Hypochondriasis: When Worrying About Your Health Goes Too Far

“All the powers of imagination combine in hypochondria.” ~ Mason Cooley

If you were to google the symptoms from hunger pains and a low-grade fever, the internet might tell you you have appendicitis or another life-threatening illness. It is likely that you have had something similar happen–thinking a minor sickness is actually something far more concerning. While this may be laughable for many people, some individuals genuinely and subconsciously worry they have contracted (or may contract) a very serious illness from day-to-day life. This type of excessive worry is uncontrollable for some, and is a type of mental illness called hypochondriasis.

While hypochondriasis is the proper name for this illness, you have likely heard of it referred to as health anxiety, illness anxiety disorder, hypochondria, or that someone struggling with this mental illness is a “hypochondriac.” It is defined as the excessive worry of being or becoming seriously ill–even with the absence of worrisome physical symptoms. You may believe that normal body sensations or minor symptoms are signs of severe illness, even if or when a thorough medical exam does not reveal a serious medical condition.

This mental illness, like several others, is difficult in the fact that it is relentless–it never stops. No matter where you go, you worry about germs and contracting deadly sicknesses; it is as if the rest of your life is merely background music to the constant worrying that is hypochondriasis. This severe distress can majorly interrupt your life.

Symptoms of illness anxiety disorder involve preoccupation with the idea that you are seriously ill, based on normal body sensations (like the sounds of a hungry stomach) or minor signs (like a minor rash). Signs and symptoms may include:

  • Being preoccupied with having or getting a serious disease or health condition
  • Worrying that minor symptoms or body sensations are indicative of a serious illness
  • Being easily alarmed about your health status
  • Finding little or no reassurance from doctor visits or negative test results
  • Worrying about a specific medical condition because it runs in your family
  • Having so much distress about possible illnesses that it is hard for you to function
  • Repeatedly checking your body for signs of illness or disease
  • Frequently making medical appointments for reassurance (or even avoiding medical care for fear of being diagnosed with a serious illness)
  • Avoiding people, places or activities for fear of health risks
  • Constantly talking about your health and possible illnesses
  • Frequently searching the internet for causes of symptoms or possible illnesses

The causes for hypochondria are unclear, but there are three common hypothesis. First, you may have a difficult time accepting the uncertainty of an uncomfortable or unusual symptom in your body, which may lead you to search for evidence that would provide a more concrete answer–often resulting in an unnecessarily serious diagnosis. The second option is that you have had a parent or other family member excessively worry about their own or your health. The third possibility is that you have had a past experience with a serious illness that has created an overwhelming fear or paranoia surrounding unusual physical sensations.

The best prevention and treatments for hypochondria are simple. First, see your doctor for your routine check-ups to ensure optimal health. He/she can help reassure you that you are healthy, and this professional diagnosis may be useful to fall back on if you start worrying about your overall health. Second, if you have problems with anxiety, seek professional guidance from a mental health counselor as quickly as possible to help stop symptoms from worsening and impairing your quality of life. Third, learn to recognize when you are feeling stressed, how stress affects your body, and how to manage your stress (think meditation, exercise, a healthy diet, self-care, etc). And lastly, stick with your treatment plan to help prevent relapses or worsening of symptoms.

Just as you would go to a medical doctor with a broken limb or an unresolved alarming health concern, you should see a qualified, trained and experienced therapist to treat your mental needs. Hypochondria is a very real and debilitating mental illness. There is a way to work through your excessive worries and fears of sickness. I am here to help. Please contact me today with questions or 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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Supporting A Loved One Through Alcohol Addiction

Each Al-Anon Family Group has but one purpose: to help families of alcoholics. We do this by practicing the Twelve Steps of AA ourselves, by encouraging and understanding our alcoholic relatives, and by welcoming and giving comfort to families of alcoholics.

It can be so difficult to know your place if you have a friend or family member struggling with an alcohol addiction. You may not know what to say or how to help; you may feel like their addiction is straining your relationship; you may resent their choices. While it is true that you cannot force a person to get help for alcoholism, there are various ways you can support them and encourage them to seek treatment.

