Category: Mental Illness

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Mental health rehabilitation centers provide structured, long-term treatment for individuals facing serious mental health disorders. These centers focus on recovery beyond crisis intervention, offering the tools and environment needed to regain stability, function, and independence.

From severe depression to complex disorders like schizophrenia and co-occurring diagnoses, mental health rehabilitation centers support a wide range of conditions that require more intensive care than short-term or outpatient treatment.

What Is a Mental Health Rehabilitation Center?

A mental health rehabilitation center is a specialized facility designed to help individuals with persistent or severe mental health problems. Unlike short-term hospitalization or outpatient therapy, these centers offer structured, residential or semi-residential treatment programs.

Mental health rehabilitation centers provide 24/7 care, therapeutic support, psychiatric services, and holistic wellness plans to guide patients toward long-term recovery. The goal is to stabilize symptoms, improve functioning, and empower individuals to reintegrate into society with lasting coping skills and support systems.

Who Needs a Mental Health Rehabilitation Center?

Rehabilitation centers serve individuals who need more intensive care than weekly therapy sessions or brief hospital stays can provide. Common scenarios include:

  • People with treatment-resistant depression
  • Individuals with schizophrenia or schizoaffective disorder
  • Patients struggling with bipolar disorder in manic or depressive episodes
  • Those recovering from substance-induced psychosis
  • Individuals with chronic anxiety interfering with daily functioning
  • People with co-occurring diagnoses (e.g., addiction coupled with a mental health disorder)  

These individuals often require round-the-clock support and a structured routine to achieve and sustain recovery.

Types of Mental Health Rehabilitation Programs

Inpatient vs. Outpatient Programs

Inpatient programs provide 24/7 care within a secure facility. Patients live on-site and follow a highly structured daily schedule that includes group therapy, medication management, wellness activities, and individual discharge planning.

Outpatient programs allow patients to live at home while attending scheduled treatment sessions several times per week. This format offers flexibility, but is best for those with stable symptoms and a strong support system at home.

Residential Mental Health Programs

Residential programs offer long-term care in a live-in environment. These therapeutic communities integrate individualized therapy, life skill development, and holistic approaches like yoga, nutrition, and mindfulness training.

Patients develop routines, build relationships, and receive care beyond basic symptom management within residential programs. Stay duration can vary between 10 days and 3 months depending on a patient’s needs. At Lindner Center of Hope, the typical length of stay is about 30 days.

Partial Hospitalization and Day Programs

Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) serve clients who need structured therapy and support but do not require overnight stays. Generally, these programs run several hours per day and can be a step-down from inpatient care or a preventive option to avoid hospitalization.

Therapies and Treatments Provided

Mental health rehabilitation centers offer a variety of evidence-based therapies tailored to individual needs:

  • Cognitive Behavioral Therapy (CBT) addresses negative thought patterns and behaviors.
  • Dialectical Behavior Therapy (DBT) teaches emotional regulation and interpersonal skills.
  • Radically Open Dialectical Behavior Therapy (RO-DBT) targets overcontrolled behavior patterns and promotes openness, flexibility, and social connection.
  • Group Therapy builds peer support and communication.
  • Art and Music Therapy offers non-verbal avenues for emotional expression.
  • Medication Management ensures psychiatric medications are optimized and monitored.
  • Mindfulness and Holistic Practices focus on body-mind wellness.  

How to Choose the Right Rehabilitation Center

Accreditation and Licensing

Always verify that the center is licensed and accredited by recognized agencies (e.g., The Joint Commission). Accredited facilities employ licensed professionals and follow established care protocols. These standards ensure patient safety, privacy, and effective treatment delivery.

Specialized Programs

Look for centers that offer specialized care for your specific needs, such as:

  • Co-occurring diagnosis treatment for mental illness and substance use
  • Trauma-focused care using EMDR or trauma-informed therapy
  • Programs tailored to teens, adults, or veterans  

Specialized programs improve outcomes by targeting the root causes of mental health issues.

