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All couples go through difficult times. We fall in love, commit to one another through marriage or within our own hearts. Life moves so beautifully fluent… until it doesn’t. One day we look up and realize that a small whisper of “something’s not quite right” has turned into a screeching cry of “nothing is right!” giving chills – like fingernails on a blackboard… Or, worse, the deafening silence of that given up voice that can no longer find itself.
We have experience in helping couples work better, heal from old wounds, and increase overall relationship satisfaction through:
Learning better Communication
Conflict Resolution — actually learning to work through conflict!
Increased Intimacy
Trust building and re-building
Affair recovery
Creating a Relationship Vision
Resentment Release — letting go of past hurt and anger through resolution
Whether your relationship is in crisis, or if you just need a tune up, the benefit of getting experienced professional help can make a big difference.
Taking care of your relationship means taking care of your family — even if it’s just the two of you!
Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships. There are several different types of anxiety disorders. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder.
People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms.
Generalized anxiety disorder symptoms include:
People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.
Panic disorder symptoms include:
People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.
Social anxiety disorder symptoms include:
A thorough mental health evaluation is important, because anxiety disorders sometimes co-exist with other related conditions, such as depression or obsessive-compulsive disorder.
Call us, our experienced therapists understand anxiety and can help!
All couples go through difficult times. We fall in love, commit to one another through marriage or within our own hearts. Life moves so beautifully fluent… until it doesn’t. One day we look up and realize that a small whisper of “something’s not quite right” has turned into a screeching cry of “nothing is right!” giving chills – like fingernails on a blackboard… Or, worse, the deafening silence of that given up voice that can no longer find itself.
We have experience in helping couples work better, heal from old wounds, and increase overall relationship satisfaction through:
Whether your relationship is in crisis, or if you just need a tune up, the benefit of getting experienced professional help can make a big difference.
Taking care of your relationship means taking care of your family — even if it’s just the two of you!
If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, or pessimism
Irritability
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease with treatment
Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.
Counseling can help with depression. Call us, we care.
Below is a brief explanation regarding the effects of stress to overall health (from NIMH, National Institute for Mental Health)
The body responds to each type of stress in similar ways. Different people may feel it in different ways. For example, some people experience mainly digestive symptoms, while others may have headaches, sleeplessness, depressed mood, anger and irritability. People under chronic stress are prone to more frequent and severe viral infections, such as the flu or common cold, and vaccines, such as the flu shot, are less effective for them.Of all the types of stress, changes in health from routine stress may be hardest to notice at first. Because the source of stress tends to be more constant than in cases of acute or traumatic stress, the body gets no clear signal to return to normal functioning.
Over time, continued strain on your body from routine stress may lead to serious health problems, such as heart disease, high blood pressure, diabetes, depression, anxiety disorder, depression, obsesive-compulsive disorder and other illnesses.
Call us! Our experienced therapists have a lot of stress-busting techniques and stress reducing practices to help you live a healthier life!
Divorce is one of the hardest things you can go through. You are not only grieving what you lost, you are grieving what you thought you might have, if only…. You are grieving the past and your future, and that’s painful.
Unfortunately, sometimes marriages do not succeed long-term and divorce is the most practical end result. While the end of a marriage can be a relief for some parties involved, it is often also a stressful situation, no matter how amicable it may be. One or both partners in the marriage may experience a range of emotions, including grief, anger, confusion, fear, shame, anxiety, etc., even if one or both of the partners want to leave. If children are involved, stress levels can be even greater. Divorce counseling helps manage this pain, anger, stress, and sadness in a healthy way.
Some trauma is little — we call that trauma with a “little t.” Some trauma is big, we call that “big T” trauma. Hillside Counseling has therapists who are experienced in helping people with both simple and complex trauma, big and little. The following is a bit of information about the lingering effects that can occur after a trauma — commonly known as PTSD (post traumatic stress disorder).
Check out the Adverse Childhood Experiences Tab Below!
(from NIMH, National Institute for Mental Health)
PTSD is a disorder that develops in some people who have seen or lived through a shocking, scary, or dangerous event. (An “event” may be something sudden or over time)
It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are not in danger.
Not every traumatized person develops ongoing (chronic) or even short-term (acute) PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.
To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.
It is natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, the person may have developed PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.
Call us and get paired up with an experienced therapist who can help you heal from trauma — whether it’s a big trauma or a little trauma, we can help.
Grief is a normal part of loss. It is the container inside of us that holds what has once been outside of us – a career, a pet, a family constellation, one’s own health, a loved one, etc. What once was tangible and touchable is (after loss) mostly held within. Our grief container keeps our thoughts, what we feel, how we describe, our behaviors – reflecting what and who we have lost.
