Jenna J. Torres

Hi, Thank you for your question. There are many different therapies that are effective for panic attacks, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), psychodynamic therapy, humanistic therapy, Interpersonal Therapy (IPT), Eye Movement Desensitization and Reprocessing (EMDR), and Mindfulness-Based Cognitive Therapy (MBCT). Panic reduction techniques include deep diaphragmatic breathing, progressive muscle relaxation, grounding exercises, mindfulness meditation, practicing positive mantras or positive self-talk, guided imagery and visualization, and journaling or stream of consciousness writing. I would recommend you seek services from a mental health professional to help with panic attacks. I hope this has been helpful!

Hi, Thank you for your question. Geriatric anxiety reduction techniques may include but are not limited to, deep diaphragmatic breathing, progressive muscle relaxation, grounding exercises, mindfulness meditation, practicing positive mantras or positive self-talk, guided imagery and visualization, and journaling or stream of consciousness writing. I hope this has been helpful!

Hi, Thank you for your question. A behavioral psychologist would treat nail-biting with Cognitive-Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT), as well as refer to a psychiatrist or medical professional for a medication evaluation. I hope this has been helpful!

Thank you for your question. Yes, behavioral therapy works very well for autism. *Applied Behavior Analysis* (ABA) is the most researched and common intervention type for autism. This intervention has been used for over 50 years. Through ABA, the individual can learn play, communication, self-care, and social skills. The highly structured intervention can also help in reducing problematic behaviors. Studies showed that ABA yields positive outcomes for children with autism. It is usually the starting point for autistic children with symptoms on the severe side. The therapy can help
children learn skills, while also eliminating problem behaviors. Different types of ABA commonly used to treat autism spectrum disorder (ASD) include:

-Positive Behavioral and Support (PBS). PBS aims to figure out why a child does a particular problem behavior. It works to change the environment, teach skills, and make other changes that make a
correct behavior more positive for the child. This encourages the child to behave more appropriately.
- Pivotal Response Training (PRT). PRT takes place in the child's everyday environment. Its goal is to improve a few "pivotal" skills, such as motivation and taking initiative to communicate. These help the child to learn many other skills and deal with many situations.
- Early Intensive Behavioral Intervention (EIBI). EIBI provides individualized, behavioral instruction to very young children with ASD. It requires a large time commitment and provides one-on-one or small-group instruction.
- Discrete Trial Teaching (DTT). DTT teaches skills in a controlled, step-by-step way. The teacher uses positive feedback to encourage the child to use new skills.

*Cognitive Behavioral Therapy* (CBT) is another form of behavioral therapy that has been in use since the 1960s. Usually children with milder symptoms of autism benefit from this type of therapy. Its aim is to define what triggers the behaviors. Through the use of CBT, children can learn to see when they are going to exhibit a certain behavior, and they practice doing something different instead of problematic behavior. This form of therapy helps with fear and anxiety.

*Relationship Development Intervention* (RDI) is a family-centered approach. The aim of RDI is to focus on certain defined emotional and social objectives which are used to establish meaningful relationships. Aimed more toward the parents, RDI consultants help caregivers develop skills related to interpersonal engagement.

*Verbal Behavior Therapy* (VBT) is a type of behavioral therapy that teaches the non-vocal child how to communicate with purpose. The aim of verbal behavior therapy is to teach children how to use words functionally to get the desired response. Through repetition, children understand that communication will yield positive results. They will get what they want by using language functionally.

*Developmental and Individual Differences Relationship* (DIR) Therapy, also called Floortime, engages children through activities that they will enjoy. Parents will also participate in the session. Therapists will help the child work on gaining new skills. During this therapy, the child will be engaging and interacting with others.

*Sensory Integration Therapy* works to improve a child’s sensitivities to sensory stimuli that may be overwhelming to the child. Loud noises, bright lights, and touches may all be addressed. A therapist using this type of therapy will introduce the child to increasingly higher levels of the stimuli being worked on. While the therapist does need to push the child’s limits, there is no force involved. Sensory integration therapy does not require a lot of time per session and positive results usually occur relatively quickly if this is going to work.

