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Life is full of transitions, some of which can put even the strongest relationships to the test. Whether it’s moving to a new city, having children, or dealing with the loss of a loved one, these significant changes can create stress, anxiety, and emotional strain in a partnership. Relationship counseling provides couples with the tools to navigate these challenging moments, strengthening their bond and helping them grow together rather than apart. 

 The Impact of Major Life Changes on Relationships Every major life event brings with it adjustments that can affect how partners relate to one another. A couple might experience increased stress, differences in coping mechanisms, or even a shift in priorities. Moving to a new city or home  can cause stress related to leaving behind familiar places, adjusting to new surroundings, and managing logistical challenges. Partners may handle these changes differently, leading to tension. Having children  introduces new roles, responsibilities, and potential shifts in priorities. Balancing work, personal time, and parenting can strain a relationship without proper communication and understanding. Experiencing the loss of a loved one  is emotionally taxing, and individuals may grieve differently. This can cause misunderstandings or emotional distance between partners if not addressed in a healthy way. Health Issues  can lead to changes in roles within the relationship, such as the healthy spouse taking on more caregiving responsibilities, which can cause stress for both partners. Financial Difficulties  will often create tension between both partners and put the relationship under pressure especially when there are many bills to settle and finances are not forthcoming.   Relationship counseling provides a safe space to explore these changes, understand each other’s perspectives, and work through any tensions that may arise. 

 How Counseling Can Help During Major Transitions Counseling is designed to give couples the tools they need to cope with change and maintain a strong emotional connection during life’s biggest challenges. Here’s how it can help: Improve communication : Counselors guide couples in expressing their feelings, thoughts, and needs more effectively, preventing misunderstandings. Foster emotional support : Partners learn to provide emotional support to each other in ways that are meaningful and helpful, especially during emotionally turbulent times. Manage stress : Therapists can teach stress-reduction techniques and strategies to navigate the overwhelming emotions that come with life changes. Resolve conflict : Transition periods can heighten tensions, but counseling helps couples address issues constructively rather than letting them spiral into ongoing conflict. Rebuild intimacy : When life gets busy or stressful, emotional and physical intimacy can take a back seat. Counseling introduces tools to help partners reconnect and prioritize their relationships. 

 Counseling During Common Life Transitions Moving to a New City or Home When a couple relocates, they often experience the stress of leaving behind their support network and adjusting to a new routine. This transition can bring about feelings of isolation or homesickness. In counseling, couples can learn how to maintain emotional closeness during these adjustments and develop strategies for creating a new sense of home and community together. Having Children The transition to parenthood is one of the most significant changes in a couple’s life. The shift from being a couple to being co-parents can lead to imbalances in workload, misunderstandings, and even feelings of neglect. Counseling helps couples communicate more effectively about their needs, divide responsibilities fairly, and continue nurturing their romantic connection even amid parenting duties. Dealing with Loss Grief can affect a couple’s relationship in different ways, as individuals process loss differently. One partner may want to talk about their emotions, while the other may withdraw. Counseling helps couples navigate these differences, ensuring that each partner feels supported and understood during such an emotionally difficult time. Health Issues A health issue can require renegotiating roles, responsibilities, physical needs, emotional needs, intimacy needs, and future plans. Additionally, the daily demands of caring for a spouse with a chronic condition can take a mental toll on both spouses. Depression symptoms can increase over time, especially if each spouse has a different type of chronic condition that requires different types of self-care.  Counseling can help couples navigate their new normal and teach skills to care for themselves and each other.
 Financial Difficulties Partners need to be understanding and open-minded when it comes to financial issues so that it doesn’t adversely affect the relationship.  Counseling can help people identify the emotions that may be influencing their financial decisions and help people learn healthy coping skills to deal with the mental and psychological issues that can result from financial hardship. 

 The Long-Term Benefits of Relationship Counseling Beyond addressing immediate challenges, counseling equips couples with long-term skills to strengthen their relationship through future life transitions. Learning how to effectively communicate, manage conflict, and provide emotional support fosters a resilient partnership capable of navigating whatever comes next. Enhanced communication  that leads to a deeper understanding of each other’s needs. Stronger emotional bonds  and a greater sense of teamwork. Better stress management  that can be applied in future life transitions. 

 Conclusion: Strengthening Relationships Through Change Navigating major life changes is a part of any relationship. While these transitions can bring challenges, they also provide opportunities for growth. Relationship counseling helps couples strengthen their bond, improve communication, and support each other through difficult times. Whether you’re moving, having children, or dealing with loss, counseling offers the guidance you need to navigate these changes together. At Heritage Counseling, our experienced therapists can help you and your partner work through life’s transitions with confidence. Contact us today at 214-363-2345 to learn more about how relationship counseling can support you during times of change and strengthen your connection as a couple. 

How to Navigate Major Life Changes with Relationship Counseling

Introduction Relationships are a vital part of our lives, offering companionship, support, and joy. However, even the strongest relationships face challenges that can test the bonds between partners. Common marital challenges such as communication issues, life changes, and financial stress can create tension and conflict. Counseling provides a supportive environment to navigate these challenges, offering tools and strategies to strengthen relationships. This blog will explore common marital challenges, types of counseling available, and how counseling can help couples not just survive but thrive. Common Marital Challenges Communication Issues : Effective communication is the cornerstone of a healthy relationship. However, misunderstandings, unspoken expectations, and differences in communication styles can lead to conflict and resentment. Poor communication can escalate minor issues into major disputes, making it difficult for couples to resolve their differences.  Life Changes : Major life transitions, such as the birth of a child, empty nesting, a health crisis, career changes, relocation, or the loss of a loved one, can place significant stress on a relationship. These changes often require adjustments and can disrupt the balance and routine of daily life, leading to increased tension and conflict.  Financial Stress : Money is a common source of stress in relationships. Disagreements over spending habits, debt, savings, and financial priorities can create significant strain. Financial stress can also exacerbate other issues, making it harder for couples to find common ground and work together toward financial stability.  Intimacy and Affection : Over time, the initial spark of romance can fade, leading to a decrease in physical and emotional intimacy. This can result in feelings of neglect, loneliness, and dissatisfaction, further straining the relationship.  Different Expectations and Goals : Partners may have differing expectations and goals regarding their relationships, careers, family planning, and personal growth. These differences can lead to conflicts and feelings of incompatibility if not addressed and reconciled. Types of Counseling That Can Help Individual Counseling : Sometimes personal issues and past experiences, such as unresolved trauma, anxiety, depression, or substance abuse, can affect a relationship. Individual counseling allows one partner to work on personal growth, self-awareness, and emotional regulation. This can alleviate the strain on an individual leading to a healthier and more balanced relationship dynamic. Marriage Counseling :  Marriage is a wonderful partnership, but NOT always easy!  Also known as couples therapy, marriage counseling focuses on the relationship between partners. It provides a safe space to address specific issues, improve communication and negotiation skills, and develop strategies to resolve conflicts. Marriage counseling aims to strengthen the bond between partners and foster a deeper understanding and connection.  Additionally, with the divorce rate at almost 50%, premarital counseling can help set intentions in a marriage and be a valuable investment in a couple's future. Family Counseling : When relationship challenges involve other family members, such as children or extended family, family counseling can be beneficial. This type of counseling addresses the broader family dynamics, helping to improve empathy and communication, resolve conflicts, and create a supportive and harmonious family environment. 
 How Counseling Can Help Improving Communication : Counseling provides tools and techniques to enhance communication skills. Couples learn to express their thoughts and feelings effectively, actively listen, verbally reflect, respond with compassion, and understand each other’s perspectives. Improved communication can reduce misunderstandings and foster a deeper emotional connection.  Resolving Conflicts : Counseling offers a neutral and supportive environment for couples to address and resolve conflicts. Therapists help couples identify underlying issues, including each partner’s learned patterns brought into marriage from an individual's family of origin, that contribute to conflicts.  Counseling allows a couple to explore their emotions, develop constructive ways to manage disagreements and learn secure attachment strategies. This can lead to healthier and more productive conflict resolution.  Strengthening Emotional Connection : At the beginning of a relationship, couples spend much quality time connecting and falling in love.  As life becomes more complicated with work, kids, and other responsibilities, stress can creep in causing each to feel lonely and unsupported in the relationship.  Counseling helps couples reconnect on a deep emotional level. By exploring and addressing issues that have created distance, couples can rebuild trust, intimacy, and affection, and move towards secure attachment. This renewed emotional connection can strengthen the overall relationship.  Developing Coping Strategies : Life changes and stressors are inevitable, but counseling can equip couples with coping strategies to navigate these challenges. Therapists provide guidance on managing stress, setting realistic expectations, and supporting each other through difficult times.  Promoting Personal Growth : Counseling encourages individual and mutual growth through understanding and supporting the “me” and “we” in relationships.  Partners learn to support each other’s personal development, which can lead to a more fulfilling and balanced relationship. Personal growth contributes to a stronger, more resilient partnership. 
 Counseling is Beneficial for All Couples It’s important to note that couples do not have to be in crisis to benefit from counseling. In fact, regular check-ins with a therapist can be incredibly helpful in maintaining a healthy and thriving relationship. Just as one might hire a mechanic for ongoing and preventative maintenance of their car, counseling can be viewed in a similar way.  Proactive counseling can help couples address minor issues before they escalate, strengthen their bond, and prevent potential conflicts. Regular counseling sessions can serve as a preventive measure, providing couples with ongoing support and guidance. These sessions can help couples stay connected, communicate effectively, and navigate life’s challenges together. By investing in their relationship, couples can build a strong foundation for a lasting and fulfilling partnership. Conclusion Navigating relationship challenges is a normal part of any partnership. Whether you’re dealing with communication issues, life changes, financial stress, or other challenges, counseling can provide the support and tools needed to strengthen your relationship. At Heritage Counseling, we offer a range of counseling services, including individual, marriage, and family counseling, to help you and your partner thrive. Remember, you don’t have to be in crisis to seek counseling. Regular check-ins can be incredibly beneficial for maintaining a healthy and happy relationship.  Reach out to Heritage Counseling today at 214-363-2345 to learn more about our services and set up an appointment. Let us help you navigate your relationship challenges and build a stronger, more fulfilling partnership.  

