A daydreamer who started her professional journey as a Forex Consultant but eventually turned into a psychology and philosophy enthusiast as a result of becoming a victim of alexithymia.
Puberty is marked by sudden physical, psychological, social, and emotional changes a child goes through as he/she steps into adolescence. It is the time when both boys and girls mature sexually.
There are a lot of uneasy changes happening when children step into adolescence. And not all of them are physical. They are growing physically, psychologically, socially, and emotionally. And this is when puberty can become challenging for them.
According to G. Stanley Hall, a psychologist who is known as the founder of child and educational psychology, called Adolescence is the period of ‘Storm and Stress’. Where ‘Storm’ meant reduced self-control, ‘Stress’ referred to the increased levels of sensitivity.
Further, Storm and Stress are divided into the following three categories:
Parent-Child Conflict
Adolescents have the tendency to fight or go against authority for they go behind freedom and liberty.
Disruption of Mood
Biological changes like changes in hormones and cognitive stress during adolescence results in emotional changes. These are responsible for fluctuation in moods.
Risky Behavior
Both emotional immaturity and the neurological need for excitement compel adolescents to take up risky behaviors during this time.
Now, according to Stanley, these sudden and multiple changes during puberty become challenging to manage for adolescents. And that is why they go through Storm and Stress.
And in many cases, these pubertal complexities can result in adolescents showing signs of teenage depression.
Why Does Depression Increase During Puberty?
As per research studies, the rate of occurrence of depression is equal both in both girls and boys before puberty. However, girls are close to two times more likely than boys to experience depression after the onset of puberty.
Puberty is a phase where adolescents experience various complexities. These complexities become difficult to handle or manage since they happen early on in life. And that is why these may result in teenage depression and other psychological disorders in adolescents.
Let’s have a look at the various factors that increase depression during puberty.
The Sudden and Multiple Pubertal Changes
Puberty is a phase that is marked by sudden, massive changes responsible for unstable behaviors, attitudes, and mood swings in children turning into adolescents.
It is typical for parents to take the normal changes due to puberty as a mental illness in teens. This is because it is challenging to tell when these changes are normal and when they take the shape of a mental illness.
Let’s first have a look at some of the important changes children go through during puberty.
1. Physical Changes
These are the most visible changes and are thus easy to spot. Both girls and boys go through various bodily changes during puberty. These are as follows:
Girls go through bodily changes like:
hair growth under armpits and in the pubic region
developing of breasts
the onset of the menstrual cycle with an increase in height
On the other hand, boys witness physical changes like:
hair growth under armpits and in the pubic area
the growing size of the testicles and penis
deepening of the voice, facial hair growth, and muscle growth with an increase in height (in boys) gets difficult to accept.
Now, when the children develop physically, there’s a change in the way they think about themselves and how people connect with them socially. In many cases, children find it difficult to accept sudden bodily changes. They feel uneasy and awkward. This increases the chances of exposing them to teenage depression.
2. Changes in Social Outlook
Likewise, puberty is also the time when a transition from childhood to adolescence is marked by a changing social outlook. Early adolescence is a tough time where focus shifts from parental relationships to peer relationships.
Adolescents give more importance to their relationships with peers or friends and how well are they accepted by others. They seek independence from their parents and increasingly depend on close friendships.
They start valuing social relationships more and show increased dependence on friends and romantic partners. Initially, friends and parents are equally important. However, friends and romantic partners become more important than parents eventually as they reach the end of puberty. And this is where fear of rejection, peer conflict, social pressure, and relationship issues come in.
Teens seek acceptance, popularity, and are conscious of their social status. Not being able to meet these needs can cause issues of self-esteem, worthlessness, excessive guilt, and in extreme cases self-harm. Thus, it is important to keep track of changes in moods, behaviors, and attitudes which are unavoidable due to the changing social landscape.
3. Hormonal Changes
Much like the physical changes, there is a sudden spike in hormone production in teens. The pituitary gland releases hormones that guide the body to increase the production of sex hormones like progesterone and estrogen in the case of girls and testosterone in the case of boys.
This increased production of hormones during puberty is responsible for developing secondary sex characteristics in both boys and girls. It is responsible for mood fluctuations that can, in some cases, result in symptoms of depression.
There are studies that reveal that gonadal steroids progesterone and estrogen impact the brain regions that regulate mood and behavior.
Further, social pressures, early maturing in the case of girls, and the fear of fitting in hold the potential for causing depression during puberty.
4. Neurological Changes
These refer to the neurological needs that adolescents have of excitement or stimulation. Neurological connections speedily come together that compel adolescents to indulge in risky behaviors.
This may prove devastating both for the child and the people around.
Additionally, there are a lot of other factors apart from these physical, emotional, and biological changes that increase complexities during puberty. These may further increase the likelihood of teenage depression.
Pubertal Status and Pubertal Timing
Both Pubertal Status and Pubertal Timing are the two most researched factors that are said to affect the psychological adjustments of adolescents.
Pubertal Status
Pubertal Status is the existing level of development that the adolescent goes through against the total overall pubertal change that typically takes place. That is to what degree is the adolescent currently experiencing the change as compared to the overall changes that take place during puberty.
Therefore, Pubertal Status lets you know at what stage of physical development is the adolescent at present or at a given point in time.
Now, Pubertal Status is critical as it involves a comparison of signs of physical maturation. For example, one is able to define the degree of physical growth via the development of physical aspects like:
breast growth
facial hair
deepening of voice
hair growth in the pubic region and armpits
increased size of male sex organ
increased height and weight
These physical changes not only invite responses from parents, friends, and others. They also lead to responses from the adolescent experiencing such changes himself.
For example, increased weight results in advanced pubertal status in the case of girls. This may lead to body image issues that can trigger depression symptoms and self-esteem issues in them.
However, mature Pubertal Status is a good predictor of depression in the case of girls relative to boys.
Pubertal Timing
Pubertal timing refers to the level of an adolescent’s development as compared to his/her peers. Therefore, early, on-time or late development of an adolescent relative to his/her peers can also lead to maladjustment issues in adolescents.
In fact, pubertal timing contributes much more to the pubertal maladjustment issues in contrast to the pubertal status in the case of both girls and boys. It results in sad moods in both males and females. Also, the timing of menarche (or period) in the case of females always contributes to depressive symptoms in them when compared to pubertal status.
Further, when we talk about pubertal timing, we refer to both the physical and psychological development involved in puberty. This is because it includes an adolescent comparing his/her physical development with both social and regular standards. Thus, pubertal timing is actually one of the important factors that indicate whether an adolescent will face adjustment issues or not. That is why it is an important predictor of an adolescent’s overall welfare as compared to the pubertal status.
There are studies that indicate that before time or late development puts the adolescents at the risk of mental issues like anxiety, depression, aggression, and criminality.
However, there are other studies that only hold that before time or early maturation only results in problem behaviors in adolescents. For instance, early maturing girls were found to indulge in increased smoking and sexual activities.
Menarche in the Case of Girls
Apart from the degree of development and pubertal timing, one of the important factors to take into account is menarche. Menarche, or the onset of menstruation, is the last phase in puberty. Thus, the age at which the girl experiences the first occurrence of menstruation also influences the development of depression symptoms in girls.
Thus, puberty is an extremely tight time for both males and females as it leads to a bunch of changes. The changing social relationships defining deeper bonds with peers over authority figures and increased consciousness of social status expose adolescents to social stressors that may result in depression symtoms.
As peer acceptance becomes extremely important, adolescents fear peer rejection and interpersonal issues. Interpersonal issues with peers result in the development of internalizing symptoms in females. These include anxiety, sadness, loneliness, etc.
Also, rejection sensitivity or an expectation of being rejected by peers is also responsible for increased mental issues in the case of adolescents.
Accordingly, females who are sensitive to rejection are more likely to have peer conflict and issues with their relationships. Therefore, the increased probability of being liked by peers makes adolescents less sensitive to rejection.
Signs of Depression
As mentioned earlier, puberty is a difficult time for both males and females. Various physical, biological, and emotional changes may result in a sad mood, rumination, and even self-harm.
Therefore, it is important for parents, caregivers, and other authority figures to know various signs of depression in teenagers. This will help them to identify the depression symtoms and seek the right help for the children at the right time.
irritable mood
losing interest in activities that earlier interested the adolescent
significant weight loss or gain
excessive sleep or difficulty in sleeping
feelings of excessive worthlessness or guilt
loss of energy
difficulty in focusing or concentrating
the threat of losing a loved one (mostly parents)
self-esteem issues
avoiding school
poor performance in academics
risky behaviors like drug abuse
thoughts of self-harming oneself
Depression Treatment: What Helps in Overcoming Teenage Depression?
Depression in teenagers can be treated by anti-depressants, psychotherapeutic intervention, or a combination of both.
Anti-depressants
Anti-depressants are recommended by mental health professionals as an initial treatment for mild, moderate, and severe cases of depression. Various anti-depressants are suggested considering the person’s inquisition and various side-effects linked with the medication. Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line anti-depressants commonly used to treat depression.
Psychotherapeutic Interventions
Apart from anti-depressants, mental health professionals also recommend various psychotherapeutic interventions for treating depression in teenagers. Some of the commonly used psychotherapies include:
You may experience Posttraumatic Stress Disorder (PTSD) if you have been through a trauma. Trauma includes dangerous events that you have been through which may include combat, assault, physical or sexual abuse, natural disasters, or serious accidents. If your reaction to these shocking events does not fade away with time, chances are you have PTSD.
As per the Anxiety and Depression Association of America (ADAA), more than 8 million Americans between the ages of 18 years and above suffer from PTSD. In some cases, PTSD complicates as the impact of the traumatic event may leave you anxious for years. As a result, you may have questions like is PTSD hard to treat or how to treat PTSD?
Now, it is common for people to go through traumatic events and have intrusive memories of the event for years. And the trauma survivors who suffer from PTSD face issues like difficulty in trusting others, problems in communication, and problem-solving. These issues impact theory relationships with family and friends.
Further, women are two times more likely to suffer from PTSD than men. Likewise, children, too, are at the risk of experiencing PTSD post a traumatic event.
In this article, we will discuss what is PTSD, is PTSD a mental illness or disorder, PTSD symptoms, and treatment.
What is PTSD?
PTSD is a mental disorder that you may suffer after going through a traumatic or life-threatening event. These events could include combat, assault, physical and sexual abuse, a natural disaster, or a car accident. It is marked by emotional reactions to such life-threatening events that do not go away with time. The emotional reactions may include fear, hopelessness, and horror.
As a result, you may have intrusive memories of the traumatic event or flashbacks. Or lose interest in things that earlier used to give you pleasure. Similarly, you would find yourself feeling detached from your mind and body or you may feel the world around as unreal.
Is PTSD a Mental Illness or Disorder?
Yes, PTSD is a serious mental illness that makes you weak and occurs if you have experienced trauma. It is quite common to have memories that upset you post experiencing a traumatic event. Initially, you may find it challenging to carry out your routine chores like going to work, being with loved ones, having issues with sleeping, etc.
Many people start feeling better a few months after the traumatic episode. However, if these issues continue to show longer than a few months, there are higher chances that you may have PTSD. For instance, you may find yourself dealing with the memories of the traumatic event by trying hard to avoid it. Likewise, the anniversary of the traumatic event may make you upset or show severe stigma of mental issues.
Also, you may feel irritated, show anger, feel helpless, and upset as a result of the combat you had years before if you served during wartime.
But the good thing is that PTSD diagnosis and necessary treatment can treat this mental health issue.
What are PTSD Symptoms?
The mental health professionals check for symptoms for PTSD diagnosis. As per DSM-5 criteria, the following are the PTSD symptoms that medical professionals check for in children younger than 6 years, children older than 6 years, adolescents, and adults.
The following PTSD symptoms apply to children older than 6 years, adolescents, and adults.
1. Trauma
Going through a traumatic event. This may include:
experiencing the trauma directly
seeing others experiencing a trauma
knowing about the traumatic event occurring to a loved one
exposing to the traumatic event details repeatedly
2. Intrusive Symptoms Related to Trauma
Showing one or more of the following intrusive symptoms related to the traumatic event
repeated, intrusive memories of trauma
repeated dreams whose content relates to trauma
dissociative reactions such as flashbacks
excessive psychological distress when exposed to internal or external triggers that remind of trauma
physiological changes when exposed to internal or external triggers that remind of the traumatic event
3. Avoiding Triggers
Avoiding the triggers continuously, to get rid of distressing memories or people, places, etc, that give rise to distressing feelings.
Negative changes in thought process and mood
Changes in the reaction linked to the traumatic event
The above-mentioned disturbances last for more than a month which impairs important areas of functioning.
In addition to the above symptoms for PTSD, the individual also suffers from either depersonalization or derealization in response to stressors. Depersonalization refers to continuous experiences of feeling detached from one’s body, feeling as if you’re in a dream. Likewise, derealization refers to continuous experiences of the unreality of the surrounding environment.
Further, you can even self-screen or your family member for PTSD. If you have been feeling worried about a host of events in your routine life, take our PTSD online self-assessment. This will help you understand your PTSD symptoms and see if you need professional help.
Is PTSD Curable?
PTSD is a complex and difficult psychophysiological and psychosocial disorder to treat. There may not be any specific cure for PTSD, but there are treatments that help in reducing the PTSD symptoms.
These include therapies and medications that help the individuals in reducing or even getting rid of the PTSD symptoms.
Why is PTSD Hard to Treat?
There are a number of factors that make PTSD complex and hard to treat.
People suffering from PTSD experience a host of posttraumatic reactions which persist long after the happening of the traumatic event.
They experience intrusive and repeated memories of trauma, avoid trauma-related stimuli, go through negative changes in cognitions and moods linked to trauma, and changes in reactivity. This makes things challenging for them.
Further, PTSD may be mild in nature or extremely devastating. In fact, it can even expose individuals to retraumatization or revictimization.
Apart from this, some people suffering from PTSD also have the risk of comorbidities. These may include anxiety, depression, substance abuse, personality and dissociative disorders, higher risk of suicide or self-injury.
Such factors may result in psychosocial consequences like poverty or homelessness.
Thus, all these factors make PTSD difficult to treat. That’s why the American Psychological Association has come up with certain guidelines in respect of treatments that are effective for PTSD.
How is PTSD Usually Treated?
PTSD is a complex mental issue and thus needs a professional who is an expert in treating PTSD. One of the major PTSD treatments includes short-term psychotherapies. However, each PTSD patient undergoes different treatments. This is because each patient may show different PTSD symptoms.
Accordingly, a treatment that may have worked for someone else may not work for you. Thus, the mental health professional specializing in PTSD treatment would look at the symptoms faced by you and then suggest the necessary treatment.
What is the Most Effective Treatment for PTSD?
The APA specifies various treatment interventions that clinicians adopt considering their practice. Such interventions are evidence-based that help patients in decision-making.
The following section answers the question ‘What are the best practices for trauma treatment’. Typically, clinicians recommend four interventions to treat PTSD. Further, the interventions are variants of Cognitive Behavioral Therapy (CBT).
1. Cognitive Behavioral Therapy (CBT)
CBT is one of the best therapies that is used for PTSD treatment. This is considered to be the most effective short-term as well as the long-term treatment for treating PTSD. It is a therapy that concentrates on the link between thoughts, behaviors, and feelings and observes how alterations in one area can enhance the functioning in other areas.
Cognitive psychotherapy concentrates on solving the individual’s present problems. It is an approach that alters an individual’s dysfunctional behavior and thought process.
How CBT Helps People With PTSD?
There exist a host of theories related to trauma that explain how CBT helps people in improving PTSD symptoms.
I. Emotional Processing Theory
As per this theory, people who experience a traumatic event build connections. They build such connections among the meaning, responses, and things that serve as reminders of the trauma.
For instance, they may relate certain people or instances with trauma (reminder), draw the meaning that the world is an unsafe place, and go through feelings of fear (response).
In CBT, the therapists help patients in identifying these connections. This is done to change such associations which result in impaired functioning of the patients.
II. Social Cognitive Theory
As per this theory, there are people who attempt to integrate the traumatic experience into current beliefs about themselves, others, and the world. This is what leads them to misunderstand their experiences and their understanding of regulating themselves and the world around them.
For example, say someone believes in the fact that you are your karma and experiences sexual abuse. Such a person may think that it is due to one of her bad karma’s that she faced this traumatic event of sexual abuse. Whereas, she should instead understand this episode as a pure act of violence on the act of the person who did this to her.
How is CBT Used to Treat PTSD?
CBT therapists use a variety of techniques to enable patients to reduce PTSD symptoms and improve overall functioning. They help patients to re-think their thought patterns so as to recognize unreasonable thoughts or distortions. These may include negative thoughts that kill the positive ones, over-exaggerated outcomes, over-generalizing bad outcomes, etc. The intention is to help patients develop a more effective thought pattern.
This helps individuals to re-understand their traumatic experiences together with their awareness about themselves and their potential to deal with PTSD.