*Treatment and Education of Autistic and Related Communication Handicapped Children* (TEACCH model) is used to help children with autism achieve positive results with their social and maladaptive behaviors. It uses an environment that is structured and organized at all times. In addition, activities are predictably sequenced and visually organized to enhance the environment for the child. Children proceed to practice activities and skills in a specific fashion. Outcomes are more positive when the parents are taught to use a similar method at home.

Overall, behavior therapy for individuals with autism varies widely among therapists. Different types of therapies work better for each child and finding the right protocol for each child is the key to success. I hope this has been helpful!

Best,

Jenna Torres, PsyD
Clinical Psychologist
LifeStance Health
(626) 808-4600 x109

According to the DSM5, there are 3 distinct dissociative disorders: Dissociative Identity Disorder (DID), Dissociative Amnesia, and Depersonalization/Derealization Disorder. There are no subtypes for DID.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Pasadena Clinic Director
Licensed Psychologist
New Day Psychotherapy Group
(626) 808-4600 x109

Thank you for your question. There are many techniques used in family therapy, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Psychodynamic/Psychoanalytic Therapy, Humanistic/Existential Therapy, Interpersonal Therapy (IPT), Internal Family Systems Therapy (IFST), Mindfulness Based Cognitive Therapy (MBCT), Acceptance and Commitment Therapy (ACT), Behavior Modification, Cognitive Processing Therapy (CPT), Exposure and Response Prevention (ERP), Motivational Interviewing (MI), Solution Focused Therapy, Structural Family Therapy, Strategic Family Therapy, Parent-Child Interaction Therapy (PCIT), Positive Parenting Program (PPP), Emotionally Focused Therapy (EFT), and Play/Art Therapy.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Pasadena Clinic Director
Licensed Psychologist
New Day Psychotherapy Group
(626) 808-4600 x109

Thank you for your question. Exposure and Response Prevention (ERP), an evidence-based practice that utilizes exposure hierarchies to address the compulsive behaviors used to neutralize anxiety that accompanies obsessive thoughts, has been shown to be highly effective in treating phobias. I highly recommend you seek out some support from a mental health professional to guide you through the process.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Pasadena Clinic Director
Licensed Psychologist
New Day Psychotherapy Group
(626) 808-4600 x109

A psychiatrist would treat anxiety with antianxiety or antidepressant medications. Examples of antianxiety meds include benzodiazepines (Xanax, Valium, Ativan, Klonopin) and non-benzodiazepines (Buspar). Examples of antidepressant meds include Selective Serotonin Reuptake Inhibitors (SSRIs- Prozac, Zoloft, Paxil)/Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs-Effexor, Cymbalta), Tricyclics (TCAs- Elavil, Anafranil, Tofranil), Monoamine-Oxidase Inhibitors (MAOIs- Nardil, Marplan), and others like Wellbutrin and Remeron.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Pasadena Clinic Director
Licensed Psychologist
New Day Psychotherapy Group
(626) 808-4600 x109

Thank you for your question. Three types of therapy are especially helpful in the treatment of bipolar disorder:

*Cognitive Behavioral Therapy*- In CBT, you examine how your thoughts
affect your emotions. You also learn how to change negative thinking
patterns and behaviors into more positive ways of responding. For
bipolar disorder, the focus is on managing symptoms, avoiding triggers for relapse, and
problem-solving.

*Interpersonal and Social Rhythm Therapy*- IPSRT focuses on current
relationship issues and helps you improve the way you relate to the
important people in your life. By addressing and solving interpersonal
problems, this type of therapy reduces stress in your life. Since stress is
a trigger for bipolar disorder, this relationship-oriented approach can
help reduce mood cycling. Interpersonal therapy is often combined with
social rhythm therapy for the treatment of bipolar disorder. People with
bipolar disorder are believed to have overly sensitive biological clocks,
the internal timekeepers that regulate circadian rhythms. This clock is
easily thrown off by disruptions in your daily pattern of activity, also
known as your “social rhythms.” Social rhythm therapy focuses on
stabilizing social rhythms such as sleeping, eating, and exercising. When
these rhythms are stable, the biological rhythms that regulate mood remain
stable too.