Navigating Relationship Challenges: How Counseling Can Help

In today's fast-paced and interconnected world, stress and anxiety have become prevalent issues affecting millions of people worldwide. The modern lifestyle is characterized by constant demands, high expectations, and an ever-increasing pace of life, all of which contribute to heightened levels of stress and anxiety.  The prevalence of stress and anxiety in modern life can also be attributed to a combination of factors including societal pressures, technological advancements, and unhealthy lifestyle habits. Recognizing these factors is crucial in addressing and managing stress and anxiety effectively in today's society; however, the difference between the experience of stress versus anxiety can be confusing and needs clarity.  The terms "stress" and "anxiety" are often used interchangeably, but they represent distinct experiences that have different implications for our mental and physical well-being.  


 
 Defining Stress Stress is a natural response to external pressures or demands, often referred to as stressors. These stressors can be real or perceived and may include situations such as work deadlines, financial pressures, relationship conflicts, or major life changes.  Stress is often short-term and caused by a recognized threat.  While stress is a normal part of life and can sometimes be beneficial in motivating us to take action, chronic or excessive stress can have negative effects on our physical and mental health.  



 Understanding Anxiety Anxiety, on the other hand, is a persistent and excessive worry or fear about future events or situations. Unlike stress, which is typically tied to specific stressors, anxiety often lacks a clear trigger or may be disproportionate to the actual threat posed by a situation. Some amount of anxiety is a normal reaction to stress.
 Anticipation and dread play significant roles in anxiety, often exacerbating its symptoms and impact on individuals' lives. Anticipation involves looking forward to or anticipating future events or situations, while dread refers to a sense of impending doom or fear about what may happen. Both anticipation and dread can contribute to the cycle of anxiety in several ways including heightened sensitivity, cognitive distortions, physical symptoms, ruminations, and avoidance behaviors. While stress is usually temporary and tied to specific stressors, anxiety can be ongoing and pervasive, affecting various areas of life. Generalized Anxiety Disorder (GAD) is a common anxiety disorder characterized by excessive worry and anxiety that persists for at least six months and interferes with daily functioning.  According to the latest data from the National Institute of Mental Health, 31% of Americans will experience an anxiety disorder during their lifetimes. 


 
 Signs and Symptoms of Stress Stress can manifest in various physical and emotional signs, and individuals may experience a combination of these symptoms. Here are some common physical and emotional signs of stress: 
 Physical Signs: 
 Muscle Tension : Stress can cause muscles to tense up, leading to headaches, neck pain, back pain, and overall body stiffness. Fatigue : Feeling tired or exhausted even after a full night's sleep is a common sign of stress. Sleep Disturbances : Stress can disrupt sleep patterns, leading to difficulties falling asleep, staying asleep, or waking up feeling unrested. Digestive Issues : Stress can affect the digestive system, leading to symptoms such as stomach pain, bloating, diarrhea, constipation, or nausea. Changes in Appetite : Stress can alter appetite, leading to overeating or undereating, which may result in weight gain or weight loss. Increased Heart Rate : Stress activates the body's fight-or-flight response, causing the heart to beat faster and blood pressure to rise. Breathing Difficulties : Stress can lead to shallow or rapid breathing, chest tightness, or shortness of breath. Weakened Immune System : Chronic stress can suppress the immune system, making individuals more susceptible to infections and illnesses. 


 Emotional Signs: 
 Anxiety : Feeling anxious, nervous, or on edge is a common emotional response to stress. Irritability : Stress can make individuals more easily frustrated, agitated, or irritable in response to minor irritations. Mood Swings : Stress can cause fluctuations in mood, leading to mood swings ranging from sadness and despair to anger and frustration. Difficulty Concentrating : Stress can impair cognitive function, making it challenging to focus, concentrate, or remember things. Feelings of Overwhelm : Stress can make individuals feel overwhelmed or overloaded by responsibilities, tasks, or obligations. Sense of Loss of Control : Stress can lead to feelings of helplessness, powerlessness, or a lack of control over one's circumstances. Low Self-Esteem : Stress can negatively impact self-esteem and self-worth, leading to feelings of inadequacy or self-doubt. Social Withdrawal : Stress can cause individuals to withdraw from social interactions, preferring to isolate themselves from others. 
 Stress responses, often associated with feelings of discomfort or distress, actually serve a vital adaptive purpose in certain situations. The stress response, also known as the "fight-or-flight" response, is a physiological reaction triggered by perceived threats or challenges. While chronic or excessive stress can have negative effects on health, in certain contexts, stress responses can be adaptive and beneficial.  By activating physiological, cognitive, and behavioral responses, stress responses help individuals cope with threats or challenges, promote survival, and facilitate learning and adaptation. Understanding the adaptive nature of stress responses can help individuals develop effective coping strategies and harness the positive aspects of stress to navigate life's challenges more effectively. 
 