You have likely heard of Alcoholics Anonymous (or AA). In April, I wrote a post that detailed the basics of Alcoholics Anonymous. I tried to cover everything from what it is, to how it started, its main tenets, if it works, and how it applies to those who do not believe in God. I detailed the strength that comes from utilizing this specialized support group of complete strangers who understand the path of the alcoholic’s addiction.  This is a program of recovery for specifically for alcoholics; Al-Anon, however, is different. It is a program of recovery for people who are affected by someone else’s drinking, whether that be a friend or family. It is one of many resources available to support those indirectly affected by alcoholism. This post is dedicated to how you can support a loved one through alcohol addiction.

There is no one exact formula that will tell you how to support someone facing an addiction to alcohol. Every person is different and, therefore, each person’s recovery process will be unique. Some people may rely heavily on their support system and want to involve you in each step during treatment; others may be more reserved and may only come to you when they need a listening ear or want to talk. The best thing you can do for a loved one who is recovering is to motivate and support them every step of the way. Here are several specific ideas for how you can get involved and offer support:

  • Learn about his/her condition. Understanding that, over time, alcohol rewires a person’s brain and causes it to function differently, sheds light on why he/she cannot simply choose to stop drinking alcohol.
  • Know the warning signs. Some signs are recognizable while others are subtle. Several telltale signs of a potential drinking problem are irrational behavior, lack of interest in hobbies and ignoring responsibilities. (This step is particularly important for those who have not yet recognized the need for help to overcome an alcohol addiction.)
  • Offer to help research alcohol rehab programs and types of therapy. Deciding on where to go for treatment is one of the most important factors in a person’s recovery journey.
  • Attend support group meetings or counseling sessions with your loved one. This will give you insight to their journey as well as guide you in how to handle different situations. (AA meetings are generally open, which means you can attend with your loved one. These meetings offer a great deal of support and advice for living with someone who has a drinking problem.)
  • Attend Al-Anon meetings. Just as those facing alcohol addiction will attend AA meetings, you should attend Al-Anon meetings. Here you will find support as you meet others who also love someone with an alcohol addiction, and will be able to personally work through the 12 steps of Al-Anon. Visit this website to find a meeting near you.
  • Help with the post-rehab recovery plan. Be constant as your loved one navigates life as a recovering addict.
  • Be optimistic. Addiction recovery is a steady uphill battle that will come with victories and defeats. When setbacks come, try not to be critical and face the future with hope. When progress occurs, celebrate it and continue pushing forward.

Family and friends should understand that the recovery process can come with many ups and downs–for both parties. When things get difficult, remember that having a steady support system will make a profound difference for your loved one. Your support will surely influence whether or not he/she seeks help for their drinking problem, will buoy him/her through treatment, and will increase the likelihood that he/she will maintain sobriety after treatment. Your role is crucial!

More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment.  Alcoholics Anonymous is a free resource available to all that will offer tools to both the individual facing the addiction, as well as his/her loved ones. Alcoholism affects everyone, including family members and friends of the alcoholic. This can damage relationships and cause you to feel a wide range of emotions like disappointment, anger, doubt and denial. Although your primary goal is likely to get your loved one help, be sure to get the help you might also need. In many instances, speaking with a counselor is helpful and even necessary. If you feel you could use professional help, I invite you to contact me today or schedule a session. Whether you are the one facing the addiction, or the one offering support, I am here to help you every step of the way!

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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Continuing the Conversation on Teen Suicide: How to Help

“Don’t you know things can change / Things’ll go your way / If you hold on for one more day / Can you hold on for one more day?” ~ ”Hold On” by Wilson Phillips

Our community has felt the rippling effects of tragic suicides over the last year. We continue to grieve the loss of students and loved ones we miss so dearly. We know our community is not the only one experiencing the difficult aftermath of suicide, so we want to raise our voice to raise awareness.

Over the last few months, I have written two posts on the subject of teen suicide. Because this is such an important topic, I decided to split up my posts to do each one justice. First, I gave a general overview of teen suicide. Then I discussed the warning signs. Finally, I want to offer my personal and professional advice about how you can help.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

As I said, I dedicated an entire post to the warning signs someone considering suicide will likely exhibit. Please refer to that for a greater understanding on that subject. The main indicators are suicidal talk, self-harm, hopelessness, and neglecting appearance/friends/important activities.

