Neuropsychological Assessment and Treatment
Attention Deficit Hyperactivity Disorder
College of Psychologists of Ontario
Ontario Psychological Association
Canadian Psychological Association
Anxiety TOPWhen you have an anxiety disorder, it can be as disabling as a major medical disease. It’s just not as visible to family, coworkers or friends, and one’s suffering is internal.
Through human evolution, a normal amount of anxiety has been inherited as necessary to survival. (Are there poisonous snakes near the children? Is that woolly mammoth going to charge? Do I have enough dried berries and fish for the winter?). But like any human trait, some of us may inherit a few too many of these genes. Combined with some personality traits, life experiences, stressors or lifestyle habits and…..there you go – you’re in your doctor’s office knowing something is terribly wrong, or lying awake half the night gripped with fear and dread.
Whether its panic attacks, OCD, health anxiety, generalized anxiety, posttraumatic stress, social or other phobia, there are very effective techniques that can be learned to recover from an anxiety disorder. Although some people will also need medication in their recovery, research shows that Cognitive Behavioural Therapy is an equally effective and longer lasting treatment than medication.
Obsessive Compulsive Disorders Ontario
Anxiety Disorders Association of America
Mood Disorders TOP
As the name suggests, mood disorders are characterized by disturbance in mood as a predominant feature. Mood Disorders fall into two general categories: the Depressive Disorders (e.g. Major Depressive Disorder, Dysthymic Disorder, Post-Partum Depression, Seasonal Affective Disorder) and the Bipolar Disorders (e.g. Type I, Type II, Cyclothymia). Mood disturbance may also occur due to medical conditions and use of substances.
Depression has often been referred to as the “common cold” of mental health difficulties due to its high prevalence. Approximately 15-25% of women and 10-15% of men will experience a major depressive episode during their lifetime. Depression is different than simple unhappiness or grief following the loss of a loved one. It encompasses a range of symptoms that include emotional (low mood, feeling hopeless), physical (change in appetite or sleep), behavioural (talking slowly, social withdrawal) and cognitive (negative thoughts, difficulty concentrating) symptoms.
Depression may be treated by medication, psychotherapy or a combination of these two approaches. Numerous studies have shown that Cognitive Behavioural Therapy (CBT) can effectively treat depression by targeting behaviour and thinking patterns that cause and maintain depression.
The Bipolar Disorders are characterized by episodes of depressive and manic/hypomanic (elevated mood) symptoms. Manic-type symptoms include decreased need for sleep, an increase in goal-directed tasks, grandiose ideas, agitation, and inflated self-esteem. This class of disorder is best managed by a combination of medication, and psychotherapy that targets active coping strategies, stress management, medication compliance and negative thinking.
It is important to emphasize that suicidal thoughts and difficulty with daily functioning are common for those experiencing a mood disturbance. It is extremely important to consult with your physician, or seek the help of a qualified mental health professional, if you believe that you or someone you care about may be struggling with a Mood Disorder. Mood disturbance can be effectively treated or managed with the assistance of skilled health care providers. For further information, visit the Mood Disorders Association of Ontario at www.mooddisorders.on.ca.
The Bipolar Workbook: Tools for controlling your mood swings. (2006). By Monica Ramirez Basco. New York, NY: The Guilford Press.
Ending the Depression Cycle: A step-by-step guide for preventing relapse. (2003). By Peter J. Bieling and Martin M. Antony. Oakland, CA: New Harbinger Publications, Inc.
Mind Over Mood: Change how you feel by changing the way you think. (1995). By Dennis Greenberger and Christine A. Padesky. New York, NY: The Guilford Press.
The Feeling Good Handbook: Revised Edition. (1999). By David D. Burns. New York, NY: Penguin Putnam, Inc.
The Mindful Way through Depression. (2007). By M. Williams, J. Teasdale, Z. Segal, and J. Kabat-Zinn. New York: NY: The Guilford Press.
Eating Disorders TOP
Eating Disorders have become an increasingly common problem over the past five decades. These disorders most commonly affect adolescent girls and young adult women. However, adolescent boys, men, young children and middle aged and elderly individuals may also be affected. Eating disorders can involve different combinations of symptoms.
Individuals with Anorexia Nervosa are significantly below a healthy weight for their age and height and females may have stopped menstruating. They may perceive themselves to be overweight and are fearful of weight gain. They place a great deal of emphasis on physical appearance when evaluating their self worth. About half of those effected by Anorexia purge after eating.
Individuals with Bulimia Nervosa may be overweight or normal weight. These individuals engage in recurrent episodes of binge eating followed by inappropriate compensatory behaviours to prevent weight gain. Compensatory behaviours may include self induced vomiting, laxative abuse, starvation or excessive exercise. These individuals experience a feeling of lack of control over eating and like those with Anorexia, their self evaluation is unduly influenced by their body shape and weight.
Individuals with Binge Eating Disorder are likely to be overweight, though they may be normal weight. These individuals engage in recurrent episodes of binge eating in the absence of compensatory behaviours.