Thus, CBT helps an individual to understand the way he or she construes his problem. Further, it also enables the individual to know how such perceptions would impact his/her emotions.
CBT involves a therapist and the patient working together. In the CBT session, the therapist helps the patient identify automatic thoughts that occur to the patient. These are thoughts that occur to the patient spontaneously and that take the patient away from reality.
Thus, such thoughts interfere with the patient’s routine functioning and that is why the therapist helps the patient to analyze in a conscious way.
How Therapist Helps the Patient?
Likewise, the CBT therapist helps the patient to:
recognize his emotions
differentiate between negative thoughts and emotions
label his emotions
quantify the degree of emotions they are experiencing
understand the degree of emotions he is currently facing
analyzing his automatic thoughts
identify how he will respond to the automatic thoughts
Therefore, the therapist exposes the patient to the trauma reminders, feelings, and the trauma account. This is to help the patient lessen the negative connections with the traumatic experience.
Now, all of this is undertaken slowly, in a regulated way where both the therapist and the patient work together.
The intention is to help the patient learn skills like self-control, self-confidence, and reducing maladaptive behaviors.
Thus, the skills learned during the CBT sessions are practiced repeatedly which helps in improving PTSD symptoms. Typically, the CBT treatments last for 12-16 weeks.
2. Cognitive Processing Therapy (CPT)
CPT is also a type of cognitive-behavioral therapy that has proven to be effective in lessening PTSD symptoms. These symptoms could be the result of traumatic events like child abuse, sexual or physical assault, natural disaster, military combat, etc.
This therapy helps patients to question and change the illogical thoughts associated with the traumatic event. CPT generally undertakes over 12 sessions which help the patient to challenge his thought pattern and develop a new and improved understanding of the traumatic episode.
Such a change helps in reduce the impairment caused due to unreasonable thoughts in respect of trauma in routine functioning.
How is CPT Used to Treat PTSD?
1. Psychoeducation
The first thing that the therapist undertakes is of psychoeducation in respect of PTSD, its symptoms, associated thoughts, and emotions. In this, the patient becomes increasingly aware of the thoughts and emotions and the connection between them. This helps him to identify the automatic thoughts that are responsible for sustaining PTSD symptoms.
2. Writing the Traumatic Event
In addition to this, the patient is asked to pen down a statement that reveals the impact the traumatic event had on him/her. This statement details the patient’s present understanding of the trauma, why it took place, and the influence it had on the beliefs about oneself, others, and the world around them.
3. Socratic Questioning for Challenging Illogical Thoughts
Socratic questioning involves the therapist asking questions that help the patients to direct their thoughts and behavior toward goals that help them alter their thinking. These questions are not instructional in nature. Instead, they are such that they help the patients build new perspectives.
These questions enable the patients to challenge their negative thoughts about the traumatic event. Lately, once the patients learn these skills of recognizing and questioning unreasonable thoughts, they use these skills repeatedly. This enables them to analyze and alter their unreasonable beliefs in respect of the traumatic event.
At this stage, the therapists attempt to help the patients learn and practice these skills outside therapy sessions. And this is what helps in improving the overall functioning of the individuals.
In addition to this, CPT can be undertaken both through individual and group sessions. Also, therapists give practice assignments that are to be done outside the session.
4. Cognitive Therapy (CT)
Cognitive Therapy is a technique that is acquired from CBT. As per this theory, an individual is bound to show PTSD symptoms if he processes the traumatic event in a manner that results in he/she feeling severe threat.
This is the result of excessive negative analysis of the traumatic event or some issues in one’s memory of the traumatic event. In this, the individual tends to relive some part of trauma in an unregulated way. This results in unreasonable behavior and cognitive coping responses.
How is CT Used to Treat PTSD?
CT too focuses on changing the negative analysis and memories linked to trauma. The intent is to break the thought patterns that impair the individual’s routine functioning.
CT, much like CBT, is offered in weekly sessions over a period of three months in the form of individual or group sessions.
1. Identifying Negative Triggers
The first step involves the therapist recognizing negative memories, analyses, and triggers linked to trauma. This is because it is these negative associations that result in sustaining PTSD symptoms.
Once the negative evaluations are identified, the therapist helps the patient to understand the meaning of his/her traumatic memories. In addition to this, the therapist also explains how the patient is understanding them at present. He also explains that negative evaluations of trauma may result in increased feelings of threat.
Here too, the therapist uses Socratic questioning to help the patient alter his evaluation of trauma.
2. Incorporating Modified Evaluation With Trauma
The altered evaluation is now incorporated with trauma memories. This is achieved through the patient’s writing and thinking about the new, improved evaluation as he thinks about the trauma memory.
Alternatively, the new analysis is incorporated by the patient reliving the trauma in his imagination with this new evaluation in mind.
Similarly, the therapist guides the patient to develop a new, meaningful account of the traumatic experience. This is achieved through various means. For instance, the patient can either write the account of the traumatic experience, relive the trauma in his imagination, or visit the same location again where the traumatic event took place.
No doubt the patient here is exposed to the aspects of trauma. However, the aim here is to see particular trauma-related memories that trigger certain responses.
This is done so that the therapist can use cognitive restructuring to help the patients to question the unreasonable thinking connected to trauma.
3. Alter Behaviors to Reduce PTSD Symptoms
Lastly, the therapist helps the patient to prevent behaviors and thought processes that may reduce the current threat. However, it may let PTSD symptoms persist in the long run.
Thus, both the patient and the therapist work together on issues like suppressing thoughts, rumination, and behaviors that seek safety. Thus, the therapist makes the patient realize that these are unhelpful strategies and avoid these to reduce PTSD symptoms.
5. Prolonged Exposure (PE)
This is a strategy that is used by therapists to help patients face their fears. PE is a type of CBT that guides patients to approach memories, emotions, and circumstances related to trauma slowly.
Typically, people try to avoid everything that triggers them to remember the traumatic experience they have gone through. However, preventing these cues only adds to fear. However, if the patient faces what he’s trying to avoid, it increases the chances of reducing PTSD symptoms. This is because facing what they have been avoiding helps them to learn that trauma-related triggers are not risky.
How is PE Used to Treat PTSD?
In this, the therapist begins by giving the patient an outline of the treatment and knowing the patient’s prior experiences. They then continue educating the patient about PTSD and its treatment and teach breathing exercises to the patients to deal with anxiety.
The therapist then initiates the exposure after making an assessment and taking the first session. Now, many patients get anxiety-ridden going through the process. That’s why the therapist makes sure that the patients find this therapy relationship to be safe. This is to allow the patients to face even the scariest of the stimuli during the therapy session.
The following types of exposures are used with the speed of the exposure adjusted as per the comfort of the patient.
1. Imaginal Exposure
In this, the patient describes the traumatic event during the therapy session. Thus, both the therapist and the patient come together to understand the emotions that come out as a result of describing the event in detail.
Further, the session is even recorded. This is to make the patient listen to the audio for processing the emotions and practicing breathing techniques.
2. In vivo Exposure
These are therapy sessions where the patient is asked to face the traumatic triggers outside the session. Typically, the therapist and the patient together work on recognizing the events, places, persons that act as triggers.
Then, both the patient and the therapist work out the triggers that the patient needs to face. These are typically experienced by the patient in between the therapy sessions. Thus, the therapist motivates the patient to face these triggers gradually. This enables the patient to experience some success in facing these triggers and helps him to deal with them.
Apart from the above treatments that are highly recommended, there are treatments that are recommended on the basis of certain conditions. These include:
6. Brief Eclectic Psychotherapy (BEP)
BEP is a technique that combines some components of CBT with the psychodynamic approach. Here, the focus is on altering the feelings of shame and guilt and the relationship shared by the patient and the therapist.
This is a 16-session approach where the patient is asked to narrate the traumatic event. They are then taught breathing techniques for relaxation that help them to concentrate Further, the patient is also asked to write a letter to the person whom he blames to be responsible for the event.
Next, the therapist and the patient together review the progress made during the therapy and make changes accordingly. The patient is guided on how the event has impacted him and what things he can learn from the same.
In the last session, the therapist devises a relapse plan and the patient identifies that trauma once ruled over him. He understands that PTSD and its symptoms are now things of the past.
7. EMDR Therapy
Eye Movement Desensitization and Reprocessing Therapy (EMDR) is a technique that is divided into various stages. In this, the patient is motivated to focus on the trauma memory and at the same time made to experience eye movements.
The various stages of this therapy include:
knowing the trauma history
preparing the client
evaluating the trauma memory
desensitizing where the client focuses on the memory with eye movements. The therapist then reports these eye movements to the patient.
helping clients understand the physical symptoms they go through as they think over trauma
reevaluating in which the therapist looks at the current psychological position of the client and sees how therapy sessions have helped the patient. The therapist also identifies aspects that still need improvement.
8. NET
Narrative Exposure Therapy (NET) is a type of treatment that focuses on the patient narrating his traumatic experience. This includes describing in detail his emotions, thoughts, sensory information, and physical responses.
This way, NET helps the patient in creating a complete biography or account of what happened to him. NET is based on the understanding that a person’s narrative of the trauma that he describes or tells himself impacts the way he thinks about his experiences and overall well-being. The patient receives the documented autobiography towards the end of the session which is created by the therapist.
This narrative helps the patient to appreciate his human rights and regain his self-respect.
9. Medications
One of the typical questions in respect of PTSD treatment is “what is the best medication for PTSD? Well, SSRIs and SNRIs are commonly recommended PTSD treatment medications by doctors.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Sertraline, paroxetine, and fluoxetine are the commonly recommended SSRIs for treating PTSD. These are the first class of medication used in PTSD treatment. Further, only sertraline and paroxetine are the SSRIs approved by the FDA.
Venlafaxine is the SNRI that is recommended conditionally for treating PTSD.
Can PTSD Be Cured Without Medication?
As stated earlier, therapies like EMDR can help people reduce PTSD symptoms without medication. PTSD treatment medication comes under conditional treatment for PTSD.
This means that the psychotherapies and medications that come under conditional treatment may show favorable results. However, there isn’t enough strong proof for their success in reducing PTSD symptoms as the highly recommended methods like EMDR, CBT, etc.
Further, these medications also come with side effects and they aren’t able to maintain the balance between the benefits offered and adverse effects.
Apart from the highly recommended psychotherapies, people are able to deal with PTSD symptoms with other treatments. These include neurofeedback, vagus nerve stimulation, gratitude journal, and others.
Complex PTSD Treatment
Complex PTSD is a mental condition closely associated with PTSD. It is a mental disorder that occurs as a result of traumatic events being faced repeatedly over days or months. This is unlike PTSD which results from a single traumatic event being faced by an individual.
The common symptoms of PTSD include:
patient not being able to control his feelings
negative view of self
finding difficulty in managing relationships
thinking about the abuser and having feelings of revenge
dissociating with one’s emotions or forgetting the traumatic event
losing faith in things you once believed and having a negative view of the world
Accordingly, complex PTSD is treated using a mix of psychotherapy and medications. CBT and EMDR are the commonly used psychotherapies to treat PTSD.
Similarly, commonly used SSRIs or antidepressants for treating PTSD include sertraline, paroxetine, and fluoxetine.
1. What are the 5 Signs of PTSD?
The 5 major signs of PTSD include experiencing a traumatic event, showing intrusive symptoms like repeated trauma memories, flashbacks, psychological distress, etc, avoiding triggers, negative changes in mood and thought, and changes in reaction associated with the traumatic event.
2. What are the 5 Stages of PTSD?
There are five stages of PTSD. These include:
Impact Stage This is the first stage that follows immediately after the individual experiences trauma. At this stage, the individual is trying hard to deal with what he has been through. Denial Stage Not everyone goes through this stage. But, there are people suffering from PTSD who use denial to avoid experiencing PTSD symptoms. By avoiding complex emotions, one tries to protect himself from experiencing pain. It tries to do away with the stress linked to trauma. This is where a mental health professional can help them to deal with pain in place of avoiding it. Rescue Stage In this stage, the individual begins to accept the traumatic event he has been through. Thus, the person may visit or visit places that were part of the traumatic event. This stage makes the person go through feelings of confusion, denial, sadness, etc. Intermediate Stage Also called the short-term recovery stage, the person begins to return back to normal. This takes place after the person has met his survival needs. They begin to understand how PTSD has impacted them. This understanding further paves the way for things they can do to deal with PTSD symptoms. Recovery Stage This is a stage when the person initiates working out and executing the recovery plan. One learns how to cope with PTSD symptoms and utilizes these newly learned skills in routine life. This stage may stretch for a longer period as many people go back when they encounter triggers. Thus, it is very important for the p[erson to execute the coping strategies and skills learned. This is because it will help him deal with PTSD and deal with life.
3. What are 3 treatments for PTSD?
As stated earlier, there are a host of psychotherapies and medications used for treating PTSD symptoms. Some people are treated using only psychotherapies like CBT, EMDR, etc. While others are given medications like SSRIs and SNRIs. However, a mix of psychotherapy and medication is used in many cases to treat PTSD symptoms.
Posttraumatic Stress Disorder (PTSD) is a disabling mental health issue for which a victim must consult a mental health professional. A traumatic life event such as military combat or losing a loved one may result in PTSD. Hence, a victim must get this treated. Different mental health professionals use various treatments like EMDR, PE, CBT, etc to cure PTSD. However, one of the major challenges that an individual faces is how to find a good therapist for PTSD?
Well, several credible sources help you find a good PTSD therapist or a mental health care provider. These sources help you find the best fit type of mental health professional.
The first few steps that you can take is to ask your family doctor for a referral. Similarly, you can even ask your friends or people close to your family for recommendations. And if you have health insurance coverage like Medicare or Medicaid, you should ask for a recommendation from your insurance provider.
This is because your insurance provider would give you a list of therapists to whom your insurance coverage may apply.
In this article, we will help you with several sources that you can refer to for locating a good PTSD therapist. Further, we’ll also help you with things that you should consider when looking for a PTSD therapist.
Note: Finding a PTSD therapist might take some time. This is because you need to think and evaluate how to locate the best-fit therapist. But if you are experiencing a crisis and need immediate help, here are some hotline numbers that you can dial to seek help.
National Domestic Violence/Child Abuse/Sexual Abuse: 1-800-799-SAFE
How Do I Find a Therapist for PTSD?
There are a host of ways through which you can locate a therapist for PTSD. Good PTSD therapists hail from different disciplines, have experience working in different settings, use a variety of treatment techniques, and have sound experience.
However, there are certain things that you must keep in mind while searching for a PTSD therapist.
Things to Remember
1. Medical Professional’s Education and Years of Experience
Since there are different types of mental health professionals, they have different areas of expertise, credentials, and experience. Thus, you must check their educational background, years of experience, credentials, and area of expertise before choosing a PTSD therapist.
2. Treatments Used for PTSD
Make sure you look for a mental therapist who concentrates on using evidence-based treatments for PTSD. These may include psychotherapies like Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and PTSD medications that include antidepressants like SSRIs and SNRIs.
3. Insurance and Fees
You should also consider the type of insurance your mental health care provider accepts. This will help you understand whether your mental health care provider will accept insurance coverage and to what extent. Also, it will help you know the amount you have to pay out of your pocket (in part or in full) and the overall cost of the treatment.
4. Different Types of Therapists
Many of us do not understand which mental health professional to consult, especially if we are first-timers. There are a variety of mental health care professionals who hold different credentials, licenses, educational degrees, and training. They can also offer different services based on their area of expertise. You can consider visiting one of the mental health care providers based on your need mentioned in the section below.
5. Validation of Feelings
The first step towards successful treatment is to open up about your issues, feelings, and experiences with the mental health professional. Therefore, seeking PTSD treatment would be of no use if you do not share comfort with your therapist. Now, there are several things you can consider here. For instance, whether you would want to meet the therapist in person or whether online therapy is more convenient for you. Similarly, you may consider the gender of the mental health professional as per your comfort.
Also, one-on-one therapy is one thing that works best for most individuals. This is because they feel safe disclosing trauma-related feelings. As a result, they share a trusting relationship with their therapist.
Thus, observe closely your therapist’s personal capabilities. These may include his intuition, perceptions, and the extent to which he can understand your unsaid things. You need to see if the therapist is really interested to hear your story and the issues you are facing. Check if you feel validated.
6. Check for Collaboration Between You and Your Therapist
Another important criterion for choosing a therapist is to see if he empowers you in place of forcing his treatment on you.
Thus, you and your therapist need to work together as partners. This involves sharing responsibility, expertise, as well as trauma-related perspective. The most important part of PTSD treatment is that both parties need to work together and participate actively. This is because the therapist may be an expert in his field. However, it is you, the PTSD survivor, who will tell him about what you feel and go through. Thus, check whether the therapist offers you things like respect, hope, connection, and information, which are the pillars of your healing relationship.
Once you are clear with the above things, the next step is to refer to the right sources that help you locate credible mental health care providers.
Finding a PTSD Therapist
You can adopt various means to locate a suitable mental health care provider.
