Common Conditions

Attention Deficit Disorder (with or without hyperactivity) ADD/ADHD affects between 3-5% of children and can persist into adulthood. It is characterized as difficulty focusing, hyperactivity, organizational difficulties, and impulsiveness. Problems can arise is various areas of life, at home, school, work, or in relationships. ADD/ADHD is often over diagnosed, as anxiety, depression, and other conditions influence attentional capabilities. Proper assessment is essential to determine if, in fact, someone has ADD/ADHD, or what might be impacting their attentional and organizational skills. Behavioral treatment, organizational skills, structural skills, and lifestyle modifications such as exercise are often part of therapy.

Many of my clients are Physicians, Attorneys, Dentists, Executives / C-suite, Psychologists & Therapists, Business owners & Entrepreneurs, Finance / Wealth-Management Professionals, Accountants, Prominent Celebrities, and Scientists. Harry Levinson, in his classic article that appeared in the May-June 1981 issue of Havard Business Review, identified the following characteristics of executive burnout: (1) chronic fatigue; (2) anger at those making demands; (3) self-criticism for putting up with the demands; (4) cynicism, negativity, and irritability; (5) a sense of being besieged; and (6) hair-trigger display of emotions.
Executives, corporate leaders, and professionals are under tremendous pressure and extreme feelings of stress are pervasive and growing worse. Within the current economic climate increased competition, downsizing, re-engineering, and doing more with less have increased pressures tremendously.
Compounding the problem, executives typically don’t have a good idea of when they need change strategies for themselves, take time off or are reaching “the edge.” They have been taught and trained to get the job done and not show weakness (or what may be perceived as weakness). They are often better at supporting their direct reports and other staff than themselves. This can result in depression, substance abuse, a lack of balance in life, and relationship difficulties.
Health care professionals, lawyers, business owners, and other professionals are typically bright, skilled, hard working, agreeable, a little obsessive, and good at putting their heads down and getting the “job done.” This frequently leads to neglecting their own needs, important relationships, and dissatisfaction in life. Creating balance in life is important, and being able to focus on work when working, and enjoy life when not working is possible.

People with a high IQ see the world and process experiences differently than others. What seems simple and obvious to you may be complex and unreachable to others. You quickly solve a problem that others are struggling with. You notice nuances of experience that others do not see. You run the board on “Jeopardy” when others are quiet. Sometimes this can result in being frustrated, inpatient and feeling disconnected from others. The high-IQ person has an active mind. Sometimes this can lead to sleep problems or be interpreted as anxiety, Obsessive-compulsive disorder, or Attention-Deficit Disorder.
I have helped high-IQ people develop healthy ways of quieting the active mind, sleeping better, relating better socially, and being less frustrated.

Clinical depression is very common, and very treatable. Symptoms include: sleep problems, weight or appetite changes, concentration problems, low energy, physical sluggishness, feelings of guilt, loss of interest in things that were once pleasurable, thoughts of self-harm, low motivation, and low libido. People who are depressed often have a negative view of themselves, others, and the future. Data from the National Institute of Mental Health, World Health Organization, and the Centers for Disease Control and Prevention all show that about 1 in 10 people meet the diagnostic criteria for clinical depression.
There are different forms of depression, some more severe than others. For instance, major depressive disorder is an episode where someone experiences at least 5 depressive symptoms for a two-week period (fewer than 5 symptoms is still significant), dysthymia has fewer and lower-level symptoms that exist more days than not for a 2-year period.

