Schizophrenia

SCHIZOPHRENIA

Schizophrenia is a mental disorder in which people have trouble interpreting reality. People with schizophrenia require lifelong treatment, but early treatment may help control symptoms before serious complications develop and may help improve the long-term outlook. Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms, but some symptoms may always remain present. Typically, symptoms fall under five categories which include, delusions, hallucinations, disorganized thinking, abnormal motor behavior, and negative symptoms.
In depth explanations of these symptoms include:
  • Delusions are false beliefs that are not reality. For example, one may believe they are being harmed or harassed, certain gestures or comments are being directed at them, or they have exceptional ability or fame. Delusions occur in most people with schizophrenia.
  • Hallucinations usually involve seeing or hearing things that don’t exist. Yet for the person with schizophrenia, they have the full force and impact of an actual experience. Hallucinations involve any of the senses, but hearing voices is the most common hallucination.
  • Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions are completely unrelated.
  • Abnormal motor behavior may show up in a number of ways, from childlike silliness to unpredictable agitation. Behaviors can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.
  • Negative symptoms refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion (doesn’t make eye contact, doesn’t change facial expressions or speaks in a monotone). Also, the person may have lost interest in everyday activities, or withdraw socially.
WHY IDCC?
At IDCC, we have worked with many cases of schizophrenia and have found that with special attentive care, this disorder can be treated. While schizophrenia is considered a lifelong process, science is working rapidly to find new treatments, a development which IDCC’s clinicians are constantly monitoring. There are many cases where those who have schizophrenia, received treatment and are now highly functioning members of society.
TREATMENT OPTIONS
Psychosocial therapy is often used to treat schizophrenia and addresses the behavioral, psychological, and social aspects of living with schizophrenia. One psychosocial therapy used is Assertive Community Treatment (ACT), which is a way of organizing psychosocial services to help integrate a person with schizophrenia into the community. When a good ACT team which may include a social worker, a psychiatric nurse, and other counselors, is in place, the likelihood of recurring symptoms and hospital admissions is reduced, and medication compliance is improved.
Antipsychotic drugs have proven to be crucial in relieving the psychotic symptoms of schizophrenia. They are thought to control symptoms by affecting the brain neurotransmitter dopamine. Though the psychiatrist may try different drugs, antidepressants or antipsychotic medications are the most popular drugs. It can take several weeks to notice an improvement in symptoms.

OCD

OCD

Obsessive Compulsive Disorder 

Obsessive-Compulsive Disorder (OCD) symptoms are unique to each individual, but some common patterns do exist. The condition is characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with daily life. Obsessions are unwanted, recurrent, and disturbing thoughts, impulses or images that are difficult to suppress.
Symptoms of obsessions include:
  • Fear of contamination or dirt
  • Needing things orderly and symmetrical
  • Aggressive or horrific thoughts about harming yourself or others
  • Unwanted thoughts, including aggression, or sexual or religious subjects
  • Fear of touching objects others have touched
  • Doubts that you’ve locked the door or turned off the stove
  • Intense stress when objects aren’t orderly or facing a certain way
  • Images of hurting yourself or someone else that are unwanted and make you uncomfortable
  • Thoughts about shouting obscenities or acting inappropriately that are unwanted and make you uncomfortable
  • Avoidance of situations that can trigger obsessions, such as shaking hands
Compulsions are repetitive, ritualized behaviors that a person feels driven to perform to alleviate the anxiety or discomfort created by the obsessions. Symptoms of compulsions include:
  • Excessive cleaning
  • Following a strict routine
  • Demanding reassurances
  • Hand-washing until your skin becomes raw
  • Checking doors repeatedly to make sure they’re locked
  • Checking the stove repeatedly to make sure it’s off
  • Counting in certain patterns
  • Silently repeating a prayer, word or phrase
  • Arranging your canned goods to face the same way
WHY IDCC?
At IDCC, we provide evidence-based treatment for OCD. Treatment includes exposure and response prevention, as well as strategies to enhance emotion regulation and adaptive coping which help people manage their personal stressors.
During an initial evaluation, we aim to assess symptom presentation, treatment goals, and the level of treatment appropriate for each person. Our clinicians also offer medication consultation and management to ensure the medication is the correct dosage and taken responsibly.
TREATMENT OPTIONS
Consistent with IDCC’s approach to treating mental illness, we first consider a form of psychotherapy, not medication. The most trusted psychotherapy option for OCD is Exposure Response Prevention (ERP) therapy.
ERP exposes individuals to the thoughts, images and objects that trigger anxiety in order to give them the tools they need to prevent responding to anxiety with compulsions and rituals. This therapy is conducted in a controlled environment and is always facilitated by mental health professionals who have been trained in ERP therapy.
If deemed necessary, medication is an option that has seen success in treating OCD. A series of trials on different medications is not uncommon to ensure adverse effects, if any, are kept to a minimum.

