Debunking the Myth: Men CAN Have Anxiety

“No matter what our circumstances, we’re all carrying around things that hurt — and they can hurt us if we keep them buried inside,” he wrote. “Not talking about our inner lives robs us of really getting to know ourselves and robs us of the chance to reach out to others in need.” 

~Kevin Love of the Cleveland Cavaliers 

There is much conversation about women experiencing anxiety in the workplace, in forming and maintaining relationships, all throughout motherhood… It is well understood that women of all ages across the globe undeniably face anxiety in nearly every stage of their lives. But why are men so quickly excluded from the dialogue on anxiety? In today’s post, I would like to do my part in creating an open conversation on men and anxiety!

Do men experience anxiety, too? The short answer is a resounding yes! Anxiety is no respecter of person; men and women alike are vulnerable to its effects. Everyone feels anxious from time to time. Not only is it common, but it is actually important that humans have the capacity to feel anxious because anxiety is the body’s way of telling you that there is a threat that needs attention. (Note: With an anxiety disorder, a person may repeatedly respond to situations as if there is a perceived threat, although there is not one.) While both men and women can feel anxious during their lives, they tend to respond to their anxiousness differently. 

The facts about men and anxiety:

  1. Studies have found that about 1 in 5 men (and about 1 in 3 women) will have an anxiety disorder during their lifetime. On top of that, only half of the men experiencing anxiety will be diagnosed and untreated! (In a recent Wall Street Journal article, it was reported that mental health professionals fear these figures grossly under-report male cases.)
  2. It is more common for men to experience anxiety than depression
  3. Men and women are prone to different types of anxieties. For instance, women are more commonly affected by generalized anxiety disorder, specific phobias, and panic disorders than men. When it comes to social anxiety disorder specifically, men and women are equally affected. 
  4. Suicide rate among men is four times higher than the suicide rate among women. This is important to note because suicide is often set in motion by indicators of anxiety–narrowing of vision, a hopelessness, the sense that things are not going to get better, etc. 
  5. Anxiety manifests itself differently in men than in women. Women tend to manifest anxiety through nervousness, excessive worry and avoidance of frightening situations. Men manifest their anxiety in ways that often seem unrelated to anxiety which can lead to many instances going undiagnosed. Researchers and psychologists are finding that men report headaches, difficulty sleeping and muscle aches and pains. Or their anxiety is masked by anger, irritability, and aggression. Men are also more likely to use alcohol and drugs to cope with anxiety, so what looks like a drinking problem may actually be an underlying anxiety disorder. 
  6. It is more socially acceptable for men to employ strategies such as substance use and alcohol to suppress their emotions than to admit to anxiety. There needs to be more talk about productive resources like men needing a good friend with whom to talk, the benefits of self-care in combating anxiety, the power of communication instead of bottling up (or ignoring altogether) feelings of anxiousness. 
  7. Men are socialized to not ask for help or be vulnerable. An informative study found that when male (but not female) leaders ask for help, they are viewed as less competent, capable, and confident. And when men make themselves vulnerable by disclosing a weakness at work, they are perceived to have lower status. This is problematic as it becomes a vicious cycle where men needing help are not able to admit to it, let alone treat it. 

In my research on men and anxiety, I came across an example that perfectly illustrated the stigma around men and anxiety: A construction worker, who worked on scaffolding 30 feet high, described daily panic attacks that would come on quickly and would make him feel dizzy, nauseous, and disconnected from reality. This went on for ten years before he sought treatment. When he finally got help, he was asked why he had waited so long; he said he felt his ‘episodes’ were a manifestation of a weakness on his part. He believed he could control them (“mind over matter) but he tried for ten years without success. This construction worker did not free himself from his debilitating anxiety until he admitted to needing and sought for help. This is the case for any man or woman struggling with anxiety: Healing and balance is possible but often requires getting professional help. 

If you struggle with anxiety, reach out. Talk about it. Get help from a trained professional. Anxiety is not a weakness. Anxiety disorders are real–often a chemical imbalance of the brain. It exists in men and women. Men, you are not alone and it is okay to get help! Everyone deserves to live their life with tools to face anxiety and be in control of their life. Healing is possible! Please do not hesitate to contact me and schedule a session.

