Adult Psychiatrist

Joseph Simpson, MD,PhD

Adult Psychiatrist

Elizabeth Roberts, MD

Child, Adolescent Psychiatrist

Michael Ferguson, LCSW

Therapist

Enas Elshiwick,MFT, PsyD

Therapist - Psychologist

Sandy Moghadam, DMFT

Therapist

Danielle Organista, LMFT

Therapist

Catherine Speckmann, LCSW

Therapist

Mary-Louise Henson, LMFT

Therapist

Teena Honstetter, PsyD, LMFT

Therapist- Psychologist

Lana Delshadi, Ed.D.

Neuropsychological testing

Jessica Denbo, Psy.D

Thetapist- Psychologist

April Murray, RD

Registered Dietitian

Treatment for :

Depression

Mood Disorder

Bipolar Disorder

Anxiety

Panic Disorder

OCD

Social Phobia

Eating Disorders

Binge Eating Disorder

Compulsive Overeating

Sleep Disorder

Learning Disability Evaluation

Alcohol and Drug Abuse

Alcohol and Drug Dependency 

Addiction

ADD - ADHD  Testing

ADD - ADHD Treatment

Unhealthy Habits

Stress

Loss and Grief

Trauma and PTSD

Anger Management

Family Issues

Psychosis and Thinking Disorders

Laguna Behavioral

949.367.1200

28281 Crown Valley Parkway

Suite 140

Laguna Niguel, CA 92677

Long Beach Behavioral

562.597.7575

4500 E. Pacific Coast HWY

Suite 120

Long Beach, CA 90804

We accept:

Visa

Master Card

America Express

Discover

Checks

Blue Cross

Blue Shield

Pacific Care

United Healthcare (UBH)

Cigna

Value Options

Aetna PPO

TriCare

Health Net PPO

Humana

Joseph R. Simpson, MD, PhD

EDUCATION

M.D. and Ph.D., Washington University School of Medicine, St. Louis, Missouri, 2001 B.A. magna cum laude in biology, Harvard University, Cambridge, Massachusetts, 1992

POSTGRADUATE TRAINING

Fellowship in Forensic Psychiatry, Keck School of Medicine, USC Institute of Psychiatry, Law and Behavioral Science, Los Angeles, California, July 2005-June 2006

Chief Resident, Psychiatric Intensive Care Unit (acute inpatient ward), West Los Angeles VA Medical Center, Los Angeles, California, July 2004-June 2005

Internship and Residency, UCLA Neuropsychiatric Institute/West Los Angeles VA Medical Center, June 2001-June 2005

LICENSURE

California Medical License No. A81057.

BOARD CERTIFICATIONS

American Board of Psychiatry and Neurology, Psychiatry Certificate No. 56947, 2007

American Board of Psychiatry and Neurology, Forensic Psychiatry Certificate No. 1797, 2009

ACADEMIC APPOINTMENTS

Clinical Assistant Professor of Psychiatry, University of California, Irvine School of Medicine, July 2009-present

Clinical Assistant Professor of Psychiatry, USC Keck School of Medicine, July 2006-present

Clinical Instructor, Dept. of Psychiatry, USC Keck School of Medicine, July 2005-June 2006

PROFESSIONAL TRAINING AND EXPERIENCE

Attending Psychiatrist, Mental Health Treatment Center, VA Long Beach, July 2006-January 2011. Performed initial intake evaluations, provided same-day psychiatric urgent care, and admitted patients to inpatient unit when indicated.

Attending Psychiatrist, Inpatient Geriatric Psychiatry Unit, VA Long Beach, January 2011- present. Responsible for 15-bed inpatient unit. Supervise nurse practitioners, psychiatry residents, and geriatric medicine fellows in delivery of inpatient care.