1. Searching for PTSD Therapist Online
There are several credible online platforms that can help you find a mental health professional for PTSD treatment.
a) Anxiety and Depression Association of America (ADAA)
ADAA is an international non-profit organization that is a credible online resource for treating, preventing, and educating about mental health disorders. These include anxiety, depression, obsessive-compulsive, traumatic disorders.
ADAA has its own therapist directory that has listed licensed mental health care professionals. The mental health care providers include counselors, psychologists, psychiatrists, clinical social workers, and other professionals. These are specialists of mental disorders like anxiety, depression, PTSD, OCD, and other linked mental health issues. Further, all the specialists listed in the directory are professional members of ADAA. ADAA selects these specialists.
Note that ADDA itself is only an online platform that educates, lists mental health care providers, and provides mental health research. That is, it serves you with information that helps you reach credible mental health professionals and make informed decisions. It does not provide clinical treatment, advice, or care of its own.
b) American Psychological Association (APA)
APA is one of the principal scientific and professional organizations that represents psychology in the United States of America. Its members include doctoral-level psychologists who contribute in various sectors. These include research academics, schools, hospitals, prisons, and practitioners.
The APA psychologist locator helps you to find a licensed psychologist. All you need to do is simply fill in the name or the expertise of the health care professional and your city/state zip code.
These professionals specialize in treating various mental health issues. You can search for a mental health care provider based on several criteria. These include telemental health, treatments provided, languages spoken, insurance accepted, etc
c) EMDR International Association (EMDRIA)
EMDRIA is a professional organization that has professionals trained in EMDR therapy as its members. Apart from listing profiles of EMDR specialists, EMDRIA provides clinical information on EMDR therapy and numerous other resources for professionals.
Much like other platforms mentioned above, EMDRIA has an EMDR therapist directory. This contains a list of EMDR specialists registered on the platform with their details like name, specialty, language, contact details, etc.
Accordingly, you can search for an EMDR specialist based on parameters like name, location, specialty, language, insurance, population served, etc.
d) Substance Abuse and Mental Health Services Administration (SAMHSA)
SAMHSA is an association that comes under the US Department of Health and Human Services. This agency makes information, research, and services associated with substance abuse and mental disorders more easily available to people.
SAMHSA has its own therapist locator called Behavioral Health Treatment Services Locator. You can use various filters to narrow your search and find a therapist that is the best fit for your mental health issue. For instance, you can sort by city, zip code, facility name, facility address, phone number, state, county, distance, services provided, etc. The locator provides you with complete details of the mental care provider like name, address, contact details, website, services offered, etc.
e) International Society for Traumatic Stress Studies (ISTSS) Clinician Directory
ISTSS is a society that is devoted to providing information about the impact of trauma. It is a platform that shares research about policies and programs that help in reducing stressors that result in trauma. In addition to this, ISTSS provides a forum where researchers can share their research, strategies, and policy in respect of trauma. This platform brings psychologists, psychiatrists, counselors, nurses, social workers, etc together from around the world.
ISTSS has its own clinician directory which lists licensed mental health care providers. You can choose from various types of mental health care providers by applying various filters. These include zip or postal code, state, city, last name, specialty, gender, languages spoken, etc.
f) Sidran Institute Help Desk
Sidran Institute is a non-profit organization that enables people to understand, treat, and recover from traumatic stress including PTSD. It also helps people to know and deal with dissociative disorders and co-occurring issues like suicidality, addictions, self-injury, etc.
It is a community of people who are impacted by the effects of trauma. Accordingly, it includes adolescents, adults, mental health, crisis, public professionals, schools, support networks, and others.
Sidran Institute offers a Help Desk that helps you locate a mental health care professional near you, mental health care centers across the country, and organizations devoted to survivor groups.
g) Psychology Today
Psychology Today is one of the leading mental health online resources across the world. It has a ‘Find a Therapist’ locator that helps you to find a mental health professional that fits your needs. You can fill in the zip code, city, or name of the therapist in the search bar and apply various filters. These include teletherapy, treatment centers, support groups, etc.
2. Finding a PTSD Therapist Via Phone
Apart from these online platforms, you can also approach a mental care provider by phone. You can contact the professionals through the hotline numbers mentioned above.
In addition to these, you can check mental health services in the phone book. Similarly, you can look in the ‘County Government Offices’ section in the Government pages and search ‘Health Services (Dept. of)’ or ‘Department of Health Services. You’ll see ‘Behavioral Health’ or ‘Mental Health’ listed there.
Likewise, you also have mental health care providers in the yellow pages. These are listed under ‘behavioral health’ ‘psychologists’, ‘mental health’, etc.
3. Locating PTSD Therapist for Veterans
The mental health care needs of veterans including PTSD treatment are different from others. That’s why there are different sets of treatment choices available for them.
For instance, there are VA Medical Centers and various VA clinics that offer PTSD treatment and are under the U.S. Department of Veterans Affairs. This VA locator helps you find out mental health professionals for veterans using various criteria. These include your location, facility type, and service type.
Similarly, there are some special programs offered by VA centers for PTSD. You can go for the VA PTSD Program Locator to search for a VA PTSD program.
Then, there are VET centers that offer to counsel veterans and their families post-war. You can look for a VET center near you to seek such counseling.
To know more about treatment and programs available for veterans, check Help for Veterans.
What kind of Therapist Should I See for PTSD?
Typically, the terms ‘counselors’ or ‘therapists’ are terms that are generic and do not fall under any regulation. Therefore, these terms are typically used to refer to any kind of mental health care provider.
In fact, these terms can be used by anyone who is offering mental health treatment with no need for some specialized training.
Therefore, it is important to check the educational backgrounds of mental health care providers you get associated with. The following are the types of mental health care professionals you can approach for PTSD treatment.
1. Psychologists
We consider people who are Ph.D.’s as psychologists. But this is certainly not the case. People who complete a minimum of four years of post-graduation are Doctors of Education Ed.D, Psychology (Psy.D.), and Philosophy (Ph.D.). However, only those who are given licenses can be called psychologists.
The licensed clinical psychologists have special training in evaluating the client to work out the mental health issue the person is going through and provide necessary treatment.
That’s why one should not assume all Ph.D. holders as psychologists. It may be the case that some of them may have degrees in academics that are not related to therapy in any way. However, they may still decide to practice therapy without any license or professional training.
2. Marriage and Family Therapists and Professional Counselors (LMFT)
LMFTs and professional counselors (LPCs) typically attend two years of graduate school and have at least a master’s degree out of the following:
Master of Science (M.S.)
The Master of Arts (M.A.)
Master of Education (M.Ed.)
Apart from this, LMFTs have special training in family therapy. Also, professional counselors have a wide range of general training in counseling and psychology. The professional counselors typically include Certified Addiction Counselors (i.e. C.A.C. I, II, and III ). Further, it is not necessary that a counselor will have a master’s degree.
They are mental health professionals who offer supportive therapy and concentrate on behavioral challenges that are not categorized as mental illness. Also, counseling is not as rigorous as psychotherapy.
3. Social Workers
These are clinical social workers (CSW) who have attended two years of graduate school and hold at least a master’s degree. Some may even earn doctoral degrees and have varied credentials. A few of the common ones include:
Bachelor’s of Social Work (B.SW.)
Master’s of Social Work (M.SW.)
Academy of Certified Social Workers (A.C.SW.)
Diplomate of Clinical Social Work (D.C.S.W)
One thing that you must remember here is that all social workers, except a few, have an ‘L’ in front of their degree. For example, L.B.S.W.
4. Other Types of Professionals
There are other mental health care providers who extend mental health care services to people. These include:
(a) Psychiatrists
Psychiatrists, like any other physician, are medical doctors (M.D.s). They earn their medical degree and undertake a specialty course in psychiatry that lasts for four years. Since they are medical doctors, they charge the highest fee among all the mental health care professionals.
They prescribe medication and do not use talk therapy frequently. Further, it is not necessary for you to refer to a psychiatrist for PTSD or any other trauma-related disorder. However, you may do so if you experience complicated or co-occurring medical conditions.
Typically, psychiatrists work with other non-medical mental health professionals for treating and prescribing medication to people with trauma disorders.
(b) Psychiatric Nurses and Nurse Practitioners
These are mental health care providers who have the following credentials.
Registered Nurse (R.N.)
Registered nurse Practitioner (R.N.P.)
Master’s of Science in Nursing (M.S.N.)
(c) Hypnotherapists
Hypnotherapists are skilled professionals who put trauma survivors in a state of trance. This is done to help survivors use their subconscious minds and alter their behavior or thought processes.
Hypnotherapists, while guiding survivors to undertake some exercises, enable them to reach their subconscious state. This is to encourage the survivors to change their negative thoughts and do away with unwanted habits or addictions.
(d) Pastoral Counselors
They are clergymen and women who have credentials like Master of Divinity (M.Div.) and Doctor of Theology (Th.D.). In addition to this, they also have supplementary training in therapy along with a degree from a seminary.
Can Therapy Make PTSD Worse?
Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) are two of the most exhaustively researched and evidence-based CBT treatments for PTSD. That’s why these are the most commonly used treatments for PTSD across various settings and facilities.
Despite being effective, these cognitive-behavioral treatments remain underutilized. This is in part because of the worries of both the researchers and clinicians in respect of using these treatments. The concerns that treatments like PE and CPT result in intensifying or making PTSD symptoms worse or increased dropouts have long been in the discussion.
Now, there have been various studies on whether treatments like PE and CPT result in increased patient dropouts or make PTSD symptoms worse. A few studies suggest that worsening PTSD symptoms or increased dropout as a result of PE and CPT are myths. And this is what is preventing clinicians from using these treatments for PTSD.
However, there are studies that suggest either way. For instance, research undertaken by Kilpatrick and Best claimed that repeated exposure to a traumatic event may result in increased anxiety and dropouts. This specifically applies to people who have experienced sexual assault.
Similarly, victims of childhood sexual abuse may find difficulties with exposure therapy leading to dropout.
In addition to this, a study by Pitman et al. came out with case studies that revealed that EMDR could be better accepted and tolerated by patients and therapists. However, there was no solid reasoning behind it.
Accordingly, it is important to know in what cases does exposure to past trauma lead to intensifying PTSD symptoms and increased dropouts.
When Exposure Therapy May Not Be Ideal?
Revisiting, writing, or talking about past trauma has proved effective with many PTSD patients. In fact, Prolonged Exposure (PE) and CPT are the most commonly used psychotherapies to treat PTSD.
This is because these make the survivor revisit trauma and encounter or feel the process. Such an exposure results in:
awareness and expressing one’s feelings which helps in healing
building of trust and faith with the therapist that helps survivors overcome shame or guilt. This is because they feel comfortable coming out with their feelings.
such opening up results in increased positive thinking and helps overcome anxiety and depression
survivors understanding and becoming conscious of what happened and why which reduces distress.
survivor talking his feelings out that helps in healing
However, this may not work in each case.
Revisiting the Past Trauma Can Be a Problem
Despite exposure therapies like PE and CPT having been proved effective in treating PTSD symptoms, these may not be useful in some cases. In fact, these may result in even increasing or worsening PTSD symptoms.
In some cases, the past traumatic event may be too negative or difficult to deal with. That’s why revisiting the trauma may add to the problem. One may feel impaired despite the therapy.
Therefore, it is important to know that avoiding re-exposure to trauma can in some cases prove effective. There are PTSD survivors who chose to focus on other well-balanced, healthy actions instead of going back in time and re-experiencing trauma.
They take up activities like painting, exercising, etc that prove therapeutic for them. Let’s consider the claims made by veteran David J. Morris who is a trauma survivor in his article. He holds that exposure therapy can make things worse, as was the case with him. And that’s what made him drop out of the therapy before completing the sessions.
Likewise, he mentions the study undertaken by a Harvard Medical School psychiatry professor Roger K. Pitman. This was a study on Vietnam veterans who faced some complications post the PE therapy. These included experiencing suicidal thoughts, panic attacks, or depressive moods.
How Do You Get Diagnosed With PTSD Online?
You can take our PTSD online test to know about the PTSD symptoms that may be going through. You can then share these PTSD symptoms with your mental health care provider so that he can undertake a proper diagnosis.
To locate a therapist who can undertake proper diagnosis, you can visit online-therapy.com and register yourself for receiving online treatment.
How Long Does Therapy Take for PTSD?
One of the other typical questions asked with respect to PTSD therapy is ‘How many therapy sessions are needed for PTSD?’ Well, the time period for therapy would vary from case to case, given varying degrees of symptom severity. It is important to note here that both the type and length of therapy must be aligned with the person’s nature and severity of symptoms he’s going through.
For instance, intense PTSD symptoms require more time for treatment than mild symptoms. Likewise, what therapy is your mental health care provider using for treatment also decides the time duration? Similarly, Let’s have a look at the usual time it takes for each of the different therapies used for PTSD.
1. Cognitive Behavioral Therapy (CBT)
CBT is one of the commonly used psychotherapies for treating CBT. As a PTSD survivor, whatever skills you learn during CBT sessions must be practiced repeatedly for symptom improvement. As your therapist focuses on the traumatic event, the idea is to make you identify, understand and alter your thinking and behavior patterns.
Although it may vary from case to case, the CBT usually takes place over 12 to 16 weeks.
2. Prolonged Exposure Therapy (PE)
In Prolonged Exposure, you are asked to revisit the traumatic event. The aim is to face the feelings and trauma memory in a safe, controlled environment repeatedly. This is to help the PTSD survivor overcome trauma-related fear.
PE stretches over 3 months where the sessions are conducted on a weekly basis. Further, each session lasts between 60-120 minutes.
3. Cognitive Processing Therapy (CPT)
In CPT, again the focus is to help the PTSD survivor challenge the current negative thoughts related to trauma. The aim is to enable the survivor to develop a new understanding of the traumatic event. This is to enable the survivor to reduce the negative impact of trauma on his routine functioning.
CPT typically lasts for 12 sessions.
4. Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is unlike the other psychotherapies where changing the emotions related to the trauma is the focus. In this, the trauma-related memory of the PTSD survivors is the focus. The mental health care providers aim to change the trauma-related memory that is understood and stored in the survivor’s brain. Further, survivors are also asked to simultaneously face bilateral stimulations like eye movement. This helps in reducing the emotions related to trauma.
EMDR is provided once or twice a week and typically contains 6-12 sessions.
Why Do Clients Smile When Talking About Trauma?
It is a common practice amongst PTSD survivors to smile when talking about their trauma in the therapy sessions. Smiling certainly is not a gesture they should be showing while narrating the painful, horrifying, abusive childhood experiences.
Yet, you would find trauma survivors laughing and smiling as they come out with those humiliating experiences they had. This mismatch between emotions and their painful stories can actually provide insights about so much about the survivors.
1. It May be a Strategy To Reduce the Trauma Impact
Traumatic events like childhood abuse or losing a loved one bring feelings of humiliation, hate, disgust, and sadness. Thus, to not go into the zone of these feelings, many survivors laugh or smile as they narrate their painful traumatic experiences.
This helps them to keep such feelings at bay. And this is what helps them to reduce the pain associated with revisiting the traumatic memory.
2. Smiling While Narrating Traumatic Experience Can Be a Sign of Feelings of Shame and Disgust
Trauma survivors smiling as they share their painful stories can also be a sign of them feeling shameful or disgusted. It requires a brave heart to come out with experiences that are marked by shame and humiliation.
So smiling may be a way to tell the therapist the shame and embarrassment the survivors are going through. Also, it helps the survivors to not go into the deeper analysis of the traumatic memory.
3. It May Be Used as a Defense Strategy to Avoid Pain
Another thing can be that laughter may help the survivors avoid trauma-related pain. Survivors have the understanding that once the feelings like shame, disgust, anger, hate, etc are processed, they will be possessed by these emotions.
And when such emotions would overpower them, they feel they have no control over their pain. So laughing while narrating their traumatic experience can help them to avoid pain.
4. Laughter Can Indicate Towards Issues With Expressing Certain Feelings Since Childhood
Laughing can also be a sign that there were certain feelings that the survivor was not allowed to express during childhood. For example, many families prevent children from expressing feelings of anger and frustration. In fact, they are looked down upon by elders in the family if children express these feelings.
So laughing or smiling as they express their painful stories can also be an indicator of feelings that they were not permitted to express.
5. It May Reveal Self-Esteem Issues
Laughing while sharing their painful experience may also show a lack of self-worth in survivors. Since the survivor may think he or she is not worthy enough, he may smile to express that he/she is not that important that his painful issue must be discussed.
6. Smiling is a Sign That the Survivor Does Not Know How to Emote Negative Feelings
Finally, it may be an indicator that the survivor is not equipped to express his negative feelings. Many trauma survivors are scared to bring out their negative feelings. This is because they fear how they will react and deal with these negative feelings. Therefore, smiling is a way to deal with such a situation.
This is where the therapists need to understand that the survivors first need to be equipped with emoting negative feelings. Only then can they go ahead with therapy.
