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Dialectical Behavioral Therapy (DBT) Mental Health Mood Disorders Recovery Therapy Treatment

DBT With Dr. Georgina Smith, Ph.D

We are pleased to welcome Dr. Georgina Smith, Ph.D to the Visions clinical team. She has been working with adults, families, and children since 2001, making her vast knowledge of neurofeedback and Dialectical Behavorial Therapy (DBT) accessible to a wide range of clientele. Dr. Smith specializes in treating survivors of trauma, abuse, and those suffering from eating disorders, and addiction. She also treats individuals suffering from chronic depression, self-injury, mood, personality, and anxiety disorders. Her knowledge and use of neurofeedback and DBT allows her to help her clients in a way that empowers them be engaged in their own recovery. Dr. Smith’s approach is holistic, and caring, and she ardently believes in ensuring that her clients feel seen. Her work with adolescents has built an authentic treatment style where she is able to form a genuine connection with her clients, so they feel seen, heard, validated and challenged. Dr. Smith encourages them to be ok in the skin they’re in. That particular tenant of treatment spreads healing throughout one’s mind, body, and spirit.

With the addition of Dr. Georgina Smith, clients have access to DBT in all phases of their treatment. DBT, in particular, is one of the most efficacious treatments for mood disorders, namely Borderline Personality Disorder. DBT uses mindfulness, self-awareness, and skill building in the areas of trauma, emotional regulation, interpersonal effectiveness and crisis management.  One of the most remarkable pieces of DBT is its effectiveness in teaching clients to regulate their emotions and recognize when they are becoming deregulated. Self-awareness in someone trying to manage extreme emotions is undeniably helpful.

Currently, Dr. Smith is seeing Visions’ clients for DBT as well as running a DBT group on a weekly basis. We are looking forward to working with Dr. Smith and are excited to have her as part of our clinical staff.  She is down to earth, and brings a sense of realness to her groups and throughout her clinical practice. She says it best, “So many of the kids I’ve worked with are struggling to make sense of things they’ve been through, struggling with their sense of self and others, and a confusing, chaotic world. The space I create with them is about being ok wherever they are, whoever they are, so we can open the doors to choice and change. It is about ownership, realness & empowerment.” Welcome to the VTeam, Georgina!

Categories
Depression Mental Health

Depression in Adolescence

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Depression affects teens as well as adults but is often missed partly because it can co-occur with the natural emotional ups and downs that are part and parcel to being a teenager. Simply put, growing up is a naturally stressful process, and that’s without any external conflicts acting as a contributing factor! The other organically occurring components fostering an environment for adolescent depression are things like hormones, and conflict with parents. When we include disturbing events like a breakup, death of a friend or relative, or difficulty at school, one’s susceptibility to depression increases.

Adolescence is a time for expressing independence, which sometimes means drawing a firm line in the sand with one’s parents in order to create autonomy. On occasion, those efforts can create a snag in parent/child communication. Puberty is inherent to the organic and experiential part of being human. It also means there is going to be infallibility and imperfection. Sometimes, as parents, we forget what it was like and spend too much time reacting and taking things personally and not enough time taking action. Think of it this way: if a teen is suffering from depression, they more than likely won’t tell you. In fact, they may be surreptitiously hoping that you take notice, because talking about it might be too scary or embarrassing.

According to the National Comorbidity Survey-Adolescent Supplement (NCS-A) via the National Institute of Mental Health (NIMH): “About 11% of adolescents have a depressive disorder by age 18. Girls are more likely than boys to experience depression. The risk for depression increased as a child gets older.” And according to the World Health Organization (WHO), “Major depressive disorder is the leading cause of disability among Americans age 15-44.” Further, the NIMH site notes that since childhood behaviors vary from one childhood stage to another, “it can be difficult to tell whether a child who shows changes in behavior is just going through a temporary ‘phase’ or is suffering from depression.

