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Most people feel sad or “blue” from time to time, but depression is much more severe than feeling “down in the dumps”. If you are suffering from depression, the feelings do not go away. They persist and interfere with your everyday life. Depression can run in families and is more common in women than in men.


  • Sadness
  • Loss of interest or pleasure in activities you used to enjoy
  • Change in weight
  • Difficulty sleeping or oversleeping
  • Energy loss
  • Feelings of worthlessness
  • Thoughts of death or suicide


Anxiety is a normal part of life. It can even be useful when it alerts us to danger. Anxiety becomes a problem, when this normal psychological and physical reaction happens at an unnecessary time. Anxiety is a persistent problem that interferes with daily activities such as work, school or sleep. This type of anxiety can disrupt relationships and quality of life. Left untreated, anxiety can lead to health problems.


  • Feeling apprehensive
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly (hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or fatigued

Anxiety disorders are broken down into several diagnoses:

  • Panic attacks can start suddenly and cause apprehension, fear or terror. You may have feelings of impending doom, shortness of breath, heart palpitations or chest pain. You may feel as if you’re choking, being smothered or that you’re “going crazy.”
  • Agoraphobia is anxiety about, or avoidance of, places or situations where you might feel trapped or embarrassed to leave if you start to feel panicky.
  • Specific phobias are characterized by significant anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
  • Social phobias are characterized by significant anxiety provoked by exposure to certain types of social or performance situations and a desire to avoid them.
  • Obsessive-compulsive disorder (OCD) is characterized by persistent, recurring thoughts, images or impulses (obsessions) or an irresistible desire to perform irrational or seemingly purposeless acts or rituals (compulsions). Often it involves both obsessive and compulsive behavior.
  • Post-traumatic stress disorder (PTSD) is characterized by the feeling that you are re-experiencing an extremely traumatic event. It causes intense emotions and physical reactions along with a desire to avoid anything that might remind you of the event.
  • Acute stress disorder is characterized by symptoms similar to those of post-traumatic stress disorder that occur immediately after an extremely traumatic event.
  • Generalized anxiety disorder is characterized by at least six months of persistent and excessive anxiety and worry about small or large concerns. This type of anxiety disorder often begins at an early age. It frequently occurs along with other anxiety disorders or depression.
  • Anxiety disorder due to a medical condition is characterized by prominent symptoms of anxiety that are directly caused by a physical health problem.
  • Substance-induced anxiety disorder is characterized by prominent symptoms of anxiety that are a direct result of abusing drugs, taking medications or being exposed to a toxic substance.
  • Separation anxiety disorder is a childhood disorder characterized by anxiety related to separation from parents or others who have parental roles.
  • Anxiety disorder not otherwise specified is a term for prominent anxiety or phobias that do not meet the exact criteria for any of the other anxiety disorders but are significant enough to be distressing and


Trichotillomania (trik-o-til-o-MAY-ne-uh) is an irresistible urge to pull out hair from your scalp, eyebrows or other areas of your body. Hair pulling from the scalp often leaves patchy bald spots, which people with trichotillomania may go to great lengths to disguise.

Trichotillomania can be mild and generally manageable. Other times, the urge to pull hair is overwhelming and can be accompanied by considerable distress. For some people, hair pulling is intentional and focused. They’re aware that they’re pulling their hair out and may even develop elaborate rituals for doing so. Other people pull their hair unconsciously. The same person may also do both, depending on the situation and mood.


  • Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but it can be from other body areas as well
  • A strong urge to pull hair, followed by feelings of relief after the hair is pulled
  • Patchy bald areas on the scalp or other areas of your body
  • Sparse or missing eyelashes or eyebrows
  • Chewing or eating pulled-out hair
  • Playing with pulled-out hair
  • Rubbing pulled-out hair across your lips or face

Eating disorders

Eating disorders such as anorexia, bulimia, and binge eating disorder include extreme emotions, attitudes, and behaviors surrounding weight and food issues. An eating disorder manifests in behaviors surrounding food, weight, and shape and is accompanied by low self-esteem. Eating disorders require multi-systemic care, meaning that the psychologist works closely with other professionals (i.e., primary care physician, nutritionist, etc). In addition, family therapy is many times recommended as being part of the solution.

Anorexia Nervosa
Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss. Anorexia includes an intense fear of gaining weight, a distorted body image, denial of the seriousness of the illness, and loss of menses. Those, who meet criteria, refuse to maintain a weight within 15% of average body weight for age and height.

Anorexia predominantly affects adolescent girls and young adult women, however, anorexia and other eating disorders do occur in males, younger girls and older women.

Binge Eating Disorder
Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.

Bulimia Nervosa
Bulimia Nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting, diuretics, laxatives, or excessive exercise designed to undo or compensate for the effects of binge eating.