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

References:

Q&A: Is My Anxiety Curable?

“Keep your face to the sunshine and you cannot see the shadow.” ~ Helen Keller

Everyone feels worried from time to time. You may worry about a presentation you have to do in school or work; or perhaps you worry about your spouse on a work trip, or your child away from home for the first time. Feeling worried is a normal emotion. Feeling anxious, however, is different. Maybe you have experienced both sentiments, but presumed them to be synonymous? Join the club. These two terms are often used interchangeably in casual conversation, but, in reality, they are quite different. Read on to learn the fundamental differences between worry and anxiety, if anxiety is a curable or not, and four everyday tools anyone can use to manage anxiety.

How are worry and anxiety different?

In a study where 189 university students were asked about the differences between anxiety and worry, worry and anxiety were defined very similarly. However, certain negative outcomes–like depression and confusion–were more related to anxiety than to worry, and problem solving was more related to worry than to anxiety. Other key differences include the following:

Worry…

Is experienced in the head. 

Is specific

Does not provoke mental imagery elicit a cardiovascular response.

Is accompanied by problem solving. 

Creates mild emotional distress. 

Is caused by a specific concern.

Is often controllable. 

Is temporary. 

Does not impact one’s overall functioning. 

Is considered to be a normal/common emotional state. 

Anxiety…

Is manifest in the body.
Is vague or general.

Provokes mental imagery and elicits a cardiovascular response.

Is not accompanied with problem solving.

Creates severe emotional distress. 

Is a non-specific, broad fear.

Is difficult to control. 

Lingers. 

Does impact one’s overall functioning. 

Is not a normal/common emotional state.

Are you beginning to see the difference between being worried and experiencing anxiety? Though there is some overlap, the two emotions are actually quite different. If I could add one more, it would be that being worried occasionally usually does not lead one to see a therapist, whereas therapy can be very helpful with prolonged anxiety.

Is anxiety a life sentence? NO!

I always tell my clients, who are battling anxiety, that what they are facing is not a life sentence! While you may feel seriously burdened by your anxiety at present, you do not need to be controlled by it. The goal of therapy is not to get rid of everything that may be causing you anxiety, but rather to give you the tools to face your anxiety and to learn from it. 

Four things you can do TODAY to get relief from your anxiety:

  1. A deep relaxation technique. There are several options for this tool. I would recommend muscle relaxation, visualization, or meditation to start. Force yourself to slow down, take deep breaths, relax, and release some of the tension you are feeling. Here are some helpful apps: Calm; Stop, Breathe & Think; UCLA Mindful.
  2. 30 minutes of vigorous exercise. This suggestion may seem obvious as regular exercise is recommended to achieve optimal health. Exercising is an amazing tool in combating worry and anxiety. Exercising releases a feel-good hormone in the brain and nervous system that positively affects you physiologically–naturally combating worry and anxiety. Additionally, vigorous exercise during the day will lead to better sleep at night which has many benefits. There is great power found in exercising!
  3. Good nutritional habits. Similar to exercise, having a balanced diet will benefit you in many aspects of your life. When you fuel your body with a well-rounded diet to sustain yourself throughout the day, your overall health with be positively influenced. You will have more energy to deal with life’s stressors, you will be less likely to fall sick, and you will be able to think more clearly. All of these outcomes will aid you in the process of rising above worry and anxiety.
  4. Replacing negative self-talk with positive affirmations to counter mistaken beliefs. Self-care is a major focus with my clients, and one form of that is positive self-talk or affirmations. You are your own worst critic. When you change your self-talk from negative and degrading to supportive and loving, you will break negative patterns to see life (and yourself!) through a different lens. This is a major step in working through anxiety.

Your anxiety does not have to be a life sentence. Seek out an experienced, qualified therapist. Develop a daily practice of deep breathing/mindfulness, get up and move your body for 30 minutes a day, eat a colorful and balanced diet, and speak kindly to yourself. Implementing these four tools in tandem will yield astronomical results in combating anxiety. Let’s get started today!

