A Nurse Practitioner’s Perspective on Mental Health

Posted by on Jun 25, 2018 in Blog From The Experts | 0 comments


What are Some Causes of Depression and Anxiety?

Depression and anxiety are very common in the US. High stress with work, family commitments, or pressure to instantly respond with social media are just a few common causes. Anxiety with overwhelming worry and difficulty letting the worry go can be very uncomfortable physically and can interfere with normal functioning.


How to Handle Depression and Anxiety

If you have depression or anxiety that is affecting your day-to-day life (for example: your sleeping or eating habits are disrupted, you are struggling to manage daily tasks at work or home that you didn’t have trouble with before, you feel like your relationships with family, friends, or coworkers are becoming strained, or you are having physical symptoms like headaches or stomach aches that do not have medical causes), the key to recovery is to learn strategies for managing the anxiety and depression in combination with medication for stabilizing the symptoms.


You Need a Team

It’s important to have professionals on your team who are on the same page for your care. Your counselor and prescriber should be coordinating together to make sure you are getting what you need. Your prescriber should follow you closely to monitor your medications, symptoms, and adjust your dosages to fit you. There are many medications that are non-addictive; prescribed to help you feel better so you can utilize what you learn in counseling and build on your strengths to cope with life’s changes and challenges. Many people have never been on medications for issues like this, so if you have questions, don’t hesitate to talk to your prescriber about your concerns or fears. Worries and fears are part of anxiety and addressing the concerns is essential to a positive outcome. If you are currently taking medication for anxiety or depression but you are still experiencing symptoms, it might be good to seek a second opinion.


Written by Lois Nicholson, MSN, CNS Certified Psychiatric Clinical Nurse Specialist, Adult Psychiatry 

When Summer Doesn’t Cure Sadness

Posted by on Jun 18, 2018 in Blog From The Experts | 0 comments

Summer is  has finally begun. Perhaps you are relishing the sun, the longer days and the easier schedule. Perhaps you find your mood is better and you have more energy. Great! Drink it in and relish each moment.
But perhaps you have noticed you are feeling irritable or more down, less energy but not sleeping well. A sense of disappointment is also there because many of us tell ourselves, “I’ll feel better once this awful winter is over”. And it’s over. And you don’t. Or perhaps you are puzzled by someone in your life who appears to be more grumpy!
There are a few possibilities for these feelings.
 One is the illness of depression. Frequently I will see someone in June who decides to come to counseling because the improved weather just doesn’t help. This is because depression is an illness that impacts our emotions, our thinking and our bodies. With treatment – counseling and maybe medication, too – people find their spirits lift and they can enjoy the beauty of summer.
Another reason is Seasonal Affective Disorder (SAD) Wait, you say, that is only in the winter! Well, there is a type of this disorder that impacts people who have difficulty adjusting to the increased light. They cannot fall asleep and wake up way too early. Sometimes blackout blinds and curtains, going to bed at a set time and limiting light in the evenings is all they need. Sometimes medical help is needed. Doing some research, speaking with your PCP and making some small changes may be just the ticket.
Lastly, if we are facing major losses or challenges in our lives, they do not just disappear with the snow. Speaking with a counselor can frequently help to lessen the emotional pain and allow the person to enjoy moments of hope.
Finally – get outside, run through a sprinkler, list to children laugh. Life can be good. If you are struggling, please call.
Written by Marty D. Laska LPCC-S, LICDC-S, ACHT

Are You Raising Your Daughter to be Resilient?

Posted by on Jun 8, 2018 in Blog From The Experts | 0 comments

We all want our daughters to be secure in themselves and make positive choices in their lives. We want them to feel good about the way they look and recognize each of their individual talents. We want them to be prepared to work through their own problems and grow up to be a healthy and happy adult. As parents, why does it seem so challenging at times to encourage resiliency?

Even girls growing up in the best homes with loving and supportive families experience emotional injuries. Failures and disappointments, criticisms, disapproval, or exclusion from peers – these moments of anxiety, sadness, and anger are part of life and are invaluable lesson-learning opportunities. How they learn to deal with and heal from these injuries will lay the groundwork for how well our daughters will problem-solve and function in daily life as adults. As we all know, these emotional blows do not decrease as we get older.


Ways You Can Encourage Resilience in Your Daughter:

Promote High Self-Esteem: Talk to your daughter about negative thought patterns that decrease self-esteem and identify strengths that encourage it.

