Individual Services

Bipolar Disorder

Once known as manic-depressive illness or manic depression, this psychiatric disorder affects mood, energy, concentration and the ability to function. The disorder is evident when there is a distinct mood shift from elation to hopelessness. When the manic periods are less severe, they are known as hypomanic episodes.

To date, there are three types of bipolar disorder: bipolar I disorder, bipolar II disorder and cyclothymic disorder.

Types of Disorders

Bipolar I Disorder

The length of clear manic episodes is at least seven days and requires hospitalization. Depressive episodes last around two weeks. Depressive and manic symptoms can occur alongside each other.

Bipolar II Disorder

Unlike bipolar I disorder, this type is typically characterized by depressive and hypomanic episodes. These are called episodes with mixed features. Full-blown manic episodes do not define this disorder.

Cyclothymic Disorder

Also known as cyclothymia, this type of disorder widely varies. It is defined by periods of hypomanic symptoms and periods of depressive symptoms lasting for at least two years. In adolescents and children, they must last for one year. Symptoms do not meet the diagnostic requirements for hypomanic and depressive episodes.

Diagnosis and Treatment

Only a doctor or licensed healthcare provider can properly diagnose these disorders. Physical exams and other medical tests will be performed to ensure there is not another underlying or presenting condition. A mental health evaluation will then be completed. Diagnosis by a mental healthcare provider is usually based on symptoms, lifetime/family history and experiences.

Major Depressive Disorder

Major depressive disorder (MDD) is rooted in genetic, biological, environmental and psychological factors. While this disorder usually presents itself in adulthood, sometimes after a major illness, it can show up in children and adolescents as irritability rather than low mood. In adults, MDD can be caused by medications used to treat a medical condition. All cases, even the most severe, can be successfully treated. The sooner a patient is diagnosed, the easier the disorder is to treat.

There are five forms of presentation: persistent depressive disorder (dysthymia), postpartum disorder, psychotic depression, seasonal affective disorder and bipolar disorder.

Types of Presentations

Persistent Depressive Disorder (dysthymia)
Persistent depressive disorder is a low mood that can span the length of two years. A patient may have major depressive episodes and periods of less severe symptoms. To be diagnosed with this disorder, symptoms must last for two years.

Postpartum Disorder
Postpartum goes beyond the typical baby blues characterized by mild depression and anxiety symptoms that usually clear up two weeks after birth. With this disorder, patients experience a major depression pre- or postpartum. This experience is marked by sadness, anxiety and exhaustion. Given the severity of these symptoms, patients have trouble caring for themselves and their offspring.

Psychotic Depression
Psychotic depression is an unfortunate combination of severe depression and psychosis, with delusions and hallucinations.

Seasonal Affective Disorder
Seasonal affective disorder usually occurs during the winter months when there is a lack of sunshine. Symptoms include social isolation, sleeping too much and weight gain. This disorder can occur every year during the onset of the colder months.

Bipolar Disorder
Bipolar disorder is not the same as depression, but is included with MDD for the periods of morbidly low moods that are similar to the benchmarks of major depression.

Diagnosis and Treatment
Depression, even in the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Treatment includes medications and psychotherapy separately or in tandem. However, if the patient is not progressing, electroconvulsive therapy and similar brain stimulation therapies can be explored. Antidepressants may improve the way the brain sends out signals to control mood and stress. Doctors may try several antidepressants at varying doses to manage symptoms and side effects. These medications are to be taken for two to four weeks before the effectiveness can be assessed. If the patient would like to get off the medication after six months to a year, a doctor should monitor them to prevent withdrawal symptoms.

Psychotherapy is a valuable tool when dealing with depression, including cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy. Brain stimulation therapies are a solid alternative when medication and therapy do not produce the desired results, or when a first-line intervention is needed. Electroconvulsive therapy (ECT) can be performed on an outpatient basis as a series of sessions.