Body Image Concerns

Body image is how you see yourself when you look in the mirror or picture yourself in your mind. Body image is how one perceives her own body and level of physical and/or sexual attractiveness. There are many contributing factors to females having poor images of their own bodies, including the media and societal norm. At the same time, one’s own experiences with weight and shape have the greatest impact. Not feeling good about how we look can affect us in a negative way on a daily basis, and have a negative effect on our self-esteem.

Substance Dependence

Addiction (termed substance dependence by the American Psychiatric Association) is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period:

  1. Tolerance, as defined by either of the following:
    • A need for markedly increased amounts of the substance to achieve intoxication or the desired effect
    • Markedly diminished effect with continued use of the same amount of the substance.
  2. Withdrawal, as manifested by either of the following:
    • The characteristic withdrawal syndrome for the substance
    • The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
  3. The substance is often taken in larger amounts or over a longer period than intended.
  4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
  5. A great deal of time is spent in activities necessary to obtain the substance (such as visiting multiple doctors or driving long distances), use the substance (for example, chain-smoking), or recover from its effects.
  6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
  7. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).DSM-IV criteria for substance dependence include several specifiers, one of which outlines whether substance dependence is with physiologic dependence (evidence of tolerance or withdrawal) or without physiologic dependence (no evidence of tolerance or withdrawal). In addition, remission categories are classified into four subtypes: (1) full, (2) early partial, (3) sustained, and (4) sustained partial.

Self-Harm (cutting)

Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or upsetting relationship problems. They may be dealing with feelings that seem too difficult to bear, or bad situations they think can’t change.

Some people cut because they feel desperate for relief from bad feelings. People who cut may not know better ways to get relief from emotional pain or pressure. Some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness.

People who cut may not have developed ways to cope. Or their coping skills may be overpowered by emotions that are too intense. When emotions don’t get expressed in a healthy way, tension can build up — sometimes to a point where it seems almost unbearable. Cutting may be an attempt to relieve that extreme tension. For some, it seems like a way of feeling in control. The urge to cut might be triggered by strong feelings the person can’t express — such as anger, hurt, shame, frustration, or alienation.

Cutting is sometimes (but not always) associated with depression, bipolar disorder, eating disorders, obsessive thinking, or compulsive behaviors. It can also be a sign of problems that cause people to have trouble controlling their impulses or to take unnecessary risks. Some people who cut themselves have problems with drug or alcohol abuse.

Low Self-Esteem

Self Esteem is made up of both beliefs and feelings about ourselves. The belief is usually a judgment of overall worth. The beliefs tell us about our abilities, traits, and physical characteristics. The feeling is a core sense of being good or bad. The feelings can

  • School Refusal
  • Anger/Aggression
  • Difficulty Regulating Emotions
  • Obsessive-Compulsive Disorder
  • Panic Attacks
  • Adolescent/Parent/Family Dilemmas
  • Relationship Conflicts

Bipolar Disorder

Bipolar disorder causes mood swings that range from of the lows of depression to the highs of mania. When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts in the other direction, you may feel euphoric and full of energy. Mood shifts may only occur only a few times a year, or as often as several times a day. In some cases, bipolar disorder causes symptoms of depression and mania at the same time.

Although bipolar disorder is a disruptive and long-term condition, you can keep your moods in check by following a treatment plan.

Bipolar disorder is divided into several subtypes. Each has a different pattern of symptoms. Types of bipolar disorder include:

  • Bipolar I disorder. Mood swings with bipolar I cause significant difficulty in your job, school or relationships. Manic episodes can be severe and dangerous.
  • Bipolar II disorder. Bipolar II is less severe than bipolar I. You may have an elevated mood, irritability and some changes in your functioning, but generally you can carry on with your normal daily routine. Instead of full-blown mania, you have hypomania — a less severe form of mania. In bipolar II, periods of depression typically last longer than periods of hypomania.
  • Cyclothymia. Cyclothymia is a mild form of bipolar disorder. With cyclothymia, hypomania and depression can be disruptive, but the highs and lows are not as severe as they are with other types of bipolar disorder.

The exact symptoms of bipolar disorder vary from person to person. For some people, depression causes the most problems; for other people manic symptoms are the main concern. Symptoms of depression and symptoms of mania or hypomania may also occur together. This is known as a mixed episode.

