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DEC 03, 2021

Whether you have been living with diabetes for years or have been recently diagnosed, you realize the profound way diabetes affects every facet of your daily life. No chronic disease demands more time and energy than diabetes. Managing your diet and activity, monitoring your blood sugar levels, and taking your medications correctly can consume your waking hours, even during times when your diabetes is in control and properly managed. You may not be aware of the scope and magnitude of challenges to your mental well-being that are unique to people living with diabetes. If you have diabetes and are suffering from anxiety, depression, or other mental health issues, you are not alone. The mental health toll from both Diabetes 1 or 2 is significant but, unfortunately, largely unrecognized. Prevalence of Mental Health Issues in Diabetics If you have diabetes, you are likely to experience depression. If you are depressed, you are twice as likely to develop Type II Diabetes at some point in your life. Studies show that depression and diabetes occurring in the same individual are twice as likely as in the general population. A recent study showed that 24% of people with diabetes experience major depression, and the depression tends to linger. Adolescents with Diabetes I and II have not been researched as widely, but 9-24% are affected by depression. Only 25 to 50% of people with diabetes with depression are treated. Researchers aren’t yet clear about all the reasons depression and diabetes are so closely related, but their correlation is strong. Some of the following factors have been explored: Daily management of an unstable chronic disease is stressful. Complications from diabetes are numerous, and as the disease burden increases, the potential for depression increases. Depression diminishes the energy to make smart lifestyle choices. Exercise, healthy eating, medication adherence, and self-care take a back seat when a person is just trying to make it through the day. There is a possibility that some anti-depressants adversely affect metabolic control and weight gain, thereby leading to a greater chance of the development of diabetes. Ways to Manage Diabetes and Depression Together Diabetes self-management programs: Diabetes programs focused on behavior have helped people improve their blood sugar control, manage weight loss and develop good physical fitness habits. They can also help improve your sense of well-being and quality of life. Psychotherapy: Cognitive behavioral therapy has improved depressive symptoms and enabled patients to take better care of themselves. Medications and lifestyle changes: Medications — for both diabetes and depression — and lifestyle changes, including different types of therapy coupled with regular exercise, can improve both conditions. Depression is a serious condition that can lead to even more problems for the person suffering. Untreated depression can lead to loss of employment, substance abuse, and even suicide. Chronic depression is different from the type of sadness you feel after a break-up or the loss of a pet. It can interrupt your daily life to the point where you are barely functioning. Depression should be taken seriously and will very likely not “go away with time.” If you suspect that you or someone you care for are suffering from depression, please seek out assistance as soon as possible. Symptoms of Depression Feeling sad or empty Losing interest in favorite activities Overeating or not wanting to eat at all Not being able to sleep or sleeping too much Having trouble concentrating or making decisions Feeling very tired Feeling hopeless, irritable, anxious, or guilty Having aches or pains, headaches, cramps, or digestive problems Thoughts of suicide or death Stress and Anxiety Stress is normal. Relationships, employment, parenting, or merely watching the news can contribute to a racing heart, sweating, and fear. Add constant management of an unpredictable disease, and many will become overwhelmed. People overwhelmed by stress often ignore self-care. Stress hormones produced by your body can cause blood sugar to drop or rise quickly. Stress from illness or injuries can cause blood sugar to rise dangerously. Anxiety is a reaction to stress. Symptoms may include nervous feelings, a feeling of panic or doom, increased heart rate, hyperventilation, feeling weak or tired, or trouble concentrating. Anxiety can also feel like low blood sugar, and low blood sugar can feel like