People who have depression tend to feel depressed or down for much of the time, or feel like they don't want to do or enjoy the things that they used to like or find interesting.

Symptoms of depression may include:

*   Having changes in your appetite (either increases or decreases)
*   Difficulty sleeping (insomnia) or sleeping too much (hypersomnia)
*   Difficulty concentrating or making decisions
*   Feeling guilty or critical about yourself
*   Feeling tired
*   Thoughts about ending your life or your death
*   Changes in your movement where you either feel slowed down or sped up

People with depression symptoms may not have all of these symptoms, and it's important to speak with a licensed provider to find out if depression is a problem you are currently experiencing.

It is common for depression to occur after a person has experienced a significant stressor, such as a major life change, a traumatic event, or a serious illness. For example, the COVID-19 pandemic has resulted in an increase in depression rates, as many people have experienced financial stress, isolation, and loss of loved ones during the pandemic.

Another common time for depression to occur is during or after the postpartum period. The hormonal and physical changes that occur after giving birth can lead to feelings of sadness, anxiety, and exhaustion. In addition, the challenges of caring for a newborn can be overwhelming, leading to feelings of inadequacy and hopelessness. It is important for new mothers to be aware of the signs of postpartum depression and to seek help if necessary.

![Depression - Diagram](/site_images/Resources/depression1.png "Depression - Diagram")

**Fortunately, there are several highly effective evidence-based treatments for depression.**

**Behavior Therapy (or Behavioral Activation)**

One leading treatment focuses on breaking a cycle of behaviors that keep people depressed. When people feel sad and low, they start to do less of the things that matter to them or that they used to find enjoyable (usually because they no longer feel this interest or pleasure). Unfortunately, this then causes people to feel even less motivated to do things and experience even lower energy, which causes them to go deeper into their depression and do less of the things that are important to them. They end up in a vicious cycle: depression makes them not want to do anything enjoyable, rewarding, or meaningful, and not doing those things keeps them depressed.

Behavior therapy (or behavioral activation) is a type of cognitive-behavior therapy that helps people understand the relationship between what they are doing and their mood. It helps them take up activities that are meaningful to them and provides them with a sense of enjoyment and accomplishment in order to break this cycle of depression.

**Cognitive Therapy**

Another form of CBT places a greater focus on how thinking patterns fuel low and depressed mood. Many people with depression have thoughts that are overly negative and “sticky,” or difficult to change. These thoughts can cause people to stay stuck in their low mood. Cognitive therapy works by helping people examine the way they're thinking and test whether their thoughts are balanced, helpful, or overly negative. It also teaches people strategies to arrive at more balanced ways of thinking.

**Interpersonal Psychotherapy**

Another treatment for depression focuses on how relationships impact emotions and vice versa. This two-way street provides several points of entry for change.

Interpersonal psychotherapy is a treatment that focuses on addressing problems people might be experiencing in their relationships in order to improve depression. Interpersonal Psychotherapy is also helpful for people experiencing grief and loss reactions.

**Psychodynamic psychotherapy**

Early childhood experiences have a significant impact on how people behave in the present day. Sometimes they're even the reason why people experience depression.

Psychodynamic Psychotherapy focuses on insight, earlier learning in important relationships, and bringing behavioral patterns into full awareness so that change can occur. Psychodynamic psychotherapy is particularly helpful when people are interested in changing long-standing behaviors and emotional habits.

These are the treatments that experts strongly recommend, but there are also second line and third line treatments that have some scientific backing and are still being tested. These include:

*   Mindfulness-based CBT
*   Humanistic therapies
*   Emotion-focused therapy
*   Acceptance and commitment therapy

If you are looking for support with symptoms of depression at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Identify depression symptoms and treatments like behavior therapy, cognitive therapy, interpersonal therapy, and psychodynamic therapy. Get help at Nellie.

Effective therapies for depression and low mood

Everyone experiences stress in their life and, in fact, stress is actually a healthy and important part of living. Without stress, we would not be able to keep ourselves safe, get important things done, and help the ones we love. However, sometimes we experience too much stress, or for too long, or we experience stress in situations where it isn't useful to us.

The body's natural stress response is evolutionarily designed to keep us safe. Let's say, for example, you were being chased by a wild tiger - your body's natural stress response would signal your body to:

*   Produce hormones to have extra energy to run from the tiger,
*   Slow down digestion,
*   Increase your breathing and heart rate, and
*   Dilate your pupils to increase your ability to see the tiger.

All of this would be vital to keep you safe from the tiger. Of course, being chased by a wild tiger is not something that happens as often to humans today. However, we have evolved to have this stress response system to keep us safe in the face of danger.

For many, stress doesn't include things that cause imminent life threat, but our body still responds to stress in a similar way to how it would when being chased by a tiger. This is because the physical stress response can't tell the difference between real and unreal danger- it just knows that you're stressed. This is why many people with anxiety or other life stressors (e.g., relationship challenges, minority stress) often experience symptoms such as:

*   Being extra alert or on guard
*   Increased heart rate
*   Experiencing changes in appetite
*   Difficulty sleeping
*   Muscle pain or tension
*   Feeling ‘keyed up' or on edge
*   Panic attacks

Prolonged and unhelpful stress can also have a number of negative consequences to our mental and physical health and can cause problems such as insomnia, muscle pain, high blood pressure, and a weakened immune system.

Often when feeling overwhelmed or stressed, people turn to unhelpful coping strategies that, while may help provide immediate relief, end up making stress worse in the long term. Some examples of **unhelpful coping strategies** may include:

*   Substance abuse: Using alcohol or drugs as a way to escape from stress can lead to addiction and other negative consequences.
*   Overeating: Some people may turn to food as a way to cope with stress, which can lead to weight gain and other health problems.
*   Withdrawing from social support: Instead of seeking help and support from others, some people may isolate themselves and try to deal with stress on their own.
*   Procrastination: Putting off tasks and responsibilities can increase stress in the long run, as the burden of unfinished work can weigh on you.
*   Negative thinking: Focusing on negative thoughts and dwelling on problems can contribute to feelings of stress and helplessness.

It's important to recognize that these coping strategies may provide temporary relief, but they can ultimately make stress worse in the long run. Instead, it's important to find healthy ways to cope with stress and manage it effectively.

**Fortunately, there are many healthy ways to cope with stress that do not involve the use of substances. These include:**

*   Exercise: Physical activity can help reduce stress by releasing endorphins and helping to relax the mind and body.
*   Practice mindfulness: This can involve activities such as meditation, deep breathing, or simply paying attention to the present moment.
*   Seek social support: Talk to a trusted friend or family member about your feelings, or consider joining a support group.
*   Get enough sleep: Lack of sleep can increase stress, so it's important to make sure you're getting enough rest.
*   Take breaks and engage in leisure activities: Make time for activities you enjoy, whether it's reading, watching a movie, or going for a walk.
*   Seek professional help: If you're feeling overwhelmed by stress and are struggling to cope, consider speaking with a mental health professional who can **help you develop healthy coping mechanisms.**

If you are looking for support with stress at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Understand the causes and consequences of stress. Discover healthy coping strategies. Get help at Nellie.

Coping with stress in daily life

Most of us will experience or have experienced something extremely stressful in our lives, and sometimes the things that happen to us are so stressful that we call them traumatic. Some people even develop a condition that involves having difficulty moving past the trauma called Posttraumatic Stress Disorder (PTSD). PTSD also co-occurs with other conditions like anxiety and depression quite often.

PTSD is a set of symptoms that people sometimes experience after they go through something extremely stressful or difficult, which we call a trauma or traumatic event.

There are four groups of PTSD symptoms:

**Re-Experiencing Symptoms**

The first group is often called the ‘re-experiencing' symptoms, because they involve re-experiencing or re-living the traumatic event in some way.

This includes experiences like having nightmares about the trauma, “flashbacks” where it feels like the trauma is happening all over again, sleep paralysis, or feeling very upset in response to reminders of the trauma.

**Hyperarousal Symptoms**

The next group of symptoms is called \"hyperarousal\" symptoms because it involves the mind and body being hyper- (or over-) activated.

People who have these symptoms often experience sudden increases in anger or feel easily startled or jumpy.

They may also have difficulties sleeping (i.e., insomnia) or feel that they need to be on guard or watchful for something bad that may happen all the time. The symptoms in this category are similar to symptoms of anxiety.

**Avoidance Symptoms**

The third group of symptoms are called the \"avoidance\" symptoms because they involve avoiding things that remind people of the trauma.

This could be places (e.g., where the trauma happened), people, or specific sensations (e.g., smells, sounds), but it could also be thinking about, or remembering the trauma.

**Negative Changes in Mood and Thinking**

Finally, the last group of symptoms involves changes to mood and thinking..

This may involve feeling less connected to important or close people like loved ones, feeling less interested in doing things that were previously enjoyable, feeling numb or unable to experience positive emotion, or feeling negative emotion much of the time.

It may also involve having negative, unhelpful thoughts about the trauma itself, like blaming oneself when, in reality, one didn't cause the trauma to happen. The symptoms in this category are similar to symptoms of depression.

People with PTSD may not have all of these symptoms, and it's important to speak with a licensed provider to find out if PTSD is a problem you are currently experiencing.

**The good news is that there are many different types of treatments for PTSD, and several of them are highly effective.**

Several frontline treatments involve changing the way you think about trauma or respond to things that remind you of it to change how you feel. These types of treatments are called Cognitive Behavioral Therapies or CBT.

**Cognitive Processing Therapy**

Sometimes the way that people make sense of and understand traumatic events is what prevents trauma recovery. Cognitive Processing Therapy (CPT) is a type of CBT that aims to promote trauma recovery through coming to more helpful ways to understand what happened, why it happened, and what it means.

**Prolonged Exposure**

Sometimes the way that people avoid objectively safe things that remind them of their trauma, like sounds, smells, or memories prevents trauma recovery. Prolonged exposure is a type of CBT that helps people face these reminders and memories to understand that they are not a threat.