References:


I’m Not Crazy! Overcoming the Stigma Around Therapy

“In Hollywood if you don’t have a shrink, people think you’re crazy.” ~ Johnny Carson

Therapist Help

Imagine the following scenario: You go running and roll your ankle. You hear a pop and are in great pain. It turns black and blue and swells quickly. You are concerned it is broken or seriously torn, but you fear going to the doctor for help. What will your neighbors say? Will they gossip about how weak you are for not just “getting through it” or figuring it out on your own? You decide to avoid the doctor, take some Tylenol, hobble around like nothing is wrong, and hope it will just go away on its own.

This example might seem foolish to you…why would you not go to the doctor?! It may seem downright silly to not get help when help is needed!  Likewise, when a person encounters trauma, addiction, abuse, or mental illness, it is of legitimate concern and often necessitates professional help like therapy. In the exact same way a broken or sprained ankle often requires the attention of a doctor, many mental health issues require professional help. And there is nothing wrong with that! 

Recently I had a client look me in the face and say, “I don’t belong here.” She felt she should not be in my office sitting on my couch getting help from a licensed therapist because she was not crazy. She had a fulfilling career, many dear friends, and owned lots of expensive things. She did not believe she fit the image, she had in her head, of someone who needed therapy. In short, she thought therapy was for people that outwardly looked like they did not have their life together and she was not one of them. It hurts my heart to hear the shame she, and other clients have felt for being brave and seeking help. 

When studying roadblocks to receiving therapy, Patrick Corrigan and Andrea Bink (2016) had participants report fear of being stigmatized was the leading factor for avoiding treatment. Participants feared they would be treated differently by their friends and coworkers, that they would encounter rejection or discrimination as a result of seeking out mental health treatment.  Most participants would hide their psychiatric status from coworkers, friends, and even family to avoid being the victim of stigma. Thankfully, in recent years–due in large part to social media attention around the stigma around mental health and therapy–it has become much more socially acceptable to receive mental health care. It is not uncommon to hear about celebrities and prominent figures seeing a therapist; many of them highly recommend it for every- and anyone! I applaud these men and women for using their influence to break the mold and speak up on the many benefits of therapy!

The latest statistics show that the amount of people seeking and receiving mental health support is increasing! In 2018, 47.6 million U.S. adults experienced mental illness…that is 1 in 5 adults! Thankfully, 43.3% of U.S. adults with mental illness received treatment in 2018 and 64.1% of U.S. adults with a serious mental illness received treatment in the same year. 50.6% of U.S. youth aged 6-17 with a mental health disorder received treatment in 2016. Millions of Americans experience mental health challenges each year and millions are receiving help by medical and mental health professionals!

Going to therapy does not mean you are crazy. It means you are smart. Would you sit at home, alone, and let your broken ankle “do its thing” without getting help? No. You would make the proper appointments and follow the advice of the professionals so you could soon be running again. My hope, my plea, my job is to help my clients find lasting healing.  The average delay between onset of mental illness symptoms and treatment is 11 years. Eleven years people will struggle with an emotional “broken ankle” before getting help. Ouch! You do not need to suffer any longer. Make the call–get in to see a therapist today.

I felt sad for the client of mine, and any others who share her sentiments. Just because you receive mental health attention does not mean you are crazy. Just the other day a client, who begrudgingly started therapy at the insistence of their spouse, recently told their new employer that they thought everyone should go to therapy, after they experienced the personal benefits of therapy. While I acknowledge you may believe that going to therapy means you are weak, crazy, limited, hopeless, etc–these stigmatic ideas could not be farther from the truth. I know my clients: THEY ARE BRAVE. They are good people who see their worth. My clients–and those who seek help in other ways–are my heroes and I will always and forever shout that from the rooftops! We need to do away with any and all stigmas that therapy is just for broken, crazy people. It could not be farther from the truth! 

If you have been letting your emotional broken ankle heal on its own because you have felt you do not “belong” in therapy, the time to act is now. Allow a licensed, qualified, experienced therapist, to help you. Emotional health, healing and happiness are possible. Contact me today!

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

References:

Q&A: Why Did I Become A Therapist?

“We all have worth; sometimes we just need to be reminded of our worth!” -Melissa Cluff 


Many of us evaluate the previous year to decide what we want to continue to do in the new year and what we want to do differently. One of the new things I want to do is spend time answering some of the  common questions that clients and potential clients ask me. I thought I would start by answering one of my most frequently asked questions–one that is a little more personal: Why did I become a therapist?