anxiety. Check your blood sugar if you suddenly feel anxious. Usually, therapy works better than medications for anxiety. Ways to lower stress A quick walk can lower stress for hours Meditation or yoga Calling a friend who understands you, not someone who causes you stress Limiting alcohol and caffeine Adequate sleep Doing something you enjoy (Paint! Read a book! Watch your favorite movie!) Diabetic Distress People living with diabetes may be experiencing multiple distressing feelings and emotions. It’s common to feel burned out, angry, frustrated, and worried from the continuous demands of managing your disease. So many diabetics experience these feelings daily, in fact, that the syndrome has been termed Diabetic Distress, which is reported by 33% to 50% of adults with diabetes during any 18-month period. This is not a medical diagnosis but a term describing an emotional state causing several distressing emotions at once. This distress makes it very difficult to take care of yourself and can cause your diabetic symptoms to worsen. Diabetic distress looks very much like depression or anxiety but may not respond to the most common treatments. What are some of the common sources of distressing feelings? Management of Diabetes: The endless activities involved with managing your diabetes include checking blood sugar, selecting healthy foods, the need to be physically active, and remembering to take your medication. Fear of hypoglycemia or low blood sugar: Low blood sugar can quickly become a medical emergency for diabetics. Blood sugar can drop quickly in the event of too much insulin, too little food, excessive exercise, or other causes. Symptoms can range from mental disorientation to seizures to death. The initial feeling of dropping blood sugar is uncomfortable and usually frightening for most people. Once a serious episode has occurred, no one wants to experience another, and it can spurn worries about future social embarrassment. Many people allow their blood sugars to exceed the recommended levels to avoid having low blood sugar. Worry about diabetes complications: From the time of diagnosis, diabetics are educated about the complications of their disease. A diabetic is twice as likely to die from heart disease, including stroke. Diabetes is the leading cause of lower limb amputation. Diabetes is also the foremost cause of kidney disease, which affects 25% of adult diabetics. High blood sugar can cause permanent vision complications. These are big (and very real) worries to be permanently burdened with. Some people with diabetes are unable to stop thinking about dire outcomes, particularly when they are diligently trying to control their disease without seeing appreciable improvement. Acceptance of Diagnosis; Denial and Uncertainty Diabetes can be a difficult diagnosis to accept in the beginning. Understanding you have a life-long condition requiring daily management is daunting. Responses can range from depression and grief to denial and avoidance. Steps you can take to help with your distress If possible, see a diabetic specialist (ideally, an endocrinologist) for your diabetes care. He will likely have more understanding of your unique challenges and be more up to date on diabetic care and new developments. Ask your doctor to refer you to a mental health counselor who specializes in chronic health conditions. See a diabetes educator, hopefully, one-on-one. They have special training and excellent skills to help their patients’ problem solve; to find solutions to seemingly insurmountable obstacles. Identify one or two goals for management and focus on them. Trying to “fix everything” at once will only lead to more feelings of overwhelm. Join a diabetes support group. Talking with a group of people who share some of your worries and challenges can be reassuring. You will likely learn from each other as well. Helping others really is an excellent means of helping yourself. Diabulimia Eating disorders are characterized by an unhealthy relationship with food. In many cases, that means obsessively counting calories or controlling every morsel that passes through one’s lips. Managing diabetes means doing just that (to some extent), and as a result, diabetes can be a high-risk factor for developing an eating disorder. “Diabulimia” specifically refers to restricting insulin in order to lose weight. Sometimes the person will already have body image issues when they are diagnosed, and the realization that restricting insulin will facilitate weight loss exacerbates a previously existing eating