Anxiety Disorder

Life can make anyone anxious. Traffic, school exams and stressful decisions can make someone doubt their abilities to an extreme degree. However, these feelings of dread usually pass. A patient with anxiety may never feel at ease and may even develop worsening symptoms. The impact of these symptoms can be observed when performing daily activities, including work, school and social interactions.

Anxiety disorders fall into the categories of generalized anxiety disorder, panic disorder, and a multitude of phobia-related disorders.

Types of Disorders

Generalized Anxiety
Generalized anxiety disorder expresses itself through an unreasonable amount of worry every day for at least six months. These worries can include everyday life circumstances, such as work, health and social interactions. Those that suffer from this disorder may feel on edge and experience unsatisfying sleep, irritability, difficulty concentrating and uncontrollable worry.

Panic Disorder
Panic disorder is the unexpected or triggered reoccurrence of sudden periods of overwhelming fear that peaks within minutes. The sufferer may experience feelings of doom, heart palpitations, smothering sensations and a feeling of being out of control. These attacks are so distressing many self-isolate to save themselves the embarrassment of someone witnessing them. Some may develop agoraphobia as a result.

Phobias
Phobias are the avoidance of certain objects or situations. These may be common fears, such as snakes, or flying. The fear generally outweighs the degree of danger truly presented. Sufferers may develop irrational behaviors to cope with the overwhelming anxiety.

Sufferers of social phobia have an intense fear of social or performance situations. They excessively worry that others will negatively evaluate them to great embarrassment based on their actions and behaviors.

Agoraphobia is the intense fear of using public transportation, being in open or enclosed spaces, being part of a crowd or being left outside of the house by oneself. Many fear the loss of control and being ridiculed for suffering a panic attack.

Separation anxiety disorder is not just for children. Adults can deeply fear being separated from those who give them comfort and/or their attachment figures. Many will avoid being alone for that reason, have trouble sleeping due to nightmares, and experience distressing physical symptoms when thoughts occur about unexpected or anticipated separation.

Diagnosis and Treatment
A combination of psychotherapy and medication are used to treat anxiety disorders. Therapy must be customized to each patient’s specific worries and needs. Cognitive behavioral therapy teaches new ways/approaches to thinking, behaving, socializing and reacting to triggers. Exposure therapy works in the same way. This type of therapy allows patients to confront plaguing anxieties by engaging in fearing-inducing situations or guided relaxation exercises. Medication can relieve the symptoms of anxiety. These include benzodiazepines, antidepressants and beta-blockers.

Schizophrenia

Schizophrenia is a complicated mental disorder that cannot be cured. Many sufferers of schizophrenia seem to have lost touch with reality and exhibit signs of extreme confusion or paranoia. This chronic and severe mental disorder impacts thinking, feeling and behavior. While relatively uncommon, the symptoms can be disabling and alarming to those who do not fully understand this disorder. Onset usually occurs between 16 and 30 years of age. Although rare, children can have schizophrenia and must deal with symptoms that will last the rest of their life.

Symptoms

Symptoms are broken down into positive, negative and cognitive. As an important note.

Positive symptoms refer to the ability to feel. Positive symptoms are characterized by the departure from reality that includes hallucinations, delusions, and thought and movement disorders.

Negative symptoms are focused upon a specific numbness. Negative symptoms include disassociation from normal emotions, producing a flat affect that reduces feelings of enjoyment, speaking and sustaining activities.

Cognitive symptoms can be subtle or severe, depending on the patient. Symptoms include decreased thinking and memory retention. Many have trouble understanding information and using it upon learning something new. Making decisions and focusing are a challenge. Many sufferers benefit from being in group homes where caregivers can ensure safety and relative good health.

