Seasonal Affective Disorder

The popular phrase, “Spring ahead. Fall back,” referring to the changing of our clocks for Daylight Savings Time has a deeper impact for some people. Have you recently been experiencing depressed moods, a noticeable loss of energy and motivation, more time spent in bed and sleeping, increased anxiety, and difficulty staying focused? 

You are not alone, and you might be experiencing seasonal affective disorder (SAD). Seasonal affective disorder, also sometimes referred to as “winter depression,” is a form of depression that presents itself at certain times of the year, typically beginning in late fall or early winter and lasting into the spring.

Reported incidences of SAD afflict around 4-10% of the population in the United States. Those are only the reported cases. Studies suggest that as much as 20% of people suffer from some form of SAD, ranging from very mild to more severe cases.

The symptoms of seasonal affective disorder include:

  • Depressed moods
  • Increased sleep
  • Energy loss
  • Increased anxiety
  • Difficulty concentrating and focusing on tasks
  • Irritability
  • Change in appetite
  • Losing interest in activities you previously enjoyed
  • Feelings of hopelessness

Studies have shown that seasonal affective disorder may be caused by a biochemical change in our brains that is triggered by shorter days and reduced sunlight during the winter months. Serotonin and melatonin, in particular, have been linked to changes in mood, energy, and patterns of sleep. 

Serotonin production in our bodies is activated by sunlight. Less sunlight in the winter time could lower the level of serotonin our bodies produce. Low levels of serotonin have been associated with some forms of depression.

Melatonin production, on the other hand, works the opposite way. Our bodies produce more of it in darkness. Melatonin, of course, is a popular supplement for its ability to regulate sleep. Higher levels of melatonin can cause sleepiness and a general feeling of sluggishness.

Indeed, some studies have found that people with seasonal affective disorder do feel better after exposure to bright light. Seems simple enough, but it is a little more complicated than that.

Alfred Lewy, MD, a seasonal affective disorder researcher at Oregon Health & Science University, says it is not just about getting more light. It’s about when you get that light. 

“The most important time to get light is in the morning,” he says.

He thinks that SAD is due to a shift in our body’s circadian rhythm, which is our 24-hour sleep-wake cycle. Your alarm might say it is time to wake up, but your body’s internal clock is telling it that it should be resting.

Bright light in the morning can help to reset your circadian clock.

In addition to light therapy, other treatments for SAD include traditional psychotherapy and sometimes antidepressant medications.

It is completely normal to have days where you feel down, but if you feel down for days at a time, cannot get motivated for activities you normally enjoy, notice your sleep patterns changing, turn to alcohol for comfort or relaxation, or you have prolonged feelings of hopelessness, it is more than just the changing seasons and it is time to get help.

Although it might seem that “winter depression” is just a cycle you have to go through, any form of depression can be serious and should be treated as such.

Mobile Gaming Addiction On The Rise

family playing games on mobile devices

Like most of us today, you have probably experienced playing some form of game or games on your mobile device at one time or another. If you have, you likely already understand just how easy it can be to get engulfed in solving puzzles, shooting your opponents, unlocking new collectible items, and climbing to the top of leaderboards. You also likely understand how one can completely lose track of time while doing so. That’s not by accident.

Mobile game developers are using several different methods and strategies to keep players glued to their mobile devices and feed their addiction. Everything from color schemes to the soundtracks are well thought out in these games and designed to keep you coming back.

One of the most successful games in history on any platform is Candy Crush. It has been downloaded over 2.7 billion times, has over 70 million followers on its Facebook page, and has had over 1.1 trillion rounds of the game played. At its peak, over 93 million players played daily.

Candy Crush uses a very simple formula. They release new levels every weak, force players to wait for lives to “refill”, and it provides a simple method to purchase additional lives and other boosters for the game with just a couple of clicks.

So called freemium games like Candy Crush are a leading driver behind mobile game addiction. These games are free to install and play, but give options for in-app purchases. These purchases may allow a player to play more often. They may give boosts to progression in the game. In some games they unlock additional characters or cosmetic items.