disorder. And other times, it goes the other way around; the person may not have body image issues to begin with, but discovering this “easy,” yet the incredibly dangerous method of losing weight quickly leads to an eating disorder. The DSM-5 (a diagnostic tool for mental health professionals) classifies the restriction of insulin as a purging behavior. One can “binge” and then restrict insulin. Hence the term “diabulimia,” or they can restrict both food and insulin, in which case they may be diagnosed with anorexia nervosa. Both conditions are incredibly dangerous and should be looked out for, especially in teenage girls and young women who are already vulnerable to the dangers of an eating disorder. The risks of this behavior are severe. In the short term, you can expect disruptions in menstruation, severe dehydration, yeast infections, and muscle atrophy. In the long term, there is a risk of kidney disease, liver disease, heart disease, coma, stroke, and eventually death. Warning Signs of Diabulimia Increasing neglect of diabetes management Secrecy about diabetes management Avoiding doctors appointments Fear that insulin “makes me fat” Extreme anxiety about body image Avoiding eating in public or around friends and family Overly strict food rules Withdrawal from friends and family Infrequently filled Treatment for Diabulimia The best-case scenario for diabulimia treatment is to see an endocrinologist as well as a mental health professional. The endocrinologist specializes in both diabetes and eating disorders, and the mental health professional can help the patient get to the root of their eating disorder, whether it’s depression, anxiety, or solely a reaction to diabetes. Diabulimia is a serious mental health condition, and stressing the dangers of diabetes complications is definitely not helpful in this case. The patient needs specialized and ongoing care in order to learn to manage their diabetes without endangering their life. You Can Live with Diabetes Diabetes is a chronic, lifelong medical condition that needs to be taken seriously. It takes time, practice, and possibly a bit of trial and error in order to learn how to manage it properly and healthily. It can be scary and overwhelming, and you are not alone if you are afraid for yourself or your loved one living with diabetes. It is not the end of the world though, even if it feels like it right now. Like any other challenging thing you’ve faced, you will feel stronger and more capable once you have acquired the tools necessary for living with diabetes. Don’t go through this alone. Lean on your loved ones for support. Talk to your doctor and mental health care provider openly and honestly. It is absolutely normal and acceptable to feel depressed, anxious, angry, or overwhelmed by your diagnosis of diabetes, but it does not have to consume your whole life. With proper assistance, support, and education you can live your absolute best and fullest life despite your diabetes; it doesn’t have to define you or control you. Resources 10 Tips for Coping with Diabetes Distress. (2021, August 10). Centers For Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/diabetes-distress/ten-tips-coping-diabetes-distress.html Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). The prevalence of comorbid depression in adults with diabetes: A meta-analysis. Diabetes Care, 24, 1069 –1078. Castro, M.D., R. (2020, September 3). Diabetes and Depression: Coping with the two conditions. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/diabetes-and-depression/faq-20057904 Dada, J. H. (2012, August 1). Understanding Diabulimia — Know the Signs and Symptoms to Better Counsel Female Patients. Today’s Dietician. https://www.todaysdietitian.com/newarchives/080112p14.shtml Felman, A. (2019, May 24). How does diabetes affect mood and relationships? Medical News Today. https://www.medicalnewstoday.com/articles/317458#diabetes-and-mood-swings Holt, R. I. G. (2014, June 14). Diabetes and Depression. National Institutes of Health (NIH). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476048/ National Eating Disorders Association. (2018, February 21). Diabulimia. https://www.nationaleatingdisorders.org/diabulimia-5 Robinson, D. J. (2018, April 1). Diabetes and Mental Health. Canadian Journal of Diabetes. https://www.canadianjournalofdiabetes.com/article/S1499-2671(17)30841-9/fulltext Young-Hyman D, de Groot M, Hill-Briggs F, et al. Psychosocial Care for People with Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016; 39: 2126–2140.
THERAPY