Can PTSD Be Cured?
PTSD is no doubt a complex mental health issue. As such, there is no particular cure for PTSD. Yet, there are various treatments available that help in reducing PTSD symptoms.
Mental health care providers use both psychotherapy and medication to treat PTSD. But there is no doubt that it is challenging to treat PTSD.
This is because PTSD survivors repeatedly experience intrusive, trauma-related memories long after the traumatic event. They experience negative alterations in their cognitive abilities and in many cases even witness revictimization.
Not only this, many are at the risk of suffering comorbidities like substance abuse, anxiety, depression, etc.
But, psychotherapies like CBT, CPT, PE, EMDR, etc, and antidepressants have been proved useful in treating PTSD symptoms.
What Therapy is Best for Trauma?
There exist a few therapies that are highly recommended for treating PTSD. All of these therapies are different forms of CBT. These therapies are some of the most widely used and are considered best for trauma. Further, the following section will also help you to understand what happens in therapy for PTSD.
1. Cognitive Behavioral Therapy (CBT)
CBT is a type of psychotherapy where the therapist and the trauma survivor come together to identify and alter unhelpful thought patterns. CBT works by the therapist motivating the survivors to re-analyze their thought patterns and assumptions.
This is to help them recognize unpleasant thought patterns and shift towards more positive and balanced thoughts. Unpleasant thoughts, also called distortions, typically include negative thinking, always thinking of disastrous outcomes, etc which impair routine functioning.
In this, the survivor is exposed to the past traumatic event and reminded of the feelings or emotions associated with it. The aim is to help the trauma survivor reduce avoidance behavior and maladaptive associations with the traumatic event.
Accordingly, some of the important CBT principles involve focusing on the present problem and setting goals, educating the survivor to be his own therapist, and being structured and time-bound.
2. Prolonged Exposure (PE)
This is a type of CBT where the trauma survivors are taught to slowly approach their memories, events, and feelings related to trauma. The aim is to enable the survivors to learn that memories and events related to trauma involve no danger. Hence, there is no need for the trauma survivors to escape from them.
It is typical with trauma survivors to avoid trauma-related memories, feelings, and events. However, running away from anything that reminds them of trauma only adds to their fear.
PE is based on the idea that by repeatedly facing the trauma narrative and dreadful feelings associated with it, one can reduce PTSD symptoms. That is, facing the fear instead of escaping from it can actually help in reducing the PTSD symptoms.
PE involves the therapist giving the trauma survivor a briefing of the treatment and hearing out the survivor’s past trauma. Then, after psychoeducation, the survivor is exposed to the traumatic event. This involves asking the survivor to either re-imagine or relive the trauma. Or it involves identifying places, people, and vents outside the therapy session that remind the survivor of the trauma. The survivor is then asked to face these people, places, etc as a home assignment to get rid of the fear attached to them.
3. Cognitive Processing Therapy (CPT)
This is a type of CBT where the trauma survivor is educated about symptoms of PTSD and the relationship between trauma-related thoughts and feelings. The survivor is made to understand how this association and the automatic thoughts maintain the PTSD symptoms. Here techniques like Socratic Questioning are used by the therapist to help the survivor identify unhelpful thoughts related to trauma. The idea is to help the survivor to identify and alter the maladaptive thoughts.
4. Cognitive Therapy (CT)
CT is also psychotherapy that comes from CBT. The aim of this therapy is to help the trauma survivor alter the negative evaluations and memories associated with trauma. The aim is to interfere with the unhelpful behavior and thought patterns that impair day-to-day functioning.
Here, the mental health care provider enables the survivor to understand the meaning of the trauma-related memories. Not only this, but the professional also helps the survivor to understand how the survivor currently understands them. He also enables the survivor to become aware of the negative evaluations that the survivor has done of the trauma. And that such evaluations will only add to the problem.
The typical strategy used by professionals here is Socratic Questioning, This involves asking questions that help the survivor to evaluate the trauma differently. Not only this, but the therapist also enables the survivor to combine this new, meaningful evaluation with the traumatic memory.
The therapist also directs the survivor to write a meaningful account of trauma by reliving it or revising the places, people, etc who were part of the event. The aim of such exposure is to identify the triggers that evoke strong responses and use cognitive restructuring at that moment.
This helps in getting rid of those unhelpful thoughts related to trauma. Lastly, the mental health care provider also helps the survivor do away with behaviors that may maintain PTSD symptoms in the future. These may include suppression of thoughts, rumination, etc.
People suffering from anxiety issues often go through the uneasiness caused by excessive fear and threat. However, it is actually the avoidance behaviors that they display that are the main reason for their impairment. This is because avoidance behaviors stop them from carrying out routine functions like socializing, dealing with their feelings, etc.
Take the case of a person with OCD. While behaving obsessively can be the cause of concern for him, it is the avoidance behaviors that stop him from normal functioning. For instance, he may perform certain compulsive behaviors like tapping, or checking repeatedly if the doors are closed to avoid any threat or harm.
Thus, what you need to understand here is that fear is a natural response to and is not generally dangerous. It is a natural, automatic response to the threat which is necessary for survival. It results in identifying danger, putting us in fight or flight mode, and taking actions that help us survive. For instance, we may either fight back or run away from the danger. Whereas anxiety is more related to muscle tension, avoidance behaviors, and being vigilant so as to be prepared for the upcoming danger.
Now, what can prove to be harmful is the avoidance behavior seen in people with anxiety. For instance, the fear of talking to people may make them avoid meeting people for work. This may deny them some good work opportunities.
Similarly, people may resort to heavy drinking or drug abuse to avoid painful thoughts.
Let’s have a look at what avoidance behavior is, is avoidance a form of anxiety, how does avoidance prevent anxiety, and how can we reduce avoidance behavior.
What is Avoidance Behavior?
The American Psychological Association (APA) defines avoidance behavior as a single act of a string of actions that help a person to avoid or predict painful events, situations, and stimuli. This also includes conditioned aversive stimuli.
Typically, avoidance behaviors are taken as maladaptive as a response to anxiety or fear. This is because they add to or maintain anxiety disorders. That’s why psychotherapies like Prolonged Exposure or CBT expose people with anxiety to situations, events, or people that trigger anxiety. The idea is to reduce or discourage such people from displaying avoidance behaviors which include escaping or behaviors that induce safety.
Well, there are circumstances where avoidance behaviors can be therapeutic and effective coping strategies for people with anxiety disorders. This is because such behaviors may improve a person’s sense of control over the possible threat as well as the surrounding environment.
So, Is Avoidance a Form of Anxiety?
The question that you may be asking yourself right now could be “Is avoidance a mental disorder” or “Is avoidance a form of anxiety?”
Well, avoidance is not a form of anxiety or mental disorder. Instead, avoidance behaviors are one of the typical characteristics of some anxiety disorders. In fact, the fear and anxiety resulting from an anxiety disorder are closely linked to avoidance behaviors. Though in some cases, avoidance may be adaptive in nature in place of being maladaptive. That is, these avoidance strategies may serve as adaptive coping strategies to deal with anxiety disorders.
Let’s first discuss why avoidance results in maintaining anxiety disorders.
Why Does Avoidance Make Anxiety Worse?
There are various theories of avoidance learning that explain why avoidance makes anxiety worse. These will help us to understand how avoidance leads to maintaining anxiety disorders.
1. Fear, Anxiety, Fear Generalization, and Avoidance
The theory that explains fear and anxiety leading to avoidance behaviors and fear generalization is the Pavlovian Fear Conditioning. As per this theory, avoidance is a consequence of fear and anxiety. Further, one develops fear or anxiety because of Pavlovian Conditioning.
One of the most famous psychological cases where Pavlovian conditioning was first applied is the Little Albert Experiment. In this experiment, an 11-month olds child named Little Albert was exposed to a white rate (Conditioned Stimulus (CS)) to which he showed no fear.
But, the psychologist John B. Watson and his student Rosalie Rayner combined the white rat with the loud noise of a hammer striking the metal bar (Unconditioned Stimulus (UCS)).
When the boy was exposed to such a pairing, Little Albert showed fear and avoidance behaviors, even when he was exposed to the white rat alone. Not only this, the little boy also showed fear and avoidance behaviors towards objects that were similar to the white rat. This indicated words fear generalization. That is, once conditioned to fear an object, one also fears and avoids objects that are similar to the fear object.
Thus, fear and avoidance behaviors towards safe stimuli (CS) and novel stimuli which are similar to the fear object increase instances where people are reminded of the feared object. Therefore, each time they come across the feared object or something similar to it, they experience more fear and anxiety.
For instance, a woman lost her first job because she was not used to checking and replying to emails. Now, whenever she receives any email or a message from a colleague, it triggers fear and anxiety. Even though the email may be an appreciation from a senior or a simple work request. She gets extra vigilant in checking her inbox and delivering work as requested.
2. Avoidance to Protect Oneself From Threat Results in Anxiety
One of the typical things that a person does when he anticipates a threat or is anxious is to display defensive behavior. Now, such a behavior may include avoiding the feared situation or threat to reduce anxiety. Such a behavior may help the person temporarily or in the short-term. However, he may keep feeling fear and anxiety in the long-term.
The following explains how fear and anxiety result in avoidance behaviors and avoidance adds to more anxiety with the help of avoidance theories.
(a) Avoidance Used as a Defense for Perceived Threat
The theory that explains this is the Perceptual-Defensive-Recuperative model. This involves three stages. In the first stage, a person perceives threat.
In the second stage, the person adopts defensive behavior like avoiding people, places, thoughts, or events that remind him of the pain. Or doing activities that save you from the threat . These are called Safety Behaviors which are also a kind of avoidance behavior. Such behaviors help the person to reduce the pain sensitivity.
Finally, he enters the recuperative stage where the behaviors linked to pain return after the threat has passed. Thus, avoidance here may help the person in reducing anxiety in the short-run. However, he may continue to experience fear and anxiety in the long run.
For example, say you perceive the threat of being judged by people for your looks. Now, in order to not feel the pain associated with your looks, you avoid meeting certain people (avoidance behavior) or only step out with makeup on (safety behavior, also a type of avoidance) .
Such defensive behaviors may help you to reduce anxiety associated with perceived threat in the short-run. However, the fear and anxiety will certainly resume once the threat has passed. In this case, people whom you were supposed to meet or the need to step out of home.
In other words, your concerns with regards to your looks will keep appearing in the long-run.
(b) Avoidance Learned Through Negative Reinforcement
B.F. Skinner’s Operant Conditioning also explains how fear and anxiety results in learning of avoidance behavior. Operant Conditioning states that learning depends upon action and its outcome. That is, a behavior is likely to be repeated in the future if such a behavior results in positive or favorable outcomes. However, a behavior is less likely to be repeated in the future if it results in negative or unfavorable outcomes.
Say a person fears talking to people and chooses an action of not taking phone calls which results in reduced anxiety. The chances of avoiding the phone calls in the future increase as this results in reduced anxiety. Thus, the person learns the behavior of avoiding phone calls through negative reinforcement. This is because avoiding the phone results in no anxiety or reduced anxiety for the person.
Now, this too may be helpful temporarily. But, the person may continue to be unwilling to take calls and face such anxiety in the long-run. He continues to believe that taking calls is a threat and should be avoided no matter what.
Further, he does not challenge his devastating thoughts about what may happen if he attends the phone calls. Similarly, he also continues to be extra vigilant of the danger and safety cues which adds to his anxiety.
How Can I Break the Avoidance Cycle?
The main characteristic of anxiety is constant and excessive worry about the anticipated threat. You try to deal with a potential or future occurrence that you think would be devastating. This typically takes place by you being extra vigilant and focusing on cues of such a future occurrence. You also pay attention to yourself and see if you can deal with such a threat.
However, when you see your anxiety symptoms occurring, you get an understanding that you won’t be able to deal with the event. This is what makes you more anxious and initiates the vicious anxiety cycle.
The Vicious Cycle of Anxiety
(1) Being Extra Vigilant
As mentioned earlier, the vicious cycle of anxiety begins with you increasingly inspecting the environment for threat. This leads to increased physical symptoms of anxiety like headache, shortness of breath, stomach pain, etc
(2) Escape or Avoidance Behaviors
Now increased physical symptoms result in restricting your focus only on yourself. This is when you take actions that will keep you away from feeling anxiety. That is, you will either escape or avoid the situation, people, places, conversations, etc.
(3) Short-term Relief From Anxiety
Such avoidance behaviors certainly help in providing relief from anxiety in the short-run. This is because you longer have to face the feared stimuli like socializing, receiving a phone call, going to a shopping center, etc.
(4)Anxiety and Fear Exist in the Long Run
Avoidance may certainly be helpful in reducing anxiety temporarily. However, you will continue to face fear or anxiety from the feared stimuli in the long-run. That is, there will be increased physical symptoms of anxiety, excessive worry, loss of confidence in dealing with anxiety, increased avoidance and safety behaviors.
This will add to more fear and anxiety and that’s how the vicious cycle of anxiety will continue. This is because you are not disconfirming your excessive worry about the anticipated threat. Further, you are continuously scanning the environment for signals of the upcoming danger and what you can do to avoid, escape, or save yourself from such a threat.
This results in more anxiety and generalizing of fear or threat to other situations.
As discussed, vicious cycles play a critical role in sustaining your anxiety disorder. However, you can adopt certain strategies to break this vicious cycle.
How Can We Reduce Avoidance Behavior?
The next question that may come to your mind is how can we reduce avoidance behavior. Well, here are some strategies that you can adopt to reduce avoidance behavior.
(1) Understand the Vicious Cycle of Avoidance
People with anxiety disorders do not purposely allow anxiety and avoidance behaviors to show up. If you are facing anxiety issues, you do not choose to bring in anxiety or show avoidance behaviors in fearful situations. However, the issue is that once the avoidance behavior shows up, it consumes your thoughts and takes control over your emotions and behaviors. As discussed earlier, escape and avoidance behaviors only provide temporary relief from anxiety. But, you must understand that it doesn’t resolve the anxiety issues permanently.
This is because instead of disapproving of your catastrophic predictions, you are getting into learning behaviors. You continue to believe in the fact that the feared stimuli is dangerous and must be avoided no matter what. This intensifies your avoidance and safety behaviors and makes you extra vigilant for signals of danger and safety.
This turns vicious and self-limiting in nature. Therefore, the first step should be to understand this vicious avoidance cycle which helps you to know how you behave, what you worry about, your physical symptoms, etc so that you can know how to break it.
(2) Identifying and Changing Your Behaviors
Identifying what you do in situations that prompt anxiety will come from understanding the vicious cycle. Only then would you be able to change those behaviors. But, why is there a need to identify and change avoidance and safety behaviors?
Let’s take an example here to understand what kind of behaviors you may exhibit and why you need to alter them. Say, you have issues with attending phone calls and hence choose to avoid them. This is because you think taking phone calls may end up consuming your precious work time and leave you exhausted.
Now, you may exhibit the following types of behaviors to reduce your anxiety.
(1) You May Overtly Avoid the Feared Stimuli
Over avoidance is when you dont’ attend the phone calls. This is because you believe that your anticipated fear of you being left with less time or exhausted would come true. Thus, in overt avoidance, you don’t get into the situation where someone would take up your valuable time and leave you exhausted.
(2) You May Covertly Avoid the Feared Stimuli
This is when you take the phone calls but have a conversation with yourself. This is hidden avoidance where you are physically there in the anxiety provoking situation. But, you may not indulge in it.
This may include you saying repeatedly that you shouldn’t have received the call and that you are losing out on precious time. You may not show much interest in having a detailed conversation with the person on the other side. But, this ultimately leaves you sad. Thus, in covert avoidance,
Further, each time you avoid or escape from the feared situation, you are validating that the situation is threatening as you anticipated it to be. So, if you’re taking the phone calls that you were earlier avoiding, you are validating that it is not as bad as you predicted it to be.
Thus, it simply goes like this. The more times you prove your catastrophic predictions, the more evidence you have that the anticipated event was not dangerous.
(3) Alter Your Expectations About Upcoming Threat
Here’s what your original expectation would sound like:
” That person will consume all my time and leave me exhausted. Then, the guilt of offending that person and the pressure of not being able to do my work will leave me sad.”
Here’s what your new expectations can sound like:
” The person I’m talking to may take my time. But, I don’t need to talk for hours. I can talk for sometime, discuss things that add value to the conversation, learn from the other person’s perspective, make them feel good, and get to know him/her better.
(4) Gradually Expose Yourself to Fearful Events
Instead of facing your fear all at once, it’s better to start small and then lead your way towards the intensely feared situations. This will enhance your confidence, reduce your anxiety, and will help you encounter situations that are critical to be dealt with in your case.
Thus, slowly approaching your intensely feared situations is called Graded Exposure. This involves you beginning with facing events that are easier for you to deal with. As you get comfortable and used to such situations, you then shift to more challenging situations. This way, you build up on your confidence, utilize what you have learnt, and face the most challenging situations in a step-by-step way.