There are models for processing through grief, Elizabeth Kubler-Ross being perhaps the most notable for proposing the 5 stages of grief: denial (disbelief), anger, bargaining, depression, and acceptance. While an informative model, we now know that processing through grief can be more complicated and messier than that of five stages.
Mourning is our outward expression of our inside grief. It is an important part of the process. Sharing with others and expressing feelings and thoughts with understanding and compassionate people is a healthy part of mourning.
Counseling is often a helpful way to navigate through grief and mourning.
Call us and get paired with a therapist who is a good fit to help walk alongside and help you process and move through your grief and loss through healthy mourning.
How do I know if I have a problem? While there are certainly diagnostic criteria (as described below) in our experience working with people who are trying to figure out their substance use there is often a knowledge within the person that states the answer to that question. In other words, a look in the mirror, an echoing within one’s own ear can usually help you tell yourself the truth.
According to the DSM-5, a “substance use disorder describes a problematic pattern of using alcohol or another substance that results in impairment in daily life or noticeable distress.” As with most addiction problems, despite any consequences a person who has a problem with either alcoholism or drugs suffers, they will generally continue to use their drug of choice. They may make attempts to stop or cut back their use, usually to no avail.
The DSM-5 states that in order for a person to be diagnosed with a disorder due to a substance, they must display 2 of the following 11 symptoms within 12-months:
Consuming more alcohol or other substance than originally planned
Worrying about stopping or consistently failed efforts to control one’s use
Spending a large amount of time using drugs/alcohol, or doing whatever is needed to obtain them
Use of the substance results in failure to “fulfill major role obligations” such as at home, work, or school.
“Craving” the substance (alcohol or drug)
Continuing the use of a substance despite health problems caused or worsened by it. This can be in the domain of mental health (psychological problems may include depressed mood, sleep disturbance, anxiety, or “blackouts”) or physical health.
Continuing the use of a substance despite its having negative effects in relationships with others (for example, using even though it leads to fights or despite people’s objecting to it).
Repeated use of the substance in a dangerous situation (for example, when having to operate heavy machinery, when driving a car)
Giving up or reducing activities in a person’s life because of the drug/alcohol use
Building up a tolerance to the alcohol or drug. Tolerance is defined by the DSM-5 as “either needing to use noticeably larger amounts over time to get the desired effect or noticing less of an effect over time after repeated use of the same amount.”
Experiencing withdrawal symptoms after stopping use. Withdrawal symptoms typically include, according to the DSM-5: “anxiety, irritability, fatigue, nausea/vomiting, hand tremor or seizure in the case of alcohol.”
Getting experienced help through counseling / therapy can help you make the changes you are desiring — often uncovering what is surrounding the substance abuse / mis-use.
The term codependency has been around for almost four decades. It was first first identified as the result of years of studying interpersonal relationships in families of alcoholics. However, we know now that co-dependency is really about keeping a dysfunctional status quo. In other words a person who is relationship with someone who has bad behavior or even a chronic illness can become “co-dependent” upon the moods, behaviors, feelings, and habits of the other person. When they are angry, you walk on eggshells. When they are happy, you are happy (with some fear of when it will change usually). When they are in a bad mood, your mood follows. There is generally a sense of orbit around the “main” character by the co-dependent person. Being in this type of relationship or being raised with these roles can include (but is not limited to):
Codependency creates stress and leads to painful emotions. Shame and low self-esteem create anxiety and fear about being judged, rejected or abandoned; making mistakes; being a failure; feeling trapped by being close or being alone. The other symptoms lead to feelings of anger and resentment, anxiety, depression, hopelessness, and despair. When the feelings are too much you may feel numb.
People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” Each mood episode represents a drastic change from a person’s usual mood and behavior. An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.
Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. Symptoms of bipolar disorder are described below.
Mood Changes
Behavioral Changes
Mood Changes
Behavioral Changes
Bipolar disorder can be present even when mood swings are less extreme. For example, some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomanic episode, you may feel very good, be highly productive, and function well. You may not feel that anything is wrong, but family and friends may recognize the mood swings as possible bipolar disorder. Without proper treatment, people with hypomania may develop severe mania or depression.
Bipolar disorder may also be present in a mixed state, in which you might experience both mania and depression at the same time. During a mixed state, you might feel very agitated, have trouble sleeping, experience major changes in appetite, and have suicidal thoughts. People in a mixed state may feel very sad or hopeless while at the same time feel extremely energized.
Sometimes, a person with severe episodes of mania or depression has psychotic symptoms too, such as hallucinations or delusions. The psychotic symptoms tend to reflect the person’s extreme mood. For example, if you are having psychotic symptoms during a manic episode, you may believe you are a famous person, have a lot of money, or have special powers. If you are having psychotic symptoms during a depressive episode, you may believe you are ruined and penniless, or you have committed a crime. As a result, people with bipolar disorder who have psychotic symptoms are sometimes misdiagnosed with schizophrenia.
