Archive for February, 2009

Understanding Eating Disorders

This week, February 22 through February 28, 2009, is NEDAwareness Week, the largest annual eating disorders outreach effort in the United States, sponsored by the National Eating Disorders Association (NEDA). Most people are unfamiliar with this national event, let alone with eating disorders themselves.

Living with an eating disorder is often a very private struggle, which might stem from the fact that eating disorders are generally misunderstood in our society and therefore seem easier to hide rather than to confront. Sadly, in this case, ignorance is not bliss, and it can be detrimental to the recovery of those suffering from eating disorders and other mental illnesses. NEDA works to expand our awareness of the propensity of eating disorders affecting people of all ages and backgrounds in our society and throughout the world.

When people think of eating disorders, they often think solely of anorexia nervosa and bulimia nervosa, which seem to be the most publicized eating disorders. It is hard to avoid hearing these terms on a regular basis; the media seems to issue commentary on the weights of different actresses on a weekly basis in magazine articles and entertainment programs on television. Although anorexia and bulimia are the most well-known eating disorders, this does not mean that they are the only ones. Another prevalent set of eating disorders that have recently started to receive attention are eating disorders not otherwise specified, of which there are six types, including binge eating disorder.

The definitions of anorexia nervosa and bulimia nervosa are rather rigid and, because of this, a number of people suffering from eating disorders go unnoticed and untreated. Recent research suggests that eating disorders actually fall on a continuum, with asymptomatic (normal) eating on one end and full-blown disorders on the other. In between those ends lie a range of disordered behaviors, from dieting to bingeing to various forms of purging (e.g., vomiting, laxative use, excessive exercise). It is said that eating disorders exist on a continuum because certain eating behaviors often lead to other disordered eating behaviors. For example, dieting might cause binge eating when a person violates his or her self-imposed eating rules and, due to all-or-nothing thinking, continues to break the diet rules to an extreme. Some people might follow this binge eating with purging practices in order to compensate for this rule violation, thereby generating a cycle of unhealthy eating behaviors that may stay in a subclinical range or that may escalate into a full-blown clinical eating disorder.

Given the propensity of diet books and programs in our culture, one might assume that almost everyone, regardless of sex or age, decides to tweak his or her eating behaviors at some point in time. How many of these people actually suffer from eating disturbances? Studies have found that eating disorders not otherwise specified occur in four to six percent of the general population (Herzog & Delinsky, 2001), which is approximately twice the amount of people who are suffering from full-blown anorexia and bulimia. If the diagnostic criteria of anorexia and bulimia are relaxed even slightly, which is the direction in which researchers of eating disorders are headed, 75 percent of people diagnosed with eating disorders not otherwise specified could be reassigned to anorexia nervosa alone (Anderson, Bowers, & Watson, 2001).

Eating is an everyday activity. Some might assume that something as ordinary as eating, which people must do for survival, is relatively simple, but it is clearly more complex than that for some people. It is important to be conscious of the behaviors surrounding one’s eating habits to the best of one’s abilities so to prevent these habits from escalating into full-blown eating disorders. If you or someone you know is suffering from disordered eating habits, please contact a mental health professional for help. All too often people fear that they are the only ones suffering from these issues, but the more that people bring them to light, the more we will begin to understand these issues and hopefully expand the ways to treat and prevent them. Ashburn Psychological Services has a highly trained team of psychiatrists and psychologists who accurately diagnosis and treat eating disorders. You can reach us at: (703) 723-2999 or visit us at: www.ashburnpsych.com

Laura Cusumano, B.A.

Ashburn Psychological Services Office Manager

Columbia University MA Psychology Program (Starting Fall 2009)

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Michael Oberschneider, Psy.D., a clinical psychologist and director of this practice, wrote an interesting article on this blog “stress and the economy” where he examined many of the mental health issues that arise during bad economic times. Often, people’s social and emotional problems are, in some part, linked to the occupational and academic problems of their career path.

It can be hard, when it comes to career, especially in these times, to put all the puzzle pieces together on your own.