Foster Communication: Teach your daughter how to identify and verbalize her feelings. Teach your daughter that all emotions are okay.

Discuss Relationships and Boundaries: Teach your daughter how to recognize unhealthy relationships or significant others and how to set boundaries in her current relationships.

Don’t Accommodate Every Need: It’s important to provide certainty and comfort, but don’t get in the way of your daughter’s development of problem-solving skills.

Identify Stress and Teach Coping Skills: Help your daughter learn what triggers her stressors and other negative emotions, and how to cope with stress.

Model Resiliency: Be aware of how your actions affect your daughter. Try to be calm and consistent. But also, if you react poorly to a situation, admit it. Use it as an example and talk about better ways to handle it next time.


Written by Lisa Borchert-Hrivnak, M.A.Ed., LPCC, Owner of Avenues of Counseling and Mediation, LLC

Make a Resolution Early… Work on Your Marriage

Posted by on Jun 2, 2018 in Ask The Therapist | 1 comment

Now is the time to honor your relationship by investing your time and energy into enhancing it. Research shows that if couples do not continue to put energy into a relationship, it deteriorates. In truth, you have to put energy into a relationship to just keep it where it is. For it to improve, you have to put more energy into it.


What Predicts Divorce or Continued Relationship Misery?

1. Positive to Negative Ratios: The couples who are happy in their relationships have a 5:1 ratio of positive to negative during conflict discussions; and a 20:1 positive to negative ratio when just hanging out. Conclusion: Relationships have to be a very rich climate of positivity to feel good: lots of kindness, attention, interest in one another, affection, humor, good sex, and so on.

2. Criticism: Complaining as if there is something defective in your partner’s personality. Conclusion: Be gentle in your approach.

3. Defensiveness: Self-protective responses, victimhood. Conclusion: accept responsibility, even for a small part of the problem.\

4. Contempt: Speaking from a superior plane, a holier-than-thou position. Conclusion: appreciate, catch your partner doing something right.

5. Stonewalling: Emotionally disengaging, withdrawing, isolating, not listening when overwhelmed. Conclusion: self soothe, so you can be present, listen, actively hear, take breaks to not get overwhelmed, and check out.


If your marriage is in the negative ratio or negative perspective, it’s because something is wrong with the friendship in the marriage. One or both of you don’t feel your partner is really interested in the relationship; there’s not much affection going on. There are feelings of rejection, there’s not much romance or good sex in the relationship.

Counseling can be a tool to learn to turn toward one another, cherish one’s partner’s positive qualities and nurturing gratitude for what one has with this person, instead of comparing one’s partner to an “imagined” other.


Written by Anjelica Nelson, M.Ed., LPC, MFT

How to Turn Confusion Into Certainty When it Comes to Career Choices

Posted by on May 19, 2018 in Ask The Therapist | 0 comments

If we roughly calculate that hours that we as Americans spend at work throughout our lives, they add up to a significant chunk of our time on Earth. Of all the waking hours across the average American’s lifespan, 35% of them are spent at work. If you think about your work-life in that way, it’s glaringly clear that having a job that fits your natural skills and leaves you feeling fulfilled is important to your short-term and long-term life satisfaction. But many of us feel “stuck” in our current jobs. If can be really challenging to even imagine what the next step might be in becoming satisfied with your work-life, especially if you have spent years of even decades in the same job or field of work. It can be even more frightening to actually make the decision to change job or career paths.


How Can Career Counseling and Life Designing Help?

My approach to career counseling involves life designing, in which I have individuals with career concerns use their own autobiographies to clarify decisions and make commitments. I begin by asking individuals to tell a set of five stories about themselves, interests, and aspirations. I use these stories to compose a life portrait. If the individual wishes, I can administer an interest inventory that shows which occupational groups the individual resembles. I help people conceptualize and envision the next chapter in the story of their career. I then work to systematically transform these intentions into actions in their lives, whether on campus, on the job, or in a new position. Life Designing is a transformational experience that can change confusion to certainty about choosing a college, declaring a major, considering graduate or professional school, changing occupations, or even planning retirement.