If you see any of these warning signs in a friend or family member, the first thing you could do is talk about it. While it may be uncomfortable to discuss suicidal thoughts and behaviors, it may end up curbing a suicide attempt and saving a life. It is worth it! Some ideas to start this conversation could be something like, “I have been feeling concerned about you lately,” or, “Recently, I have noticed some differences in you and wondered how you are doing.” Similarly, you could say, “I wanted to check in with you because you have not seemed yourself lately.” If the person admits to feeling suicidal, you can then ask things like, “When did you begin feeling like this?” or, “Did something happen to make you start feeling this way?” as well as, “How can I best support you right now?” and even, “Have you thought about getting help?” Finally, words of comfort might include, “You are not alone in this. I’m here for you.” Another powerful idea is, “I may not be able to understand exactly how you feel, but I care about you and want to help,” as well as, “When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.”

If someone confides in you that he/she is considering suicide, evaluate the seriousness of the situation. Those at the highest risk for committing suicide in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. Here is a suggestion for how to assess someone’s risk to suicide:

Low: Some suicidal thoughts. No suicide plan. Says he or she won’t attempt suicide.

Moderate: Suicidal thoughts. Vague plan that isn’t very lethal. Says he or she won’t attempt suicide.

High: Suicidal thoughts. Specific plan that is highly lethal. Says he or she won’t attempt suicide.

Severe: Suicidal thoughts. Specific plan that is highly lethal. Says he or she will attempt suicide.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

If it seems the person is in the low to moderate range, offer empathy and a listening ear. Let your loved one know that he or she is not alone and that you care. A teen’s school counselors, teachers, or administration are trained and equipped to help too! If you are afraid to talk to someone face to face, call or text a crisis line for advice and referrals. Where applicable, you can help your friend/family member locate a treatment facility or take them to doctor appointments. Overall, I highly recommend encouraging the person to see a certified mental health professional as soon as possible.

If the person is in the high to severe ranges, and a suicide attempt seems imminent, call a local crisis center, dial 911, or take the person to an emergency room immediately. Remove anything that could be potentially harmful, like guns, drugs, knives, and other lethal objects from the vicinity. Do not, under any circumstances, leave a suicidal person alone!

If you are the one experiencing suicidal thoughts or feelings, surround yourself with people you trust and get help. There are so many resources available today, including the National Suicide Prevention Hotline (24 hours a day at 1-800-273-8255) as well as counselors in the schools. They can be trusted to help you. Remember that suicide closely affects at least six people–often many more! Absolutely no one will be better off with you gone…quite the contrary, actually. You matter. You are worthy of love and life. Life is worth fighting for. Do not give up on yourself!

A suicidal person may not ask for help, but that does not mean help is not wanted. People who take their lives do not want to die—they simply want to escape the hurt. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide (or if you are considering taking your own life), be brave. Speak up. Get help. Talking openly about suicidal thoughts and feelings can save a life, including yours!

Resources:

Continuing the Conversation on Teen Suicide: Warning Signs

“There’s no need to go and blow the candle out / Because you’re not done. / You’re far too young / And the best is yet to come.” ~”Lullaby” by Nickelback

Suicide is devastating to family, friends, and a community. The loss from suicide leaves a gaping hole in families, neighborhoods, schools, and communities; each suicide intimately affects at least six other people. Parents, siblings, classmates, coaches, and neighbors may be left wondering if they could have done something to prevent that young person from turning to suicide. In this post I will go over the suicide warning signs someone who is contemplating suicide might exhibit. In a future post, I will discuss how to help this person, or get help if you are the one considering suicide.

The World Health Organization estimates that approximately 1 million people worldwide die each year from suicide. For those who are not in the grips of suicidal depression and despair, it may be difficult and even confusing to understand what would drive so many individuals to take their own lives. However, a suicidal person is in so much pain that he or she can see no other option. This is why knowing what to look for can prevent suicide and provide help and hope as an alternative.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

WARNING SIGNS

There are many potential warning signs to suicide; the following are some of the most common red flags to look for:

