Medwin Telehealth Counseling

Mental Health Information -Medwin Telehealth Counseling

Anxiety and Stress

Physical and Emotional Abuse

Anxiety and Stress

All human beings worry. Sometimes the worries are real. There are potential scenarios with possibly negative consequences, such as a difficult medical diagnosis or a family crisis. Sometimes pending life changes such as marriage, divorce, the upcoming birth of a new baby, new job, etc. can be a cause for some sleepless nights. A few counseling sessions may be helpful to better cope with the new challenges you are facing.

Generalized Anxiety: For some people worrying and fear is a big part of who they are. They tend to stress about everything, anticipating the worse, even when such a scenario is highly unlikely. When this interferes with every day functioning, mental health counseling can be very helpful. Having some of the following symptoms suggest you could benefit from counseling: excessive fear and/or anxiety, difficulty controlling the anxiety, frequently restless, keyed up or on edge, easily fatigued, difficulty concentrating, muscle tension, difficulty sleeping.

Panic attacks:, This is an extreme form of anxiety, and is a type of fear response. Symptoms include palpitations or pounding of the heart, sweating, trembling or shaking, sensations of shortness of breath, chest pain or discomfort, dizzy, feelings of unreality or detachment from the situation, fear of losing control or "going crazy." There are coping tools available to help lessen the intensity or frequency of panic attacks.

Specific phobias: Some people get excessively anxious only in specific situations. Some examples are: Social Anxiety (fear of being in social situations) and Agoraphobia (fear of being in open spaces, enclosed places with other people, standing in line or being in crowds, being outside the home alone.) There are counseling methods than can help a individual better deal with such situations.

Trauma

Physical and Emotional Abuse

Anxiety and Stress

Experiencing trauma can alter our mental health and functioning. Some traumatic events are isolated moments that are intense enough to have a long term effect. Other people have experienced on-going, long term traumatic stress, especially in childhood, which can affect how they function later in life.

People react differently to different types of trauma. Here are possible responses that could be helped with therapy:

Adjustment Disorder - this is a reaction to an identifiable stress that causes symptoms within three months of the event. Some of these symptoms include: marked distress that is out of proportion to the severity or intensity of the stressor and/or significant impairment in social, occupational or other areas of functioning.

Acute Stress - exposure to an actual or threatened death, serious injury, or sexual violation directly or as a witness which causes intrusive thoughts, negative mood, dissociation, avoidance, or anxious arousal.

Post Traumatic Stress Disorder (PTSD) - Exposure to actual or threatened death, serious injury, or sexual violence that causes recurrent, involuntary, and distressing memories or dreams of the event; intense prolonged psychological stress at cues that symbolize or represent the trauma; flashbacks in which the person feels the traumatic event is recurring; avoidance of situations that may bring on intense emotions; extreme irritability, reckless or self-destructive behavior, hyper vigilance, problems with concentration and sleep.

Complex PTSD - This is a result of long-term traumatic exposure such as repeated sexual, verbal, emotional or physical abuse, and/or neglect or abandonment. This is harder to detect because the "flashbacks" are not reliving the actual trauma. Rather they are non-specific emotional flashbacks that seem to set off extreme emotional reactions for apparently no reason. People who have experienced complex trauma may have overwhelming fear, shame, alienation, rage, grief, harsh self-criticism, low self-esteem, feeling defective, depression, and anxiety.

Therapy can help those who have experiences any of these types of trauma.

Physical and Emotional Abuse

Ongoing physical and emotional abuse can have long term effects when it occurs as a child or an adult. (For long term trauma as children, see Complex PTSD under "Trauma.")
Adults that are in an abusive relationship, either physical or emotional are traumatized by the experience. Living through such experiences changes their world view and view of themselves. An abused person no longer feel safe in any situation, is always on edge never knowing when the next attack will occur. They often feel hopeless and helpless, sure that they are worthless human beings, and perhaps deserving of such treatment. A person who is abused will feel like it is their fault. "If only I didn't do that." If only I acted differently it would stop."
In reality, abuse is about power and control for the abuser. Physical abuse is obvious and can include slapping, choking, hitting, or beating, throwing large objects at the person being abused.
Signs of emotional abuse are more subtle and include: being insulted, demeaned or embarrassed by your partner; your partner controls what you do, who you talk to, and where you go; makes all the decisions without your input or consideration of your needs, tells you that you're a bad parent and threatens to take away the children, prevents you from working or attending school, act like the abuse is no big deal or is your fault, intimidates or threatens you with weapons or knives, destroys your personal property.
If you are being physically abused you need to protect yourself and/or your children. Call the National Domestic Violence Hotline for immediate assistance. 1-800-799-7233 or go to their website (thehotline.org).
If it is not an immediate emergency it can be helpful to find a safe place to talk about what is happening and discuss your options of what to do. Counseling can be that place for you. You don't need to live like this. You don't deserve to be treated like this.