 Signs and Symptoms of Anxiety One of the biggest differences between stress and anxiety is the lack of a specific trigger.  Once a specific stressful situation is resolved, oftentimes, so goes the stress response. Anxiety can linger and not necessarily have an identifiable cause.  Along with the marks of stress, anxiety may come with additional distressing features including: 
 Excessive Worry :  Persistent and uncontrollable worrying about various aspects of life, including work, relationships, health, or future events. Irrational Fears:  Experiencing irrational or disproportionate fears about specific objects, situations, or activities, such as fear of heights, spiders, or social interactions. Emotional Symptoms:  Emotional symptoms of anxiety often include those of stress but add feelings of dread or a sense of impending doom. Pervasive Avoidance Behaviors:  Individuals with anxiety may engage in excessive avoidance behaviors to cope with their fears or discomfort, such as avoiding certain places, activities, or social situations that trigger anxiety. 
 Anxiety can have a significant impact on daily functioning in multiple domains of life.  Anxiety can hinder cognitive function, leading to difficulties concentrating, making decisions, or performing tasks effectively at work, school, or in daily activities. It can strain relationships and social interactions, causing communication breakdowns, withdrawal from social activities, or conflicts with others due to heightened stress levels.  Chronic and severe anxiety may lead to absenteeism from work or school due to challenges managing symptoms or feeling overwhelmed by responsibilities, impacting productivity and academic performance. 
 


 Recognizing Red Flags Recognizing when stress or anxiety is evolving into a more significant mental health concern is crucial for early intervention and effective management. While occasional stress and anxiety are normal, persistent and intense symptoms that interfere with daily life may indicate a more serious problem. This includes constant worrying, panic attacks, or overwhelming feelings of fear or dread.  Chronic physical symptoms may also indicate that stress or anxiety is taking a toll on both mental and physical health.  While occasional avoidance behaviors are normal, engaging in excessive avoidance to cope with stress or anxiety, such as avoiding social situations, responsibilities, or activities that trigger anxiety, can indicate a worsening condition.
 Increased reliance on substances such as alcohol, drugs, or prescription medications to cope with stress or anxiety may indicate the need for professional help.   Persistent thoughts of self-harm or suicide, or engaging in self-destructive behaviors, are serious warning signs that require immediate attention and intervention, including potential emergency services. 
 Self-awareness is essential in recognizing these signs and taking appropriate action to address them. It involves paying attention to one's thoughts, feelings, and behaviors, as well as being open to feedback from trusted friends, family members, or healthcare professionals.   



 When Should I Seek Counseling? Ultimately, the decision to seek counseling for stress and anxiety is a personal one, and there is no one-size-fits-all answer. However, if stress and anxiety are impacting your quality of life and ability to function effectively, seeking support from a trained therapist or counselor can be an important step towards healing and recovery.  In counseling, individuals work to identify triggers and patterns that contribute to their anxiety. By understanding the specific situations, thoughts, and behaviors that exacerbate anxiety symptoms, individuals can develop targeted coping strategies to manage their anxiety more effectively.
 Cognitive-behavioral therapy  (CBT) is a widely used approach in counseling for anxiety. CBT focuses on identifying and challenging negative thought patterns and beliefs that contribute to anxiety, replacing them with more adaptive and realistic thoughts. Therapists teach individuals practical skills and techniques to manage anxiety symptoms, such as relaxation exercises, mindfulness, and problem-solving strategies.  Exposure therapy is another effective technique used in counseling to treat anxiety disorders, particularly phobias and obsessive-compulsive disorder (OCD). Exposure therapy involves gradually exposing individuals to feared situations or stimuli in a controlled and supportive environment, allowing them to confront their fears and learn that they can tolerate and manage anxiety-provoking situations. Counseling helps individuals develop stress management skills to reduce the overall impact of stress on anxiety symptoms. Therapists may teach relaxation techniques, such as deep breathing, progressive muscle relaxation, or guided imagery to help individuals calm their minds and bodies in times of stress.  Counseling provides a safe and supportive space for individuals to explore the underlying factors contributing to their anxiety, such as past experiences, trauma, or unresolved emotions. By gaining insight into these underlying issues, individuals can begin to address them and reduce their impact on current anxiety symptoms.
 In conclusion, there are several key distinctions between stress and anxiety.  Stress is a natural response to external pressures or demands, while anxiety is a persistent and excessive worry or fear about future events or situations. Stress is typically tied to specific stressors and is often short-term, while anxiety can be ongoing and pervasive, lacking a clear trigger or may be disproportionate to the actual threat posed by a situation.  Stress can cause physical symptoms such as muscle tension, fatigue, and headaches, while anxiety may also present with physical symptoms but is often characterized by heightened arousal, irrational fears, and a sense of dread. 



 Heritage Counseling Can Help At Heritage Counseling, we specialize in stress management and anxiety counseling, providing personalized treatment plans tailored to your unique needs. Our therapists have extensive training and expertise in helping individuals navigate the complexities of stress and anxiety. We offer a range of therapeutic techniques and evidence-based approaches to help manage stress and anxiety including Cognitive Behavioral Therapy (CBT), Mindfulness-based Techniques, Relaxation training, and  Neurofeedback , a cutting-edge therapy that uses real-time brainwave monitoring to teach individuals how to regulate their brain activity. By providing feedback on brainwave patterns associated with stress and anxiety, Neurofeedback helps individuals learn to control their brain function, leading to reduced symptoms and improved emotional well-being. 
 It's crucial to be proactive in recognizing signs of stress and anxiety and seeking support when needed.  If you're struggling with stress or anxiety, don't hesitate to reach out to Heritage Counseling at 214-363-2345 for support and guidance. Our team of compassionate and experienced therapists is dedicated to helping you overcome obstacles, develop coping skills, and lead a more fulfilling life. Take the first step towards healing by contacting Heritage Counseling today. 





 




 Sources: https://www.apa.org/topics/stress/anxiety-difference#:~:text=People%20under%20stress%20experience%20mental,the%20absence%20of%20a%20stressor .  https://www.medicalnewstoday.com/articles/stress-vs-anxiety   https://www.mentalhealthfirstaid.org/external/2018/06/stress-vs-anxiety/   https://www.cmich.edu/podcast/episode/what's-the-difference-between-stress-and-anxiety   https://www.healthline.com/health/stress-and-anxiety   



















Understanding the Difference Between Stress and Anxiety

In 1990, only  3% of Americans  said they had no close friends; in 2021, nearly 12% said the same. The United States is in the grips of a  loneliness crisis  that predates the Covid pandemic.  Having adult friendships is important for many reasons, as they play a significant role in enhancing one's overall well-being and quality of life. They fulfill our need for social connection, emotional support, and personal growth, leading to improved mental and physical well-being and a richer, more fulfilling life. Cultivating and maintaining quality adult friendships should be a priority for overall life satisfaction and happiness. 



 The Health Benefits of Adult Friendships Research shows adult friendships provide multiple health benefits including: Emotional Support : Adult friendships provide a strong emotional support system, allowing you to share your thoughts, feelings, and concerns with people you trust. This emotional support can be invaluable during challenging times in your life. Reducing Isolation and Loneliness : Friendships combat feelings of isolation and loneliness, which can have detrimental effects on mental and physical health. Having friends to connect with helps you feel more connected to the world around you. Social Connection:  Human beings are inherently social creatures, and maintaining adult friendships allows you to fulfill your social needs for connection, interaction, and belonging. Increased Happiness and Decrease in Loneliness : Spending time with good friends often leads to feelings of joy, laughter, and happiness, which can improve your overall mood and well-being. Loneliness often stems from a lack of meaningful companionship. Friends provide companionship by spending time with you, offering a sense of togetherness, and reducing the sense of isolation.  Quality counts more than quantity. Stress Reduction : Friends can serve as a source of comfort and stress relief. Sharing your concerns with friends and receiving their support can help reduce stress levels. Improved Mental Health : Strong friendships are associated with lower rates of depression, anxiety, and other mental health issues. Friends can offer a sense of purpose and fulfillment in your life. Physical Health Benefits : Research has shown that strong social ties are associated with improved physical health, including reduced blood pressure and a lower risk of chronic illnesses. Emotional Resilience : Adult friendships contribute to your emotional resilience by providing a support system that helps you cope with adversity and bounce back from setbacks. 



