Q & A Disorders  

What is Anxiety?

We all know what it’s like to feel anxious. Most of us experience anxiety when we’re faced with stressful situations or traumatic events. Our heart may pound before a big presentation or a tough exam. We may get butterflies in our stomach during a blind date. We worry and fret over family problems or feel jittery at the prospect of asking our boss for a raise. Anxiety is part of our natural “fight-or-flight” response. It’s our body’s way of warning us of danger ahead. And for the most part, anxiety is adaptive. It gears us up for life’s challenges and spurs us to action when we’re faced with a threat. However, if anxiety is preventing you from living your life the way you’d like to, you may be suffering from an anxiety disorder.

What is Attachment Disorder?

If the attachment bond doesn’t occur with sufficient regularity, then the necessary safe and secure experiences do not occur as they should. Instead, insecure attachments are formed. All insecure attachments arise from repeated experiences of failed emotional communication. They take one of three different forms. Before listing some of these, it is important to note that parents of insecure children are themselves products of insecure experiences. Insecure attachment is passed on from one generation to the next unless repair occurs.

  • When a parent is unavailable or rejecting, a child may become “avoidantly” attached, meaning that the child adapts by avoiding closeness and emotional connection.
  • An “ambivalently” attached child experiences the parents’ communication as inconsistent and at times intrusive. Because the child can’t depend on the parent for attunement and connection, he develops a sense of anxiety and feelings of insecurity.
  • Disorganized” attachment occurs when the child’s’ need for emotional closeness remains unseen or ignored, and the parents behavior is a source of disorientation or terror. When children have experiences with parents that leave them overwhelmed, traumatized, and frightened, the youngsters become disorganized and chaotic. Disorganized attachment leads to difficulties in the regulation of emotions, social communication, academic reasoning as well as to more severe emotional problems.

Socio-economic status has nothing to do with the ability to establish successful attachment relationships. Orphaned children who spend their early years in orphanages or move from foster home to foster home are at risk for severe attachment disruption. It also can occur as a result of severe illness in the parent or the child, parental unavailability, or emotional trauma. Some children have inborn disabilities or temperaments that make it difficult for them to form a secure attachment, no matter how hard the parent tries. In any case, there generally are several factors involved. The major causes are:

  • physical neglect
  • emotional neglect
  • abuse
  • separation from primary caregiver
  • changes in primary caregiver
  • frequent moves or placements
  • traumatic experiences
  • maternal depression
  • maternal addiction to drugs or alcohol
  • undiagnosed, painful illness such as colic, ear infections, etc.
  • lack of attunement or harmony between mother and child
  • young or inexperienced mother with poor parenting skills.

What is ADD or ADHD?

Attention Deficit (Hyperactivity) Disorder (ADD / ADHD) is a condition characterized by poor self-regulation. The person with ADD has difficulty inhibiting their spontaneous responses. According to Gabor Mate “The hallmark of ADD is an automatic, unwilled "tuning out," a frustrating non-presence of mind. People suddenly find that they have heard nothing of what they have been listening to, saw nothing of what they were looking at, and remember nothing of what they were trying to concentrate on. One misses information and directions, misplaces things, and struggles to stay abreast of conversations. Tuning out creates practical hardships, and it also interferes with one’s enjoyment of life”

What is Asperger's Disorder

Qualitative impairment in social interaction, as manifested by at least two of the following: marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction failure to develop peer relationships appropriate to developmental level lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) lack of social or emotional reciprocity Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus apparently inflexible adherence to specific, nonfunctional routines or rituals stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) persistent preoccupation with parts of objects. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. Criteria are not met for another specific pervasive developmental disorder or schizophrenia.

What is Autism?

Individuals with autism struggle with a neurodevelopmental disability that can cause lifelong challenges.  Each person with autism presents with their own unique behaviors and symptoms.

The following core symptoms can vary in intensity and severity:

1.  Disturbances in Speech Language and Communication such as

·         Delayed speech

·         Low frequency use of body language and or paired gestures when communicating

·         Use of jargon

·         In verbal children, the use of phrases out of context  or repeating lines from a video or DVD program

·         Unusual rhythm or tone of voice

2.  Social Impairment

·         Trouble identifying social cues and reacting to them appropriately

·         Young children with autism may have a greater interest in objects than they do people

·         Interactions that typical peers may view as odd or unusual

·         Get stuck or hyper focused on a topic that a communication partner eventually loses interest in

·         Trouble understanding conversation and communication as a two way street

·         May have difficulty sustaining eye contact or it may seem that child is looking through you

3. Unusual Responses to Sensory Stimulation

·         This is sometimes referred to as sensory processing problems or sensory integrations dysfunction

·         May impact a child’s ability to filter out stimuli in the environment and attend to relevant details so they pay too much attention to some stimuli and not enough attention to others

4.  Unusual, Obsessive, Repetitive Behavior

·         Rigidity of routine

·         Difficulty with change and transitions

·         Fixation with movement, lights, or how things work

·         Parting with an object of interest may cause tantrum or distress

·         Self-stimulatory behavior (a few of many examples are  hand flapping, spinning objects, watching the wheels of a toy car roll)

·         May not use toys or objects in ways typically used by others

·         Diminished use of symbolic play 

What is Childhood Onset Bipolar Disorder? 

