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Raychelle Cassada Lohmann Aside from adult privacy, we also have to consider what's being posted about our children. Often, as parents, we may be the very culprits and share too much information about our kids. In fact, our need to overabundantly share our children's information online has been given a word all to itself - sharenting. I recently wrote an article "Sharenting and Privacy" on Psychology Today. If you want to learn more about how to virtually protect your child's online privacy, visit the link below. https://www.psychologytoday.cm/intl/blog/teen-angst/202002/sharenting-and-privacy Raychelle Cassada Lohmann, Ph.D., NCC, LCMHCS, ACS, GCDF

Have you ever had a nagging doubt of your own accomplishments or an irrational fear that you’ll be exposed as a fraud? You may have had a bout of impostor syndrome. While not a mental disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), impostor syndrome is a term used to describe the phenomenon of feeling like a fraud or not deserving what one has achieved. You may be convinced that others view you as more accomplished, successful, or intelligent than you really are and may view your successes as the result of luck. You may also feel afraid of or guilty about success. If you’ve ever experienced this, you’re not alone. Up to 70% of us will experience signs of impostor syndrome at least once. Impostor syndrome is related to symptoms of depression, such as poor self-esteem and feeling a sense of failure. It can also be associated with anxiety. When first described in the late 1970s, impostor syndrome was observed mostly in women. Later studies determined that the phenomenon occurs roughly equally in men and women. It may occur more often in certain minority groups, particularly in certain settings. Although we usually think of impostor syndrome occurring in academia or the workplace, it can occur in other settings as well, such as a neighborhood (feeling undeserving of living in a “nice” neighborhood), in certain social interactions, and in romantic relationships (feeling unworthy of one’s partner and worrying that the partner would leave them if they really knew them). Anyone can have a bout of impostor syndrome, but research has identified some correlates among individuals who struggle with the symptoms. People who lean toward perfectionism are more likely to experience these feelings, but perfectionistic behavior can also result from impostor syndrome as the sufferer anxiously tries to live up to their achievement. You are more likely to experience impostor syndrome if your parents were overprotective or had unreasonably high expectations of you. The onset of symptoms can correlate with a new success, such as a promotion, a new job, or graduating from college. The impostor symptoms may represent feeling unprepared or unqualified for the new status or role. If you are struggling with impostor syndrome, there is hope! Talking it over with trusted peers, a counselor, or a mentor in your field can help you to work through your feelings and improve your courage and self-esteem surrounding your successes. If you find that you take the full weight of responsibility for your failures, yet you attribute your successes to luck or happenstance, re-evaluate your position. Are you really being fair to yourself? Take some time to do a realistic self-assessment of your knowledge, skills, and abilities. Did you have unrealistic expectations of how much you would know or how you would feel before you achieved the success or achievement that resulted in impostor feelings? Recognize that you don’t have to be the absolute best to be worthy and deserving. Recognize that you’re always learning, making mistakes is part of growth, and you deserve whatever rewards your accomplishments have brought your way.

Happy New Year, Etheridge Psychology Community! Each year I put together an awareness calendar hoping to encourage people to volunteer to a charitable organization globally, nationally, or locally. In an effort to increase awareness and inspire acts of volunteering, I wanted to share this resource with each of you as well. Please visit the following link to the Psychology Today site to access the Awareness Calendar and make a difference in 2020. Awareness Calendar: Volunteering in 2020 - Research shows helping others also helps us. Happy New Year! Dr. Raychelle Cassada Lohmann

Have you ever wondered why some things get worse before they get better? Take, for example, deciding that you’re going to get professional counseling to work on a potentially problematic behavior, like anxiety, and just when you commit to change, you notice that every little thing seems to make you more anxious and stressed out. Maybe you decide to work on your temper, and when you start to pay attention to how often you’re mad, you seem to become angrier. If you experience an increase in the behaviors you’re trying to fix, you may decide to quit counseling because it isn’t working. But wait! Before throwing in the towel, it’s important to know that what you are experiencing, feeling worse before feeling better, is entirely normal. Although getting worse before getting better isn’t a steadfast rule, it does happen to a lot of people a lot of the time. As with many things in life, when we decide that we want to improve ourselves, we undergo a series of changes. The first change involves admitting to ourselves that there is a problem. As a whole, it’s not easy to point out our flaws, and we sure don’t like changing them. Acknowledging there is an issue is the first step, but that alone is not going to make a difference. No, we have to explore what’s going on, and this reflective process is known as self-awareness. Self-awareness requires us to place our issues under a microscope and scrutinize each little detail. As one could imagine, this is an experience that can set off a tidal wave of emotions, including shame, fear, anger, and even pain. As a result, we may become more aware of what we need to change and start to notice how much our little nuance is affecting us. We may even become consumed or super sensitive with the very behavior that we are trying to work on, resulting in us experiencing it more frequently. That’s why it feels worse but never fear; if you stick with a commitment to change, these intensified behaviors should subside within a short amount of time. When you feel more in control, a door of endless possibilities will begin to open. When that door opens, we may realize that we can’t tackle our issues alone. Unfortunately, many people go into counseling looking for a quick fix, but truthfully that’s not how it works. Odds are we didn’t get to where we are overnight, and it’s sure not going to be fixed that quickly either. Counseling involves a lot of self-reflection and commitment to change, and frankly, that’s not fun. It also requires that we visit places of shame, hurt, and pain in our lives, and honestly, that doesn’t feel good. So, just know that if you commit to a change, you may feel a little worse before you feel a little better, and that’s A-OK. Stick with your plan, and watch change happen from the inside out!