Court Psychiatrist, Los Angeles County Superior Court, Department 95 (Mental Health Branch), May 2007-August 2010

Los Angeles County Superior Court Expert Witness Panel, 2007-present San Bernardino County Superior Court Expert Witness Panel, 2007-2008 Orange County Superior Court Expert Witness Panel, 2006-present

Forensic Psychiatry Fellowship, 2005-2006

Conducted psychiatric-legal evaluations for attorneys and judges in criminal, juvenile and dependency law. Evaluated and treated in a jail setting mentally disordered misdemeanor offenders found incompetent to stand trial. Performed evaluations of sex offenders’ appropriateness for group therapy. Conducted sex offender group therapy.

Program for Torture Victims, 2004-2005

PGY-IV Elective Rotation. Provided outpatient diagnostic evaluations and medication management for refugees who suffered torture in their home countries seeking asylum in the United States.

Twin Towers Correctional Facility, 2003-2004

PGY-III Elective Rotation. Performed diagnostic evaluations, placement decisions and

medication management for male and female county jail inmates with mental illness.

California State Prison at Corcoran, 2003-2004 Weekend patient care at a 75-bed hospital (including a 25-bed psychiatric ward) and an outpatient psychiatric clinic at a maximum-security prison.

TEACHING EXPERIENCE

Clinical Assistant Professor, University of California, Irvine School of Medicine, July 2009- Present

Provide clinical supervision of second-year psychiatry residents in emergency and urgent- care psychiatry. Lecture to second-year psychiatry residents on forensic psychiatry and medico-legal issues and to first- and second-year psychiatry residents on substance abuse.

Clinical Assistant Professor, University of Southern California Keck School of Medicine, July 2006-Present

Provide lectures to forensic psychiatry fellows on firearms laws, on neuroimaging and genetics in forensic psychiatry. Provide mentoring of forensic psychiatry fellows.

Forensic Psychiatry Fellowship, July 2005-June 2006

Supervision of PGY-I and II residents on civil commitment of patients, supervision of PGY-III residents on forensic cases, and instructor for medical school forensic psychiatry elective.

Chief Residency, Psychiatric ICU, West LA VAMC, July 2004-June 2005?Delivered weekly lectures to interns and second-year residents. Supervised inpatient rounds regularly. Evaluated housestaff clinical performance.

SELECTED PUBLICATIONS

Simpson JR and Isacson O. Mitochondrial impairment reduces the threshold for in vivo NMDA- mediated neuronal death in the striatum. Experimental Neurology 121: 57-64, 1993.

Drevets WC, Price JL, Simpson JR Jr., Todd RD, Reich T, Vannier MW and Raichle ME. Subgenual prefrontal cortex abnormalities in mood disorders. Nature 386: 824-7, 1997.

Simpson JR Jr., Ongur D, Snyder AZ, Conturo TE, Ollinger JM, Akbudak E and Raichle ME. The emotional modulation of cognitive processing: an fMRI study. Journal of Cognitive Neuroscience 12 Supp. 2: 157-170, 2000.

Simpson JR Jr., Snyder AZ, Gusnard DA and Raichle ME. Emotion-induced changes in human medialprefrontalcortex:I.Duringcognitivetaskperformance. ProceedingsoftheNational Academy of Sciences 98: 683-687, 2001.

Simpson JR Jr., Drevets WC, Snyder AZ, Gusnard DA and Raichle ME. Emotion-induced changes in human medial prefrontal cortex: II During anticipatory anxiety. Proceedings of the National Academy of Sciences 98: 688-693, 2001.

Simpson JR Jr., Thompson CR and Beckson M. Impact of orally disintegrating olanzapine on use of intramuscular antipsychotics, seclusion and restraint in an acute inpatient psychiatric setting. Journal of Clinical Psychopharmacology 26: 333-335, 2006.

Simpson JR. Issues related to possession of firearms by individuals with mental illness: An overview using California as an example. Journal of Psychiatric Practice; 13:109-114, 2007.

Simpson JR. California Mental Health Firearm Laws: A Brief Summary. California Psychiatrist; 22:8, 15-16, 2007.

Simpson JR. Bad Risk An Overview of Laws Prohibiting Possession of Firearms by Individuals with a History of Mental Illness Treatment. Journal of the American Academy of Psychiatry and the Law, 35:330-338, 2007.