Manic phase of bipolar disorder
Signs and symptoms of the manic or hypomanic phase of bipolar disorder can include:

  • Euphoria
  • Extreme optimism
  • Inflated self-esteem
  • Poor judgment
  • Rapid speech
  • Racing thoughts
  • Aggressive behavior
  • Agitation or irritation
  • Increased physical activity
  • Risky behavior
  • Spending sprees or unwise financial choices
  • Increased drive to perform or achieve goals
  • Increased sex drive
  • Decreased need for sleep
  • Inability to concentrate
  • Careless or dangerous use of drugs or alcohol
  • Frequent absences from work or school
  • Delusions or a break from reality (psychosis)
  • Poor performance at work or school

Depressive phase of bipolar disorder
Signs and symptoms of the depressive phase of bipolar disorder can include:

  • Sadness
  • Hopelessness
  • Suicidal thoughts or behavior
  • Anxiety
  • Guilt
  • Sleep problems
  • Low appetite or increased appetite
  • Fatigue
  • Loss of interest in daily activities
  • Problems concentrating
  • Irritability
  • Chronic pain without a known cause
  • Frequent absences from work or school
  • Poor performance at work or school

Other signs and symptoms of bipolar disorder
Signs and symptoms of bipolar disorder can also include:

  • Seasonal changes in mood. As with seasonal affective disorder (SAD), some people with bipolar disorder have moods that change with the seasons. Some people become manic or hypomanic in the spring or summer and then become depressed in the fall or winter. For other people, this cycle is reversed — they become depressed in the spring or summer and manic or hypomanic in the fall or winter.
  • Rapid cycling bipolar disorder. Some people with bipolar disorder have rapid mood shifts. This is defined as having four or more mood swings within a single year. However, in some people moods shifts occur much more quickly, sometimes within just hours.
  • Psychosis. Severe episodes of either mania or depression may result in psychosis, a detachment from reality. Symptoms of psychosis may include false but strongly held beliefs (delusions) and hearing or seeing things that aren’t there (hallucinations). In some people, sudden psychosis (a psychotic break) is the first sign of bipolar disorder.

Symptoms in children and adolescents
Instead of clear-cut depression and mania or hypomania, the most prominent signs of bipolar disorder in children and adolescents can include explosive temper, rapid mood shifts, reckless behavior and aggression. In some cases, these shifts occur within hours or less — for example, a child may have intense periods of giddiness and silliness, long bouts of crying and outbursts of explosive anger all in one day. Changing sleep patterns are also a common indicator of childhood bipolar disorder.

Mid-life transition

Not everyone will experience what is known as midlife crisis. However, everyone will experience a midlife transition.

You become aware of your physical changes – hair loss, weight gain (around the middle), muscular tone, and more.

  • You undertake a self-appraisal of your life to date.
  • You feel that your life has been wasted on constantly giving and the hard work you have done so that everyone else around you may be comfortable. You question “What about me now?”
  • You feel depressed and that your life is a failure.
  • You begin to hide your feeling of depression through self medicating and you seek out “feel good” antidotes.
  • Your lifestyle changes. You spend more.
  • You may have an extramarital affair.
  • You may have even lost marriage, family, home, job and hope.
  • You notice a loss or change in your sexual drive and performance.
  • You enter a full blown midlife crisis.

Low self esteem

Self Esteem is essential for psychological survival. Each of us needs some measure of self worth. Without it, life can be very painful without our most basic needs being met. With low self-esteem comes self-judgment. Judging and rejecting parts of yourself can be very painful. Many individuals with low self-esteem take a backseat in life in order to not put themselves at risk of aggravating that pain. People begin to avoid social, academic, career risks. Some bury themselves in perfectionistic work, brag, or make excuses as a defense.

The great thing is that self-esteem is learned, which means that we can all learn to have more of it. Many times clients come to the office with depression, anxiety, relationship problems, etc, and we find that they really have an issue with low self-esteem.

School Refusal

School Refusal occurs, when a student experiences severe distress related to school attendance. Studies show that 46% of school refusal is actually a symptom of another problem rather than the problem itself. Eighty three percent of children who struggle with school refusal and develop the skill set necessary to combat their problem through Cognitive Behavioral Therapy show a return to regular school attendance.

Relationship Conflicts

Conflict is painful, especially, when the conflict that we experience is within the relationships that are most important to us. Relationship conflict can be with a spouse, family member, friend, or coworker. We can only control what we say and what we do, however, relationships are much more satisfying for all involved, when we take responsibility for our own behavior and learn the skills necessary to minimize conflict.

Family and Parenting Challenges

It is often difficult to know healthy solutions, when we are so emotionally invested in the problem. Being a parent, being a family member isn’t always easy. Parenting and family sessions are used to help with issues such as family stress, parent-child conflict, communication breakdown, sibling conflict, defiance of household rules.


Behavioral Consultation
Intervention for Psychological Conditions
Adjustment Issues
Adolescent Crises
School Liaison
Coping with Serious Medical Conditions
Adoption Issues

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Scranton, PA 18503


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