Diagnosis and Treatment
The cause of schizophrenia is unknown, making its treatment somewhat of a challenge. Eliminating and reducing symptoms is the general focus of treatments. Antipsychotics can be given as pills, liquids or injections. After the patient and doctor have found a suitable medication and dose, they may explore psychosocial treatments. These treatments focus on learning coping skills so patients may work or go to school. They also prevent relapses and hospitalization. Coordinated specialty care blends medication, psychosocial therapies and family involvement.

Psychosis

Psychosis is the term used to describe a state in which the sufferer has lost their sense of reality. These periods of illness are called psychotic episodes and must be handled by an experienced mental health professional. The patient may suffer from delusions and hallucinations of extreme distress to themselves and others. Speech may be incoherent, and there may be marked inappropriate behavior, such as screaming in public places and clothing removal.

Symptoms

Early symptoms include a shift in school and work performance, sudden trouble concentrating, new, odd or zero feelings. If the patient has a significant drop in hygiene or can no longer distinguish between fantasy and reality, a psychotic episode may be imminent.

Milder symptoms that can impair everyday function can include depression, anxiety, trouble falling or staying asleep, isolation and hopelessness. From the onset of psychotic symptoms to the start of treatment is called the duration of untreated psychosis (DUP).

Diagnosis and Treatment
Treatment should be administered as soon as symptoms appear. While that is not always possible, the earlier the treatment, the greater the chance the sufferer will have a full life after recovery. There is no guarantee that psychotic symptoms will never return. It is not currently possible to specify the root of psychosis. It may be a symptom of other mental illnesses, such as bipolar disorder or schizophrenia. In some cases, severe sleep deprivation, medication, medical conditions or substance abuse may cause psychosis. The diagnosis can only be made through psychologists, psychiatrists, or trained social workers.

Antipsychotic medications are used to treat psychotic episodes.

ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder that is characterized by the sufferer’s inconsistent ability to focus and be composed. Often, this disorder can negatively impact function in adults and development in children. The disorder is marked by inattention, hyperactivity, and impulsivity. As a person ages, their symptoms will, too. Any of the three symptoms of inattention, hyperactivity or impulsivity may become more prominent and last into adulthood.

Types of Disorders

Inattention
Inattention is characterized by lack of persistence and focus when attempting to complete a task. The sufferer may also be disorganized, and their inability to concentrate is not caused by defiance or lack of understanding of the task.

Hyperactivity
Hyperactivity is when a sufferer compulsively moves around when it is not appropriate for the situation. Movements can include fidgeting, tapping and excessive talking.

Impulsivity
Impulsivity means the sufferer cannot control their fight or flight reflex. They may also seek immediate gratification through hasty actions without thinking of the long-term consequences.

Diagnosis and Treatment
There is currently no cure for ADHD. With the right treatment, symptoms can be reduced to increase functioning. Options include medication, psychotherapy and training. All these treatments can be combined. With the right dose of medication, children and adults can focus on learning and performing the tasks in front of them. Stimulants may be used to increase dopamine and norepinephrine levels. These chemicals are essential for thinking and attention. Stimulants may decrease the appetite and increase anxiety. Non-stimulant medications are also available if other health conditions are not compatible with prescription stimulants. However, these types of medications can take longer to work.

An antidepressant might also be prescribed by itself or in combination with a stimulant. These work best in children and adults with pre-existing anxiety. ADHD can negatively impact the family dynamic. Behavioral therapy can help change the behavior of children and adults in supportive sessions. This type of therapy can give sufferers ways to monitor their behavior, acquire positive coping skills and award praise when choosing more positive thoughts and actions.

Post-Traumatic Stress Disorder

Returning to normal life after a dangerous or shocking event is a complicated process. Post-traumatic stress disorder (PTSD) can result when fear becomes overwhelming and the fight or flight reflex is easily triggered. The brain naturally wants to protect the body from harm. Many who experience traumatic events will be able to recover on their own, generally after a six-month period. Over time, the stress associated with the event will not be easily triggered. However, some may not. Those who do not will be diagnosed with PTSD.