With millions of jobs being lost since December 2007, it can be difficult for a college student to select a major that they will enjoy and where their will be opportunities when they graduate. It can be difficult for a early career or mid-career employer to see the opportunities for change. It can be equally as hard for executives contemplating a job to the top job to figure out how to make the next move up.

There is no question, bad economy or not, that there are career-related opportunities for everyone. The surprising part might be that some of these opportunities are created by the poor economic times themselves. Here is some general advice for trying to figure out your career during these heady economic times:

  • Start early. Don’t procrastinate. It might take longer to get a job than in the past, so if you start figuring out what you want and who you are now, you will be in the application pool earlier.

  • Talk to a career coach about your aptitudes, strengths, weaknesses, resume, cover letters and the types of jobs and work environments that are best for you. Consider career-related motivation, aptitude and personality testing. This will give you an idea of the jobs you’ll be targeting and a rough estimate how long it will take for you to get a shot. This can be equally as helpful to a top executive or a mid-career employee as it is to a earlier-career employee or a college or high school student.

  • Network, talk to friends, neighbors, parents, uncles and aunts, alumni from your schools, faculty and anyone else who might have a job idea for you.

  • Since its unlikely you’ve interviewed we’ll consider reaching out to a career coach to help you find someone to do mock interview preparations with you.

  • Go to career fairs, company information sessions, corporate open houses and any other events that allow you to develop face-to-face connections with people involved in the hiring process. If you are in high school or college, this is a great reason to do an internship or apprenticeship.

  • Have your resume reviewed, edited and strengthened to highlight the qualities that recruiters are now looking for now that the career market has shifted.

  • Career coaches can also help you hold onto jobs that you don’t want to lose or make strides to move up in your company.

  • Talk to recruiters, career coaches and others who understand the nuances of this economic market, and who can pick up on things which companies are expanding or which ones have begun hiring because they realized they had laid off too many people.

If you have anymore career questions or would like to set up a career consultation, you can contact me at (703) 723-2999, Ext. 711 or read more at www.ashburnpsych.com.

~ Jayson Blair, Certified Life Coach, APS

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DBSA-Ashburn is a self-help organization serving individuals with bipolarmanicdepression2 disorder and their families and friends. The group is only for those with bipolar and is run by those with bipolar.

The support group meets each Wednesday at 8 p.m. in Ashburn Psychological Services‘ Suite 214 in the conference room on the second floor of 44110 Ashburn Village Shopping Plaza. The office building can be reached by entering the shopping center’s center courtyard and entering the double doors on your left. Take the elevator or stairwell to the second floor and we are in the first room on the right. We are open to anyone who has bipolar and can help those with other mood disorders or family members and friends find other resources and support groups.

courtyard1We help people accept their illness, manage their illness and improve their quality of life. We are an independent affiliate of the national Depression and Bipolar Support Alliance. Members of our support groups come primarily from Loudoun, Fairfax, Prince William counties, and, some, from as far away as Frederick, Md. And Winchester, Va. We also are able to help family members and friends of those who have bipolar disorder to find support groups in the area and resources. We can also help people find referrals to mental health professionals, programs and other resources.

Our support groups are for those with bipolar. Our support groups serve to enhance the lives of those with bipolar disorder through sharing, learning, helping and growing with a group of people who have been through similar experiences.

Contacting Us

Contact the Office Manager, Rita Meredith, at Ashburn Psychological Services for information:  (703) 723-2999 or ashburnpsych@gmail.com.

About Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

It is estimated that somewhere between 2 million and 5 million American adults, 1 or about 1 percent to 2 percent of the population, have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life. It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person’s life.

Kay Redfield Jamison, a psychologist who specializes in mood disorders and suffers from bipolar herself, wrote in her critically acclaimed book An Unquiet Mind , “Manic-depression distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide.” She adds, “I am fortunate that I have not died from my illness, fortunate in having received the best medical care available, and fortunate in having the friends, colleagues, and family that I do.

Bipolar disorder causes dramatic mood swings—from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.