Checklist: What to Look for in a Mental Health Rehabilitation Center

 ✅ Licensed and accredited  

 ✅ Qualified staff and therapists  

 ✅ Range of evidence-based treatments  

 ✅ Individualized treatment plans  

 ✅ Aftercare and transition planning  

 ✅ Flexibility working with your financial situation  

 ✅ Positive reviews and testimonials  

 ✅ Specialized programs (e.g., trauma, dual diagnosis, age-specific)

Life After Rehabilitation

Recovery doesn’t end at discharge. The best mental health rehabilitation centers offer aftercare planning. This may include:

  • Outpatient therapy
  • Support groups
  • Medication management
  • Ongoing case management
  • Relapse prevention programming  

These services help maintain progress and prevent setbacks during the transition to independent living.

Taking the Next Step Toward Healing

A mental health rehabilitation center can be a life-changing resource for those facing chronic or serious mental health disorders. These centers provide the structure, care, and therapies necessary for real recovery. Early intervention leads to better outcomes, so begin exploring your options today for yourself or your loved one.


If you or someone close to you needs support, reach out to a licensed mental health rehabilitation center or a qualified professional. Help is available, and recovery is possible. We invite you to learn more about Lindner Center of Hope. Our exceptional team is ready to answer your questions and guide you through the admissions process.

Please consider scheduling a consultation, touring our facilities, or exploring how our residential, inpatient and outpatient programs can help you or your loved ones on a road to recovery. Contact us online or call 513-536-HOPE (4673).

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Understanding Modern Depression Treatments

Decades ago, depression treatment options were extremely limited. Patients had access to tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), lithium, electroconvulsive therapy (ECT), and off-label stimulants. While these treatments helped many, they often came with significant side effects, and we lacked the evidence-based therapies available today.

Thankfully, advancements in mental health care now provide a wide range of depression treatments, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, Auvelity, ketamine therapy, transcranial magnetic stimulation (TMS), cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and personalized approaches like genetic testing to guide medication selection.

The Goal of Depression Treatment: More Than Just Feeling Better

When seeking depression treatment, many individuals and families wonder:

  • Should I aim to feel “better” or completely “well”?
  • What does full recovery from depression look like?
  • Is it possible to return to my normal self again?

The goal of effective depression treatment is not just symptom relief but full wellness—meaning no lingering symptoms, restored emotional well-being, and the ability to function fully in daily life. When I see patients for the first time, I emphasize that we work toward complete recovery, not just improvement.

What Are the Best Treatment Options for Depression?

Medication Options: Finding the Right Antidepressant

With numerous antidepressants available today, including SSRIs, SNRIs, bupropion (Wellbutrin), mirtazapine (Remeron), and newer treatments like esketamine (Spravato), finding the right medication often requires trial and adjustment. We consider genetic testing, side effects, past medication responses, and co-occurring conditions when selecting the best treatment approach.

Therapy for Depression: What Works Best?

Evidence-based psychotherapy is a cornerstone of depression treatment. Cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy help patients develop coping skills, identify negative thought patterns, and improve relationships. Many people find that therapy combined with medication leads to the best long-term results.

Alternative and Emerging Treatments for Depression

For individuals who do not respond to traditional treatments, alternative therapies like transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), ketamine infusion therapy, and mindfulness-based cognitive therapy (MBCT) may offer significant relief. Lifestyle interventions, including exercise, nutrition, and social support, also play a key role in long-term mental health.

How to Overcome Side Effects and Treatment Challenges

A common concern about antidepressants is side effects such as weight gain, fatigue, emotional numbness, and sexual dysfunction. By working closely with a mental health provider, we can often adjust dosages, switch medications, or explore alternative therapies to minimize side effects while maintaining symptom relief.

The Role of Medical Psychotherapy in Depression Recovery

Good psychotherapy is more than just following a structured method. Authenticity, empathy, and a deep understanding of patients’ struggles help individuals navigate life stressors, build healthy coping mechanisms, and maintain long-term wellness. A strong therapeutic alliance significantly enhances treatment success.

How to Get Help for Depression and Find the Right Provider

If you or a loved one is struggling with depression, it’s important to reach out to a psychiatrist, therapist, or primary care doctor for support. Online directories, telehealth services, and mental health hotlines can help you find local providers who specialize in treating depression.