**Eye Movement Desensitization and Reprocessing**

Lastly, some people believe that PTSD is caused by how the memory is stored in the brain. Eye Movement Desensitization and Reprocessing, or EMDR, is different from CBTs. Like prolonged exposure, it involves remembering the traumatic event(s) while attempting to stimulate areas of the brain through things like eye movements, body tapping, and listening to tones. Similarly to how prolonged exposure works, research suggests that it is the remembering of the traumatic events, rather than the movements or tones, that helps this treatment work.

**PTSD and Relationships**

While there are individual treatment options for PTSD, research shows that PTSD impacts both trauma survivors _and_ their loved ones, as does the anxiety and depression that often go along with it. We also know that strong, healthy relationships can be a helpful tool in trauma recovery, and relationship problems can get in the way of recovery.

Dr. Candice Monson (Nellie Founder and CEO) and her colleagues developed an effective couple treatment for PTSD called Cognitive-Behavioral Conjoint Therapy (CBCT) that focuses on improving relationships and PTSD at the same time.

CBCT is a cognitive-behavioral therapy, which means it focuses on helping people with PTSD and their partners identify and change the thoughts and behaviors that affect the symptoms of PTSD, other areas of their life, and their relationship. Ultimately, CBCT aims to bring people in a relationship together as a team to push back against PTSD together, rather than having it drive them apart.

Studies show that CBCT is effective in reducing trauma-related symptoms (for example, avoidance, intrusive thoughts, emotional numbing, anger, loss of interest), as well as supporting enhanced communication, intimacy, closeness, and relationship satisfaction.

If you are looking for support with symptoms of PTSD at this time, we would be glad to help you get the support that you need. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Looking for Cognitive Processing Therapy in Ontario or support with symptoms of
PTSD? At Nellie, we are committed to provide compassionate Cognitive Processing Therapy in
Ontario that focuses on improving relationships and PTSD at the same time.

PTSD Ontario | Cognitive Processing Therapy Ontario

Posttraumatic stress disorder (ptsd): Understanding the symptoms and getting help

Studies show that the majority of people will experience at least one traumatic event in their lifetime, which may include sexual or physical assault or abuse, a serious accident, natural disaster, war, or learning about one of these events happening to someone that they're close to.

After an extremely stressful or traumatic event, most people will experience symptoms such as:

*   Unwanted memories, flashbacks, or nightmares about the trauma
*   Intense distress when reminded about the trauma
*   The urge to escape or avoid reminders of the event(s)
*   Negative changes in mood
*   Difficulty falling asleep
*   Feeling less connected to people, things, or activities that they usually care about
*   Trouble focusing and concentrating

Studies show that most people will experience a few of these symptoms after trauma, and most will recover from the symptoms naturally over the weeks or months that follow the trauma through a process sometimes referred to as “natural recovery”. However, some people will continue to experience these symptoms and go on to experience posttraumatic stress disorder [see article on PTSD](https://www.nelliehealth.com/resources/articles/getting-help-and-understanding-ptsd-therapy).

**Why do some experience natural recovery from trauma, and some develop PTSD?**

When posttrauma symptoms, such as memories and flashbacks, are unbearable, people may try to avoid thinking about or feeling their emotions about a traumatic event. They may do this by keeping very busy, drinking or using drugs, or avoiding reminders of the trauma.

Although it makes sense that people would want to avoid these difficult emotions, research shows that avoidance of trauma actually prevents people from naturally recovering. Having strong emotions in the wake of trauma is natural, and taking the time to feel at least certain emotions can be important to recovery. Avoiding doing this can not only prevent recovery, but also maintain these symptoms over time.

Another reason that some people don't recover naturally from trauma involves the stories they tell themselves about why the trauma happened, or what it means. After trauma, many people start to think about the trauma and what it means in ways that are unhelpful and can interfere with their recovery. When people interpret the trauma in ways that are inaccurate and unhelpful (e.g., self-blame), they are more likely to “get stuck” and not recover on their own.

Common distressing thoughts that people with PTSD have related to traumatic event(s) are:

*   “It is my fault that this happened”
*   “Because I didn't do something different at the time of the trauma, it is my fault that it happened.”
*   “If I had been paying more attention, the trauma wouldn't have happened.”
*   “I should have known this was going to happen”
*   “Because I did not tell anyone, I am to blame for what happened.”

This form of thinking can prevent people from recovering from trauma, and can lead to other problems like posttraumatic stress disorder, depression, or anxiety. Fortunately, there are science supported treatments that can help people recover from these forms of thinking.

**The good news is there is very compelling evidence to show that approaching difficult emotions in psychotherapy can be highly effective in helping people recover from trauma.**

If you are looking for support with trauma recovery at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Looking for Trauma Therapy or Trauma Therapist in Ontario? At Nellie Health, our
Trauma therapist in Ontario is committed to offer compassionate trauma therapy that leads to
lasting change in your life.

Trauma Therapy Ontario | Trauma Therapist Ontario

Why do some people develop ptsd after a traumatic experience?

Sleep complaints are extremely common and can affect people of all ages. According to the National Sleep Foundation, about 50-70 million Americans suffer from some form of sleep disorder. Insomnia, which is difficulty falling asleep or staying asleep, is the most common sleep complaint, affecting about 30% of the general population. Other common sleep complaints include sleep apnea, which is a disorder in which a person's airway becomes partially or completely blocked during sleep, and restless leg syndrome, a condition that causes an uncontrolled urge to move the legs while trying to sleep. Many people with sleep complaints experience a range of symptoms, including fatigue, difficulty concentrating, irritability, and decreased productivity.

**Insomnia**

Insomnia may include trouble falling asleep, staying asleep, and waking up early, which result in a dissatisfaction with one's quality of rest. Individuals with insomnia often go on to experience mood problems like depression, chronic fatigue, and difficulties with their thinking (e.g., having a hard time concentrating). It is important to note that insomnia is different from other sleep problems, like sleep apnea, where people experience breathing problems in sleep that recurrently and briefly wakes them up at night.

One of the leading theories today about what causes insomnia and keeps it going is called the 3 P Model, which was developed by Aurthur Spielman in 1987. The 3 P model of insomnia is a framework for understanding the complex and multifaceted nature of insomnia, and says that there are three main factors that relate to insomnia:

*   Predisposing factors are those that may increase an individual's vulnerability to insomnia, such as genetics, personality traits, or certain medical conditions. These factors may make a person more likely to experience insomnia, but they do not necessarily cause it.

*   Precipitating factors are specific events or circumstances that trigger an episode of insomnia, such as a major life stressor, a change in sleep schedule, or the use of certain medications.

*   Perpetuating factors are those that maintain or exacerbate insomnia over time. These can include negative sleep habits, like spending a lot of time in bed or taking naps during the day, irregular sleep schedules, as well as negative beliefs and attitudes about sleep.

**The good news is that there are highly effective treatments available for insomnia disorder.**

Cognitive Behavioral Therapy for Insomnia (CBT-I) is based on the theory that people with insomnia tend to worry a lot about their sleep and what it means to be awake at night. As a result of that worry, they tend to pay more attention to signs that they aren't sleeping, and accidentally engage in behaviors that make it even harder for them to fall asleep, such as:

*   paying attention to the time on the clock;
*   spending more time in bed than needed;
*   and engaging in less activities during the day that would otherwise help promote restful sleep.

These behaviors often seem helpful at the time, but they tend to keep people with insomnia stuck in insomnia.

CBT-I focuses on helping people understand how their sleep systems work, and engaging in the types of behaviors that can most effectively reset your system to promote restorative sleep.

CBT-I has been extensively tested and evaluated, and we know that it can significantly reduce insomnia symptoms. The other good news is that CBT-I can be quite brief, as research shows it can often work in between two to four sessions.

In addition to helping people with insomnia sleep better, research shows that treating insomnia can help with other problems that often co-occur with insomnia, including depression, chronic pain, and anxiety.

**The relationship between sleep and depression**

There is a strong link between sleep and depression, which makes treating insomnia so much more important for people who also have depression. Poor sleep can contribute to the development of depression, and depression can also cause sleep problems. People with depression may have difficulty falling asleep, staying asleep, or getting restful sleep. They may also experience changes in their sleep patterns, such as sleeping more or less than usual.

On the other hand, people with sleep problems, such as insomnia, may be at an increased risk of developing depression. This can be due to the negative impact that sleep deprivation has on mood and overall well-being.

Research has shown that treating sleep problems can improve depression symptoms, and treating depression can also improve sleep. It is important for individuals experiencing both sleep problems and depression to seek medical help in order to properly address both conditions.

The relationship between depression and sleep difficulties is complex, but some of the reasons why they might be connected include:

*   People with depression having intense or repeated negative thinking that interferes with nighttime sleep
*   People with depression having reduced activity during the day that impacts the body's drive to produce deep sleep
*   People with depression getting less exposure to bright light throughout the day, which can help to improve mood and sleep

Sleep challenges can play an important role in keeping depression “alive” over time. When difficulty with sleep is persistent, people may develop insomnia disorder.

Treatment for depression alone is sometimes less effective in these cases, because without treating the insomnia directly, the sleep difficulty continues and then keeps the depression going.

Fortunately, there are treatments that are highly effective in treating insomnia, and research shows that treating insomnia in just four sessions of CBT-I leads to improvement in both insomnia and depression. In fact, this brief insomnia treatment can be as effective for depression as antidepressant medication (Cunningham & Shapiro, 2018).

If you are looking for support with symptoms of insomnia at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Learn about the causes of sleep difficulty and the link between insomnia and depression. Find effective treatments for sleep complaints and insomnia at Nellie.