Dopamine and Mobile Game Addiction

Game developers are using strategies to increase a player’s dopamine levels in order to keep them hooked on the game. Dopamine is a chemical in the brain largely responsible for controlling your feelings of pleasure. When players earn rewards in games, especially difficult to achieve ones, they will often experience a release of dopamine.

Increased dopamine levels are a significant factor in most types of addiction, including opioids and alcohol. Individuals struggling with addiction often will drink more alcohol or use drugs to achieve higher levels of dopamine. With video games, players will invest more time in the game and/or spend more money to unlock the same sort of feelings.

Because both are often described as impulse control disorders and alter our brain’s dopamine levels in a way that keeps people coming back for more, gaming addiction is most often compared to a gambling addiction. Some who suffer from gaming addictions may also suffer from other mental health disorders that contribute to the addiction.

The Risk

Mobile game addiction increases an individual’s risk for a number of physical and emotional health problems. It can also lead to significant complications in one’s day-to-day life.

Some common issues seen in those suffering from a mobile game addiction include:

● ADD and ADHD

● Learning disabilities

● Weight gain

● Neglect of personal hygiene

● Increased anxiety

● Sleep disorders

● Poor nutrition

Overcoming a Mobile Gaming Addiction

A gaming addiction is not often overcome by simply deciding to spend less time gaming. It usually involves counseling and behavioral therapy that can help show someone how to prevent themselves from turning to video games as a way to escape from reality or avoid facing problems. By learning to identify and cope with the underlying causes of their addiction, a person can take the first step to overcoming it.

6 Signs You May Need Anger Management Help

signs you might need anger management

Everyone experiences feelings of anger from time to time. It can even be healthy to let that anger out. However, not everyone can keep control of those emotions. Experiencing uncontrolled anger is certainly not the most comfortable situation, but what can be even worse is having to deal with the ramifications. If you or someone you know finds yourself in that situation frequently, it might be time to evaluate whether there is a serious problem in dealing with anger.

Anger and an anger management problem are two totally different things. Releasing anger from time to time is normal. Doing so is an instinctive phsyiological reaction to some situations and is our body saying that something is wrong. Sometimes it might even push us to take action.

As an example, someone might feel anger at the site of seeing an animal being abused and that anger might push them to intervene or get help.

More unhealthy displays of anger include rage, passive agressiveness, resentment, and verbal or physical abuse.

If you are wondering if the anger levels you or someone you know is experiencing are normal, here are a few signs that there might be an anger management problem.

1. Passive Aggressiveness

When most people think of anger management problems they think of more vocal and/or physical demonstrations of anger, but passive aggressiveness can be just as much of a sign of trouble as the more traditional displays of anger.

Some people do not even relize they are dipping into this type of anger. Passive aggressive behavior is often expressed in sarcasm, acting mean, or just being apathetic.

2. Blaming Others

When you lay the blame for problems at the feet of others, it is easy to feel angry. Feeling like your situation is entirely the fault of someone else can be infuriating.

However, anger problems often times have little to do with what actually happens to you and instead are a result of how you interpret what happens to you.

If you find yourself constantly blaming others for failed relationships or poor performance at work, that can be a sign of an anger problem.

3. You Anger Frequently

Feeling angry all the time is not only a sign of an issue, but it is also physically and emotionally unhealthy. If you find yourself angry more often than not, that is a sign of a problem.

4. Aggression

This is an easy one to identify. All of us experience feelings of anger from time to time. Not all of us express it in road rage, by physically or verbally abusing those around us, or by punching walls and doors.

This sort of behavior often results in physical damage to property or other people.

If you are expressing your emotions in these ways, you likely have a problem controlling your anger.

5. The Duration of Your Anger is Too Long

One of the telltale signs of an anger management problem is when angry outburts last for a long time.

An example of this is if on your way to work, someone upsets you and you are still simmering about it at the end of the day. This inability to quickly and easily let things go is a typical problem people who are struggling with their anger face.