Bereavement

BEREAVEMENT
The period after losing a loved one can be one of the toughest periods in one’s life. Feelings of loss, bereavement, and grief are normal and natural for the healing process after a death is experienced. While bereavement is highly individual when it prohibits someone from taking part in daily activities, this can be a sign that they should seek professional help. Many people report feeling an initial stage of numbness after first learning of a death, but there is no real order to the grieving process.
Some emotions one may experience include:
  • Denial
  • Disbelief
  • Confusion
  • Shock
  • Sadness
  • Yearning
  • Anger
  • Humiliation
  • Despair
  • Guilt
WHY IDCC?
At IDCC, our team of healthcare professionals, including our staff of on-site medical doctors, work with each person to truly understand the unique way that they are approaching the loss. Special attention to cultural and religious backgrounds as well as family dynamics, are also considered by IDCC clinicians, as these factors have a profound effect at the time of a death. Clinicians that help treat bereavement develop personalized therapy plans that allow each individual to absorb the impact of a major loss at their own pace, so they can recover and move on to living a normal happy life.
TREATMENT OPTIONS
The mainstay of treatment is usually grief therapy which can be facilitated in support groups or one-on-one talk therapy sessions. The goal of grief therapy is to identify and solve problems the mourner may have in separating from the person who died. Once those problems are recognized, counseling can then continue to help the bereaved accept the loss by helping them talk about the loss, learn effective modes of coping, and even start new relationships.

Anger And Aggression

ANGER AND
AGGRESSION

Individuals who have trouble controlling anger or who experience anger outside of a normal emotional scope may have one of several different types of anger disorders. Anger can take on various forms, the main categories of anger disorder include:
  • Passive anger – This does not always come across as anger and can be difficult to identify. While aggressive behaviors have a clear and obviously negative impact on those involved, those who express their anger passively may not even be aware they are angry.
  • Chronic anger includes constantly recurring or prolonged anger episodes. This form of anger can impact the immune system and can possibly be the cause of other mental disorders
  • Overwhelmed anger is mainly caused by life demands that are too much for an individual to cope with.
  • Self-inflicted anger is generally directed toward the self and may be caused by feelings of guilt.
  • Judgmental anger is typically directed toward others and may come with feelings of resentment.
  • Volatile anger involves sometimes spontaneous bouts of excessive violence.
WHY IDCC?
IDCC has years of experience in working with anger management in a non-judgmental way and has learned that most people want to heal themselves and their relationships when given an opportunity to do so.
In our unique and highly successful approach, we do not facilitate couples therapy until each individual with anger and/or aggression has gone through personal therapy. Once there is a commitment and skills to managing one’s anger, family and/or couples counseling can commence. Underlying psychiatric causes for the behavior is also addressed.
TREATMENT OPTIONS
Many therapeutic strategies are available to help those dealing with anger issues. Some of these include cognitive behavioral therapy, improvements in communication skills, and problem-solving training.
While it is possible to improve an anger response without external assistance, a qualified practitioner can help the process in a far quicker manner.
These therapies and methods help people adjust to life with an anger disorder. With therapy, patients get used to personal triggers and learn how to deal with each particular issue using conscious, goal-centered strategies.

Anxiety

ANXIETY

In today’s stressful world, it’s normal to feel anxious from time to time. However, when excessive anxiety and worry become difficult to control and interfere with daily activities, this may be a sign of an anxiety disorder.