People with bipolar disorder may also abuse alcohol or substances, have relationship problems, or perform poorly in school or at work. It may be difficult to recognize these problems as signs of a major mental illness.
Bipolar disorder usually lasts a lifetime. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of symptoms, but some people may have lingering symptoms.
There are multiple Bipolar diagnosis and a lot to rule out as well. It is important to have an accurate diagnosis to get the right help. Good therapy with an experienced therapist who knows how to help manage bipolar disorder is imperative. Call us, we can help!
Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships. People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.
People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” Each mood episode represents a drastic change from a person’s usual mood and behavior. An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.
Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. Symptoms of bipolar disorder are described below.
People with borderline personality disorder may experience mood swings and display uncertainty about how they see themselves and their role in the world. As a result, their interests and values can change quickly.
People with borderline personality disorder also tend to view things in extremes, such as all good or all bad. Their opinions of other people can also change quickly. An individual who is seen as a friend one day may be considered an enemy or traitor the next. These shifting feelings can lead to intense and unstable relationships.
Not everyone with borderline personality disorder experiences every symptom. Some individuals experience only a few symptoms, while others have many. Symptoms can be triggered by seemingly ordinary events. For example, people with borderline personality disorder may become angry and distressed over minor separations from people to whom they feel close, such as traveling on business trips. The severity and frequency of symptoms and how long they last will vary depending on the individual and their illness.
The cause of borderline personality disorder is not yet clear, but research suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.
Although these factors may increase a person’s risk, it does not mean that the person will develop borderline personality disorder. Likewise, there may be people without these risk factors who will develop borderline personality disorder in their lifetime.
There are evidence-based treatments and experienced therapists who work well with this diagnosis. Additionally, many people with the disorder experience fewer or less severe symptoms, and an improved quality of life with the right treatment, the right therapist and trauma informed adjuncts to further uncover roots. It is important that people with borderline personality disorder receive evidence-based, specialized treatment from an appropriately trained provider. Other types of treatment, or treatment provided by a doctor or therapist who is not appropriately trained, may not benefit the person.
Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with borderline personality disorder and their loved ones to be patient and to receive appropriate support during treatment. Often treatment and counseling for BPD is long-term.
Psychotherapy is the first-line treatment for people with borderline personality disorder. A therapist can provide one-on-one treatment between the therapist and patient, or treatment in a group setting. Therapist-led group sessions may help teach people with borderline personality disorder how to interact with others and how to effectively express themselves.
It is important that people in therapy get along with, and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with the disorder to maintain a comfortable and trusting bond with their therapist.
Two examples of psychotherapies used to treat borderline personality disorder include:
A licensed mental health professional—such as a psychiatrist, psychologist, or psychotherapist—experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder by:
Borderline personality disorder often occurs with other mental illnesses. Co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with the symptoms of borderline personality disorder. For example, a person with borderline personality disorder may be more likely to also experience symptoms of depression, bipolar disorder, anxiety disorders, substance use disorders, or eating disorders.
NIMH-funded studies show that people with borderline personality disorder who don’t receive adequate treatment are:
Borderline personality disorder is also associated with a significantly higher rate of self-harm and suicidal behavior than the general public.
People with borderline personality disorder who are thinking of harming themselves or attempting suicide need help right away.
If you or someone you know is in crisis, call the toll-free National Suicide Prevention Lifeline (NSPL) at 1-800-273-TALK (8255), 24 hours a day, 7 days a week. The service is available to everyone. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are free and confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Read more on NIMH’s Suicide Prevention health topic page.
A survivor of suicide is a family member or a friend of a person who died by suicide.
Being left behind in the wake of someone’s suicide is often shocking and painful. If that “someone” is someone you love, you will most likely experience not just grief, but trauma over the death. The person you loved just killed the person you love. It’s complicated. It hurts and it is almost unbearable. The unthinkable has not only been thought, but it has been carried out. And, whether you are left to pick up the pieces or watching it from a distance, the shockwaves are undeniable.
It may be thought, and could be true, that a person who completes suicide pays the ultimate price to be pain-free. Their life – their trump card. But the survivors, the ones left behind, will have to reconcile the deck. Each survivor pays a price, an involuntary ante, to play out a hand dealt to them. And, each will hold a spade of guilt, as if the cards were stacked.
As you can surmise, suicide grief is different. It is extremely individual, yet there are some progressional similarities as well as similar emotional experiences. Some common emotions experienced are:
These feelings are normal reactions and expression of them is healthy and natural. At first – during the first days and months of grieving survivors may feel overwhelmed by their emotions. Expressing what you are thinking and how you are feeling is important.