Thus, doing this repeatedly over time helps you reduce your anxiety and fear with regards to those situations.
How Does Avoidance Prevent Anxiety?
Until now, we discussed how avoidance behavior can be self-limiting, add to more anxiety, and provide only a temporary fix to your anxiety issues. But in this section, we will discuss Adaptive Avoidance.
Adaptive avoidance is when avoidance behaviors are actually helpful in coping with anxiety disorders. Coping as a concept is a little challenging to understand. This is because coping occurs in a variety of ways.
There is no one particular cause of depression. You can experience depression for a host of reasons. Depression occurs differently in different people and thus there are various stimuli that can act as triggers.
For instance, there may be people who experience depression due to a stressful event. This could be losing a loved one, experiencing divorce, terminal illness, etc.
Also, there can be a combination of events that can act as triggers for depression. For instance, you may experience an illness and at the same time lose a loved one.
Many people also go into depression with age. This is mostly due to the financial crisis they are into or their social life which makes them depressed.
People who feel depressed also mention the downward spiral of events. For instance, one may see a financial crunch which may make them withdraw from social life, lose interest in routine activities, and get into alcohol consumption.
Let’s see what are the top 4 causes of depression.
1. Environmental Factors
One of the top reasons for depression is unfavorable childhood experiences. Different types of unpleasant childhood experiences are one of the critical predictors of depression later in life. These majorly include stressful events like seeing the separation of one’s parents, child abuse, losing a loved one, etc.
Events like these make one withdraw from family and friends and deal with things on their own.
2. One’s Temperament
Personality or one’s nature also plays a significant role in making one vulnerable to depression. For instance, you may be facing low self-esteem issues or could be excessively critical about yourself.
This could result from your childhood experiences, your genes, or both.
3. Genetic and Physiological Factors
It is quite likely to inherit depression from someone in your first blood. In fact, iaf you have someone in the first-degree family who suffered from depression, the chances of you having depression increase by two – four times.
4. Course Modifying Disorders
As per DSM-5, all the non-mood disorders increase the risk of depression in an individual. Some of the common non-mood disorders include anxiety, substance use, and BPD.
A serious illness may also result in one showing depressive symptoms. These illnesses could be diabetes, cardiovascular disease, or morbid obesity.
5. Loneliness
You may experience loneliness which may be an outcome of withdrawing from family and friends. Similarly, those who decide to stay alone or do not seek partnerships suffer from loneliness which has the higher possibility of leading to depression. on-mood disorders increase the risk of depression in an individual.
What Should You Avoid if You Have Depression?
As discussed in the earlier sections, there are a number of things that you should avoid if you are depressed.
1. Do not lose connection with people. Withdrawing from family and friends or being lonely adds to your depression.
2. It’s difficult to move out of bed. But, don’t stay in bed for days as this makes you feel more depressed. Instead, exercise and get going.
3. Don’t consume alcohol and indulge in smoking cigarettes. Where alcohol acts as a depressant, smoking tobacco works like a stimulant. These add to your depressive mood, despite giving you temporary relief.
4. Listening to negative news also acts as a trigger and adds to the depressive mood. It makes one more pessimistic about life as its various aspects.
5. Avoid processed foods, foods high on sugar and salt, caffeine intake though tea, coffees, and chocolates.
6. Avoid negative thoughts that make you pessimistic and severely impact your mood.
7. Don’t work till late nights and make sure you are having a good night’s sleep.
How Can I Stop Being Sad Anymore?
The strategies mentioned above can help you to stop being sad anymore. For instance:
Connecting with your family and friends and letting them know the kind of support you want from them
Taking up mindful meditation to become aware of the current situation without being judgemental
Taking up activities that make you feel good. These could include painting, reading, exercising, having a hot bath
Creating a gratitude journal which involves writing things that you are grateful for appreciate, or are thankful for
Having a good night’s sleep
Avoiding consumption of recreational substances like alcohol, cigarettes, and caffeine
Managing your diet and making sure that you consume healthy foods
Increasing positive feelings
Visualizing a positive future that can help uplift your mood
Identifying and practicing your core strengths like love for learning, perseverance, honesty, kindness as a trigger and adds to
What is The First Line Treatment for Depression?
Antidepressants serve as the first-line agents for treating depression. The commonly used antidepressants for treating depression and approved by the FDA are as follows:
SSRIs: These are the antidepressants that are highly prescribed by the mental health professionals for treating depression. These include citalopram, escitalopram, sertraline, fluoxetine, paroxetine, and fluvoxamine.
What Happens in the Brain During Depression?
The depression symptoms like lack of interest and self-worth, poor concentration, etc are the result of dysfunctional neural networks.
Likewise, there are other processes that take place in depression. These include biological processes that involve changes in neurotransmitters, hormonal homeostasis of stress, metabolic dysfunction, increased inflammation leading to impaired metabolism, etc.
Yes, PTSD is a serious mental illness that makes you weak and occurs if you have experienced trauma. It is quite common to have memories that upset you post experiencing a traumatic event. Initially, you may find it challenging to carry out your routine chores like going to work, being with loved ones, having issues with sleeping, etc.
Many people start feeling better a few months after the traumatic episode. However, if these issues continue to show longer than a few months, there are higher chances that you may have PTSD. For instance, you may find yourself dealing with the memories of the traumatic event by trying hard to avoid it. Likewise, the anniversary of the traumatic event may make you upset or show severe stigma of mental issues.
Also, you may feel irritated, show anger and feel helpless and may still be left upset by the combat that you had years before if you served during wartime.
But the good thing is that PTSD is a mental health issue that can be treated with PTSD diagnosis and necessary treatment by professionals.
What are PTSD Symptoms?
The mental health professionals check for symptoms for PTSD diagnosis. As per DSM-5 criteria, the following are the PTSD symptoms that medical professionals check for in children younger than 6 years, children older than 6 years, adolescents, and adults.
The following PTSD symptoms apply to children older than 6 years, adolescents, and adults.
Going through a traumatic event. This may include:
experiencing the trauma directly
seeing others experiencing a trauma
knowing about the traumatic event occurring to a loved one
repeatedly getting exposed to the unpleasant details of the traumatic event
Showing one or more of the following intrusive symptoms related to the traumatic event
repeated, intrusive memories of trauma
repeated dreams whose content relates to trauma
dissociative reactions such as flashbacks
excessive psychological distress when exposed to internal or external triggers that remind of trauma
physiological changes when exposed to internal or external triggers that remind of the traumatic event
Avoiding the triggers continuously to get rid of distressing memories or or people, places, etc that give rise to distressing feelings.
Negative changes in thought process and mood
Changes in the reaction linked to the traumatic event
The above mentioned disturbances last for more than a month which impairs important areas of functioning.
In addition to the above symptoms for PTSD, the individual also suffers from either depersonalization or derealization in response to stressors. Depersonalization refers to continuous experiences of feeling detached from one’s body, feeling as if you’re in a dream. Likewise, derealization refers to continuous experiences of unreality of the surrounding environment.
Further, you can even self-screen or your family member for PTSD. If you have been feeling worried about a host of events in your routine life, take our PTSD online self-assessment. This will help you understand your PTSD symptoms and see if you need professional help.
Is PTSD Curable?
PTSD is a complex and difficult psychophysiological and psychosocial disorder to treat. There may not be any specific cure for PTSD, but there are treatments that help in reducing the PTSD symptoms.
These include therapies and medications that help the individuals in reducing or even getting rid of the PTSD symptoms.
Why is PTSD Hard to Treat?
There are a number of factors that make PTSD complex and hard to treat.
People suffering from PTSD experience a host of posttraumatic reactions which persist long after the happening of the traumatic event.
They experience intrusive and repeated memories of trauma, avoid trauma-related stimuli, go through negative changes in cognitions and moods linked to trauma, and changes in reactivity. This makes things challenging for them.
Further, PTSD may be mild in nature or extremely devastating. In fact, it can even expose individuals to retraumatization or revictimization.
Apart from this, some people suffering from PTSD also have the risk of comorbidities. These may include anxiety, depression, substance abuse, personality and dissociative disorders, higher risk of suicide or self-injury.
Such factors may result in psychosocial consequences like poverty or homelessness.
Thus, all these factors make PTSD difficult to treat. That’s why the American Psychological Association has come up with certain guidelines in respect of treatments that are effective for PTSD.
If you’re showing clinical depression symptoms, you may not know whom to approach to seek help. This is typically the case with first-timers. You may have a questions like “Should I see a psychologist or psychiatrist for depression.”
Medical professionals may go for physical examination, laboratory tests, and blood tests to make a correct diagnosis for depression. They would talk to you to know about the depression symptoms you have been experiencing, how long you have been experiencing them, your family history of mental illness, etc.
The first step is a personal interview with the medical professional. In this he tries to analyze the depression symptoms by asking you about your feelings and if you have been going through the depression symptoms.
They consider the following DSM-5 criteria for diagnosing depression symptoms in individuals. Doctors would talk to you and hear about the symptoms you are currently experiencing. For instance, you may tell the doctor about your behavior patterns, moods on a routine basis, your lifestyle, etc. They may ask you a set of questions for screening depression.
Symptoms of Depression
As per DSM-5, the following are the symptoms of clinical depression, also called Major Depressive Disorder (MDD). Further, you must experience at least five or more of the following for the two-week period. Also, a minimum of two of these symptoms must be either lack of interest or loss of interest that you should experience almost daily.
The following depression symptoms help you answer common questions like:
What are the three main symptoms of depressive disorders?
What is the number one symptom of depression?
Which are the 5 characteristics of depression?
Depressed mood
Lack of interest or pleasure in activities you used to enjoy earlier
Insomnia or hypersomnia
A noticeable weight gain or weight loss
Fatigue or loss of energy
Feelings of worthlessness and excessive guilt
Psychomotor agitation or retardation
Repetitive suicidal thoughts
Inability to concentrate or focus and indecisiveness
Is it Possible to Diagnose Yourself With Depression?
You can take our depression test online to know if you are experiencing depression symptoms. This is a self-assessment questionnaire that will put you in various life situations to help you identify depression symptoms. Taking this test will help you understand how you are feeling specifically from the past 12 months. However, this is not a diagnostic tool and in any way does not replace the diagnosis made by a mental health professional.
Much like the above symptoms, there are certain physical signs of depression.
Physical Signs of Depression
People experiencing depression commonly face Physical symptoms. These physical signs of depression can result in severe pain as well as complex treatment.
In fact, people who go for treatment in primary care settings typically claim to experience physical symptoms only. This makes it very difficult to diagnose depression. In fact, physical symptoms and depression share a strong connection.
The neurotransmitters like norepinephrine and serotonin impact pain and mood. And it is the deregulation of these neurotransmitters that causes depression and pain.
Some of the physical signs of depression are as follows.
Severe joint pain
Back pain
Fatigue
Sleep issues
Gastrointestinal issues
Limb pain
Changes in appetite
Psychomotor activity changes
Given these depression symptoms, it is important to know that depression is very different from anxiety. Let’s have a look at the signs of anxiety to understand how anxiety varies from depression.
What are Signs of Anxiety?
Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. Excessive fear, anxiety, and associated behavioral disturbances mark all anxiety disorders. Where fear is an emotional reaction to a real or imaginary threat, anxiety is a forecast of a future threat.
The following are the signs or symptoms of GAD.
Excessive anxiety and worry for more than a minimum of six months
Finding it difficult to control excessive worry
Feeling restless or on the edge
Getting easily tired
Finding it challenging to focus or mind going blank
Feeling irritated
Muscle tension
Disturbed or excessive sleep
How Do You Diagnose Depression?
The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians recommend that all adults 18 years and above must be screened for depression. This is irrespective of whether there exist any risk factors for depression.
Since depression occurs differently in different individuals, it is hard to diagnose depression. For instance, some people suffering from depression may have disturbed sleep and loss of appetite. While there may be others who may have a sad mood and loss of interest in routine activities or hobbies they used to love before.
Likewise, at times, a depressed person may have severe internal issues relative to the behavioral patterns that are visible.
How Do Depression Symptoms Help in Diagnosing Depression?
As specified earlier, you must experience a minimum of five depression symptoms as mentioned above for a period of at least two weeks or more. Also, the two symptoms must be a depressed mood and lack of interest which you must experience almost every day.
Going through these symptoms can impact your social, personal, and professional life. They interfere with your routine functioning, making it difficult for you to undertake daily chores. These may include difficulty in eating, moving out of bed, taking care of your health and hygiene, etc.
Now, there can be a host of reasons for feeling depressed. Letting your doctor know about such triggers can help in giving him the correct diagnosis.
What are 4 Major Causes of Depression?
You may not experience depression for any specific reason. There are a number of reasons why depression may occur. Depression symptoms occur differently across people. Therefore, a number of events can trigger depression symptoms.
For instance, various stressful events like losing a job, experiencing a divorce, death of a loved one, etc may trigger depression.
Similarly, age could be a factor to cause depression in people. You may experience financial distress with time or a dull social life which may get them into depression.
Also, there are people who feel depressed as a result of multiple distressing events that take place simultaneously.
For example, they may have lost a loved one and at the same time experience feelings of worthlessness.
Let’s see what 4 major causes of depression are.
1. Environmental Factors
The kind of experiences a child has is one of the critical causes of depression later in life. Unfavorable experiences like child abuse, losing a loved one, seeing the separation of one’s parents can trigger depressive symptoms in such individuals in their teenage or adulthood.
2. One’s Temperament
Your personality type or nature can also trigger depression during later life. For instance, you could be a person who excessively criticizes yourself for everything happening in your life. Likewise, your self-esteem issues are linked to your experiences as a child, your genes, or both.
3. Genetic and Physiological Factors
It is quite likely to inherit depression from someone in your first blood. In fact, if you have someone in a first-degree family who suffered from depression, the chances of you having depression increase by two-four times.
4. Course Modifying Disorders
As per DSM-5, all the non-mood disorders increase the risk of depression in an individual. Some of the common non-mood disorders include anxiety, substance use, and BPD.
A serious illness may also result in one showing depressive symptoms. These illnesses could be diabetes, cardiovascular disease, or morbid obesity.
5. Loneliness
You may experience loneliness which may be an outcome of withdrawing from family and friends. Similarly, those who decide to stay alone or do not seek partnerships suffer from the loneliness which has a higher possibility of leading to depression. on-mood disorders increase the risk of depression in an individual.
Dismissing Other Possibilities
1. Laboratory Tests for Diagnosing Depression
Much like depression symptoms, doctors would ask you to go for various laboratory tests. This is to dismiss that the depression symptoms are not a result of some other illness. The other issues may include medical illnesses like thyroid, vitamin D deficiency, etc. For which the medical professionals may ask you to go for blood tests.
Therefore, when conducting physical tests to reject other causes of depression, the medical professionals mainly concentrate on the endocrine and neurological systems.
It is because both the central nervous system and endocrine system issues can result in depression. For instance, endocrine disorders like the following can result in depression.
a. Hypothyroidism
This is a thyroid disease in which the thyroid gland becomes underactive. In other words, your thyroid gland does not make enough of the thyroid hormone.
The thyroid controls your body’s metabolism, which is nothing but how your body cells take energy from food. Also, metabolism also impacts your heart rate, body temperature, how properly your body burns calories. Thus, your body metabolism goes for a toss if it does not produce enough thyroid.
b. Hyperthyroidism
This relates to the overactive thyroid gland producing excessive thyroid hormone called thyroxine. Since your thyroid controls metabolism and heart rate, hyperthyroid can make the metabolism accelerate due to excessive thyroid hormones.
c. Cushing’s Disease
This disease is related to adrenal glands in which these glands produce excessive cortisol. Thus, you suffer from Cushing’s disease when there is excessive cortisol in your body for a long period of time.
And depression is one of the critical symptoms of this disease. Therefore, doctors conduct lab tests to check if you suffer from depression because of this disease.
d. Central Nervous System Issues and Injuries
Illnesses associated with CNS and related injuries can also result in depression. Some of these issues may include stroke, CNS tumors, head trauma, etc.
2. Additional Tests for Diagnosing Depression
Apart from blood tests, doctors may at times suggest you undergo supplementary tests. Some of them may include:
ECG to detect heart issues
CT scan or brain MRI to reject issues like brain tumors
EEG to track the electrical activity of the brain
3. Screening Instruments for Diagnosing Depression
Professionals use various instruments for diagnosing depression. These instruments help in assessing depressive symptoms that enable professionals to work treatment options.
1. Patient Health Questionnaires (PHQ – 9)
PHQ is a self-reporting technique used to screen depression symptoms. It is a three-page questionnaire that a patient can completely self-administer. The PHQ-9 is a 9 item depression module from the complete PHQ. This helps in identifying symptoms of various types of depression
Further, the mental health professional checks the test for positive responses once the patient completes the test. This is done by using the diagnostic criteria given towards the bottom of every page.
