​It is important to realize that not everyone needs medication to treat their mental health symptoms, and not everyone who needs medication will need it forever. The purpose of this article is to provide basic education about psychotropic medications, because I find that most of my clients who take psychotropic medications are under-educated about them, and many clients who do not take medications are scared to start for the same reason.

​Mental health disorders (anxiety, depression, bipolar disorder, etc…) are a result of chemical imbalances in the brain, specifically of the neurotransmitters serotonin, norepinephrine and dopamine.  These chemical imbalances can be endogenous (genetic factors, internally caused), exogenous (life events, trauma, external factors), or both.  Psychotropic medications work to create balance in neurotransmitters by adjusting how the receptors in the brain absorb the chemical, effectively reducing negative symptoms.  Different medications work on different neurotransmitters, and it varies individually what each person’s brain needs or will respond to, depending on symptoms and brain chemistry.  
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Antipsychotic Medications
Used to treat Bipolar Disorder, Schizophrenia, Personality Disorders, Severe Depression and Severe Anxiety.

Used to treat the mood swings of Bipolar Disorder, and sometimes to enhance the effect of other medications when treating Depression. Reduce excitability in the brain, to calm overstimulated and overactive neurons. Many anticonvulsant medications are used as mood stabilizers. Examples: Lithium (Eskalith), Depakote (Divalproex Sodium), Lamictal (Lamotrigine), Tegretol (Carbamazepine), Topamax (Topiramate), Trileptal (Oxcarbazepine)
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Used to treat Attention Deficit Hyperactivity Disorder (ADHD), increase dopamine and norepinephrine. Can be addictive and can easily form a dependence. Examples: Adderall (Amphetamine), Vyvanse (lisdexamfetamine), Focalin (dexmethylphenidate), Ritalin/Concerta (methylphenidate), Dexedrine (dextroamphetamine)
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While a licensed therapist or counselor may be knowledgeable about psychotropic medications, only medical professionals can prescribe them. The medical professionals with the most knowledge and training in prescribing psychoactive medications are Psychiatrists.  Psychiatrists are medical doctors (MD) that have completed residency and training in psychiatry.  Most psychiatrists do not engage in talk therapy; they focus on symptom and medication management in brief (15-20 minute) appointments.
 
Other medical professionals able to prescribe psychotropic medications are Primary Care Physicians (MD/GP), Physician Assistants (PA), Psychiatric/Mental Health Nurse Practitioners (PMHNP), Nurse Practitioners (NP), Certified Nurse Midwives (CNM), and Gynecologists/Obstetricians (OB/GYN).
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In my practice, for someone who is not currently taking psychotropic medications, I will generally recommend medications if we seem to continue hitting a wall with ongoing negative symptoms, despite all reasonable efforts to improve them.  If adding structure, recognizing and changing thinking, improving overall physical health, learning emotional identification and expression, and addressing spiritual health doesn’t improve symptoms markedly, this indicates to me that the symptoms are endogenous in nature, and need chemical help to mitigate.
 

All medications generally have some risk of side-effects, some more troublesome than others.  Speaking with your prescribing physician and doing your own research are important before starting on any psychotropic medication.  Most common side-effects for psychotropic medications are disturbances in sleep and appetite.  Some of these can be mitigated by adjusting the time of day they are taken (morning if the medication is activating to your brain at night), and taking them with food to reduce nausea.
 
Research has shown that the most effective treatment for mental health disorders is a combination of medication and therapy.  Taking psychotropic medications without including therapy will not result in lasting change and improvement in symptoms.  For real and sustained life change, medications can help provide enough of a lift or relief of symptoms so work can happen in therapy, to prevent recurrence of negative symptoms.
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References:
http://www.drugs.com
http://www.pdr.net

We're so proud of therapist Jamia Davis for her wonderful interview on UNC-TV on July 22, 2021. In recognition of National Minority Mental Health Awareness month, the purpose of this townhall was to educate North Carolinians about the challenges African Americans face in terms of mental health and substance use and access to services. Leading the conversation were representatives of Voices of Affrilachia (VOA), which is a broad regional coalition of stakeholders focused on improving equitable service delivery in behavioral and mental health services across the footprint of Appalachia region of North Carolina.

Watch the recording here. Thanks to Jamia for raising awareness and educating our community about these important issues. We're lucky to have her on the BTC team! 

​To schedule an appointment to work with Jamia, click here. 

As private practice clinicians, we are generally aware of the importance of the therapeutic environment we create, with lighting, comfortable seating, and soothing colors being the norm. 

​​What you may not think, however, is how to create a safe environment for clients who have experienced trauma.  Whether or not you specifically work with clients who have encountered trauma, it is important to recognize that certain things in the therapeutic environment can be triggers, even re-traumatizing, if we’re not careful.

As clinicians, these are small yet effective ways of intentionally creating a safe space for our clients to be able to be vulnerable and engage in healing. 

