It is common to feel down from time to time. However, some people experience a more long-lasting and pervasive low mood that is often accompanied by a loss of pleasure in activities that you used to find enjoyable. Some people also notice physical changes, as well as changes in the sleeping, appetite, energy levels, concentration and decision-making abilities. Individuals suffering from depression often feel worthless, a sense of guilt or shame, or have thoughts of death or suicide.
CBT is a highly effective treatment for depression that focuses on identifying and modifying your negative thoughts using an evidence-based approach. CBT also focuses on increasing activities and returning you to things that you find enjoyable. Studies also demonstrate that CBT results in a lower relapse rate compared to using medication alone.
Anxiety is a fundamental human experience. We all feel anxious or worry on occasion. The experience of anxiety is the activation of our “fight or flight” response when we encounter something we feel threatened by. It’s almost like a smoke detector that goes off when there’s a fire.
Some people have a more sensitive anxiety system and may experience more pervasive anxiety or may find that their system activates when there is no danger, similar to a false alarm of a smoke detector.
Anxiety can be experienced in different areas:
- Repetitive panic attacks that seem to come out of the blue
- Difficulty in crowded or enclosed spaces
- Anxiety in social situations, or when making a presentation
- Fears, or phobias, of animals, insects, heights, or blood
- Pervasive worry, or “what if?” type questions
- Health worries, including fear of having or acquiring certain diseases
- Intrusive thoughts that don’t make sense but repeat over and over. Sometimes this can lead to having to perform a response to lessen the anxiety, like washing your hands, counting things, or checking things over and over.
- Re-experiencing a traumatic event
CBT is one of the gold standard treatments for anxiety and is demonstrated to be highly effective. CBT works by identifying and modifying your anxious thoughts using an evidence-based approach. We also help you face your fears as evidence shows that repeated exposure to one’s fear can help decrease or eliminate it.
Schizophrenia / Psychosis
Schizophrenia and psychosis refer to a number of different symptoms:
- Hallucinations, which are generally auditory, is where someone may hear voices that are distinct from their own thoughts. They could be familiar or unfamiliar voices and can sometimes be pleasant, but can also be threatening or telling you to do things you don’t want to do.
- Delusions, which are very strong beliefs that you may find other people don’t agree with. Examples are believing you are being followed by others, that someone is out to get you, that you have special powers, or that certain messages are being sent to you.
- Disorganized thinking, which involves trouble making sense of thoughts or thinking in an unorganized manner
- Disorganized behaviour, sometimes involving repetitive or inappropriate behaviours
- Negative symptoms such as difficulties with motivation, loss of interest or pleasure in activities, social withdrawal, or a poverty of speech.
CBT has been shown to be effective, particularly with early intervention, in addressing the symptoms of schizophrenia and psychosis. In particular, CBT has been shown to help people cope with and challenge their hallucinations and delusions in order to return to a happier life.
Eating Disorders include Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Avoidant Restrictive Food Intake Disorder.
These disorders are often coping reactions to times of stress with a belief that eating less or more can lessen emotions. However, these disorders can cause long-term physical, cognitive and emotional problems.
The under-control or over-control of food intake can have sizeable cognitive and medical consequences, even death when left untreated.
Body image distress, which is pervasive in our society, can also be a trigger of maladaptive eating behaviours.
Cognitive Behavioral Therapy is an evidence-based treatment for eating disorders in adolescence and adulthood. We work with individuals to regain a healthy relationship with food and a more balanced and healthy body image.
We focus on taking a team approach involving your other healthcare providers and supportive family members. Family-based approaches can also be highly effective and beneficial for the treatment of eating disorders.
Attention Deficit Hyperactivity Disorder (ADHD) includes symptoms which involve:
- Inattention – trouble focusing and paying attention, difficulty staying on task, forgetting and losing things, having a hard time following a conversation, and difficulty completing tasks or meeting deadlines.
- Hyperactivity and Impulsivity, such as restlessness, fidgeting, interrupting others, and making decisions without thinking them through.
Because some of the symptoms of ADHD can overlap with symptoms of other conditions, a comprehensive assessment is generally required to make a diagnosis. This involves an intake interview, medical history, a review of your academic difficulties as a child, and cognitive and personality testing.
CBT for ADHD mostly involves behavioural strategies to help improve focus, organization, and prioritization. This allows people to complete tasks more effectively at home, work or school.
Some people find themselves limiting their lifestyle to prevent or decrease unwanted and frustrating physical symptoms (e.g. pain, fatigue, gastro-intestinal symptoms, itch, headache).
Acceptance and Commitment Therapy and Cognitive Behavioral Therapy help you cope with unwanted physical symptoms to allow you to pursue a better life while managing and soothing your symptoms. This can be a paradoxical approach as our tendency is to wait for symptoms to subside before returning to our full lives. Nevertheless, it can be a highly effective approach to living a life less impacted by physical symptoms.
Chronic Medical Conditions
Our physical and mental health are very connected. Chronic medical issues, or pervasive, uncomfortable and distressing physical symptoms can lead to issues like anxiety and depression.
We work with you on how to respond to unwanted physical symptoms and to live a fulfilling life, even while you are coping the symptoms. Learning to work with these sensations rather than resisting them can allow for a more fulfilling life. Treatment can also help improve relationships with your healthcare providers and loved ones. We help you to understand your medical condition and be a strong advocate in your medical care.
Perfectionism is a coping reaction we use when we are worried about making a mistake. While perfectionism can be societally reinforced, it often causes individuals to feel anxious, isolated, depressed and demoralized even when they appear successful by other peoples’ standards.
CBT is a highly effective treatment for perfectionism. We work with individuals to challenge their beliefs about “success” and widen their ideas of meaningful and satisfying living.
Grief and Bereavement
Loss of a person or pet we are close to can generate the greatest pain that we encounter as human beings. It can be overwhelming to understand and process the loss of a loved one. This can be exacerbated with a sudden death or a complicated relationship.
We offer a supportive, individualized approach. Many emotions arise in the grieving process, and each person’s grieving process is unique. We will support you and help you understand and manage these emotions.
Hair Pulling and Skin Picking
Hair pulling and skin picking can be extremely distressing and are often coping reactions to strong emotions like anxiety, anger or boredom.
CBT, and more specifically habit reversal training, can be very effective in reducing or eliminating these behaviours and addressing the underlying emotions. We work with individuals to identify the patterns of these behaviours and to try to prevent the triggers or replace these behaviours with new, more helpful coping mechanisms.