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January 24, 2021

It’s been almost a year since we became aware of the COVID-19 novel coronavirus. We had no idea how it would impact us. As time went by and we began to be witness to the thousands of deaths from this deadly virus, our lives changed. We retreated into the safety of our homes. “Safer at Home” became our mantra. Months passed and more people died and we noticed that at home with family, while safe, began to feel limiting. We felt estranged from friends, from work, from church life, from groups we belong to. We became aware that freedom to dine at our favorite restaurants, or travel to places on our bucket list was no longer a safe option. The reality of COVID had taken the breath our of our sails.

Fast forward, a vaccine became available. Is it safe? Should I take it if it becomes available to me? What about my lingering malaise? What about my unexpected anxiety about reuniting with my out-of-the-home relationships? COVID fatigue is a real thing. I’ve listened to my patients talk about how isolated they feel, and some are reluctant to reconnect even with social distancing and face coverings. They are tired. They are exhausted from the hyper-alert safety measures they’ve put into their daily life. So, what now?

Re-entry into life after COVID will take time. Therapy can help with the dysphoria and anxiety. In the meantime, there is HOPE. There are vaccines that can protect us, but we must continue for now, to socially distance and wear our masks. Take care and be safe!

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Mental Health Awareness Week October 1-7, 2017

It’s Mental Health Awareness Week!

Let’s get the word out that mental illness is NOT a condition that effects a small portion of our society. Facts don’t lie. One in five people in any given year will be challenged by a mental illness. Depression is the leading cause of disability in the world according to the World Health Organization ( Can you believe it? Yet people continue to feel ashamed to seek help for one of the most common problems that people everywhere experience.

But, let’s not stop there. There are a number of serious mental health disorders other than Depression that you or your family member, friend, co-worker, neighbor might experience that are in need of attention from a qualified mental health professional. Think Bipolar Disorder, Generalized Anxiety Disorder, Panic Disorder, Post-traumatic Stress Disorder, Schizophrenia, and substance use disorders, to name a few. Frequently, disorders will occur in combination with one or more disorders, e.g., Depression and substance use disorder, or an anxiety disorder with substance use accompanying disorder.

If you or someone you love is struggling with a mental health concern, don’t wait. Reach out now. Now is the time. It could be too late tomorrow.

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Anxiety 101

Thinking about that final exam next week; that next project director’s meeting, or an upcoming speaking engagement? Feeling tense and anxious, even flush or breaking out in a sweat? Anxiety symptoms vary from person to person and can be mildly to moderately disturbing as a normal part of life, in response to facing challenging or threatening circumstances. Anxiety can provide the impetus to plan ahead, meet deadlines, focus on a task, and/or accomplish goals. In that sense, anxiety can be a motivator for success.

But when people experience intense anxiety that interferes with the quality of everyday life, it may be that an anxiety disorder is causing the distress and the individual may benefit from treatment. The first step is to see your primary care physician to make sure your symptoms are not the result of a physical illness. Once that’s determined and assuming there is no general medical condition better able to account for the symptoms, a combination of medication and psychotherapy may be recommended.

Three of the most common anxiety disorders are Generalized Anxiety Disorder, Panic Disorder and Social Phobia (or Social Anxiety Disorder). Psychotherapy or “talk therapy” is often helpful for individuals with anxiety disorders. Psychotherapies used to treat anxiety disorders may include but are not limited to Cognitive Behavioral Therapy, Family Therapy, and psychodynamic psychotherapy. When medically indicated, common medications used to treat anxiety disorders can include anti-depressant medications, anti-anxiety medications, and beta blockers.

