Leslie "Les" Gura, LCMHC, NCC, CCTPPsychotherapist The spring equinox represents the passing of season, from the harshness of winter’s cold and early darkness to the brightness of warmer temperatures and longer days. Many people welcome this time of year with joy in their eyes and a spring (so to speak) in their step. But it’s rarely that simple, is it? Some people are sad to say goodbye to winter. I’m one of them. It’s not that I love the cold or snow – although the storm that dumped 6 inches on us the last day of January was the most beautiful in my 23 years in North Carolina. It’s just that this time of year reminds me of two difficult dates in my life. My dog, Nilla, the most gentle, perfect canine ever, died on March 17, 2023. Thanks to social media, I am reminded of that day constantly this time of year. And April 2 will mark what would have been my father’s 106th birthday. My best friend and most important influence has been gone for nearly 44 years. In other words, when I think about the onset of spring, my mind goes to those two huge losses. My throat is tightening as I write this blog. The thing is, treating grief is an essential part of counseling. And my lived experience informs and strengthens my work with clients who are grieving. Some don’t even know it because grief, though centered on loss, is not always about death. Often, I will gently point out to clients that their anxiety or depression over losing a job or breaking up with a partner is actually the way they are experiencing grief. Regardless of the type of grief, how do you recognize it? Here are a handful of ways:
And how do we learn to manage grief’s symptoms? It starts with recognizing a loss, because once we accept we have suffered one, we can begin to grieve it more openly. My father’s death in 1982 was shattering because it came out of the blue; he had appeared at age 62 in the best shape of his life. I was just 22 and didn’t know how to shed tears, much less grieve. It took seven years, when the 1989 movie Field of Dreams was released, before I grieved my dad’s death. At the end of the movie, Kevin Costner’s Ray Kinsella turns around in the twilight to see his father emerge from the cornfield and they get to play catch. In the darkened theater, my throat caught. I could barely breathe. And, oh, I felt hot tears rolling down my cheeks more quickly than I could wipe them away. My wife noticed. And for the first time, I was able to share the pain of my dad’s death with another person. Flash forward 34 years and grieving came easily, but no less painfully, when I recognized my dog, Nilla, was in decline. In October 2022, I chose to get ahead of the grief to come by through a series of daily social media posts honoring Nilla, sharing fun, nostalgic and poignant pics of my 14-year-old dog. Then, after she died, I let the immediate pain subside and eventually blogged about knowing when and how to make that awful, merciful decision about a beloved pet.  There are many ways to manage grief. Here are a few ideas:
Remember, if you find your throat tightening or eyes welling this season, let the tears flow. More than anything, grief is a process that, like the seasons, can be hard to predict.
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Christine Ridley, MSW, LCSW, ADHD-CCSPPsychotherapist The holidays can be tough for some people, with a variety of emotions showing up. This holiday season, I felt some melancholy. My grandfather entered hospice. I watched my mother grieve her father. I spent time in a hospital room, a memory care unit, and by a hospital bed while others were celebrating togetherness. How many of us find the joy of the holiday season difficult to hold while we are aware there is an empty seat at the table? Grief is many things and is not limited to the death of a loved one. Grief can also arise from the loss of a job, having to detach from a friend, ceasing contact with a family member due to their active addiction and not wanting to enable their behavior, experiencing the ‘empty nest’, or missing a previous time in your life that you cherished.  A Swiss-American psychiatrist, Elisabeth Kubler-Ross, coined the 5 Stages of Grief based on her work with terminally ill patients and they have been widely adapted to the framework of grief. Note that these stages are fluid and not linear.
In my counseling work, I use a skill called dialectics from the Dialectical Behavioral Therapy (DBT) framework to hold grief. Dialectics is a philosophical framework in which two seemingly opposite truths can coexist. With grief, dialectics sounds like this: “I am devastated by their loss and I am relieved they are no longer in pain.” By holding two opposite truths at the same time, we are not invalidating that there is pain here, we are acknowledging the pain, while noticing what is around that pain, so that we can better move through the emotions without judgment, without pushing away the pain, and honoring it. I often encourage my clients to have a daily practice or ritual where they honor their grief. You may choose to have a sacred space where you sit daily. This is a space that is comfortable for you, whether it is outside on a park bench or inside your home in your favorite chair. You may set a timer for 15 minutes and light a candle. Leaning into stillness, name your emotions, notice the physical sensations that may be there in your body, and honor them. For example, “I am noticing sadness here. Sadness feels like tears forming behind my eyes and heaviness in my chest. To honor this, I am going to let my tears flow, open up my chest, breathe in some calm and breathe out sadness. To honor the sadness I feel today, I am going to notice that while I am sad, I notice I am allowing myself to heal in brave ways.” Blow the candle out and this is the end of the practice. By allowing yourself time to have this practice daily, this prevents the build up of grief and allows for healing, one day at a time. May you find peace in your healing journey.
In the practice of psychotherapy, therapists learn about and utilize many tools to help our clients find lasting change, improving their overall mental health and wellbeing, and psychotropic medications can be one of those tools. 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. How do psychotropic medications affect the brain?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. What are the types of psychotropic medication? Anti-Anxiety Medications
Anti-Depressant Medications
Antipsychotic Medications Used to treat Bipolar Disorder, Schizophrenia, Personality Disorders, Severe Depression and Severe Anxiety.
