TALK about it. Awareness is the first step!
  • Recognize triggers. Shame is good at hitting us where we are vulnerable. A new mom who secretly feels out of her depth is more likely to feel shame when her parenting style is questioned. A husband who worries about providing may see his spouse’s comment about the neighbor’s new car as an attempt to shame him rather than an innocent observation. We must know where our armor is thin and work to strengthen and protect those areas.
  • Stop striving for perfection.  Dr. Brown has said that perfectionism is like a process addiction–the more you do it, the more you feel compelled to do it. Perfectionism is a common ailment among many of my clients, and it is corrosive. It tells us nothing we do is good enough…so why try?  Perfectionism and shame go hand-in-hand. When we work to stop one, we will find there is not room for the other!
  • Practice positive self-talk. The first option for positive self-talk is positive affirmations. These are powerful; by voicing what we believe (or want to believe) about who we are, and what we are capable of, can decrease our feelings of shame. By literally repeating something (out loud) enough we will start believing it. The second option is simply speaking more kindly to ourselves. If we were to talk to ourselves the way we would talk to our children…we would never speak to them as negatively as we do to ourselves! Be kind. Practice self-love through our inner dialogue.
  • Deeply root self-worth. If we define ourselves by what we do, we put the power of our happiness in the hands of others. When separate what we do from our sense of self-worth we will find freedom. When we are comfortable in our own skin, we can look at both praise and condemnation with the perspective each deserves, absorb any helpful critiques, and move on.

Shame is one of the most debilitating emotions humans can feel. It can stunt growth and corrode motivation. It is always looming. Unfortunately, we cannot “beat” or overcome shame once and be done with it. Instead, we must view our relationship with shame as ongoing: recognize when shame is creeping in (know our triggers), speak kindly to ourselves (affirmations), and remember that we are so much more than what we do or look like. Working to cut shame off at the knees is one of the most common subjects among my clients–everyone is feeling it! I fully understand that shame can get in the way of the important things and relationships in life. If you want to more fully understand how shame is holding you back, or if you have questions and would like additional help, I would be more than happy to assist you. Feel free to contact me or schedule a session!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

The Truth About Men and Depression

The Truth About Men & Depression - Cluff Counseling - Lewisville TherapistAlthough women are more likely to attempt suicide due to depression, men are 4x more likely to succeed. This means that the suicide rate is 4 x greater in men than in women! I believe that talking about and raising awareness about men and depression will hopefully set in motion some necessary changes to our societal stigmas.

Certain stigmas, in our society, have become widely believed despite the fact that they are inaccurate or untrue. Last month I addressed one of these in my blog post about women who face pornography addiction–in hopes to dispel the misnomer that men are by and large the ones to become porn addicts. This month, I wish to speak to another fallacy: that women are the main ones who face depression. Last May I wrote a general post on Depression entitled “Depression is Not a Life Sentence”, Today I want to build on that foundation and hone in on a more specific group suffering from depression: MEN.

There is a wonderful book by Terrence Real entitled, I Don’t Want to Talk About It which addresses this issue head on. I highly recommend reading it if you or a male loved one is battling depression. It is a compelling read uncovering the frightening fact that just as many men face depression as women, but only a fraction get help.  He writes about how these men battling depression often go undiagnosed because they do not want to tell others for fear of no one listening or of damaging their image.

The truth is that everyone feels sad or irritable and has trouble sleeping once in a while. But these feelings pass after a little while–usually a couple of days. Depression, on the other hand, is a common yet serious mood disorder that has symptoms that do not dissipate with time. Depression affects one’s ability to feel, think, and handle daily activities.  To be diagnosed as depression, these symptoms must be experienced for at least two weeks.

Signs and symptoms of depression in men

Just like with any illness or mental illness, there are a plethora of symptoms, but the common depression symptoms include the following:

  • Anger or irritability
  • Feeling anxious or restless
  • Loss of interest in work, family, or hobbies
  • Problems with sexual desire and performance
  • Feeling sad, empty, or hopeless
  • Difficulty concentrating or remembering details
  • Fatigue, not being able to sleep, and/or oversleeping
  • Overeating
  • Loss of appetite
  • Thoughts of suicide or suicide attempts
  • Physical aches or pains, headaches, cramps, or digestive problems
  • Inability to meet the responsibilities of work, caring for family, or other important activities
  • Engaging in high-risk activities
  • A need for alcohol or drugs
  • Withdrawing from family and friends; isolation.

Every man will respond to his depressive feelings differently. Some may exhibit several of these behaviors while others may only experience a few.

