Most people have experienced anxiety from time to time when taking an exam, having a job interview, etc.  But sometimes, the anxiety can be overwhelming to the point that people become paralyzed. This might affect different areas of their life such as school, work, relationships and physical health.  People might avoid certain situations to try to reduce their level of anxiety such as social gatherings, people, public places or might start to isolate themselves which can make things worse.  People who experience intense levels of anxiety describe it as having multiple thoughts at once without control, worrying a lot, having physical sensations such as heart beating fast, trouble breathing, sweating, shaking, feeling lightheaded and restless.  People who experience anxiety might have trouble concentrating, trouble falling asleep or they might wake up often during the night and may have difficulty eating a whole meal.  Have you ever experienced any of the above? Do you worry a lot about your future? Do you feel your anxiety is out of control and you don’t know what to do? Have you tried to cope with it but is not working out? Is it getting worse? Anxiety requires treatment if not it can get worse. 



Sometimes is normal to feel sad when things happen.  But other times people may experience an intense sadness that does not go away.  It can happen on and off for days, weeks, months and even years.  Most people have a decrease in their level of motivation, difficulty concentrating, a lack of interest in things they used to enjoy before and might start isolating.  Some people might describe this as feeling apathetic.  People who experience this condition have a hard time doing or starting their daily routines such as getting up in the morning, taking care of themselves, difficulty sleeping or eating. This can sometimes affect their school, work, relationships and physical health as their level of functioning can become impaired.  Have you ever experienced any of these? Do you feel an intense level of dissatisfaction with your life? Do you feel guilty or worthless? Sometimes you might not want to put a label to your condition or seek counseling because of the stigma associated with both.  But major depression is a condition that requires treatment if not it can get worse. It is not uncommon for people to have thoughts of death, self-harm, or suicide.  If that is the case is important to reach out for help. Here are some resources that could be helpful if you are thinking of suicide: call 911 or the National Crisis Hotline at 1-800-273-8255. For resources available in your country go to the following link


Relationship concerns

Dealing with romantic and relationship concerns can have a great impact in your mental health. I have worked with many individuals who struggle with this concern.  People have a hard time knowing what to do.  Sometimes, the first thing you might want to do is seek the support of somebody you trust.  Other times you might not have somebody to turn to.  You might not want to share your relationship problems with others.  Many times when couples have problems is due to an accumulation of things they did not talk about or worked through what happened in the past. Speaking to the person that you love might be the hardest thing to do. But is one of the most important things in a relationship.  Have you felt that way? Communication is one of the crucial factors in strengthening a relationship to make it work. When people start a relationship or have years in a relationship getting acquainted is just as important, talk about values, likes, dislikes and respect for each other differences.  It is important to talk about how to compromise when you have differences.  Counseling can be helpful to identify patterns or discrepancies in relationship.  Remember a relationship means two so both parties have to be willing to work together to make the relationship work.  If one of the partners has an untreated mental or substance use disorder the other partner might not know what to do to help that person which might make the situation harder.  Some people might not want to seek counseling because of the stigma associated with it.  Whatever the situation remember you don’t have to be alone trying to figure things out, there is help out there.  

Adjustment concerns

Change is happening constantly but dealing with it can be tough at times.  Moving to a new a place or country, retirement, starting a job, studying abroad, etc, all these events might be lead to stress.  You might feel excited about the change that is about to happen and the first few days will be good, but sometimes that can change. People may start to feel isolated if they don't believe they are fitting in or things are not working like they thought.  Sometimes it's hard to meet people, make friends or even start a new activity.  This might lead to an increase sense of isolation and questioning whether you made the right choice.  Sometimes, you start to get used to the change and you may feel better, but sometimes that might not be the case.  People may want to leave their current circumstances and go back to what they had because they think that will make things better.  When the change is rough certain feelings come to the surface that feel uncomfortable. People may see an increase in their anxiety level or even experience panic attacks. The first thing people think of is to do something to change those feelings rather than trying to understand where those feelings are coming from.  People tend to compare themselves to others 'why is that person fitting in better than I am?, or they seem to have it together.'  You don't know that you only see what they show.  Those people could be having a hard time just like you.  Try not to be so hard on yourself.  The important thing is to focus on what you feel and know that it is normal to have difficulty adjusting to change, to a new country, to a new culture, etc.  You don't necessarily have to move to a new country to experience diversity.  Moving to a new place is not the only thing that leads to adjustment concerns.  If you are having a tough time adjusting to your current circumstances and you need somebody to talk to then is important to seek help.  You may need extra support in this transition.  

Helping a friend in distress

We all have experienced stress at some point in our lives.  Stress can be positive (buying a house, going to college, etc) or negative (an illness, losing a job, etc).  Whether positive or negative, stress is stress.  Sometimes, stressors can become overwhelming that a person might not know how to respond.  They may start showing signs that can be worrisome or like they are not acting like themselves.  Has this ever happened to you or maybe to somebody you care for?

Excess of stress can manifest in a person in several ways such as:

  • Irritability, intense sadness, extreme anxiety or worry, crying spells, angry outbursts
  • Restless, hyperactivity or pressured speech 
  • Self-injury (cutting, scratching)
  • Sleeping problems or changes in eating habits 
  • Loss of interest in activities once enjoyed before, social withdrawal

How to help if you are concerned about somebody or if they come to you for support:

  • Reach out to them and talk to them in private in a nonjudgmental and supportive way.  
  • Let them know you have noticed some changes in them (describe behaviors you’ve seen) that make you feel worried.  Offer an open ear and listen.  Let them do the talking.  
  • Based on what you hear you can provide support by acknowledging what they have shared ‘it sounds like you have a lot going on.’ 
  • Don’t offer advice right away let them finish if they share how they are feeling.  If they don’t just let them know you are there for them whenever they are ready to speak.  Don’t pressure them to share if they say no.  
  • Talk to them about seeking professional help.  Let them know of crisis hotline numbers in your area.  Offer your assistance in making phone calls or looking for counselors. 
  • Offer to check-in with them about how they are doing. 