Mood Stabilizers 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) Stimulants 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) Who can prescribe psychotropic medications? 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). How do I know if I need psychotropic medications? 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. What do I need to be aware of if I start taking psychotropic medications? 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.
Almost an entire year into a worldwide pandemic, you may be feeling more stressed than ever. COVID-19 has made life different for everyone. From social distancing to virtual learning, everything has changed. Our routine isn’t what we were used to, and that can come with challenges.If you find yourself struggling, finding a mental health counselor who can help you through this tough time is essential, even through a screen. You wouldn’t just brush off a broken arm, would you? So why would you ignore your mental health? Your brain is your most complex and important organ. You have to take care of it. The Impact of COVID on Mental HealthThe world has been turned upside-down in the last year, from social distancing to having to go through virtual learning. All these changes are making it rougher for mental health than normal everyday life. It’s no secret that a pandemic is rough on mental health. It’s been documented before that a pandemic will see a rise in mental health issues like anxiety, depression, and even OCD. There has been a rise happening with mental health issues because of the isolation, social distancing, and virtual learning and work. Social Distancing & IsolationOne of the first things that happened in many places was the closure of non-essential businesses and schools all over the United States. People were told that staying home and only going out when needed was going to help prevent the spread of the virus. All restaurants were closed to dine-in, and other social gatherings were put on hold till further notices. There are reported issues that come with social isolation, which is where we are now. People are feeling the adverse effects of what is our new normal. There has been a rise of about 37% in mental health issues ranging from anxiety to depression during this quarantine. The biggest worry is that of suicidal ideation during this time. Isolation is a risk factor for suicide, and being forced to be in isolation can increase the thoughts that lead to it. This is why talking to a mental health professional is vital. If you are finding yourself in a dark place, find a counselor in your area. These times are hard, and having someone to talk to is going to be essential. If you aren’t able to contact a counselor, then reach out to your family and friends. You may not be able to see them in person but use FaceTime and Zoom to meet people. Your mental health is so important, and you have to take care of yourself, even in isolation. Virtual LearningThere are many children out there that are still doing virtual learning. Your child may be one of them, and you can see them struggling. Many parents are worried about their child falling behind in social and emotional development during this time. It's a valid worry. Children need to have one another to thrive and grow into adults later on. Zoom classroom isn’t the same as being in a school, but it is better than nothing. Make sure your child is logging into the meetings and participating. This is going to help them in the long run, and if they are struggling, talk to the teacher yourself. For special needs children, this virtual learning is more challenging. IEPs and other learning accommodations aren’t easy when it comes to a virtual classroom. Now, as children start going back to the building, there are even more worries. For students with social anxiety, it may be heightened after being in isolation for so long. Take it easy on them and try and work with them to know it is okay. This virus is scary but wearing the mask, washing your hands, and staying six feet apart is helping. Finding a mental health professional that can help with these worries will be vital in helping those who struggle. Being able to talk to someone who understands is going to be helpful in the long run. Job InsecurityLosing a job during COVID-19 has been at an all-time high. This is a tough place to consider that have not only jobs been lost, but also insurance. This takes a toll on anyone’s mental health, not knowing how we can get the help we need. The less money you make, the worse the impact is when it comes to losing a job. It is a scary place to be when you don’t know how you will afford to take care of your health. Take the time to research what you can do if you lose your job and insurance. While it isn’t ideal, COBRA is an option if you can afford it. Your mental health should come first when dealing with something as stressful as a pandemic. Mental Health CheckIt 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.
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. Contact us to schedule an appointment with one of our licensed counselors today. Written by Tia Kitchens for Banyan Tree Counseling & Wellness. Holding a degree in Psychology from Capella University, Tia is a writer with a passion for psychology and learning. In her free time she enjoys being with animals and hopes to work with therapy animals in the future. Ultimately, she aspires to spread awareness about the importance of mental health.
If your body parts could talk, what would they say?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. 
 Some photos of Banyan Tree Counseling's space: Suite 203, 1348 Westgate Center Dr. Winston Salem, NC 27103. There is lots of growing, healing, thriving, playing, and difficult yet joyful work happening in this sacred space... Come join us! Calling a therapist is often the best thing you can do for yourself, your child, or your family. Our fees are affordable and office is centrally located. We look forward to connecting with you.
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Banyan Tree Counseling & WellnessWe are a team of licensed clinicians with a holistic, strengths-based, and evidence-based approach. We offer counseling for people of all ages, life coaching, group therapy, educational consulting and advocacy, assessments, and dietary nutrition services. 
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© 2015-2026 Banyan Tree Counseling PLLC | Banyan Integrated Health PLLC | Banyan Tree Wellness LLC | All Rights Reserved.
All content on this website, unless otherwise specified, is the sole property of Banyan Tree Counseling & Wellness and is protected by copyright laws.
Any unauthorized reproduction, distribution, or use of this content is strictly prohibited and may result in legal action.