Anxiety is a normal response to stress, and, in fact, can be a good and productive part of life. When nervousness, worry, obsessiveness, “what if” thinking, and fear are excessive, it can be extremely difficult to manage and function optimally without treatment.
There are different forms of anxiety including:
Generalized Anxiety Disorder is characterized by excessive worry about minor or major concerns. People typically realize that their anxiety is excessive, but can’t get rid of their concerns. They often characterize themselves as “a worrier” and have difficulty relaxing, startle easily, and often have trouble falling asleep or staying asleep.
Panic disorder is characterized by sudden and recurring attacks of fear or terror that come on with or without warning. Often resulting in a cardiac evaluation or a trip to the ER, physical symptoms of a panic attack include sweating, chest pain, palpitations, and a feeling of choking.
People with Obsessive-Compulsive Disorder are plagued by constant intrusive thoughts or fears that often cause them to perform certain rituals or routines. Thoughts are called obsessions, and the rituals are called compulsions. For example, a person with an unreasonable concern of germs who constantly washes their hands.
Post-Traumatic Stress Disorder can develop when a person experiences or witnesses a traumatic and/or terrifying event where death or serious injury was possible. Events can include a sexual or physical assault, combat, a car accident, or a natural disaster. People with PTSD tend to be emotionally numb and frequently re-experience the event via dreams or flashbacks, have a heightened starte response, and avoid situations that are related or similar to the event. PTSD can also occur after a friend or family member experiences danger, is harmed, or dies suddenly.

The misuse of substances and other addictive behaviors such as problem gambling and computer addiction are widespread problems effecting millions nationally. Generally, an addiction is the repeated use of a psychoactive drug, or repeated behavior despite adverse consequences.
Substance Abuse is characterized by failing to fulfill role obligations at work, school, or home; continued use despite social or personal difficulties; and potential legal problems due to the effects of substances.
With Substance Dependence the person experiences tolerance (needing more to achieve desired effect) and/or withdrawal (physical and psychological symptoms experienced when reducing or discontinuing a substance), uses in larger amounts or longer than intended, has a persistent desire or one or more unsuccessful efforts to cut down, and spends a great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of substances.
A Dual-Diagnosis or Co-Occurring Disorder is a condition where an individual has both a substance-related problems as well as a psychological or psychiatric condition. This can be complex, as the effects of many substances can cause or mimic psychological conditions, and people with psychological conditions can use substances as a method of self-medication or escape. Treatment for this complex situation can be particularly challenging, as there is often a separation between substance abuse treatment and psychological intervention. An integrated approach is often best.

Bipolar Disorder (Manic Depression) is a condition where mood, energy, activity, and the ability to function can fluctuate greatly. Severity can fluctuate from wild mood swings and psychotic behavior, to mild to moderate mood swings with the person maintaining an ability to function.
Diagnostically, a person must have at least one manic or hypomanic episode. Frequently, they have recurring depressive episodes. A manic episode is defined as: abnormally and persistently elevated, expansive, or irritable mood for at least 1 week, inflated self-esteem or grandiosity, decreased need for sleep, pressured speech, flight of ideas or racing thoughts, distractibility, increase in goal-directed activity, and an excessive involvement in pleasurable activities that have a high potential for painful consequences.

Post-Traumatic Stress Disorder (PTSD) develops in some people who have experienced or witnessed a shocking, scary, or dangerous event. Sadly, people experience accidents, rapes, fires, or natural disasters. Some are in combat environments, have dangerous jobs, or witness or hear about terrible situations. When people first experience a trauma, shock and denial are typical. PTSD symptoms reactions include:
1. Re-experiencing the event or situation: spontaneous memories of the event, flashbacks, bad dreams related to it, or other intense psychological distress.
2. Avoidance: avoiding thoughts or feelings associated with the event, staying away from situations similar to or reminding of the event.
3. Arousal: aggressive, reckless or self-destructive behavior, sleep disturbances, hyper-vigilance, exaggerated startle response, or related problems.
4. Negative alterations in cognitions and mood: persistent and distorted blame of self or others, persistent negative emotional state, estrangement from others, diminished interest in activities, inability to remember key aspects of the event.
My experience includes working for several years in VA settings including a year at the National Center for PTSD Ann-Arbor VAMC. I have worked with countless Combat Veterans, Law Enforcement Officers, Government Employees, and Private Contractors. I have heard many stories of traumatic and sometimes brutal experiences. I have helped people unwind survivors’ guilt, process traumatic experiences to reduce PTSD symptoms, embrace intimacy and vulnerability, and become themselves again.