by David Kearby, LCSW, BCD
Most people have heard the term "agoraphobia" but what does it mean and how does it affect people? Agoraphobia is the fear of open spaces but generally manifests as the fear of certain places or situations such as supermarkets, shopping malls, parks, etc. Persons with agoraphobia experience extreme anxiety when visiting or thinking about visiting these places. Additionally, some people with agoraphobia become house-bound as they fear leaving their home. Panic attacks are commonly experienced by persons with agoraphobia.
Treatment for agoraphobia can include both pharmacological and psychological interventions. While medications can help with the anxiety symptoms, psychotherapy assists the person in understanding their phobia and focuses on slowly exposing individuals to feared places or situations. This form of treatment is called "exposure therapy" and is very effective for agoraphobia and other phobias.
Agoraphobia can be a crippling experience and causes many individuals to stay indoors, often not leaving their homes for years on end. If you or someone you know may have agoraphobia, call us today to schedule a consultation!
by David Kearby, LCSW, BCD
Many people come to therapy wanting to change something in their life. Perhaps they are looking to change a certain behavior, for example, they may wish to quit smoking, reduce their intake of alcohol, manage their anger, etc. The key is change and there are 5 stages of change central to changing old behaviors and adopting new habits.
1) Precontemplation Stage
Precontemplation is the earliest stage of change. People in precontemplation are either unaware they have a problem or are unwilling to change their behavior. The goal in this change is to assist the person in recognizing there is a problem are there are solutions to the problem. In this stage, some of drinks alcohol to excess is either not aware they drink to excess (denial) or isn’t willing to change. In short, they don’t believe they have a problem.
2) Contemplation StageIn the contemplation stage, the person recognizes that they have a problem and are willing to begin thinking about change and what it would mean for them. They have gone from denying the problem to accepting that change is needed. In this stage, contemplators struggle to understand the problem and the solution to the problem but they do recognize a problem exists. With the person who drinks alcohol to excess, they have gone from denying their alcohol consumption is a problem to contemplating how alcohol has had a negative effect on their life. They are considering or contemplating what needs to happen to make change.
3) Preparation Stage
In the preparation stage, the person is ready to change in the near future. They are on the verge of taking action. The goal in this stage is to plan how change will occur. The goal is identified and the objectives are developed to help ensure the person is successful in making change.
In the action stage of change people most overtly modify their behavior. They stop or reduce the habit or behavior and make the necessary changes to minimize relapse and to maximize success. This is the time the person implements the plan identified in step
Maintenance is the final stage in the process of change. Sustaining behavior can be difficult. In the maintenance stage, the person works to consolidate the gains attained during the action stage and struggles to prevent relapse.
It seems everyone has a new year’s resolution: lose weight, get organized, develop an exercise routine, eat healthy, find a new job, etc. Have you ever wondered what makes new year’s resolutions so popular? Have you noticed new year’s resolutions rarely work and either we continue to push back our goals or poop out after a week or two?
New year’s resolutions are popular because it allows one to put the dreaded change into the future and when better than at the start of a new year? However, this approach is rarely effective. If you can’t find the time NOW to begin changing your behavior you will likely find an excuse not to begin when the new year commences.
Below are a few tips and tricks to get you on the path to behavior change.
David Kearby, LCSW, BCD is a board certified clinical social worker and psychotherapist with a private practice in downtown Indianapolis.
Depression comes in many forms and its symptoms, duration and causes are varied. Below is a simplified list of the most common types of depression.
Anaclitic depression is commonly seen in infants whose caregivers have had a difficult time attaching to the infant and providing the necessary relational experiences basic for development. Symptoms may include apprehension, sadness, weeping, withdraw and refusal to eat. Anaclitic depression is often noticed in infants around 9 months of age.
Major depression, also known as clinical depression and unipolar depression, is a diagnosable condition experienced at any life stage. Symptoms may include sadness, loss of interest in pleasure, social withdraw, irritability, feelings of low self-worth, appetite changes and fatigue. Additionally, persons with major depression often experience depressive episodes that can last anywhere from two weeks to several months followed by periods of average mood. Treatment for major depression can include psychotherapy, counseling, group therapy and/or medication. Major depression is one of the most common mental health disorders treated in the United States.
Dysthymia or persistent depressive disorder is a milder form of depression that is present for at least two years. Individuals experiencing dysthymia typically feel down and depressed most of the time with little or no relief. Treatment often includes psychotherapy and medication.
Reactive depression can occur in anyone and is a reaction to a specific event. Typically, persons may experience reactive depression as a result of the loss of a loved one, job loss, marital and relationship conflict, etc. Because reactive depression is considered a normal reaction to difficult situations, it is not a diagnosable disorder and not typically covered by insurance. For individuals who struggle to get through their reactive depression, psychotherapy and counseling can be very effective by allowing the individual to discuss and process their experience. Medication can be helpful in some cases but is not typically the first step when treating reactive depression.
Bipolar depression is experienced by individuals who have bipolar disorder. The main difference between major depression and bipolar depression is identified during the periods when the depression is absent. Instead of the individual experiencing an “average” mood, the individual experiences either hypomanic or manic episodes which are characterized by expansive moods that may include impulsivity, risky behavior, elated mood and little insight into behavior. Individuals with bipolar disorder tend to have extreme mood swings where they go from one extreme to another. Bipolar disorder is treated with medication (mood stabilizers) and psychotherapy. It is recommended individuals with bipolar disorder do not take typical antidepressants as the medications can cause rapid cycling of moods.
David Kearby is a Board Certified Clinical Social Worker with a psychotherapy practice in downtown Indianapolis. David specializes in mood disorders, LGBTQ concerns and men's issues.
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320 N. Meridian St. STE 804
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