Phone:   (949) 640-4033
Fax:  (949) 721-9572

 

Adult Attention Deficit Disorder (ADD)
Attention Deficit Hyperactivity Disorder,(ADHD)
Anxiety Disorders:
  Panic Disorder
  Generalized Anxiety Disorder (GAD)
  Social Phobia or Social Anxiety Disorder
  Post-Traumatic Stress Disorder (PTSD)
  Obsessive Compulsive Disorder (OCD)
Bipolar Disorder
Chronic Fatigue Syndrome (CFS)
Chronic Pain Syndrome (CPS)
Depression
Eating Disorders
Endrocrine Related Disorders
Enuresis
Fibromyalgia Syndrome (FMS)
Mood Disorders
Oppositional Defiant Disorder (ODD)
Premenstrual Dysphoric Disorder (PMDD)
Sleep Disorders
Stress Management
Substance Abuse & Addiction
Women’s and Female Hormonal Issues
Work-Related Issues

 

PSYCHIATRIC DISORDERS

ADULT ATTENTION DEFICIT DISORDER (ADD)

ADD is characterized by an inability to focus attention, plan, concentrate, manage time and tasks, and make thoughtful decisions. No other condition can be found to explain the impairments. Affected individuals have serious problems in one or more of the following areas:

  • Screening out distractions

  • Starting and completing tasks

  • Remembering and organizing information and belongings

  • Being on time

  • Keeping priorities in order


ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

ADHD, is one of the most common mental disorders that develop in children. Children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. ADHD or ADD is characterized by a majority of the following symptoms being present in either category (inattention or hyperactivity). These symptoms need to manifest themselves in a manner and degree, which is inconsistent with the child's current developmental level. That is, the child's behavior is significantly more inattentive or hyperactive than that of his or her peers of a similar age.

Symptoms of Inattention

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

  • Often has difficulty sustaining attention in tasks or play activities

  • Often does not seem to listen when spoken to directly

  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)

  • Often has difficulty organizing tasks and activities

  • Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)

  • Often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)

  • Is often easily distracted by extraneous stimuli

  • Is often forgetful in daily activities

Symptoms of Hyperactivity

  • Often fidgets with hands or feet or squirms in seat

  • Often leaves seat in classroom or in other situations in which remaining seated is expected

  • Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

  • Often has difficulty playing or engaging in leisure activities quietly

  • Is often "on the go" or often acts as if "driven by a motor"

  • Often talks excessively

Symptoms of Impulsivity

  • Often blurts out answers before questions have been completed

  • Often has difficulty awaiting turn

  • Often interrupts or intrudes on others (e.g., butts into conversations or games)

Symptoms must have persisted for at least 6 months. Some of these symptoms need to have been present as a child, at 7 years old or younger. The symptoms also must exist in at least two separate settings (for example, at school and at home). The symptoms should be creating significant impairment in social, academic or occupational functioning or relationships.


ANXIETY DISORDERS

Panic Disorder

People with panic disorder have sudden, recurrent panic attacks that cause terror, severe anxiety and a feeling of being completely out of control. Panic attacks are highly uncomfortable episodes and the frequency and intensity vary from person to person. People are considered to have panic disorder if their panic attacks consist of a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

  • Palpitations, pounding heart, or accelerated heart rate

  • Sweating

  • Trembling or shaking

  • Sensations of shortness of breath or smothering

  • Feeling of choking

  • Chest pain or discomfort

  • Nausea or abdominal distress

  • Feeling dizzy, unsteady, lightheaded, or faint

  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)

  • Fear of losing control or going crazy

  • Fear of dying

  • Numbness or tingling sensations

  • Chills or hot flushes

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, fear of losing control, exaggerated worry and tension, even when there is little or nothing to provoke it. People with generalized anxiety disorder can't seem to shake their concerns. The anxiety and worry are associated with three (or more) of the following six symptoms:

  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)
  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating

Social Phobia, or Social Anxiety Disorder

Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social Phobia is a very common problem, characterized by fear of being negatively judged by other people in social situations: parties, public speaking, job interviews, meeting new people, etc. 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. Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, nausea, and difficulty talking.

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. The traumatic event is persistently reexperienced in one or more of the following ways:

  • Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.

  • Recurrent distressing dreams of the event.

  • Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated).

  • Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

  • Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

The individual also has persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by 3 or more of the following:

  • Efforts to avoid thoughts, feelings, or conversations associated with the trauma

  • Efforts to avoid activities, places, or people that arouse recollections of the trauma

  • Inability to recall an important aspect of the trauma

  • Significantly diminished interest or participation in significant activities

  • Feeling of detachment or estrangement from others

  • Restricted range of affect (e.g., unable to have loving feelings)

  • Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Persistent symptoms of increased arousal (not present before the trauma), as indicated by 2 or more of the following:

  • Difficulty falling or staying asleep

  • Irritability or outbursts of anger

  • Difficulty concentrating

  • Hypervigilance

  • Exaggerated startle response

Obsessive-Compulsive Disorder (OCD)

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 hand washing, 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. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.


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. characterized by dramatic, clearly defined “highs and lows” of one's mood. A person must have experienced at least one manic episode to be diagnosed with bipolar disorder. Even if depression has not yet occurred or has not been diagnosed, one episode of mania is enough to diagnose bipolar disorder. Symptoms of mania include:

  • Extreme irritability
  • Intense feelings of euphoria
  • Increased energy, activity and restlessness
  • Decreased need for sleep or insomnia
  • Racing thoughts
  • Rapid talking
  • Increased sexual drive
  • Drug or alcohol abuse

The depression that alternates with mania also has recognizable symptoms. They include:

  • Ongoing sad, anxious or empty feelings

  • A loss of interest in normally pleasurable activities, including sex

  • Appetite and weight changes (either loss or gain)

  • Sleep problems (insomnia, early morning wakening or oversleeping)

  • Irritability

  • A loss of energy and a sense of fatigue, or being "slowed down"

  • Feelings of guilt, worthlessness, helplessness

  • Feelings of hopelessness, pessimism

  • Difficulty in concentrating, remembering, making decisions

  • Thoughts of death or suicide, or suicide attempts

  • Ongoing body aches and pains or problems with digestion that are not caused by another medical condition.


CHRONIC FATIGUE SYNDROME (CFS)

CFS is characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of illness. People are diagnosed with CFS if they have severe chronic fatigue of six months or longer duration and concurrently have four or more of the following symptoms:

  • Substantial impairment in short-term memory or concentration

  • Sore throat

  • Tender neck or armpit lymph nodes

  • Muscle pain or multi-joint pain without swelling or redness

  • Headaches of a new type, pattern or severity

  • Unrefreshing sleep

  • Post-exertional fatigue lasting more than 24 hours.


CHRONIC PAIN SYNDROME (CPS)

CPS consists of chronic anxiety and depression, anger, and changed lifestyle, all with a variable but significant level of genuine neurologically based pain. Chronic pain is different than acute pain or short-acting pain. Acute pain is a symptom of a medical problem, illness or injury, and is only temporary. Chronic pain is more than a symptom - it is an actual illness or medical problem that persists beyond the healing phase, usually three to six months, and has not responded to traditional medical treatment, such as rest, medicine, injections, physical therapy or surgery. With time the pain spreads and increases in intensity.

Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system). People are diagnosed with CPS based on the following:

  • The patient has chronic complaints of pain
  • Symptoms frequently exceed signs on physical exam
  • There is minimal relief with standard treatment
  • History of having seen many physicians
  • Frequent use of several nonspecific medications

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. It is characterized by the following 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

A person who suffers from a major depressive disorder (sometimes also referred to as clinical depression or major depression) must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. Social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. For instance, a person who has missed work or school because of their depression, or has stopped attending classes altogether or attending usual social engagements. The signs and symptoms of major depression are:

  • Ongoing sad, anxious or empty feelings
  • A loss of interest in activities that normally are pleasurable, including sex
  • Appetite and weight changes (either loss or gain)
  • Sleep problems (insomnia, early morning wakening or oversleeping)
  • Irritability
  • A loss of energy and a sense of fatigue, or being "slowed down"
  • Feelings of guilt, worthlessness and helplessness
  • Feelings of hopelessness and pessimism
  • Difficulty in concentrating, remembering, making decisions
  • Thoughts of death or suicide, or suicide attempts
  • Ongoing body aches and pains or problems with digestion that are not caused by physical disease

EATING DISORDERS

Eating disorders include a range of conditions that involve an obsession with food, weight and appearance. The obsession is so strong that it disrupts everything from health to relationships to daily activities. Eating disorders frequently develop as a way of coping with emotional pain, conflicts related to separation, low self-esteem, depression, stress or trauma. Common eating disorders can include:

  • Restricting food intake
  • Binge eating
  • Induce vomiting after eating
  • Following eating rituals
  • Guilt related to eating
  • Preoccupied with food
  • Critical of self (especially the body)
  • Hide eating habits

Treatment requires developing an understanding of the specific symptom and it’s underlying cause. It also involves developing more effective ways of dealing with those issues and constructing a lifestyle that supports and enhances that growth.