Simpson JR and Sharma KK. Mental Health Weapons Prohibition: Demographic and Psychiatric Factors in Petitions for Relief. Journal of Forensic Sciences, 53:971-974, 2008.

Simpson JR. Functional MRI lie detection: Too good to be true? Journal of the American Academy of Psychiatry and the Law, 36:491-498, 2008.

Simpson JR and Beckson M. Methamphetamine in Criminal Court. American Academy of Psychiatry and the Law Newsletter, 34:17-18, 2009.

Simpson JR and Farhadi P. California’s Mentally Disordered Offender Law. American Academy of Psychiatry and the Law Newsletter, in press.

Simpson JR, Editor. Neuroimaging in Forensic Psychiatry: From the Clinic to the Courtroom. Wiley-Blackwell, 2012.

SELECTED PRESENTATIONS

“Firearms and the Mentally Ill: Demographics and Psychiatric Characteristics of Individuals Petitioning for Early Relief from Firearms Prohibition,” Annual Meeting of the American Academy of Forensic Sciences, February 23rd, 2007

“The Psycho-Legal Implications of Brain Trauma: A Case of Episodic Dyscontrol and Central Brain Tumor”, by A.M. Weisman and J.R. Simpson, Annual Meeting of the American Academy of Forensic Sciences, February 24th, 2007

“Overview of Mental Health Firearms Laws,” Meeting of the Southern California Chapter of the American Academy of Psychiatry and the Law, June 23rd, 2007

“fMRI Lie Detection: Too good to be true?” Annual Meeting of the American Academy of Psychiatry and the Law, October 18th, 2007

“Functional MRI in Lie Detection: Reality or Fantasy?” Meeting of the Southern California Chapter of the American Academy of Psychiatry and the Law, January 19th, 2008

“Overview of Mental Health Firearms Prohibitions,” Annual Meeting of the American College of Forensic Psychiatry, April 6th, 2008

“Methamphetamine, Psychosis and Violence in Criminal Forensic Psychiatry,” by M. Beckson, D. Kan and J.R. Simpson, Annual Meeting of the American Academy of Psychiatry and the Law, October 24th, 2008

“Veterans’ Issues in Forensic Mental Health,” Meeting of the Southern California Chapter of the American Academy of Psychiatry and the Law, June 4th, 2011

ACTIVITIES

Councilor, Southern California Psychiatric Society (APA District Branch), April 2010-present Member, Ethics Committee, VA Long Beach Healthcare System, 2009-present

Member, Suicide Prevention Committee, VA Long Beach Healthcare System, 2008-present Member, Forensic Neuropsychiatry Committee, American Academy of Psychiatry and the Law(AAPL), 2011-present

Member, Criminal Behavior Committee, AAPL, 2008-present

Member, Psychopharmacology Committee, AAPL, 2008-present

Member, Addiction Psychiatry Committee, AAPL, 2006-2011

PROFESSIONAL SOCIETY MEMBERSHIPS

American Academy of Psychiatry and the Law, 2004-present

American Psychiatric Association, 2001-present

California Psychiatric Association, 2001-present

Southern California Psychiatric Society (APA District Branch),

2001-present

Adel Eldahmy,MD,MBA

Dr. Eldahmy is a Psychiatrist who completed Psychiatric Training in UCI

-University of California - Irvine. Adel Eldahmy, MD, MBA has been in private

practice in Southern California since 1984, He has taken care of patients in

Psychiatric Inpatients Hospitals, Psychiatric Urgent Care facilities, worked with

seriously ill psychiatric patients and now working in Outpatient Clinics in Orange

County - Laguna Niguel, CA and Long Beach CA.

What is Depression?

Depression is a serious medical illness; it’s not something that you have made up in your head. It’s more than just feeling "down in the dumps" or "blue" for a few days. It’s feeling "down" and "low" and "hopeless" for weeks at a time.

Signs & Symptoms

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed 

Treatment

A variety of treatments including medications and short-term psychotherapies have proven effective for depression. 