Not only is this emtionally unhealthy, but when your body is kept in that state throughout most of the day, it is physically draining.

6. Your Anger is Disproportionate to the Situation at Hand

There is nothing wrong with feeling angry from time to time. If you find yourself having a complete meltdown, especially over a issue that is small, that is not okay.

As a baseball fan, when I think of this I think of some of the classic meltdowns of managers like Earl Weaver and Tommy Lasorda. As fans we laugh about it and sometimes even cheer them on. Off the baseball field, behavior like that is a sign that someone needs to seek anger management therapy, and quickly.

If you find that your anger is causing problems for you personally and professionally, if outbursts at work have put your employment in jeopardy, if your relationships are becoming damaged, it is time to seek help from an anger management therapist.

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Social Media Anxiety Disorder

When was the last time you checked your Facebook, Twitter, Instagram, or Snapchat account? Do you ever feel anxious when you are unable to check them? You may be surprised to know that social media anxiety disorder is a real disorder. It is a mental health condition with great similarities to social anxiety disorder.

Anxiety disorders are the most prevalent mental health disorders in the United States, and social media anxiety is becoming one of the fastest growing of those disorders.

Technology is supposed to make things easier and more convenient for us. However, there are times when technology can cause us added stress. Some studies have shown that almost 20% of people with social media accounts cannot go more than three hours without checking them.

Most people with social media accounts do not feel anxious when they are unable to check their accounts and updates for a few minutes. Those who suffer from social media anxiety disorder can feel great deals of stress and anxiety just from being separated from their accounts for a short period of time.

Social media anxiety disorder has some common symptoms to look out for:

● Lying about how much time you spend on social media.

● Checking social media accounts in the middle of conversations.

● Loss of interest in other activities.

● Withdrawal from friends and family.

● Being distracted at work by social media.

● Neglecting tasks at home or work in order to comment on a social media thread.

● An overwhelming need to share things on social media sites.

● Severe feelings of stress or anxiousness when unable to check social media statuses for a period of time.

According to a survey published by the National Center for Biotechnology Information, about 30% of students using social media spend over 15 hours per week online. This time can greatly take away from relationships, work, and education. Spending several hours per day on social media sites such as Facebook can be a sign of social media anxiety disorder, and it can greatly affect both mental and physical health.

Spending too much time online has been proven to often cause eye strain, neck pain, lower back problems, and hand and wrist cramping. In more severe cases it can also lead to obesity, poor nutrition, and even heart disease.

On the mental health side, research has shown that social media anxiety disorder and spending too much time online in general can lead to depression, paranoia, loneliness, and attention deficit hyperactivity disorder (ADHD). The problems come not just from the need to share things online but also from comparing themselves with others on Facebook. It can cause feelings of jealousy and depression.

There is also an unhealthy need to be “liked” on sites like Facebook. Social media anxiety disorder is not just about a compulsive need to check statuses and notification. Sufferers also often times feel a need to have their posts and notifications liked, shared, and commented on by others.

When the response to their activities does not meet their expectations, it can trigger feelings of sadness, loneliness, and even lead to depression.

What Can Be Done?

The most important thing is recognizing the problem and that your expectations on Facebook and Instagram may not be realistic. Those people posting are usually only posting highlights of their life and the good stuff. They have the same struggles as everyone else.

It’s easy to say that someone needs to get out and enjoy “real” life, but for a sufferer of this disorder it is often not as simple as just turning off their phone or computer and getting out of the house. Talking to a counselor about why they are having these obsessive feelings is the best way to get their social media life under control. If you or someone you know is suffering, call us today or contact us online to schedule a consultation.

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Recognizing and Understanding Panic Attacks

I have heard it described many times before.

It usually starts with, “I didn’t know what was happening to me.”

They then go on to describe an overwhelming feeling of fear. Feelings of dizziness and or being a little lightheaded come on. Palms sweat and sometimes shake. Their face feels flushed. Blood pressure goes through the roof.