Insomnia: Causes, consequences, and treatment

Alcohol and substance related challenges can be very challenging to navigate and can leave an individual feeling out of control over their alcohol or substance use. Psychologists use the term “alcohol use disorder” or “substance use disorder” to define challenges with addiction that are very upsetting, get in the way of people's lives, and may warrant treatment. Besides alcohol, individuals can become addicted to a number of substances including but not limited to:

*   Nicotine (e.g., cigarettes, smoking, vaping)
*   Opioids, such as heroin, “painkillers”, fentanyl
*   Cocaine
*   Cannabis (e.g., weed, pot, marijuana)
*   Crystal methamphetamine, such as crystal meth

People who have an alcohol or substance use disorder may experience a number of issues related to their alcohol or substance use. This may include:

*   drinking or taking more of a substance than they mean to
*   wanting to cut down on it but being unable to
*   spending a lot of time drinking or using it (or recovering from it)
*   having regular cravings to use it
*   difficulty getting things done at work or school
*   putting a strain on their relationships
*   drinking or using substances in spaces that may not be safe for them, or drinking or using even if they know it is causing them some harm
*   the experience of tolerance, where they need to drink or use more and more in order to get the effects that they want
*   withdrawal, where they have uncomfortable, painful, or even dangerous symptoms if they stop drinking or using.
*   the threat of an overdose

**The good news is that there are many different types of treatments for alcohol and substance related challenges, and several of them are highly effective.**

**Motivational Enhancement Therapy** emphasizes the importance of the client taking an active role in their recovery. Motivational Enhancement Therapy is very collaborative, and rather than instructing the client on what to do to change, the therapist supports the client's independence to lead their recovery process in the way that feels right to them.

**Relapse Prevention** focuses on helping clients understand the factors that may increase their risk for substance or alcohol use. It also helps clients understand lapses in their recovery from alcohol or substance use as a potential part of recovery, and plan how to identify these periods of resumed use and get back on track as quickly as possible.

**12-Step Facilitation Therapy** is based on a philosophy that focuses on accepting addiction as a chronic and progressive illness that an individual does not have control over. It also suggests that abstinence (i.e., being sober), one day at a time, is the only way to overcome addiction. The 12 steps are guiding principles that include admitting one's powerlessness over alcohol or substances, looking at the past and the actions that they may be responsible for, and making amends with people they have harmed while struggling with addiction.

**Community Reinforcement Therapy** is based on the idea that things that happen in our environment impact our thinking and our behaviors, and that some environments are more likely to lead to addiction than others. It helps clients shape aspects of their environment to create a life that is more rewarding than the one that involves addiction.

If you are looking for support with symptoms of addiction at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Learn about effective treatments for alcohol and substance use disorders. Start your journey toward recovery from addiction with Nellie. Reach out today.

Treatment for alcohol and substance use disorder

As many as one in seven pregnant or postpartum individuals may experience depression. The significant stress of pregnancy, childbirth, and the postpartum period can contribute to the high prevalence of depression in this population. We also know that changes in the body that often occur in pregnancy (e.g., hair loss, period and menstruation changes, lochia) as well as complications that may arise (e.g., preeclampsia, hemorrhage) can drive increased stress that results in depression.

It can be frightening to go through these emotions during or after pregnancy, and those with perinatal depression may feel guilty for feeling sad during what is typically a joyous time. If you are experiencing perinatal depression, remember that it is not your fault and that you are not alone.

Some of the common signs and symptoms of depression include:

*   Feeling sad or depressed for much of the time
*   Feeling tired
*   Problems with eating or sleeping
*   Difficulty concentrating or making decisions
*   Feeling guilty or very critical about yourself
*   Thoughts about hurting yourself or your baby
*   Changes in your movement where you either feel slowed down or sped up

In more severe cases, people may experience postpartum psychosis, which is a rare but serious condition that can occur in the days or weeks following childbirth. Symptoms include hallucinations, delusions, confusion, and manic or agitated behavior. Postpartum psychosis is considered a medical emergency and requires immediate treatment, which may include hospitalization.

**Fortunately, however, there are many highly effective evidence-based treatments for individuals experiencing postpartum depression.**

Treatments include:

**Behavior Therapy (or Behavioral Activation)**

One of the leading treatments focuses on the types of things that people with perinatal depression do in their day, and how that relates to their mood. In particular, when people feel sad and low, they may do less of the things that matter to them, leading them to feel less motivated and experience even lower energy. Of course, it can be even more difficult for people with perinatal depression to do things that they enjoy when preparing to have a baby, or adjusting to motherhood.

Behavior therapy (or behavioral activation) is a type of cognitive-behavioral therapy (CBT) that focuses on how the types of activities we do have a direct impact on our mood. It helps perinatal patients develop strategies to take up activities that are meaningful to them and provides them with a sense of enjoyment and accomplishment in order to break the cycle of depression.

**Cognitive Therapy**

Another form of CBT places a greater focus on how thinking patterns fuel low and depressed mood. Many people with depression have thoughts that are overly negative and “sticky,” or difficult to change. These thoughts can cause people to stay stuck in their low mood. Cognitive therapy works by helping people examine the way they're thinking and test whether their thoughts are balanced, helpful, or overly negative. It also teaches people strategies to arrive at more balanced ways of thinking.

**Interpersonal Psychotherapy**

Another treatment for depression focuses on how relationships impact emotions and vice versa. This two-way street provides several points of entry for change.

Interpersonal psychotherapy (IPT) is a treatment that focuses on addressing problems people might be experiencing in their relationships in order to improve depression. IPT is also helpful for people experiencing grief and loss reactions.

**Psychodynamic Psychotherapy**

Early childhood experiences have a significant impact on how people behave in the present day. Sometimes they're even the reason why people experience depression.

Psychodynamic psychotherapy focuses on insight, earlier learning in important relationships, and bringing behavioral patterns into full awareness so that change can occur. Psychodynamic psychotherapy is particularly helpful when people are interested in changing long-standing behaviors and emotional habits.

If you are looking for support with symptoms of depression at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started with your recovery today.

Get support for perinatal depression at Nellie, with effective treatments like behavior therapy, cognitive therapy, and more. Start your recovery today.

Getting help for perinatal and postpartum depression

Cannabis and its related products have been called many things including weed, marijuana, mary jane, and pot. Several studies have been conducted to understand how prolonged cannabis use impacts mental health, including both CBD and THC (the chemicals found in cannabis). There is some evidence to suggest that heavy, long-term use of cannabis can have negative effects on mental health.

Many people report taking cannabis to help them sleep, calm their nerves, reduce anxiety, or improve their mood. Indeed, cannabis can have calming effects that can help people cope with some of these problems and other negative emotions in the short-term. However, frequent use of cannabis has been associated with an increased risk of developing conditions including:

*   Sleep difficulty
*   Psychotic symptoms, including paranoia and hallucinations
*   Depression
*   Feeling mentally foggy
*   Anxiety
*   Suicidal thoughts

**Cannabis use and sleep**

There is also some evidence to suggest that cannabis use can negatively affect sleep. Using cannabis may help people fall asleep through its calming properties in the short term, however, long term cannabis use may interfere with the quality of their sleep and make it more difficult to fall and stay asleep.

This is because cannabis can affect the body's natural sleep-wake cycle and cause vivid dreams and nightmares, which can disrupt sleep. Additionally, some people may experience withdrawal symptoms when they stop using cannabis, which can also affect sleep.

**Cannabis use and psychosis**

There is also some evidence to suggest that frequent, heavy use of cannabis can increase the risk of developing psychosis, which is a mental health condition characterized by very distressing thoughts and unusual perceptions. For example, a person with psychosis may experience hallucinations (seeing or hearing things that are not there) or delusions (irrational beliefs). Additionally, the risk of psychosis may be higher with certain strains of cannabis that contain high levels of THC, which is the psychoactive compound in cannabis.

It's important to note that not everyone who uses cannabis will experience negative mental health effects, and the severity of these effects can vary depending on a variety of factors, such as the amount and frequency of cannabis use, as well as an individual's overall health and genetic predisposition.

If you are looking for support with symptoms of addiction at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Discover the potential impact of prolonged cannabis use on mental health. Explore treatment options and support at Nellie Health.

Does cannabis cause mental health problems?

Grief can leave you feeling overwhelmed with many difficult emotions. Grief is a natural response to the experience of loss that can be very painful. We know that grief can happen in response to a number of losses in life, including:

*   Loss of health when illness arises
*   Loss of a job
*   Relationships ending
*   Loss of a loved one
*   Loss of safety after trauma
*   Loss of an imagined future
*   Death of a pet
*   Retirement

We know that grief can include all kinds of very difficult and sometimes surprising emotions, such as anger, shock, guilt, and sadness. Grief may also cause people to experience difficulty sleeping, changes in appetite, and difficulty concentrating or making minor decisions.

The stages of grief are a commonly used framework to describe the emotional process that people go through after experiencing a significant loss. These stages were first introduced by psychiatrist Elisabeth Kübler-Ross in her 1969 book \\"On Death and Dying,\\" and they are often referred to as the \\"five stages of grief.\\" The stages are:

*   **Denial:** In this stage, the person may refuse to accept the reality of the loss and may try to avoid thinking or talking about it.
*   **Anger:** In this stage, the person may feel anger or frustration toward the person who caused the loss, toward themselves, or toward a higher power.
*   **Bargaining:** In this stage, the person may try to make deals or agreements with themselves or with a higher power in order to try to avoid or undo the loss.
*   **Depression:** In this stage, the person may feel sad, hopeless, and disconnected from others. They may also have physical symptoms such as changes in appetite or sleep patterns.
*   **Acceptance**: In this stage, the person may come to accept the reality of the loss and may start to adjust to a new way of life without the person or thing that was lost.

It's important to note that not everyone experiences these stages in the same order or to the same extent, and some people may not experience all of the stages. The grieving process is unique to each individual and can be influenced by many factors, including the nature of the loss and the person's cultural and personal background.

**Healing from Grief**

One thing to know about healing from grief is that ignoring painful emotions can make them even more intense in the long term. Coping strategies like distracting or avoiding emotions may help provide some relief in the short term. However, research shows that it makes it more difficult in the longer term. That's why it's so important to talk about your feelings and approach the difficult experience.

**Fortunately, studies show that talking about grief in therapy can be very helpful**; working with a therapist as you are grieving can help you process the loss that happened, including how you have come to make sense of the loss and what the loss means to you.

If you are looking for support with grief at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Navigate grief with support from Nellie. Experience healing by processing your loss, finding meaning, and receiving support from a therapist. Get help today.

Healing from grief and loss

Obsessive-Compulsive Disorder is a common disorder that involves experiencing either obsessions, compulsions, or both.

**Obsessions** are distressing and intrusive thoughts that people often experience seemingly out of the blue.

By intrusive, we mean that the thoughts are unwanted, feel distressing, and also often feel really different from the way someone actually thinks or what they value (e.g., a mother having an intrusive thought about harming her child when she loves her child).