Also, PHQ checks for 8 diagnoses that are categorized under the threshold and subthreshold disorders. The threshold disorders include MDD, panic disorder, bulimia nervosa, and other anxiety disorders. On the other hand, the subthreshold disorders include binge eating disorder, other depressive disorder, possible alcohol abuse, and somatoform.
2. Beck Depression Inventory (BDI)
This is a self-reporting tool that is commonly used for screening depression, measuring behavioral changes, and severity of depression. The BDI screening test contains 21 self-reporting items which you have to finish using the multiple-choice format.
3. Hamilton Depression Rating Scale (HAM-D)
HAM-D, also written as HRSD or HDRS screens depression in people before, during, and after the treatment. Medical professionals conduct this test which contains 21 items. However, you are given scores on this test based on the first 17 items.
4. Center for Epidemiologic Studies Depression Scale (CES-D)
CES-D is a 20 item self-report screening tool for depression that was specifically designed for the general population. However, it is also used as a screening tool for depression in primary care settings. This test accounts for major dimensions of depression witnessed in the last week.
5. EQ-5D
EQ-5D is a standard instrument in the form of a questionnaire that is not related to any specific illness. It is an instrument that measures the quality of life with respect to health. Also, it evaluates the quality of life in respect of the following five parameters:
This is a rating scale that measures the severity of depression in people 18 years and above using a 10-item questionnaire. MADRS is the changed version of HAM-D and has an increased sensitivity to change over time.
What are the Levels of Depression?
Different classification systems have been used for determining different levels of depression. These systems have been based on a combination of factors such as duration, severity, nature, number, and pattern of symptoms.
Different studies have been conducted to know the best way to describe various levels of depression. As per one such study, it is critical to assess three dimensions to diagnose a depressive disorder. These include severity, duration, and course.
i. Severity
We can’t define severity alone as the dimension for defining the level of depression. However, it is useful in judging the severity of at least the number of major depression symptoms. Therefore, major depression based on severity using DSM – IV criteria can be classified as follows. These should be taken as examples and not as separate categories.
ii. Subthreshold Depressive Symptoms
This is when an individual shows less than five symptoms of depression.
iii. Mild Depression
This includes the individual showing a few symptoms over and above five symptoms that are needed for diagnosis. These symptoms lead to only minor functional impairment.
iv. Moderate Depression
This is a level of depression that lies between mild and severe major depression.
v. Severe Depression
Here the majority of the symptoms occur with or without psychotic symptoms. Further, these interfere with a person’s routine functioning.
vi. Duration
Major depression can be classified into the following based on duration:
vii. Acute Depression
This includes meeting one of the severity parameters for at least 2 weeks and not longer than 2 years.
viii. Chronic Depression:
This is when the individual meets one of the severity criteria for more than 2 years.
ix. Course
This is not taken as a classificatory parameter. However, it is important from the point of view of the recurrence of depression.
x. Number of lifetime depressive events and the time gap between the recent events
The number of depression episodes ranges from a single episode to repeat occurrences. A minimum of 2 months of complete or partial remission are needed to differentiate the episodes.
xi. Stage of the Episode
This relates to where the individual is in the course or journey of his depression. That is, if the depression is worsening, improving, or static.
Why See a Professional: Role of Mental Health Professionals
Major Depressive Disorder (MDD) or clinical depression is one of the most common depressive disorders across the world. As seen earlier, it is different from normal sadness and is much more than that. It is extreme sadness that lasts for over two weeks and interferes with one’s routine functioning.
You need to understand that depression may be one of the major causes of disability in the world. Yet, it is a mental issue that needs the right professional help for treatment.
This is because mental health professionals are trained individuals with the right amount of experience. They know what medications and know various psychotherapy approaches they can adopt to treat depression.
Also, they hear you out and have the right knowledge, instruments, and experience to identify depression symptoms. Not only this, these mental health professionals help you meet your recovery goals and help you cope better with your thoughts, feelings, and behaviors.
Whom to Consult?: Psychologist Vs Psychiatrist Vs GP
One of the typical questions for people showing depression symptoms is “Should I see a psychologist or psychiatrist for depression?” Well, this question is bound to trouble you for both psychiatrists and psychologists who treat depression. However, they differ in terms of their education, experience, and treatment approaches. Therefore, it is important to consider all these things before deciding whom to approach for menstrual health support.
Let’s have a look at the various mental health professionals and how they can help. This will help you in understanding whom to approach for seeking depression treatment.
1. What is a Psychologist?
Practicing psychologists are professionally trained individuals who possess the necessary clinical skills to help people deal with life and mental health issues.
They hold a doctoral degree in clinical psychology or another area of expertise like education or counseling.
They are trained to understand the person’s mental health position through clinical interviews, psychological tests, and analysis. Accordingly, they can diagnose mental health issues and offer individual or group therapy.
After the requisite years of study and experience, they are licensed by the states to offer a host of services. These include analyses and psychotherapy. They use a wide range of techniques and take into account the patient’s circumstances, unique values, characteristics, and goals.
How Can a Psychologist Help You?
Not many people are aware of the wide range of behavioral health issues that psychologists are trained for. You may talk to a psychologist for dealing with mental issues like feeling depressed, anxious, or angry for some time. You may even seek their support for severe conditions that impact your routine functioning and your physical and mental health.
There are still others who seek help from psychologists for short-term issues they want to deal with. These may include bereaving over the death of a loved one, dealing with the anxiety of a new job, etc.
Similarly, you can also consult a psychologist for:
overcoming opioid abuse
diagnosing and treating dementia
diagnosing and managing autism
helping you maintain a healthy lifestyle
controlling your diabetes
getting your weight under control
helping with anxiety disorders
helping with insomnia
managing severe pain
Further, they use a variety of evidence-based techniques to help improve the lives of people dealing with such issues. The most widely used treatments by psychologists include psychotherapy or talk therapy.
Psychotherapy further includes several therapy styles that can be adopted. The psychologist talks to you and hears you out to see what style is the best fit to treat your mental health issue.
Commonly Used Therapies
There are various types of therapies that a psychologist may use. These include:
CBT
Interpersonal therapy
Psychodynamic therapy
Humanistic therapy, and
A combination of these
Also, psychologists use these therapies for individuals, couples, and families. In addition to this, some psychologists are also trained for hypnosis to treat anxiety disorders.
Thus, psychologists help you manage chronic illnesses, get rid of addictions, deal with stressful events, and conduct tests and evaluations.
These help them to diagnose your current conditions and help them understand your feelings, thoughts, behaviors, and moods. These evaluations also give them a better understanding of your intellect, strengths, weaknesses, personality traits, choices, etc.
Psychologists And Their Study
Psychologists are medical professionals who graduate in psychology. In graduation, psychology students are trained on various characteristics of human behavior and personality. It also includes courses on research, statistics, and psychotherapy. Assessment, and ethics.
As per the American Psychological Association (APA), the doctoral degree is the minimum that is needed as an educational requirement for psychologists.
The doctoral degrees range from the Ph.D. – doctor of philosophy, PsyD – doctor of psychology, or EdD – doctor of education.
Total Period for Study:
2 years for masters
4-6 years for a doctoral degree
1-2 years of full-time internship
How to Choose a Psychologist?
There are several factors to consider when choosing a psychologist you want to work with.
1. Look for Comfort
Make sure you share comfort with the psychologist so that you can come out with your issues in detail with him/her
2. Check for License
See if he is licensed by the state in which he is a practicing psychologist
3. See if He’s An Expert in Dealing with Your Issues
You should let the psychologist know about your feelings (like anger, anxiety, excessive worry, etc) and issues you are currently facing (like marriage, losing a loved one, job, etc). Then ask him whether he is trained or expert in dealing with such issues.
4. Ask for His Area of Expertise
You also need to know if the psychologist is trained in dealing with families, couples, children, or individuals.
5. Types of Treatments He Uses
Be clear about the type of treatments used for dealing with various issues. Also, be clear about how effective such treatments have proved for others.
5. Check for the Fees and Insurance
Look for the number of charges a psychologist takes for a typical session that lasts for 45-50 minutes. Also, see if the psychologist accepts your insurance under Medicare or Medicaid.
5. Check his Credentials
You must see the psychologists’ education, years of experience, clients handled, star ratings, and reviews, if available. For the qualifications he must have, you can check the above section. Similarly, you also need to check if the psychologist is licensed by the state in which he undertakes his practice.
2. What is a Psychiatrist?
As per APA, a psychiatrist is a physician who is a specialist in diagnosing, treating, preventing, and studying mental, personality, and behavioral disorders. He is a medical doctor who is a specialist in mental health and substance use disorders.
Further, he is a licensed doctor who has attained psychiatric training. Accordingly, he can diagnose mental health issues, prescribe and regulate medications, and also offer therapy.
In addition to this, he is equipped to evaluate both the mental and physical problems of psychological issues that you go through. Thus, people approach psychiatrists for seeking help for:
Suicidal thoughts
Panic attacks
Dreadful hallucinations
Hearing of voices
Long term issues like hopelessness
Prolonged sadness
Excessive worry and anxiety
How Can a Psychiatrist Help You?
A psychiatrist is a medical doctor who can carry out a wide range of laboratory and psychological tests. This, together with the conversations with you, help him to understand your feelings and state of mind in a better way.
Thus, it is their education and training that enables them to understand complicated things like:
the connection between emotions and psychological illness
the link between genes and family history
understanding the complex psychological data
diagnosing a mental illness
working out treatment plans with the patients
Further, a psychiatrist helps to ascertain if you need medication to cope with depression symptoms. He will ask you about the other medications that you are currently taking. This helps him to understand what drug to prescribe, given your current medications.
Commonly Used Treatments
A psychiatrist may use treatments like psychotherapy, medications, psychosocial treatments, and others like ECT. This is based on the condition of the patients in question.
Psychiatrists And Their Study
A psychiatrist is a licensed medical doctor who has undertaken his psychiatric training. He/she is a physician who is a specialist in diagnosing, preventing, treating, and studying behavioral patterns.
For a psychiatrist in the United States of America, the education includes:
4 years of pre-medical training in college
a 4-year course in a medical school. During this, the last two years of the course are spent in clerkships. This includes studying with physicians in a minimum of five specialty areas
a 4-year residency in a hospital or agency that is allowed by the American Medical Association
on completing residency, Apart from completing their residency training in psychiatry, they are Doctor of
What to Look for in a Psychiatrist?
Much like a psychologist, you need to consider the following before choosing a psychiatrist.
i. Area of Expertise
The first thing you need to check is the psychiatrist’s area of expertise. This is to understand if the psychiatrists’ area of expertise matches your needs. As in, are you ling for a general psychiatrist or the one with a subspeciality in say BPD, additions, etc
ii. Educational Background and Other Screening Factors
This should include checking the selected psychiatrist’s medical school, residency, and post-residency. You can also see if the mental health professional has any certifications like psychopharmacology. Likewise, you must check the years of experience, the publications are written, and any academic affiliations like teaching psychiatry, etc.
iii. Check For Insurance
You must check with your insurance provider if the psychiatrist you have selected is part of the insurance network. Accordingly, see what percentage of your therapy fees are covered and how much would you be required to pay.
iv. See if He Provides Online Therapy
It may be the case that it might not be possible for your loved one with PTSD to see a doctor in person. In such a situation, having an online therapy facility is helpful.
v. See Your Comfort
This relates to considering factors that will make you feel comfortable to share your worries and feelings with the psychiatrist. For instance, there may be patients who feel comfortable with a psychiatrist who has been practicing for many years. While there may be others who would open up in front of a younger practitioner.
Likewise, you may even consider gender and if you want to visit in person or go for an online session.
Should I See a Psychologist or Psychiatrist for Depression First?
Many people are experiencing mental health issues. However, they do not have an understanding of whom to consult or where to start from for treating their mental health issues.
In the above section, we have laid out the difference between a psychologist and a psychiatrist. This is to help you seek professional treatment from trained professionals who can better diagnose and treat depression and other mental health issues.
Since now you have clarity about the roles of both the psychiatrists and psychologists, it will be easy for you to choose.
Here are certain things that you can consider to choose between the two.
You can visit a general practitioner who may evaluate your symptoms, family history, etc. After hearing you out and making his assessment, he may suggest to you whom to visit.
Psychologists use psychotherapies like CBT and talk therapy to deal with your mental health issues. Thus, they may evaluate your issue symptoms and have a one-on-one session to work it out.
Whereas, psychiatrists, on the other hand, suggest medication to reduce your mental health issue symptoms.
3. Other Mental Health Professionals
1. Counselors, Therapists, and Clinicians
These professionals hold master’s degrees and are trained to analyze the person’s mental health condition. They use a variety of therapeutic techniques and work under job titles like counselors, therapists, or clinicians.
Accordingly, people facing mental health issues can reduce their symptoms and improve their way of thinking if they choose to consult them.
License and Certifications
Their licenses and certifications vary depending on the state they are practicing in. Typically, these may include licensed:
Marriage and Family Therapist, LMFT
Professional Counselor, LPC
Clinical Alcohol and Drug Abuse Counselor, LCADC
2. Clinical Social Workers
These are also trained to understand and analyze an individual’s mental health. In addition to this, clinical social workers use therapeutic techniques as per particular training programs.
Further, these workers also have training in advocacy services and case management. Advocacy services include these social workers helping individuals be engaged in the important decisions that impact the individual’s life. These advocates help individuals:
to express their viewpoints
in understanding and exploring their choices
by attending meetings, writing letters, etc.
Similarly, as case managers, these social workers help individuals to meet their individual and family health needs. This is achieved via advocacy, communication, and available resources. The idea here is to provide safety, quality of care, and cost-effective results to the patient.
3. Psychiatric or Mental Health Nurse Practitioners
These are mental health professionals who can evaluate, diagnose, and offer therapy in respect of various mental health issues and substance use disorders. In the case of certain states, psychiatric or mental health nurse practitioners even prescribe and regulate medications.
Educational Qualifications and Licenses and Credentials
Degrees they hold include:
Doctor of Philosophy (Ph.D.) or Master of Science (MS) in nursing with a special focus on psychiatry
Likewise, licenses and credentials include:
National Council Licensure Examination, NCLEX
Board Certification in Psychiatric Nursing via the American Academy of Nurses Credentialing Center, PMHNP-BC
4. Family Nurse Practitioners (FNPs)
FNPs are professionals who can offer general medical services. These include services as provided by a primary care physician considering the state laws in which they practice.
Accordingly, FNPs can prescribe medication to the patient. However, he would prefer to see a mental health specialist for that. Therefore, both mental health specialists and FNPs need to work together to work out a plan for the mental wellbeing of the patient.
Educational Qualifications and Licenses and Credentials
Degrees they hold include:
Doctor of Philosophy (Ph.D.) or Master of Science (MS) in nursing
Likewise, licenses and credentials include:
National Council Licensure Examination, NCLEX
Family Nurse Practitioner Board Certified, FNP-BC
5. Primary Care Physicians
Primary care physicians can also recommend medication. But, you would always prefer consulting a mental health professional for the issues you face. Here also, both primary care physicians and mental health professionals should work together to work a plan that works best for you.
Educational Qualifications and Licenses and Credentials
Degrees they hold include:
Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (DO)
Likewise, licenses and credentials include:
Licensed physicians in the state in which they are carrying out their practice.
6. Psychiatric Pharmacists
They are pharmacists who carry out an advanced practice and specialize in mental health care. Further, they can even prescribe medication if they are permitted to do so in the state they are practicing.
In addition to this, they moderate medication based on how you respond to them and alter treatment accordingly. Also, many of them have even completed additional training in geriatric psychiatry, substance use disorders, and child or adolescent psychiatry.
Educational Qualifications and Licenses and Credentials
Degrees they hold include:
Doctor of Pharmacy (PharmD). Further, completion of residency training is not needed. However, it is commonly undertaken by Psychiatric Pharmacists.
Likewise, licenses and credentials include:
Having a pharmacist license in the state in which the psychiatric pharmacist is carrying out his practice.
He may also be given a Board Certified Psychiatric Pharmacist by the Board of Pharmacy Specialities.
7. Social Workers
Social workers have B.A. or B.S. degrees and offer case management, placement services, etc. This helps in supporting the healthy life of individuals.
8. Pastoral Counselors
These are clergy members who are trained in pastoral education. They have proper training in diagnosing and providing counseling.
9. Certified Peer Specialists
These are people who have themselves been through a mental health issue or a substance use disorder. They are usually trained, certified, and prepared to help patients in recovering from mental health issues. This is done by helping patients set goals and build on strengths. These specialists typically provide guidance and support.
Why is Googling Symptoms a Bad Idea?
It is a common practice for many of us to search on Google when experiencing any medical condition for symptoms. For instance, you or your loved one might be experiencing nasal congestion. And you may have found yourself googling for symptoms to know more about the health condition.
1. Anyone Can Post Content Online
Google search can put you in the right direction and make the right decision if you’re aware of your health condition. But, if you are self-diagnosing your health condition by looking on search engines, you may be misleading yourself.