First, let me introduce myself. Although I was not born in Texas, I consider myself a Texan.  The fact that Texans had a lot of pride did not hit me until I went to Brigham Young University and saw many Texas flags proudly displayed in dorm rooms. In case you were wondering, I have never used a Texas flag as a decoration, and I also do not own a cowboy hat! I grew up in a large family and it has continued to grow with the addition of in-laws and nieces and nephews. Texas is where I was raised and it is where I returned after receiving my Masters degree from Oklahoma State University. When I am not working in my private practice, I enjoy traveling, hiking, working out, family time, and attending concerts and musicals. 

Growing up I thought I would become a teacher since I liked to boss around my younger brothers and enjoyed helping my mother with her pre-k lesson plans. In high school, someone close to me shared that they had a positive experience in therapy and that I reminded them of their therapist. That comment was the catalyst for me to seriously think about counseling as a career option and I enrolled in AP Psychology. Around that same time, I noticed that I felt drawn to the people who I knew were experiencing pain. For example, I yearned to reach out to the siblings of a student who had committed suicide, and to a football player who had been involved in a car accident where the other driver, a fellow student, had died. I wanted to go up to them and say something, but I did not know what to say or if what I had to say would be received since I did not know them.

In college, I decided to pursue becoming a therapist; I felt the “call” to be a resource for those that carry seen and unseen pain. I majored in Psychology and was on the path to getting a PhD, since I thought that was the only route to provide counseling. During my Sophomore/Junior year, I discovered MFT (Marriage and Family Therapy), which was a newer field, and learned that I would be able to see clients after earning a Master’s degree. I was thrilled with this information! Relationships were something that I wanted to focus on in therapy and becoming a LMFT (Licensed Marriage and Family Therapist) would prepare me well and support my desired direction. 

Graduate school was difficult and I had to put more effort into it than I have ever had to put into anything previously. Luckily, I knew that grad school was the means to my desired end of becoming a marriage and family therapist; I pushed forward and graduated in 2007 with boxes of well-worn, 3-inch binders stuffed with annotated articles, and textbooks. I knew everything I needed to know…or so I thought! 

It quickly became evident, in my first counseling job, that I needed further training–namely in the areas of sex addiction and the related trauma. When I had saved enough money, I pursued my certification to become a CSAT (Certified Sexual Addiction Therapist) and EMDR (Eye Movement Desensitization & Reprocessing). Those certifications increased my confidence that I could be a reliable resource for people in pain. I have continued to seek out training in areas that would help me better serve my clients, and that are of interest to me. Although I never loved school, I have loved pursuing higher education through additional certifications and training opportunities.

I have been in the field of marriage and family therapy since 2005 and my passion for it continues to grow! One of my most cherished roles, as a therapist, is helping the people in my office see that they are lovable and have worth. A paycheck, job promotion, or waist size does not give a person more worth; an addiction, a struggle with mental health, or strained relationship does not take away from a person’s worth. We all have worth; sometimes we just need to be reminded of our worth! 

Thank you for giving me the opportunity to share why I became a therapist. If you have a question for me, email me at melissa@cluffcounseling.com.

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

Self-Care is a Family Matter

“Family is not an important thing. It’s everything.” –Michael J. Fox

When you think of self-care, you might envision yourself with cucumbers on your face getting a massage. Or maybe you think of axe throwing, running several miles, or playing an instrument for fun. Self-care has been in the limelight with endorsements from celebrities and other influencers on their social media accounts. Self-care is important because it helps you maintain a healthy relationship with yourself and others, it produces positive feelings, improves confidence and self-esteem…the benefits to practicing self-care are endless (additional sources on the benefits of self-care are included below). But what about family self-care? What are you doing to make sure your family wellbeing is maintained and functioning optimally?