**Compulsions** are behaviors or things someone does in their mind over and over again after they experience obsessions, or because they have rules in their mind about how compulsions need to be done.

People with OCD symptoms engage in compulsions in order to reduce distress they feel or prevent something bad from happening, even if the compulsions aren't actually related to the things they are supposed to prevent.

When people have OCD, their obsessions and compulsions take up a lot of time and are highly upsetting. The good news is that OCD does not need to be “permanent”, and there are frontline treatments that have been shown to be highly effective.

Studies show that OCD often co-occurs with other mental health conditions, including anxiety and depression. As well, the rate of OCD among people with autism spectrum disorder is as high as 17%. This is higher than the general population where the prevalence of OCD is estimated to be around 2%. Studies suggest that individuals with autism spectrum disorder are more likely to have repetitive behaviors and rituals that may be mistaken for compulsions associated with OCD, which can make it challenging to differentiate between the two conditions.

The leading recommended treatment for OCD is cognitive behavioral therapy, which is a therapy that focuses on the types of thoughts that you might be having, and the types of things you might be doing to cope with anxiety and worry.

**Cognitive behavioral therapy for OCD** is based on the theory that people with OCD have intrusive thoughts (i.e., “obsessions”) that cause them a lot of distress, and as a result, they tend to engage in “compulsions” to reduce the distress associated with their intrusive thoughts or prevent their intrusive thoughts from coming true.

Compulsions do indeed reduce people's distress in the short-term. However, in the long-term, they keep OCD going by preventing people from learning that their intrusions are not actually dangerous, are unlikely to occur, or are not as bad as people think if they do occur.

CBT for OCD therefore involves helping people to repeatedly bring on their intrusive thoughts but refrain from engaging in their compulsions so that this learning can take place. This is often referred to as “exposure and response prevention”. Although temporarily distressing, this intervention helps people become less and less distressed by intrusive thoughts over time, and feel less controlled by the need to engage in compulsions.

If you are looking for support with symptoms of OCD at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Explore the symptoms of obsessive-compulsive disorder (OCD) and learn about reducing symptoms through exposure and response prevention. Get help at Nellie.

Treating obsessive-compulsive disorder (ocd) through exposure and response prevention

Anger is a normal human emotion that everyone experiences to varying degrees; it can range in severity from feeling annoyed to intense fury and rage. Anger is a healthy emotion that is necessary for survival because it helps people respond in situations that may involve some sort of stressor or threat, such as being attacked. Sometimes anger arises as a response to trauma-related triggers or anxiety. Understanding where your anger comes from may help guide you in your healing.

Anger is accompanied with a number of biological changes, such as:

*   Increased heart rate
*   Tightness in the chest
*   Hot flushes
*   Sweating
*   Faster breathing
*   Increased energy hormones in the body such as adrenaline and noradrenaline.

Sometimes anger can feel out of control and frightening. In these cases, it may be important to seek support to manage this difficult emotion.

Fortunately, there are several strategies that can help individuals manage their anger in a healthy way. These strategies can be useful for both short-term anger management in the moment, as well as long-term management of chronic anger.

One set of strategies has to do with regulating your anger in the moment when it is especially intense. These are called “TIPP Skills”, which are a set of skills used in Dialectical Behavior Therapy (DBT) to help individuals manage intense emotions and improve their ability to tolerate distress. The acronym TIPP stands for Temperature, Intense Exercise, Paced Breathing, and Progressive muscle relaxation.

*   **Temperature**: The temperature skill helps to regulate the body's physical response to stress. This can be done by applying a cold pack to the face or taking a warm shower.
*   **Intense Exercise**: Engaging in intense physical activity can help to release pent-up emotions and reduce stress. This can be any form of physical exercise that raises heart rate such as running, jumping, or dancing.
*   **Paced Breathing**: Paced breathing is a technique that helps to regulate the body's physical response to stress by slowing down and regulating the breath. This can be done by counting to four as you inhale and then counting to four as you exhale.
*   **Progressive muscle relaxation**: Progressive muscle relaxation is a technique that helps to release tension in the body by tensing and then relaxing different muscle groups. This can be done by tensing and then relaxing each muscle group starting from the feet and working up to the head.

These skills are designed to be used in the moment when an individual is experiencing intense emotions and need to quickly regulate their emotions, it's important to remember that they are not a substitute for therapy and are best used in conjunction with other coping strategies.

Another set of strategies relates to the way you are communicating your needs when you are experiencing anger. These may include:

*   **Use "I" statements**: Instead of blaming the other person, use "I" statements to express your own feelings. For example, instead of saying "You always leave the dishes in the sink," say "I feel frustrated when the dishes are left in the sink."
*   **Listen actively:** Listen actively to the other person's perspective and try to understand where they are coming from. This will help to defuse the situation and make it more likely that the other person will be open to hearing your side of the story.
*   **Take a time out if emotions are too intense**: If the conversation becomes too heated, one strategy is to take a time out and come back to it later. It's helpful to decide how long the time out will last, such as 5 minutes, or enough time for both parties to cool down and approach the situation with a clear head.

If you are looking for support with anger difficulties at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Discover physical signs of anger and learn new, effective strategies to manage anger and communicate effectively. Find support for anger management at Nellie.

Anger management and coping skills

Borderline personality disorder (BPD) is a disorder that involves disruptions in people's emotions, relationships, thinking, sense of self, and behaviors.

One thing that's important to understand about BPD symptoms is that the name “borderline personality disorder” is inaccurate, and BPD is frequently misunderstood. Having borderline personality disorder symptoms doesn't mean that there is anything wrong with someone's personality, and borderline personality disorder is a treatable condition using science-supported treatments.

As well, borderline personality disorder is sometimes confused with bipolar disorder, however, these conditions are not the same.

Symptoms of borderline personality disorder tend to include the following:

*   Very intense, quickly changing, and painful emotions. For example, they may rapidly shift from feeling okay to sad, to panicked, to angry in a day.
*   Struggle controlling anger, and may lash out at people or objects.
*   Lots of conflict or intense ups and downs in relationships,
*   Fear of people leaving or abandoning them. People with Borderline Personality Disorder may do desperate things when they fear abandonment, like texting someone many times or blocking a door so that they cannot leave.
*   Paranoia or dissociation where things start to feel unreal or they feel disconnected from their body or surroundings.
*   Lack of a clear sense of self-identity.
*   An uncomfortable sense of emptiness.
*   Risky, impulsive behaviors that could be harmful, such as suicide attempts, self-harm, drinking or substance use, going on eating binges, or impulsively spending lots of money.

People with borderline personality disorder may not have all of these symptoms, and it's important to speak with a licensed provider to find out if borderline personality disorder is a problem you are currently experiencing.

Fortunately, there are several highly effective evidence-based treatments for borderline personality disorder.

One of the leading treatments is called Dialectical Behavior Therapy (DBT), which is based on the notion that people who struggle with borderline personality disorder and related problems experience sensitive, large, and long-lasting emotions that they struggle to modify or change. These challenges with emotions (i.e., emotion dysregulation) are understood to drive most problems that people with borderline personality disorder and related problems experience. DBT therefore focuses on helping people learn new ways to work with emotions, as well as learn other skills that they need to build the lives they want (i.e., lives worth living).

**DBT involves strategies from three primary areas:**

**Behavioral strategies** are derived from behavioral therapies and are used to help people make the changes that they need to make to build lives worth living.

**Acceptance based strategies** are derived from Zen Buddhism, and help people to reduce suffering by accepting themselves, their difficult experiences, and their lives.

**Dialectical strategies** come from Dialectical Philosophy, which suggests that we can hold two seemingly opposite perspectives at the same time and both perspectives can be true. Therefore, in DBT, people need to both change (using behavioral strategies) and accept themselves (using acceptance strategies). These opposite perspectives of acceptance and change make up the overarching dialectic in DBT.

If you are looking for support with symptoms of borderline personality disorder or other personality disorders (e.g., schizotypal personality disorder, antisocial personality disorder) at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Learn about the different symptoms of borderline personality disorder (BPD) and how dialectical behavior therapy (DBT) can help. Get support at Nellie.

Understanding borderline personality disorder (bpd) and dialectical behavior therapy (dbt)

Borderline Personality Disorder (BPD) is a mental health disorder that is characterized by a pervasive pattern of instability in mood, interpersonal relationships, self-image, and behavior. This instability often leads to impulsive actions and a tendency to engage in unhealthy or destructive relationships.

People with BPD often struggle with intense and unstable relationships, as well as a fear of abandonment. They may have difficulty maintaining healthy boundaries and may act in ways that are manipulative or controlling in order to avoid being abandoned by their partners.

The symptoms of BPD can be extremely distressing and can cause significant problems in relationships. Some common symptoms of BPD that can impact relationships include:

*   **Unstable and intense relationships:** People with BPD may have very intense and unstable relationships. They may idealize their partners at first, but then quickly become disillusioned and start to see them as all-good or all-bad. This can lead to sudden changes in how they feel about their partners, and may result in impulsive actions such as breaking up or getting back together multiple times.
*   **A fear of abandonment:** People with BPD often have a deep-seated fear of being abandoned by their partners. They may become anxious or panicked at the thought of being alone, and may go to great lengths to avoid being left alone. This can lead to clingy or needy behavior, and may cause problems in relationships.
*   **Difficulty with boundaries:** People with BPD may have difficulty establishing and maintaining healthy boundaries in their relationships. They may not know how to say "no" to their partners, and may end up feeling overwhelmed or taken advantage of. They may also struggle with jealousy and may try to control their partners in order to feel more secure.
*   **Impulsive behavior:** People with BPD may act on impulse, without thinking about the potential consequences of their actions. This can lead to dangerous or reckless behavior, and may cause problems in relationships. For example, a person with BPD may impulsively quit their job or end a relationship without considering the potential consequences.

Fortunately, there are treatments that have been shown to work to help individauls with BPD. One of the leading treatments is called Dialectical Behavior Therapy (DBT), which is based on the notion that people who struggle with borderline personality disorder and related problems experience sensitive, large, and long-lasting emotions that they struggle to modify or change. These challenges with emotions (i.e., emotion dysregulation) are understood to drive most problems that people with borderline personality disorder and related problems experience. DBT focuses on helping people learn new ways to work with emotions, as well as learn other skills that they need to build the lives they want (i.e., lives worth living).