  1. Self-harm or suicidal talk. Take any talk or mention of suicide very seriously. This is not just a warning sign, it is a cry for help!
  2. Talking or writing a lot about death or dying.
  3. Hopelessness. Though subtle, studies have found that hopelessness is a strong predictor of suicide. This hopelessness is often accompanied by “unbearable” feelings, a bleak future, and feeling like there nothing to look forward to.
  4. Loss of interest in day-to-day activities.
  5. Neglect of his/her appearance.
  6. Big changes in eating or sleeping habits.
  7. Withdrawing from friends and family. Increasing social isolation and the desire to be left alone.
  8. Dramatic mood swings or sudden personality changes, such as switching from outgoing to withdrawn or well-behaved to rebellious.
  9. Self-loathing and self-hatred. Feelings of worthlessness, guilt, shame, and self-hatred; feeling like a burden that no one would miss.
  10. Self-destructive behaviors. Increased alcohol or drug use, reckless driving, unsafe sex.
  11. Seeking out lethal means, such as weapons and drugs.
  12. Getting affairs in order. Making out a will, giving away prized possessions, making arrangements for family members.
  13. Saying goodbyes. This might include unusual or unexpected visits or calls to family and friends and saying goodbye to people as if they will not be seeing each other again.

These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide. Take these red flags very seriously!

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

If you see or experience any of these warning signs, do not dismiss them! I will write a detailed post on what to say and how to help in these situations next week. If you need immediate help, I suggest approaching a teacher or school counselor–they are trained to assist you and your classmates with this delicate yet urgent matter. Additionally, the National Suicide Prevention Hotline is available for calls and chats 24 hours a day (1-800-273-8255), and most communities have hotlines you can text for immediate anonymous help. In dire circumstances, call 911.

Knowing these warning signs could save a life. Pay attention to your peers. As always, please do not hesitate to contact me with questions. If you are battling thoughts and feelings of hopelessness and self-harm, please click here to schedule a session. My door is always open for you!

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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Alcohol Anonymous: Strength in Numbers

Alcoholics Anonymous

“When I stopped living in the problem and began living in the answer, the problem went away.”

~ Alcoholics Anonymous

According to the 2015 National Survey on Drug Use and Health, 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime. While it may not lead to an addiction for some, it does for others. Alcohol has touched all of our lives in one way or another, whether it is personally or through someone we care about. Because April is Alcohol Awareness month, I want to dedicate a post to one of the most helpful, renowned support groups for those working to overcome an addiction to alcohol: Alcoholics Anonymous.

WHAT IS ALCOHOLICS ANONYMOUS (AA)?

Alcoholics Anonymous is an international group of men and women who have had or are working to conquer a drinking problem. AA is open to all races, politically neutral, self-supporting, and is available almost everywhere. There are no age or education requirements, and membership is open to anyone who wants to do something about his or her drinking problem.

HOW DID AA START?

Alcoholics Anonymous was founded by Bill Wilson and Dr. Bob Smith, who were both recovering alcoholics. In 1935, Alcoholics Anonymous began as a community-based fellowship which encouraged sobriety for other recovering alcoholics. These two men developed the 12 steps to aid their attendees, and later introduced the 12 traditions to help further define the group’s purpose and achieve continuity for AA groups across the country (and later around the globe). AA paved the way for other support groups; today Narcotics Anonymous, Gamblers Anonymous, and Overeaters Anonymous are just three of the many groups that have modeled themselves after the AA meeting concept.

WHAT ARE THE MAIN TENETS OF AA?

The original steps are still intact and many former addicts credit the group with helping them through recovery. The 12 steps that govern all AA group meetings are presented in linear fashion, but participants see them as an ongoing circle. The following steps may be revisited until the recovering addict is comfortable in that stage of their recovery process:

  1. Admit powerless over alcohol
  2. Accept that a higher power, in whatever form, will restore your sanity
  3. Make a decision to turn your will and life over to a higher power
  4. Take a moral inventory of yourself
  5. Admit to a higher power, another human, and yourself the nature of your wrongdoings
  6. Accept that a higher power will remove your character defects
  7. Humbly request the higher power remove your shortcomings
  8. List people you hurt during your addiction and be willing to make amends
  9. Make amends to those people unless it would harm them
  10. Continue to take a personal inventory, and when you’re wrong, admit it
  11. Use prayer and meditation to connect with the higher power
  12. Carry the message of AA to other alcoholics and continue to practice the principles of the 12 steps in your daily life

DOES AA WORK?

