Common Presenting Concerns

I address a variety of presenting concerns in my practice.  While the following list is not all-inclusive, it describes many of the common presenting concerns I am accustomed to treating:

Life Changes: Change may be the only constant in our lives, the only thing we can continually count on to keep us on our toes.  Some change may be positive, such as a new relationship or marriage, while some change is more likely negative, such as the loss of a loved one, divorce, or receiving a scary new medical diagnosis.  Still other change may be either depending on your experience, such as having a new baby, starting college, or beginning a new job.  Regardless of how you conceptualize your new change, it is likely to be stressful and may even change the way you conceptualize yourself.  You're now a college freshman, or a mother/father, or a cancer patient.  And now you have to learn to deal with that new identity.  Whatever your change is, I can help address the stress and together we can figure out how you're going to live with this new puzzle piece.  And hey, since we know change is constant, by dealing with whatever new change is stressing you out now, you'll better be able to tackle the next one.

Anxiety: Anxiety is normal and something we all experience in our lives; however, at times it can be intense enough to be disruptive.  Sometimes anxiety becomes so extreme it meets criteria for one of several anxiety or related disorders.  Whether you have an anxiety disorder or not, it can be useful to learn strategies for managing anxiety.  I say manage because we all have some anxiety and it can be a useful experience.  Therefore, our goal will be to bring anxiety within a healthy limit - usually by introducing strategies you can practice in session and on your own, in the situations that spark your anxiety.  Below is a list of some of the anxiety problems I treat.  While each is framed as a disorder, each can also be troubling in a milder form that does not meet full criteria of the disorder itself.  Treatment can be helpful whether or not the problem counts as a "disorder."

Panic and Agoraphobia
Social Anxiety
Obsessive Compulsive Disorder
Generalized Anxiety
Post-Traumatic Stress
Specific Phobia

Depression: Sadness is one of six basic human emotions, along with happiness, anger, fear, disgust, and surprise.  Almost everyone has periods of sadness, or low mood, and most of us find that this mood can interfere with our work or social lives.  For some people, however, low mood lasts for an unusually long time or worsens into depression, indicating a possible depressive disorder.  Whether you are experiencing transient sadness or a clinical diagnosis, it can be useful to address your mood therapeutically - usually by exploring the role your thoughts, behaviors, and social interactions play in your emotional state.  Below is a list of the depressive disorders I treat, including bipolar disorder, a mood disorder characterized by extremely high mood that may or may not involve low mood. 

Major Depression
Dysthymia
Bipolar Disorder ( I & II)

Disordered Eating: Eating is so central to human nature that disturbances in normal eating behavior can be very difficult to understand.  For most people, food and eating are rich aspects of human existence and the focal point of many social engagements.  But for those who are vulnerable to disordered eating, these seemingly harmless events can be incredibly frightening and difficult to navigate.  In extreme cases, some people may restrict what they eat, inappropriately compensate for what they eat, or overly indulge in food, meeting criteria for one of the eating disorders listed below.  Whether you fit into one of these categories, alternative eating concerns, or an entirely different variant of eating behavior, it can be useful to address your concerns with a professional.  Addressing an eating concern may seem daunting as food cannot entirely be abstained from as substances can in the treatment of substance use disorders.  Together, however, we can improve your relationship with food and make eating a more manageable and enjoyable activity.

Anorexia Nervosa
Bulimia Nervosa
Binge-Eating Disorder

Sexuality: Humans are (often) sexual beings.  Some of us are oriented toward the opposite gender, others toward our own gender, and many more to both genders, neither, or the fluid space in between.  I offer services for people experiencing a wide variety of concerns related to sexual orientation, including those who are questioning their orientation or considering "coming out."  Many people find themselves questioning whether they are gay, straight, bisexual, transsexual, or asexual.  Although there is no rule that says we must define ourselves clearly or for good, this issue has a bearing on the relationships we form and aspects of the future we envision for ourselves.  Reflection can clarify many of these concerns.  Similarly, being open about a non-heterosexual orientation can be both an important and difficult issue for many people.  Who do you come out to?  How?  When?  Although I cannot answer these questions for you, counseling offers the opportunity to explore these issues.  Counseling can also be a useful forum for concerned parents and family members, people dealing with sexually transmitted infections (e.g., HIV/AIDS), and people affected by sexual difficulties.

Substance use: While many of us can use substances without problem or impairment, others fall into a pattern of abuse or dependence. Some of this is genetic and some is due to our environment and the role substances play coping with day-to-day stressors. For those who abuse substances, problems often arise - including legal consequences (which is more common when the substance or pattern of use is illegal), lost jobs, or impaired relationships. For others, a pattern of dependence emerges that is classified by increased tolerance and the onset of withdrawal symptoms when the pattern of use stops or decreases. Whether your pattern of use cleanly fits into one or both of these categories or not, counseling can be useful if there are only whispers of a problem, or if someone else has expressed concern but you’re not sure if you agree with them. Talking about a possible problem early can be the best way to explore the issue further and stop the pattern from getting worse. While many more substance use disorders may be diagnosed, below are the ones I work with most:

Alcohol Use Disorder
Cannabis (Marijuana) Use Disorder
Tobacco Use Disorder

Trauma: Trauma, unfortunately, is something that happens to many people. It is defined as experiencing or witnessing actual or threatened death, serious injury, or sexual violence. While some people may experience relatively few complications as a result of trauma, it can take a dramatic toll on others, coloring their world and changing their perception of other people, the world, and themselves. People with such an reaction to trauma may experience intrusive flashbacks, memories, or nightmares reminiscent of the trauma. They may avoid people, places, and emotions that serve as a reminder of the trauma. They may also develop an increased startle response and vigilant awareness of their surroundings or experience memory loss and low mood. Counseling can be a useful forum to explore trauma further and its ramifications on a person's life. It can also be a place to become more accustomed with the "trauma narrative" which drives so many of the above symptoms. Such a response to trauma is generally associated with:

Posttraumatic stress disorder

Note: Information on these pages is provided for educational purposes only.  It should not be taken as a substitute for care from a licensed healthcare professional.