Often the first time it happens it is shrugged off as just an odd episode. It’s not until it happens a few more times that the person realizes it is time to seek some help. They are usually thinking that they must be ill. What they learn is that they are not in fact ill, but are experiencing panic attacks.

Anyone can suffer from a panic attack. Many people who experience them do not immediately recognize the source of their discomfort.

The good news is that panic attacks are easily explainable and with the guidance of a therapist they are also treatable.

What is a Panic Attack?  

Mental health professionals describe panic attacks as sudden rushes of intense dread or distress which are often accompanied by a number of physical symptoms that can include: dizziness, sweating, a racing heart, chest pain, difficulty breathing, trembling, numbness, and even disorientation.

Inside the brain, things can be just as concerning. During a panic attack one will often experience thoughts of fear and dread as well as a fear of doing something uncontrollable or of dying.

Panic attack sufferers are not actually dying. Their blood is pumping with adrenaline. Their bodies are reacting in the same way it would if an immediate threat was present.

In simple terms, their body has triggered their “fight or flight” response in order to protect the individual.

Obviously, there is often no immediate threat when a panic attack sets in. The mind realizes this, but the body ignores this information. The body is saying run. The mind is saying stay. The confusing signals between the mind and body will cause the person to stay in one place.

What Can Cause a Panic Attack?

There is no typical profile for a person who is prone to experience a panic attack. Typically, someone who experiences panic attacks has their first panic attack as a child, but not always. Women tend to experience them more than men, and some research points to genetic dispositions.

Even though panic attacks can seemingly sneak up out of nowhere, they can be triggered by a lack of sleep, drugs, caffeine, alcohol, as well as chemical or hormonal imbalances. Many times they are also often connected to traumatic or challenging life situations, most often ones that have occurred in the past 12 months.

Individuals who experience regular panic attacks cannot often predict when they’ll strike. They find they are more susceptible when they are under extreme stress. Other times they will strike seemingly randomly.

What Can You Do if Experiencing a Panic Attack?

If someone has been diagnosed with panic attacks, they can often make simple lifestyle adjustments to reduce symptoms. Things such as getting more sleep and exercising more regularly can help.

Although they are not recommended for frequent use because they can be habit forming, anti-anxiety medications such as Xanax can be useful for specific situations that are likely to induce panic such as sailing on a boat or flying on a plane.

If panic attacks start to occur frequently, there is a possibility that the the individual has a panic disorder. In the case of a panic disorder, the individual becomes so worried about having a panic attack that their anxiety becomes a source of more anxiety.

To avoid having another attack, they will try to stay away from situations, people, or places that trigger their symptoms. If they feel panic setting in, they will try to fight the fear, which unfortunately, usually makes it worse.

Panic disorders can be managed in the short-term with antidepressants, but are best treated through cognitive behavioral therapy. Cognitive behavioral therapy is a treatment that tries to help patients tap into the thoughts and feelings that drive their actions. Through this therapy they can identify and examine the fears that trigger their anxiety.

The goal is to break the cycle of panic through anxiety counseling. By understanding what causes the feelings of panic, an individual does not have as strong of a physical or emotional response to it. With this new found understanding, they can recognize the feelings of panic for what they are and adopt coping skills.

If you experience panic attacks and are ready to get started learning why, you can contact us to schedule your first appointment.

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Is Facebook Bad for Your Mental Health?

Facebook is bad for your mental health.Ping. Ping ping ping. Swoosh. Ping.

Oh hi. Hello. I’m sorry, I didn’t see you there. Ping. Sorry. Okay, I’ll put this thing away. I posted a video of my dog on Facebook this afternoon; he learned to hula hoop. I had to share. The people love it. Ping ping ping.

That’s one way to start a conversation with a friend, a business partner or a would-be lover.

Personally, I prefer to communicate, to become acquainted with others in analog.