Because AA is anonymous, some members of the group do not participate in studies since it could breach anonymity. Many want their participation in AA to remain unidentified, in line with the group’s original intention. Additionally, participants might not want to admit to relapse. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.  Alcoholics Anonymous’ Big Book touts about a 50% success rate, stating that another 25% remain sober after some relapses. Though it is difficult to know just how effective it is, it is safe to say that many people have been helped by regularly attending AA. Just how effective depends on the participant.

CAN AA WORK FOR THOSE WHO DON’T BELIEVE IN GOD?

The first time I read through the twelve steps, I was surprised how often God was referred to. While the faith-based program of AA may be effective for some, it does not work for everyone — particularly those who do not subscribe to God as a higher power.  Might I offer a solution: AA founder, Bill Wilson, encountered the term “higher power” in the book, Varieties of Religious Experience, by William James. In this book, James offers many examples from Christian traditions, as well as non-Christian examples. One of the best examples of “higher and friendly power” is borrowed from Henry David Thoreau walking in the midst at Walden Pond feeling a sense of connection to pine needles. He cited other examples of a “higher power” to potentially include moral principles, patriotism, civic engagement, and even a higher or better self. Therefore, the term “higher power” does not have to be a faith-based term and thus varies from participant to participant.

You could go to an AA meeting in Los Angeles, London or Lima and each one would be carried out in a similar fashion. This is because the steps and traditions of Alcoholics Anonymous are the foundation for every meeting. In each meeting, members will get to know one another, discuss progress and relapses, and support each other through sponsor programs. Although it can be difficult going to an AA meeting with complete strangers and admitting to such a personal issue, it is the only place where every participant knows exactly how you feel. They have been where you are and can support you in your journey. That is powerful. To quote AA literature: “The feeling of having shared in a common peril is one element in the powerful cement which binds us.”  This instantaneous bond cultivates a unique feeling of community and understanding that is incredibly helpful to those recovering from alcohol addiction.

The only real way to find out if Alcoholics Anonymous can help you is to give it a try. See for yourself if you think the help and support from others struggling with the same problem can help you stay sober. As Alcoholics Anonymous has no dues or fees, you have nothing to lose in choosing to visit a few meetings. I strongly encourage it. Call now at 877-600-9205 or go online and use a meeting finder to find a meeting in your area. Click here if you are local to the Dallas/Ft. Worth area and could benefit from community resources. In like manner, if you feel you could use professional help, I invite you to contact me today or schedule a session to begin your journey toward recovery. I am here to help you along the uphill road of addiction recovery!

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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Healthy Brain, Happy Life

Healthy Brain, Happy Life

“The mind of man is capable of anything.” –Joseph Conrad

There are certain things you and I have learned to do to take care of our bodies. These include brushing our teeth, washing hands, wearing sunscreen in the sun, eating a balanced diet, and trying to fit in regular exercise. There is so much knowledge about how to keep the body physically healthy! In like manner, new research has yielded valuable information about things that can be done to promote a healthy brain.  In recent years, research on the brain has made leaps and bounds, and has impacted my practice for the better.  Much of what I do–especially helping clients who are battling anxiety, depression, or other diagnosable mental illnesses–is impacted by this research. It can positively impact you, too. Today I want to share some of the findings that will help promote a healthy brain.

The benefits of keeping the brain healthy are innumerable. The following action list will not only help keep your brain young and healthy, but also positively impact other parts of your body, health, and life in general. Read the list, then consider one or two things you can start doing today to rejuvenate your brain. Your brain ten years from now will thank you!