Signs You Are Making Progress in Therapy

JUL 27, 2021

In 2020, 1 in 6 Americans entered therapy. Admitting that you need help and seeking therapy is the first step in the long process of recovering from mental illness. If you’re in therapy, you know that healing from your past traumas and learning new coping skills can be a taxing, difficult process. So, how do you know that therapy is helping? Mental health disorders have different effects on everyone. What looks and feels like health and wellness for you could be very different from someone else’s. Because of this, there is no one "measurement" for success in therapy. But there are a few markers to watch out for as you process your therapy experience. What Does Success in Therapy Look Like? As we mentioned, success in therapy looks different for everyone. But if you’re trying to measure how whether or not your therapist is a good fit, here are some of the signs to look out for. Improved Mood While depression and anxiety aren’t the only reasons to seek therapy, an improved mood could still mean that your therapy is working. Therapy is a tool that can help you in every aspect of your life. If you’re starting to feel more cheerful or have a more positive outlook on your day, that’s a good sign that it’s working. Shift in Thoughts A big factor of mental illness is the way it changes our thought patterns. We fall into dangerous thinking cycles that can leave us unhappy or in danger of harm. Therapy helps us reshape our thinking. How many negative or destructive thoughts are you having? Are you focusing on unattainable things or frightening possibilities? Or, are you more focused on the present, focused on working with what you have? The latter is an indication that therapy is working. Changed Behaviors As our thoughts start to change, our behaviors change too. Therapy is all about building habits and coping mechanisms to help you combat your mental illnesses. Have you started creating healthy boundaries? Are you taking care of your personal hygiene more frequently? Are you spending more time appreciating yourself? All of these are behaviors that could indicate a positive change in therapy. Improved Relationships An improved relationship with your spouse, family members, and friends could also indicate that therapy is working. Do you have relationships that used to be contentious that are now more peaceful and cooperative? Less conflict in your relationships could mean that you’re using your conflict resolution skills. Feelings of Satisfaction If you’ve noticed an uptick in your general feelings of overall satisfaction, it could be a sign that therapy is working. This is a hard one to define. Just because you’ve had a few good days doesn’t mean your cured, right? That’s why we ask that you look at the overall patterns you’ve noticed. Are you having more positive days than negative days? No amount of therapy will ever ensure that you never have days that bring you down. But it will help you develop tools and coping skills to handle it better. Change in Diagnosis One great benchmark for improvement in therapy is if your diagnosis changes. Some disorders don’t ever go away, no matter how long you see a therapist. But if you’re seeing a therapist for depression and anxiety and your diagnosis changes, it’s a definite sign that you’re improving. Not All Progress is Obvious These are just a few of the metrics that some people use to determine if therapy is working. It isn’t the same for everyone. In fact, some of the more important measurements are frustrating because they aren’t exactly tangible. Every therapy plan is different. If you’re receiving incite-centered therapy, success looks like a deepened insight. You have a better understanding of yourself, how you feel, and the way you behave. Another helpful measurement to look at is if you’re using the tools your therapist is teaching you. Are the skills you’re learning in your sessions starting to help you outside of them as well? These things all indicate a behavior change, however, they aren’t quite as objective. They’re difficult to measure. Another sign that therapy is working is that you feel the need to be seen less often. If your problems no longer feel as urgent and you feel like you’re able to cope with your issues on your own, you may be progressing. Keep in mind that just because you feel like you’re ready to take on the world without therapy doesn’t mean it’s true. Our brains are the things that are sick when we’re dealing with mental illness. We may not always have the clearest picture when it comes to knowing when to seek out help. Keeping Track of Your Success In order to help you determine your success in therapy, your therapist might suggest keeping a diary centered around your symptoms and how often they happen. Your diary should keep track of your emotions, your behaviors, your interactions, and the coping skills you use. For example, were you faced with the desire to self-harm or did you have intrusive thoughts about suicide? What coping skills did you use to keep yourself calm in a difficult situation? Progress is Not Linear It’s important to remember that therapy won’t always be pushing you towards these goals. Sometimes you’ll feel worse, and that’s okay. Progress isn’t linear and sometimes we have to dig deep and really open ourselves up to painful vulnerability if we want to heal. The end goal for therapy isn’t to be happy, foregoing all other emotions. It just means that you’re going to be able to experience these emotions without completely losing sight of reality. Ask What Progress Looks Like for You Never be afraid to ask your therapist what success in therapy looks like for you. It’s so hard to define and measure success when it comes to treating and healing mental illness. So, discuss your treatment goals with your therapist directly and always come to them with the questions you have as you move forward. For more information on how you can experience the benefits of therapy, contact us today.