*Family Focused Therapy*- Living with a person who has bipolar disorder can
be difficult, causing strain in family and marital relationships.
Family-focused therapy addresses these issues and works to restore a
healthy and supportive home environment. Educating family members about the
disease and how to cope with its symptoms is a major component of
treatment. Working through problems in the home and improving communication
is also a focus of treatment.
Other therapies may be helpful as well:

*Electroconvulsive Therapy*- ECT is a brain stimulation procedure that can
help people get relief from severe symptoms of bipolar disorder. In
ECT, electrical currents are passed through the brain, intentionally triggering a brief
seizure. ECT seems to cause changes in brain chemistry that can reverse
symptoms of certain mental illnesses. With modern ECT, a person usually
goes through a series of treatment sessions over several weeks. ECT is
delivered under general anesthesia and is safe. It can be effective in
treating severe depressive and manic episodes, which occur most often when
medication and psychotherapy are not effective or are not safe for a
particular patient. ECT can also be effective when a rapid response is
needed, as in the case of suicide risk or catatonia (a state of
unresponsiveness). ECT may be an option for bipolar treatment if you don't
get better with medications, can't take antidepressants for health reasons
such as pregnancy, or are at high risk of suicide.

*Transcranial Magnetic Stimulation*- TMS is a newer approach to brain
stimulation that uses magnetic waves. It is delivered to an awake patient
most days for 1 month. Research shows that TMS is helpful for many people
with various subtypes of depression, but its role in the treatment of
bipolar disorder is still under study.

*Light and Dark Therapy*- Like social rhythm therapy, light and dark
therapy focuses on the sensitive biological clock in people with
bipolar disorder. This easily disrupted clock throws off sleep-wake cycles, a disturbance
that can trigger symptoms of mania and depression. Light and dark therapy
regulates these biological rhythms—and thus reduces mood cycling— by
carefully managing your exposure to light. The major component of this
therapy involves creating an environment of regular darkness by restricting
artificial light for ten hours every night.

*Mindfulness Meditation*- Research has shown that mindfulness-based
cognitive therapy and meditation help fight and prevent depression, anger,
agitation, and anxiety. The mindfulness approach uses meditation, yoga, and
breathing exercises to focus awareness on the present moment and break
negative thinking patterns.

*Acupuncture*- Some researchers believe that acupuncture may help people
with bipolar disorder by modulating their stress response. Studies on
acupuncture for depression have shown a reduction in symptoms, and there is
increasing evidence that acupuncture may relieve symptoms of mania also.

*Medications* may include mood stabilizers, anticonvulsants, 2nd generation
"atypical" antipsychotics, and antidepressants including SSRIs.

Other things you can do to help relieve symptoms of Bipolar Disorder:

*Regular Exercise: *Regular aerobic exercise, such as jogging, brisk
walking, swimming, or bicycling, helps with depression and anxiety,
promotes better sleep, and is healthy for your heart and brain. There is
also, some evidence that anaerobic exercises such as weightlifting, yoga, and
Pilates can be helpful. Check with your health care provider before you
start a new exercise regimen.

*Keeping a Life Chart:* Even with proper treatment, mood changes can occur.
Treatment is more effective when a patient and health care provider work
together and talk openly about concerns and choices. Keeping a life chart
that records daily mood symptoms, treatments, sleep patterns, and life
events can help patients and health care providers track and treat
bipolar disorder over time. Patients can easily share data collected via smartphone apps –
including self-reports, self-ratings, and activity data – with their
health care providers and therapists.