Overall, BPD can be a challenging disorder to live with, particularly when it comes to relationships. However, with the right treatment and support, people with BPD can learn to manage their symptoms and have healthy and fulfilling relationships.

If you are looking for support with symptoms of borderline personality disorder at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Explore the impact of Borderline Personality Disorder (BPD) on relationships, including unstable relationships and fear of abandonment. Seek support at Nellie.

How does borderline personality disorder (bpd) impact relationships?

A panic attack is a sudden and intense episode of fear or anxiety. Some people refer to panic attacks as “anxiety attacks”; these are typically accompanied by physical symptoms such as:

*   rapid heartbeat
*   shortness of breath
*   dizziness
*   chest pain
*   sweating
*   numbness or tingling

Panic attacks can be extremely distressing and can interfere with a person's daily life. They often come on suddenly and without warning. They can last for several minutes, but some people may experience symptoms for longer periods of time. During a panic attack, a person may feel like they are losing control or having a heart attack.

Panic attacks can be triggered by a variety of factors, including stress, certain situations or environments, or certain thoughts or memories. For some people, a panic attack may be the first sign of an underlying anxiety disorder.

It is important to seek treatment for panic attacks, as they can become more frequent and severe over time. Treatment typically involves a combination of therapy and medication.

Cognitive Behavioral Therapy (CBT) is a common form of therapy for panic attacks. It focuses on helping people identify and change negative thought patterns and behaviors that contribute to their panic attacks. One key factor that is believed to contribute to panic attacks is **interpreting harmless bodily sensations as dangerous**. For example, an individual who experiences panic attacks may misinterpret an increase in heart rate as a sign of danger, which can trigger a panic attack.

CBT aims to address this by helping individuals examine their beliefs and perceptions surrounding these sensations and teaching them how to utilize coping mechanisms to manage their symptoms and prevent future panic attacks from occurring.

Overall, panic attacks can be distressing, but they are treatable. With the right treatment and support, people can learn to manage their symptoms and lead fulfilling lives.

If you are looking for support with panic attacks at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Recognize the signs and symptoms of panic attacks. Learn about effective therapy options for panic attacks and panic disorder. Get help at Nellie today.

Understanding and managing panic attacks

A dual diagnosis occurs when an individual presents with a mental health disorder and a substance use disorder simultaneously. Substance use disorders

Dual diagnoses typically have more severe symptomatology. Some examples of common dual diagnoses are:

*   PTSD and alcohol use disorder
*   Depression and cocaine addiction
*   Schizophrenia and cannabis use disorder
*   ADHD and alcohol use disorder
*   PTSD and opioid abuse

Historically, treatment plans for individuals with a dual diagnosis involved treating one disorder before the other. However, recent research has shown that treatment plans where both disorders are treated at the same time have produced significant improvements in symptoms for a longer duration of time. This is because addressing one disorder without addressing the other can lead to a relapse of the untreated disorder.

Treatment for dual diagnoses typically involves a combination of therapy, medication, and support from family and friends. Some common treatment approaches for dual diagnoses include:

*   **Cognitive Behavioral Therapy (CBT):** CBT is a type of therapy that focuses on helping individuals identify and change negative thought patterns and behaviors. CBT is highly effective for treating a range of mental health challenges, including anxiety disorders, depression, post traumatic stress disorder, insomnia, and addiction.  
    
*   **Dialectical Behavioral Therapy (DBT):** DBT is a type of therapy that combines CBT with mindfulness and emotion regulation techniques. It can be particularly useful for individuals with dual diagnoses who have difficulty managing their emotions and impulses.

If you are looking for support with multiple mental health problems or dual diagnoses at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Dual diagnosis occurs when individuals experience a mental health disorder and a substance use disorder simultaneously. Get help for dual diagnoses at Nellie.

Exploring dual diagnosis and integrated treatment approaches

Relationships are a major part of adult life, and just like the seasons, they go through periods of change. These periods can be times of growth, but they can also be times of hardship and difficulty. Learning to navigate the challenges that come along with relationships takes time, effort, and understanding. Common challenges that may arise in romantic relationships include:

*   **Financial disagreements**: Money is often a contentious issue in relationships and can lead to disagreements and stress. This can include disagreements about spending, saving, and budgeting, as well as disagreements about larger financial decisions such as buying a house or starting a business.
*   **Intimacy difficulties**: Intimacy issues can include a lack of physical or emotional closeness, difficulties with communication, and problems with sexual intimacy. These issues can occur due to a variety of factors, including past trauma, differing levels of desire, and relationship problems.
*   **Unattuned parenting styles**: When parents have different parenting styles, it can lead to conflicts and stress in the relationship. For example, one parent may be more lenient than the other.
*   **Differing life goals and priorities**: Having different visions for the future, whether it be career aspirations, family planning, or retirement goals, can create tension and stress in a relationship.
*   **Communication breakdown**: Difficulty in communicating effectively can lead to misunderstandings, resentment, and a lack of trust in a relationship.
*   **Infidelity**: Infidelity can cause a significant amount of emotional pain and can lead to trust issues and feelings of betrayal. It can also cause a ripple effect of problems in the relationship.
*   **Jealousy and possessiveness**: Feelings of jealousy or possessiveness can be a source of conflict and can lead to frustration and resentment.
*   **Lack of trust**: Trust issues can stem from past experiences, communication breakdowns, or infidelity, and can cause significant problems in a relationship.  
    
*   **Lack of respect and empathy**: A lack of respect or empathy for one's partner can cause a relationship to become toxic and can lead to feelings of resentment and disconnection.

Regardless of the challenge that two people are facing in a relationship, a reasonable question to consider is what might be causing the relationship problem?

1.  Individual differences

Every relationship has two sides, and two people that carry their own beliefs, values, ideas, and practices that shape who they are. Often, these factors can contribute to a thinking pattern that conflicts with that of the other person in the relationship.

1.  Communication problems

The way in which people communicate with one another can play a major role in either keeping relationship challenges going or coming to a respectful understanding. Practicing healthy communication habits can help many disagreements from becoming a significant strain on the relationship.

1.  Avoidance of emotions

In many relationships, one or both individuals may avoid feeling or addressing their emotions in order to “keep the peace.” However, when people suppress their feelings in a given situation, it can build resentment toward the other person. Being attuned to and embracing emotions can allow for more honest and open conversations which is the key for overcoming relationship challenges.

If you are looking for support with relationship challenges at this time, we would be glad to help you get connected to therapy that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Struggling with relationship challenges? Learn effective communication, resolve conflicts, and build stronger connections. Find the support you need at Nellie.

Building stronger bonds: Overcoming challenges in romantic relationships

Friendships can be one of the most rewarding and fulfilling aspects of life, but they can also be challenging at times. Some of the common challenges in friendships include:

*   **Communication**: Good communication is crucial for maintaining healthy friendships. Without it, misunderstandings and conflicts can arise. For example, friends may assume things about each other that aren't true or may not express their feelings and thoughts clearly. This can lead to feelings of resentment and distance in the friendship.
*   **Trust**: Trust is the foundation of any friendship. When trust is broken, it can be difficult to regain. This can happen when friends betray each other's confidence or when one friend does something that the other perceives as dishonest.
*   **Time**: Busy schedules and conflicting priorities can make it difficult for friends to find time to spend together. These challenges can lead to feelings of distance and disconnection in the friendship.
*   **Distance**: Long-distance friendships can be challenging to maintain, especially if friends are not able to see each other often. This can sometimes lead to feelings of isolation and loneliness.
*   **Change**: As people grow and change, their friendships may change as well. It can be difficult to adapt to these changes and maintain the same level of closeness. This can happen when friends grow apart due to different life experiences, or when one friend changes in a way that the other can't accept.

*   **Jealousy**: Jealousy can arise when one friend achieves success or happiness that the other does not. This can lead to feelings of resentment, insecurity, and distance in the friendship. In therapy, individuals can learn how to manage their jealousy, how to celebrate their friends' successes, and how to focus on their own happiness.
*   **Differences in values or opinions**: Friends may have different beliefs, values, and interests which can lead to conflicts and disagreements. This can happen when friends have different opinions about politics, religion, or lifestyle choices.

Therapy can be a helpful tool for addressing and overcoming the challenges that can arise in friendships. A therapist can provide a safe and confidential space for individuals to express their thoughts and feelings and work through any difficulties they may be experiencing in their friendships. For instance, therapy can be a useful tool for:

*   **Learning effective communication skills**: Therapy can be a useful tool for learning how to effectively communicate with friends. A therapist can teach individuals how to express themselves clearly, how to actively listen, and how to manage conflicts in a healthy way. This can help individuals to build deeper, more meaningful connections with their friends, and to better understand and support one another.

*   **Processing changes in friendships**: As people grow and change, their friendships may change as well. Therapy can be a useful tool for processing these changes and learning how to adapt to them. A therapist can help individuals to understand and accept the changes in their friendships, and to find ways to maintain a sense of closeness and connection with their friends.

*   **Brainstorming ways to maintain friendships**: Busy schedules and conflicting priorities can make it difficult for friends to find time to spend together. Therapy can be a useful tool for brainstorming ways to maintain friendships despite these challenges. A therapist can help individuals to prioritize their relationships, to find creative ways to stay connected, and to balance their responsibilities.

*   **Working through experiences of jealousy in friendships**: Jealousy can arise when one friend achieves success or happiness that the other does not. Therapy can be a useful tool for working through these experiences of jealousy and learning how to manage them. A therapist can help individuals to understand the root causes of their jealousy, to focus on their own happiness, and to celebrate their friends' successes.

In therapy, individuals can also learn how to navigate through their emotions, learn how to set healthy boundaries, and manage their expectations. It also helps individuals to gain self-awareness and insight into their own behavior and how it affects their relationships. They can also work on their emotional regulation and learn how to cope with the negative emotions that may come with the challenges in friendships.