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Social Skills Groups

Ashburn Psychological Services is now forming social skills groups for Spring.  We are planning to have child and adolescent Attention Deficit Hyperactivity Disorder (ADHD and ADD) groups and child and adolescent Asperger’s Disorder groups.  All groups will be run by two Ph.D level psychologists and will be comprised of a social skills group for the child or adolescent coinciding with a parent education/support group.  Please contact our office manager, Laura Cusumano, at (703) 723-2999 to reserve your child or adolescent’s spot.  You may visit us to review our team bios and services at www.ashburnpsych.com

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Military Suicide Rate is the Highest in Two Decades

The number of suicides in the Army increased last year to startling numbers not seen since the Vietnam War.  It has been reported that 115 troops committed suicide in 2007, and about a quarter of those deaths occurred in Iraq.   Several factors appear to be contributing to the higher rates including, the extension of deployments and repeated tours of duty for our young service men and women.  The military acknowledges that there is now a greater need for more screening, training and education programs.  The military has also approved the hiring of more than 300 psychiatrists, psychologists and other mental health professionals to address the current problem.

According to Lt. Gen. Michael Rochelle, the deputy chief of staff for personnel, suicide ranks as the fourth leading manner of death for soldiers, exceeded only by hostile fire, accidents and illnesses.  He added, earlier this year on the Army’s Website, “Even more startling is that during this same period, 10 to 20 times as many soldiers have thought to harm themselves or attempted suicide.”

I am very concerned about our young service men and women – both those going off to war and those returning.  The recently released suicide data certainly suggests that overall our young service men and women need additional training and education to prepare for and to cope with the stresses they will face once away.  The data over the past few years has also shown higher than ever rates of service men and women returning from war with Posttraumatic Stress Disorder.  As a civilian psychologist, a portion of my practice is reserved for those in the military.  I find working with service men and women rewarding, and I also feel it is my duty as a citizen.  Ashburn Psychological Services has a team of highly trained psychiatrists and psychologists ready to support military service men and women in our community.  Please contact our office manager, Laura Cusumano, at:  (703) 723-2999 or you can visit us at www.ashburnpsych.com

My old supervisor and friend, Dr. Barbara Romberg, is the founder of Give an Hour (www.giveanhour.org).  Give an Hour is a non-profit mental health professional volunteer network program to assist service men and women and their families.  I invite my local colleagues to consider joining Give an Hour in support of military service men and women and their families.  I’ve attached Give and Hour’s Mission Statement below for review.

Give an Hour

Our Mission
Our mission is to develop national networks of volunteers capable of responding to both acute and chronic conditions that arise within our society. Our first target population is the U.S. troops and families who are being affected by the current military conflicts in Afghanistan and Iraq. Give an Hour is asking mental health professionals nationwide to literally give an hour of their time each week to provide free mental health services to military personnel and their families. Research will guide the development of additional services needed by the military community, and appropriate networks will be created to respond to those needs. Individuals who receive services will be given the opportunity to give an hour back in their own community.

Our Focus
Our organization is currently focusing on the psychological needs of military personnel and their families because of the significant human cost of the current conflicts. Over 1.6 million troops have been deployed in Afghanistan, Iraq, and the Persian Gulf since September 11, 2001. Nearly 550,000 of these troops have been deployed more than once. According to the U.S. Department of Defense, as of January 30, 2009, a total of 4,878 American troops have died in Iraq and Afghanistan. In addition, 33,683 U.S. troops have been injured during these conflicts.

In addition to the physical injuries sustained, countless servicemen and servicewomen have experienced psychological symptoms directly related to their deployment. According to a RAND report released in April 2008, over 18 percent of troops who have served in Iraq and Afghanistan–nearly 300,000 troops–have symptoms of post-traumatic stress or major depression. At the same time, about 19 percent of service members reported that they experienced a possible traumatic brain injury. And let us not forget: millions of Americans belong to the families of these servicemen and servicewomen. Spouses, children, parents, siblings, and unmarried partners of military personnel are all being adversely affected by the stress and strain of the current military campaign.