What are the different forms of depression?

There are several forms of depressive disorders. The most common are major depressive disorder and dysthymic disorder.

Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Some forms of depressive disorder exhibit slightly different characteristics than those described above, or they may develop under unique circumstances. However, not all scientists agree on how to characterize and define these forms of depression. They include:

Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

Postpartum depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

Seasonal affective disorder (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes-from extreme highs (e.g., mania) to extreme lows (e.g., depression).

What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.

Signs & Symptoms

People with generalized anxiety disorder can't seem to shake their concerns. Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, and hot flashes.

Treatment

Effective treatments for anxiety disorders are available, and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives. 

What is Panic Disorder?

Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

Signs & Symptoms

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. During a panic attack, most likely your heart will pound and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have nausea, chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control.

Treatment

Effective treatments for panic disorder are available, and research is yielding new, improved therapies that can help most people with panic disorder and other anxiety disorders lead productive, fulfilling lives.

What is Social Phobia?

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation — such as a fear of speaking in formal or informal situations, or eating or drinking in front of others — or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

Signs & Symptoms

People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work or school, and other ordinary activities. Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, nausea, and difficulty talking.

Treatment

Effective treatments for social phobia are available, and research is yielding new, improved therapies that can help most people with social phobia and other anxiety disorders lead productive, fulfilling lives.

What Are Eating Disorders?

An eating disorder is marked by extremes. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.

Types of eating disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Binge-Eating Disorder

Treatment

Researchers are unsure of the underlying causes and nature of eating disorders. Unlike a neurological disorder, which generally can be pinpointed to a specific lesion on the brain, an eating disorder likely involves abnormal activity distributed across brain systems. With increased recognition that mental disorders are brain disorders, more researchers are using tools from both modern neuroscience and modern psychology to better understand eating disorders.

Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior. Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or misusing laxatives, diuretics or enemas.

Many people with anorexia see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions. A person with anorexia typically weighs herself or himself repeatedly, portions food carefully, and eats only very small quantities of only certain foods. Some who have anorexia recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic form of anorexia, in which their health deteriorates over many years as they battle the illness.

According to some studies, people with anorexia are up to ten times more likely to die as a result of their illness compared to those without the disorder. The most common complications that lead to death are cardiac arrest, and electrolyte and fluid imbalances. Suicide also can result.

Many people with anorexia also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development.

Other symptoms may develop over time, including:

• thinning of the bones (osteopenia or osteoporosis)
• brittle hair and nails
• dry and yellowish skin
• growth of fine hair over body (e.g., lanugo)
• mild anemia, and muscle weakness and loss
• severe constipation
• low blood pressure, slowed breathing and pulse
• drop in internal body temperature, causing a person to feel cold all the time
• lethargy

TREATING ANOREXIA involves three components:

1.  restoring the person to a healthy weight;

2.  treating the psychological issues related to the eating disorder; and

3.  reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing relapse.

Some research suggests that the use of medications, such as antidepressants, antipsychotics or mood stabilizers, may be modestly effective in treating patients with anorexia by helping to resolve mood and anxiety symptoms that often co-exist with anorexia. Recent studies, however, have suggested that antidepressants may not be effective in preventing some patients with anorexia from relapsing. In addition, no medication has shown to be effective during the critical first phase of restoring a patient to healthy weight. Overall, it is unclear if and how medications can help patients conquer anorexia, but research is ongoing.

Different forms of psychotherapy, including individual, group and family-based, can help address the psychological reasons for the illness. Some studies suggest that family-based therapies in which parents assume responsibility for feeding their afflicted adolescent are the most effective in helping a person with anorexia gain weight and improve eating habits and moods.

Shown to be effective in case studies and clinical trials, this particular approach is discussed in some guidelines and studies for treating eating disorders in younger, nonchronic patients.