Coping with Bipolar Disorder

Living with bipolar disorder can be challenging, but there are ways to help
make it easier:

- Get treatment and stick with it—recovery takes time and it’s not easy.
But treatment is the best way to start feeling better.
- Keep medical and therapy appointments and talk with the provider about
treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping and make
sure to get enough sleep and exercise.
- Learn to recognize your mood swings and warning signs, such as
decreased sleep.
- Ask for help when trying to stick with your treatment.
- Be patient; improvement takes time. Social support helps.
- Avoid misuse of alcohol and drugs.

I hope this has been helpful!


Best,

*Jenna Torres, PsyD*
Pasadena Clinic Director
Licensed Psychologist
New Day Psychotherapy Group
(626) 808-4600 x109

Hi,

Thank you for your question. It sounds like you are having an anxiety reaction that is manifesting physically in your body since the EKG and medical tests were normal. I would recommend you seek professional mental health services for treatment.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Licensed Psychologist
LifeStance Health
(626) 808-4600 x109

Hi,

Thank you for reaching out, although I'm not sure what your question is. I'm sorry to hear about your pain and would recommend you seek professional services from a psychiatrist regarding the medication side effects.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Licensed Psychologist
LifeStance Health
(626) 808-4600 x109

Hi,

Thank you for your question. If you are seeing or hearing something that you think might not really be there in reality, I would recommend you seek professional mental health services for treatment of the hallucinations and anxiety.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Licensed Psychologist
LifeStance Health
(626) 808-4600 x109

Hi,

Thank you for your question. Yes, anxiety can cause a feeling of lightheadedness or head rush, as well as panic, sweaty hands, and difficulty breathing. I would recommend you seek professional mental health services for treatment.

I hope this has been helpful!

Best,

*Jenna Torres, PsyD*
Licensed Psychologist
LifeStance Health
(626) 808-4600 x109

Hi, Thank you for your question. It sounds like you have a very active imagination, and could possibly channel some of that creativity using visualization techniques to retrain your brain to think about calming or relaxing things instead of milk exploding or jumping off public transportation. Forgetfulness can have many causes, such as inattention, dissociation, or a neurological issue, so I would recommend you seek support from mental health and/or medical professional. I hope this has been helpful!

Hi, Thank you for your question. For recommendations related to psychotropic medications, I would recommend you seek consultation with a psychiatrist or medical doctor. Examples of antianxiety meds include benzodiazepines (Xanax, Valium, Ativan, Klonopin) and non-benzodiazepines (Buspar). Examples of antidepressant meds include Selective Serotonin Reuptake Inhibitors (SSRIs- Prozac, Zoloft, Paxil)/Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs-Effexor, Cymbalta), Tricyclics (TCAs- Elavil, Anafranil, Tofranil), Monoamine-Oxidase Inhibitors (MAOIs- Nardil, Marplan), and others like Wellbutrin and Remeron. I hope this has been helpful!

Hi, thank you for your question. If you are experiencing physical issues without mental anxiety, I would recommend you seek support from a medical doctor. I hope this has been helpful!

Hi, Thank you for your question. Here are some tips that might help:
- plan and establish regular eating patterns including meals and snacks,
try to go no more than 3-4 hours between meals
- identify your triggers to binging, make note of when you binged or ate
without being hungry
- recognize the cycle, keep a journal, and document how you feel before and
after each meal or snack
- find alternatives to triggering situations
- learn to listen to your body, it will signal physical hunger and fullness
cues
- seek out therapy to get support from an eating disorder professional to
help change your thoughts about food, your body, your weight, your shape,
etc. (you can ask your primary care doctor or call your insurance for
referrals)
- CBT, DBT, and interpersonal psychotherapy have been found to be
successful forms of therapy
- consult with a doctor or psychiatrist regarding a medication evaluation
to determine if that could be helpful
- speak with a nutritionist or dietician about a healthy meal plan and/or
nutritional supplements
- stop labeling foods as "good" or "bad" which can increase feelings of
guilt and make you more likely to binge
- stop dieting! get rid of any books or magazines that make you feel
inadequate or judge yourself to unattainable ideals
- ditch the rigid rules and "cheat days" since no foods are "off-limits"
- stay off the scale, as the number on the scale does not reflect your
self-worth as a person, your weight does not define you!
- make self-care a priority, including maintaining a healthy, nutritious
diet
- engage in positive self-talk and be kind/compassionate to yourself
- reach out for help from trusted friends and family members in your
network of social support
- find some joyful activities that help give meaning and pleasure to your
life
- practice mindful or intuitive eating
- practice gratitude and positive affirmations about yourself regularly
- focus on actions, not outcomes
- celebrate your victories and don't dwell on minor setbacks
- be patient and manage your own expectations
- don't try to be perfect, it's about progress, not perfection!
I hope this has been helpful!