Loss, Grief, and Mourning

Prolonged/Complicated Grief Disorder Therapy

Physical and Emotional Abuse

Sometimes loss, grief and mourning are mistaken for depression. Both have the symptom of extreme sadness. Grief is a normal reaction to loss. The loss can be a physical loss such as the death of a loved one. It can also include other losses such as being a new empty nester, loss of a marriage to divorce - even if the divorce is wanted, loss of a job, loss of community due to moving, and loss of function in chronic illness or disability.

Other forms of grief include:

Anticipatory Grief - Your loved one is still around but has been diagnosed with a terminal illness. It is common to begin the grieving process, even while your loved one is still alive.
Disenfranchised Grief - Because of circumstances or social norms, others around you may not acknowledge the grief you are feeling so you don't get the support from friends and family one usually receives after an official death. This can include having a loved one with Alzheimers/Dementia, loss of a loved one to stigmatized illness such as death by suicide, loss of an important person in your life who is not an official family member.
Ambiguous Loss - the person is physically absent but presumed alive, such as a missing person, or a loved one in prison.
Prolonged Grief Disorder - Grief is a natural response to the loss of a loved one. For most people, the symptoms of grief decrease over time. For a small group of people however, the feelings of intense grief persist with symptoms severe enough to interfere with their ability to continue on with their lives. There is a special therapy designed for those suffering from Prolonged or Complicated Grief. (see Prolonged/Complicated Grief Disorder Therapy)

These are steps that can be helpful for those dealing with loss. Michele can help you navigate these steps.

1. Acknowledge the reality of the death/loss.

2. Move toward the pain of loss in a safe supportive place, rather than avoiding it.

3. Convert the relationship with the person who died (or the loss you are grieving) from one of presence to one of memory.

4. Develop a new self-identity.

5. Search for meaning.

6. Continue to receive support from others.

These steps don't have to be in a specific order.

Find out more

Prolonged/Complicated Grief Disorder Therapy

Michele is certified in Prolonged Grief Disorder Therapy. This is a special carefully researched therapy that follows a step by step process to help a person who is "stuck" in acute grief usually for a year or longer. Research studies show this process to be very effective. Common symptoms of prolonged grief include:

persistent unending sorrow
inability to accept the death
second guessing the death
"If only" thinking
Excessive avoidance of reminders of the death or the person who died
Impairment of day to day functioning
Persistent intense emotion or physiological activation
maladaptive rumination about trouble aspects of the death.

Some of the steps of Prolonged/Complicated Grief Disorder Therapy include:

16 structured sessions with clear focus and goals
Strategies and techniques to meet grievers where they are, offering an impactful learning experience.
Managing difficult times such as birthdays and holidays.

Do you believe you or a loved one is suffering from Prolonged/Complicated Grief? Contact Michele for a consult. You can also click on 'Find Out More" below for a link to a website with the following questionnaire to fill out - "Inventory of Complicated Grief." This may give you some additional insights to your situation.

Find out more

Alzheimer's Families

Prolonged/Complicated Grief Disorder Therapy

More than 5 million people in the United States have Alzheimer's disease or dementia. Most of the focus is on the patients and how to make their lives as easy as possible. But sometimes the family members get overlooked. Watching a family member with Alzheimer's or dementia slowly decline is heartbreaking, frustrating, and emotionally draining. We are here to help such family members better cope with the situation.

Michele's D.Min. thesis was entitled, "Alzheimer's Families: Emotional and Spiritual Tools for Coping." Combining her personal experience of family members with Alzheimer's as well as doing extensive research interviewing such family members, she has developed different ways to find inner peace while dealing with a loved one with Alzheimer's or dementia.