Others have noted that a combined approach of medical attention and supportive psychotherapy designed spe-cifically for anorexia patients is more effective than just psychotherapy. But the effectiveness of a treatment depends on the person involved and his or her situation. Unfortunately, no specific psychotherapy appears to be consistently effective for treating adults with anorexia. However, research into novel treatment and prevention approaches is showing some promise. One study suggests that an online intervention program may prevent some at-risk women from developing an eating disorder.

Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise.

Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week. Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.

Other symptoms include:

• chronically inflamed and sore throat
• swollen glands in the neck and below the jaw
• worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acids
• gastroesophageal reflux disorder
• intestinal distress and irritation from laxative abuse
• kidney problems from diuretic abuse
• severe dehydration from purging of fluids

As with anorexia, TREATMENT FOR BULIMIA often involves a combination of options and depends on the needs of the individual.

To reduce or eliminate binge and purge behavior, a patient may undergo nutritional counseling and psychotherapy, especially cognitive behavioral therapy (CBT), or be prescribed medication. Some antidepressants, such as fluoxetine (Prozac), which is the only medication approved by the U.S. Food and Drug Administration for treating bulimia, may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behavior, reduces the chance of relapse, and improves eating attitudes.

CBT that has been tailored to treat bulimia also has shown to be effective in changing binging and purging behavior, and eating attitudes. Therapy may be individually oriented or group-based.

Binge-eating disorder is characterized by recurrent binge-eating episodes during which a person feels a loss of control over his or her eating. Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating.

Obese people with binge-eating disorder often have coexisting psychological illnesses including anxiety, depression, and personality disorders. In addition, links between obesity and cardiovascular disease and hypertension are well documented.

TREATMENT OPTIONS FOR BINGE-EATING DISORDER are similar to those used to treat bulimia. Fluoxetine and other antidepressants may reduce binge-eating episodes and help alleviate depression in some patients.

Patients with binge-eating disorder also may be prescribed appetite suppressants. Psychotherapy, especially CBT, is also used to treat the underlying psychological issues associated with binge-eating, in an individual or group environment.

What is Bipolar Disorder?

Bipolar Disorder, also known as manic-depressive illness, is a serious medical illness that causes 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.

What are the symptoms of bipolar disorder?

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.

People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.

A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.

Symptoms of bipolar disorder are described below.

Treatment

Most people with bipolar disorder can achieve substantial stabilization of their mood swings and related symptoms over time with proper treatment. A strategy that combines medication and psychosocial treatment is optimal for managing the disorder over time.

You might not realize that you have a drinking problem. You might not drink every day, or you might not drink large amounts when you drink. You might go for days or weeks between drinking episodes. You might say you're a "social drinker."

But even if you don't drink very often, it's still possible to be abusing alcohol and to be at risk for becoming addicted to it.

Symptoms of alcohol abuse in children and teens sometimes are different from adult symptoms.

Signs of alcohol abuse

Watch for the following signs of alcohol abuse:

• You have problems at work or school because of your drinking. These may include being late or absent, being injured at work, and not doing your job or schoolwork as well as you can.
• You drink in dangerous situations, such as before or while driving a car.
• You have blakouts. This means that after a drinking episode you cannot remember what happened while you were drinking.
• You have legal problems because of your drinking, such as being arrested for harming someone or driving while drunk (intoxicated).
• You get hurt or you hurt someone else when you are drinking.
• You continue to drink despite health problems that are caused or made worse by alcohol use, such as liver disease (cirrhosis).
• Your friends or family members are worried about your drinking.

Signs of alcohol dependence or addiction

Watch for the following signs of alcohol dependence or addiction:

• You cannot quit drinking or control how much you drink. You drink more often than you want to, or you drink larger amounts than you want to.
• You need to drink more to get the same effect.
• You have withdrawal symptoms when you stop drinking. These include feeling sick to your stomach, sweating, shakiness, and anxiety.
• You spend a lot of time drinking and recovering from drinking, or you have given up other activities so you can drink.
• You have tried unsuccessfully to quit drinking or to cut back the amount you drink.
• You continue to drink even though it harms your relationships and causes you to develop physical problems.