Our military leaders are well aware of the human cost of this campaign. Indeed, they are attempting to address the psychological needs of the troops through a variety of programs within the military culture. Unfortunately, the tremendous number of people affected makes it impossible for the military to respond adequately to the mental health needs in its greater community. For example, according to the RAND study, only 43 percent of troops reported ever being evaluated by a physician for their head injuries. Moreover, returning combat veterans suffering from depression, anxiety, and post-traumatic stress disorder (PTSD) are not routinely seeking the mental health treatment they need. RAND also reports that only 53 percent of service members with PTSD or depression sought help over the past year.

A major barrier preventing military personnel from seeking appropriate treatment is the perception of stigma associated with treatment. Many fear that seeking mental health services will jeopardize their career or standing. Others are reluctant to expose their vulnerabilities to providers who are often military personnel themselves, given the military culture’s emphasis on strength, confidence, and bravery. Servicemen and servicewomen might be more inclined to seek help if they know that the services provided are completely independent of the military. By providing services that are separate from the military establishment, we offer an essential option for men and women who might otherwise fail to seek or receive appropriate services.

We are also offering services to parents, siblings, and unmarried partners who are not entitled to receive mental health benefits through the military. Although these individuals may have access to mental health services through other means, they are less likely to seek the help they need and deserve if that help is difficult to find or costly. Our goal is to provide easy access to skilled professionals for all of the people affected by the current war. The participating mental health professionals offer a wide range of services including individual, marital, and family therapy; substance abuse counseling; treatment for post-traumatic stress disorder; and counseling for individuals with traumatic brain injuries. Whether it is a young military wife who is anxious because her four-year-old has had nightmares since her husband’s deployment or a father who is struggling to cope with his son’s loss of a leg as a result of an explosion in Iraq, both will receive the assistance they need to move through their experience. The healthier the support system for the returning troops, the lower the risk of severe or prolonged dysfunction within these military families.

Our Plan
Give an Hour is reaching out to the military community in several ways. As a member of America Supports You, a Department of Defense program that provides opportunities for citizens to show their support for the U.S. Armed Forces, we are identifying individuals involved in post-deployment processing of returning troops. We are developing collaborative relationships with the commanding officers of returning troops so that these officers are aware of and comfortable with the services we provide. We are also working closely with a number of veterans service organizations to promote our services directly to the family members of troops. Furthermore, we are working with individuals affiliated with Walter Reed Army Medical Center in Bethesda, Md. We are also collaborating with the Veterans Administration to distribute information about our services through Vet Centers across the country.

Finally, we are promoting our services to the military community and the public through a media campaign that includes print, television, and radio coverage. In fact, our founder and president, Dr. Barbara Romberg, has been interviewed in national media outlets from the Washington Post to NPR’s Diane Rehm Show, Ladies’ Home Journal, and HD Net’s World Report.

Give an Hour recruits mental health professionals in several ways. We have been endorsed by four major mental health associations in the United States–the American Association of Pastoral Counselors, the American Psychiatric Association, the American Psychological Association, and the National Association of Social Workers. Only licensed mental health professionals are included in the network. Licenses are verified. Nonlicensed pastoral providers may be included in the network as long as they meet other criteria, including membership in professional organizations. In addition to coordinating with national organizations, we also recruit mental health professionals through professional publications and Web sites.

As of May 2008 we have a redesigned Web site, expanded to include materials to guide visitors seeking services as well as reference materials to inform mental health professionals. Only mental health professionals trained and experienced to work with trauma victims will identify themselves as available to work with soldiers who have experienced combat. We are working with experts in the trauma field to prepare materials for our Web site and to find appropriate mental health professionals for recruitment.

The Eli Lilly and Company Foundation recently awarded Give an Hour, in partnership with the American Psychiatric Foundation, a major grant that will allow us to spread our message to the leaders of the mental health community in every state.

We are recruiting volunteers from a number of organizations and institutions as well as through our Web site to assist us in the implementation of our program. Volunteers from retired military personnel to members of military families to concerned civilians throughout the country are helping Give an Hour. Volunteers are checking licenses, distributing brochures, and coordinating community partnership opportunities for those troops and family members interested in giving back an hour to their own community.

