Starting therapy for depression can feel intimidating. You might wonder what you’re supposed to say, worry that your problems aren’t “serious enough,” or fear being judged. These concerns are common—and they’re often the very things depression tells us to believe that keeps us from getting help. Therapy is about having a safe space to be honest, supported, and understood so you can get to your therapy goals. Knowing what to expect in the first few sessions can make taking tha

I am often asked about psychiatric medications as part of a mental health treatment plan. In this blog, I ask some of the most common questions I receive to Yeganeh "Anna" Jalaeian, DNP, MS, FNP-BC, PMHNP-BC, CARN-AP, CAS, who is licensed in Virginia and who I collaborate with for medication management. Why is it important to seek thorough clinical assessment for ADHD or ADD prior to seeking a prescription to treat it? Difficulties with focus and concentration can come from m

The holiday season brings some much needed time off, traditions, and for many of us, an opportunity to reconnect with family. But if you’re like a lot of people, family gatherings can be a source of stress rather than joy. From old conflicts to differing opinions, the dynamics that come with being around family during the holidays can trigger feelings of frustration, anxiety, and even resentment. The holidays don’t have to be a time of dread when it comes to family. With some

Alex (a fictional patient) came to me seeking help with lying, saying that whenever he is “in trouble” – in his partnership or at work, he lies to escape accountability. He says he doesn’t understand why he does this as a pattern but wants to stop because he is no longer trusted at home and his credibility at work is waning. As we explore some of his early experiences, he shares that whenever he made a mistake, his parents met him with overwhelming punishment and was made to

I often hear from couples how one partner shares their pain over something the other partner did or didn’t do, and how poorly their repairs go, leaving both feeling unsatisfied about their efforts to re-connect. I also hear from frustrated partners who are confused because their effort at apologizing fell flat. This post addresses some general guidelines for making an apology or amends. Listen The first part of repairing a rupture is to listen. Listen to the effects that you

Grieving a breakup is a profound and often surprising process of mourning. While the end of a relationship is not a physical death, the pain is real and should not be minimized. It is the death of a shared future, companionship, physical intimacy with that person, and of a specific identity you held within that partnership. Whether a long marriage or a brief but intense romance, the pain of breakup grief is valid and requires time and attention to heal. Acknowledging the grie

Keri and Bart have been married for 13 years and have a son and a daughter. Bart has had a relationship with alcohol for as long as Keri has known him, but over the years, his intake has increased to the point that he drinks excessively about four nights a week and only slightly less most other nights. He’s not emotionally present, and often not physically present, instead in his workshop for the evening as soon as dinner is over, leaving Keri to help their kids with homewor

Clients sometime ask me questions about psychiatric medications. In this blog, I ask some of the most common questions I receive to Andrea D. Skrocki, PMHNP-BC, a Psychiatric Nurse Practitioner licensed in Colorado who I collaborate with. When do you think it is appropriate for patients in talk therapy to consider a medication assessment? While talk therapy is highly effective for many people, there are certain situations where supplementing therapy with psychiatric medicatio

All of us, at one time or another, have experienced betrayals in our lives – big ones, small ones, by friends, family, partners, employers, neighbors, and others. How do you feel when that happens? For it to be a betrayal, there had to be some level of trust. What do you say to yourself that someone you trusted betrayed you? How important are you to them? Is this the latest in a series of betrayals? If so, what do you say to yourself about continuing to trust after having bee

In the natural order of things, our parents die before us – not always the case, but mostly. In fact, by the time we reach the age of 62, about 75% of us will have lost both parents. Grief isn’t something we, as a society, spend much time talking about, and the loss of a parent can be a unique and powerful loss that shakes us to the core. I want to use this article as an opportunity to normalize so many of the struggles I often work with when someone’s parent dies. When a par

Anyone who has experienced a panic attack knows that they feel awful. There is often a sense of, “I need to get out of here!” or a loss of control. For more extreme panic attacks, it may feel like you are dying. More commonly, the following fears may come to mind: ·       Having some kind of breakdown ·       Fainting or collapsing ·       Being unable to breathe ·       Feeling trapped ·       Confusion and not being able to relieve it Panic tries to negate your trust in you

A significant part of my practice is working with people who are in a relationship with someone in active substance use disorder (SUD). At the start of our work, the client often sees very few ways in which they enable the addictive behavior to thrive. If you are in this kind of relationship, consider the following: ·       Do you use a substance with this person, even occasionally? Have you considered how this can send a mixed message: “Your substance abuse is a problem, but