Other signs of possible trouble with alcohol include the following:

• You drink in the morning, are drunk often for long periods of time, or drink alone.
• You change what you drink, such as switching from beer to wine because you think that doing this will help you drink less or keep you from getting drunk.
• You feel guilty after drinking.
• You make excuses for your drinking or do things to hide your drinking, such as buying alcohol at different stores.
• You worry that you won't get enough alcohol for an evening or weekend.
• You have physical signs of alcohol dependence, such as weight loss, a sore or upset stomach(gastritis), or redness of the nose and cheeks.

What is Obsessive-Compulsive Disorder?

Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.

Signs & Symptoms

People with OCD may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. They may be obsessed with germs or dirt, and wash their hands over and over. They may be filled with doubt and feel the need to check things repeatedly.

Treatment

Effective treatments for obsessive-compulsive disorder are available, and research is yielding new, improved therapies that can help most people with OCD and other anxiety disorders lead productive, fulfilling lives.

What is Depression?

Depression is a serious medical illness; it’s not something that you have made up in your head. It’s more than just feeling "down in the dumps" or "blue" for a few days. It’s feeling "down" and "low" and "hopeless" for weeks at a time.

Signs & Symptoms

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed 

Treatment

A variety of treatments including medications and short-term psychotherapies have proven effective for depression. 


What are the different forms of depression?

There are several forms of depressive disorders. The most common are major depressive disorder and dysthymic disorder.

Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Some forms of depressive disorder exhibit slightly different characteristics than those described above, or they may develop under unique circumstances. However, not all scientists agree on how to characterize and define these forms of depression. They include:

Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

Postpartum depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

Seasonal affective disorder (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes-from extreme highs (e.g., mania) to extreme lows (e.g., depression).

What is Generalized Anxiety Disorder?

Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.

Signs & Symptoms

People with generalized anxiety disorder can't seem to shake their concerns. Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, and hot flashes.

Treatment

Effective treatments for anxiety disorders are available, and research is yielding new, improved therapies that can help most people with anxiety disorders lead productive, fulfilling lives. 

What is Panic Disorder?

Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

Signs & Symptoms

People with panic disorder have feelings of terror that strike suddenly and repeatedly with no warning. During a panic attack, most likely your heart will pound and you may feel sweaty, weak, faint, or dizzy. Your hands may tingle or feel numb, and you might feel flushed or chilled. You may have nausea, chest pain or smothering sensations, a sense of unreality, or fear of impending doom or loss of control.

Treatment

Effective treatments for panic disorder are available, and research is yielding new, improved therapies that can help most people with panic disorder and other anxiety disorders lead productive, fulfilling lives.

What is Social Phobia?

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation — such as a fear of speaking in formal or informal situations, or eating or drinking in front of others — or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

Signs & Symptoms

People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work or school, and other ordinary activities. Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, nausea, and difficulty talking.

Treatment

Effective treatments for social phobia are available, and research is yielding new, improved therapies that can help most people with social phobia and other anxiety disorders lead productive, fulfilling lives.

What Are Eating Disorders?

An eating disorder is marked by extremes. It is present when a person experiences severe disturbances in eating behavior, such as extreme reduction of food intake or extreme overeating, or feelings of extreme distress or concern about body weight or shape.

Types of eating disorders

• Anorexia Nervosa
• Bulimia Nervosa
• Binge-Eating Disorder

Treatment

Researchers are unsure of the underlying causes and nature of eating disorders. Unlike a neurological disorder, which generally can be pinpointed to a specific lesion on the brain, an eating disorder likely involves abnormal activity distributed across brain systems. With increased recognition that mental disorders are brain disorders, more researchers are using tools from both modern neuroscience and modern psychology to better understand eating disorders.

Anorexia nervosa is characterized by emaciation, a relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight, a distortion of body image and intense fear of gaining weight, a lack of menstruation among girls and women, and extremely disturbed eating behavior. Some people with anorexia lose weight by dieting and exercising excessively; others lose weight by self-induced vomiting, or misusing laxatives, diuretics or enemas.

