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Stephanie N. Dunn, MS is a counselor in Winooski, VT specializing in counseling.
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Anxiety
Anxiety is a generic name given to a variety of conditions characterized by unusual amounts of fear and worry, especially unrealistic fears and tension. People who suffer from anxiety often are aware that their fears are irrational, but that knowledge does not make the feeling of being scared and anxious go away. To qualify as anxiety, symptoms must last for 6 months or more and interfere with the way a person lives their daily life. Some cases may be mild, where, for example, a person simply avoids certain situations. Other cases can be severe enough to be disabling.
Some of the specific conditions covered under the general label of anxiety include:
Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.
Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.
Borderline Personality Disorder (BPD)
Borderline personality disorder (BPD) is a disorder that causes emotional instability. Once triggered, people with BPD experience more intense feelings that influence how they treat others and themselves. Essentially, people with BPD "hear" amplified emotions at a higher volume and for longer periods of time than those without BPD. Some who have BPD describe "being on the border," often feeling insecure and split between both negative and positive feelings. Mood swings, impulsivity, and insecurity are all hallmark symptoms of borderline personality disorder. No single cause of BPD is known, but it may arise from factors such as:
As BPD is rooted in an unstable sense of self and intense personal emotions, symptoms of BPD may vary between patients. Common symptoms of BPD include:
Borderline personality disorder is diagnosed by a psychologist, psychiatrist, clinical social worker, or other mental health professional. The disorder is a type of "Cluster B" personality disorder, which are chronic conditions characterized by unstable and dysfunctional behaviors that affect one's relationships with others. People with BPD often have co-existing mental conditions, such as depression, anxiety, PTSD, or substance abuse.
Borderline personality disorder is known to develop and become present during adolescence, however, mental health providers rarely diagnose anyone under the age of 18 with BPD. Mental health providers analyze behaviors, family history, and discuss symptoms with their patients, which may lead to a diagnosis using the DSM-5 criteria for BPD.
Borderline personality disorder is treated with psychotherapy and oral medications. Forms of therapy like dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT) can help people with BPD identify self-destructive attitudes and harmful behaviors, which they may then be able to manage or change. Group therapy is another treatment option which may improve people with BPD's ability to share their emotions and to promote positivity. Psychiatrists may prescribe patients antidepressants and/or anxiety medications such as Prozac (fluoxetine), Wellbutrin (bupropion), and Zoloft (sertraline). Some patients may receive antipsychotic drugs which can help stabilize mood and reduce impulsivity.
With consistent treatment, people with BPD are able to recognize and prevent destructive behaviors and mood swings, typically by changing their patterns of thought. Many people with borderline personality disorder are able to live successful and healthy lives.
Dialectical Behavior Therapy
Dialectical behavior therapy, or DBT, is a form of cognitive behavior therapy (CBT) that was originally developed to help the most severely mentally ill and depressed patients accept therapy. It relies on the same concept in CBT that examines the relationship between thoughts, feelings, and actions, but in DBT the emphasis is first on acceptance rather than change. There is also an emphasis on mindfulness, 'being in the moment,' and relaxation techniques such as yoga. These are combined with a great deal of validation and encouragement from the therapist.
The word 'dialectical' means acting through opposing forces, and this word refers to a few different opposing concepts in DBT:
Dialectical behavior therapy was developed when therapists attempting to use CBT techniques on the most seriously ill patients ran into a problem. When they suggested that a patient change their thoughts, these very vulnerable patients would become overwhelmed and turn aggressive or suicidal. DBT was developed to support these patients with acceptance and validation while still guiding them towards changing problematic thoughts. Although also used for suicidal and self-harming patients today, these days, DBT is mainly used to treat borderline personality disorder. It is one of the few effective interventions for this serious illness.
DBT has been shown to be very effective at reducing self-destructive behavior. It can also be used to teach new coping skills and increase a patient's self-esteem and motivation to become healthier.
She has a state license in Vermont.
Licensed In: Vermont
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Ms. Stephanie Dunn is a counseling specialist in Colchester, VT and Winooski, VT. These areas are among her clinical interests: borderline personality disorder (BPD), feminist therapy, and mindfulness.