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LONG ISLAND CITY THERAPISTS

Finding a Therapist in Long Island City, NY

JUN 17, 2021

Are you a Long Island City resident that’s looking for someone to help you strengthen your ability to build relationships? Do you need someone that can offer psychiatry and assist you along your quest for mental wellness? If so, then you need to find a Long Island City therapist. Doing so can help you find someone to address the issues and trials that you’re going through. It can provide couple therapy, individual therapy, family therapy, and so forth. See below for an in-depth guide on how you can find a trustworthy Long Island City therapist and why heading to Williamsburg might be the solution! Why Consider a Williamsburg Therapist? Whenever you hear someone talk about Long Island City, you’re bound to hear about the great neighborhood surrounding it. That’s not a fallacy. There is a reason that Long Island City is the fastest growing neighborhood in the entire city! It’s a great place to live for many reasons. It has several means of transportation, such as bus lines, subway lines, river ferries, and even a railroad. The lifestyle is great as well. It’s filled with great cafes to get a morning cup, restaurants of all different shapes and sizes, and parks for you to get out and breathe in the fresh air. That said, certain services might be difficult to find in this lively neighborhood, such as the right therapist or psychologist for your needs. You shouldn’t have to settle for a lesser psychologist just for the sake of proximity. That’s why we recommend taking a quick trip to Williamsburg. Here at Williamsburg Therapy Group, we offer a plethora of treatments and methods for psychology. We’re not afraid to tackle difficult topics. With frequent treatment, you can begin the road to a more mentally healthy life. We think traveling to Williamsburg is worth it for that kind of return, wouldn’t you agree? What to Look for in a Therapist Some of you have been burned by therapists in the past. Others of you might be afraid to reach out to one out of hesitancy or fear. Whatever your story might be, doing a little bit of research on the therapist before you reach out to them can help you find the perfect fit. See below for several things you should be looking for in a Williamsburg or Long Island City therapist. The Type of Therapy You Need First, let’s take a moment to assess your situation. What is the source of the stress or mental fatigue that you find yourself dealing with? Are you dealing with severe anxiety or depression? Do you have family issues that need to be addressed? Are you battling an addiction? It can be tough to take a deep introspective dive. But doing so allows you to pinpoint the type of therapy that will best suit you. We at the Williamsburg Therapy Group offer over 13 different types of therapy. We have team members with doctorate-level training in: Individual Therapy Family Therapy Couples Therapy Addiction Child Therapy Medication Management Group Therapy Business Partner Therapy Severe Emotional Conditions Neuropsychological Assessments LGBTQ+ Affirmative Therapy & more Perhaps you saw a few methods on this list that you might benefit from. We’re happy to help you in any way that we can. Safe Environment One of the biggest benefits of finding the best Long Island City therapist is having a safe place that you can depend on. We believe that our clients see the biggest breakthrough when they have the opportunity to peel back one layer at a time. Remember, this is a marathon, not a sprint. Williamsburg Therapy Group gives you all of the social support you need. We pride ourselves on having a professional environment to explore the subjects and topics that other therapists might not. Once you’re comfortable and have opened up the discussion with your therapist, we’ll help you better understand your struggles and give you methods to combat them. Team of Various Psychologists Not everyone will click with one therapist. While someone in your network might love a certain Long Island City therapist, you might not feel the same way once you meet with them. Several factors could contribute to that. It could be their gender, their age range, whether they use an old-school or modern approach, and so on. Take the time to think through what you’re looking for in a psychologist. Here at the Williamsburg Therapy Group, our team is made of several doctoral-level psychologists and psychiatrists from all different backgrounds. We’re confident you’ll find a match that you’ll love and trust. Smooth First Session The first appointment is vitally important. It gives you your first exposure to the therapist and how they communicate with their clients. If you find a therapist that you think is a good fit, all that’s left is to book an appointment with them. That’s when you can gauge their approach, how they communicate, and whether or not you feel an initial comfort (even if it’s slight at first) with them. Make sure your therapist listens to you. If they spend a majority of the session talking over you or ignoring what you’re saying, it’s time to search elsewhere. Find the Best Williamsburg and Long Island City, Therapist Now that you have seen how to find a Long Island City therapist that you can trust, why not go right next door to Williamsburg for the premium therapy you need? Be sure to read this article for more information on the role of a clinical psychologist and whether they’re the right solution for your needs. To get started, take the time to visit this page and book an appointment with one of our therapists online.