One may feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety persists and can get worse over time if it is not treated. In most cases, generalized anxiety disorder improves with psychotherapy or medications.
Making lifestyle changes, learning coping skills, and using relaxation techniques can also help. There are several different types of anxiety disorders, of which the main categories include Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety Disorder. Symptoms for these categories are listed below.
Generalized Anxiety Disorder:
  • Being easily fatigued
  • Difficulty concentrating or feeling the mind go blank
  • Irritability
  • Excessive Anxiety or worry
  • Restlessness or feeling on edge
  • Muscle tension
  • Difficulty controlling feelings of worry
  • Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)
Panic Disorder:
  • Sudden periods of intense fear
  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating, trembling or shaking
  • Recurrent unexpected panic attacks
  • Sensations of shortness of breath, smothering, or choking
  • Feeling of impending doom
  • Sudden and repeated attacks of intense fear
  • Feelings of being out of control during a panic attack
  • Intense worries about when the next attack will happen
  • Fear or avoidance of places where panic attacks have occurred in the past
Social Anxiety Disorder:
  • Staying away from places in which there are other people
  • Having a hard time making friends and keeping friends
  • Blushing, sweating, or trembling around other people
  • Fear of social situations
  • Anxiety about public speaking or engaging in a performance in which one feels embarrassed, judged, rejected, or fearful of offending others
  • Feeling highly anxious with other people and having a hard time talking to them
  • Being self-conscious in front of other people and worried about feeling humiliated, embarrassed, rejected, or fearful of offending others
  • Worrying for days or weeks before a social event
  • Feeling nauseous or sick to the stomach when other people are around
WHY IDCC?
Some physical health conditions, such as an overactive thyroid or low blood sugar, as well as taking certain medications, may worsen an anxiety disorder. A thorough mental health evaluation is important as anxiety disorders often coexist with other related conditions, such as depression or obsessive-compulsive disorder.
TREATMENT OPTIONS
IDCC’s expert mental health professionals use evidence-based methods to evaluate and diagnose anxiety disorders. Our clinicians are informed of the most recent developments in the research of anxiety disorders and work with scientifically proven treatments. IDCC’s compassionate clinicians and mental health professionals listen to your concerns to thoroughly understand your concerns, health issues and experiences with anxiety to create a treatment plan suited to your needs.
There are various treatment options for treating anxiety disorders including some of the following. Talk Therapy or psychological counseling involves working with a therapist to reduce anxiety symptoms. Another treatment is Cognitive Behavioral Therapy (CBT) , a short-term treatment focused on teaching specific skills to directly manage worries and help the patient gradually return to the activities that have been avoided because of anxiety.
If deemed necessary, medication may also be used as treatment as well. Medications used to treat anxiety include antidepressants and sedatives. These medications work to balance brain chemistry, prevent episodes of anxiety, and ward off the most severe symptoms of the disorder. Using medicine together with the likes of talk therapy has been proven as a very efficient method for treating anxiety.

Depression

DEPRESSION

Depression is a common but serious mood disorder. Many people feel sad, “blue”, or disappointed at times. These feelings are usually temporary and pass within a few days. However, when feelings of sadness, hopelessness, or worthlessness persist and begin to interfere with daily life, it may be a sign of depression. Depression, also known as Major Depressive Disorder or Clinical Depression, may cause severe symptoms that affect how one feels, thinks, sleeps, and eats. To be diagnosed with depression, symptoms must be present for at least two weeks.
Symptoms that may be a sign of depression include:
  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
WHY IDCC?
IDCC successfully treats thousands of individuals who have been diagnosed with Depression each year. Our team of clinicians and on-site medical staff work with each patient to understand their unique situation in order to develop a personalized and comprehensive treatment plan. Steps and goals are set on a weekly basis in order to support a meaningful recovery. Patients traditionally make significant progress when working together with our clinicians and following a disciplined approach to depression.
TREATMENT OPTIONS
Depression is a treatable condition and most people see improvements in their symptoms when treated with medication, psychotherapy, or a combination of the two.
Psychotherapy (or talk therapy) has an excellent track record of helping people with depressive disorder. While some psychotherapies have been researched, the most popular therapy for Depression is Cognitive Behavioral Therapy (CBT). During CBT, a therapist will help identify negative or false thoughts and replace those thoughts with healthier, more realistic ones.
For example, if one feels worthless or believes that their life is in a downward spiral, perhaps obsessing over shortcomings, CBT will help make the patient aware of these toxic thoughts, teaching them to replace these thoughts with positive ones. The change in attitude will many times lead to a change in overall behavior. If one experiences moderate to severe depression, one of our doctors may prescribe an antidepressant medication, along with psychological treatments.
Antidepressants are sometimes prescribed when other treatments have not been successful or when psychological treatments alone are not possible due to the severity of the condition or a lack of access to the treatment. While there are many different medications that can help reduce the symptoms of depression, most studies have found medication is most effective when it is used in conjunction with therapy.