FAQs About Depression Treatment and Recovery

  1. How long does it take for depression treatment to work?
  • Antidepressants typically take 4–6 weeks to show effects, while therapy may lead to improvement within a few sessions.
  1. Can depression go away on its own?
  • While some cases of mild depression may improve with time, severe or persistent depression requires treatment to prevent worsening symptoms and improve quality of life.
  1. What is the most effective treatment for depression?
  • The most effective treatment varies by individual, but a combination of medication, therapy, and lifestyle changes provides the best results for many people.
  1. Are there natural remedies for depression?
  • Exercise, a healthy diet, mindfulness, and social support can complement traditional treatments but should not replace professional care.
  1. How can I support a loved one with depression?
  • Encourage treatment, offer emotional support, and help them stay engaged in therapy, medication, or lifestyle changes.

 

Paul Keck, MD, is the author of this article. Dr. Keck is the Senior Consulting Psychiatrist and Emeritus Founding President and CEO of the Lindner Center of Hope, a state-of-the-science, UC-affiliated comprehensive mental health center in Mason, Ohio. He is also Emeritus Professor of Psychiatry and Behavioral Neuroscience at the University of Cincinnati (UC) College of Medicine. Dr. Keck has conducted extensive research in bipolar disorder, depression and clinical psychopharmacology, supported by grants from the NIMH, NARSAD, the Stanley Foundation, the Marriott Foundation, and industry. Since 1996, he has been in the top 20 of the most cited scientists in the world publishing in the fields of psychology and psychiatry.

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Seeking help for mental health concerns is a courageous step, and finding the right treatment center can make a significant difference in recovery. With various treatment options available, understanding the types of facilities and their offerings is essential.

This guide will walk you through the different types of mental health treatment centers, how to choose the best one for your needs, and what to expect during treatment.

Understanding Mental Health Treatment Centers

Mental health treatment centers provide structured environments where individuals can receive professional care for mental health disorders. These facilities offer a range of therapies and support systems designed to help individuals:

  • Manage their conditions
  • Regain stability
  • Develop coping strategies

Treatment centers play a crucial role in addressing conditions such as depression, anxiety, bipolar disorder, schizophrenia, and substance use disorders.

Types of Mental Health Treatment Centers

Different treatment centers cater to varying levels of mental health needs. The right choice depends on the severity of symptoms, level of care required, and personal circumstances.

Inpatient Treatment Centers

Inpatient facilities, also known as psychiatric hospitals or mental health wards, provide 24/7 medical supervision in a structured setting. These centers are best suited for individuals experiencing severe mental health crises, including suicidal ideation, psychosis, or an inability to care for themselves. Treatment typically includes intensive therapy, medication management, and crisis intervention.

Outpatient Treatment Centers

Outpatient treatment centers allow individuals to receive care while continuing to live at home. These programs offer therapy sessions, medication management, and support groups, often requiring multiple visits per week. Outpatient care is ideal for those with mild to moderate mental health conditions who need support, but do not require round-the-clock supervision.

Residential Treatment Centers

Residential treatment centers offer a middle ground between inpatient and outpatient care. Patients live at the facility for an extended period—typically weeks to months—while engaging in structured therapy and support programs.

Residential treatment centers provide a more home-like environment and focus on long-term recovery, making them beneficial for individuals struggling with chronic mental health conditions or co-occurring substance use disorders.

How to Choose a Mental Health Treatment Center

Selecting the right treatment center is a crucial decision that should be based on individual needs, treatment approaches, and available resources.

Factors to Consider

  • Accreditation and Licensing. Ensure the facility is accredited by organizations like The Joint Commission.
  • Staff Qualifications. Verify that the center has licensed therapists, psychiatrists, and medical professionals.
  • Types of Therapy Available. Look for evidence-based treatment approaches such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and medication-assisted treatment.
  • Location and Environment. Consider whether a local or distant center is preferable based on family involvement and personal comfort.