When you think about the word “depression”, what is the first thing that comes to mind? Is it sadness? While this is one component, there are many other less obvious symptoms that may not initially register in your mind as signs of depression. According to the DSM-5, there are several types of depressive disorders and different criteria for each. Feeling sad isn't the only symptom. Read on to learn about sneaky symptoms of depression. 1. Lack of pleasure in activities that you used to enjoy. Things that previously brought you happiness now feel hollow. The hobbies you participated in now feel “meh”. 2. Lack of motivation. Depression can decrease motivation to perform necessary activities such as paying bills, going to work, and even showering. 3. Social withdrawal. You may stop returning texts or make excuses to get out of social invitations. This behavior may develop because of the exhaustion that depression brings or even feeling like you're bringing everyone else down. 4. Sleep disturbance. Depression can cause both insomnia (difficulty falling asleep or staying asleep) and hypersomnia (sleeping too much). 5. Fatigue; feeling weighed down. Depression can feel like you're wearing heavy weights on your body – imagine you had to do that during your day-to-day activities. You’d become fatigued relatively quickly. 6. Poor concentration. Another sign of depression is feeling like you cannot think straight or make decisions. Have you experienced some of these sneakier symptoms of depression? It's important to note that some of these symptoms are not exclusive to depression and can be explained by a number of mental health or medical problems. Getting a proper diagnosis is important. Depression is complex and affects each individual in different ways. However, if you have noticed that you are experiencing some or all of these symptoms, scheduling an appointment with a mental health professional is one of the steps you can take to get some relief from your symptoms. Talk therapy can provide a safe space to talk about your feelings, as well as teach you coping skills to work through your symptoms. A final note: If you are thinking about suicide, you need immediate professional help. You can call 911, walk into your local emergency room, or even call a crisis hotline. Also please remember that you can talk to a therapist about your suicidal thoughts without fear that you will be put into a hospital against your will. Mental health professionals will only seek hospitalization for you if they assess you and determine that you are at imminent risk of following through with a suicide attempt. #depression #suicide

Do you have a friend or family member who is convinced that the Earth is flat? Vaccines cause Autism? 9/11 was an inside job? Have you ever experienced the frustration of talking to them about it? A conspiracy theory is an unfounded but deeply held belief that is accompanied by the belief that the “truth” has been covered up in some elaborate and sinister plot to fool the masses. The “conspiracy” part is not the belief itself, but the belief in a cover-up by some large and powerful group. A conspiracy theorist will often gather “evidence” that supports their views, while ignoring or dismissing credible evidence to the contrary. Conspiracy theorists are known for talking themselves up about having special knowledge while disparaging nonbelievers as being “sheep” who have wool pulled over their eyes. Conspiracy theories aren’t new to society. For example, the Flat Earth Society has been around for a couple of centuries. In the age of the internet, however, outlandish beliefs abound, and fellow theorists are easy to find. Mass media has led to much more visibility of conspiracy theories and their believers. Additionally, when people like movie stars and politicians endorse a conspiracy theory, it tends to fuel the belief in others. Why do people believe in conspiracy theories? Conspiracy theorists are famous for cherry-picking data. Incredibly, they tend to discount peer-reviewed scientific research in favor of YouTube videos and anecdotal data. Therefore, I find it somewhat amusing that I consulted only the peer-reviewed literature to determine why people believe these theories in the first place. Paranoia is associated with belief in conspiracy theories. Imhoff & Lamberty (2018) discovered that these individuals harbor paranoid ideations about large, powerful groups, such as the government, large corporations, and even Hollywood celebrities. They tend to have significant difficulties with trust. Hawley (2019) wrote that conspiracy theorists distrust standard sources of information and believe that they have unique insight into the shadowy underpinnings of the belief at hand. They may scour the internet for information that fits their belief and readily disregard information that does not. This doesn’t mean that all conspiracy theorists are mentally ill. Sure, some of their beliefs may be delusional, but that doesn’t mean they have a diagnosable mental disorder. Certainly, some conspiracy theorists have a mental illness, but that does not necessarily mean that the conspiracy theory is caused by or even related to the illness. Political extremism on both the “left” and the “right” is also associated with belief in conspiracy theories (Prooijen, Krouwel, & Pollett, 2015). This is not to say that political party affiliation causes people to believe in conspiracy, but perhaps whatever led the person to harbor radical political positions may also contribute to their unfounded beliefs. There may be personality differences in those who believe in conspiracy theories vs. those who don’t. Green & Douglas (2018) found that an anxious