Who Can Benefit from Life Design:

  • Students transitioning from high school to college
  • Current college students who aren’t sure if they picked the right major
  • College grads having trouble launching their career after graduation
  • Any adult at any point in their work-life who is currently dissatisfied with their current job, or wants to explore a career path that best suits their abilities, interests, and personality


Written by Suzanne Savickas, M.Ed., M.F.A., CRC, LPC

Social Media, Smartphones, and Teen Mental Health

Posted by on May 12, 2018 in Blog From The Experts | 0 comments

It’s probably a surprise when you don’t see the teenagers in your life entertaining themselves with a smartphone, tablet, computer, or video game. Often they’re texting sharing, trolling, and scrolling on social media apps like Snapchat, Instagram, Twitter, or Facebook. You might expect that they spend time using these apps because it makes them happy, but most data suggests it does not.


The Monitoring the Future Survey, funded by the National Institute of Drug Abuse, analyzed teenagers from 8th to 12th grades, starting back as early as 1975. The survey asked teens how happy they were and how much of their leisure time they spent on different activities, including non-screen activities and, in recent years, screen activities (social media, browsing the web). The results could not be clearer: teens who spent more time than average on screen activities were more likely to be unhappy. Teens who spent more time than average on non-screen activities were more likely to be happy. There was not a single exception. All screen activities were linked to more unhappiness, and all non-screen activities linked to more happiness. Other current research is also finding more negative effects of social media and screen time than positive.


So why can’t they put that phone down? Many apps and social media platforms are carefully designed to capture the brain’s pleasure centers, (the “like-feedback loop”) and young people with developing brains have less ability to resist. Adults and teens alike are easily sucked into the mindset that likes, loves, comments, and followers are a barometer for popularity and self-worth. The “fear of missing out” on what friends are doing or liking online can also cause overwhelming pressure to stay connected.


It’s also challenging for teens to recognize that what they see on social media is often the rosiest possible picture of their peers’ lives. As adults, we cab all relate to going on Facebook and seeing other traveling, smiling with their spouse, showing their best selves, while leaving out the inevitable low points of real life. Now put yourself in the mindset of a teenager.


What Can Parents Do?

  • Be involved in what apps are on your teen’s phone, read messages, follow them and their friends on social media.
  • Discuss the feelings you have at the times when on Facebook.
  • Have phone-free days or hours.
  • Encourage active online presence (looking up info, learning) not passive such as gaming or social media.
  • Be more active! Extracurriculars, outdoor activities, family activities (game night).
  • Model good smartphone behavior (put your phone away during dinner).
  • No phones after 9 pm (get an alarm clock instead of a phone alarm).
  • Limit passive screen time to 1.5 hours a day or less.



Written by Lisa M. Borchert-Hrivnak, M.A.Ed., LPCC, Owner of Avenues of Counseling and Mediation, LLC

End of the School Year Stress

Posted by on May 5, 2018 in Hot Topics | 0 comments

It is all too familiar the feelings of nervousness and panic students feel as they are wrapping up their school year. It can seem almost impossible to avoid the extra stress. Here are some ways to let go of that stress to be more productive, and overall happier during the final months of school.

Starting off, one thing to remember during this time is to be kind to yourself. You are very busy right now and may not feel like yourself, but don’t forget to be caring towards your needs. Studying or worrying about studying can seem like your top priority right now, but take a few hours to do something you enjoy. Unrealistic expectations can really set you back, so know your limits. Exercising is supposed to be a great way to relieve stress, so if you are into that, maybe try it out during a study break.

Something that will help immensely is creating a to-do list. At first, it can be difficult to keep track and follow, but once you get the hang of it, it is life changing. You will easily be able to stay on track and see what is ahead. Also, something about getting to check things off a list give you a great sense of accomplishment and pride. Try to plan out your day as much as possible, because the more prepared you are, the more at ease you will feel.

A big component of relieving stress during the end of the school year it to remember to snap out of the mindset that “I am going to fail all my finals” or “I just hate school so much.” Thinking negatively can actually make stress much worse. Try to remind yourself that if you plan out and prepare, the end of the year will be here before you know it and you will be ready for any finals.

Understanding Eating Disorders

Posted by on Apr 28, 2018 in Hot Topics | 0 comments

In  the United States, about 30 million people (all genders and ages) have an eating disorder. Some commonly known eating disorders include: anorexia, bulimia, and binge eating. An unfortunate stigma that comes with these can make it difficult for people to talk about. Pushing off something like this can make it extremely difficult for those who need it to seek help.

Genetics, environmental factors, and personality traits all combine to create risk for an eating disorder. It is difficult to know exactly what you should do if you start noticing behaviors that might be associated with an eating disorder. It is important to remember to be open and honest about what you are seeing, and do not try to be a therapist, but be supportive.