ENDOCRINE DISORDERS

The endocrine system is composed of glands that secrete hormones directly into the bloodstream. These hormones regulate many body processes and research has found that many psychiatric illnesses are profoundly influenced by the endocrine system. Normal and cyclical changes in hormone levels as well as abnormal hormone levels occur under conditions of profound stress, anxiety and mood disorders. Our goal is to integrate the mind and body in a comprehensive approach to the patient's care.


ENURESIS

Enuresis, more commonly called bed-wetting, is a disorder of elimination that involves the voluntary or involuntary release of urine into bedding, clothing, or other inappropriate places. Enuresis commonly affects young children and is involuntary. Many cases of enuresis clear up by themselves as the child matures, although some children need behavioral or physiological treatment in order to remain dry. To be diagnosed with enuresis, a person must be at least five years old or have reached a developmental age of five years. Below this age, problems with bladder control are considered normal.

  • Primary enuresis refers to wetting in a person who has never been dry for at least 6 months.

  • Secondary enuresis refers to wetting that begins after at least 6 months of dryness

  • Nocturnal enuresis refers to wetting that usually occurs during sleep (nighttime incontinence)

  • Diurnal enuresis refers to wetting when awake (daytime incontinence)


FIBROMYALGIA SYNDROME (FMS)

Fibromyalgia, is a chronic syndrome that causes pain and stiffness throughout the tissues that support and move the bones and joints. Fibromyalgia may occur alone or in conjunction with rheumatoid disorders such as arthritis, osteoarthritis, or lupus. The major symptoms of fibromyalgia are:

Widespread muscular and joint pain (as aching, stiffness, and tenderness around joints, muscles, tendons, and ligaments). Pain may appear in one or more locations at the same time and also in many different parts of the body. The pain is located within the muscles themselves, as well as the points where ligaments attach muscles to bones.

  • Extreme tenderness in specific "tender points"

  • Poor sleep

  • Fatigue. Some people experience fatigue as a lack of muscle endurance, while others describe the fatigue as an overall sense of lack of energy. Much of the fatigue is thought to result from lack of sleep

These symptoms may be aggravated by stress, anxiety, depression, hormonal changes, cold environments as well as the change in weather. Other symptoms that may accompany fibromyalgia are Raynaud's phenomenon (poor circulation to the hands or toes), tension headaches, migraine headaches, dizziness, tingling and numbness, an irritable bowel, muscle tremors, bladder spasms, and blurred vision.

FMS is not a psychological condition, although it has some psychological components. As with other conditions that cause chronic pain, it's not unusual for people with FMS to develop anxiety and depression, which can aggravate their symptoms. It may be comforting to know that FMS isn't progressive or life threatening. With appropriate treatment and self-care, symptoms can be reduced and quality of life can be improved.


MOOD DISORDERS

The disorders in this category include those where the primary symptom is a disturbance in mood. In other words, inappropriate, exaggerated, or limited range of feelings. Everybody gets down sometimes, and everybody experiences a sense of excitement and emotional pleasure. To be diagnosed with a mood disorder, your feelings must be to the extreme. In other words, crying, and/or feeling depressed, suicidal frequently. Or, the opposite extreme, having excessive energy where sleep is not needed for days at a time and during this time the decision making process in significantly hindered. Disorders in this category include: Bipolar Disorder, Cyclothymic Disorder, Dysthymic Disorder, Major Depressive Disorder


OPPOSITIONAL DEFIANT DISORDER (ODD)

ODD, is one of the most common psychiatric problems in children and is characterized by a pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present:

  • Often loses temper

  • Often argues with adults

  • Often actively defies or refuses to comply with adults’ requests or rules

  • Often deliberately annoys people

  • Often blames others for his or her mistakes or misbehavior

  • Is often touchy or easily annoyed by others

  • Is often angry and resentful

  • Is often spiteful and vindictive


PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

PMDD is a condition associated with severe emotional and physical problems that are linked closely to the menstrual cycle. Symptoms occur regularly in the second half of the cycle and end when menstruation begins or shortly thereafter. PMDD is not just a new name for premenstrual syndrome (PMS), a condition that affects as many as 75% of menstruating women. It is, however, considered to be a very severe form of PMS that affects about 5% - 10% of menstruating women. Both PMDD and PMS share similar symptoms, however, what sets PMDD apart is its severity. Women with PMDD find that it is severe enough to interfere with work, social activities, and relationships their lives. The symptoms of PMDD can include any of the following:

  • Mood swings
  • Depressed mood or feelings of hopelessness
  • Marked anger, increased interpersonal conflicts
  • Tension and anxiety
  • Irritability
  • Decreased interest in usual activities
  • Difficulty concentrating
  • Fatigue
  • Change in appetite
  • Feeling out of control or overwhelmed
  • Sleep problems
  • Physical problems, such as bloating

SLEEP DISORDERS

Sleep is absolutely essential for normal, healthy function. Sleep appears necessary for our nervous systems to work properly. Some experts believe sleep gives neurons used while we are awake a chance to shut down and repair themselves. Without sleep, neurons may become so depleted in energy or so polluted with byproducts of normal cellular activities that they begin to malfunction.

There are more than 70 different sleep disorders. These disorders and the resulting sleep deprivation interfere with work, driving, and social activities. Symptoms of sleep disorders may include:

  • Insomnia
  • Sleep Apnea
  • Restless Legs Syndrome
  • Narcolepsy
  • Nightmares
  • Sleepwalking
  • Sleep Terrors

STRESS MANAGEMENT

Stress is mental or physical tension brought about by internal or external pressures. The feeling of stress may be mild or severe and it can last a short time or over a longer period. Many events may cause stress. They range from everyday occurrences such as taking a test or driving through rush-hour traffic to more traumatic experiences such as the death of a loved one or a serious illness. Some of the physical signs of stress are:

  • Dry mouth and throat
  • Tight muscles in the neck, shoulders and back
  • Chronic neck and back problems
  • Headaches
  • Indigestion
  • Tremors
  • Muscle tics
  • Insomnia
  • Fatigue

Emotional signs of stress include:

  • Tension
  • Anxiety
  • Depression
  • Emotional Exhaustion

SUBSTANCE ABUSE & ADDICTION

Addiction is defined as persistent use of a substance despite negative consequences. It is a complex disease, the course of which is influenced by the interaction of genetics and environmental factors. Addictions can be created for any activity or behavior, which allows people to escape from life and its problems. Many people automatically think of drugs and alcohol when they hear of addictions but they encompass many other areas of our lives.

 

Other addictions include shopping, spending, gambling, food, weight loss, sexual activities, pornography and sometimes other people. Addiction is a chronic and treatable disease.


WOMEN’S & FEMALE HORMONAL ISSUES

Depression and anxiety disorders are common in women between puberty and menopause, resulting in a powerful link between female hormones and brain function. Our treatments are designed to assess and diagnose women of all ages experiencing disruption of mood, energy, anxiety, sexual function and well being due to hormonal influences on the brain.


WORK-RELATED STRESS

Work-related stress is a condition whereby individuals develop psychological symptoms of anxiety, depression and acute stress disorder. The main sources of work-related stresses are:

  • Increased quantities of work

  • Pressure to reach targets

  • Role issues and increased level of responsibility

  • Organization issues/ interpersonal relationships

  • Bullying

  • Domestic stress

  • Quality of work is compromised leading to further threat and increased stress

Coping strategies of the individual are compromised:

  • Lack of organizational support
  • Lack of awareness of stress factors by both individuals and organizations

  • Maladaptive strategies to cope with the stress
  • Individuals vulnerability

Effect of stress on individuals:

  • Psychological – anxiety and depression
  • Physical – tiredness, hypertension and self-neglect

  • Emotional

  • Behavioral – irritability, inability to function, alcohol abuse

  • Absence from work compromising both the individual and the organization

Also see Modalities of Treatment