Questions to Ask Before Enrolling

Before committing to a treatment center, ask the following:

  • What mental health conditions does the facility specialize in?
  • What is the staff-to-patient ratio?
  • What therapies and treatments are included in the program?
  • What aftercare services are provided?
  • What is the expected length of stay?
  • Are family visits and participation encouraged?

Treatment Options Available at Mental Health Centers

Most treatment centers offer a combination of therapy, medication, and holistic approaches to address mental health conditions.

Therapy and Counseling

Therapy is a cornerstone of mental health treatment, helping individuals process emotions, develop coping strategies, and build healthier thought patterns. Common therapy options include:

  • Individual Therapy. One-on-one sessions with a therapist to address personal challenges.
  • Group Therapy. Sessions where individuals with similar conditions share experiences and support one another.
  • Family Therapy. Counseling for family members to improve communication and support.

Medication-Assisted Treatment

For some mental health conditions, medication is a key component of treatment. Psychiatrists may prescribe antidepressants, mood stabilizers, or antipsychotic medications as part of a comprehensive care plan. Medication is often combined with therapy for the best outcomes.

Holistic and Alternative Therapies

Many treatment centers incorporate holistic approaches to support mental well-being, including:

  • Mindfulness and Meditation. Techniques to reduce stress and improve emotional regulation.
  • Exercise and Physical Activity. Activities such as yoga or outdoor recreation to enhance mental and physical health.
  • Nutrition Counseling. Dietary guidance to support brain health and overall well-being.

What to Expect During Treatment

Understanding the treatment process can help individuals and their families feel more prepared.

Intake and Assessment

The first step in treatment is an intake assessment, where medical and mental health professionals evaluate the individual’s condition, history, and treatment needs. This assessment helps create a personalized care plan.

Daily Life in a Treatment Center

Daily schedules in treatment centers typically include therapy sessions, group discussions, recreational activities, and personal time for reflection. Structured routines help individuals establish stability and focus on recovery.

Aftercare and Ongoing Support

Recovery does not end after leaving a treatment center. Aftercare plans often include continued therapy, support groups, medication management, and relapse prevention strategies. Some centers offer alumni programs to provide ongoing support and community connections.

Taking the Next Step

Finding the right mental health treatment center is a crucial step toward recovery. By understanding the different types of centers, treatment options, and what to expect, individuals can make informed decisions that best suit their needs.

If you or a loved one is struggling with mental health challenges, don’t hesitate to reach out for help. Are you ready to take a powerful step toward healing and well-being? Please contact the Lindner Center of HOPE inpatient team to discuss admission, call 513-536-4673, or contact us online.

You can also contact the National Mental Health Hotline: 1-800-662-HELP (4357) or dial 988 for the 988 Suicide and Crisis Lifeline for immediate attention that doesn’t require emergency services. Dial 911 for emergencies.

Our patients’ journeys are at the heart of what we do. Lindner Center of Hope is proud to be among the top mental health treatment centers that patients and families recommend. You can hear inspiring stories of recovery and well-being that showcase our impact and commitment to providing the best mental health care. Explore some of our patients’ Stories of Hope.

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Tracking symptoms is a critical part of managing mental health conditions. Many individuals experience fluctuating symptoms that can impact their daily lives, but without structured monitoring, it can be difficult to identify patterns or assess the effectiveness of treatments.

The Daily Record of Severity of Problems (DRSP) is a valuable tool designed to provide a systematic way to track symptoms over time. Used primarily for conditions like premenstrual dysphoric disorder (PMDD) and other psychological concerns, the DRSP helps individuals and clinicians gain insights that can lead to better treatment decisions.

What Is the Daily Record of Severity of Problems (DRSP)?

The Daily Record of Severity of Problems (DRSP) is a structured self-report questionnaire developed to track daily symptoms, particularly in relation to PMDD and other mood disorders.

Originally designed as a diagnostic aid, it allows individuals to record their experiences with specific symptoms over the course of a menstrual cycle. However, it has also been used for broader mental health monitoring, helping individuals and healthcare providers detect patterns and assess the severity of emotional and physical symptoms.