Children with symptoms of this disorder rarely fit the classis symptoms associated with adult Bipolar I or Bipolar II Disorder.  Adults with bipolar disorder cycle between episodes of depression and a heightened or elevated mood state called mania or hypomania.  Many adults with this disorder experience periods of wellness in between episodes of cycling.  Children with bipolar disorder do not display this clear pattern.  They tend to cycle more rapidly with frequent highs and lows within can happen within just one day.   

Some Symptoms Associated with Childhood Onset Bipolar Disorder are:

·         Oppositional attitude and/or behavior

·         Very irritable

·         Periods of explosive rage triggered by a parent setting a limit or telling the child “no”

·         Long drawn out tantrums where reasoning or distraction from the topic is virtually impossible

·         Tantrums may include aggressive behavior toward family members, self, or property

·         May not show this behavior to others outside of the family

·         Frequent and/or seemingly abrupt mood swings

·         May have history of fussiness as a baby/  difficult to soothe

·         Periods of hyperactivity and or impulsiveness

·         Frightening or intense nightmares

·         Fears of separation or harm befalling self or family members.  Separation anxiety may have been more extreme as a baby.

·         Strong cravings for carbohydrate or sweet foods

·         Sensory processing difficulties

·         Trouble maintaining friendships

·         Bright, creative, intense, and areas of development that may seem quite advanced for his or her age.

What is Obesity? 

Being overweight is the result of a complex interaction of genetic heritage, imbalance of brain-body chemistry, psychological, and social factors.  The social and psychological factors may not cause the weight gain but it may compound the struggle with weight.  People may eat for a variety of reasons that may include self-soothing or stuffing negative feelings.  The social climate encourages eating as social gatherings often revolve around food.  Obesity can affect physical and emotional comfort and health. 

What is Stress?

Emotional strain or tension that is experienced in relation to pressures and demands imposed by life situations that may be aggravated by a person’s thoughts and behavior patterns.  Stress is felt when life seems unbalanced and/or our ability to cope is impaired.  Treatment may focus on development of healthy coping strategies, identifying a support network, developing cognitive flexibility, positive and rational self-talk, and connecting with a social support system. 

What is Depression?

We all go through ups and downs in our mood. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. We may feel “down in the dumps” for a short period of time, but gradually the painful feelings dissipate and we move on with our lives—often the wiser for the experience. But if these feelings of sadness don't go away or if they are so intense that they interfere with your ability to work, study, eat, sleep, and enjoy life, you may be suffering from depression.

According to the National Institute of Mental Health, 1 in 10 American adults—or approximately 21 million people suffer from a depressive illness each year .

What is a Developmental Delay?

Developmental Delay is when your child does not reach their developmental milestones at the expected times. It is an ongoing, major delay in the process of development. If your child is slightly or only temporarily lagging behind, that is not called developmental delay. Delay can occur in one or many areas—for example, motor, language, social, or thinking skills.

Developmental Delay is usually a diagnosis made by a doctor based on strict guidelines. Usually, though, the parent is the first to notice that their child is not progressing at the same rate as other children the same age. Special testing can also help gauge your child's developmental level.

What is a Learning Disability?

Learning involves four stages of information processing:

  • input: the brain takes in and records information relayed by the senses
  • integration: the brain interprets the information
  • memory: the brain stores the information in a way that it can be retrieved later
  • output: the learner reproduces the information through language or motor activity.

People with learning disabilities have trouble with one or more of these steps; they have difficulty taking in, organizing, and/or acting on information their brains receive through the senses. That information can be nonverbal, but more commonly, the difficulty has to do with understanding or using written or spoken language. The problems are based on brain structure and function: a case of poor wiring in one or more areas of the brain.

Learning disabilities are not the same as low intelligence; when given IQ tests, people with learning disabilities generally show average or above-average intelligence. But there’s typically a big gap between how smart they are and what they’re able to achieve, because the brain sets up roadblocks that keep them from processing and reproducing information. Consequently, a hallmark of learning disabilities is that people who have them consistently learn and work below their intellectual capabilities.

Learning disabilities fall within the class of neurological issues called developmental disabilities, in that they are chronic, they limit success in one or more major life areas and they cannot be reversed by medication. This classification includes mental retardation, but most developmental disabilities, such as cerebral palsy and autism, don’t by definition encompass low intellectual function. One of the most painful aspects of having a learning disability is to have your brain’s inability to process information in certain ways mistaken for low intelligence.