Our Vision
Our primary focus will always be to attend to those in need by linking them to individuals in our society best equipped to respond effectively. In addition, we will develop research and educational programs to further promote the value and importance of a new kind of volunteerism. We hope to encourage an increase in shared responsibility for those citizens who are suffering. We need only look at the outpouring of aid and support following both the terrorist attacks of September 11, 2001, and Hurricane Katrina in August 2005 to see the potential we have to become a truly compassionate and united nation. And we need only look at the significant costs of the war in Iraq and the relief efforts for Katrina’s victims to see that federal and state governments are already strained beyond their means. We have not only the potential but the duty to help one another in times of need.

For more information, contact
Barbara V. Romberg, Ph.D.
Founder and President

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Understanding and Preventing Teen Suicide

According to the Centers for Disease Control and Prevention, suicide is currently the 3rd leading cause of death among young adults and adolescents 15 to 24 years of age, following unintentional injuries and homicide. Suicide is often a desperate attempt at escaping a seemingly impossible situation or to find relief from bad thoughts or feelings. These feelings could be rejection, hurt, shame, guilt, despair, loneliness, isolation or a host of others. According to the National Institute of Mental Health, scientific evidence has shown that almost all people who take their own lives have a diagnosable mental or substance abuse disorder. Those who suffer from depression and other disorders are less able to cope with situations than others and treatment is necessary to help those suffering see that there are many alternatives and better ways to deal with their problems. In other words, the feelings that often lead to suicide are highly treatable if the help is sought by the individual or if others can recognize the warning signs.

Researchers estimate that there are between 8-25 attempted suicides for each teen suicide death and that four out of five teens who attempt suicide have given clear warnings. There are many behavioral indicators that can help parents or friends recognize the threat of suicide in a loved one. Since mental and substance-related disorders so frequently accompany suicidal behavior, many of the cues to be looked for are symptoms associated with such disorders as depression, bipolar disorder anxiety disorders, alcohol and drug use, disruptive behavior disorders, borderline personality disorder, and schizophrenia.

Some common symptoms of these disorders include:

– Extreme personality changes

– Loss of interest in activities that used to be enjoyable

– Significant loss or gain in appetite

– Difficulty falling asleep or wanting to sleep all day

– Fatigue or loss of energy

Feelings of worthlessness or guilt

– Withdrawal from family and friends

Neglect of personal appearance or hygiene

– Sadness, irritability, or indifference

Extreme anxiety or panic

Self-destructive behavior (drinking alcohol, taking drugs, or cutting, for example)

Poor school performance

Difficulty concentrating

Tragically, many of these signs go unrecognized and while suffering from one of these symptoms certainly does not necessarily mean that one is suicidal, it’s always best to communicate openly with a loved one who has one or more of these behaviors, especially if they are unusual for that person.

There are also some more obvious signs of the potential for committing suicide. Putting one’s affairs in order, such as giving or throwing away favorite belongings, is a strong clue. And it can’t be stressed more strongly that any talk of death or suicide should be taken seriously and paid close attention to. It is a sad fact that while many of those who commit suicide talked about it beforehand, only 33 percent to 50 percent were identified by their doctors as having a mental illness at the time of their death and only 15 percent of suicide victims were in treatment at the time of their death, according to the National Institute for Mental Health. Approximately one-third of teens who die by suicide have made a previous suicide attempt, so a history of suicide attempts is a cause for careful monitoring of behavior.

If you or is someone you know exhibits any of the warning signs of suicide, get help right away. Talk to someone you trust as soon as you can, such as a parent, teacher, school counselor, or therapist. If you are uncomfortable talking about your feelings with someone you know, call a suicide crisis line (such as 1-800-SUICIDE or 1-800-999-9999) or 911. These toll-free lines are staffed 24 hours a day, 7 days a week by trained professionals who offer confidential support to help you work through tough situations. Ashburn Psychological Services has a team of child, adolescent and adult psychologists and psychiatrists available to provide support and can help teens build their own coping skills for dealing with problems.

Michael Oberschneider, Psy.D

Clinical Psychologist


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