Since its inception in February 2004, Facebook has been used as a gathering place to meet like minds and to like faces; to stay connected with old friends; and of course, to share cat memes and argue over Dexter’s fate. But these days we argue over other things too, real life things with real consequences. Now, instead of bringing people together our collective constant presence on Facebook is tearing them apart.

Facebook might be bad for your mental health.

Arguments. The comments section. It’s all compounded by the comparisons. Your college roommate has it all: the husband, the house, the baby. Her life is perfect. Or it seems that way. Her life may be great, but yours is too. That’s hard to remember sometimes when filters so easily mask credit card debt and sleepless nights.

The truth is, Facebook is making us all pretty unhappy. A Danish research firm, the Happiness Research Institute, has the evidence to prove it. A study conducted among 1,095 Facebook users asked participants to not log in to the site for a period of seven days. A control group was instructed to maintain normal activity. At the end of the study period, those who abstained were 55 percent less likely to feel stressed and reported many fewer instances of restlessness or loneliness. Of the control group, 81 percent reported feeling ‘happy’ while 88 percent of non-Facebook users felt happiness.

“Facebook is a constant bombardment of everyone else’s great news, but many of us look out of the window and see grey skies and rain, especially in Denmark.” said Meik Wiking, CEO of the Happiness Research Institute said. “The main takeaway from this study is awareness of the negative aspects that social comparisons have, and how we should be mindful of how Facebook and social media affect how we evaluate our lives.”

It’s true of Denmark, and of Washington DC and Bethesda MD too. When envy and conflict rise over community and the generous spirit of sharing good tidings, it might be time to consider taking a break — for seven days or longer. Spend the time you’d take to share the video of our friend’s hula hooping dog, and read a book with your toddler; linger a little longer over the dinner table; and take care to take care of yourself first.

Prioritize Your Mental Health in 2017

make your mental health a priorityWhile your friends and family are resolving to cook more dinners at home; to lose 50 pounds; to travel more; or to check seeing Tom Petty in concert off the old bucket list, but you’re starting smaller: with yourself. You’ve decided the year 2017 is the year of you.

2017 is the year you have chosen to make your mental health your priority.

Your mental health affects how you think, how you feel, and how you act every day, in every situation. Your mental health affects the way you perceive yourself and how your friends, loved ones, and strangers perceive you too. Your New Year’s resolution for 2017 is to become a better — nay, the best version of yourself by improving your mental health.


The practice of meditation has been shown to offer a variety of health benefits, including improved sleep and decreased anxiety. But it is a practice. To reap the rewards — even and especially when the status quo is ‘busy’ — set aside ten minutes per day to quiet the noise. Take a few moments to reflect on the day; express gratitude for the blessings in your life, and focus on becoming fully present.

Commit to regular exercise.

Exercise is great not only because it releases endorphins in your brain that make you a happier version of yourself, but it helps you work toward that other goal of losing weight. Even better, when the weather is nice, get outside. Research has suggested that walking outdoors surrounded by nature has even more mood-boosting power.

Find your tribe.

Winter is cold and it’s dreary, and for those who struggle with Seasonal Affective Disorder (SAD) it’s even worse, but getting out of the house — social connection and bonding are imperative to mental health, so go on. Get out of the house and do something fun; make new friends. Go to the beach, or schedule a car service for a night on the town. It’ll be worth it.

Eat well.

Healthy eating leads to healthy bodies and healthy minds. Strive to incorporate many different types of fruits and vegetables in your diet, and other tasty brain boosting foods like walnuts. Don’t skip meals, and stay hydrated, and you’ll be well on the path to prioritizing your health and mental well being all year long.

Schedule an appointment with your Washington DC psychotherapist.

The wisdom and guidance of a professional psychotherapist in Washington DC can help you onto a path of self-discovery, and toward more effective methods of dealing with depression, stress, anxiety, and every day life.

Contact Keith Miller Counseling & Associates to discuss how psychotherapy in Washington DC can help you achieve your goal of a happier, healthier you in 2017.