The Anxiety and Depression Association of America (ADAA) define the primary symptoms of Generalized Anxiety Disorder as “persistent, excessive, and unrealistic worry about everyday things. People with the disorder, which is also referred to as GAD, experience excessive anxiety and worry, often expecting the worst even when there is no apparent reason for concern”. Panic Disorder is defined by the ADAA as the experience of “spontaneous seemingly out-of-the-blue panic attacks”, accompanied by the fear of a recurring attack. Panic attacks can occur without warning, even while sleeping. Social Phobia or Social Anxiety Disorder is defined as “the extreme fear of being scrutinized and judged by others in social or performance situations” (http//

If you or someone you care about is experiencing any of these symptoms, please consider contacting my practice for additional information and to discuss opportunities for treatment that are designed to help alleviate anxiety symptoms. You or your loved one deserves a quality of life that is rich and fulfilling, not dampened by the potentially disabling symptoms of anxiety.

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The Robin Williams Effect

The day I learned that Robin Williams had died it was as if everything stopped and stood still. That moment was surreal. In the same space of time I felt both grieved and shocked – but not entirely. It was a locomotive that could’ve been seen coming. That’s what we tell ourselves after the fact. After all, hadn’t we known of the paradox of his life, the brilliance of his life’s work in the presence of his personal demons? How does someone the world fell in love with, lose his life in the face of having made so many people happy? Were it so simple to see the train coming. The afterthoughts are deafening. We hear ourselves asking the obvious questions. Who did he tell, hint to, leave veiled messages for?

Williams was known most for his improvisational comedy routines. He made us laugh hysterically. We couldn’t help ourselves. Williams got down to our level and made us feel good about our circumstances. He made us see the humor in the face of war in “Good Morning Vietnam”. He made us wish we had an alien friend in “Mork and Mindy”. In “Good Will Hunting” we became believers in psychotherapy and pulled for the patient to accept the reality of his own gifts, despite his past and his present situation. In “Mrs. Doubtfire” we got a little taste of the tension between reality and pretending. Robin Williams showed us through his work that above all, we are all human.

We didn’t know Robin Williams, yet we identified with him. He gave so much of himself in his performances. He sought to make us laugh, think, re-think and think again. He was the icon of modern day comedy, and yet he took his own life. Why?

According to the Center for Disease Control (CDC), 39,518 individuals in the United States lost their life to suicide in 2011. Another 487,000 were treated for self-inflicted injuries. Isn’t it time to take suicide prevention seriously? The CDC identifies certain hallmark symptoms of suicide risk as follows:
History of previous suicide attempts
Family history of suicide
History of depression or other mental illnesses
History of alcohol or drug abuse
Stressful life event or loss
Easy access to lethal methods
Exposure to suicidal behaviors of others
Rest in Peace Robin Williams. May your choices in death lead us toward the path to better treatment outcomes, more compassion and understanding, and better judgment when we hear the train in the distance.

If you or someone you know is having suicidal thoughts, please call our office at 334-329-7155 for an appointment. For immediate help call the National Suicide Hotline at 800-273-8255, go to the nearest emergency room, or dial 911.

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Spring Fever!

How many times have we said, or heard someone say, “I’ve got spring fever”? What does having spring fever mean, anyway? In an effort to gather data *wink* on the matter, I asked a small sample of my own household (N=1). What is spring fever? Not surprisingly, I heard pretty much what I expected to hear. “It’s when you’ve been cooped up in the house all winter and suddenly you want to go outside and start cleaning up the yard, pruning the shrubs (ok, maybe that should’ve been done a few weeks earlier), and you start thinking about that flower garden and what vegetables to grow this year”. Following the long winter, it’s about cleaning out and preparing for things new. There’s a sense of vibrant energy in the air.

The fact is it’s not just that the days are longer, but our bodies have biochemical responses to the increase in light. We begin to produce less melatonin, an agent that impacts the sleep cycle. Moreover, the body produces increases in serotonin, leading to improved mood and increased energy. And any teacher will tell you this, attention spans may wane, thoughts wander, and sometimes we get off task. It’s spring, after all!