attachment style was significantly correlated with belief in conspiracy theories, while the avoidant and secure attachment styles were not. This was true even when controlling for other known predictors, such as right-wing authoritarianism, level of interpersonal trust, and demographic factors. Conspiracy theorists will readily engage logical fallacies in their efforts to maintain their beliefs: Ad hominem: “You’re just a sheep, that’s why you can’t see that I’m right." Straw man: “Vaccines are awful! How could you even think of injecting your child with poison?!” or “Jet fuel can’t melt steel beams!” False dichotomy: “You believe people actually landed on the moon? Wow, you believe everything the government tells you!” False analogy: “The Twin Towers must have been brought down by bombs planted by the government, because buildings demolished by dynamite fall down the same way.” My own feeling is that some people are simply motivated by a deep yearning for identity and to feel special and important. We are all driven to find meaning in our lives. Perhaps those who struggle with that experience a touch of satisfaction in their conviction that they hold unique knowledge about the world. Are you seeing some of these traits in your conspiracy-theorist friend or family member? How do I deal with people like this? It is unlikely that you will be successful at convincing a die-hard conspiracy theorist to change their beliefs. Providing them with evidence to the contrary isn’t likely to help, as their “research” is already littered with confirmation bias. They are not interested in the systematic and logical pursuit of knowledge that is the scientific method. When faced with evidence to the contrary, a conspiracy theorist may dismiss the evidence as being part of the nefarious plot to hide the “truth,” or they may criticize you, the deliverer of the message. If your conspiracy theorist loved one’s belief is harming someone else, take appropriate action. For example, if your aunt believes prescription drugs are mind-control devices the government dispenses to control us and refuses to give her child needed medication, a call to your area child protective services or law enforcement is in order. Otherwise, if no real harm arises from the belief, there are two good choices: 1. Set boundaries. Say, “I know you are convinced that this is true, but I’m not, and I’m not interested in hearing any more about this. In order for us to get along, it’s important that we just not talk about this topic anymore.” 2. If setting boundaries does not work, you may have to distance yourself from the person. Many conspiracy theorists truly believe that they are correct and that the rest of the world is deluded. They believe their “truth” as much as you believe the sun rises and sets every day. You will not talk them out of it, and if they refuse to stop trying to convert you or berate you for being “blind to the truth,” you may have to cease contact with them. In closing, I will leave you with this light-hearted joke found somewhere on Reddit: Three conspiracy theorists walk into a bar. ... ... You can't tell me that's just a coincidence. References: Green, R. & Douglas, K. M. (2018). Anxious attachment and belief in conspiracy theories. Personality and Individual Differences, 125, 30-37. DOI: 10.1016/j.paid.2017.12.023 Hawley, K. (2019). Conspiracy theories, impostor syndrome, and distrust. Philosophical Studies. doi:10.1007/s11098-018-1222-4 Imhoff, R., & Lamberty, P. (2018). How paranoid are conspiracy believers? Toward a more fine-grained understanding of the connect and disconnect between paranoia and belief in conspiracy theories. European Journal of Social Psychology, 48(7), 909-926. doi:10.1002/ejsp.2494 Prooijen, J. V., Krouwel, A. P., & Pollet, T. V. (2015). Political Extremism Predicts Belief in Conspiracy Theories. Social Psychological and Personality Science, 6(5), 570-578. doi:10.1177/1948550614567356 #family #relationships

We can all relate to a sleepless night, but when it happens night after night it’s exhausting. It’s hard to function when we’re sleep deprived. Unfortunately, sleep deprivation is what many of our teens are experiencing — and it’s affecting their ability to make good decisions! According to the National Sleep Foundation, teens need 8-10 hours of sleep each night, but only about 15 percent of them are even getting close to that amount. In fact, they’re lucky if they get 7 solid hours of zzz’s a night — and if it’s a school night, odds are many are only averaging around 6 hours. According to the American Psychological Association, 69 percent of youth experience sleep problems one or more times a week. Now that’s a lot of sleepy teens! There are many reasons for sleep loss. For example, it can be voluntary, like staying up late playing on an electronic device or chatting with friends. According to the National Sleep Foundation, nearly 72 percent of youth ages 6-17 sleep with an electronic device in their bedroom, which can result in an hour of sleep loss each night. Not all sleep loss is voluntary though. It can also be caused by insomnia, a sleep disorder that affects approximately 24 percent of adolescents. Insomnia is characterized by having trouble falling asleep, staying asleep, waking up too early, or any combination of these disturbances. Studies have shown that between 6 percent to 10 percent of adults meet the criteria for an insomnia disorder, in which sleep disturbances occur at a minimum of 3 times per week and are present for 3 months. To top it off, many of these sleep problems begin during the teen years. In adolescence, teen clocks are wired to fall asleep later and wake-up later. Getting them up at 5:30 