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Mindfulness & Self Care Are Key to Relieving Holiday Stress

Stress & Anxiety During the Holiday Season | Washington DC psychotherapistIt’s the hap-happiest season of all
With those holiday greetings and gay happy meetings
When friends come to call
It’s the hap-happiest season of all

For some of us, the holiday season dredges up more feelings of stress and anxiety than it does feelings of comfort and joy. The family gatherings, buying gifts and the travel to relatives: You may have every intention to celebrate, but something is holding you back. Maybe you just can’t wait for it to be January?

But it doesn’t have to be that way. You can take good care of yourself without completely unplugging from your family’s ritual and tradition. Perhaps it means skipping an event or two to lower your stress level. Try to find your own way to enjoy family time the way you want to.

Talk to a few family member about how you’re feeling.

Do you have a trusted family member — maybe it’s that aunt, a sibling, or a favorite cousin — you can confide in? Confide with cheer. Share what’s on your mind and know you’re not alone if you feel stressed or anxious about spending so much time with the family. Make a plan to get away together; go out for coffee, pack your hiking boots, or download some relaxing meditations to help you let go when it all gets to be too much.

Get involved.

Sitting on the sidelines can amplify our anxiety. Sometimes our level of satisfaction is directly linked to our level of feeling invested, even though it’s more effort and work. Maybe this is the year you offer to host the family’s Christmas Eve gathering. Or perhaps you only do one part with gusto —,you plan plan the menu, find the centerpieces, or concoct the holiday cocktail. Think about your own interests and energy level, and offer to do something you feel good about doing.

Give back.

You don’t have to spend all of your time with your family. Take a few hours this holiday season, and spend them giving back to your community; volunteer opportunities may be available through local places of worship, homeless shelters, or animal shelters.

Be mindful of your own mental health.

Only you know your own triggers for stress. If going caroling with the family is going to put you in a sour mood, plan ahead and talk it through with family so they’re in the loop about what could make the activity more enjoyable for you. Maybe hire a car service to drive you to holiday parties or shopping? Maybe this is the year you decide to accept your uncle’s choices and let go of the burden of feeling responsible for his behavior. And if the general hubbub of the season leads to overwhelming anxiety that overtakes your daily thoughts and feelings, stop and reach out for help.

Everyone needs a little extra support every now and then; there is absolutely no shame in seeking out the help you need. Talk to a trusted family member or a friend, or:

Contact the experienced Washington DC psychotherapists at Keith Miller & Associates for an appointment to discuss how you can relieve holiday stress.


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When Your Way is the Right Way: The Methodology of Persuasion

Persuasion methodology | Bethesda psychotherapistTo be persuasive is an important skill that can help you get ahead — and make you happier — at work, at home, and in social situations, too. But that’s not all it’ll do: Learning the tricks of persuasion can also provide unique insight into how and when they’re being used on you.

Consider the following subconscious, but very persuasive techniques.

With these simple techniques, and a little practices, soon you’ll convince everyone around you that your way is the best way, and leave them wondering why they ever thought differently.

Use framing to influence thought.

Framing, put simply, is a way to change how we sort, categorize, associate, and assign meaning to events, objects, or behaviors. An example? A pessimistic person would say, “This glass is half empty.”, thus calling specific attention to the empty part of the glass, while an optimist uses language to point out the full portion of the glass.

There is where the power of framing as a tool for persuasion lies. The word you choose will conjure images that carry positive, negative, or neutral connotations, thus influencing how the person to whom your are speaking feels or thinks about a subject.

Use the mirroring technique.

This practice of mimicking the movements and body language of the person you are trying to persuade creates a sense of empathy; he or she will understand that you understand their problem or need, and will more readily accept the solution you have offered.

Mirror hand gestures; lean forward or away from the person; or mimic various head and arm movements. The truth is, we all do this naturally, and becoming aware of its power will only work the tool to your advantage. But take care to be subtle, so your actions won’t be seen as mocking.

Use herd behavior to influence a decision.

It’s the concept of herd behavior that you’ll find at play behind peer pressure, and herd behavior that caused your mom to say, “If So-and-So jumped off a bridge…” But when employed under just the right circumstances, this tactic has the invaluable power to position you as an effective leader.