Not everyone experiences the elevated moods of spring that are commonly observed with “spring fever”. Whereas, most people who experience seasonal depression find that their symptoms tend to occur during the winter months, some people have the opposite experience and find their depression to worsen during the spring and summer months.
Depression, regardless of when it occurs, is a treatable condition. There is hope for those who experience symptoms beyond those mood disturbances occurring in everyday life. If you or your loved one is experiencing symptoms of depression, contact Auburn Behavioral Health at (334) 329-7155. Voice mail is checked regularly, 7 days/week. For psychiatric emergencies, call 911 or go to the nearest Emergency Room.

(Sources: DSM 5; Journal of Rational Emotive Cognitive Behavioral Therapy; Canadian Journal of Applied Sciences; European Neuropsychopharmacology; and European Review for Medical and Pharmacological Sciences).

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When “Sadness” Crosses the Line

Everyone feels sad some of the time. We feel sad during times of loss, grief, fear, sickness and even in times of significant change, when sadness is the least expected feeling, such as major life changes including graduations, weddings, retirements, and the like.

But, when sadness crosses the line and becomes overwhelming, making it difficult if not impossible to get through the everyday activities of daily life, it’s time to think about the possibility that something more complicated is going on. Depression. What? No. Not me. Not my child. Not my family member. Not my spouse, partner, lover. But, maybe…maybe I should think again. When DOES sadness cross the line? When should I be concerned? And when should I get help?

Sadness is a natural experience in response to the natural order of life. Things happen. It’s not all good. We wish it were, and we rail against the preposterous outcome of the natural order that something makes us sad, but it does. And, we are, after all, human. Nothing wrong with that! We’re human and part of being human is to feel sad. Period.

BUT. When sadness begins to creep into our lives in such a way as to interfere with the quality of our everyday lives and the effective carrying out of daily life responsibilities in such a way that we become despondent…lose interest in things that would ordinarily bring us happiness, joy or comfort, we should begin to wonder. What is going on, and has my sadness crossed the line into…Depression?

This is where a professional can be helpful in redefining our natural response of “No” with an explanation of why “Yes”; the sadness has crossed the line and become a treatable condition we’ve all heard about called Major Depression, depression, clinical depression, mood disorder, Bipolar depression and similar terms. These terms are known to a reputable therapist as conditions, that once properly diagnosed, are both treatable and from which recovery can be experienced.

If you or your loved one is experiencing any combination of the following that has come to a point in your observation, feels like it’s beyond the norm, call my office for a diagnostic evaluation and treatment plan to recovery:

From the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition – DSM 5:

– Depressed mood most of the day
– Loss of interest
– Significant weight loss or gain
– Sleep disturbance
– Agitation or “slowed down” that goes beyond verbalizing “feeling” slowed down
– Fatigue or loss of energy nearly every day
– Feelings of worthlessness or inappropriate guilt
– Diminished ability to think
– Recurrent thoughts of death

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The Disconnect Between Faith and Behavioral Health

How do we reconcile the fact that mental illness exists alongside evangelical beliefs that the burden of sin brought about the pain and suffering of the human condition? Are we less Christian if we have a mental illness? Do we hide the fact that our child suffers from mental illness from the church, fearful that we will be “judged” as poor parents as a result of the truth? Is the Church the last frontier in the fight against the stigma of mental illness?

Merriam-Webster defines stigma as “a set of negative and often unfair beliefs that a society or group of people have about something”. Is it so difficult to accept that mental illness is a condition that requires treatment?

For the faithful, its important to remember that Jesus, “the Great Physician” spent most of his time with people who were not considered the most healthy and respected. He spent a great deal of time among the poor, the sick, the “sinners”, as many were called, that lived amongst the righteous.

He ministered to everyone’s needs, no matter how insignificant they were thought to be by others. Shame was rampant when it came to sickness, and the sick were often hidden from the rest of the community. When word got out that Jesus was in the area, people brought the sick out into the open, often the outcome of a great deal of trouble doing so. He continued to heal them because of their faith.