Trauma

TRAUMA

Trauma is a type of injury to the mind that occurs as a result of a severely distressing event. It is often the result of an overwhelming amount of stress that exceeds one’s ability to cope or integrate the emotions involved with that experience. Reactions such as shock, fear, jumpiness, nightmares, or trouble sleeping are common after a traumatic event. For most people, these reactions diminish over time. However, for people with PTSD, the feelings remain as fresh as they were when the event occurred.
Some additional symptoms of PTSD include:
  • Denial or disbelief
  • Confusion
  • Difficulty concentrating
  • Anger
  • Irritability
  • Mood swings
  • Anxiety and fear
  • Guilt, shame, or self-blame
  • Withdrawing from others
  • Feeling sad or hopeless
  • Feeling disconnected or numb
While PTSD is typically caused by experiencing the event first hand, there are other forms of exposure which can cause PTSD including:
  • Witnessing the event in person as it happens to others (e.g. witnessing a kidnapping)
  • Learning that it occurred to a close family member or close friend (if actual or threatened death ­ must have been violent or accidental: e.g. seeing a friend die in a car accident)
  • Experiencing repeated or extreme exposure to aversive details of the event (e.g. police officers repeatedly exposed to violent murder victims)
WHY IDCC?
Led by board-certified psychiatrists, the PTSD team at IDCC, has received specialized training to treat various types of trauma. Treatment plans are designed for each individual’s specific needs and all are based on methods that have been proven to be effective. In addition to employing some of the top PTSD mental health professionals in the New York area, IDCC has been chosen by the state of New York to treat special cases requiring highly trained and experienced clinicians due to the rare nature of the events that occurred.
TREATMENT OPTIONS
IDCC’s approach to treat PTSD with Cognitive-Behavioral Therapy (CBT) involves educating the individual and their family about the symptoms and what is causing the reactions. It is our belief that building a robust support network is vital for recovery. As drug and alcohol abuse is closely related to PTSD, clinicians also facilitate education sessions on substance abuse. This helps if substance abuse is present or helps avoid future issues.
The most common medications used for treating PTSD are antidepressants called Selective Serotonin Reuptake Inhibitors, or SSRIs. These medications work by raising levels of the brain chemical serotonin, which regulates mood, appetite, and sleep. This helps to improve communication between nerve cells, leading to improved mood and decreased anxiety.
This in turn allows the brain to cope with processing the distressing event that was experienced. In cases where symptoms include rage or anger, mood stabilizers may be used as well.

DMDD

DMDD
Disruptive Mood Dysregulation Disorder
Also known as: Anger Management, Impulsive Disorder
Disruptive Mood Dysregulation Disorder (DMDD) is a childhood condition of extreme irritability, anger, and frequent, intense temper outbursts. DMDD symptoms go beyond being a “moody” child, as children with DMDD experience severe impairment that requires clinical attention.
DMDD symptoms typically begin before the age of 10, but the diagnosis is not given to children under 6 or those over 18 years of age. A child with DMDD experiences:
  • Irritable or angry mood most of the day, nearly every day
  • Severe temper outbursts (verbal or behavioral) at an average of three or more times per week that are out of keeping with the situation and the child’s developmental level
  • Trouble functioning due to irritability in more than one place (e.g., home, school, with peers)
To be diagnosed with DMDD, a child must have these symptoms steadily for 12 or more months.
DMDD is a relatively newly discovered mood disorder. Previously, it was misdiagnosed as a form of Childhood Bipolar Disorder, and now that has been corrected. Some of the symptoms associated with DMDD are also present in other child psychiatric disorders, such as Depression, Bipolar Disorder and Oppositional Defiant Disorder. Some children with DMDD also have a second disorder, such as problems with attention or Anxiety. This is why it is particularly important to get a comprehensive evaluation by a trained and qualified mental health professional for your child.
WHY IDCC?
DBT clinicians have been specifically trained to work with DBT in children, and IDCC also offers family therapy, as well as parent coaching, to assist with problem solving and help decrease negativity in a child. During a session, a child works with a therapist to learn how his or her thoughts, feelings, and behaviors influence one another. Adolescents learn how to develop better social- and problem-solving skills to help them in relationships.
TREATMENT OPTIONS
Dialectical Behavior Therapy is an evidence-based treatment developed to help reduce self-destructive behavior through self-regulation, distress tolerance, mindfulness skills, and interpersonal effectiveness skills. Children learn to identify problems so that they can effectively deal with them in adaptive fashion. Children with DMDD can also learn to communicate more effectively.