At the end of September, I wrote about fun family activities to get everyone involved in the nationwide holiday Family Health and Fitness Day. When practiced individually, self care can benefit you and I emotionally, spiritually, mentally, practically and socially. In like manner, when implementing on family self-care strategies, it will greatly benefit you to focus on each of these areas; it will keep your family healthy, happy, and united. The following are some suggestions for each of those areas:

Emotional:

  • Watch a move
  • Write each other positive notes
  • Discuss each others’ talents/gifts
  • Verbalize and talk about feelings
  • Draw self-portraits
  • Say, “I love you”
  • Spend time writing
  • Try a new craft

Spiritual

  • Write a gratitude list
  • Go outside
  • Talk about forgiveness
  • Write thank you notes
  • Volunteer
  • Spend time outdoors in nature
  • Plant a tree
  • Practice positive self-talk

Mental

  • Read together
  • Draw or write stories
  • Meditate
  • Find shapes in clouds
  • Practice belly breaths
  • Go on a walk to find new things
  • Make vision boards
  • Try Headspace for Kids
  • Create mandalas
  • Make mindfulness jars
  • Mind strength games like “Memory”

Practical

  • Clean up
  • Declutter old toys
  • Assign chores
  • Make a grocery list
  • Learn about money
  • Make a weekly budget check-in
  • Make a weekly cleaning check-in
  • Do homework/study
  • Establish a morning/evening routine

Social

  • Play in the park
  • Call or visit relatives
  • Have family dinner
  • Play boardgames
  • Host a sleepover
  • Invite friends over
  • Plan a BBQ
  • Join a team
  • Organize a food drive
  • Discuss friendship and how to be a friend

Maybe by reading this list you have thought of your own ideas for one or more of these areas. Figure out what works for you and your family; what leaves you feeling recharged, connected, and happy? Do those things. And do them regularly. Individual self-care is a daily effort; staying balanced and connected as a family is no different. Carve out time for your family, make it a priority, be consistent, make it fun, and you will find that family self-care is the answer you have been needing for your family. Should you find you need help in increasing your family togetherness, please contact me today 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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Family Fun Day

“When planning family activities around movement it is important to make fun the overriding factor. In fact, don’t even use the word exercise. Think of using games, competitions, etc.” ~Gregory Florez, the senior adviser on workplace leadership and vitality for the American Council on Exercise.

At the end of every month, I do a post on self-care. I have covered self-care topics such as: why it is important, how it is not selfish, how self-care can mitigate anxiety, help us forgive, and boost self-esteem. I have even given some zany ideas for out-of-the-box self-care. These posts have primarily focused on the individual nature of self-care. This month I want to start taking self-care a different direction; I want to focus on family self-care–why it is important, and what it looks like. 

As a short reminder, self-care is any activity that we do deliberately in order to take care of our mental, emotional, and physical health. Viewed through the lens of family self-care, this is any activity we purposefully do to better our family in general–to strengthen relationships, to deepen trust, to build strength (literally and figuratively), and to have fun. Individual self-care puts you in a better place in your relationships; imagine doing self-care activities together as a family unit. It is essentially relationship maintenance and will function like an oil change or tune-up on your car. In future months, I will write more about various emotional, spiritual, mental, practical, and social activities families can do for family self-care, but today we are going to focus on physical activities because Family Health and Fitness Day is TODAY!

I feel confident in saying that each parent wants to teach their children healthy habits. What better way to teach them than by being active with them–as a family? One of the goals of the U.S. Surgeon General’s Report on Physical Activity and Health is to get the entire family involved in exercise. According to the report, Americans–especially those between the ages of 12 and 21–are not active enough. Let’s change that!

Since the 28th (and the last Saturday of September each year) is designated as National Family Health & Fitness Day, I have been thinking about encouraging my readers to participate. Yes, this is a day to get up, to get out, and to exercise (read: PLAY) together as a family, but I hope we all are doing this more than just once a year. Let’s make a habit of exercising together as frequently as possible. Jennifer Hopper, director of Employee Wellness, Worklife and Fitness at Piedmont recommends aiming for 30 minutes of family movement every day…then everyone wins!

National Family Health & Fitness Day will prompt families to be more active. On the 28th, local organizations throughout the country will host family-related health and fitness events at schools, park districts, hospitals, YMCAs/YWCAs, malls, health clubs and other community locations. Local family health and fitness activities will vary widely based on the organization hosting the event and the interests of local families. Activities will be noncompetitive and may include walking events, low-impact exercises, health screenings, open houses, games and health information workshops.