Human beings as a species are observant; we watch what those around us do before deciding how to act ourselves, for no reason other than we crave acceptance. It’s for that reason that we are far more likely to follow or be persuaded by someone we like.

Be charming and confident; praise a leader the person whom you are trying to persuade admires; trigger positive thoughts in that person’s mind, and they’ll likely associate those same qualities with you.

To be persuasive is a skill that will help you get ahead and make you happy, and one that requires at least a basic knowledge of human psychology; for more information, and help influencing those around you, contact Bethesda, MD’s experienced psychotherapists at Keith Miller Counseling & Associates.


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Mental Illness Is Not a Four-Letter Word. Know the Warning Signs.

Washington DC Anxiety Therapy“Mental illness isn’t something that can happen to me. Not to my family.”

The thing is, it could happen. You might be surprised to learn just how common mental disorders are; an estimated 54 million Americans suffer from some form of mental disorder in a given year.

Even given these numbers, most families are caught unaware and unprepared to cope with learning their loved one has a mental illness. There will be challenges, physical and emotional, and you might often feel vulnerable to the opinions and judgments of others, but through it all, the most important thing to remember is this:

There is hope, and there is help for coping with mental illness.

Mental illness is not a four-letter word.

A mental illness is a disease, plain and simple — one that causes mild to severe disruptions in thought or behavior, and can inhibit the sufferer’s ability to meet life’s ordinary demands and routines. The American Medical Association recognizes more than 200 forms of mental illness, the more common of which are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders.

Such illness can be caused by, or related to any number of factors such as excessive stress, genetics, biochemical imbalances, or a combination of these things. A patient can often be treated to full recovery with the aid of an experienced Washington DC psychotherapist.

What are the warning signs of mental illness?

There are a number of physical and psychological signs that may indicate the presence of a mental illness. It’s especially important to pay attention to sudden variations in thoughts and behavior; review the lists of potential signs below, but keep in mind that it’s the onset of drastic change that might indicate a serious problem.

In Adults, Young Adults and Adolescents:

  • Confused thinking
  • Prolonged depression (sadness or irritability)
  • Feelings of extreme highs and lows
  • Excessive fears, worries and anxieties
  • Social withdrawal
  • Dramatic changes in eating or sleeping habits
  • Strong feelings of anger
  • Strange thoughts (delusions)
  • Seeing or hearing things that aren’t there (hallucinations)
  • Growing inability to cope with daily problems and activities
  • Suicidal thoughts
  • Numerous unexplained physical ailments
  • Substance abuse

In Older Children:

  • Inability to cope with problems and daily activities
  • Changes in sleeping and/or eating habits
  • Excessive complaints of physical ailments
  • Changes in ability to manage responsibilities – at home and/or at school
  • Defiance of authority, truancy, theft, and/or vandalism
  • Intense fear
  • Prolonged negative mood, often accompanied by poor appetite or thoughts of death
  • Frequent outbursts of anger

In Younger Children:

  • Changes in school performance
  • Poor grades despite strong efforts
  • Changes in sleeping and/or eating habits
  • Excessive worry or anxiety (i.e. refusing to go to bed or school)
  • Hyperactivity
  • Persistent nightmares
  • Persistent disobedience or aggression
  • Frequent temper tantrums

If you or someone you know is in crisis now, seek help immediately. Call the experienced psychotherapists in Washington DC and Bethesda, Maryland for guidance and mental health counseling.

If you or someone you know is suicidal, the best place to go is to your nearest emergency room. You may also find these resources helpful:

National Suicide Hotlines USA
Toll-Free / 24 hours a day / 7 days a week




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Our psychotherapy fees start at $175 per hour (psychiatry fees start at $200 for 30 minutes).
We do not accept insurance, meaning we are not "in-network" with any health plans.
However, many of our clients submit claims to their out-of-network health insurance and receive 40-60% reimbursement.