This is because it may be the case that you or your loved one may have normal nasal congestion. But search through a search engine like Google may show you symptoms of acute sinusitis or sleep apnea.
Likewise, there is a higher probability that the insights you come across may not be correct. This is because your search query may serve you with a medical website with credible content.
However, it may also show information posted on personal blogs, forums, or Wikipedia pages, which can’t be trusted.
2. Google Ranking Factors May Not Show Content you Want
Google ranking factors rank those articles higher that are well optimized for the search engine. That is to say that many credible resources that are not well optimized as per the Google algorithm may not rank higher. Likewise, priority is assigned to the content that is repetitively searched on the internet.
Thus, if more people are searching for headaches under brain tumors, information related to brain tumors would appear higher on google.
Therefore, it can be difficult to come across the right resource for information given the algorithm and the volume of information available.
3. Googling Symptoms Causes Anxiety
As per a study, googling for symptoms adds to worry and anxiety. This is specifically the case with people who have no medical background or training.
The behavior of googling for health symptoms is termed Cyberchondria (CYB). It is a behavior that is marked by too much online searching for medical conditions leaving the searchers anxious.
Dealing With Depression? Seek Help
If you’re dealing with depression or any other mental illness, it is highly recommended to see a mental health professional. Mental health professionals conduct proper analysis and recommend treatment and medication based on the diagnosis.
Attention Deficit-Hyperactivity Disorder (ADHD) is a mental disorder marked by a continuous pattern of inattention and hyperactivity-impulsivity. Such ADHD symptoms in adults or individuals become evident during childhood, before the age of 12 years.
As per earlier studies, ADHD was considered a psychological disorder found only in children and its occurrence in adults was questionable. However, with long-term research studies, it is now clear that 40% – 60% of children suffering from ADHD continue to experience this mental issue in adulthood as well.
Further, as per DSM-5, 2.5% of adults experience ADHD as compared to 5% of children across various cultures across the world.
The first symptoms of ADHD are noticed by parents in the form of excessive motor activity when their child is still a toddler. However, it is extremely difficult to differentiate ADHD symptoms of hyperactivity from normal behavior before the child turns at least 4 years old.
Such inattention and hyperactivity-impulsivity symptoms are impairing and interfere with routine functioning and overall development.
Inattention
Inattention means lack of perseverance, lack of concentration, and vulnerable to distraction. It may also mean wandering off task, and being messy and disorganized. For instance, an adult at work may lack focus, unable to complete assignments, and distracts easily. He may even daydream at work, forget tasks, etc.
Hyperactivity
On the other hand, hyperactivity in adults is characterized by restlessness and causing fatigue in others with the activities they undertake. For instance, an adult at work may have issues sitting at one place or remaining still when doing solitary tasks like a group project. Further, his peers may complain about the adult being extremely talkative, careless, and disorganized.
Impulsivity
Finally, impulsivity refers to actions or decisions taken in a hurry, without lending proper thought or reasoning. Such decisions or activities have higher odds of causing harm to the person in question and the people associated with him.
Further, impulsivity may also make people seek results immediately or delay gratification. Such impulsive behaviors are socially-interrupting. For instance, they may find it difficult to wait for their turn when standing in a queue.
Or such people may interfere in other people’s work, conversations without letting them finish, or use the possessions of others without their permission.
Also, such behaviors may make people make decisions without thinking about the long-term outcomes of their decisions.
For example, people may end up in jobs that are misfit for them or engage in toxic partnerships.
In this article, we will discuss what are symptoms of ADHD in adults checklist so that you can seek the right help, for the right people, at the right time.
What are ADHD Symptoms in Adults?
Want to know what are the signs and symptoms of ADHD in adults? Here’s the DSM-5, criteria for ADHD in adults.
I. Inattentive ADHD Symptoms in Adults
At least five of the following inattentive ADHD symptoms in adults must be present for a minimum of six months. Also, such ADHD symptoms must be present to an extent that is contrary to the developmental level and has a negative influence on one’s social and occupational activities.
a. Unable to Focus on Details
One of the ADHD symptoms in young adults as well as older adults is that they are unable to pay attention to minute details. As a result, they commit careless mistakes at work at their jobs, in schoolwork, and while undertaking other tasks. Such individuals suffer from inaccuracy there due to a lack of close attention to detail.
b. Difficult to Maintain Attention
One of the other symptoms of ADHD in adults and young adults is their inability to maintain focus and attention in tasks they undertake. For example, young adults may find it challenging to focus during lectures. Similarly, adults may find it difficult to concentrate during conversations or lengthy reading or orientations.
c. Has Mind Wandering When Someone Talks
People with ADHD have their minds somewhere else when someone talks to them. This happens even when there is no distraction to bother them.
d. Face Difficulty in Completing Tasks
Such individuals find it really challenging to finish their tasks in time. For instance, young adults may not be able to finish their college assignments. Whereas adults may be unable to finish office work in time and meet deadlines. They may start work before time but still can’t finish work due to lack of focus.
e. Can’t Organize Things
Adults with ADHD symptoms are disorganized and messy. It is really hard for them to keep their materials and possessions in proper order. They are extremely poor at meeting deadlines, managing time, and doing work in a very disorganized way.
f. Dislike Doing Work That Needs Continuous Mental Exertion
Such people don’t like to undertake work that requires too much or consistent mental work. You would always find them avoiding or escaping from such work. For example, adults with ADHD run away from preparing spreadsheets, reports, going through lengthy papers, etc.
g. Lose Important Items for Tasks/Activities
You’ll also find adults with ADHD losing things or possessions that are important to undertake certain tasks. For instance, losing important paperwork, files, mobile phones, eyeglasses, books, wallets, keys, etc.
h. Get Easily Distracted
It is very easy for them to get distracted by external stimuli events. For instance, sudden or unrelated thoughts may make them lose focus while working.
i. Forgetful in Daily Chores
One of the other inattentive ADHD symptoms in adults is that they usually forget in carrying out daily tasks. For instance, they will forget to pay bills, answer back calls, etc.
II. Hyperactivity and Impulsivity ADHD in Adults Symptoms
Adults must meet at least five of the following hyperactivity and impulsivity symptoms of ADHD in adults checklist. Also, an individual must show such symptoms for a minimum of six months to an extent that is contrary to one’s development level. Apart from this, such symptoms have a negative impact on the occupational or academic activities of the individuals.
a. Fidgeting or Tapping
One of the signs of impulsivity in adults with ADHD is that they typically fidget, tap their hands or feet, or wiggle in their seats.
b. Leave Their Seats When in Tasks That Require Sitting
Also, such individuals leave their seats or move while undertaking tasks or activities that require them to sit. For instance, you’ll find young adults moving the classroom and adults moving offices or workplaces.
c. Being Restless in Inappropriate Situations
One of the other symptoms of ADHD in young adults and adults is that they may feel restless in situations that require calmness and peacefulness. These may include orientations, meetings, church gatherings, etc.
d. Can’t Involve in Leisure Activities in Peace
They find it really hard to engage peacefully in leisure activities. For instance, playing board games with family and friends.
e. Always in a Hurry
You’ll find such individuals always in a hurry as driven by a motor. Such individuals can’t sit still for very long, such as in cinema halls, restaurants, meetings, etc. That’s why others find it difficult to deal with them.
f. Excessively Talkative
Another sign of hyperactivity and impulsiveness is that people with ADHD are extremely talkative. They don’t know when to stop talking.
g. Answer Even Before They Hear the Question Completely
You’ll often find such individuals answering questions before even you complete the sentences fully. They just can’t wait for their turn to answer.
h. They Can’t Wait In a Queue
It is very difficult for such people to wait for their turn when standing in a line at the billing counter or collecting food through a drive-thru.
i. Interfere With What Others Are Doing
People with ADHD often interfere with what others do. For instance, they just simply break in while others are having conversations, playing games, or undertaking different tasks. Likewise, they may start using other people’s belongings without seeking their permission. Still better, they may directly take over tasks that other people are undertaking.
There are certain things that you must note along with these symptoms of ADHD in young adults and adults. Many of these inattentive or hyperactive-impulsive signs must be present in individuals before the age of 12 years.
Now, such a requirement makes one thing very clear. It shows how critical it is for parents and family members to get children showing ADHD symptoms clinically examined.
Also, you must see many of these symptoms in two or more setups in people with ADHD. These setups could be home, office, public places, in meetings with friends and relatives, etc.
Additionally, one can’t authenticate people showing ADHD symptoms in various setups without confirming it from other people. These people are those who have seen people with ADHD in various situations showing ADHD symptoms.
Take The ADHD Symptoms in Adults Test
Here are our online ADHD symptoms in the Adults test online. Taking this test and showing these symptoms does not mean that you have ADHD. However, taking this ADHD online test can certainly help you in seeking help from a specialist and getting the right treatment at the right time.
If you feel that you have ADHD, taking this test would help you to know if you need to see a professional for ADHD diagnosis and ADHD treatment.
It is important to note that this test is simply a guide. Only a mental health professional can tell if you or your loved one has ADHD and can prescribe the right treatment for it.
The ADHD Symptoms in Adults Women
ADHD symptoms in female adults are the same as the ones mentioned above. However, females are more likely to experience mainly inattentive symptoms as compared to males.
Also, they are less likely to have ADHD as compared to males.
ADHD Symptoms in Male Adults
Male adults also show the same symptoms of ADHD as discussed above. However, ADHD is more common in male adults as compared to females with a prevalence ratio of close to 1.6:1.
Untreated ADHD in Adults Symptoms
Adults having ADHD experience serious functional consequences. Therefore, untreated ADHD in adults symptoms can interfere with one’s routine functioning and can impact one’s mental and physical wellbeing.
Some of the functional outcomes of ADHD are as follows:
Such adults may experience social rejection and poor performance at work. It could also result in low attendance at work, higher odds of job loss, increased interpersonal conflicts.
Also, such adults have a higher probability of showing anti-social behavior and as a result experience substance use disorders and incarceration.
ADHD adults are more likely to get an injury. This is because they showcase impulsive or hyperactive behaviors. For instance, they experience road accidents and consequences of violating traffic rules
In addition to this, adults with ADHD have a higher probability of facing obesity issues.
As mentioned earlier, people with ADHD have issues undertaking tasks that require continuous effort. This results in their peers taking them to be lazy, irresponsible, or a failure.
Also, adults with ADHD symptoms have poor peer relationships. This is because the peers often tease and reject them.
Finally, severe ADHD symptoms interfere with one’s social and occupational undertakings.
ADHD and Comorbid Disorders
People with ADHD symptoms are highly likely to experience comorbid disorders. For instance, certain adults that meet the ADHD criteria also have substance use disorders.
Likewise, adults with ADHD may also experience personality disorders, obsessive-compulsive disorder, tic disorders, and an autism spectrum disorder.
Similarly, conduct disorder occurs in a quarter of the young adults with ADHD symptoms. However, this depends on their age and the environment. Additionally, many young adults experience disruptive mood dysregulation disorder together with symptoms of ADHD.
Causes of ADHD Symptoms in Adults
As mentioned earlier, ADHD is not a mental disorder that comes by as a result of adult life. For an adult to have ADHD, he must have had it since childhood. However, some ADHD symptoms in adults are a result of brain injuries or organic reasons.
Similarly, ADHD in adults is related to increased separation, divorce rates, and frequent job changes.
Further, a host of factors cause ADHD in adults. These include genetic, environmental, and biological factors.
Genetic and Non Genetic Factors
There is a higher probability of ADHD in individuals who have first-degree relatives suffering from ADHD. There are higher odds of people inheriting ADHD.
Further, there are certain genes that associate with ADHD. However, they are not mandatory or sufficient factors that cause ADHD.
In addition to this, issues like visual and hearing difficulties, sleep disorders, metabolic abnormalities, nutritional deficiencies, and epilepsy are closely related to influencing ADHD symptoms.
Environmental Factors
Much like genetic factors, the surrounding environment may also be the cause of ADHD in adults. For instance, individuals with very low weight at the time of birth, which is less than 1500 grams, may have a two to three-fold risk for ADHD.
Similarly, mothers who smoke during pregnancy have a higher probability of bearing children who may experience ADHD symptoms.
Also, there can be some cases of ADHD as an outcome of the response to aspects of diet. Further, children in the mother’s womb may face exposure to alcohol, infections, or lead. Likewise, people with ADHD may have a history of child abuse, multiple foster placements, and neglect.
Temperamental Factors
Some individuals find it hard to exercise control, experience negative emotionality, or seek novelty. Such individuals are observed to have ADHD.
Also, decreased behavioral inhibition may make children vulnerable to facing ADHD symptoms.
ADHD Symptoms and Treatment in Adults
Following are the methods that manage ADHD symptoms in adults.
I. Psychotherapy
The mental health professionals recommend psychotherapeutic interventions for adults with ADHD symptoms. The most effective and commonly used is cognitive-behavioral therapy.
ADHD adults are trained through CBT. They are trained to learn time management, problem-solving, and organization. In addition to this, such adults are also guided on prioritizing, emotional control, and are motivated by professionals which are seen to reduce ADHD symptoms.
CBT is typically used with pharmacotherapy as a treatment for ADHD.
II. Pharmacological Treatment
Pharmacotherapy has shown short-term effects like reduction in ADHD symptoms and enhancement in daily functioning. For instance, stimulants like amphetamine and methylphenidate are taken as the most effective medication for treating ADHD. Likewise, the one non-stimulant medication that is approved for treating ADHD includes atomoxetine.
One can see the ADHD symptoms reducing immediately after the medications are given to the individual.
a. Stimulants
Stimulants such as amphetamine and methylphenidate are considered most effective for ADHD treatment. These stimulants are controlled-release formulations. That is, they release the medicine slowly throughout the day.
As per studies done in a controlled environment, people showing ADHD symptoms have shown a positive response to these stimulants. Accordingly, 70% of adults with ADHD symptoms showed improvement in attention levels and a reduction in distractions within no time.
Now, how much dosage must be administered varies from person to person. But these stimulants come with a caveat. They have side effects which include insomnia headaches, weight loss, depression, anxiety, dry mouth, and loss of appetite.
In addition to this, stimulants have the capacity for abuse. That is the reason they are categorized as Schedule II substances by the Drug Enforcement Agency.
a. Non-Stimulants
Atomoxetine is the only non-stimulant that is approved to treat ADHD symptoms. Unlike stimulants, Antomoxetine has less potential for abuse and may be administered to people with ADHD symptoms together with substance-use disorders.
Further, it is also given to people with anxiety, psychosis, or tics.
FAQs on ADHD Symptoms in Adults
1. What are the symptoms of ADHD in adults?
People including adolescents, young adults, and adults show the same symptoms of ADHD.
So, what are the symptoms for ADHD in adults?
Some of the typical symptoms of ADHD in adults include inattention symptoms like inability to focus on details, difficulty to maintain attention, wandering mind while talking, disorganization, difficulty in completing tasks, a dislike for tasks that require persistent mental effort, losing important items needed for tasks, forgetfulness, and distraction.
Likewise, adults with ADHD also show hyperactivity-impulsivity symptoms. These include fidgeting, tapping, restlessness, inability to sit continuously at one place, always in a rush, talkativeness, inability to wait for their turn, and interfering in what others are doing.
2. What triggers ADHD in adults?
Some of the common factors that stimulate ADHD in adults include improper sleep, stress, technology, certain types of food, being overstimulated. Adults need to identify such triggers so that it helps them to make requisite adjustments. This will help them in coping with ADHD symptoms.
3. What are the three main symptoms of ADHD?
As specified above, the three main ADHD symptoms include Inattention which may be marked by lack of focus, wandering mind while talking, etc. The next important ADHD symptom includes impulsivity which is characterized by difficulty in waiting for their turn, excessive talking, etc.
Finally, the third important symptom includes hyperactivity which is marked by difficulty in sitting in one place.
4. What does ADHD in adults feel like?
Adults with ADHD symptoms get distracted easily, have reduced attention levels, are forgetful about daily chores, are disorganized, and face difficulty in completing tasks. You’ll always find them in a hurry as they are hyperactive and impulsive.
That is why they find it challenging to wait for their turn, are extremely talkative, are restless, and find it challenging to sit at one place for long hours.
Online therapy is increasingly used as a medium to provide mental health support to people. With governments implementing stay-at-home orders due to the pandemic, online therapy has been the only option for people in need of mental care. Its usage has increased 38 times from the pre-COVID-19 baseline, despite both the pros and cons of online therapy.
COVID-19 made the shift to online therapy inevitable. This has been due to:
social distancing leaving online therapy as the sole option
the changing consumer and provider attitudes in favor of online therapy
relaxing regulations permitting increased use of online therapy. For instance, the Centers for Medicare and Medicaid Services broadened the reimbursable telehealth codes for the 2021 physician fee schedule.
Mental health issues are becoming increasingly common across the world, with the pandemic making it worse. Over the years, international organizations and governments have accepted the critical part mental health plays in global development.