Depression is a common diagnosis of family caregivers of those with Alzheimer's disease due to the symptom of extreme sadness. Yet, often this is a misdiagnosis. A more accurate description is grief and mourning as the family member mourns the many losses of the personhood of their loved one that declines over the years. Grief and mourning is treated differently than depression so it is important to understand the differences of these two causes of sadness.

Many family caregivers as well as adult children often suffer in silence since no one really understands what they are going through. Michele hopes to reach out to these families and offer counseling, guidance, support, and understanding.

Anger Management

Sexual Orientation and Gender Identity

Does this sound like you or someone you know?

Scream and yell a lot
Get easily frustrated and act out your frustrations
Overreact to minor problems
Say hurtful things to the ones you love
Road rage
Throwing and breaking objects
Physical violence such as punching walls or wanting to or actually hurting people

There are two approaches to people who want help managing their anger. The first is using various mental health tools which help you become aware of when your anger is starting, ways to calm down, become aware of what you are thinking that makes you react, and working on changing your thoughts. These techniques can help reduce the intensity and frequency of anger outbursts.

The second approach involves finding out where the anger is coming from. Chronic anger often stems from unresolved childhood issues or emotional flash backs to very difficult times in your life. Healing past emotional woulds can go a long way in helping to dissipate current anger.

Depending on your interests and needs, therapy can involved one or the other approach. Combining both approaches is most effecting in helping to get rid of unwanted anger.

If this sounds like someone you live with, and they are not ready to come in for therapy, there are techniques you can learn through your own therapy to better cope with living with someone who has anger issues.

Sexual Orientation and Gender Identity

While society often classifies people as male or female, heterosexual or homosexual, gender and sexual identity really are fluid and fall on a spectrum. Fortunately our society is starting to change its attitudes towards understanding gender and sexual identity, but it has a long way to go towards acceptance and equality.
People who self-identify as LGBTQ+ struggle with the same life concerns and daily stressors as everyone else. However, their stressors can be more complex. Even if there is family acceptance, social stigma can add to stress, self-acceptance, and self-esteem. Discrimination is common. When family is not accepting, the LGBTQ+ person also deals with loosing what they know as "home," even if they are still physically living in their home. This can lead to higher levels of depression, anxiety, and other mental health concerns.
Having a safe place to process the mixed emotions that can arise from the LGBTQ+ experience can be the start of easing some of the stresses involved. Therapy can help a client deal with the challenges of normal every day living along with the complications that arise from gender and sexual identity issues.
Medwin counseling provides non-judgmental, affirmation counseling in a supportive environment to help you explore your identity and live life as your authentic self, or help you process the emotional conflicts of remaining "in the closet" if you are not ready to come out. Therapy can help you identify and clarify issues, express feelings, and move towards personal healing.

Depression

Sexual Orientation and Gender Identity

Depression

When you say, "I am depressed," what does that really mean? There is often a feeling of deep sadness associated with depression. Sometimes other signs and symptoms are present that suggest mental health treatment could be helpful, especially if these symptoms interfere with your normal day to day functioning. These are: decreased interest or pleasure in most activities, fatigue or loss of energy, no motivation to do anything, difficulty getting out of bed in the morning, feelings of worthlessness avoiding contact with friends, seeing everything through negative eyes. Men often express depression as anger (SEE ANGER MANAGEMENT in this section). Sadness without these other symptoms can be a sign of loss and mourning rather than depression. (See LOSS, GRIEF, AND MOURNING in this section.) Bipolar Disorder, a type of depressive disorder, comes in different forms but usually includes mood swings, cycling from from being very depressed, to very elated. Treatment usually includes medication as well as mental health counseling. A more serious form of depression is accompanied by recurrent thoughts of death, recurrent suicidal thoughts without a specific plan, or a suicide attempt or specific plan to die by suicide. IF YOU ARE FEELING SUICIDAL CONTACT THE NATIONAL SUICIDE PREVENTION LIFELINE at 1-800-273-8255. It is free and confidential, 24/7, or call 911.

Online telehealth therapy is not recommended for those who have suicidal ideation or thoughts of self harm. Such clients would be better served with a therapist in their area who does in person counseling.