AM is like us getting up at 4:00 AM. Aside from being night owls, teen sleep deprivation has also been linked with anxiety, stress, and depression. Regarding depression, one study showed that 90 percent of people who suffer from depression also struggle with insomnia. Sleep deprived teens may try to self-medicate by turning to stimulants such as caffeine and nicotine to make it through the day, but those only provide temporary relief. Some youth may even look for something stronger to help them get through the night, like alcohol. A study of seventh and eighth-grade students, published in the journal of Addictive Behaviors showed that sleep problems in youth were indeed a risk factor for alcohol use. In this study, researchers examined associations between alcohol use and sleep-related issues. Results indicated alcohol use was significantly correlated with both insomnia and daytime sleepiness. To supplement these findings, there have been numerous studies linking sleep deprivation with drinking, binge-drinking, drinking and driving, and risky sexual behavior. Research indicates teens need sleep to function and perform well; without it, they are in jeopardy to engage in risk-taking behaviors. Sleep deprivation is a serious matter that can adversely affect a teen’s behavior. If you suspect your teen has a chronic sleep problem, please seek professional attention. At Etheridge Psychology, we can help your child establish healthy sleep routines. We use a variety of evidence-based practices to design customized interventions to meet your child’s specific needs. These services are also offered for adults. Nothing can recharge a battery like a good night’s sleep. Fortunately, healthy habits can be made to establish good sleep, which will reduce symptoms of sleep deprivation and insomnia. Empower your teen to establish these disciplines in their life. There’s no doubt about it, a well-rested teen is a happier one!

Starting therapy seems fairly straightforward, doesn’t it? Perhaps you notice you’ve been feeling more anxious after receiving a job promotion. Maybe you’re feeling lethargic and down following the end of a relationship. So, you decide you’ll pursue therapy. You figure, I’ll come in, talk about my problems, and then I’ll feel better. Sounds pretty simple. While being a therapy client can be as simple as coming in, discussing your problems and working out potential solutions, there are numerous things you can do in order to make the most out of your therapy sessions. You’re likely spending your valuable time, energy, and money to participate in your therapy sessions, so why not make sure you’re using your resources as effectively as possible? Here is a list of recommended “do’s” and “don’t's” around getting the most out of your therapy sessions. DO your homework in researching potential therapists. Finding a therapist with whom you connect can be almost as challenging as being in therapy. Every therapist brings different therapeutic modalities, thoughts, experiences, and insights into session, and if you do your homework by researching different therapists beforehand (hello, PsychologyToday!), you may be more likely to find a therapist with whom you resonate. DO come to session on time. It may seem trivial, but consistently arriving to your therapy sessions even a few minutes past your scheduled appointment time has consequences. Not only can it disturb your therapist’s appointments with other clients, but it also takes away from your valuable therapy session. You’ve made the effort to make it all the way to your appointment- why not make yourself a priority by making it to your therapy session on time? Better yet, try to make it to your appointment 5-10 minutes early to give yourself a few minutes to get a drink of water, use the restroom and ground yourself before your session. DO be honest and transparent with your therapist. Imagine this: You wake up in the middle of the night with chest pains. You rush yourself to the hospital to get some help. When you get to the hospital your doctor asks you what’s wrong, and you tell her you’re in pain. You don’t tell her where you’re having pain, just that you’re experiencing pain. You refrain from sharing crucial information that ultimately impacts how much your doctor can help you. Talking to your therapist without being as transparent and honest as possible ultimately impacts how much your therapist can help you. Use your therapy time to the best of your ability by being as honest and open as you can. DO tell your therapist how much you’re drinking alcohol or using drugs. Your therapist likely has no interest in judging you on the number of cocktails you’re drinking on a Friday night. However, using drugs or alcohol can impact your vulnerability to negative emotions, and refraining from sharing your substance use with your therapist is like leaving out a major piece of your therapy puzzle. Your therapist can’t help you with what they don't know. Be honest and up front with your therapist about what you’re using and how often you’re using it in order to give her as much information as possible around how she can support you in working towards your goals. DO complete your therapy homework. Trust me, I get it. The minute you walk out of your therapist’s office, you’re faced with all of the stresses and responsibilities you were dealing with before you walked into your appointment. Sometimes incorporating what you’ve learned in session can feel burdensome and exhausting. However, if you only use what you learn in therapy in therapy and not in your life outside of your sessions, you’re wasting your time and money. Using what you work on in therapy outside of therapy can speed up