That is why WHO included ‘Ensuring Mental Health’ as one of the goals in its Sustainable Goals Agenda 2030. Despite advancements across the globe, depression is one of the major causes of disability today. In fact, the second major cause of death among people aged between 15 and 29 years is suicide.
Yet, 75% of people with mental health issues in low-income countries do not receive the required treatment. Online therapy has come to solve many issues like reaching out to more people in need of mental support at less cost. Likewise, online therapy has helped people overcome barriers like not seeking it due to the fear of visiting a mental health clinic.
Virtual therapy incorporates certain challenges despite so much good it can achieve for victims. Let’s understand what virtual therapy is and what are the pros and cons of online therapy.
What is Virtual Therapy?
Virtual Therapy is the therapy that is offered electronically or over the internet to people in need of mental support. Virtual therapy is known by various terms that are used interchangeably.
For instance, virtual therapy is also referred to as internet therapy, e-therapy, e-mental health, online counseling, cyber counseling, online therapy, or teletherapy. In fact, it comes under the term ‘Telepsychology’ in the American Psychological Association (APA)index of terminology.
APA has set up a Task Force on Telepsychology that defines Telepsychology as providing psychological services through telecommunication technologies. In other words, it includes preparing, transmitting, communicating, or processing information through electronic means.
These may include a number of technologies. For instance, videoconferencing, chat, text, email, the internet which includes self-help websites, blogs, social media, telephone, and mobile devices.
Benefits of Online Therapy
Using these technologies have made it really easy to extend mental care to individuals who were constrained by:
Geographic location
Medical illness
Financial issues
Other barriers like the stigma attached to mental illness.
There is no doubt that online or virtual therapy offers a good opportunity for mental health care providers. This is to increase patient access to psychological services. In fact, online or virtual therapy gives a boost to the traditional face-to-face counseling sessions given to people with mental health issues.
Also, the use of digital technology helps in providing psychological services through new methods. These include therapy given through interactive videoconferencing, online psychoeducation, etc.
But to direct mental health professionals in respect of their conduct and behavior, APA has come up with guidelines. These have been released to help professionals offer the best guidance as they adopt virtual therapy.
APA Guidelines
Some of these guidelines include:
the competency of psychologists to use these technologies
taking informed consent of the patients/clients
maintaining the confidentiality of details related to clients
ensuring that there are proper measures to protect client data
being well-versed with and complying with laws when providing services to clients across jurisdictions
But despite these measures taken, there are both pros and cons of online therapy. Therefore, it is important to consider them before taking online therapy.
Pros of Online Therapy
The following are the pros of online therapy for patients/clients or mental health care seekers.
1. Accessing More People Needing Mental Care
You may not know that many people facing mental issues like anxiety and mood disorders never receive treatment. As per WHO, anxiety and depression cost the global economy US $1 trillion every year. Yet, 76% – 85% of people with mental health disorders receive no treatment.
There is a gap between the need or demand for treatment and its provision. And this gap is something that can be reduced with the help of virtual therapy. Thus, if you are one of the patients who haven’t received treatment for years, you can now be reached and given evidence-based psychological treatment via online therapy.
With online intervention, you are now able to seek therapy even if you reside in remote and rural areas. Online therapy is certainly an advantage if you haven’t been able to seek treatment because of various constraints. These limitations could be challenges of traveling, lack of transportation, physical or mental disabilities, etc.
With the increase in online counseling, more people can now receive telehealth services. This means you can receive mental health treatment, anytime, anywhere even if you’re bound by such constraints.
2. Meet Therapist Frequently and Through Many Ways
Virtual therapy allows you to meet your therapist anytime, anywhere, and multiple times in a day, week, or month. In cases of emergency, you can immediately fix up an online therapy session with a mental health professional, as per your need.
This means no hassle of going to the clinic, no waiting time of a week, and instant help to people who need help in an emergency.
Online therapy also is best for mental health care seekers who need frequent support. This is because telehealth enables you to connect to a mental health professional in a number of ways.
For instance, you can get in touch with your therapist over text, video call, audio call, etc. This gives you the flexibility to choose the way you feel convenient to have a therapy session with your therapist. Many people express themselves freely when on a video over text or audio call. Similarly, there are others who open up more freely when on an audio call or texting.
3. Increased Comfort and Flexibility of Receiving Treatment
The convenience of receiving mental treatment has increased more than ever with online therapy. Now, there could be a number of limitations on your end for not being able to visit a mental health professional’s clinic. For instance, you could have fear of you being identified by someone when sitting in a clinic, waiting for your turn. This could be due to the stigma attached to mental health or the culture you come from.
Similarly, you may have issues like traveling, time constraints, having no transportation facility, scheduling appointments, etc. This is where virtual therapy shines and comes to your rescue. You can take online therapy sessions from the comfort of your home, without the stress and anxiety that is usually caused due to the constraints mentioned above.
Also, you get a lot of flexibility in terms of having an online therapy session as per your comfort. For instance, you can schedule a session while you’re traveling, during work breaks, or when you’re free over the weekends.
4. Help Meet the Shortage of Mental Health Professionals
As per the latest WHO statistics, the USA had 10.54 psychiatrists per 100,000 people IN 2016. This shows that the gap between the number of people who need mental health care and the number of mental health care providers is huge.
However, this gap can be filled with the help of virtual therapy. This is because mental health professionals can reach clients/ patients in any part of the world.
All the patients and the professionals need is a stable internet connection, a mobile phone, laptop, or a tablet through which they can connect having a good quality camera. With connecting over the internet being that simple, virtual therapy helps professionals reach out to more people needing mental healthcare.
For instance, mental health professionals can reach out to people in remote or rural areas. This wasn’t possible earlier as rural areas could not get the resources and care of medical health professionals.
5. Cost-Effective Relative to Traditional Therapy
Well, at times online therapy can be cost-effective relative to traditional therapy. This is because online mental health care providers may provide you unlimited access to mental health services at a weekly or a monthly fee. Likewise, you may find virtual therapy cost-effective in comparison to in-office visits.
But you need to be careful here when comparing the cost of online therapy vs traditional therapy. This is because many online therapy websites and applications do not come under your insurance cover. Many insurance companies cover mental health treatment that is taken in person.
However, as per statistics, the traditional therapy costs betweeb $75 – $150 for a 45 – 60 minutes in-person session. These are rates after your insurance coverage. Thus, online therapy still turns out to be cheaper than in-person sessions. For instance, online therapy provider online-therapy.com charges between $30 – $65 per week.
6. Go for Online Therapy Instantly
One of the biggest advantages of virtual therapy is that you can go for it just a few hours after you schedule an appointment with your therapist. In some cases, it’s even faster than that.
However, you may take some time if the online therapy provider needs your health insurance. Still, the process is faster as compared to traditional therapy. If you’re signing up with an online therapist for the first time, searching for a relevant mental health professional also is not a big challenge.
This is because the algorithms are such that they ask you questions and track your search history. And this is what helps them in connecting you to the right professional within no time. But, in cases where professionals are not a part of the affiliate programs of the online therapy network searching for and connecting with a relevant specialist may take some extra time.
Also, the benefit of taking online therapy, anytime, anywhere is certainly a boon.
Cons of Online Therapy
The following are the cons of online therapy or the disadvantages of online therapy for mental health care seekers.
1. Online Therapy May Not Be for You
There is no research on online counseling suggesting that online therapy alone or as the only therapy can apply to every case and situation. You have to see whether the application that offers online therapy applies to your case.
This is because there are many websites and online platforms that claim to provide online therapy for various mental health issues. But, its effectiveness totally depends on the type of mental issue you have, how severe the symptoms are, and whether these can be identified over a video, email, text, or audio call with a mental health professional.
For instance, if you have a severe psychiatric illness and need in-person intervention, online therapy as a standalone option may not work. In such a case, you need the direct involvement of the mental health professional and need to see him in person to seek treatment for your complex situation.
2. Your Insurance Plan May Not Cover Online Therapy
There are many insurance companies that provide cover for mental health treatment only if you seek it in person from a professional. Thus, if you visit your psychologist in his clinic and work with him on your mental issue, your insurance plan may cover a complete or some portion of the fee.
In this case, mental health professionals issue you an invoice against which you can get reimbursed by sharing the same with your insurance company.
But, virtual therapy is generally not covered by the majority of insurance providers.
Similarly, many online therapy providers do not accept insurance coverage as payment. So, if you are looking to use your cover, check with your insurance company and the online therapy provider.
If insurance coverage is not applicable, you will have to pay the treatment fee in full out of your pocket.
3. Lack of Confidentiality, Security, and Privacy
Psychotherapy has been effective in treating mental disorders as it provides a safe, private environment to the clients. This makes them share their personal issues and express their complex feelings to the mental health professional with ease.
Since you know you have a private space where no one is listening to you, you can come out with your fears and difficult feelings easily. You know that there is no one to judge you. What you say, do, come out with is going to stay between you and your mental health professional. Now, privacy and confidentiality may be at threat when it comes to online therapy. This is because the information being transmitted online is exposed to hacks or has odds of leaking.
Similarly, technological glitches may at times create issues and make the situation complex for you.
4. Inter-State Laws Restrict Therapy to State Licensed Professionals Only
No doubt virtual therapy allows you to take mental health treatment from anywhere, but there is a caveat here. Psychology licensing laws are not catching up with the changing dynamics in providing mental health care services to people who need support.
According to the telepsychology licensing laws, the therapists licensed in your state only can provide you with online therapy. This means for therapists to provide online therapy outside their licensed state, they need to own a license for the other state. This is apart from the state in which they are licensed to provide online therapy.
There are, however, exceptions to this. There exist many states that allow out-of-the-state psychologists to provide services to clients for a period of 30-60 days in a calendar year.
5. Lack of Direct Help in Period of Crisis
Virtual therapy can help to seek help in less time. However, it lacks when in-person or direct help is needed by a person in crisis. For instance, a person having a major panic attack or suicidal thoughts needs direct help from a mental health care provider.
In such a crisis situation, online therapy may not be able to successfully be of help to the person facing severe or complex situations like these.
6. Can’t Read Body Gestures
One of the other disadvantages of online therapy is that the mental health care provider is not able to read your body gestures. For instance, your facial expressions while you talk, the tone of your voice, your actions may be clear in video calling. But, therapy over text, email, and audio calls lack this facility.
Even online therapy over video calling may lack that personal touch and detail as is present in a face-to-face session. These signals are very important for therapists to take into account in order to clearly understand the severity of your issue.
7. Ethical Issues Like Is the Therapist Licensed
Licensing is out of the few dangers of online therapy. Having a licensed therapist providing you with mental health is critical. Basically, licensing gives you protection as words like psychotherapist and therapist are not legally backed in many states.
This means that anyone can say that he/she is a therapist and provide you with mental therapy. It is absolutely necessary for your psychotherapist or mental health professional to have a license in the state in which he is providing mental health care services.
Thus, licensing gives you that guarantee that only the person who is qualified and trained is providing you mental health care services.
Also, you can count on and go back to your therapist in case you have any issues in receiving your treatment. Therefore, before you register with any online therapy website, make sure that you do the necessary research. This is to find out that the network of therapists registered on the website is authentic and has a license.
You can check the state for which the therapist is a license holder. You can also check his license number from the state online directory.
Ethical Issues With Online Therapy
The following are some of the major ethical issues with online therapy.
1. Medical Professional’s Training and Competence
It is important for mental health care service providers to be competent in using technologies to provide online psychotherapy. Further, they also need to have clinical competencies that are appropriate to the online setup.
For instance, the medical professional would need to know the ethical guidelines and legal requirements for providing online therapy. It is important to note here that the in-person therapeutic skills of the medical professional would not mean that he’s competent to handle mental health care seekers online. One of the drawbacks or issues with online therapy is that guidelines for online therapy are not well defined. Also, there are fewer training and educational programs in respect of virtual therapy.
Therefore, the therapists would have to be well-versed with the international laws and legal requirements of their clients. This is in case they are providing therapy to people in remote areas.
2. Insufficient Research Showing Effectiveness of Online Therapy
One of the other ethical issues with online therapy is that there is not enough research that supports the effectiveness of online therapy. In other words, much still needs to be studied and researched about online therapy.
For instance, the efficacy of virtual therapy, its effectiveness, the long-term outcomes of online therapy relative to in-person therapy.
3. Informed Consent of the Patient
The therapists need a specific type of informed consent from the patients when it comes to online or informed consent difference lies in legal and technical requirements. It may be challenging to determine whether the patient sitting for online therapy is legally capable to give consent or take their mental health services.
4. Lacking Technological Know How
It is a possibility that the medical professional may not have the requisite technical competence to undertake online therapy. Similarly, both the patient and the mental health care provider may not be well aware of the technical skills they possess so that they can have the online therapy session uninterruptedly.
5. Incomplete Guidelines
As discussed earlier, there is a gap when it comes to guidelines in respect of virtual therapy. The much-needed guidelines and regulations are either incomplete or do not exist. Likewise, the regulatory bodies to do not provide any guidelines with regards to virtual therapy.
Similarly, there are many queries that are not dealt with regard to online therapy. This is because of the lack of guidelines or code of conduct with regard to virtual therapy.
Online Therapy Vs Traditional Therapy
Let’s now compare online therapy vs traditional therapy so as to get a clear picture of how the two are different from each other. This will help you to get a better understanding of which one is better for you.
Basis
Online Therapy
Traditional Therapy
Definition
Online therapy refers to providing mental health support electronically, anytime anywhere. It may be provided through various forms such as text, video conferencing, audio calls, and email. It is also called telepsychology, online therapy, or virtual therapy.
Traditional therapy, on the other hand, is providing mental health care support in-person, in a clinical setup. This is where both the therapist and the patient are present in person and have a 45-60 minute long therapy session.
Communication
Therapists are able to communicate via text, audio, or video calls. When it comes to text or audio calls, therapists can’t see non-verbal cues which are very important to consider for understanding mental health issues. The video call, however, may allow the therapist to see the patient. But it lacks the intimacy and intricacy of an in-person session.
The in-person session allows the therapist to read the body language, the tone of voice, the way patients express or emote. This helps in understanding the non-verbal cues which are important to consider to reach any conclusion in respect of the mental health issue the patient is going through.
Convenience
Online therapy offers the comfort of undertaking the session anytime, anywhere. All you need is a strong internet connection and a mobile device, desktop, or tablet. Many people can freely express themselves given the comfort of their home and no one judging them. But a technological glitch may put your privacy at risk. This is because it may lead to your information leaking or the website being hacked.
The traditional therapy sessions give patients a space away from home. The mental health professional’s clinic gives them the space away to talk about their worries and share their complex stories with the therapist. Again, patients feel comfortable expressing themselves. Also, there’s an added advantage of the therapist being able to extend direct support, clearly getting the non-verbal cues and going into much detail.
Access
Online therapy can be accessed very easily. All it takes is a simple sign up and you can choose to meet the specialist you want to. Plus, you don’t need to get into the stress of visiting the clinic of the therapist. Online therapy makes it really easy for people bound by lack of transport facilities, physical or mental disabilities, etc to have access to mental health support.
It may be a challenge for people sitting in rural or remote areas, lacking transport facilities, disabilities, or work to go for in-person therapy. Also, one needs to schedule an appointment at a good time before they want to go for a traditional therapy session.
Cost
Online therapy is cheaper than traditional therapy. However, many online therapy sessions are not covered by insurance plans. There are various online therapy providers. The pricing for some of them starts at $30 per week. And neither do many online therapy providers accept insurance cover. So, you may have to pay the entire fee from your own side.
Traditional therapy is relatively costly. Although, the rates for traditional therapy sessions vary from state to state. The average cost for a 45-60 minute traditional therapy session costs between $75 – $150.
Support
Although seeking instant support is not an issue here, it may not be suitable for many mental health issues. For instance, a person having suicidal thoughts needs the direct assistance of a therapist. This is not possible with online therapy.
This is good for a crisis situation when a person needs direct support from the therapist. Also, the personal touch in the in-person therapy session is what is needed in severe cases.
Online Therapy Controversy
As mentioned above, one of the dangers of online therapy is determining the authenticity of the online therapy websites.
It is difficult to determine whether the person registered as a therapist on the online therapy platform is a licensed therapist or not.
Few of the leading online therapy-providing websites came into question for their exploitative privacy policy and regulations.
In fact, some of the social media influencers claimed that these online therapy websites were sharing client data with big social media companies of the world.
Not only this, these platforms were also exploiting genuine therapists by underpaying them.
These online therapy websites were even questioned for undertaking paid partnerships with some of the big celebrities. All promoting these websites that had questionable guidelines, no clarity with the credentials of the therapists registered, and clients being paired to specialists not matching with their needs.
Research on Online Counseling
More researchers have been going through online websites and applications to check their effectiveness. As per research, these internet-based tools can be helpful when used together with in-person therapy.
For instance, both researchers and patients are finding therapy over text helpful. Likewise, online video-conferencing is helpful in providing therapy to people in remote areas.
Here are some of the research studies undertaken to check the effectiveness of online therapy.
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