If you are looking for support with friendship challenges at this time, we would be glad to help you get connected to therapy that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Struggling with your friendships? Learn to improve communication, rebuild trust, manage jealousy, and adapt to changes. Get help with relationship support at Nellie.

Resolving conflict and building healthy friendships

The COVID-19 pandemic has had a significant impact on mental health. As people around the world have been forced to stay home and avoid social contact, many have experienced feelings of isolation, anxiety, and depression. Many have also lost loved ones due to COVID-19, and may be experiencing grief or trauma-challenges such as PTSD. In addition, the uncertainty and fear surrounding the virus have added to the stress and anxiety that many people are feeling.

The impact of the pandemic on mental health has been particularly severe for those who have lost loved ones to the virus, as well as for health care workers who have been on the front lines of the crisis. The isolation and stress of the pandemic have also exacerbated existing mental health conditions, such as anxiety disorders, substance use challenges, and depression.

As the world continues to emerge from the COVID-19 pandemic, many people are beginning to readjust to social life after a year of isolation and distancing. The transition back to "normal" life can be challenging, as the pandemic has changed the way we interact with others and has left many feeling uncertain and anxious. Some of the ways COVID-19 has affected people include:

**Loss of social connections**

One of the biggest changes many people have experienced is a loss of social connections. During the pandemic, people were forced to limit their interactions with others and many lost touch with friends and loved ones.

Re-establishing these connections can be difficult and may take time. It's important to be patient and to take small steps to reconnect with others. This might include reaching out to old friends, joining a club or group, or volunteering.

**The return to public spaces**

Another change that many people are grappling with is the return to public spaces and crowded places. After a year of avoiding these places, it can be hard to adjust to being around large groups of people again.

For some, it may help to start small, by visiting less crowded places and gradually working up to more crowded environments. It's also important to remember that everyone's comfort level will be different and that it's okay to take things at your own pace.

**Anxiety about the future**

Finally, as we continue to live with the ongoing threat of COVID-19, many people may be feeling anxious about the future. It's important to remember that it's normal to feel this way, and that it's okay to take time to adjust.

It's also important to seek out support if you're struggling. Whether it's talking to a friend, therapist, or support group, connecting with others can help you feel less alone and more supported as you navigate this difficult time.

If you are looking for support with mental health at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Learn about common mental health consequences of COVID-19. Find support for coping with anxiety, grief, and readjusting to post-pandemic life at Nellie.

Mental health consequences of covid-19

Emotional dysregulation refers to poorly regulated emotional responses that are not within a range of typically accepted emotional reactions. It is a common problem that can affect people of all ages and can lead to a variety of negative outcomes, such as difficulty in relationships, poor academic or work performance, and increased risk for mental health problems. Individuals suffering with the following mental health disorders may also struggle with emotional dysregulation:

*   Posttraumatic stress disorder (PTSD)
*   Borderline Personality Disorder (BPD)
*   Attention-Deficit / Hyperactivity Disorder (ADHD)
*   Obsessive Compulsive Disorder (OCD)
*   Generalized Anxiety Disorder (GAD)
*   Substance Use Disorders (SUD)
*   Major Depressive Disorder (MDD)
*   Bipolar Disorder
*   Schizophrenia
*   Eating disorders such as Anorexia Nervosa and Bulimia Nervosa

There are several factors that can contribute to emotion dysregulation, including:

**Genetic Factors**

Some research suggests that there may be a genetic component to emotion dysregulation, as it tends to run in families.

**Environmental Factors**

Growing up in a chaotic or unstable environment can make it more difficult to learn healthy ways of dealing with emotions. Exposure to traumatic experiences may also make it difficult to regulate emotions.

Symptoms of emotion dysregulation can include:

*   Difficulty managing intense or overwhelming emotions
*   Frequent mood swings
*   Impulsivity or acting out in response to emotions
*   Difficulty calming down after becoming upset
*   Chronic feelings of emptiness or numbness
*   Self-harm or suicidal thoughts

Emotional dysregulation is often thought of as a childhood problem that resolves itself as a child learns proper emotional regulation skills and strategies. However, it can sometimes continue into adulthood. For these individuals, emotional dysregulation can lead to a lifetime of struggles, including problems with interpersonal relationships, school performance, and the inability to function effectively in a job or at work.

If you are looking for support with emotional dysregulation at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Emotional dysregulation is a common symptom of many mental health disorders. Learn about its contributing factors and the treatments available at Nellie.

Reclaiming balance: Coping with emotion dysregulation

**Note: If you or someone you love is in an emergency situation or in immediate danger, please call 911 or attend the nearest emergency room. A list of crisis resources is also available here.**

Suicide is a major public health concern that affects individuals from all walks of life, regardless of their age, gender, or background. It is a tragic and complex issue that can have a profound impact on individuals, families, and communities. Suicide is a serious problem that is difficult to predict, as the reasons why individuals may consider or attempt suicide can be complex and multi-faceted.

It is important to note that suicide is preventable and there are resources available to help those who may be at risk. Early intervention and treatment can greatly reduce the risk of suicide and provide individuals with the support they need to overcome their struggles.

Some warning signs of suicide might include:

*   Expressing feelings of hopelessness or helplessness: This can include statements such as "Nothing will ever change," "Things will never get better," or "I can't take it anymore."
*   Talking about wanting to die or kill oneself: This can include passive suicide ideation such as "I wish I were dead," "I wish I could go to sleep and never wake up”, or more active suicide ideation that includes more of a plan for how someone wants to go about suicide.
*   Speaking of feeling trapped, like there's no way out: This can include statements such as "I can't see any other way out," "I'm stuck and can't move forward," or "I can't imagine living like this for much longer."
*   Increasing alcohol or drug abuse: Substance abuse can be both a cause and a symptom of suicidal thoughts and can exacerbate feelings of hopelessness and helplessness.
*   Acting anxious or agitated; behaving recklessly: These behaviors can be a sign of someone who is struggling to cope with overwhelming emotions and is looking for a way to escape the pain.
*   Withdrawing from friends and activities: This can include isolating oneself from friends and family, canceling plans, and avoiding social situations.

It's important to note that not everyone who experiences suicidal thoughts or engages in suicidal behavior will exhibit all of these warning signs. Some people may be very good at hiding their distress.

Suicide is a complex issue that is influenced by a variety of factors, including:

*   Mental health disorders such as depression, insomnia, borderline personality disorder, and post-traumatic stress disorder. People who experience these disorders have a higher risk of suicidal ideation and suicide attempts.
*   Alcohol or substance use challenges, such as addiction or abuse of drugs or alcohol, can also increase the risk of suicide. These substances can impair judgment and decision-making, and can also worsen underlying mental health conditions.
*   Major life stressors or transitions, such as the loss of a job or financial insecurity, ending of a relationship, chronic medical conditions, or recent diagnosis of a medical condition can also contribute to the risk of suicide. These stressors can cause feelings of hopelessness, helplessness, and loss of control.
*   Trauma, such as physical or sexual abuse, can also increase the risk of suicide. Trauma can cause a wide range of mental health problems, such as PTSD, depression, and anxiety, which can contribute to suicidal thoughts and behavior.
*   Social isolation and lack of social support, can also increase the risk of suicide. People who feel alone and unsupported may be more likely to have suicidal thoughts and less likely to reach out for help.

It's important to note that these are not the only risk factors and that different people may have different reasons for suicide. It's also important to mention that not everyone who has these risk factors will necessarily attempt suicide. Nonetheless, it's important to be aware of them and provide support to those who may be at risk.

If you suspect that someone you know may be thinking about suicide, it is important to take their feelings seriously and to offer support and help. Here are some steps you can take to help a friend who may be suicidal:

*   Staying in touch: Suicide related thoughts can pull individuals to withdraw and isolate from loved ones. If you are experiencing thoughts of suicide, it may be important to reach out to loved ones, or spend time with loved ones even if you don't feel like it. If your friend or loved one is struggling with suicide, check in on them when you can. If you are able to, offer to spend time together and do things they enjoy.
*   Create a plan for safety: It can be helpful to write a plan for what you or your loved one will do when suicide-related thoughts or urges become intense. This may include a list of warning signs and triggers, coping strategies such as distraction or soothing activities, contact information of people to reach out to for support, and resources for help.

It's important to remember that suicide is preventable and that seeking help is a sign of strength. If you are looking for support with mental health concerns at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Learn about the warning signs and risk factors for suicidal ideation, self-harm, and suicide attempts. Seek help and support for suicidality at Nellie today.

Finding strength in vulnerability: Coping with suicide ideation and suicide attempts

A life transition n is a significant change or period of change in a person's life. These changes can be exciting and positive, but can also be stressful and challenging, as they often involve adjusting to new roles and responsibilities. Life transitions can include:

*   Starting or ending a relationship
*   Starting or ending a job or career
*   Having or adopting a child
*   Moving to a new home or location
*   Starting or finishing school
*   Retiring from work
*   Losing a loved one
*   Receiving a medical diagnosis or becoming injured
*   Financial changes
*   Changes in personal identity or lifestyle.

Life transitions, whether positive or negative, can have a significant impact on an individual's mental health. During a transition, it is normal for an individual to experience a range of emotions, such as excitement, anxiety, and uncertainty. The stress of major life transitions may also bring feelings of sadness or depression, difficulty sleeping, stress, and changes in appetite. These emotions can be overwhelming and can make it difficult for an individual to adjust to the new situation. It's important to remember that it takes time to adjust, and that it's important to be patient with yourself during this process.

When these symptoms are more severe and interfere with an individual's ability to function, it can be indicative of mental health conditions such as adjustment disorder or depression. The stress of a transition can also exacerbate existing mental health conditions such as anxiety or posttraumatic stress disorder (PTSD). In these cases, it's important to seek the help of a mental health professional who can help the individual manage their symptoms and navigate the transition.

Negative transitions, such as a job loss or the end of a relationship, can be particularly challenging and can lead to feelings of grief, loss, and depression. In these cases, it's important to seek support and to take the time to process the loss and to grieve.

Positive transitions, such as starting a new job or having a child, can also be stressful and can lead to feelings of anxiety and uncertainty. In these cases, it's important to set realistic expectations and to remember that it takes time to adjust to new roles and responsibilities.