Causes of depression in men


Current research suggests that depression is caused by a combination of risk factors including genetics, environmental stressors (like financial problems, loss of a loved on, major life changes, or any stressful situation), and illness (particularly serious illnesses like diabetes, cancer, heart disease or Parkinson’s disease). There is no difference with how men and women arrive at depression–it is a chemical imbalance in the brain. Studies suggest you are at greater risk of developing depression if you’ve suffered a severe loss as a child, an overwhelmingly stressful event as an adult, or you have a family history of depression.

Regardless of how one develops depression, men react differently than women.  When men experience depressive episodes, they retract completely from their social circles. One man reported that he did not want to get out of bed or leave the house, that his depression took over his life. He said, “Men are not supposed to be depressed. Men are supposed to be the providers, the pillar of strength, the one everyone else turns to. You can’t talk about it because…you don’t want to admit any weaknesses.” Men facing depression feel ashamed and embarrassed, which leads them to internalize their struggle with depression, close themselves off from others, and not seek professional help. This greatly affects their work performance, their relationships, as well as their self-image and self-worth. Many men who feel depressed enter into this negative cycle of denying/ignoring their symptoms, isolating themselves, experiencing diminished self-worth, and not receiving treatment. It is likely because of this that men are four times more likely to commit suicide than women!

Treatment for with depression

Now knowing that both men and women can experience depression, let’s talk about treatment. These suggestions are not gender specific. Such suggestions include spending time with friends, family, or coworkers; increasing your level of physical activity (particularly important for men who are supposed to be masculine and strong); breaking large tasks up into small ones; delaying important decisions until you feel better; keeping daily routines; and avoiding alcohol, drugs, or harmful substances. These are suggestions that will help if are not yet ready to receive professional help.

For those that have had enough and are ready to stand up to depression, here is my plea: Remember that help is available! To effectively treat depression, a combination of medication and therapy is recommended–regardless of gender.  If you are struggling with depression, it is okay to ask for help. I want to support you. I want to offer you hope! The amazing news is that researchers has proven that between talk therapy and medications, about 80 percent of depression cases can now be treated effectively–for both women and men! In reality, the risks of untreated depression far outweigh those of taking antidepressant medications under a doctor’s supervision. You do not need to carry the heavy burden of depression any longer. Please, contact me today or click here to schedule a session. You are not alone! Help is out there!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Practical Ways to Practice Mental Hygiene

Mental Hygeine - Cluff Counseling, Lewisville Marriage & Family TherapistOver the last few years, much progress has been made in understanding how to take care of ourselves physically–we see the value in exercising, eating healthy, and taking advantage of modern medicine. We believe in maintaining our physical hygiene and encourage our children to take care of themselves, too. But are you doing anything to take care of your minds?

Let’s change that!

Think about it. Once or twice a day we brush our teeth–even before there is a cavity. We exercise regularly and we try to eat a balanced diet because we know it is good for our heart health and our bodies in general. We wear sunscreen to prevent skin cancer. We eat vitamins to  ensure we are getting the necessary nutrients. All this to maintain our physical health. But what are we doing for our mental hygiene?

Just like doctors who take care of us physically, psychologists and therapists are most certainly available when there is a mental health problem. Yes, therapists and psychologists are trained to understand mental illness and a certain level of dysfunction, but what can we preemptively do to take care of our mental health…before there is a problem necessitating a trained individual? In this blog post, I will first define mental hygiene, explain why it is necessary to maintain, and I will end by giving some ideas for how to stay on top of your mental health.

What is mental hygiene?

We need to take care of our minds just as much as we need to take care of our bodies!  Mental hygiene is simple. Basically, it entails redirecting your thoughts to be more uplifting and positive, managing stress in a productive manner, and having a healthy inner dialogue. Allowing anything that is uplifting and good into your life is practicing mental hygiene. It is focusing on the good instead of lingering on the negative. You might find that this is best done for you through praying, meditating, getting out in nature, or maybe you are unsure. Keeping up on your mental hygiene will prepare you for and help prevent the roadblocks of failure, rejection, and disappointment that life will inevitably deliver. Read on for strategies on how to practice mental hygiene, which will help you recover from mental injuries as well as develop mental resilience.

Why practice mental hygiene?