your therapy process and save you time and energy. DO feel comfortable challenging your therapist. There is an inherent power differential within any interaction between a therapist and client. It is your therapist’s job to be mindful of this power differential and to work to keep the therapist/client dynamic equal, comfortable and supportive. If you disagree with something your therapist has said during session or with how your therapy session is going altogether, I invite you to share these thoughts and feelings with your therapist. Your therapist doesn’t know how to solve all of your problems, nor is your therapist always going to be correct in her interpretations of your personal experiences. Practice your interpersonal effectiveness skills by challenging your therapist. While we’ve covered a handful of suggestions as to what you could do make the most out of your therapy experience, here are a few suggestions as to what you could avoid in order to have effective and worthwhile therapy experiences. DON’T be discouraged if you aren’t connecting with your therapist. As previously mentioned, it can be challenging to find a therapist who you feel really understands you. If you notice you’re feeling misunderstood, uncomfortable, or disconnected after a few sessions with your new therapist, try not to feel discouraged. Each therapist brings something different to his or her sessions, and what your therapist is bringing to your sessions may not resonate with you. Feel free to share with your therapist if you feel you may not be a good therapy fit. Your therapist may validate your emotions and, if you ask, provide you with additional referral options. While ending a therapy relationship can be uncomfortable, it is ultimately useful to cut ties if you feel the therapeutic relationship or sessions aren’t suiting your needs. DON’T use your therapy time as a venting session. Venting about the argument you had with your spouse or the obnoxious behaviors of your coworker has its place, and your therapy session is not it. Venting to your therapist on occasion can be appropriate and even therapeutic, but using your therapy session solely as a venting session is ultimately an ineffective use of your time and your therapist’s time. While venting in session may feel helpful in the moment, it can end up activating your emotions and taking away from valuable problem-solving and processing time. If you feel you absolutely need to vent to your therapist, give yourself five minutes and then move on. Save the venting for your friends and family members. DON’T expect extra therapy time if you are late to your session. As previously mentioned, making your therapy sessions a priority by coming to sessions early or on time is incredibly valuable. If you get caught up in traffic or lose track of time and get to your session late, do not expect any extra time with your therapist after the scheduled end of your session. Having less time with your therapist due to tardiness is a natural consequence, so make your therapy a priority by getting there on time.

I am often asked this question specifically related to Asperger syndrome no longer being considered a diagnosis. I’ve been asked, “Did Asperger syndrome just disappear?” No, it did not disappear – it was just renamed and reclassified. Individuals who had a diagnosis of Asperger syndrome (or “Asperger’s”) would now be said to have a different disorder that is more in line with current research on developmental disorders. For example, they may now be said to have a mild, or high-functioning, version of Autism Spectrum Disorder or possibly a diagnosis of Social Communication Disorder. First, some history on the nomenclature of mental illness. Some of the terms that historical medical and mental health professionals used to describe mental illnesses, and people with mental illnesses, are surprising and offensive to modern society. People with various psychological and developmental disorders were classified using terms like moron, feeble-minded, idiot, imbecile, hysterical, and lunatic. Now considered rude and offensive insults, these terms were once actual diagnoses. These terms are no longer used by professionals for two broad reasons: The words morphed into insults and became degrading to use as diagnostic labels. Renaming a disorder whose name has become offensive in society is simply the right thing to do. Research in mental health has redefined and reclassified symptoms and features into other disorders. For example, “idiot” was likely used to describe people we now know had one of a number of distinct disorders, such as Intellectual Disability, Autism Spectrum Disorder, genetic disorders such as Downs Syndrome, and the effects of a traumatic brain injury. As you may already know, mental health and medical professionals use the Diagnostic and Statistical Manual of Mental Disorders, currently in its 5th Edition, to describe and classify mental disorders. Before the first DSM was ever written, however, the 1840 United States Census devised a single category for mental illness for the purpose of data collection. That category? “Idiocy/insanity.” The American Statistical Association protested this categorization, citing in part that African-American citizens were disproportionately coded as “insane.” Seven categories of mental illness were used for the 1880 census. The American Psychiatric Association was formed in 1844, then called the wordy Association of Medical Superintendents of American Institutions for the Insane. By 1880, terms like dementia and epilepsy were being used, along with now-archaic labels such as melancholia. In 1917, a primitive classification manual was developed by the APA that