It's important for individuals to have a support system in place during a transition. This can include family, friends, or a therapist. Talking to someone about what you're going through can help to validate your feelings and can provide a sense of perspective. A common therapy myth is that therapy is only for people with a diagnosed mental illness. This couldn't be further from the truth. Therapy can be beneficial for individuals dealing with a range of stressors, including difficult life transitions.

If you are looking for support with difficult life transitions, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Navigating life transitions is challenging. Learn about common mental health symptoms that can arise from stressful life transitions. Seek support at Nellie.

Adapting to change - the impact of life transitions on mental well-being

Studies show that psychological disorders (e.g., major depressive disorder; obsessive-compulsive disorder) are very common in the general population, with as many as one in five people experiencing at least one psychological disorder in their lifetime. However, despite the prevalence of psychological disorders, misconceptions about mental health diagnoses remain widespread.

Among the most problematic pieces of misinformation is the idea that psychological disorders are permanent and lifelong. While many people struggle with mental health challenges for long periods of time, diagnoses are not permanent. They also do not define the person as a whole.

**If not a permanent label, then what is the purpose of mental health diagnosis?**

**1\. To help people better understand their experiences**

Diagnostic categories, such as “panic disorder” or “bipolar disorder” describe clusters of symptoms that commonly occur together. Assigning diagnoses can be a helpful step in empowering individuals to learn about their symptoms, understand the challenges they are facing, and find support by connecting with other people who have experienced similar challenges. Often, individuals find that having a name to describe their problems feels validating and helps to provide a sense of clarity.

**2\. To help guide the most effective treatment plan**

Another reason why diagnosis is so helpful is that it can support treatment planning by allowing therapists to draw on research about the most effective ways to treat a given problem. The most effective treatments for psychological disorders are those that have been scientifically developed and tested, and in order to test treatments, having a way to define and describe problems (i.e., through diagnosis) is often needed .

**2\. To improve communication between healthcare professionals that are involved in an individual's care  
**

Individuals who are seeking therapy often want their therapists to communicate with their family doctors or other healthcare providers about the difficulties they are facing. Diagnoses can help facilitate this process. In addition, accurate diagnoses help to facilitate scientific research, as they allow researchers to explore ways to best help individuals with specific presenting problems and symptoms.

If you are looking for support with your mental health at this time and would like an assessment, we would be glad to help you get connected to a provider who can help. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started with your journey today.

What does it mean to have a mental health diagnosis?

In a world filled with misinformation about mental health and mental health treatments, it's important to be a knowledgeable consumer when looking for treatments that work

It is important to know that evidence-based treatments for mental health problems are:

*   Based on a theory or way of understanding a problem
*   Scientifically supported and shown to work
*   Guided by a treatment plan that is designed for the problem at hand
*   Time-limited and outcome focused

These characteristics of **mental health treatments that work** can support your search for an effective provider by guiding the types of questions you should ask when starting therapy. A good therapist will have answers to the following types of questions and wouldn't feel “put off” by you asking them.

1.  1\. What theory do you use to understand and treat my problem?

To find out if your therapist is indeed using an evidence-based approach to treating the problem you are experiencing, you can ask them questions to better understand what model they use to guide their treatment (note: common models may include cognitive-behavioral, psychodynamic, interpersonal, dialectical behavior frame).

1.  2\. What evidence is there to support your therapeutic approach?

A therapist who provides evidence-based treatment should always be able to speak to the available evidence that supports the treatment for the given problem. Some will even be able to tell you about the different evidence-based treatments that work and support you in choosing which one would be best for you.

1.  3\. How many sessions do you expect this to take? What will it cost?

An effective therapist will always be able to discuss a plan for your treatment, which should include a target number of sessions, what those sessions will entail, and an estimate of the total cost for your treatment. Of course, things may change and these estimates are not perfect, but you should receive an estimated treatment timeline.

1.  4\. What percentage of people like me get better? How will you be able to tell if I'm better?

This question is directed at understanding what outcome the therapist expects for you from your treatment. They should be able to give you a sense of how many people with your problem(s) tend to get better, and they should have ways to measure that progress. For example, therapists that deliver evidence-based treatments often use symptom assessment measures throughout treatment to monitor progress overtime.

If you are looking for support with your mental health at this time and would like to meet with one of our expert providers,, we would be glad to help you get connected to a provider who can help. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started with your journey today.

How to find a mental health treatment that works

Anxiety is a normal part of the human experience. In fact, if we didn't have anxiety, we wouldn't be able to function in a healthy way in our daily lives. However, sometimes, anxiety becomes more long-lasting, frequent, or intense than is helpful. In those cases, we might start to have what is called an "anxiety disorder". Just like anxiety can be focused on many different things, there are many different disorders that fall under the general heading of "anxiety disorders".
All of these disorders share a common thread of involving high levels of anxiety or fear that is negatively interfering with someone's life or causing them high amounts of distress. For example:

### Social Anxiety Disorder

Social anxiety disorder is a disorder that involves having anxiety in situations where you might be judged in a negative or harsh way by other people. This can include things like giving presentations, making small talk, or meeting new people.

### Panic Disorder

Panic disorder is a disorder that involves being particularly anxious about the possibility of having panic attacks, which are intense and fast psychological and physiological surges of discomfort. These disorders also involve avoiding situations that bring on the fear or anxiety, or getting through those situations with high amounts of distress.

### Generalized Anxiety Disorder

Generalized anxiety disorder is a disorder that involves experiencing a high level of worry that feels difficult to control about a number of areas (e.g., money, work, family). It also involves a range of symptoms that come along with the worry, like muscle tension, feeling irritable, having a hard time concentrating, and having problems with sleep.

### Anxiety Cycle

People with anxiety may try a range of strategies to cope with their anxiety that actually make anxiety worse in the long term. For example, people with anxiety may find temporary relief in anxiety through substances like alcohol and cannabis; they may also try distraction techniques, such as excessive scrolling on social media or playing video games.

However, these strategies often only help temporarily and actually make anxiety worse in the long term. They may also lead to other problems, such as social isolation or difficulty focusing on important tasks.

![Anxiety](/site_images/Resources/Articles/therapy-for-anxiety-disorders/anxiety1.png "image_tooltip")

![Reversing](/site_images/Resources/Articles/therapy-for-anxiety-disorders/anxiety2.png "image_tooltip")

### Cognitive Behavioral Therapy for Anxiety

Fortunately, there are several highly effective evidence based treatments for anxiety disorders that have been scientifically tested and proven to work. Cognitive behavioral therapy (CBT) is a front-line recommended treatment that is based on the theory that people with anxiety tend to make overly negative predictions or interpretations about the likelihood of something bad happening, or their ability to cope with such bad things happening. These ways of thinking make people experience more anxiety before, during, and after interacting with the things they are afraid of.

When people become more anxious, they start to avoid the things that they are afraid of. Avoiding things that make people anxious may make their anxiety better in the short term, but it actually keeps it going in the long term because it prevents people from learning that the fearful beliefs they have may not be accurate.

CBT for anxiety therefore involves working with your therapist to challenge and test out different ways of thinking about the thing(s) that drive your anxiety, and reducing avoidance so that inaccurate beliefs can be updated through your own experience.

If you are looking for support with symptoms of anxiety at this time, we would be glad to help you get connected to treatment that actually works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Explore effective treatments for anxiety disorders and find support at Nellie Health. Discover the benefits of cognitive behavioral therapy at Nellie.

Escaping the anxiety cycle: Therapy for anxiety disorders

Parenting a child with mental health challenges can be a rewarding and fulfilling experience, but it can also be challenging. Children with mental health challenges may have difficulty with behaviors, emotions, and relationships, and it can be difficult for parents to know how to support them.

Some common mental health challenges that children may face include anxiety, depression, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and conduct disorder. Other challenges can include developmental disorders, such as learning disabilities, as well as trauma and abuse. Additionally, children may experience difficulties with emotional regulation, impulse control, and social skills. These conditions can affect a child's ability to learn, communicate, and interact with others. They can also lead to a range of behaviors, such as tantrums, aggression, or withdrawal.

As a parent, it's completely normal to feel stress and anxiety if your child is struggling in these ways, and it is important to find support for yourself in this process if you notice that you are struggling. Some of the challenges that parents of children with mental illness report experiencing most often include:

*   Feelings of helplessness
*   Anger with self or others
*   Struggling with unwanted advice from others
*   The unpredictability of the course of their recovery
*   Feelings of shame and embarrassment
*   Excessive guilt for their child's experience
*   Relationship challenges
*   Feeling disconnected from their child

If you are a parent of a child who is struggling with their mental health, it is important to know that you are not alone, and that there are many avenues for support that have been shown to help relieve challenges that you may be facing. In addition to there being effective psychotherapies for children's mental health, there are also interventions that research supports for parents to learn how to effectively promote recovery in their children's mental health.

In addition, there are also research-supported interventions available to help you cope with your own mental health, stress, and emotional challenges related to being a parent of a child who is struggling.

If you are looking for support with parenting challenges at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Discover support for parenting a child with mental health challenges at Nellie. Find interventions for your child's recovery and coping strategies for yourself.

Parenting for children with mental health challenges

Work stress is a common problem that affects many people. Stress or anxiety at work can come from a variety of sources, including tight deadlines, heavy workloads, difficult coworkers, and demanding supervisors. It can lead to a range of physical and emotional symptoms, such as headaches, difficulty sleeping, irritability, and anxiety.

Work stress can have a negative impact on both an individual's health and their work performance. It can lead to burnout, absenteeism, and turnover, which can harm both the individual and the organization. It is important for individuals to be aware of the signs of work stress and to take steps to manage and prevent it.