Life is hard. There are certain experiences we all go through that may be roadblocks to positive mental health, but we can recover from them if we practice good mental hygiene. The first roadblock to positive mental health I would like to mention is failure. Our initial inclination is to make excuses, retreat, or give up. But if we are actively trying to practice healthy mental hygiene, we can instead recognize and remember that failure is an incredibly valuable teacher and we will all experience failure at some point. Then, we can evaluate why we failed and make a plan for success in the future. See the difference? By practicing healthy mental hygiene, we can have a healthy mindset around failure even before we fail and sets us up nicely to respond to failure in a healthy manner in the future (because we are sure to face it again!).

The second inevitable roadblock to positive mental health is rejection and judgement. Unfortunately, we all judge because it is part of our human nature. And sometimes that judgement is pointed at us. When other people judge or dislike us, it hurts. Our natural tendency is to get defensive or reflect those negative feelings onto others. What practicing good mental hygiene means here is that we will remember that other people’s opinions are the variable…not us! If someone does not like us, that absolutely does not mean we are not loveable!  Instead of getting defensive and upset by what other people think about us, we will focus on positive emotions, take their criticisms constructively, and remember our self worth. Practicing good mental hygiene means that we will be able to separate our worth from what people think about us–which is hard and takes practice.

The final roadblock practicing good mental hygiene can prepare us for is disappointment. Whether this disappointment is unmet expectations or tragic news (like sickness, death, financial instability, infidelity, etc), it is bound to happen at some point or another. Our natural tendency is to respond poorly, possibly even shut down or shut others out. But if we are practicing healthy mental hygiene, we can respond in a positive way, manage our stress effectively, self-regulate or manage our emotions. It is impossible to prepare for this type of mental roadblock specifically, but we can prepare for how we will respond by taking care of our mental health. This means that we must know how we react in stressful situations, be able to practice gratitude during difficult times, ask for help, find an outlet, and many other possibilities.

How do I practice mental hygiene?

You might be feeling like you have no idea how to take care of your mental hygiene. I understand that mental hygiene might seem like a new idea even still, but there are so many things you might already be doing or want to be doing that will help you take care of your mental health. The following list of ideas will provide simple ideas on how you can start to improve your mental health today:

  1. Focus on the good things in your life.
  2. Track gratitude and achievement in a journal.
  3. Set up a getaway (check out this post from last week on how traveling will benefit your relationship!).
  4. Use your talents/strengths.
  5. Mindfully set some goals.
  6. Get creative! Try a new recipe, paint, pick up an instrument…
  7. Make someone else feel loved (cue Love Languages).
  8. Eat dark chocolate. Seriously, it boost brain power!
  9. Open up. Whether it is to your partner or a confidant, on social media, in a journal, or with a therapist, do not bottle up your emotions.
  10. Color. Yes, it may seem childish, but it will help clear your mind.
  11. Laugh. Comedic relief is real.
  12. Unplug. Try doing a digital detox or going off the grid to get some clarity.
  13. Dance. It truly reduces cortisol, the stress hormone!
  14. Take a warm bath.
  15. Do animal therapy. Fuzzy friends always make everything better.
  16. Tour your own town.
  17. Meal plan and prep. It will offer some control over your week!
  18. Practice forgiveness. The people who forgive have better mental health and report being more satisfied with their lives.
  19. Smile. It really helps!
  20. Send a thank you note.
  21. Exercise or get outside.
  22. Get some sun. Vitamin D is a mood elevator.
  23. Eat well, drink lots of H20, and avoid drugs and alcohol.
  24. Surround yourself with good people.
  25. Quiet your mind.
  26. Practice positive affirmations.
  27. Sleep!

Does mental hygiene make a little more sense now? Another term for practicing mental hygiene is mindfulness. Taking care of our minds is something we need to do each and every day; all of the suggestions above can be carried out regularly and will not require much time or money to accomplish. When you find what works for you, try to incorporate that good habit into your life–make it a regular practice. I assure you that you will feel its effects in your life!

And as always, one of the best things you can do for your mental health is to get help. Even before there is an actual problem–or a mental illness. Get help. Trusting a licensed, experienced therapist can be one of the healthiest things you will ever do for your mental health. Contact me with questions or click here to schedule a session today.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Are You Are Just A Worrywart or is it Something More?

Are You Are Just A Worrywart or is it Something More - Cluff Counseling - Denton TherapistAnxiety disorders are the most common psychiatric illnesses affecting children and adults. An estimated 44 million American adults suffer from anxiety, and–even though the disorders are highly treatable–only about one-third of those receive treatment!