Seeing as how the point of this holiday is to be healthy and active, there are many ways to achieve that goal. Many family-friendly fitness activities are free. You may want to ask each member of the family to propose an activity (only rule out ideas that are truly dangerous) so everyone can be on board. Whether you want to stick close to home or are looking for an adventure, the following are some ideas for you:

  1. Wash the car together.
  2. Host your own family Olympics. Pick activities your whole family enjoys, such as kickball, hopscotch or hot potato with a Frisbee.
  3. Rake leaves together…and feel free to jump in the pile when you’re done!
  4. Plant a garden. You can make it kid-friendly by using planters rather than planting directly into the ground.
  5. Get moving for a good cause. Sign up for a fun run or charity 5K. Almost every event has an abbreviated race suited for a variety of age levels, from toddlers to adults.
  6. Go hiking, biking or walking at a nearby state park.
  7. Visit a corn maze.
  8. Take advantage of your local community center’s pool and playground, even if it’s just for 30 minutes.
  9. Window shop at the mall.
  10. Play a fitness game on a Wii or video game that induces activity.
  11. Take a bike tour of a historical part of your town.
  12. Go rafting.
  13. Squirt gun wars.
  14. “Slip-n-slide” contests.
  15. The old favorites: Kick the can, kickball, capture the flag, etc. Simple yet so fun!
  16. Flag or touch football.
  17. If you have access to a swimming pool, “Marco Polo” and other water games.
  18. A hiking treasure hunt (pick odd shaped rocks, roots, beautiful flowers, etc).
  19. Frisbee football.
  20. Badminton.
  21. Sidewalk chalk.
  22. Chase your pup until someone captures a ball or toy in his/her mouth. Keep score.
  23. The time honored tire swing.
  24. Go on a hike. 
  25. Family yoga! Ommmmmmm.

Remember to try to pick activities that keep everyone moving as much as possible. Keep it fun!

If you do not have a family or live far from them, create your own family group by inviting friends, neighbors or coworkers to get outside and get active with you. And if all else fails, get outside yourself and enjoy some nature’s cure for self-care! 

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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When Self-Regulation Seems Near-Impossible: Borderline Personality Disorder

Nearly 75% of people diagnosed with BPD are women. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression. 

We all have mood swings, and some are more intense than others. As a therapist, I teach my clients how to self-regulate, or soothe, when a strong emotion washes over them; I have to practice those same techniques when I feel an especially heavy emotion. Although many of us are able to regulate our thoughts and emotions with practice, others struggle with it. The diagnosis of Borderline Personality Disorder may shed light for those struggling in this area. My wish is that by introducing this disorder, I may bring hope to those who want to understand and correct the cycles they find themselves stuck in.

Borderline Personality Disorder (BPD) is a condition characterized by difficulty regulating emotions. People who experience BPD feel intense emotions for extended periods of time, which makes it difficult to return to a stable baseline. Ordinarily, people can tolerate the ambivalence of experiencing two contradictory states at one time. People with BPD, however, feel emotions so strongly that they cannot see past whatever they are currently feeling. If they are in a bad state, for example, they have no awareness of the good state. They view things in extremes–all good or all bad. This includes their opinions of other people; an individual who is seen as a good friend one day may be considered an enemy the next. This unpredictable pendulum of emotions affects how they see everything, including themselves and their role in the world, resulting in impulsivity, insecurity, changing interests and values, and self-image issues. Difficulties with self-regulation can also result in dangerous behaviors such as self-harm and suicidal thoughts and behaviors.  

Listed below are the symptoms of borderline personality disorder. While this list is fairly comprehensive, it is important to remember that not everyone with BPD experiences every symptom. Some individuals experience only a few symptoms, while others have many. And these symptoms can be triggered by seemingly ordinary events and then be otherwise dormant.