Crisis situations can range from mild to life threatening. Somebody in a crisis emotional state might show signs of the following:

  • Extreme agitation or panic 
  • Inability to communicate
  • Verbal or physical threats or violent acts
  • Self-injury (cutting, scratching, pulling hair, picking nails, burning)
  • Threats of suicide 
  • Disorientation and confusion

What to do:

  • If you are worried about your own safety or the safety of others, don’t take it upon yourself to solve things on your own. Seek professional help immediately and let them handle the situation.
  • Call 911 immediately or take them to the nearest emergency room if possible.  You can also call the National Crisis Hotline at 1-800-273-8255.
  • Your safety is just as important as that of the person in distress.  Think of your limits and what you can handle.  
  • Helping somebody can be stressful especially if you don’t know what to do or they don’t want help.  Seek professional help for yourself to talk through this experience and get the support that you need.  

Parenting concerns

Parents deal with multiple stressors every day such as work, finances, relationships etc.  It can become overwhelming for parents to deal with multiple stressors at once.  This in turn can impact their relationship with their children.  Some parents might not know what to do when a situation arises with one of their children.  They might not have the energy.  They might want to do as much as they can to work with or decrease a behavioral or emotional concern manifested by one of their children.  They might think they are not good parents because they can’t help their children.  They might not want to seek professional support as they might see that other parents are handling situations on their own.  Can you relate to any of the above?  Seeking help from a professional when dealing with parenting issues can help you get the support that you need.  With all the responsibilities that you have to focus on sometimes getting extra help can be an advantage.  You don’t need to have all the answers when dealing with parenting issues.  Your children did not come with a manual.  You have had to be a parent on your own or with the help of your partner.  Many times your children can react to situations around them that you were not aware of.  They might react to situations that you did not think could be an issue for them.  For some parents getting the answers that they want from their children can be difficult because verbal skills are not fully developed which might feel frustrating, but even those who have verbal skills such as adolescents might not be ready to share all their feelings which could be frustrating too.  

Trauma and PTSD

Trauma can be described as an event that has caused intense fear, horror or helplessness to a person. A person may feel threaten of their safety and the safety of others.  The event can be experienced, witnessed or vicarious.  There are different events that have been defined as traumatic such as child abuse, sexual abuse, domestic violence, sexual assault, natural disasters, chronic illness, traumatic loss, community and school violence, war among other. Approximately 70% of the US population has experienced one traumatic event in their lifetime and 20% will develop Post-traumatic Stress Disorder.  This condition leads to feeling numb, distant or cut off from people, intense physical and emotional reactions when reminded of trauma, avoidance of feelings associated with trauma, feeling startled, having angry outbursts, trouble sleeping, hyper vigilance, worried that trauma can happen again, and feeling as if the trauma is happening all over again.  This can lead to difficulties at work, school and relationships.  PTSD can develop months after or even years after the traumatic event has happened.  People can also experience depression, anxiety or panic attacks, somatic symptoms, chronic pain, dissociating sensations as a result of trauma exposure.  Not everybody who has a traumatic experience will develop PTSD.  There are a number of factors that increase the likelihood of developing PTSD such as a lack of support and resiliency, complexity of trauma, re-traumatization, alcohol or drug abuse.  Somebody that has a history of trauma is 6 times more likely to develop depression, anxiety among other.  


Alcohol and drug concerns

This can be a sensitive topic to discuss and people might not be sure whether their use of substances is considered abusive, problematic, an addiction or not.  Individuals with a substance abuse concern learn in therapy that their use might not be as moderate as they thought.  People who begin treatment for their substance use started by seeking help for other concerns such as depression, anxiety or trauma.  Some of the reasons that people start misusing substances is to cope with their mental conditions or self-medication, addiction, peer pressure, boredom, isolation, etc.  People start drinking or using a substance for a longer period than intended, try to cut down or quit but are unable to, have intense cravings, use more of a substance to get the same effect as before, spend most of their time on substance related activities, continue to abuse a substance despite worsening of emotional, physical, relationship or work related problems. People often are in denial or unaware they have a substance abuse concern.  Do you relate to any of the things mentioned above? If you are interested in learning ways to moderate your use or learn more about your pattern of use or need help in your recovery then send me a message. 

Spiritual/existential concerns

Many people struggle with this concern.  Why am I here? What is my purpose in life? How can I make a difference in this world? Is there life after death?  Sometimes it’s hard to find the answer to any of these questions.  People may feel disappointed or sad as they study or work in jobs they don’t like because they think they couldn’t find their true purpose.   When people don’t know why they exist, it can make them feel worthless or hopeless.  They may start to feel alone and depressed and questioned their own existence.  Would things be better off if I wasn’t here?  They can feel anxious and worried about their future.  Am I always going to feel this way?  Would I ever find purpose and meaning? They may start losing track of their present as they think about their disappointing past and their unknown future.  Some people may struggle with their own forgiveness for mistakes of the past and fears of the uncertainty of the future.  It can become a never ending loop that can be hard to get out of.