Many people with anorexia see themselves as overweight, even when they are starved or are clearly malnourished. Eating, food and weight control become obsessions. A person with anorexia typically weighs herself or himself repeatedly, portions food carefully, and eats only very small quantities of only certain foods. Some who have anorexia recover with treatment after only one episode. Others get well but have relapses. Still others have a more chronic form of anorexia, in which their health deteriorates over many years as they battle the illness.

According to some studies, people with anorexia are up to ten times more likely to die as a result of their illness compared to those without the disorder. The most common complications that lead to death are cardiac arrest, and electrolyte and fluid imbalances. Suicide also can result.

Many people with anorexia also have coexisting psychiatric and physical illnesses, including depression, anxiety, obsessive behavior, substance abuse, cardiovascular and neurological complications, and impaired physical development.

Other symptoms may develop over time, including:

• thinning of the bones (osteopenia or osteoporosis)
• brittle hair and nails
• dry and yellowish skin
• growth of fine hair over body (e.g., lanugo)
• mild anemia, and muscle weakness and loss
• severe constipation
• low blood pressure, slowed breathing and pulse
• drop in internal body temperature, causing a person to feel cold all the time
• lethargy

TREATING ANOREXIA involves three components:

1.  restoring the person to a healthy weight;

2.  treating the psychological issues related to the eating disorder; and

3.  reducing or eliminating behaviors or thoughts that lead to disordered eating, and preventing relapse.

Some research suggests that the use of medications, such as antidepressants, antipsychotics or mood stabilizers, may be modestly effective in treating patients with anorexia by helping to resolve mood and anxiety symptoms that often co-exist with anorexia. Recent studies, however, have suggested that antidepressants may not be effective in preventing some patients with anorexia from relapsing. In addition, no medication has shown to be effective during the critical first phase of restoring a patient to healthy weight. Overall, it is unclear if and how medications can help patients conquer anorexia, but research is ongoing.

Different forms of psychotherapy, including individual, group and family-based, can help address the psychological reasons for the illness. Some studies suggest that family-based therapies in which parents assume responsibility for feeding their afflicted adolescent are the most effective in helping a person with anorexia gain weight and improve eating habits and moods.

Shown to be effective in case studies and clinical trials, this particular approach is discussed in some guidelines and studies for treating eating disorders in younger, nonchronic patients.

Others have noted that a combined approach of medical attention and supportive psychotherapy designed spe-cifically for anorexia patients is more effective than just psychotherapy. But the effectiveness of a treatment depends on the person involved and his or her situation. Unfortunately, no specific psychotherapy appears to be consistently effective for treating adults with anorexia. However, research into novel treatment and prevention approaches is showing some promise. One study suggests that an online intervention program may prevent some at-risk women from developing an eating disorder.

Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise.

Unlike anorexia, people with bulimia can fall within the normal range for their age and weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behavior is done secretly, because it is often accompanied by feelings of disgust or shame. The binging and purging cycle usually repeats several times a week. Similar to anorexia, people with bulimia often have coexisting psychological illnesses, such as depression, anxiety and/or substance abuse problems. Many physical conditions result from the purging aspect of the illness, including electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems.

Other symptoms include:

• chronically inflamed and sore throat
• swollen glands in the neck and below the jaw
• worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acids
• gastroesophageal reflux disorder
• intestinal distress and irritation from laxative abuse
• kidney problems from diuretic abuse
• severe dehydration from purging of fluids

As with anorexia, TREATMENT FOR BULIMIA often involves a combination of options and depends on the needs of the individual.

To reduce or eliminate binge and purge behavior, a patient may undergo nutritional counseling and psychotherapy, especially cognitive behavioral therapy (CBT), or be prescribed medication. Some antidepressants, such as fluoxetine (Prozac), which is the only medication approved by the U.S. Food and Drug Administration for treating bulimia, may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behavior, reduces the chance of relapse, and improves eating attitudes.

CBT that has been tailored to treat bulimia also has shown to be effective in changing binging and purging behavior, and eating attitudes. Therapy may be individually oriented or group-based.