Do you get the jitters when you have to speak in front of an audience, take a test, or talk with a superior. To a degree, this is completely normal. But for those with an anxiety disorder, these feelings are persistent, seemingly uncontrollable, disabling, overwhelming, and excessive, to the point where they can be filled with irrational dread of everyday situations and it interferes with their daily life. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time.

If this is you, listen to me–there is no shame! Many people suffer from one type of anxiety disorder or another…even I used to! When I was little, I would fret over everything to the point that my parents coined Bob Marley’s famous beat as my theme song: “Don’t worry, be happy!” The best news of all is that help is available. My hope with this post is twofold: First, to offer a couple signs to help you differentiate between everyday anxieties and an actual anxiety disorder; and second, to eradicate the false notion that having anxiety or a “disorder” means that you are broken.

Let’s start by giving anxiety disorders a face. Anxiety disorders are real–just like physical disorders such as heart disease or diabetes. Anxiety disorders are the most common and pervasive mental disorders in the United States, and they manifest themselves in many different forms including the following: Generalized anxiety disorder (GAD), panic attacks, agoraphobia, social anxiety disorder, separation anxiety, Irritable Bowel Syndrome (IBS), obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD), and depression.

I am certain that all of us have either experienced or heard of some of the above conditions. But does that mean you have an anxiety disorder? Although the distinction between an official diagnosis and “normal” anxiety isn’t always clear, here are some signs that may indicate your worries are clinically significant:

  • Sleep problems. You struggle falling asleep or staying awake (this is more than just tossing and turning with anticipation the night before a big speech or job interview).  I mean that you routinely find yourself lying awake, worried or agitated—about a specific problem or even nothing in particular.
  • Stage fright. Sure, most everyone get butterflies before addressing a group of people or being in the spotlight. But if the fear is so strong that no amount of coaching or practicing will placate it, or if you spend an excessive amount of time thinking and worrying about it, you may have a form of social anxiety disorder. Those with social anxiety will worry for days or even weeks leading up to a particular event or situation, and may consider extreme methods to evade said responsibility! Even if they do manage to go through with it, they tend to be incredibly uncomfortable and will dwell on their performance for a long time afterward, worrying about how they were judged.
  • Self-consciousness. We are all self-conscious about how we look or appear to others–especially when we are in the limelight. This symptom may be an indication of an anxiety disorder when your self-consciousness is provoked by everyday situations such as making one-on-one conversation at a party, or eating and drinking in front of even a small number of people. In these situations, people with social anxiety disorder tend to feel like all eyes are on them, and they often experience blushing, trembling, nausea, profuse sweating, or difficulty talking. These symptoms can be so disruptive that they make it hard to meet new people, maintain relationships, and advance at work or school!
  • Muscle tension. Near-constant muscle tension (from clenching your jaw, balling your fists, or flexing muscles throughout your body) often accompanies anxiety disorders. This is the sort of tension that even regular exercise and stretching cannot abate. (Muscle tension of this severity can be so persistent and pervasive that people who have lived with it for a long time may stop noticing it after a while!)
  • Chronic indigestion. Anxiety may start in the mind, but it often manifests itself in the body. A common example is Irritable Bowel Syndrome (IBS), in which the individual experiences near constant stomach aches, cramping, bloating, gas, constipation, and/or diarrhea. This is basically anxiety in the digestive tract! (A note: IBS is not always related to anxiety, but the two often occur together and can make each other worse.)
  • Panic. A panic attack can be a sudden, gripping feeling of fear and helplessness that can last for several minutes and be accompanied by scary physical symptoms such as breathing problems, a pounding or racing heart, tingling or numb hands, sweating, weakness or dizziness, chest pain, stomach pain, and feeling hot or cold.  It is possible to be diagnosed with general anxiety disorder and have panic symptoms, but not be diagnosed with panic disorder. Not everyone who has a panic attack has an anxiety disorder, but people who experience them repeatedly may be diagnosed with panic disorder.
  • Flashbacks. Reliving a disturbing or traumatic event–like a violent accident or the sudden death of a loved one–is a hallmark of post-traumatic stress disorder (PTSD), which shares features with many anxiety disorders. (In fact, up until very recently, PTSD was seen as a type of anxiety disorder rather than a stand-alone condition.)
  • Perfectionism. This prevalent and obsessive mindset goes hand in hand with anxiety disorders. This is where you are constantly judging yourself, and have relentless anticipatory anxiety about making mistakes or falling short of your [unattainably high] standards. Some individuals with perfectionism even see fit to punish themselves through publicly slandering themselves or taking on extra responsibilities when they fail to reach the high standards they have placed upon themselves.
  • Compulsive behaviors. In order to be diagnosed with obsessive-compulsive disorder, a person’s obsessiveness and intrusive thoughts must be accompanied by compulsive action or behavior. This may be mental (like repeatedly reminding yourself that things will be okay) or physical (like excessive hand-washing, not leaving home until your makeup is perfect, hair plucking, or repeatedly checking to ensure the oven is off).