included 22 diagnoses for use by mental hospitals to classify people with mental illness. Fast forward to 1952, and the first edition of the DSM was published by the American Psychiatric Association. It included 106 named mental disorders. The DSM-II came along in 1968 and included 182 disorders. The increase in named disorders was not because more people were mentally ill, but scientists and health care professionals split broader categories into more specific collections of symptoms and revised criteria based on research. Revisions of the manual have also been aimed at increasing the reliability of diagnosis among mental health professionals and standardizing diagnosis with other countries. Notably, the sixth printing of the DSM in 1974, still known as the DSM-II, removed homosexuality as a mental illness based on research demonstrating that homosexuality is not a mental disorder. The DSM-III was published in 1980 to further improve standardized diagnostic practices and to incorporate the findings of new research discoveries. The DSM-III-R, published in 1987, included 292 diagnoses, and the DSM-IV (1994) listed 410 disorders. The DSM-IV-TR (2000) was a text revision of the manual that did not change the diagnostic categories. The DSM-5 was published in 2013 and included extensive revisions to diagnoses based on research and the work of a large task force of mental health professionals. Like its predecessors, the DSM-5 also changed some labels to better align with socially acceptable language (e.g. “Mental retardation” is now listed as “Intellectual disability”). The DSM is not a cookbook by which anyone can look up their symptoms and diagnose themselves; diagnosing a mental disorder involves far more than checking off symptoms. No matter how convinced you are that you meet all of the diagnostic criteria for a certain mental disorder, only a licensed mental health professional can make that determination. Diagnosing a mental disorder involves not only identifying the presence of symptoms, but determining the presence of “clinically significant distress or impairment” and ruling out other possible explanations for the symptoms. The DSM is, simply stated, a taxonomy of mental disorders. Just like the terms “homo sapiens” and “arachnid” are helpful in categorizing animals, the names we apply to mental disorders are made-up terms aimed at making sense of the broad range of emotional, cognitive, and behavioral symptoms in mental health. While the DSM does include information about the prevalence and possible causes of the disorders it lists, that is not its purpose, and it does not include information on treating the disorders. The DSM’s current purpose is to provide a common language for professionals to use in the study and diagnosis of mental disorders. Each revision aims to improve the identification of mental disorders and, by extension, improve access to treatment. The DSM-5 will certainly be revised again and again, as research into human psychology and behavior is ongoing. I look forward to the coming advances in the field of mental health.

The middle school experience is one of the most critical periods of psychological development. Adjustment difficulty in middle school is common and can have lasting impacts. In fact, the trauma of social rejection in middle school is one of the most common triggers of adjustment disorders and early-onset depressive/anxiety disorders. Still more, some of the most common symptoms of depression and anxiety are impaired attention and concentration, which can lead to an erroneous diagnosis of ADHD. While the use of psychostimulants such as Adderall and Ritalin can temporarily boost motivation, it can also result in exacerbation of anxiety or addiction and does not address the underlying problem. The conclusion is this: depression and anxiety during the middle school years is increasing, and these symptoms are sometimes erroneously diagnosed. The Adjustment Middle school is the time that children hit puberty and move on from the protection of the social kindness forces of elementary school. In elementary school, policies dictate assigned seating, fairness, and copious amounts of supervision. These policies insist that students bring enough Valentine’s Day treats for all. While it is true that bullying and clan-like mentality occurs in elementary schools, it becomes much more apparent during the pre-teen years. Middle school is a time of increasing autonomy and responsibility, and many middle schoolers have not yet attained the emotional regulation skills, self-esteem, self-control, and sense of identity to help the process move smoothly. Middle school is a time of selective Valentine’s Day gifts, students sitting where they want, and school dances. Rejection is overt and often public, whether in the cafeteria or on social media. It is during these years that the “us vs. them” phenomenon becomes painfully obvious to children. The rejection, or “them” experience, in middle school is a social, emotional, and psychological debit. The most loving parents and secure home is rendered neutral against these strikes. These are particularly difficult times because the young brains of middle school students sometimes employ high aggression and tribal division in ways that can only be described as medieval. This means that the more sensitive kids, as well as kids who are perceived to be “different” in some way, are targeted at a higher rate. Unfortunately, middle school can be the time that children experience the painful reality of racism and other "isms." A Primal Need for Belonging Why is this rejection so critical? When we are accepted by others, we become members of “tribes.” As young children, if