Romantic relationships can be challenging for most people but there are certain aspects of our upbringing and past relationships that set the stage for future relationships in a detrimental fashion.

If an individual has not worked through these early or difficult relationships they may continue seeking out the same types of dysfunctional relationships. Often people say they make the same mistakes again and again in relationships. They mistakes will likely continue if nothing changes in an individual’s own personal process and growth. At some point we need to go back and understand why this happened, what our thoughts are about these relationships and ourselves, and how this will impact future relationships.

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Individuals who struggle with symptoms of ADHD struggle to succeed in a variety of domains. In children, academic functioning is negatively affected because either the child is too hyperactive or too inattentive. Both of these presentations lead to different struggles in various areas of life which is frustrating to the children and those around them. In addition to academic struggles many kids experience social struggles due to their noticeably different behavior and the negative attribution they receive for it.

For adults, the struggle is seen in the workplace. Most often these individuals have challenges with getting organized, initiating tasks, utilizing working memory, managing frustration, focusing attention, and sustaining effort. As would be expected these same struggles impact an individual’s ability to connect socially and sometimes in creating close romantic relationships.

Behavioral Strategies are the most effective and only nonmedical evidenced based treatment for ADHD. Since many individuals will continue to have symptoms of ADHD, the best thing we can do for them is teach them strategies which allow them to be most successful. For children, a crucial component of behavioral modification is providing parenting strategies in managing the antecedent (what comes before) and the consequences (what comes after) of the behavior. Additionally, collaboration with the student’s teacher is vital so there is some consistency in the way both parents and teachers are engaging and interacting with the youth.

A more traditional Cognitive Behavioral Therapy (CBT) approach is effective in treatment and management of adult ADHD. Part of the reason for this is that individuals who have struggled with ADHD for a long time usually present with strong negative thoughts about their lack of success or inability to do things the way others can. Therefore, in addition to the behavioral interventions and strategies there is often and associated anxiety or depression that must be addressed as well.

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The most famous representation of anxiety is the bell shaped curve which teaches that a moderate amount of anxiety in some situations can help us to succeed. Anxiety of course is totally normal during periods of adjustment and change like attending a new school, starting a new job, or anticipating a big meeting or presentation. However, for many individuals anxiety is more consistently present at much higher levels and impacts social, academic, and professional functioning in drastic ways.

Depression can keep us stuck in the past but is is anxiety that is already way ahead in the future. Anxious concerns usually arise from uncertainty about how something will go, and usually our brain comes up with all the awful things that might happen. These worries are made up of concerns about our own future experiences but also about the future of those around us. Many people experience anxious thoughts that lead them to believe terrible things will happen to those around them. This leaves them living in a sense of fear and constantly distracted by their negative thoughts.

Anxiety is experienced and exacerbated by our thoughts and feelings but also physiologically. Think about the experience of being anxious which may include your heart racing, feeling like you can breath, shaking/trembling, or sweating. When this process occurs our thoughts tends to become more catastrophic and our anxiety skyrockets.

Some people who experience anxiety may be less aware of these thoughts and situations but experience pain, stomach aches, and headaches related to underlying anxious distress. In these cases it is important to become more aware of your experience and understand what thoughts and feeling may be contributing to these physical complaints.

The most common type of anxiety affecting young children is separation anxiety. Upon initial separations this is totally normal and part of the developmental process of growing up However, if separation anxiety continues it may be a sign of a more chronic anxiety disorder.

Cognitive Behavioral (CBT) Therapy is an evidenced based, effective treatment for assisting clients across the lifespan manage anxiety. CBT is based on the relationship between our thoughts, feelings, and behaviors. Through increased awareness of this relationship and the identification of specific thoughts feelings and behaviors, clients are supported in making small changes in their thinking and behavior than can have a positive impact on their tendency to become anxious. Clients are challenged to think about worst case scenarios in different situations and evaluate evidence to support that notion that they will get through a specific situation.

In some cases, medication management may be recommended, and may be just temporary in the case of anxiety depending on the specific symptoms, how much these symptoms impact functioning, and how much a client can benefit from using and developing skills and strategies in therapy.

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Over 3 million people across the nation struggle with depression each year. Despite the high prevalence rate, individuals who experience depression continue to feel totally alone in their struggle. Some of these people have a stronger predisposition for depression which means stressful life events and unfortunate situations likely affect you much more than someone else who may have experienced a very similar situation. This in itself can be frustrating and difficult to manage.

People of different ages and stages of life may experience depression in slightly different symptoms clusters. This is important to understand so we aren’t missing warning signs or mistaking symptoms for something else.

In children and adolescence depression most commonly presents in the form of irritability, somatic complaints (headaches, body aches), and disconnection/withdrawal from family and friends. These serve as both symptoms and initially as warning signs for depression in youth. Additional warning signs include changes in sleeping habits, eating patterns, and other areas of functioning (e.g., academic). Since adolescence is such a busy time of development it is often difficult to pinpoint whether changes in mood and behavior are due to “typical teenage stuff” or a bigger issue.

Early adulthood in full of life changes and decisions that shape the rest of our lives. Often these experiences cause feelings of stress and overwhelm. Some young adults have the coping resources to manage these stressors and seek support but other struggle to adapt to adulthood and depressive symptoms can quickly set in. Since many individuals go away to college or move out of the house it is important that they they know about the resources available to them in their new environment. Some cases of depression in early adulthood resolve after a period of adjustment; however, for other this may be the onset of a more serious depressive disorder.

Depression in adulthood typically follows a more typical trajectory and symptom profile including losing interesting in things one used to enjoy, a pervasive sense of hopelessness, changes in appetite and sleeping patterns, and isolation/withdrawal. More severe depression may be accompanied by perceptual disturbances (hallucinations, delusions).

It is definitely a common myth that depression is a normal part of growing older. Yes, there are changes one must adjust to with aging but pervasive sadness and disconnection is likely a sign of a more serious and treatable condition. Additionally, older adults may struggle with managing different physical disorders and as always, providers should work together to assist them in navigating these issues in an integrative manner.

Treating Depression
Cognitive Behavioral Therapy (CBT) is an evidenced based, effective treatment for depression across the lifespan. CBT is based on the relationship between our thoughts, feelings, and behaviors. Through increased awareness of this relationship and the identification of specific thoughts feelings and behaviors, clients are supported in making small changes in their thinking and behavior than can have a positive impact on mood. Although CBT is highly effective, there are other treatment modalities which are helpful as adjuncts including acceptance and commitment therapy, dialectical behavior therapy skills, family or couples therapy, and relational approaches (link to pages talking about this?)

In some cases, medication management may be recommended, even if it is just temporarily. In these cases medication can decrease symptoms and help you to engage and benefit from therapy interventions.

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