  1. Mental stimulation. Keep learning and challenging your brain. Mental exercise is believed to activate processes that help maintain individual brain cells and stimulate communication among them.  Any mentally stimulating activity should help to build up your brain. You can try reading, taking courses, trying word puzzles or math problems…even Sudoku! Similarly, experiment with activities that require manual dexterity as well as mental effort, such as drawing, painting, and other crafts.
  2. STAY HEALTHY! Taking care of your body will adversely promote a healthy brain. So exercise; it will lower your blood pressure and cholesterol levels, and reduce stress. Meditate. Eat healthy foods; a diet rich in omega-3 fatty acids, low in saturated fat, full of the nutrients found in leafy green vegetables, along with whole grains can help keep your brain healthy throughout your life. Get quality sleep; give your brain a rest by shutting it off for 7-9 hours a night. This is when it will reset, heal, and be restored to full health. Avoid tobacco, drugs, alcohol and other harmful substances that alter how the brain functions. Be sure to care for your emotions (read: self-care). A “reset” or self-care/personal time is everything for managing the emotions that affect both mind and body!
  3. Prioritize brain space. I am guilty of expending precious mental energy remembering where I put my phone or remembering what was on my mental grocery list. The suggestion here is to take advantage of calendars and planners, maps, shopping lists, file folders, and address books to keep routine information accessible. This way it is easier to concentrate on learning and remembering new and important things.
  4. Repetition, repetition, repetition! When you want to remember something you have just heard, read, or thought about, repeat it out loud or write it down. That way, you reinforce the memory or connection. (If you just met Emily, for example, use her name when getting to know her better: “So, Emily, where did you meet your husband?”)
  5. Be social. When you are socializing, the blood circulates to several different parts of your brain as you are listening and formulating responses. Strong social ties have been associated with a lower risk of dementia, as well as lower blood pressure and longer life expectancy. So get off your phone, Instagram and Netflix, and go interact with your friends!
  6. Protect your head. Head injuries increase the risk of cognitive impairment. Wear a helmet when you are biking, skiing, snowboarding, rafting, horseback riding, scootering, using a motorcycle, or any other activity that could potentially result in a head injury.
  7. Think positively. There is a well-known effect in the psychology of education referred to as the “Pygmalion effect.” If you set high standards for yourself and believe that achieving them is possible, they become possible. Thinking positive thoughts has a profound impact on the brain!

Take charge of your brain health. Everyday you and I make choices that affect the health of our brains both today and in the future. Prepare now for a healthy, happy future by exercising your brain and your body, meditating, ingesting healthy foods, getting quality sleep, and thinking positively. As always, should you have questions, or if you feel you would like to talk about your mental health, I invite you to contact me or schedule a session with me personally. My door is always open.

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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Living Your Best Life, ADHD Aside

“ADHD is not about knowing what to do, but about doing what one knows.” ~ Russell Barkley

Attention deficit hyperactivity disorder (ADHD), previously known as ADD, can present challenges for adults across all areas of life. It can be taxing on your health, your job, and your personal and professional relationships. Your symptoms may lead to procrastination, trouble meeting deadlines, difficulty maintaining relationships, and impulsive behaviors. You may wind up feeling alone, and as though friends and family do not understand what you are dealing with. Fortunately, there are skills you can learn to help manage the symptoms of your ADHD. You can improve your daily habits, learn to recognize and use your strengths, and develop techniques that help you work more efficiently, maintain organization, and interact better with those around you.

Over the last several years, awareness about ADHD has increased, and the stigma surrounding this mental health issue has decreased. There are many resources available for adults living with ADHD. Below, in the resources section, I have included links to articles that include specific tips for managing stress and boosting mood, ideas for staying focused and productive at work, suggestions for managing money and bills, advice for managing time and staying on schedule, and instructions to get organized and control clutter. In this post, however, I will share the basic, overarching principles you will find helpful to live your best life despite having ADHD.