 Setting Healthy Boundaries in Friendships Setting healthy boundaries in friendships is essential for maintaining positive and mutually respectful relationships.  Boundaries define the limits and expectations in a friendship, ensuring that both individuals feel comfortable and respected.  Before you can set boundaries, it's essential to understand your own needs, values, and limits. Reflect on what makes you comfortable or uncomfortable in your friendships and what you require to feel respected and safe.   Clear and open communication is the cornerstone of healthy boundaries. Talk to your friend about your feelings, needs, and expectations. Discuss what is and isn't acceptable in the friendship. Be honest and direct in your communication.  It's often easier to establish boundaries at the beginning of a friendship. However, it's never too late to set or adjust boundaries. If something makes you uncomfortable, address it as soon as possible. When discussing boundaries, be assertive rather than aggressive. Express your needs and feelings calmly and with respect. Avoid blaming or accusing your friend. Use "I" statements to convey your thoughts, e.g., "I feel uncomfortable when..."  In addition to expressing your boundaries, actively listen to your friend's perspective and boundaries. A healthy friendship involves a two-way dialogue where both individuals' needs are considered.  Understand that your friend may have different boundaries and comfort zones.  Consistency is key to maintaining healthy boundaries. Make sure to enforce your boundaries consistently, so your friend understands your limits and expectations.  Some boundaries may be non-negotiable, such as respecting your physical space or not tolerating disrespectful language. Be clear about these non-negotiable boundaries.  If something doesn't feel right or safe in the friendship, trust your instincts. It's okay to set boundaries or even consider whether the friendship is worth maintaining. If you're struggling to set or maintain healthy boundaries in a friendship, consider seeking support from a trusted friend, family member, or therapist who can provide guidance and perspective.  Remember that healthy boundaries are not about creating walls or barriers in your friendships but about fostering respectful and positive connections. When both you and your friend feel comfortable and understood, your friendship is more likely to thrive and endure. 



 Male Friendships: Beyond Stereotypes Male friendships, like friendships between people of any gender, are an essential and valuable aspect of life. These friendships often exhibit certain characteristics and dynamics that contribute to their unique nature.  It's important to note that stereotypes and societal expectations about masculinity can sometimes influence male friendships, potentially limiting emotional expression or openness. However, many men are challenging these stereotypes, advocating for more emotionally fulfilling and supportive friendships.  Modern male friendships are evolving, and many men are now comfortable expressing their feelings and providing emotional support to each other without judgment.  Vulnerability is key as it opens a potentially deeper connection beyond surface relationships.   Just like any other friendships, male friendships provide companionship and support. Having someone to talk to, spend time with, and rely on during challenging times is a fundamental aspect of these relationships.  Male friendships frequently involve shared activities and interests. These can range from sports and hobbies to common career pursuits. Engaging in shared activities can help strengthen the bond between male friends and provide a basis for connection.  Male friendships also often involve shared life experiences, such as going through school together, entering the workforce, and navigating the ups and downs of life. These shared experiences can create a strong sense of connection. Male friendships can be a source of support during significant life events, such as relationships, marriage, parenting, and career changes. Friends often provide advice, encouragement, and a listening ear during these transitions.  Men in friendships may engage in problem-solving and provide solutions to each other's challenges. This can be a constructive way to support and help one another. Ultimately, the nature of male friendships varies widely, and each friendship is shaped by the individuals involved and their personalities, values, and life experiences. What remains constant is the value of these friendships in providing companionship, support, and shared experiences throughout life. 



 Female Friendships: Nurturing Emotional Bonds Female friendships are a fundamental and cherished aspect of many people's lives. These friendships, characterized by their emotional intelligence, depth, support, and understanding, offer unique dynamics that contribute to their significance.  Female friendships often have a strong emotional bond. Women tend to express their feelings openly and are comfortable discussing personal and emotional topics with their friends.  Female friends are often highly empathetic and understanding, which can create a safe and nurturing environment for sharing and processing emotions. Communication is a cornerstone of female friendships. Conversations tend to be open, honest, and centered around personal experiences and feelings. Friends often listen actively and provide emotional support.  Female friendships can be empowering. Friends often encourage one another to pursue their goals, dreams, and ambitions, providing a strong support system for personal and professional growth. Women in friendships often take pride in celebrating each other's achievements, no matter how big or small, creating a “sisterhood effect.”  This notion refers to the positive impact and close bond that can exist between women, often characterized by mutual support, solidarity, and understanding. This concept emphasizes the importance of women supporting and empowering each other, both individually and collectively, offering genuine enthusiasm and support for each other's personal growth and self-discovery. Research has shown that strong female friendships can have positive effects on both mental and physical health. These friendships can reduce stress, promote a sense of belonging, and contribute to overall well-being.  Female friendships are multifaceted and can vary greatly from one friendship to another. What remains consistent is the emotional depth, support, and understanding that female friends offer to each other. These friendships play a crucial role in providing emotional connections, a sense of belonging, and a support system throughout life. 



 Friendships and Their Effects on Work Studies show Americans spend more than nine years at work over their lifetime, so it makes sense we are more likely to make friends at work than any other way. The impact of friendships in the workplace largely depends on the nature of the friendships, the work environment, and how individuals manage their professional and personal relationships. On the positive side, employees who are friends are more likely to share knowledge and information with each other, which can lead to better problem-solving and innovation within the organization.  Friendships can be a source of professional growth, offering advice, mentorship, and opportunities for skill development. Having friends at work can act as a stress buffer. Friends can provide emotional support during challenging times, reducing work-related stress.  When conflicts arise, friends may be more inclined to resolve them in a constructive and amicable manner, which can prevent conflicts from escalating. Having friends at work can enhance job satisfaction. Interactions with friends can make the work environment more enjoyable and fulfilling.  Friendships can promote better teamwork and collaboration. Employees who are friends may communicate more effectively and support each other in achieving common goals. Workplaces with strong social connections often have higher employee morale, creating a positive atmosphere and a sense of camaraderie. 



 Friendships and Romantic Relationships Friendship plays a significant and foundational role in romantic relationships. In many ways, a romantic relationship is often built upon a strong foundation of friendship, and it continues to be an important component throughout the course of the relationship. Balancing time and attention between friends and partners is a delicate art. It's crucial to ensure that both relationships receive the care and consideration they deserve. Effective communication is key; openly discussing expectations, boundaries, and the needs of both friends and partners can help strike the right balance. Quality time, rather than just quantity, is vital. Prioritizing the needs of both friendships and romantic relationships can lead to a harmonious life, where all relationships are nurtured. While there may be times when one requires more attention than the other, maintaining equilibrium ensures that both friends and partners feel valued and appreciated. Building a network of support for relationship challenges is a wise and proactive approach. It involves reaching out to trusted friends, family members, or even professionals who can offer guidance and a listening ear during difficult times in your relationship. This support network provides diverse perspectives, emotional comfort, and valuable insights that can help navigate challenges and conflicts. It's a way to strengthen your relationship by drawing upon the wisdom and encouragement of those who care about your well-being and the well-being of your partnership. 



 Conclusion In conclusion, the diverse benefits of adult friendships are undeniable, encompassing emotional support, stress reduction, personal growth, and enhanced well-being. It's crucial to nurture and cherish these valuable relationships, recognizing their profound impact on our lives. Healthy adult friendships contribute to our overall well-being and happiness, reminding us that the bonds we share with friends are truly treasures that enrich our journey through life.  If you are having difficulty creating or maintaining quality adult friendships, call Heritage Counseling at 214-363-2345 to speak to a clinician who can support you. 