Symptoms

Symptoms can occur as soon as three months after the event. Some sufferers may not feel the effects until years afterward. To be diagnosed with PTSD, symptoms must last longer than a month and interfere with normal functioning, such as at work or in relationships. Sufferers must have at least one re-experiencing and avoidant symptom, two arousal and reactivity symptoms, and two cognition and mood symptoms. Re-experiencing symptoms include flashbacks, nightmares and intrusive thoughts. Avoidance symptoms include isolating to avoid memory triggers, related thoughts and feelings about the traumatic event. Arousal and reactivity symptoms include being easily startled, feeling tense, difficulty sleeping and having unprovoked outbursts quite frequently. Cognition and mood symptoms include not being able to perfectly recall the traumatic event, feelings of doom about oneself and the world, unnecessary feelings of guilt or blame, and loss of interest in once enjoyable activities. PTSD may be followed by depression, addiction issues and anxiety disorders.

Diagnosis and Treatment

Medication and psychotherapy work well separately or together to treat PTSD. Antidepressants may help alleviate the fear and numbness associated with this condition. Psychotherapy involves talking to a mental health professional in a group or one-on-one session. Talking through these complicated feelings can last from six to 12 weeks. Some patients need more time to learn how to cope with and manage PTSD symptoms. Therapists can explore exposure therapy to face and control their fear, and cognitive restructuring to understand and overcome traumatic memories.

Adjustment Disorder

Adjustment Disorder is defined as the presence of emotional or behavioral symptoms in response to an identifiable stressor/s, which occurred within three months of the beginning of the stressor/s. The distress may be out of proportion with the expected reactions to the stressor and cause impairment in functioning.

The reaction is not considered part of normal bereavement and when the stressor is removed or the individual has begun to adjust and cope, the symptoms subside.

Symptoms related to Adjustment Disorder

Symptoms can show for a single event or continually stressful circumstances. The usual stressors are interruptions in close relationships except for bereavement; events that disrupt adjustment, such as disasters; and job failure or loss. Symptoms may include:

• Low mood
• Worry
• Insomnia
• Sadness
• Difficulty concentrating
• Anxiety
• Angry or disruptive behavior
• Loss of self-esteem
• Hopelessness
• Feeling as if trapped and have no other options
• Feeling isolated

Children and adolescents typically show the following symptoms in Adjustment Disorder:

• Irritable
• Depressed
• Poor sleep
• Poor grades and performance in school 

Stressors That May Cause Adjustment Disorders

Stressors can be a single event, such as:

• *Divorce or break-up of a relationship.
• *Being fired from a job.

There may be multiple stressors, including:

• *Difficulties with a business and marital problems.

Stressors may be recurrent, such as:

• *Business crises that occur in the “off-season.”
• *Unfulfilling sexual relationships.

Continuous stressors can include:

• *Continuous painful illness that increases disability.
• *Residing in a crime-filled community.

Some stressors can affect an entire family or community, such as:

• *A natural disaster.
• *Terrorism.

Some of the stressors can accompany specific developmental events, such as:

• Getting married.
• Going to school.
• Becoming a parent.
• Leaving the parents’ home.
• Re-entering the parents’ home after being away (such as having been at college, after a marriage or relationship breakup, or loss of a job).
• Failure to succeed in a career.
• Retirement

Diagnosis and Treatment

Psychotherapy is usually the best choice for Adjustment Disorder, because the disorder is seen as temporary and a somewhat normal reaction to a stressful event. The therapist works with the individual to find new behaviors and ideas and helps them to be able to deal more effectively with the problem. In addition, the therapist helps the individual find a clearer understanding of the issue/s. The treatment will often stress the significance of social support in the individual’s life. If there’s an issue with stress, therapy may also include relaxation training and techniques.

While Adjustment Disorder rarely extends beyond six months, there may be some lasting feeling that happens beyond that time frame. Those are normal and are usually not serious enough to require additional treatment.