How is it that in 2013 we continue to hide our mentally ill, recoil from them, treat them as people who, if only had enough faith would be healed from mental illness? Jesus and his disciples healed others with the gift of Divine healing. We seem to be so very comfortable with the healing hands of God working through modern day physicians trained in the practice of medicine when it comes to broken arms, flu, viruses, and more serious conditions such as heart disease, cancer and diabetes.

Serious mental illness such as clinical depression, certain anxiety disorders, Bipolar disorder and Schizophrenia are examples of neurological brain disorders. We do not pull ourselves up by our bootstraps and “get over it”. That’s one of the “negative” and “unfair” beliefs about mental illnesses that are by definition, stigma. The truth is it takes treatment to manage the symptoms of mental illness.

Does seeking help mean we lose sight of our faith? Hopefully not. Is there a place for faith in the process of treatment? Most definitely. Prayer is a powerful tool in the process of recovery from any medical condition. With serious mental illness however, prayer is a part of a holistic approach to healing; that is, attending to the whole person, mind, body and spirit.

For many people in the Christian community, the first stop on the way to obtaining help for the disabling effects of mental illness begins with a visit to their minister, pastor, priest or spiritual advisor. Clergy have been trained to recognize the difference between a spiritual struggle and a mental health crisis. Once that assessment has been made, a referral for mental health services is often facilitated. Take them seriously. Call for an appointment at (334)329-7155.

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Behavioral Health and Primary Medical Care – Why its important that you obtain a good physical at the beginning of treatment

Quality behavioral healthcare should include collaboration between the patient’s behavioral healthcare provider (e.g., therapist/counselor) and their primary care physician. You may ask, what does my physical health have to do with my behavioral health treatment? The following information will help explain why I believe so strongly in reviewing general medical conditions and symptoms with my clients, and why I ask my clients to have a complete physical, and allow me to collaborate with their primary care physician.

The fact is, people with serious mental health problems die earlier than individuals who do not have these concerns. Premature death estimates range from between 14 to 32 years earlier for those with serious mental health problems Suicide was the 10th most frequent cause of death in the United States in 2010. 38,364 individuals died of suicide, or approximately 105 people per day However, suicide is not the leading cause of death for people with serious mental health issues. Rather, co-morbidity, or concurrent general medical conditions such as heart disease, diabetes, stroke and cancer contribute to the premature death of people with more serious mental health concerns.

It’s also important to note that some physical symptoms can be misdiagnosed as mental health concerns. At the same time, some mental health issues can be secondary to general medical conditions .

Does this mean that all my clients have serious mental health issues? Of course not.The purpose of sharing this information is to encourage collaboration between behavioral health and primary care treatment. As a behavioral health provider I believe that treatment of the whole person, mind, body and spirit is essential to achievement of the best quality of life that can be achieved. Questions? Call 334.329.7155 for a brief consultation to see if behavioral health treatment is appropriate for you.

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Do You Need Psychotherapy?

People choose psychotherapy for a myriad of reasons. “Symptoms” often propel people to contact their primary care physician first to obtain a professional opinion as to the nature or cause of the symptoms. However, in addition to physicians and other appropriate health care providers, licensed professional counselors can also diagnose and treat behavioral health conditions, with the exception of prescribing medications.

Behavioral health diagnoses are treatable just like other medical conditions such as hypertension, diabetes, or heart disease. Physicians often prescribe medications for behavioral health conditions, but their time is generally limited and may not be enough to provide all the necessary supports to improve and manage symptoms such as depression, mood swings, anxiety, attention problems, confusion, fatigue, co-occurring disorders, and other possible manifestations of behavioral health conditions. Many times, this is the time when a doctor or other helping professionals will recommend psychotherapy, with or without the concurrent treatment of a condition with medication.

Generally speaking, if you are experiencing symptoms that have caused you enough concern to discuss them with a medical professional, your pastor or minister, or in close confidence with a family member or close friend; or, have been significant enough for you to wonder if you need therapy, you may be a candidate. Is it time for you to take the next step? If so, see our Contact page at