 Sources: https://www.nytimes.com/2022/10/01/well/live/how-to-make-friends-adult.html   https://hbr.org/2022/10/the-power-of-work-friends https://www.nytimes.com/2022/05/07/well/live/adult-friendships-number.html   https://www.betterup.com/blog/making-friends-as-an-adult   https://edition.cnn.com/2021/07/20/health/romantic-relationships-start-as-friends-wellness/index.html  https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/friendships/art-20044860#:~:text=Boost%20your%20happiness%20and%20reduce,drinking%20or%20lack%20of%20exercise 


The Benefits of Adult Friendships 

Mental health issues have gained significant attention in today's fast-paced and interconnected world. Among these, depression is a condition that affects millions of people worldwide, cutting across age, gender, and socio-economic boundaries. Particularly alarming is the increasing prevalence of teenage depression. The adolescent years, already marked by numerous physical and emotional changes, can be further complicated by the onset of this debilitating mental health disorder.  



 Definition of Depression Depression, often referred to as major depressive disorder (MDD), is a serious mental health condition characterized by persistent feelings of sadness, loss of interest or pleasure in daily activities, changes in appetite and sleep patterns, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and recurrent thoughts of death or suicide. These symptoms significantly impair an individual's ability to function and negatively impact their overall well-being. 
 Depression affects the brain's neurochemistry, altering the balance of neurotransmitters such as serotonin, norepinephrine, and dopamine, which play crucial roles in regulating mood, motivation, and pleasure. The causes of depression are multifactorial, including genetic predisposition, chemical imbalances, hormonal changes, life events (such as trauma, loss, or chronic stress), and certain medical conditions. 



 Rise in Depression Among Teenagers In recent years, numerous studies have indicated a troubling rise in teen depression. According to the World Health Organization (WHO), depression is now among the leading causes of illness and disability worldwide among individuals aged 10 to 19 years. This highlights the urgent need for understanding and addressing this concerning trend. 
 Several factors contribute to the rise in teenage depression. The advent of social media and the digital age has introduced new challenges, including cyberbullying, social comparison, and constant connectivity, which can exacerbate feelings of isolation, inadequacy, and anxiety.  Academic pressures, family conflicts, substance abuse, and a lack of coping mechanisms also contribute to the increased vulnerability of teenagers to depression. 
 Moreover, the COVID-19 pandemic has further intensified the mental health crisis among teenagers. The disruptions in routines, social isolation, and uncertainties about the future have magnified stressors and amplified feelings of anxiety and teenage depression. A study published in JAMA Pediatrics in 2021 found a significant increase in depressive symptoms among teenagers during the pandemic, with prevalence rates reaching 25%. 



 Common Symptoms of Teenage Depression Depression symptoms can vary in severity, but changes in your teen's emotions and behavior may include the examples below. 
 Emotional Changes: Be alert for emotional changes, such as: Feelings of sadness, which can include crying spells for no apparent reason Frustration or feelings of anger, even over small matters Feeling hopeless or empty Irritable or angry/annoyed mood Loss of interest or pleasure in usual activities Loss of interest in, or conflict with, family and friends Low self-esteem Feelings of worthlessness or guilt Fixation on past failures or exaggerated self-blame or self-criticism Extreme sensitivity to rejection or failure, and the need for excessive reassurance Trouble thinking, concentrating, making decisions, and remembering things Ongoing sense that life and the future are grim and bleak Frequent thoughts of death, dying, or suicide 
 Behavioral Changes: Watch for changes in behavior, such as: Tiredness and loss of energy Insomnia or sleeping too much Changes in appetite - decreased appetite and weight loss, or increased cravings for food and weight gain Use of alcohol or drugs Agitation or restlessness - for example, pacing, hand-wringing, or an inability to sit still Slowed thinking, speaking, or body movements Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse Social isolation Poor school performance or frequent absences from school Less attention to personal hygiene or appearance Angry outbursts, disruptive or risky behavior, or other acting-out behaviors Self-harm — for example, cutting or burning Making a suicide plan or a suicide attempt 
 It is important to note that not all teenagers will exhibit all these symptoms, and the severity and duration of symptoms can vary. The lists above are common symptoms but not exhaustive.  If you suspect that a teenager may be experiencing depression, it is crucial to seek professional help and support from a mental health practitioner or a healthcare provider. 



 Possible Causes of Teenage Depression The causes of teenage depression are complex and can involve a combination of biological, genetic, environmental, and psychological factors. Here are some possible causes of teenage depression: Biological factors : Certain imbalances in brain chemicals called neurotransmitters, such as serotonin, norepinephrine, and dopamine, can contribute to depression. Hormonal changes during adolescence may also play a role. Genetics : Teenagers with a family history of depression are more likely to experience depression themselves. There is evidence to suggest that certain genes may make individuals more susceptible to developing depression. Environmental factors : Various environmental factors can contribute to teenage depression, including: Stressful life events: Traumatic experiences, such as the loss of a loved one, divorce, abuse, or bullying, can trigger or worsen depression in teenagers. Academic and peer pressure: High expectations, intense academic workload, social isolation, or difficulty fitting in with peers can contribute to depressive symptoms. Family dynamics: Conflict, unstable family relationships, or a lack of emotional support within the family can increase the risk of depression. Substance abuse: Teenagers who abuse drugs or alcohol are more susceptible to depression. Substance abuse can both be a cause and a consequence of teen depression. Psychological factors : Certain psychological factors can make teenagers more vulnerable to depression: Low self-esteem: Negative self-perception, feelings of inadequacy, or poor body image can contribute to depressive symptoms. Negative thinking patterns: Teenagers who tend to have negative thoughts, pessimistic outlooks, or a tendency to ruminate on negative experiences may be more prone to depression. Coping skills: Lack of healthy coping mechanisms to deal with stress, emotions, and difficult life situations can increase the risk of developing depression. Learning disabilities or attention deficit hyperactivity disorder (ADHD) 
 It's important to note that these factors may interact and influence each other, and not all teenagers who experience these factors will develop depression. The individual experience of teen depression can vary, and a comprehensive assessment by a mental health professional is necessary to determine the specific causes and appropriate treatment for each person. 



 Recognizing Ten Warning Signs Adolescent suicide is the second leading cause of death, following accidents, among youth and young adults in the U.S. It is estimated that 500,000 teens attempt suicide every year with 5,000 succeeding. These are epidemic numbers.  Four out of five teens who attempt suicide have given clear warnings signs which could include:
 Suicide threats, direct and indirect (talking or joking about committing suicide) Obsession with death which might include speaking positively about death or romanticizing dying (“If I died, people might love me more”) or saying things like, “I’d be better off dead,” “I wish I could disappear forever,” or “There’s no way out” Poems, essays, and drawings that refer to death, dying, or suicide Giving away belongings Irrational, reckless, or bizarre behavior possibly resulting in having a lot of accidents resulting in injury A dramatic change in personality or appearance Severe drop in school performance Marked change in eating or sleeping patterns Seeking out weapons, pills, or other ways to commit suicide Saying goodbye to friends and family as if for the last time 
 Pay attention to these warning signs as they should be taken seriously!  Immediate help could save a young life. 



 Conclusion Depression is a complex mental health disorder that poses significant challenges to the well-being and development of teenagers. The alarming rise in teens with depression demands urgent attention from parents, educators, and healthcare professionals. By fostering open conversations, promoting mental health awareness, and providing access to appropriate support and interventions, we can work towards a future where teenagers are better equipped to navigate their formative years' emotional ups and downs.  
 If you notice your teen is struggling with the symptoms of depression discussed above, please reach out to Heritage Counseling & Consulting at 214-363-2345 for information on meeting with one of our clinicians who can provide guidance on how to work through teenage depression.  Together, we can strive for a world where mental health receives the attention it deserves, and teenagers are empowered to lead fulfilling and mentally resilient lives. 