Bereavement

BEREAVEMENT

Losses are painful and frightening, and many young children avoid their feelings so as not to be overwhelmed. Because these emotions may be expressed as angry outbursts or misbehavior, rather than as sadness, they may not be recognized as grief-related. Furthermore, because their needs to be cared for and related to are intense and immediate, young children typically move from grief reactions to a prompt search for and acceptance of replacement persons.
Unlike adults who can sustain a year or more of intense grieving, children are likely to manifest grief-related effects and behavior, on an intermittent basis, for many years after loss occurs; various powerful reactions to the loss normally will be revived, reviewed and worked through repeatedly at successive levels of subsequent development.
Thus, in dealing with children who have sustained a loss it is important to be aware of the special nature of grieving in children and not to expect that they will express their emotions like adults or that their overt behaviors will necessarily reveal their internal distress.
At the time of a death, children may experience a wide range of emotions, even when the loss was expected. Children often report feelings of numbness after first learning of a death, but the grieving process can vary by child, even within the same family.
Some emotions a child may experience include:
  • Yearning
  • Anger
  • Despair
  • Guilt
  • Irritability
  • Denial
  • Disbelief
  • Confusion
  • Shock
  • Sadness
  • Humiliation
These feelings are normal and common. Children may not be prepared for the intensity and duration of their emotions but be assured that these feelings are healthy and appropriate and will help them come to terms with the loss.
WHY IDCC?
At IDCC, we recognize that all children are unique in their understanding of death and dying. This understanding depends on their developmental level, cognitive skills, personality characteristics, religious or spiritual beliefs, teachings by parents and previous experiences with death. Our professional mental health staff work with each child to understand their unique way of dealing with loss in order to develop a personalized recovery process.
TREATMENT OPTIONS
Many times, support groups or psychotherapy are used to help during a Bereavement period. Setting small steps and goals are used to help you absorb the loss in a healthy and meaningful way. With support, patience and effort, children can and will work through the Bereavement period. After working through the pain of the loss of a loved one, children usually are left with cherished memories and can go on living a productive life.

School Refusal

SCHOOL REFUSAL

School refusal describes the disorder of a child who refuses to go to school on a regular basis or has problems staying in school. Children with school refusal may complain of physical symptoms shortly before it is time to leave for school or repeatedly ask to visit the school nurse. If the child is allowed to stay home, the symptoms quickly disappear, only to reappear the next morning. In some cases, a child may refuse to leave the house.

Common physical symptoms include:
  • Headaches, stomach aches, nausea, or diarrhea
  • Tantrums, inflexibility, separation Anxiety, avoidance, and defiance may show up too
Children with school-refusal behavior may have a specific issue or phobia underlying the need for them to be away from school. Some may include:
  • Separation Anxiety
  • Fear of being away from their parents
  • An inordinate fear of being judged
  • Fear of being called-on in class or being teased
  • A fear of riding the bus
  • A fear of walking past a dog or being out in a storm
  • Depression
WHY IDCC?
As an organization which has been licensed by the New York State of Health to facilitate in school mental health programs, IDCC is well acquainted with children’s emotions and the issues they face in schools today. Using this deep understanding, clinicians speak with teachers, principals, and parents while using a wide range of therapies to help children cope with their anxieties towards going to school and eventually help them not only attend school on a regular basis but thrive there as well.
TREATMENT OPTIONS
Play therapy for younger, less verbally oriented children helps to reenact anxiety-provoking situations or trauma and master or overcome them. Interpersonally oriented individual therapy as well as group therapy can be extremely helpful for adolescents to counteract feelings of low self-esteem, isolation, and inadequacy.
Cognitive behavioral therapy, in which patients learn to change negative thoughts and behavior is the main treatment for school-refusal behavior and the anxiety disorders that often underlie it. The primary technique is exposure therapy, where kids gradually face and master their fears.
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