The National Institute of Mental Health reports that 19 percent of American adults are affected by an anxiety disorder each year, and it is more prevalent in women, in people under 35, and in those who live in North America or Western European countries. According to these statistics, many people experience an anxiety disorder in their lifetime!

As I have said previously and will continue to emphasize, having a mental illness like an anxiety disorder is not a life sentence. You are not damaged goods. There is nothing inherently wrong with you. If we are going to take the stigma out of mental illness, we need to believe it ourselves first! This will happen as you recognize your worth and find the courage to accept help. Just a friendly reminder that help is readily available for those with anxiety disorders. There are a myriad of medications and treatments–including therapy from a licensed, experienced therapist–that can help you or your loved one control anxiety. Help is one click or phone call away. Please contact me today!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Teen Mental Health: Recognize It, Talk About It, Care For It

Teen Mental Health - Cluff Counseling, Carrollton Therapist1 in 5 teens lives with a mental health condition and less than half are receiving the support he/she needs. The fear of discrimination and being viewed as different by their friends and peers is a large barrier to young people receiving mental health services. Learn the warning signs and be aware of your teen’s mental health.

When you ask a child or teen about mental health, often they will not know how to answer or will not want to talk about it. This may not seem like a big deal, but considering the staggering statistic of 1 in 5 teens living with a mental illness, this is something we must face. We need to be talking about it with our youth! We need to be mindful of the signs and symptoms so we can recognize if/when something may be awry.

One of my good friends of many years recently told me about an interesting conversation she had with her parents.  This friend of mine had suffered abuse as a child and ensuing mental health issues that landed her in a treatment center in our twenties. She told me her dad admitted to recognizing a big warning sign in his teenage daughter–a lack of range of emotions. My friend always feigned happiness. She pretended like everything was okay. Because she was such a good actress, everyone fell for it, me included. Her dad wisely said, “Children and teens are supposed to feel and exhibit a wide range of emotions. If a child is consistently only displaying one emotion, there is a problem.”

Hindsight is 20/20 for these parents. They wish they would have seen the signs. Thankfully there has been enough experience and research done to give you and I a fairly comprehensive list of criteria to be aware of. The following are warning signs of mental illness to watch out for in your child or teen:

  1. Feeling very sad or withdrawn for two or more weeks
  2. Severe mood swings that cause problems in relationships
  3. Intense worries or fears that gets in the way of daily activities
  4. Sudden, overwhelming fear for no reason
  5. Dramatic changes in behavior (ie. if your once-ambitious or strong willed child suddenly loses desire to participate in activities he/she once did and/or is lethargic or empathetic)
  6. Plans or attempts at self-harm, or to harm others.
  7. Drastic changes in behavior, personality, sleeping, and/or eating habits
  8. Not eating, throwing up, or using laxatives to lose weight
  9. Significant weight loss or weight gain
  10. Severe out-of-control risk taking behavior that could cause harm to oneself or others
  11. Repeated use of drugs or alcohol
  12. Extreme difficulty concentrating or staying still
  13. Adrenaline rushes, cold sweats, and/or panic attacks

If you see these signs in your child or teen, tell someone you trust. Ask for help. A diagnosis of a mental health disorder will not define who your child is or their value. They can live a full life with their mental health struggles.

The best advice I can give to someone who has kids–especially teens–is to be aware of their mental health.  Remember, mental health is a person’s condition with regard to their psychological and emotional well-being. Children and teens are our most vulnerable and innocent population. Watch for changes in them.  Do not be afraid to ask questions.  Get in their business. Let them know you care about and are there for them. Adolescents fear of discrimination and being viewed as different by their friends and peers is a large barrier to seeking mental health services. Not talking about mental health increases the stigma around mental health; the fewer conversations we have about mental health conditions, the more these negative perceptions endure!

I hope that learning about these warning signs educates and helps you. Many adolescents  struggle with their mental health, but do not understand what is happening to them or have the words to reach out. We must be there for them! Please do not hesitate to contact me with any questions or concerns you may have. If a child or teen you know is experiencing one or more of these signs, talk with their parents immediately. Help with mental health is widely available and my door is always open. Please contact me today or click here to schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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