 Sources: https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985 https://medlineplus.gov/teendepression.html https://www.mhanational.org/depression-teens-0 https://www.helpguide.org/articles/depression/parents-guide-to-teen-depression.htm https://www.webmd.com/depression/guide/teen-depression https://symptommedia.com/major-depressive-disorder-dsm-5/ Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr. 2021 Nov 1;175(11):1142-1150. doi: 10.1001/jamapediatrics.2021.2482. PMID: 34369987; PMCID: PMC8353576. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health 

10 Warning Signs of Depression in Teens 

 Postpartum Depression Postpartum depression  (PPD) is an extreme mood disorder that can affect women after childbirth. It is a type of depression that can occur within the first few weeks or months after delivery, but it can also develop up to a year after giving birth.

PPD can cause feelings of sadness, anxiety, despair, and a lack of interest in things that were once enjoyable. Women with PPD may experience difficulty sleeping, changes in appetite, severe mood swings, extreme sadness or loneliness, fatigue, and difficulty bonding with their babies.  PPD is thought to be caused by a combination of hormonal changes, genetic factors, and environmental factors such as stress or lack of support.  Postpartum depression is not a character flaw or weakness.  It can be simply a complication of giving birth.*** Postpartum depression is relatively common and can affect up to 1 in 7 women who give birth (about 15 percent). It's important to note that postpartum depression is different from the "baby blues," which is a mild and short-lived condition that affects up to 80% of women after giving birth. **

The symptoms of postpartum depression are more severe and longer-lasting than the baby blues and can significantly impact a woman's ability to function and care for her baby. Risk factors for postpartum depression include a personal or family history of depression or anxiety, stressful life events, lack of social support, and complications during pregnancy or childbirth. 

Fortunately, postpartum depression is a treatable condition, and with the right support and treatment, most women are able to recover and enjoy a healthy and fulfilling life with their newborn babies. 


 Symptoms of Postpartum Depression The symptoms of postpartum depression can vary in severity and duration, but they typically develop within the first few weeks or months after childbirth. Some common symptoms of postpartum depression include:* ·  	Depressed mood present most of the day including feelings of sadness, hopelessness, or despair ·  	Loss of interest in activities you used to enjoy ·  	Overwhelming fatigue or lack of energy ·  	Changes in appetite or sleep patterns (insomnia/hypersomnia) ·  	Difficulty concentrating or making decisions ·  	Intense irritability or restlessness ·  	Anxiety or panic attacks ·  	Feelings of guilt or worthlessness ·  	Withdrawing from family and friends ·  	Thoughts of harming yourself or your baby ·  	Difficulty bonding with your baby ·  	Feelings of worthlessness, shame, guilt, or inadequacy ·  	Fear that you are not a good mother

 It's important to note that not all women with postpartum depression will experience these symptoms, and some may have additional symptoms not listed here. It's also important to distinguish postpartum depression from the "baby blues," which is a milder and more common condition that affects many new moms after giving birth.  You might have the baby blues if you:***   ·  	Have crying spells ·  	Feel overwhelmed ·  	Lose your appetite ·  	Have trouble sleeping ·  	Have sudden mood changes   The baby blues typically resolve on their own within a few days to a couple of weeks, while postpartum depression can last much longer and require professional treatment. If you're experiencing any of these symptoms, it's important to talk to your healthcare provider as soon as possible.   


 Can PPD be prevented? While there is no guaranteed way to prevent postpartum depression in new moms, some steps can reduce the risk of developing the condition. Some strategies to prevent postpartum depression include:

1.  Building a strong support system : Having a strong support system of family, friends, or a postpartum support group can help reduce stress and feelings of isolation, which are risk factors for postpartum depression.
 
2.  Getting enough rest : Adequate sleep and rest can help improve mood and reduce the risk of postpartum depression. If possible, try to get enough sleep by napping when your baby naps, and asking for help with nighttime feedings.
 
3.  Exercising regularly : Exercise can help boost mood, reduce stress, and improve sleep, which are all factors that can help prevent postpartum depression. Start with light exercises such as walking, yoga, or stretching, and gradually increase the intensity as you feel comfortable.
 
4.  Eating a healthy diet : Eating a well-balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins can help improve mood and reduce the risk of postpartum depression.  Avoid skipping meals and try to eat small, frequent meals throughout the day. 5.  Practice relaxation techniques : Relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation can help reduce stress and anxiety.

 6.  Prioritize self-care : It's important to make time for yourself and prioritize self-care activities such as taking a warm bath, reading a book, or getting a massage.  It is not selfish to take care of your needs.

 7.  Seeking help early : If you're feeling overwhelmed or struggling with your emotions, it's important to seek help early.  Postpartum depression is a treatable condition, and many effective treatments are available, including therapy and medication. Talk to your healthcare provider about your options and don't hesitate to ask for help.

 While these strategies can reduce the risk of postpartum depression, it's important to remember that the condition can affect anyone, even those who take steps to prevent it.   


 How to Take Care of Yourself as a New Mom with Postpartum Depression Taking care of yourself as a new mom with postpartum depression can be challenging, but it's essential for your health and well-being.  New mothers may feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy.  Any woman can become depressed during pregnancy or after having the baby, so it doesn’t mean you are a bad mom.  You are not alone.  You and your baby don’t have to suffer.  Talk about your feelings with your partner, supportive family members, and friends.    Avoid, if possible, making major life changes right after giving birth.  More major life changes, like moving or changing jobs, in addition to a new baby can cause unnecessary stress.  Sometimes big changes can’t be avoided so try to arrange support and help for your new situation beforehand.****   The first line of treatment for PPD is counseling and antidepressant medications.  Counseling alone may suffice for women with mild to moderate postpartum depression, especially if new moms are hesitant about starting medications and are going to nurse their newborns; however, there are pharmacological treatments safe for nursing moms. A combination of therapy and antidepressant drugs is recommended for women with moderate to severe depression.*****   


 Counseling for Postpartum Depression Several types of counseling can be effective in treating postpartum depression, and the best type of counseling for you will depend on your individual needs and preferences. Treatment is often short-term (12-16 sessions).  Some common types of counseling for postpartum depression include:**

1.  Cognitive-behavioral therapy (CBT ): CBT is a type of therapy that focuses on changing negative thought patterns and behaviors. CBT can be effective in treating postpartum depression by helping you identify and challenge negative thoughts and behaviors that contribute to your symptoms.
 
2.  Interpersonal therapy (IPT ): IPT is a type of therapy that focuses on improving your relationships and communication skills. IPT can be effective in treating postpartum depression by addressing issues in your relationships that may be contributing to your symptoms.
 
3.  Supportive therapy : Supportive therapy is a type of therapy that focuses on providing emotional support and guidance. Supportive therapy can be effective in treating postpartum depression by providing a safe and supportive space to talk about your experiences and emotions.
 
4.  Group therapy : Group therapy is a type of therapy that involves meeting with a group of other individuals who are experiencing similar issues. Group therapy can be effective in treating postpartum depression by providing a supportive environment where you can connect with other new moms who are going through similar experiences.
 
It's important to find a therapist specializing in treating postpartum depression and who has experience working with new mothers.  The growing team at Heritage Counseling & Consulting is ready to provide the help you need including in-person and virtual counseling appointments. Call Heritage Counseling & Consulting at  214-363-2345  to get more information and schedule your first appointment.    Sources * https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617     ** https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-depression     *** https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression     **** https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression     ***** https://www.ncbi.nlm.nih.gov/books/NBK519070/ 

What is Postpartum Depression?