Asking “why” is usually a big part of the grieving process because survivors wrestle with the thoughts that it could have been prevented. Sometimes, if there has been some mental illness, death may bring some relief – which is usually followed by feelings of guilt.
It is a complicated path that does not always move a survivor forward. It is important to get help if you are a survivor of suicide
From the National Conference of State Legislatures
Adverse childhood experiences (ACEs) are potentially traumatic events that occur during childhood. The Centers for Disease Control and Prevention (CDC) and Kaiser Permanente conducted the first ACE study from 1995 to 1997 and asked more than 17,000 adults about childhood experiences including emotional, physical and sexual abuse; neglect; and household challenges of parental separation, substance abuse, incarceration, violence and mental illness. Nearly two-thirds of participants noted at least one ACE and more than 1 in 5 noted three or more. Researchers identified a link between ACE exposure and a higher likelihood of negative health and behavioral outcomes later in life, such as heart disease, diabetes and premature death.
Moreover, ACEs can follow an intergenerational pattern. For example, research suggests that children who experience physical abuse may be more likely to commit violence, including abusing or neglecting their own children, and to be revictimized in the future. ACEs align with a shifting public health focus to upstream thinking and the prevention of negative behaviors and outcomes before they occur.
Since the original study, the list of ACEs in various measures has expanded with the goal of capturing diverse population data, particularly from children of color and those living in poverty. For instance, since 2011, ACEs questions on the National Survey of Children’s Health (NSCH) have incorporated familial death, neighborhood violence, economic hardship and unfair treatment based on race or ethnicity.
What Are the Consequences of ACEs?
The original ACE study and decades of research since have linked ACEs to an increased risk of developing chronic diseases and behavioral challenges, including obesity, autoimmune disease, depression and alcoholism. The greater the number of ACEs, the greater the risk for negative outcomes. Individuals with multiple ACEs may be more likely to perform poorly in school, be unemployed and develop high-risk health behaviors, such as smoking and drug use. These high-risk behaviors account for nearly 50 percent of the increased risk of negative consequences associated with ACEs. In 2019, the CDC found that at least five of the top 10 leading causes of death, including respiratory and heart disease, cancer and suicide, are associated with ACEs.
The underlying mechanisms by which ACEs exert their effects on health are through the development of toxic stress, a prolonged or excessive activation of the stress response system. Nearly all people experience stress, such as the stress felt before an important test or job interview. However, chronic stress sustained over time can be damaging to the body and the brain, particularly for children, because the earliest years are a critical time for development. The accumulation of excessive stress in the body interferes with the development of healthy neural, immune and hormonal systems and can alter the expression of our DNA. Multiple ACEs over time—especially without adequate adult support—can affect the nervous, endocrine and immune systems, and have lasting effects on attention, behavior, decision-making and response to stress throughout a lifetime.
Fortunately, researchers have identified strategies to avoid negative outcomes by preventing ACEs, some of which are identified in policy implications. The CDC estimates ACEs prevention could reduce chronic conditions, risk behaviors, socioeconomic challenges and leading causes of death in the United States.
There are also certain factors that can help mitigate long-term negative impacts after ACEs have already occurred and strengthen the ability to overcome adversity, often referred to as resilience. Protective factors, such as strong family bonds, cultivate greater resilience that can help protect children from the detrimental effects of adverse experiences. Safe, stable and nurturing relationships and communities help to build resilience, prevent violence, improve mental health and support health across one’s lifespan.
The latest National Survey of Children’s Health data shows in 2017-18, excluding economic hardship, approximately 30 percent of children experienced one ACE, and about 14 percent experienced two or more. According to a 2018 Child Trends brief, including a measure of economic hardship, about 45 percent of children have experienced at least one ACE. Parental separation and economic hardship are the most common ACEs regardless of race and ethnicity, though children of different races and ethnicities do not experience ACEs equally.
National percentages of children experiencing at least one ACE include:
In 2019, CDC scientists analyzed data from more than 144,000 adults in 25 states and found that 61 percent of them experienced at least one ACE. Nearly 16 percent of adults have experienced four or more ACEs, and women and several racial and ethnic minority groups are at greater risk for experiencing a higher number of ACEs.
We all have ups and downs in life and getting stuck can happen before we know it. Whether you are trying to break out of a rut or wanting to get on higher ground to gain clarity, growing and changing is a process that takes awareness and practice – and a little guidance can help a lot.
Professional counseling / therapy can provide that guidance and assistance. We can help you look back to see what might need attention from the past, finding relief in the “here and now,” while listening to what is calling to you on the horizon.
Maybe you are trying to do something different with yourself or a relationship or a job… Perhaps your intuition is letting you know that now is the time to get something done! Whether it’s time to confront past trauma(s), overcome anxiety, make your way through depression, or kick a bad habit… giving time and space to yourself for healing and growth is an investment that can yield great benefits now and in the future.