  • An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection
  • Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”).
  • Distorted and unstable self-image.
  • Risky and impulsive behaviors (excessive spending, unsafe sex, substance abuse or reckless driving).
  • Self-harming behavior (including suicidal threats or attempts, often in response to fear of separation or rejection).
  • Long periods of intense depressed mood, irritability or anxiety.
  • Chronic feelings of boredom or emptiness.
  • Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings (severe cases of stress can also lead to brief psychotic episodes).
  • Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety
  • Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights

The causes of BPD are not entirely understood, though scientists believe that this disorder is caused by a combination of factors. First, genetics: although no specific gene has yet been directly linked to this disorder, research has found that people who have a close family member with BPD are at higher risk of developing the disorder themselves.  Secondly, environmental factors like abuse or parental separation from a parent during childhood. Third, the neurological makeup is different in individuals with BPD than those without–particularly the parts of the brain which control emotions and decision making. This disorder commonly makes itself manifest by early adulthood.

Borderline personality disorder does not have to dictate your quality of life. Only 20% of the most serious cases necessitate psychiatric hospitalization and the vast majority of those stabilize and lead productive lives after their hospitalization. Please do not get discouraged if you have been diagnosed with BPD; you can learn to live a satisfying life with rewarding relationships. Help is available. Recovery options include therapy, medications, and group, peer and family support. The ultimate goal is for a person with BPD to self-direct their own treatment plan and to learn to regulate their emotions. Contact me to today to get started on the road to healing and recovery.

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

Resources:

The Link Between Insomnia and Mental Illness

“I’ve always envied people who sleep easily. Their brains must be cleaner, the floorboards of the skull well swept, all the little monsters closed up in a steamer trunk at the foot of the bed.”  ~ David Benioff (co-creator of Game of Thrones)

Surely you have experienced a poor night’s sleep. You wake up feeling unrested, groggy, like you got hit by a train… And the fun lasts throughout the day with slow reflexes, foggy brain, inability to concentrate, impatience, stress, worry, anxiety and even headaches. It is absolutely no surprise that sleep quality has a direct impact on your physical and mental health. Today I am going to highlight the connection between insomnia and mental illness, in hopes that those experiencing it can get the help they deserve.

Insomnia is defined as the inability to get the necessary amount of sleep to function efficiently during the daytime. It is a sleep disorder that is characterized by difficulty falling asleep, waking up often throughout the night, having trouble going back to sleep, and waking up too early in the morning. In essence, insomnia results in feeling tired upon waking. Understandably, said fatigue can lead to difficulties functioning during the daytime and have unpleasant effects on work, social and family life. 

You likely already knew all of that about insomnia. But what you may be unaware of is that insomnia can be indicative of more serious issues, including medical issues like sleep apnea, or even mental illnesses like anxiety, depression, schizophrenia, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Sleep issues can even be a sign of an impending condition such as bipolar disorder. Many existing medical and mental health conditions can be worsened by sleep-related problems because lack of sleep slows recovery from mental illness. People with depression who continue to experience insomnia, for instance, are less likely to respond to treatment for depression. They are also at greater risk of relapse than those without sleeping problems.

Many people do not know there is an undeniable link between insomnia and mental health issues. More than fifty percent of insomnia cases are related to depression, anxiety or psychological stress, and many anxiety disorders are associated with difficulty sleeping. For instance, obsessive-compulsive disorder (OCD) is frequently associated with poor sleep. Panic attacks during sleep may suggest a panic disorder. Poor sleep resulting from nightmares may be associated with post-traumatic stress disorder (PTSD). The severity of sleep issues can determine the type of mental illness a person my experience. For example, early morning wakefulness, low energy, inability to concentrate, sadness and a change in appetite or weight can be indicative of depression. A sudden dramatic decrease in sleep accompanied by an increase in energy (or the lack of need for sleep) may be a sign of mania

Poor sleep patterns can not only be indicative of mental health issues, but it can also significantly worsen them. Insomnia makes it difficult to process and react to appropriately to negative emotions. Severe sleep problems can decrease the effectiveness of certain treatments. Treatment of sleep disorders has also been studied in relationship to schizophrenia, ADHD and other mental illnesses. All of the scientific data shows the connection between medical and mental illnesses: good sleep is necessary for recovery—or prevention—in both types of conditions.

There was a research trial done where fifty-one percent of individuals who overcame depression after psychological treatment (therapy) or medication were still experiencing insomnia. Insomnia tends to persist unless it is directly targeted for treatment. Insomnia can either be short-term or long-term; short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks. This is when you need to be examined by a physician with a potential referral to a sleep disorder specialist (a psychiatrist, neurologist or pulmonologist who have expertise in sleep disorders) for assistance. A balanced diet, regular exercise, meditation and relaxation, good sleeping habits, herbal remedies, medication and therapy are powerful actions that can help relieve insomnia. 