 Mental Health America  (MHA), the nation’s leading community-based nonprofit committed to focusing on the needs of those living with mental health disorders, has released a 2023 report of The State of Mental Health in America. *  They collected information across all 50 states and the District of Columbia to provide a glimpse of state and national mental health among adults and youth.  Measuring community health needs and care access using national survey data, gathered through 2020, allowed MHA to rank states, showing which were most effective at tackling mental health issues.  Unfortunately, Texas ranked 46th overall, indicating a high prevalence of mental illness with a low rate of access to care compared to other states.  Key Findings from the 2023 report are as follows: ** 21% of adults, equating to over 50 million Americans, suffered from a mental illness in 2019-2020.  Texans populate over 3.8 million of those Americans. Texas ranked last in access to care rankings, indicating how much mental health care access exists within a state.  The access measure includes access to treatment, insurance, quality and cost of insurance, special education services, and mental health workforce availability.  The vast majority of individuals with a substance use disorder in the U.S. are not receiving treatment .  15% of adults had a substance use disorder in the past year. Of those, 94% did not receive any form of care. Millions of adults in the U.S. experience serious thoughts of suicide, with the highest rate among multiracial individuals .  The percentage of adults reporting serious thoughts of suicide is 4.84%, totaling over 12.1 million individuals. 11% of adults who identified with two or more races reported serious thoughts of suicide in 2020 – 6% higher than the average among all adults.  Texas ranks below the average (ranked #3), with 4.12% of adults reporting serious thoughts of suicide. Over 1 in 10, youth in the U.S. are experiencing depression that is severely impairing their ability to function at school or work, at home, with family, or in their social life .  16.39% of youth (age 12-17) report suffering from at least one major depressive episode (MDE) in the past year. 11.5% of youth (over 2.7 million youth) are experiencing severe major depression.  Texas is in line with the national average. Over half (54.7%) of adults with a mental illness do not receive treatment, totaling over 28 million individuals. In Texas (ranked #47), over 6 in 10 adults with a mental illness did not receive care. Almost a third (28.2%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. 42% of adults with any mental illness reported they were unable to receive necessary care because they could not afford it.  Texas is slightly above the national average   at 29.6%. 10.8% (over 5.5 million) of adults with mental illness are uninsured. Hispanic adults with any mental illness (AMI) were least likely to have health insurance, with 19% reporting they were not covered by insurance.  Texas ranked 50th with over 21% of its residents with AMI uninsured.  As of 2019-2020, Texas had not expanded Medicaid, which may explain why so many in Texas are uninsured for mental health care. 6.34% of youth in the U.S. reported a substance use disorder in the past year .  That is equivalent to over 1.5 million youth in the U.S. who meet the criteria for an illicit drug or alcohol use disorder. 22.87% of adults who report experiencing 14 or more mentally unhealthy days each month were not able to see a doctor due to costs. In Texas (ranked 49), over one-third of adults experiencing frequent mental distress are unable to afford a doctor’s visit. 59.8% of youth with major depression do not receive any mental health treatment .  Asian youth with major depression were least likely to receive specialty mental health care, with 78% reporting they did not receive mental health services in the past year. In Texas, the 2nd to last ranked state behind South Carolina, three-quarters of youth with major depression did not receive mental health services.  That’s nearly 8 in 10 youth who receive no care. Nationally, only 28% of youth with severe depression receive some consistent treatment (7-25+ visits in a year).  Most (57.3%) youth with severe depression do not receive any care.  In Texas, only 13% of youth with depressive episodes that have severely impacted functioning receive consistent care. Nationally, 1 in 10 youth who are covered under private insurance do not have coverage for mental or emotional difficultie s  – totaling over 1.2 million youth .  In Texas (ranked 50), nearly 1 in 5 youth with private insurance do not have coverage for mental health care. Only .718 percent of students are identified with emotional disturbance for an individualized education program (IEP). IEPs, with sufficient resources for schools and teachers, are critical for ensuring that youth with disabilities can receive the individualized services, support, and accommodations to succeed in a school setting. Texas is in line with this average. In the U.S., there are an estimated 350 individuals for every 1 mental health provider .  However, these figures may be an overestimate of active mental health professionals, as they may include providers who are no longer practicing or accepting new patients.  Texas is poorly ranked 50th with one mental health worker per 760 people. 
 While Texas may rank poorly in access to mental health care and the number of health care providers available, the growing team at Heritage Counseling & Consulting is ready to provide a variety of mental health treatments including in-person and virtual counseling appointments with a diversity of talented clinicians. Additionally, we provide Psychological Evaluations, such as ADD/ADHD and Autism Testing, and non-invasive alternative treatment options like Neurofeedback Therapy.  If you want to improve your mental health and meet a clinician who cares about your goals, please contact Heritage Counseling & Consulting at  214-363-2345 .   
 
 * Reinert, M, Fritze, D. & Nguyen, T. (October 2022). “The State of Mental Health in America 2023” Mental Health America, Alexandria VA. **  www.mhanational.org/issues/state-mental-health-america 
 

The State of Mental Health in Texas

As Daylight Savings begins, we tend to notice an upswing in seasonal depression. Seasonal affective disorder (SAD), also known as seasonal depression, is a type of depression triggered by a change in seasons. This seasonal depression worsens when the temperatures drop and the days get shorter in the late fall or early winter before ending in the sunnier days of spring.  Some people get a rare form of SAD called “summer depression” that starts in the late spring or early summer and ends in the fall.   Around 10% - 20% of Americans suffer from a mild version of SAD known as the “winter blues.” It is normal to feel a little down during colder months when you may be stuck inside and it gets dark early; however, full SAD goes beyond this. It’s a form of clinical  depression . Unlike the winter blues, SAD affects your daily life and activities, including how you feel and think.  About 5% of adults in the U.S experience seasonal depression. It tends to start in young adulthood (usually between 18 and 30), and seasonal depression affects women four times more than men, though researchers aren’t sure why.*    What are the Symptoms of Seasonal Depression? Seasonal depression symptoms may start mild and become more severe as the season progresses.  Once the depression hits, often lasting 4-5 months, the symptoms mimic those of nonseasonal depression, including loss of motivation for work or other activities, reduced social contact, and anxiety. The difference is that the onset of the SAD episode is predictable, and countermeasures can begin before the mood swing is severe. In that sense, those affected with seasonal depression are able to notice warning signs a bit easier than their cohorts with nonseasonal depression. *** Signs and symptoms of Seasonal Depression may include:** ·   	Feeling listless, sad, or down most of the day, nearly every day ·   	Losing interest in activities you once enjoyed ·   	Having low energy and feeling sluggish ·   	Arms and legs that feel heavy ·   	Having problems with sleeping too much ·   	Experiencing carbohydrate cravings, overeating, and weight gain ·   	Having difficulty concentrating ·   	Feeling hopeless, worthless, or guilty ·   	Anxiety ·   	Having thoughts of not wanting to live   Fall and Winter SAD Symptoms specific to winter-onset SAD, sometimes called winter depression or winter blues, may include: ·   	Oversleeping ·   	Appetite changes, especially a craving for foods high in carbohydrates ·   	Weight gain ·   	Tiredness or low energy   Spring and Summer SAD Symptoms specific to summer-onset seasonal affective disorder, sometimes called summer depression, may include: ·   	Trouble sleeping (insomnia) ·   	Poor appetite ·   	Weight loss ·   	Episodes of violent behavior ·   	Restlessness, agitation, or anxiety ·   	Increased irritability   