Since symptoms of adolescent depression differ slightly than those of an adult, it’s important to pay attention to any idiosyncrasies that may occur (sans getting over-analytical and paranoid). A child who’s depressed may complain of being sick, they may suddenly become excessively clingy, and they may often refuse to go to school; A teen, on the other hand, may sulk, get in trouble at school, be an overall grump, and feel a general sense of being misunderstood.

Symptoms of depression can include some or all of these factors:

  • Appetite changes (usually a loss of appetite but sometimes an increase)
  • Difficulty concentrating
  • Difficulty making decisions
  • Episodes of memory loss
  • Fatigue
  • Feeling upset, restless, and irritable
  • Feeling worthless, hopeless, sad, or self-hatred
  • Loss of interest or pleasure in activities that were once fun
  • Thinking or talking about suicide or death
  • Trouble sleeping, too much sleeping, or daytime sleepiness

Sometimes a person’s behavior may change, or there may be problems at home or school without any symptoms of depression:

  • Acting-out behaviors (missing curfews, unusual defiance)
  • Criminal behavior (such as shoplifting)
  • Irresponsible behavior
  • Poor school performance, grades dropping
  • Pulling away from family and friends, spending more time alone
  • Use of alcohol or other illegal substances

If you notice any of these behaviors lasting for more than two weeks, it’s time to seek help, particularly if these behaviors are beyond the normative rollercoaster ride consistent with adolescence.

For additional information and for documentation of sources for this article:


Depression in Children and Adolescents (Fact Sheet)
Use of Mental Health Services and Treatment Among Children (www.nimh.nih.gov)
Adolescent Depression (www.nlm.hih.gov)
Adolescent Depression (PubMedHealth: www.ncbi.nlm.nih.gov)
Adolescent Depression (https://health.nytimes.com) 

Categories
Bipolar Disorder Mental Health

Bipolar Children and Teens

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Bipolar disorder isn’t soley an issue for the adult population—it affects children and teens as well.
Bipolar disorder is a mental illness categorized by its behavioral and mental extremes. Often called “manic depression,” this illness is clearly defined by its moods. Typically recognized as the manic stage, the sufferer may be elated or intensely “up,” even hyper. The flip side of this is the depressive stage, identified by its extreme lows, deep sadness, physical ailments, and for some, suicidal ideation.
According to NIMH, several factors may contribute to this mental illness:
  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.
Since the causes aren’t concretely defined, scientists continue to do research, seeking more definitive answers in hopes of finding viable solutions, including a possible means of prevention.

These mood episodes can last a week or even two and are heavy in their intensity.  NIMHhas provided a listof symptoms from the two phases of bipolar disorder. Keep in mind, these symptoms are determined by their intensity and are not to be confused with the natural ups and downs of childhood emotional development.

Children and teens having a manic episode may:
  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.
Children and teens having a depressive episode may:
  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.
Bipolar disorder is difficult to diagnose in children because symptoms often mirror other issues, for example: ADHD, conduct disorder, or alcohol and drug abuse issues. Bipolar disorder can, however, occur alongside these other issues, so it’s important to see a professional skilled in recognizing the affectations of various mental health disorders. Treatment for bipolar disorder requires the use of medication, but because the effectiveness in children isn’t as well researched, it’s wise to take note that children may respond differently to medications than adults. NIMH recommends children and adolescents take the “fewest number and smallest amounts of medication possible to help their symptoms,” additionally noting the danger in stopping any medication without the advice of a physician.
Pay attention to any side effects, and immediately tell the treating physician if you recognize new behaviors. Remember: the treatment for bipolar disorder is based upon the effective treatment of adults, which typically applies the use of mood stabilizers like lithium and/or valproate to control symptoms of mania and act as a preventative to the recurrence of depressive episodes.  Still, treatment of children and adults is still being researched. At this time, “NIMH is attempting to fill the current gaps intreatment knowledge with carefully designed studies involving children andadolescents with bipolar disorder.”  Further, scientists continue to perform studies looking at different types of psychotherapy, which would support the pharmaceutical treatment used in children and teens.  
Please see below for links to additional information (note, I also used some of these as reference for this article.)