Michelle Katz Jesop, PsyD,
Behavioral Health and Consultation
Services, PLLC
Licensed Clinical Psychologist in Brentwood, TN
Treatment Specialties
Post-traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) identifies a specific and complex type of emotional and mental distress following a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or have been threatened with death, sexual violence or serious injury
Symptoms of PTSD include panic, anxiety, as well as recurring images of the event that result in feeling as if the event were taking place again, and again. Along with recurring images that occur during the day, nightmares are often experienced of the event repeatedly that can go on for months, and even years, afterwards. This can result in the survivor living with the trauma 24/7 -re-playing like a horror movie throughout the day and night.
Efforts to suppress these images, and avoid all reminders of their trauma can lead to survivors withdrawing from the world, showing less emotion, and becoming disinterested in people and activities that were once important.
Prolonged Exposure Therapy (PE) is a highly effective treatment for acute and chronic PTSD and related depression, anxiety, and anger. PE was specifically designed to help clients process trauma events and decrease trauma-induced suffering. It remains one of the most highly recognized treatments for PTSD that has demonstrated clinically significant improvement in roughly 80% of patients with PTSD.
Anxiety, Stress, & Panic
Stress is typically a response to an external event or trigger, such as work, an exam, a fight with a loved-one, discrimination, chronic illness, unemployment, divorce, or even an upcoming move. When our stress levels go up, we may experience irritability, muscle tension, fatigue, digestive problems, and sleep disturbances.
Anxiety, on the other hand, is defined by persistent and excessive worries that occur even when the stressor has gone. The symptoms and sensations of anxiety are very similar to those of stress, and can also include fatigue, muscle tension, headaches, impaired sleep, etc.
Panic attacks, unlike anxiety and stress, are short bursts of intense fear notably with increased heart rate, sweating, shortness of breath, dizziness, chest pain, feeling of choking, or being smothered, and nausea.
Each experience, either stress, anxiety, or panic, has different underlying causes, or “processes”. These can be a combination of thought patterns, patterns with acting, or a way of dealing with an ongoing problem or feared outcome. Several cognitive-behavioral based procedures, such as relaxation training, exposure, problem solving, mindfulness, and cognitive defusion, have been shown to significantly help reduce levels of distress. And more importantly, offer a new way of responding to when these events, or worries, occur again.
Depression
Everyone gets the blues. It can happen when something important doesn't go the way we hoped, we lose someone or something important to us, or we experience long-standing frustration with an ongoing problem or a blocked goal. We can feel low energy, feel less interested in doing things we typically enjoy, and may want to just stay inside, binge watch a favorite show, stay in bed, and keep to ourselves.
The problem occurs when these activities -or "in-activities" -become more regular. We desperately seek relief through whatever means available, not fully being aware that oftentimes, these short-term "fixes" may actually keep the mood going and even make it worse.
Like a wagon wheel, the cycle goes round and round, low energy, stay inside, isolate, judge yourself for inactivity, feel down and hopeless, leading to more reduced energy, more isolation, more negative thoughts of ourselves, and so on.
Evidence-based processes, such as Behavioral Activation, a treatment that focuses on increasing meaningful and reinforcing activity, targets these patterns and cycles and gets the wagon wheel moving in the opposite direction. When evidence-based strategies are paired with the whos and whats that are most important to you, you can feel more fulfilled and know how to respond to the ups and downs of life. It's not that you're not supposed to get knocked down, it's knowing how you can get back up, and making the "getting back up" part more accessible.
Emotion & Mood Dysregulation
It is common to experience feelings of frustration, guilt, anger, and anxiety throughout any 24-hour period of time. In fact, as eventful and unpredictable as life can be, that is actually the norm for most people. These emotions may arise from events and situations that occur in our relationships, work, communities, and personal lives, that we see as important to us. Emotions then enable us to notice and respond to, problem solve, or address these events when needed. In a way, they act as "assistants", letting us know that something salient is going on that we may want to attend to. And for the most part, we are able to respond in helpful, safe, and socially acceptable ways.
And yet, for some, emotions are experienced less like "assistants" and more so like tyrannical bosses. Experienced as loud, large, and intense, these emotional experiences are painful and can be physically and mentally draining. Like being tapped on the shoulder with a third degree sunburn that others cannot see, people with very intense and painful emotions may say or do things that are more reactive, and to others don't make sense or do not seem to fit the situation. Similarly, people with intense and painful emotional experiencing may resort to extreme efforts to get their emotions to "turn off" or just decrease enough for a much needed break.
The difficulty with being able to flexibly respond to and manage emotions is commonly referred to as emotion dysregulation. Dialectical Behavior Therapy (DBT), a form of cognitive behavioral therapy in which clients are taught skills and strategies for managing emotions, handling conflict, and building tolerance for uncomfortable feelings, effectively treats emotion dysregulation. It may seem at times that emotions serve to only cause more suffering, and yet, without them it is very difficult to know what is vitally important to us. With evidence based treatments such as DBT, you can know that you are the CEO of your life, and allow your emotional experiencing to assist you in navigating your course.