we were lucky, our nuclear families fulfilled our need for belonging. As children enter pre-adolescence, they begin the process of developing autonomy and independence, which entails decreasing emotional dependence on the nuclear family and increasing dependence on peers. As a pre-teen develops his or her peer group, the important process of transitioning from childhood to autonomous adulthood has begun. As we hold hands, drape shoulders, and huddle with our fellow tribal brothers and sisters in OUR places, our feeling of belonging and a deeper understanding of our worth helps “us” feel valued like never before. Our “tribe” provides psychological validation and strength in numbers. A lone wolf becomes a forceful pack of wolves. The aforementioned transformation is best described as amazing experience for a middle school student. This validation and sense of belonging can be life altering. On the other hand, those left out of or rejected from inclusion can suffer from despair, anger, and/or anxiety. Helping Your Child Find Their Tribe Parents always aspire to protect their children, but the truth is, middle school is middle school. Having noted that, encouraging your children to join clubs, sports teams, and other “us” pursuits is very helpful. Having your child engage in fellowship via church or related activities can also promote connectedness. There is evidence that humans have a primal need for “us” group inclusion but no evidence that the group must be large. Even one close friend can be enough. Of course, encourage your children to look for positive qualities in their friend candidates, and get to know your child’s friends and their families for yourself. Final Thoughts Middle school is a time of great change. This is the time for parents to begin allowing their child increasing levels of independence while keeping their eyes and ears open for signs of bullying and other negative peer influence. This is also the time to begin expecting increased responsibility in your child: setting his or her own alarm clock, learning to do laundry, and cooking basic foods like eggs, rice, and even boxed brownies. If you find yourself concerned about negative changes in your child, please reach out to a child psychologist or child counselor. Your child need not be mentally ill to see a therapist. On the contrary, we see mentally healthy children and teens in our practice all the time who just need a little help getting through one of the many adolescent challenges. Further, please try psychotherapy and psychoeducation before considering medication for your child’s struggles. Best wishes to all the middle schoolers out there struggling with their new challenges, as well as their worrying parents!

Are you contemplating seeking help for mental health concerns, but are not sure where to start? You are not alone. Identifying and selecting a treatment provider and type of mental health service can be an obstacle to receiving help. Before finding a provider, the first step is to identify what services you need. Most outpatient mental health providers offer one or more of the following: evaluations, testing, medication management, and talk therapy. Evaluations: Psychological evaluations include evidence-based assessments, often with psychological tests, that help to identify symptoms and ultimately lead to a diagnosis. A diagnosis is necessary to develop a treatment plan and inform interventions. Evaluations can range from just one appointment to four or more appointments. Typically, the first appointment is an intake in which the provider will gather information about the symptoms as well as other information about you. The information gathered during the intake session will help the provider determine which psychological tests, if any, will be helpful. Testing: Psychological testing can involve self-report multiple-choice tests (such as the MMPI-2) and tests that are administered in a one-on-one setting by the psychologist (such as IQ tests, neuropsychological tests, and projective tests). Testing is often administered to confirm, or rule out, potential diagnoses. No psychological test can be used alone to make a diagnosis. Psychological tests are tools that the psychologist uses in combination with clinical interview data and other sources of information. Medication: Psychotropic medications can be prescribed to help manage mental health symptoms that interfere with daily functioning. A psychopharmacology evaluation is generally the first step to medication, followed by routine appointments to follow and maintain the medication effectiveness. Therapy: Therapy can be done in groups, as a family, as a couple and individually. Sessions generally consist of treatment goal setting and building skills to accomplish change. Therapy should provide a safe, supportive and confidential space to talk about symptoms and stressors while working towards positive improvement. Once you have an idea of the service you need, the next step is to identify a provider. Mental Health Counselor & Marriage and Family Therapist: Licensed Professional Counselors (LPC) and Licensed Psychological Associates (LPA) are Master’s level clinicians (MS, MA, MSEd) who specialize in talk therapy (also called psychotherapy or just counseling). Licensed Marriage and Family Therapists (LMFT) are Master's level clinicians who specialize in talk therapy for couples and families. Psychologist: Psychologists hold a doctoral degree (Ph.D. or Psy.D.) in psychology. Psychologists are qualified to administer psychological evaluations and testing. Psychologists are also therapy providers. Psychiatrist: Psychiatrists are medical doctors (M.D. or D.O.) who graduated from medical