Living with insomnia is hard. The constant exhaustion and inability to sleep is an ailment which may require medical attention to overcome. Remember that insomnia often comes paired with a mental illness. Only as you work through both ailments will you find lasting relief. But it is doable, and I am here to help! Please do not hesitate to 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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When Stealing Is a Compulsion, Not a Choice

“A kleptomaniac is a person who helps himself because he can’t help himself.” ~ Henry Morgan

Although kleptomania is a relatively rare mental illness–affecting 6 in 1000 or 1.2 million Americans–you have likely heard someone referred to as a “klepto.”  An example of a public figure, who is thought to struggle with kleptomania, is Winona Ryder, one of the lead actresses from Stranger Things. She was caught stealing over $5,000 worth of designer clothes from Saks Fifth Avenue in 2001.

Kleptomania is a mental health disorder summarized as the recurrent inability to resist urges to steal. Very rarely do kleptomaniacs steal items of great worth; more often than not, they steal items that they do not need, that they could afford to buy, and that have little to no monetary value…like a keychain.  People affected by kleptomania do not compulsively steal for personal gain, on a dare, for revenge or out of rebellion; they steal simply because the urge is so powerful that they cannot resist it. Such episodes nearly always occur spontaneously, with little to no premeditation or forethought. Kleptomaniacs tend to steal from public places like stores and supermarkets. Some may even steal from friends or acquaintances. The stolen items are either stashed away, never to be used, or potentially donated, given away to family or friends, or even secretly returned to the place from which they were stolen. Kleptomania can cause much emotional pain to you and your loved ones if not treated.

Kleptomania vs. Stealing

Kleptomania is different from flat-out stealing. Ordinary theft (regardless of whether it is planned or impulsive) is deliberate and motivated by the usefulness of an object or its monetary worth. Kleptomania, on the other hand, is the recurring impulse to steal items even though said items are not needed for personal use or monetary value. Often a sense of entitlement comes with stealing, a feeling of “I deserve this”. Stealing is driven by need or want; kleptomania is a compulsion. 

Causes

The causes of kleptomania are unknown. Some scientists believe that kleptomania is part of an alcohol or substance addiction. Some think it is due to an imbalance of the brain chemical, serotonin–which helps regulate mood and emotions (low levels of serotonin are common in people prone to impulsive behaviors). Others consider it to be a deviation of an impulse control disorder like eating disorders or obsessive-compulsive disorder.  Although, in theory, anyone can have kleptomania, it seems its onset generally occurs in late adolescence or early adulthood among women. 

Symptoms

Signs of kleptomania are commonly misdiagnosed as everyday theft, but there are a few telltale symptoms and signs that accompany clinical kleptomania, such as the following:

  • Stress
  • Thoughts of intrusion
  • Powerful urges to steal items not needed
  • Inability to resist the compulsion to steal
  • Feeling pleasure, relief or gratification while stealing
  • Release of pressure following the theft
  • Feeling terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft
  • Return of the urges and a repetition of the kleptomania cycle

Effects

Aside from the emotional turmoil that would accompany dealing with the previously listed symptoms, the physical and social effects can include arrest, incarceration, being labeled a thief, developing substance abuse problems, being ostracised from loved ones, losing a job, having poor self-image, and even incurring a criminal record. Additionally, if left untreated, kleptomania can lead to other impulse-control disorders, alcohol/substance abuse, eating disorders, depression, anxiety, and even suicidal thoughts.

Kleptomania comes with a great deal of shame and guilt, as well as the potential for serious legal consequences. Uncontrollable stealing can prevent anyone battling kleptomania from living a productive life. This mood disorder is destructive to both the kleptomaniac and their loved ones, but the good news is that help is available. Although it cannot be cured, kleptomania can be managed with a combination of pharmaceutical and behavioral treatments. I am available to offer professional support to help you or your loved one live a fulfilling life, free from the grips of kleptomania. Please do not hesitate to contact me to today. Help is one click or call away!

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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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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