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THERAPY

How To Get The Most Out of Therapy: 8 Helpful Tips

JUN 04, 2021

Making the decision to start seeing a therapist is a huge step forward. Regardless of whether you’ve been struggling with your mental health, therapy is a great option. It provides you with a neutral party, a safe space to talk, and a resource for learning more about yourself. What if you’ve never been to therapy before? Or what if you’ve struggled with feeling like you’re "connecting" with your therapist? It might be time to brush up on how to get the most out of therapy sessions. While your therapist is doing their part, you still need to "put in the work," so to speak. That means making every effort to make therapy work for you. Not sure how? No problem. Keep reading to learn our top tips for how to get the most out of a therapy session. 1. Enter With an Open Mind Too many people enter therapy with specific ideas of what therapy "should" be. This might be based on media representations of therapy sessions, perspectives from people who’ve never been to therapy, or even the experiences of friends and family. Therapy is an individual and customized process. What works for someone else might not work for you. You and your therapist will put together a treatment plan that makes sense for your goals. When you start going to therapy, rest assured that your therapist has a process. You need to trust that process and be patient, even if it seems different from what you had in mind. 2. Choose the Right Therapist One problem that many people have during therapy is not meshing with their therapist. This is normal. All therapists are different. They all have their own experiences, educations, specialties, and treatment methods (more on those later). It’s okay to realize that your current therapist isn’t right for you. When you’re looking for a therapist, feel free to ask about things that concern you. Many underrepresented groups or individuals with specific concerns feel more comfortable with therapists who are openly accepting and experienced with issues that they face. These include racism, homophobia, and transphobia, or alternative relationship styles that some therapists may not be familiar with. Meanwhile, other therapists are more experienced with trauma, personality disorders, or relationship problems. If you don’t feel like your therapist is a good match, they will understand if you need to seek out someone else. 3. Choose the Right Therapy Method Not all therapy methods are alike. Most people start with talk therapy or cognitive behavioral therapy. Some people need something more specific to either work alongside their first therapy method or replace it entirely. If you’re worried that your current method isn’t giving you the right results, ask your therapist for suggestions on what may work better based on your goals. 4. Communicate Both your choice of therapist and therapy method boils down to communication. Your therapist has your best interests at heart, but they’re not a mind reader. If you have specific intentions, needs, or concerns about therapy, you need to talk to them. They don’t know if something isn’t working unless you keep them informed. Learn to be open and honest with your therapist when you’re discussing your treatment plan. They won’t be offended if you need to switch your focus and it helps them adjust your treatment plan. 5. Set Clear Goals If you’re seeking therapy for a specific concern, it’s a good idea to set clear goals when you get started, perhaps even during your first therapy session. Keep in mind that these goals may change as you progress through your therapy journey. With that in mind, setting goals allows you to determine if you’re making progress or if you need to make adjustments. Goals can be as loose as "feeling better" or as specific as "learn to set boundaries around family members." Make goals that work for you. 6. Be Vulnerable Vulnerability is hard. When you’ve been conditioned to close yourself off, opening up to a stranger is a challenge. Your therapist can’t help you if you aren’t willing to be honest with them. For you to face your challenges, you need to open up about them. As you progress through your sessions, you’ll discover that it gets easier to open up, but you have to make that effort. 7. Make The right Schedule You need to pick a time for your therapy sessions that fits your lifestyle. Many therapists prefer that you pick consistent days and times so you can establish a routine and have a "therapy mindset" when you come in. Pick a schedule that doesn’t conflict with work, school, or any other responsibilities so you don’t have to skip sessions. It’s also good to pick a time that allows you to devote all of your attention to your session. You don’t want to be distracted and you don’t want therapy to throw off the rest of your day. 8. Do Your Own Work While a lot of your work will happen during your therapy sessions, you also need to apply what you’ve learned to your life outside of the therapist’s office. Many therapists assign "homework." This isn’t like the homework you’d do in school. They may ask you to practice coping mechanisms, start setting boundaries, or work on mindfulness and lifestyle changes between sessions. This work is hard at first, and your therapist will understand if it takes a few sessions before you’re able to implement these things. But if you make an active effort, you’ll see better results. This Is How to Get the Most Out of Therapy Therapy is what you make of it. If you want to figure out how to get the most out of therapy, you need to talk to your therapist and do some introspection. It might feel awkward when you start seeing a therapist. Once you figure out what works for you, though, you’ll start seeing the progress that you’re looking for. If you’re seeking a new therapist, we want to meet you. At Williamsburg Therapy Group, we have a variety of experienced mental health professionals with a variety of unique backgrounds. Book an appointment today so we can set you up with your perfect match.

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