Hi, Thank you for your question. It can take a varied amount of time for panic attacks to go away, however, a treatment period lasting at least 6 to 9 months is usually recommended. Some people taking medicine for panic disorder are able to stop treatment after only a short time. What works for one person may not be effective at all for another. But even though there is not a magic bullet to wipe out every case, through treatment, patience, and persistence, you can find the methods that help you cope with panic disorder. Cognitive Behavioral Therapy A mental health professional can assist you in developing ways to change your thinking and behaviors that allow for lasting relief. Different types of psychotherapy have been shown to be helpful in panic disorder. One of these is CBT, a method that includes learning ways to relax, change unhelpful thinking patterns, manage stress, and increase self-confidence. Progressive or gradual exposure is a CBT technique in which therapists slowly introduce a patient to their fears and then teach them to relax while they experience anxiety. For example, if your panic is induced by driving cars on the freeway, your therapist may have you begin by simply imagining cars driving on a freeway. You will then be instructed to keep this image in mind as they guide you into noticing your tension. This focus on uneasy feelings is followed by guided attention to relaxing the body and mind. Over a number of sessions, the therapist will progressively increase your exposure to your fear, from visualizing yourself driving on the freeway, to being a passenger in a car on the freeway, to driving the car yourself. While moving through these phases, you will continue to learn how to remain calm and manage feelings of panic. There are numerous self-help resources that address issues related to anxiety and panic disorder. These are intended to help you manage panic on your own. Common self-help strategies include: Relaxation techniques, such as stretching and deep breathing positive affirmations and self-talk peaceful and reassuring visualizationsJournaling and other writing exercisesExpressing feelings through transforming a negative belief system to more constructive and optimistic viewsLifestyle changes, such as getting enough sleep, limiting the use of caffeine, eating a nutritious diet, and exercising medication Treating panic disorder with medication is often recommended when symptoms persist despite efforts to control them through therapy and self-help strategies. Medication may also be suggested when the panic disorder has become so extreme that it affects daily functioning. Antidepressants Medical professionals typically prescribe an antidepressant for panic disorder, usually from the class of
antidepressants known as selective serotonin reuptake inhibitors, or SSRIs. These drugs can relieve feelings of anxiety and reduce depression symptoms, which often coexist with panic disorder. Tranquilizers Benzodiazepine tranquilizers are another class of drugs that can ease anxiety and alleviate panic.. There is some potential for abuse with these medications. They may also lead to physical dependence if they are taken over a long enough period of time. Overall, there is no one approach that works for everyone. Give different methods a try to determine what works for you. Even though there is not a cure for panic disorder, you can still experience long-term improvements by finding the combination of treatments that is effective for you. I hope this has been helpful!

Hi, Thank you for your question. Work-related stress can contribute to depression and anxiety. Usually, there is a genetic component (family history of depression/anxiety) and then any kind of environmental stressor (work or relationships issues) can trigger a depressive episode. I recommend you seek out support from a mental health professional. I hope this has been helpful!

Hi, Thank you for your question. Yes, it is worth it to go to couples counseling for relationship issues in a marriage. I recommend you seek out support from a mental health professional to address any concerns you have. I hope this has been helpful!