A couple of days ago, Chuck wrote about why some people either believe they can’t get better or decide not to get treatment for their anxiety or OCD. Some readers had other ideas like having no money or not having access to good cognitive behavioral therapy.

Here are six ideas for overcoming such obstacles to change:

1. Money. Many people lack the financial resources for getting help. Some people can’t afford therapy at all, others have medical insurance that doesn’t cover mental health in a comprehensive way.

   Try contacting the nearest college or university. Most colleges have psychology clinics that have well supervised upper level students or graduate students work with clients in order to gain experience. Costs for such services are often modest and most use a sliding scale. Community mental health agencies also use sliding scales to charge for services.

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Some of our readers may know that Chuck and I are returning to a small private practice. I’ve written before about the, shall we say, challenges of starting up a new practice after being away for several years. Nevertheless, we are marching along. We hope to focus on providing cognitive behavioral psychotherapy. But a small part of both of our practices will feature psychological assessment.

The art and practice of psychological assessment and diagnosis can be fascinating. I get a great deal of satisfaction out of accumulating information, administering tests, delving through records, getting to know someone and putting it all together into a description and usually a diagnosis. It’s the sort of work that a good detective does; gathering facts, considering theories, and solving a mystery.

We just returned from Seattle where just about every corner has a coffee shop. I read that Seattle has 226 cloudy days a year. I’m pretty sure that the gray skies of Seattle require lots of perking up, thus lots of caffeine. Our hotel room had unusually excellent coffee and a French press. It was so good that of course, we had to find the same brand of coffee for ourselves and bring some home. It probably won’t taste as good in New Mexico, with 310 sunny days a year, as it did in Seattle.

However, with coffee on my mind, it was interesting to read the results of a recent study described today in the New York Times. This involves more than 50,000 nurses who were asked to provide detailed tracking of diet, exercise, physical health, and mental health. Among many of the variables being monitored, the amount of caffeine consumed and mood were tracked.

We all get upset from time to time. And sometimes, we let things roll off our backs. Other times, especially when we’re overtired, stressed, or vulnerable – it’s not so easy. Here are three examples.

Maybe you’re feeling a bit stressed and someone says, “Those are interesting shoes.”

Pretty benign comment right, but the shoes you are wearing are sort of weird and you’re feeling a bit off. So whether or not the comment was meant to be positive or neutral, suddenly you’re filled with feelings about your now ugly shoes. You might spend the rest of the day trying to hide your feet from others and you’re distracted with thoughts about what sorts of shoes would be “less interesting.”

Earlier this week, we wrote about seven signs that someone might need professional help. Parents often ask the same questions about their kids. They don’t want to send their kids to be evaluated if there’s nothing to worry about; after all, consulting a mental health professional costs time and money, and could cause a little anxiety in the process. By the way, we usually suggest a quick check in with the pediatrician first because signs of what appear to be behavioral, emotional, or learning issues can be caused by physical problems and medical providers often know who to go to for mental health help.

Since the signs differ a little for kids versus adults, here’s a list of seven signs that tell you if your child needs further assessment:

Everyone has bad days. And many have bad weeks. But when feeling depressed, stressed, or anxious stretches out over a period of several weeks and begins to interfere with daily life, then mental health professionals may need to be involved. Here are some signs that you or someone you care about need evaluation and possibly treatment:

1. Suicidal thoughts or plans. If you start thinking that life is not worth living, help is available. You can call the national suicide hotline at 1-800-SUICIDE or a local mental health center. If you are aware of someone else who has thoughts of suicide, the hotline can advise you of what action you should take.

You’ve read about the ongoing controversy over the effectiveness of antidepressant medications. Luminary psychologists such as Dr. Robert DeRubeis and Dr. Irving Kirsch have made persuasive arguments supporting the idea that most, if not all, of the effectiveness of antidepressant medication appears to be due to the so-called placebo effect.

In other words, their analysis of studies has led them to conclude that when patients improve on antidepressant medication, that most of that improvement is readily chalked up to the expectations of improvement that come when people take a pill they believe will improve their symptoms.

It’s spring in New Mexico. We’ll have some days of high winds, but for the most part, cold weather is gone for the season. People are starting to wear shorts and flip-flops, the costume of the summer trudger.

I have a cold. It started last week and lingered as spring colds usually do. I’m better, down to sporadic coughing fits, nose blowing, dragging, and the spacey feeling that colds often leave you with. Somehow I think that more than anything colds consume creativity and cognitive attention. They leave me with little ability to plan ahead, organize, resist temptations, set goals, make decisions, or even write for that matter.

Just ask my husband; he had to come in and save the first draft of this rambling missive. I don’t care. Colds do that to you–they make you a hopeless, inefficient, hesitant, straggler. And everyone here in the Albuquerque area seems to have one.

Information flows around the world in a manner of seconds–it’s amazing! We all watched last week when peaceful demonstrations, facilitated by social media, helped to topple a corrupt and oppressive government. So, what does this have to do with children and treatment?

Like many mental health professionals, the internet has given us opportunities to keep up with a variety of current issues, research studies, and trends in our field. Instead of trying to keep up with 3 or 4 journals a month, we have access to just about any published article, sometimes before it is even published.

When I started college many years ago, a literature search involved long hours combing through guides to periodic literature. Today a literature review involves going to an online library and reading about topics of interest from peer reviewed journals not just in English, but translated text from all over the world.

We just got back from teaching in Santa Barbara California. The temperatures were in the upper 60’s to lower 70’s and the sun was shining every day. It was a nice break from the cold weather we’d been experiencing in New Mexico.

While away, I was asked to spend a week answering questions about seasonal affective disorder on a web site called cafemom (www.cafemom.com). Cafemom is a community of mothers who chat, share information, and support each other. I agreed, thinking that there would be very few questions. I was wrong. The interest in SAD appears to be rather huge, especially at the end of January.