school. While some Psychiatrists do provide talk therapy, they are generally sought for psychopharmacology evaluations and medication management. At Etheridge Psychology, we offer many of these mental health services in one location, including psychological evaluations, testing and therapy. Here are our provider specialties in a nutshell: Raychelle Lohmann, Ph.D., LPCS, Sharyn Button MA LPC LCAS-A, and Cathryn Mainville, MSEd LPC are licensed professional counselors who provide individual therapy with different specializations. Among the three of us, we see children, adolescents, and adults with a variety of presenting concerns. Dr. Mary Anne Etheridge specializes in psychological and forensic testing and assessment. She also conducts neuropsychological and psychoeducational testing. Dr. Roy Etheridge specializes in psychological and forensic testing and assessment. He also specializes in evaluating the unique mental health needs of military veterans, particularly those with PTSD. Dr. Erin Clevenger specializes in Autism and Learning Disorder testing and assessment. We are still growing, so we expect to add more providers soon for all of your mental health needs! To learn more about the services we offer, please visit these pages: Mental health services for children and teens Mental health services for adults Forensic psychological services #mentalhealthcounselor #psychologist #psychiatrist #psychologicaltesting #mentalhealth #counseling

Making self-care a priority. As another year has come and gone, you may be sitting back reflecting on 2018 and thinking about how you want 2019 to look different. But are you making the same promises that you made last year at this time? Are you longing for contentment only you can't find it? It’s so easy to get caught up in the monotonous trap of making the same resolutions year after year and struggling with the same challenges. Sadly, most people fall short of fulfilling their personal commitments and resort back to their old habits. In fact, research published in the Journal of Clinical Psychology shows that only 8 percent of people actually meet their New Year’s resolution goals. Although this data can put a damper on an age-old tradition of making resolutions, it shouldn’t keep you from striving to improve yourself. Self-care is one of the greatest ways that you can make positive changes in your life. Attending to your personal and emotional needs is vital to your wellbeing. Sounds simple, right? Unfortunately, too often people neglect and overlook the importance of self-care. If you truly want to make a change in 2019, begin the year by making a promise to the one person who is with you day in and day out – you! This year instead of resorting to your old resolutions make a commitment to put the spotlight on you and the things that you like to do. If you don’t know where to begin below are five simple ways to help you get started. It’s time that you put first things first, change your attitude, boost your health all while improving your life and it all begins with self-care! Five ways to practice self-care. 1. Do what you love and love what you do. Identify some talents or activities that you truly enjoy and do them. Stop wishing that you had the time to go for a walk, run, paint, cook, or read a book and start making it happen. If you can only spend ten minutes doing it then great - if you have an hour even better. You aren’t in a race against the clock to spend time with yourself, you just have to make it happen. 2. Embrace each moment. Too often life is spent looking back to the past or jumping too far ahead in the future. Whether you’re attending a loved one’s wedding or having your favorite beverage at the coffee shop, stop and take time to embrace each moment. Make a conscious effort to place the hustle and bustle of everyday life in the background by focusing on the present moment. As the Dalai Lama XIV so astutely stated, “There are only two days in the year that nothing can be done. One is called Yesterday and the other is called Tomorrow. Today is the right day to Love, Believe, Do and mostly Live.” 3. Get plenty of zzz’s. Sleep is a basic need that too often gets neglected. Did you know that adults need at least seven hours of sleep each night? According to a recent study done by the Centers for Disease Control and Prevention (CDC), more than a third of Americans are sleep deprived. Coincidentally, lack of sleep has been linked to higher rates of obesity, diabetes, high blood pressure, heart disease, stroke, and mental distress. Sleep is not a luxury, it’s a necessity. 4. Begin each day with gratitude. As Tyler Trent, the twenty year old inspirational Purdue superfan, who recently lost his fight with cancer wrote, “Though I am in hospice care and have to wake up every morning knowing that the day might be my last, I still have a choice to make: to make that day the best it can be. To make the most of whomever comes to visit, texts, tweets or calls me.” We could all learn something from Tyler about making a choice to make each day the best and that all begins with a little gratitude. 5. Celebrate your victories both big and small. Don’t brush off your accomplishments. When was the last time that you took time to celebrate your successes? It’s so easy to accomplish something, brush it off, and move on to the next item on the list, but don’t sell yourself short. Instead, take time to acknowledge what you achieved. Life’s too short to not celebrate each victory big or small. Don’t let another year come and go without making your well-being a priority. Make a commitment to actively engage in self-care. You owe it to yourself to put first things first – and that begins with you.