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent, unwanted, disturbing thoughts (obsessions) and/or repetitive, ritualized behaviors that a person feels driven to perform (compulsions). Like a needle getting stuck on an old LP, OCD causes the brain to get stuck on a particular thought or action that it just can’t let go. People with OCD often say the symptoms feel like a case of mental hiccups that won’t go away.  

The Obsessive Compulsive Foundation reports that 1 in 50 adults in the United States currently experiences OCD, and twice as many have experienced it at some point in their lives. Symptoms of OCD occur in people of all ages and may change in severity over time. Most people with OCD have both obsessions and compulsions, but a minority has obsessions alone (about 20 percent) or compulsions alone (about 10 percent). Compulsions generally accompany obsessions as a result of the brain’s attempt to dismiss or neutralize the obsessions.

What is Oppositional Defiant Disorder?

Even the best-behaved children can be difficult and challenging at times. Teens are often moody and argumentative. But if your child or teen has a persistent pattern of tantrums, arguing and angry or disruptive behaviors toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). Emotionally draining for the parents and distressing for the child, oppositional defiant disorder can add fuel to what may already be a turbulent and stressful family life.

You may walk on eggshells around your child with oppositional defiant disorder, not knowing what may trigger a tantrum or argument. While this is one of the most difficult of behavioral disorders, setting firm boundaries with consistent consequences plus a commitment to improving your relationship with your child can help your family overcome the dominating grip that oppositional defiant disorder may have on your household.

The foundation of treatment of ODD is behavioral management. Parents don't have to go it alone in trying to manage a child with oppositional defiant disorder. Doctors, counselors and child development experts can help you learn specific parenting strategies and use proven techniques to help build a foundation of trust between you and your child and improve the underlying basis for these disruptive behaviors.

What is a Pervasive Developmental Disorder?

This category should be used when there is a severe and pervasive impairment in the development of reciprocal social interaction or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and activities are present, but the criteria are not met for a specific pervasive developmental disorder, schizophrenia, schizotypal personality disorder, or avoidant personality disorder. For example, this category includes "atypical autism" -- presentations that do not meet the criteria for autistic disorder because of late age of onset, atypical symptomatology, or sub-threshold symptomatology, or all of these.

What is Post Traumatic Stress Disorder?

Post-traumatic stress disorder is an anxiety disorder that's triggered by your memories of a traumatic event - an event that directly affected you or an event that you witnessed.

The disorder commonly affects survivors of traumatic events, such as sexual assault, physical assault, war, torture, a natural disaster, an automobile accident, an airplane crash, a hostage situation or a death camp. Post-traumatic stress disorder also can affect rescue workers at the site of an airplane crash or a mass shooting. It can affect someone who witnessed a tragic accident.

Not everyone involved in a traumatic event experiences post-traumatic stress disorder. However, the disorder affects more than 5 million adults each year in the United States. Post-traumatic stress disorder is twice as common in women as it is in men.

Treatment may involve a combined approach including medications and behavior therapy designed to help you gain control of your anxiety.

What is Grief?

The definition of grief includes the emotions and sensations accompanying the loss of someone or something dear to you. The English word comes from the Old French grève, meaning a heavy burden, which makes sense, given that grief can weigh you down with sorrow and other emotions, with both psychological and physical consequences.
When someone close to you dies, you don’t just lose that person on the physical level. You also face the loss of what might have been. So your pain can involve missing that person’s presence: sleeping in a bed that’s half empty, craving a scent or an embrace. But the consciousness of all the milestones in life the loved one will miss lasts longer than the pain of the physical absence. The children not born, the trips not taken, the colleges not attended, the weddings not danced at — every life marker is a reminder and can be an occasion for renewed grief.

What are Relationship Difficulties?

Marriage/Domestic Partnership psychotherapy.

All couples have conflicts or disagreements at times. The difference between a happily married (or otherwise committed) couple and an unhappy union most frequently involves the ability to discuss and resolve those differences in a positive manner that respects the interests and needs of each individual.

Common unhealthy, damaging relationship communications usually include such interactions as:

  • Hostility, or verbal or physical attacks on the other person
  • Put-downs, name-calling or other contempt for the partner
  • Dragging old information or experiences into a current argument
  • Defensive responses
  • Withdrawal from a disagreement
  • Escalating negativity in the relationship

If an unsatisfying love relationship is a part of your problem mix, see Helpguide's series, Relationship Help: Communication Skills to Find and Keep a Healthy Exciting Love Relationship.

Some therapists have specialized training in marriage therapy. A marriage counselor usually sees both members of the couple together, though some will occasionally also see each person individually. The goals of a marriage or relationship therapist are generally to help the couple:

  • improve communication patterns
  • develop empathic, active listening skills
  • improve problem-solving skills
  • resolve conflicts in ways that meet the needs of both partners
  • explore ways for old wounds (from this or previous relationships) to be healed
  • if possible, find ways to stay together in a positive and mutually satisfying relationship
  • if not possible to stay together, then to separate in a healthy and respectful way.



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