Many individuals have some of the symptoms of the above disorders but would not be given the diagnosis. However, whether an individual experiences a full blown eating disorder or just some of the symptoms of an eating disorder, these disorders are extremely painful and medically dangerous. If you see yourself in any of the above descriptions it is important that you seek help immediately. Eating Disorders have the highest fatality rate of any mental health issue and many more people become chronic and are never able to fully recover. The most common cause of death in eating disorders is heart failure due to an electrolyte imbalance which is caused by purging. There may be no warning sign that your electrolytes are out of balance so a blood test is necessary to determine if you are at risk of heart failure. Research studies have shown that early detection and treatment is associated with better outcomes.
If you are experiencing Anorexia Nervosa the initial focus of treatment will be on the restoration of normal body weight and normal eating patterns. This is because your brain is in a state of starvation and you cannot fully benefit from therapy until you’re brain is adequately fed. For individuals with Anorexia the idea of gaining weight is frightening. Rest assured that your psychologist is aware of this and will assist you to cope with this fear. You will be provided with information about the medical complications associated with your symptoms and this in itself may help you to start changing your behavior. Your psychologist will help you to gradually increase your food intake through motivational techniques and body image work. As your weight approaches normal the focus of treatment will shift to weight maintenance and exploration of the underlying issues, which must be addressed to prevent relapse.
Treatment of Bulimia also requires the normalization of eating patterns and acceptance of normal body weight. In treatment you will learn strategies for reducing the frequency of binges and purges with the ultimate goal of eliminating these behaviours. Once again treatment of Bulimia includes body image work as well as an examination of underlying issues. A similar treatment approach is utilized for Binge Eating Disorder.
Treatment approaches utilized primarily include Cognitive Behavioural Therapy and Family Therapy. In most cases mid- to long-term treatment is required, though short term treatment may be effective if treatment is commenced early on. Early intervention is associated with better long-term outcome and a higher likelihood of full recovery.
Due to the significant medical dangers associated with self starvation, binge eating and purging, it is imperative that you are under the care of a Medical Doctor throughout your treatment. This is an absolute requirement for individuals receiving treatment for an eating disorder at Markham Psychologists. If you do not have a medical doctor, or are embarrassed to tell your family doctor about these behavours, we can assist you in finding one.
Links For Parents:
Other Eating Disorder Websites:
Rehabilitation TOPRehabilitation as a Result of Injury/Trauma, Accident, or Illness
Psychologists working in the area of rehabilitation are concerned with assisting individuals dealing with limitations in their physical, sensory, emotional, cognitive, social, or occupational capacities as a result of injury, accident, trauma, or illness. Injuries or accidents such as a motor vehicle collision, work-related accident, or illnesses like cancer or stroke can impact a person's capacity to work, to learn to manage personal or family responsibilities, to maintain relationships, or to participate in social, household or recreational activities. The ultimate therapeutic aim to help individuals reclaim meaning and hope in their lives, increase quality of life, and to restore previous functioning to the extent possible.
Individuals recovering from an injury, trauma, illness, or accident may deal with a number of issues that impact their functioning such as chronic pain, fibromyalgia, post-traumatic stress, phobic and anxiety reactions, and depressive symptoms. For example, an individual recovering from an auto accident may struggle with chronic pain, physical limitations, decreased activity level, loss of independence, post-traumatic reactions (e.g., flashbacks and/or nightmares, hypervigilance symptoms), driving anxiety and avoidance, concentration and memory problems, irritability/anger, low mood, energy, and motivation, sleeping disturbances, in addition to social withdrawal.
Psychologists use several different techniques to help people to recover their strength and sense of self and improve the quality of their lives, in spite of their difficulties. Specific techniques include support, education and skill building in areas such as relaxation, stress and anger management, problem solving, realistic goal setting, pain management, sleep hygiene, and assertiveness. Cognitive approaches foster thoughts, emotions and actions that are adaptive for managing life. Behavioral approaches help people plan their activities in ways that give them more control.
Managing pain before it manages you (2002). By Margaret A. Caudill. New York: NY: The Guilford Press.
Overcoming post-traumatic stress disoder - client manual. A cognitive-behavioral exposure-based protocol for the treatment of PTSD and other anxiety disoders (1999). By Larry Smyth. Oakland, CA: New Harbinger Publications, Inc.
Coping With Mild Traumatic Brain Injury: A Guide To Living With The Problems Associated With Brain Trauma (1998). By Diane Roberts Stoler and Barbara Albers Hill. New York: NY. Avery Publishing Group.
Neuropsychological Assessment and Treatment TOP
A Neuropsychological Evaluation is a comprehensive assessment of cognitive, behavioural and emotional functions using a set of standardized tests and procedures. Your doctor may recommend that you be assessed by a Neuropsychologist if you have experienced a traumatic brain injury, stroke or seizure or if they suspect that you may have a psychiatric or neuropsychiatric disorder, medical illness or dementia.
- Ontario Brain Injury Association
Learning Disabilities TOPPsychology Works Fact Sheet: Learning Disabilities in Children
Attention Deficit Hyperactivity Disorder? TOPPsychology Works Fact Sheet: Attention Deficit/Hyperactivity Disorder
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