  1. Create structure. This is possibly the biggest help to combat ADHD. Make a routine and stick to it every day. Establish rituals around meals, school, work, free time, as well as your morning and evening routines. Simple tasks, such as laying out your clothes and items for the next day, meal prepping, and daily planning can provide essential structure.
  2. Break tasks into manageable pieces. The demands of school, work and life can leave anyone feeling overwhelmed, frustrated, and hopeless. Whatever task you are faced with, break it down into bite-sized (so to speak) steps that you CAN do. Then tackle those one by one until you accomplish your end goal.
  3. Simplify and organize your life. Create order in your home or work space. Often, the tendency to get distracted makes organizing clutter difficult. But if everything has a designated place, cleaning up will be efficient and easy. This will allow you to focus on the things that really matter. In addition, having an orderly living or work space will offer you a haven from the chaos of everyday life.
  4. Limit distractions. Individuals with ADHD welcome easily accessible distractions. Television, video games, and the computer encourage impulsive behavior that must be regulated. In addition to decreasing time with electronics, I recommend increasing time doing engaging activities outside the home as an outlet for built-up energy (see next).
  5. Encourage exercise. Physical activity burns excess energy in healthy ways, which will decrease impulsivity. Exercise will help to improve concentration, decrease the risk for depression and anxiety, and stimulate the brain. Did you know that many professional athletes have ADHD? Experts believe that athletics can help those with ADHD find a constructive way to focus their passion, attention, and energy.
  6. Regulate sleep patterns. Bedtime may be an especially difficult for individuals suffering from ADHD. The lack of sleep exacerbates inattention and hyperactivity; therefore, getting quality sleep is paramount! Not too long ago, I wrote a blog post on nightly rituals that will help you “sleep like a baby.” In addition to the suggestions in that post, I recommend eliminating stimulants like sugar and caffeine, and decreasing television time to help get better rest.
  7. Encourage out-loud thinking. Those with ADHD can lack self-control and often speak compulsively, or without thinking. Try verbalizing your thoughts and reasoning. If you do not have someone supportive with whom you can confide, I recommend keeping a journal. It is important to understand your thought process in order to be able to curb impulsive behaviors.
  8. Take breaks. It is 100% normal to become overwhelmed or frustrated with yourself as you try to manage the behaviors and impulses that accompany ADHD. Give yourself breaks, schedule them (include them in step one, when you “create structure”!). Scheduling alone time is important. Good break options include going for a walk, reading a book, taking a relaxing bath, or anything that promotes self-care.
  9. Believe in yourself. Remember that ADHD causes legitimate stress. Do not minimize your feelings of anxiety and frustration. While so doing, it will be important to remain positive and hopeful. Recognize your progress. Believe that you can work through the obstacles before you. Have confidence in yourself and be positive about the future.
  10. Get help. The final suggestion I would like to allow others to help. You do not need to manage ADHD on your own! Allow close family or friends to be part of your journey; rely on them for support and to help you make progress. Additionally, get individualized counseling with a licensed, experienced therapist. I have several patients who have learned the necessary skills to be in control of their ADHD.  I am your advocate and can be you personal cheerleader! Contact me today to schedule a session. Furthermore, some individuals find that receiving medication can help immensely help them in managing their ADHD symptoms. Finally, look into local support groups near you. This is an incredibly helpful resource!

Before I end, I want to leave you with some reminders that have been helpful to those I have worked with. Be willing to make some compromises and recognize that perfection is not realistic. Remember that while ADHD may not be visible on the outside, it is real. You are dealing with a hard thing, so please remember that when the going gets tough! Third, take things one day at a time and remember to keep everything in perspective.

Take heart. You can learn to live with manageable ADHD symptoms and be in control of your life. Let ADHD be an explanation, rather than an excuse. Be patient and remember that change will not happen overnight. These ADHD self-help strategies require practice, patience, and a relentlessly positive attitude. As I always say, my door is wide open and I am here to help. I accept new clients for in-person sessions. 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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Beginning the Conversation: Teen Suicide

“Where did I go wrong? / I lost a friend / Somewhere along in the bitterness / And I would have stayed up with you all night / Had I known how to save a life.” “How To Save a Life” by The Fray

It has been a tragic week for our community as many were impacted by the suicide of a teen from a local high school. This particular teenager was described as happy and easygoing, so this loss has rocked and taken the community by complete surprise. Whether it is from a story in the news, or from personally losing a classmate/neighbor/colleague/friend/family member, many of us have experienced the painful aftermath of suicide. Popular artists like Nickelback, Rascal Flatts, James Taylor, Green Day, Billy Joel, The Fray, Katy Perry, U2, Linkin Park, are just a few of the many artists that have also been impacted by suicide and have written songs about their experiences. With my heart heavy from this recent loss in my community, I feel the need to begin to address the mountainous topic of suicide.