 Healthy Ways to Manage SAD The good news is there are several evidence-backed ways to find relief. Bright light therapy Since the 1980s, light therapy has been a mainstay for the treatment of SAD. It aims to expose those with seasonal depression to a bright light every day to make up for the diminished natural sunshine in the darker months.  This involves sitting in front of a light therapy box, which mimics outdoor light, from fall to spring for about 30 minutes every day right when you wake up, preferably early in the morning (before 8 a.m.). This should stimulate your body to produce the right hormones to increase your wakefulness and alertness to get you through the day. When searching for a light therapy lamp, you want one that advertises 10,000 lux brightness — the equivalent of a bright summer morning. A good light therapy lamp should also be “full spectrum,” meaning it emits light that closely mimics natural morning sunlight. ****   Medication Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are also used to treat seasonal depression when symptoms occur. These agents can significantly enhance patients' moods. Commonly used SSRIs include fluoxetine, citalopram, sertraline, paroxetine, and escitalopram. The U.S. Food and Drug Administration (FDA) also has approved another type of antidepressant, bupropion, in an extended-release form, that can prevent the recurrence of seasonal major depressive episodes when taken daily from the fall until the following early spring. All medications can have side effects. Talk to your doctor about the possible risk of using these medications for your condition. You may need to try several different antidepressant medications before finding one that improves your symptoms without causing problematic side effects. ***** Vitamin D Because many people with SAD often have vitamin D deficiency, nutritional supplements of vitamin D may help improve their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect. *****   Go Outside Simply going outside can help boost your mood.  Even if it looks a little gray, the quality of light on a winter morning will be better than what you can get in your home and an excursion will most likely boost your mental health. With a little creativity and problem-solving, you can still find ways to enjoy the season you are in.  If your favorite summer activity is lying by the beach, you might come up with a version of that like lying on a sled and heading down a snowy hill.  Even snowshoeing or ice skating could help you positively engage with an otherwise gray winter.**** 
 Therapy for Seasonal Depression Cognitive behavioral therapy (CBT) is a type of talk therapy aimed at helping people learn how to cope with difficult situations; CBT also has been adapted for people with SAD (CBT-SAD). It focuses on replacing negative thoughts related to the winter season (e.g., about the darkness of winter) with more positive thoughts. CBT-SAD also uses behavioral activation, which helps individuals identify and schedule pleasant, engaging indoor or outdoor activities to combat the loss of interest they typically experience in the winter. When researchers directly compared CBT with light therapy, both treatments were equally effective in improving SAD symptoms. Some symptoms got better faster with light therapy than with CBT. However, a long-term study that followed SAD patients for two winters found that the positive effects of CBT seemed to last longer over time. ***** 


 Seasonal Affective Disorder is something many people experience, and there are many healthy ways to treat and prevent it. If you or someone you know is looking for professional help with Seasonal Affective Disorder (SAD), please give us a call at 214-363-2345 to get more information and schedule an appointment.   Sources:  * https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression ** https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651   *** https://healthmatters.nyp.org/what-to-know-about-seasonal-affective-disorder/   ****   https://www.nytimes.com/explain/2022/seasonal-depression   ***** https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder   









Seasonal Depression

What is the 988 Suicide and Crisis Hotline?  On July 16, 2022, the National Suicide Prevention Lifeline number transitioned to just three digits:  988 . The new 988 suicide prevention hotline replaces the 1-800-273-8255 (TALK) number for the Lifeline; however, this number will still work. Text messages can be sent to 988 as well.*   The 988 Hotline provides free and confidential emotional support to people in suicidal crisis or emotional distress, 24 hours a day, 7 days a week, across the United States. Launched in 2005, the Lifeline consists of a national network of more than 200 local crisis centers that help thousands of people overcome crisis situations every day. These centers are supported by local and state sources as well as the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) combining local care and resources with national standards and best practices.*** Suicide is the  second  leading cause of death  in the United States among ages 15–24.  According to a CDC report, youth suicide rates have risen by 35 percent since the start of the 21st century, and the number of teens admitted to children’s hospitals as a result of suicidal thoughts or self-harm has more than doubled during the last decade.  As youth suicide rates continue to increase, the goal of the new 988 hotline is to make assistance more easily accessible in a moment of crisis.*  Modeled after 911, the new three-digit  988 Suicide & Crisis Lifeline  is designed to be a memorable and quick number that connects people who are having suicidal thoughts or in  any other  mental health crisis to a trained mental health professional.*** "One of the goals of 988 is to ensure that people get the help they need when they need it, where they need it. So when a person calls 988, they can expect to have a conversation with a trained, compassionate crisis counselor who will talk with them about what they're experiencing. If it's the case that they need further intervention, then likely the crisis counselor will connect with a local mobile crisis team," Dr. Miriam Delphin-Rittmon, the administrator of SAMHSA, said earlier this month during a call with reporters.****  At a recent press briefing, Xavier Becerra, the secretary of the federal Department of Health and Human Services affirmed, "If you are willing to turn to someone in your moment of crisis, 988 will be there; the 988 hotline won't be a busy signal and 988 won't put you on hold. You will get help."*** Numerous studies have shown that callers feel less suicidal, less depressed, less overwhelmed and more hopeful after speaking with a LIfeline mental health crisis counselor.**     What happens when you call 988?  According to the 988 lifeline website, when someone  calls  the 988 Hotline with a mental health crisis, the call flow is as follows:** Caller hears an automated greeting with the additional option to press “1”  if they are in the military or calling about someone who has served. Pressing  “1” will send the caller to the Veteran Crisis Line, which serves our nation’s Veterans, service members, National Guard and Reserve members, and those who support them. For texts, Veterans should continue to text the Veterans Crisis Lifeline short code: 838255.*****   A caller can press “2” if they need a Spanish speaking counselor. If the caller does not press a prompt, they will listen to some music while connecting to a skilled, trained crisis counselor in the closest local center based on area code.  If the local center is unable to answer, the call is transferred to the national backup network. A mental health crisis counselor will listen to the caller, work to understand what the caller is experiencing, provide them support, and collaborate with the caller on ways to feel better and get further local help or resources.
 When someone  texts  the 988 hotline, they will complete a short survey that helps the counselor better understand their current situation, and then they will be connected to a mental health crisis counselor.
 The 988 suicide hotline fills a big gap in mental health crisis care.  Currently, the majority of people experiencing a mental health emergency end up dialing 911.  The problem is that 911 wasn't set up to address mental health needs. Callers can end up in a chaotic emergency room, waiting for hours and sometimes days to get care, or they might interact with law enforcement, which can lead to tragedy and/or trauma.  Mental health advocates hope that the 988 hotline will become a widely known, safer and more effective alternative.*** 


 Ongoing support after calling 988 
For continued mental health care, it’s important to contact a counselor who can attend to your care on a regular basis. While a 988 hotline counselor can help you with an immediate mental health crisis, regular therapy can help you deal with life’s many challenges and enjoy a more fulfilled life. It can help you understand  what  you’re feeling,  why  and  how  to cope. Just like visiting your doctor for regular wellness exams, or your dentist for checkups, meeting regularly with a therapist can help keep your mental health in order.****** Call Heritage Counseling at 214-363-2345 to get more information about ongoing counseling appointments and other services we can provide.  





 Sources: * https://www.newporthealthcare.com/resources/industry-articles/988-suicide-prevention-hotline ** https://988lifeline.org/current-events/the-lifeline-and-988/   *** https://www.npr.org/sections/health-shots/2022/07/15/1111316589/988-suicide-hotline-number   **** https://www.cnn.com/2022/07/16/health/988-national-suicide-prevention-lifeline-launches/index.html   ***** https://www.fcc.gov/988-suicide-and-crisis-lifeline   ****** https://www.dbhutah.org/reasons-to-see-a-therapist/   

988: The New Three-Digit Suicide Prevention Hotline

Nicole is a native of Little Rock, Arkansas and graduated from Harding University with a Bachelor of Business Administration in Accounting.  She obtained her CPA while working in Big Four public accounting.  After moving to Texas, she stepped away to focus on raising her children, volunteer work, and expanding the family business.  Eventually, her love and compassion for people moved her to complete a Master of Arts in Biblical Counseling from Dallas Theological Seminary.  Following graduation, she joined Heritage.

Nicole McAfee

Nicole McAfee, B.B.A., M.A.B.C., LPC-Associate