​The idea is to carry this through for all of our clients, as we may be unaware of trauma they have experienced in the past.  However, despite our best efforts at creating a safe environment, clients may still experience triggers, flashbacks, and panic episodes in session. Because of this, it is important for all clinicians to have basic knowledge of trauma, its impact on the brain, and how to deal with trauma responses in session. Even the most prepared and educated clinician may find themselves in a situation where a client is re-traumatized, and it is critical to understand how to respond in the moment. Psychological First Aid, Grounding Techniques, Breathing Exercises, and a neutral, calming presence, are all skills that clinicians should have in their repertoire, so we may help our clients process what they’re experiencing, and continue to grow and heal in therapy.

References:
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. (2014). Substance Abuse and Mental Health Service’s Administration.

It is essential to check in on your mental health and those around you. There are many signs to take in, and while some are subtle, others are loud and in your face. Here are some of the signs to look out for that may be signs you need to see a professional. 

• Sleep or appetite changes: Are you sleeping more or less than usual? Are you eating normally, or do you find yourself eating more or less? 
• Feeling disconnected: Are you finding yourself in the sense of unreality? 
• Lacking motivation: Do you feel like you can’t do anything? Or can you not bring yourself to do everyday tasks? 
• Mood changes: Is your mood fluctuating rapidly or drastically? 
• Increased anxiety: Do you find yourself worrying more than not lately? 
• Illogical thinking: Do you feel like the world is out to get you? 
• Problems thinking: Are you struggling to find your thoughts? Is your memory getting worse? Can you not concentrate on anything? 

 
Those are just some of the signs that you may need to check in with a professional. Remember, your brain sometimes needs some extra help-- it can get "sick" just like any other part of your physical body. This pandemic is taking a toll on everyone, and you shouldn’t have to feel like you are going at it alone. 

It isn’t easy right now in the world. That is clear as day. If you or someone you know is struggling, reach out. It doesn’t mean you are weak or broken-- it means you courageous and you care. We are here to help. Your mental health matters.

Our awesome therapist Amber Garcia shares some easy techniques to help you manage anxiety. These tips are great for all ages. Hope you find it helpful! 

I recently came across this article about motivating children who lack motivation. One of the points the author describes made me pause. She asks the parent what motivates their child? What does he really want? What questions can I ask that will help him discover and explore his interests? What are his goals and ambitions?

Encouraging children requires you as a parent to step far enough away to see your child as a separate person. With all our good intentions, it is easy to become wrapped up in the stress of every day life and forget our children are not mini-me's, but are separate people with different preferences, different ways of thinking, feeling, and doing things. 

For a child to feel motivated they must first feel seen. They must feel that their voice matters. That their parent takes the time to really listen-- not to what you want the answers to be, but to what your child is really saying. And if the answers happen to not line up with who you are, respect them, even if you disagree.

I read this "66 Positive Things To Say To Your Child" post today, and wrote down the ones I regularly say to my children, and the things I'm going to try. to say more often. It was a good reminder to see my children as their own separate selves that I must continue to learn and understand as they grow.

Encouraging things I say often:
#2: You make me proud.
#6: You don't have to be perfect to be great.
#17: You were right. (Especially if I had previously told them they were not!)
#37: I trust you.
#38: That was a really good choice.
#63: I love you.

Here's what I'm going to try to say more of:
#19: We can try it your way.
#34: I admire you.
#44: Thank you for being you.
#60: I'm listening.
#65: You are enough.

What are some things you say now vs. what you'd like to say more of to encourage your child and help them be the beautiful little people that they are?

Warmly,

I've used this worksheet with my own children, with students I've taught, and with clients, both children and adults. Teaching kids to "tune in" to their bodies is an essential skill and doesn't always come naturally.

There are so many benefits to learning this skill! One is emotional regulation-- kids who can listen to their body have an easier time managing and coping with their feelings, especially the really big ones, like anger, disappointment, fear, frustration, guilt, sadness.. .

They feel more capable, confident, have a more secure sense of self.

They have less behavioral problems, better social skills with peers, more empathy and supportive relationships...

It's not just a skill for kids., Adults benefit in similar ways, too, with overall mental stability, positive sense of self, solid relationships, increased career satisfaction. 

Take a moment today to tune inward,. Breathe in for 4 seconds, hold for 7, and slowly release for 8. Then scan your body and really listen to what each body part is telling you. Maybe some are silent, while others are screaming!

That's ok, no judgement.

All you have to do is listen.

Click to download the PDF to use at home.

 ​We're living through a significant time in history. This interactive packet helps parents talk with with their kids about the impact coronavirus has on their lives, and create a "time capsule" to document this experience to look back on. 

You can download the free printable below. It was originally created by Long Creations, who deserves many thanks for sharing!

you weep
as you watch the blazing fire
burn down everything
you've ever loved

in time
the ashes will nourish
the barren and
fertilize the soil

one day
you will realize this
as you stroll through
your garden of flowers.


-Chantal Hayes