Some common signs of work stress include:

*   Constant fatigue or exhaustion
*   Difficulty sleeping
*   Headaches or muscle tension
*   Irritability or anger
*   Anxiety or worry
*   Feeling depressed or blue
*   Loss of interest in work or hobbies

There are several strategies that individuals can use to manage work stress. Some helpful strategies include:

*   Prioritizing self-care: It is important for individuals to take care of their own well-being, as this can help to prevent or reduce work stress. This can include activities such as getting enough sleep, eating well, and exercising regularly.
*   Establishing boundaries: Setting clear boundaries between work and personal life can help to reduce stress. This can include setting specific times for checking email, avoiding work-related tasks outside of work hours, and disconnecting from work during vacation or time off.
*   Communicating openly and honestly: Communicating openly and honestly with supervisors and coworkers can help to prevent misunderstandings and conflicts that can contribute to stress. It is important to be clear about one's own needs and expectations, and to listen carefully to others.
*   Seeking support: If work stress is causing significant distress, it may be helpful to seek support from a mental health professional. A therapist can provide strategies for managing stress and help individuals develop healthy coping skills.

Overall, work stress is a common problem that can have negative consequences for both individuals and organizations. By prioritizing self-care, establishing boundaries, communicating openly and honestly, and seeking support when needed, individuals can manage their work stress and improve their overall well-being.

If you are looking for support with work stress at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Learn to recognize and effectively manage stress at work. Prioritize self-care, set boundaries, communicate, seek support. Find help at Nellie.

Recognize the warning signs of workplace stress and burnout

Dialectical Behavior Therapy (DBT) is a front-line recommended treatment for borderline personality disorder that involves a combination of weekly 50-minute individual therapy and 60 to 120- minute skills groups for 6 months to a year.

DBT has been thoroughly tested for the treatment of borderline personality disorder and in individuals who are highly suicidal or struggling with intense emotions. We know that DBT can be very helpful in reducing these problems.

DBT is based on the idea that people who struggle with borderline personality disorder and related problems experience strong and long-lasting emotions that are difficult to modify or change. These emotional difficulties are understood to drive most problems that people with borderline personality disorder and related problems experience. DBT therefore focuses on helping people learn new ways to work with emotions, as well as learn other skills that they need to build the lives they want (i.e., “lives worth living”).

DBT involves strategies from three primary areas:

**Behavioral strategies** are derived from behavioral therapies and are used to help people make the changes that they need to make to build lives worth living.

**Acceptance based strategies** are derived from Zen Buddhism, and help people to reduce suffering by accepting themselves, their difficult experiences, and their lives.

**Dialectical strategies** come from Dialectical Philosophy, which suggests that we can hold two seemingly opposite perspectives at the same time and both perspectives can be true. Therefore, in DBT, people need to both change (using behavioral strategies) and accept themselves (using acceptance strategies). These opposite perspectives of acceptance and change make up the overarching dialectic in DBT.

Dialectical Behaviour Therapy involves:

*   Weekly, 50-minute therapy sessions with your therapist
*   Learning about how difficulties experiencing and modifying emotions drive many people's core problems and need to be targeted in DBT
*   Completing a diary card outside of session to monitor emotions, behaviors, and skills learned
*   Completing other homework that you and your therapist design to help you accomplish your goals

Sometimes, DBT also involves:

*   Attending weekly skills groups that are outside of individual therapy sessions, where you will learn skills to regulate emotions, tolerate distress, communicate effectively with others, and build more awareness of the present moment (i.e., mindfulness)
*   24/7 access to your therapist by phone or text to get help using the skills in your daily life when you most need it, or in case you experience a crisis

If you are looking for Dialectical Behavior Therapy (DBT) at this time and would like to meet with one of our expert DBT providers, we would be glad to help you get connected to a provider who can help. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started with your journey today.

What is dialectical behavior therapy?

Dissociation is a common response to trauma or stress. It is a coping mechanism that helps individuals distance themselves from the traumatic event and the associated emotions. Dissociation can take many forms, including feeling detached from one's body, thoughts, or surroundings, and having an altered sense of time.

Dissociation can be a temporary response to a traumatic event, but for some individuals, it can become a chronic condition known as **dissociative disorder**. This condition can cause significant distress and impairment in daily functioning.

**Dissociative disorder**

Dissociative disorder is a condition characterized by symptoms of disassociation. Symptoms of dissociative disorder may include:

1.  Feeling detached from one's body or surroundings
2.  Memory loss or gaps in memory (amnesia)
3.  An altered sense of time
4.  A change in identity or sense of self
5.  Depersonalization (feeling like one is observing oneself from outside the body)
6.  Derealization (feeling like the world is not real or unfamiliar)
7.  These symptoms can cause significant distress and impairment in daily functioning.

Treatment for dissociative disorder often involves therapy, such as cognitive-behavioral therapy (including trauma-focused therapies like prolonged exposure therapy or cognitive processing therapy) to help individuals process the traumatic event and learn healthy coping strategies. In some cases, medication may also be used to help manage symptoms.

It is important for individuals who have experienced trauma to seek support from trained professionals who can help them address their symptoms and develop healthy coping mechanisms. With the right treatment, individuals can recover from the effects of trauma and improve their overall well-being.

If you are looking for support with symptoms of dissociation at this time, we would be glad to help you get connected to treatment that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started today.

Learn about dissociation, dissociative disorders, and the relationship to trauma. Get help for dissociation with trauma-focused therapy at Nellie today.

Coping with dissociation in response to stress and trauma

Family relationships can be complex and challenging. Some common issues that families may face include:

*   Communication problems
*   Conflict resolution
*   Coping with changes such as a new baby, a move, or a loss.

Some additional common issues that families may face include:

*   Parenting challenges, such as dealing with difficult behaviors in children or navigating different parenting styles among family members
*   Blended family dynamics and step-parenting issues
*   Financial stress and conflict
*   Infidelity or trust issues
*   Substance abuse or mental health concerns within the family
*   Navigating cultural or religious differences
*   Managing aging parents or adult children with ongoing needs
*   Dealing with a chronic illness or disability within the family

These issues can add extra stress on family relationships and make it hard for family members to feel connected and supportive of one another. Therapy can help families to understand and work through these challenges, build stronger relationships, and create a more positive and healthy family dynamic.

Therapy can also help families to navigate changes and transitions, such as the arrival of a new baby or the loss of a loved one. This may involve providing emotional support and guidance on how to cope with difficult feelings, as well as strategies for maintaining a sense of stability and security during these times of change.

If you are looking for support with family relationship challenges at this time, we would be glad to help you get connected to therapy that works. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started.

Explore common challenges in family relationships, including communication and conflict resolution. Learn about options for family counseling at Nellie.

Navigating challenging family relationships

There are many therapies and medications out there for psychological problems. Some have been tested and science suggests they work, others have been tested and science suggests they _don't_ work, others haven't been tested at all, so we don't know either way.

If you were diagnosed with cancer, and your doctor offered you two treatments- one that your doctor created and thinks is the best treatment but has no scientific evidence for, and one that has been tested in many scientific studies and shown to work- you would want and expect to receive the treatment that has the most scientific evidence. You should expect the same from your mental healthcare providers.

  
For a psychological treatment to be considered “research-based”, it has to go through a series of phases of rigorous scientific testing:

*   First, the therapy is developed and tested in a small group of people.
*   Then, the therapy is tested in a larger group of people to see if it leads to meaningful symptom improvements.
*   After the therapy has been shown to work in a larger group, the therapy is compared to treatments that have already been established as helpful in a study called a randomized controlled trial. Or, it is compared to treatments that work a little, but aren't the most effective, to see if it works better.
*   Once the treatment has been tested and shown to work similarly to existing treatments that work for a given problem, the treatment then gets tested in different contexts, including community settings and with different groups of patients and providers, to make sure it works in “the real world”.

Research based treatments have been through all of these phases of testing, so they've been studied many times and their results consistently show they work.

When a treatment is considered “first line”, it means that there is a lot of evidence of this type to suggest that it improves symptoms enough to make an impact on a person's functioning, and that improvements are lasting for months to years after the treatment ends.

When a treatment is considered second, or third line, it means that there is not as much evidence to support that treatment, the evidence is not as positive, or that the quality of the studies that have tested it are lower. It doesn't necessarily mean that it doesn't work, it could mean that it just hasn't yet been thoroughly tested enough.

Ask your healthcare providers for the scientific evidence for the approach they're using. You have a right to know and to receive frontline interventions!

What is research based therapy?

Many people believe that therapy is most effective when sessions are spread out over longer periods of time. However, research shows that spreading out therapy sessions may actually be **less effective** than doing therapy sessions more frequently and with shorter time in between.

We can liken the dosing in psychotherapy to the way that you might think about a course of antibiotics. In the same way that antibiotic pills need to be taken consistently within a particular time frame to be effective, research shows that psychotherapy is most effective when the treatment is active, and includes weekly engagement in homework and new skills learning.

Moreover, some recent studies have shown that putting sessions even closer together, such as daily for 10 days (i.e., “mass-dosing”) may be a highly effective way to treat post traumatic stress disorder. As this is a new area of study, more research is needed to test this in other disorders, such as anxiety and depression.

If you are looking for support with your mental health at this time and would like to meet with one of our expert providers,, we would be glad to help you get connected to a provider who can help. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started with your journey today.

Therapy session dosing and frequency

Cognitive Behavioral Therapy (CBT) is based on the theory that our thoughts, emotions, and behaviors interact with each other in a cycle. When people feel negative emotions, they tend to think in very negative ways about themselves, others, or the world. When they are thinking this way, it often makes these difficult emotions even more intense. Difficult emotions may also relate to behaviors such as trying to ignore or suppress unwanted negative emotions, which keeps difficult emotions alive in the long run.

CBT focuses on helping you understand your symptoms and how your thoughts and behaviors may keep your mental health challenges going. CBT also involves working on thinking in more helpful and accurate ways, as well as changing how you act to improve your mood.

CBT typically includes strategies aimed at both your thoughts and behaviors, including:

*   Learning about common symptoms of the problem you are experiencing, such as depression or anxiety
*   Learning about how thoughts, behaviors, and feelings relate to one another
*   Creating goals for treatment that are both realistic and meaningful to you
*   Testing out predictions that you might have about how certain activities will impact your emotions
*   Learning strategies to challenge unhelpful or inaccurate thoughts and improve your mood
*   Practicing these strategies using worksheets outside of the session

If you are looking for CBT this time and would like to meet with one of our expert CBT providers, we would be glad to help you get connected to a provider who can help. Visit [https://www.nelliehealth.com/info-call/](https://www.nelliehealth.com/info-call/) to get started with your journey today.

Resources

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