Addiction and Substance Use Disorder

Substance Use Disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequence. People with SUD have an intense focus on using a certain substance(s) (e.g., alcohol, tobacco, or illicit drugs) to the point where the person’s ability to function in day-to-day life becomes impaired. People keep using the substance even when they know it is causing or will cause problems. The most severe SUDs are sometimes called addictions.

People can develop an addiction to:

• Alcohol

• Marijuana

• PCP, LSD and other hallucinogens

• Inhalants, such as, paint thinners and glue

• Opioid pain killers, such as codeine and oxycodone, heroin

• Sedatives, hypnotics and anxiolytics (medicines for anxiety such as tranquilizers)

• Cocaine, methamphetamine and other stimulants

• Tobacco

Repeated substance use can cause changes in how the brain functions. These changes can last long after the immediate effects of the substance wears off, or in other words, after the period of intoxication. Intoxication is the intense pleasure, euphoria, calm, increased perception and sense, and other feelings that are caused by the substance. Intoxication symptoms are different for each substance.

When someone has a substance use disorder, they usually build up a tolerance to the substance, meaning they need larger amounts to feel the effects.

According to the National Institute on Drug Abuse, people begin taking drugs for a variety of reasons, including:

• to feel good — feeling of pleasure, “high” or "intoxication"

• to feel better — relieve stress, forget problems, or feel numb

• to do better — improve performance or thinking

• curiosity and peer pressure or experimenting

In addition to substances, people can also develop addiction to behaviors, such as gambling or sex.

​People with substance use and behavioral addictions may be aware of their problem but not be able to stop even if they want and try to. The addiction may cause physical and psychological problems as well as interpersonal problems such as with family members and friends or at work. Alcohol and drug use is one of the leading causes of preventable illnesses and premature death nationwide.

​Symptoms of substance use disorder are grouped into four categories:

• Impaired control: a craving or strong urge to use the substance; desire or failed attempts to cut down or control substance use

• Social problems: substance use causes failure to complete major tasks at work, school or home; social, work or leisure activities are given up or cut back because of substance use

• Risky use: substance is used in risky settings; continued use despite known problems

• Drug effects: tolerance (need for larger amounts to get the same effect); withdrawal symptoms (different for each substance)

Many people experience substance use disorder along with another psychiatric disorder. Oftentimes another psychiatric disorder precedes substance use disorder, or the use of a substance may trigger or worsen another psychiatric disorder.

Treatment Options

For many, the first step toward recovery is acknowledging their personal struggle with substance dependence. The next step is finding a treatment program that can help restore their overall health, well-being, and happiness. Led by Licensed Clinical Psychologist, Dr. Katrina Verdon, South Florida Counseling and Assessment specializes in outpatient recovery of addiction. While we do not offer all options for addiction treatment, we believe that providing you with all the information to make an informed decision is critical to your recovery.

​There are countless treatment options to choose from. For example, some people with severe forms of addiction enter a detox program before transitioning into rehab. Others may choose to begin recovery at an inpatient or outpatient facility. After treatment, it is recommended to continue reinforcing the lessons learned in rehab by attending support groups and therapy sessions. A diagnostic evaluation with Dr. Verdon can provide you with recommendations related to the appropriate level of care and information about treatment options.

​Remember: there is no such thing as a ‘one-size-fits-all’ approach to addiction recovery. Whichever treatment path you choose, be sure that it meets your needs to help you achieve a successful recovery.

​Recovering from an addiction isn’t easy!

​It takes a significant amount of willpower and self-discipline to achieve and maintain long-term sobriety. Your recovery from an addiction is dependent on how much you put into the process and the right support system. We are here to empower you and support you during your recovery.

Learn More

Types of Programs and Treatments

Therapy Approaches to Addiction

Learn About Our Addiction Outpatient Treatment Services

Types Of Outpatient Rehab

How To Stage An Intervention