Binge-eating disorder is characterized by recurrent binge-eating episodes during which a person feels a loss of control over his or her eating. Unlike bulimia, binge-eating episodes are not followed by purging, excessive exercise or fasting. As a result, people with binge-eating disorder often are overweight or obese. They also experience guilt, shame and/or distress about the binge-eating, which can lead to more binge-eating.

Obese people with binge-eating disorder often have coexisting psychological illnesses including anxiety, depression, and personality disorders. In addition, links between obesity and cardiovascular disease and hypertension are well documented.

TREATMENT OPTIONS FOR BINGE-EATING DISORDER are similar to those used to treat bulimia. Fluoxetine and other antidepressants may reduce binge-eating episodes and help alleviate depression in some patients.

Patients with binge-eating disorder also may be prescribed appetite suppressants. Psychotherapy, especially CBT, is also used to treat the underlying psychological issues associated with binge-eating, in an individual or group environment.

What is Bipolar Disorder?

Bipolar Disorder, also known as manic-depressive illness, is a serious medical illness that causes 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.

What are the symptoms of bipolar disorder?

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.

People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called "mood episodes." An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.

A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. Sometimes symptoms are so severe that the person cannot function normally at work, school, or home.

Symptoms of bipolar disorder are described below.

Treatment

Most people with bipolar disorder can achieve substantial stabilization of their mood swings and related symptoms over time with proper treatment. A strategy that combines medication and psychosocial treatment is optimal for managing the disorder over time.

You might not realize that you have a drinking problem. You might not drink every day, or you might not drink large amounts when you drink. You might go for days or weeks between drinking episodes. You might say you're a "social drinker."

But even if you don't drink very often, it's still possible to be abusing alcohol and to be at risk for becoming addicted to it.

Symptoms of alcohol abuse in children and teens sometimes are different from adult symptoms.

Signs of alcohol abuse

Watch for the following signs of alcohol abuse:

• You have problems at work or school because of your drinking. These may include being late or absent, being injured at work, and not doing your job or schoolwork as well as you can.
• You drink in dangerous situations, such as before or while driving a car.
• You have blakouts. This means that after a drinking episode you cannot remember what happened while you were drinking.
• You have legal problems because of your drinking, such as being arrested for harming someone or driving while drunk (intoxicated).
• You get hurt or you hurt someone else when you are drinking.
• You continue to drink despite health problems that are caused or made worse by alcohol use, such as liver disease (cirrhosis).
• Your friends or family members are worried about your drinking.

Signs of alcohol dependence or addiction

Watch for the following signs of alcohol dependence or addiction:

• You cannot quit drinking or control how much you drink. You drink more often than you want to, or you drink larger amounts than you want to.
• You need to drink more to get the same effect.
• You have withdrawal symptoms when you stop drinking. These include feeling sick to your stomach, sweating, shakiness, and anxiety.
• You spend a lot of time drinking and recovering from drinking, or you have given up other activities so you can drink.
• You have tried unsuccessfully to quit drinking or to cut back the amount you drink.
• You continue to drink even though it harms your relationships and causes you to develop physical problems.

Other signs of possible trouble with alcohol include the following:

• You drink in the morning, are drunk often for long periods of time, or drink alone.
• You change what you drink, such as switching from beer to wine because you think that doing this will help you drink less or keep you from getting drunk.
• You feel guilty after drinking.
• You make excuses for your drinking or do things to hide your drinking, such as buying alcohol at different stores.
• You worry that you won't get enough alcohol for an evening or weekend.
• You have physical signs of alcohol dependence, such as weight loss, a sore or upset stomach(gastritis), or redness of the nose and cheeks.

What is Obsessive-Compulsive Disorder?

Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.

Signs & Symptoms

People with OCD may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. They may be obsessed with germs or dirt, and wash their hands over and over. They may be filled with doubt and feel the need to check things repeatedly.

Treatment

Effective treatments for obsessive-compulsive disorder are available, and research is yielding new, improved therapies that can help most people with OCD and other anxiety disorders lead productive, fulfilling lives.