Signs of a Possible Eating Disorder (according to NEDA):

Emotional and behavioral

  • In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns
  • Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
  • Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
  • Appears uncomfortable eating around others
  • Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
  • Skipping meals or taking small portions of food at regular meals
  • Any new practices with food or fad diets, including cutting out entire food groups
  • Withdrawal from usual friends and activities
  • Frequent dieting
  • Extreme concern with body size and shape
  • Frequent checking in the mirror for perceived flaws in appearance
  • Extreme mood swings


  • Noticeable fluctuations in weight, both up and down
  • Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)
  • Menstrual irregularities — missing periods or only having a period while on hormonal contraceptives (this is not considered a “true” period)
  • Difficulties concentrating
  • Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low white and red blood cell counts)
  • Dizziness, especially upon standing
  • Fainting/syncope
  • Feeling cold all the time
  • Sleep problems
  • Cuts and calluses across the top of finger joints (a result of inducing vomiting)
  • Dental problems, such as enamel erosion, cavities, and tooth sensitivity
  • Dry skin and hair, and brittle nails
  • Swelling around area of salivary glands
  • Fine hair on body (lanugo)
  • Cavities, or discoloration of teeth, from vomiting
  • Muscle weakness
  • Yellow skin (in context of eating large amounts of carrots)
  • Cold, mottled hands and feet or swelling of feet
  • Poor wound healing
  • Impaired immune functioning


A very important thing to remember is to be patient with whoever is going through the healing process, whether it is yourself or a loved one. Recovery can take a long time, and there are bound to be many ups and downs. Also, the person in recovery has to want it for themselves. You are never going to force someone to recover just because you want them to be better. Knowing your own limits and being respectful can make the process a lot easier.


How Art Therapy Can Help Teens

Posted by on Apr 21, 2018 in Hot Topics | 0 comments

We all know the infamous time of teenage years. Some say it is even worse than having a toddler. Since during teen years, our brains are still developing, humans tend to be a bit impulsive and emotional. It can be extremely difficult at that time to express new emotions we are feeling. It is easy to fall into a depression and feel completely alone.

Introducing a way to nonviolently express teen emotions can make a huge difference in teaching your child coping mechanisms, and how to deal with day to day life. Art therapy is one way to express yourself and give peace to your mind. It is so effective in teens, according to, because “Art as an expressive language provides an entrée into a relationship with teenagers by tapping into their creativity and offering a form of communication that is nonthreatening and over which the adolescent has control. When teens enter the art therapy room, they find drawing materials and other forms of media on a table. They are invited to draw anything they choose and even to make a statement in images that represent their feelings about being in the therapeutic setting.”

For anyone not wanting to try it alone, there are group settings in which art therapy is available as well. If you do not want to try it out because you assume you are bad at art, just know that is not what the idea is about. You do not have to be skilled or have any experience. One of the best things about art therapy is how inclusive it is.

Staying Productive During Summer

Posted by on Apr 14, 2018 in Hot Topics | 0 comments

Summer is quickly approaching us, and especially for students, deadlines are approaching. Regardless of if you are a student, there is a certain kind of relaxation that comes with the summer months for most, at least in the beginning. The thing is, it is necessary and great to have this time to slow down, but it also could allow the stop of productivity.

Parents might have a different perspective on all of  this, such as a stay at home parent. Having the kids home all summer can be a bit overwhelming when you are used to the days being quiet. This is where keeping the whole bunch busy can be beneficial for you.

The key is finding the balance between productivity, and stressing yourself out by putting too much on your shoulders. For teens, maybe try getting a job. If you already have one, great! If you think you are not filling up your time wisely, ask for more hours. The summer can be a great time to build up income. Another option would be to split up your time. Especially if you are not someone who needs a lot of extra money, try working part time, then spending the rest of the time doing things you enjoy.

Something to not forget about is the nice weather during the summer. The warmth is not always here, so spend some time outside. Even if you are not an “outdoors person” making an effort to spend time outside can be very beneficial. Also, be sure to spend time with the people who are close to you. Summers are the best time to catch up and have a great time with friends and family. Make an effort and reach out to those close to you, someday they may not be there.

If you are a student, explore the option of online classes to get ahead. A lot of times, classes are only around 7 weeks long. This is a great way to stay on track, catch up, or even get ahead!