Suicide is devastating to family, friends, and a community. Loss, due to suicide, leaves a gaping hole; each suicide intimately affects at least six other people. Parents, siblings, classmates, coaches, and neighbors may be left wondering if they could have done something to prevent that young person from turning to suicide. This post is for those contemplating self-harm or suicide, who work with teens, who are acquainted with someone with a mental illness, or who have wanted to just go to sleep and not wake up…in short, this post is for all of us.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

It can be hard to remember how it felt to be a teen, caught in between childhood and adulthood. While it is a time of tremendous possibility, it is also a period of great stress and worry. There is intense pressure to fit in socially, to perform academically, and to act responsibly. Young people with mental health problems–such as anxiety, depression, bipolar disorder, or insomnia–are at higher risk for suicidal thoughts. Teens going through major life changes–parents’ divorce, moving, a parent leaving home due to military service or parental separation, financial changes–and those who are victims of bullying are at greater risk of suicidal thoughts.

Suicide rates differ for boys and girls. Girls think about and attempt suicide about twice as often as boys, but they typically do so by overdosing on drugs or cutting themselves. Suicide among boys is four times as common because they tend to use more lethal methods–such as firearms, hanging, or jumping from great heights. Interestingly, in the United States, suicide rates are the highest in the months of March, April, and May.

The risk of suicide increases dramatically when kids and teens have access to firearms at home. Nearly 60% of all suicides in the United States are committed with a gun. If there is a gun in your home, please ensure that it is unloaded, locked, and kept out of the reach of children and teens.

Teens who are thinking about suicide might talk about suicide or death in general. They may give hints that they might not be around anymore or talk about feeling hopeless or feeling guilty. They tend to pull away from friends or family. They write songs, poems, or letters about death, separation, and loss. They may start giving away treasured possessions to siblings or friends. They lose the desire to take part in school, sports, or other favorite activities and things. They may have trouble concentrating or thinking clearly, or experience major changes in eating or sleeping habits. They may increasingly engage in more risky behaviors. Or they may seem to suddenly be “better” or “happy” after a period of hopelessness or depression.

If you are contemplating suicide, please… talk to someone. Ask for help. Make a safety plan. The musician, Billy Joel, once attempted suicide; later he wrote the song, “You’re Only Human” to assure his listeners that better times are ahead: “Don’t forget your second wind. Sooner or later you’ll feel that momentum kick in.” Evaluate your relationships; love and friendship are all about respect. If you are in a toxic or unhealthy relationship, it has the power to negatively affect you and cause you to consider self-harm. Seek help! There are so many resources available. Similarly, if you are being bullied, help is available. You deserve love and respect. You are worth it!

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

Earlier this week, I woke up to a text message in a family thread about what is referred to as the “Momo Challenge” infiltrating YouTube kids and other online platforms. Parents, please be aware of this challenge! Participants are urged to take photos and videos of themselves completing harmful “challenges” that escalate to incredibly dangerous and even suicidal actions. The creators of these challenges have the intent to harm as they invite their users to do dangerous “challenges.” This is not something to toy with. Please, if you or someone you know has gotten sucked into the Momo Challenge or anything akin to it, please entirely disconnect from it. You do not need to play with knives or engage in other risky behaviors to get love and attention. You are worthy of love and belonging without harming yourself!

There has been a major uptick in teen suicide the last few years. Several teachers at Lone Peak High School in Highland, Utah, noticed this epidemic and made a slam poem into an inspiring video for their students. In it, the teachers share their past failures and disappointments, as well as how things changed for the better as life continued on. They plead with their students to not harm themselves, to keep going, and to remember their worth. I urge all of you to watch their video as well as to share it on your social media platforms. Here are some of their words:

This isn’t the end. High School was never meant to be the end.

It’s too early to draw the final conclusion. This proof is incomplete. This is not your denouement. It’s not the fourth quarter. This is not the curtain call.

You are more than the sport you play and the one you don’t; more than a GPA, ACT, AP, honors, regular classification on a college application.

You can do this. We believe in you. And when they call your name at graduation, we’ll call you patience. We’ll call you courage. We’ll call you hope and say we saw it all along.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

Please, my readers, if you or someone you know is contemplating suicide, please reach out. There are so many resources and so many people willing to help and listen–despite if you feel alone, helpless, or hopeless. If you feel there is no one else to turn to, please know that I am here as your advocate and your cheerleader. My door is always open! Contact me with questions 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.

Resources:

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.

Resources:

Phobias: When Fear Becomes Debilitating

Scared woman covering mouth Free Photo

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”