Purpose and Benefits of Using the DRSP

The DRSP serves as a powerful tool for symptom tracking in both clinical and personal settings. Some key benefits include:

  • Identifying Symptom Patterns. By recording symptoms daily, individuals can detect cycles and trends that may not be obvious otherwise.
  • Aiding in Diagnosis. Many mental health conditions, including PMDD, require pattern-based diagnostic criteria. The DRSP provides clear documentation of symptom timing and severity.
  • Improving Treatment Plans. With structured tracking, healthcare professionals can adjust treatment strategies based on symptom severity, duration, and frequency.
  • Enhancing Self-Awareness. Individuals can gain deeper insights into how their mood, behavior, and physical symptoms fluctuate over time.

How to Use the DRSP

Using the DRSP is straightforward and requires only a few minutes each day. Here’s how to fill it out effectively:

  1. Record Symptoms Daily. Users rate the severity of various emotional and physical symptoms, such as mood swings, anxiety, depression, fatigue, and sleep disturbances.
  2. Use a Consistent Scale. Each symptom is typically rated on a scale from 1 (none) to 6 (extreme) to measure severity.
  3. Note Lifestyle Factors. Some versions of the DRSP allow users to track medications, exercise, sleep, or diet that may influence symptoms.
  4. Maintain Regular Entries. For accurate pattern analysis, it is important to complete the DRSP every day for at least two months.

Interpreting DRSP Data

Once data is collected, individuals and healthcare providers can analyze trends to identify key insights:

  • Recognizing Cyclic Patterns. For those tracking PMDD, the DRSP can reveal whether symptoms consistently appear in the luteal phase (the time between ovulation and menstruation).
  • Measuring Treatment Effectiveness. If a person starts medication, therapy, or lifestyle changes, the DRSP can help determine if those interventions are making a difference.
  • Detecting Worsening Symptoms. A steady increase in symptom severity could indicate a need for medical intervention.

By regularly reviewing DRSP entries, individuals can work with their healthcare providers to refine treatment strategies and improve their overall well-being.

Who Should Use the DRSP?

The DRSP is beneficial for a wide range of users, including:

  • Individuals with PMDD or Mood Disorders. Those experiencing cyclical emotional and physical symptoms can use the DRSP for better self-management.
  • Healthcare Providers. Psychologists, psychiatrists, and gynecologists often use DRSP data to support diagnosis and treatment adjustments.
  • Researchers. The DRSP is commonly used in clinical studies examining hormonal influences on mood and mental health conditions.

Comparing the DRSP with Other Mood and Symptom Trackers

While many mood-tracking tools exist, the DRSP stands out because of its structured format and focus on cyclic symptoms. Unlike general mood trackers that log emotions without a clear pattern, the DRSP provides a consistent scoring system and is widely accepted in clinical settings.

Other trackers may allow more customization, but the DRSP’s standardized approach makes it highly reliable for research and diagnosis.

Where to Get the DRSP

The DRSP is available in printable and digital formats. You can find it:

  • On medical research websites and mental health organizations’ resources.
  • Through healthcare providers, who may supply it for tracking PMDD symptoms.
  • On symptom-tracking apps, where digital versions are integrated into menstrual and mood tracking tools.

Download a DRSP PDF to track mental health symptoms.

There is Hope

Tracking mental health symptoms with a structured tool like the Daily Record of Severity of Problems (DRSP) can lead to greater self-awareness and improved treatment outcomes. Whether used by individuals managing PMDD, mood disorders, or general mental health concerns, the DRSP provides clear, data-driven insights that help both patients and clinicians make informed decisions.

If you or someone you know struggles with recurring mental health symptoms, consider incorporating the DRSP into your daily routine to gain a deeper understanding of symptom patterns and their impact.

Don’t hesitate to reach out for help. If you want to contact the Lindner Center of HOPE inpatient team to discuss admission, call 513-536-4673, or contact us online.

You can also contact the National Mental Health Hotline: 1-800-662-HELP (4357) or dial 988 for the 988 Suicide and Crisis Lifeline for immediate attention that doesn’t require emergency services. Dial 911 for emergencies.

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By Chris Tuell Ed.D., LPCC-S, LICDC-CS
Clinical Director of Addiction Services, Lindner Center of HOPE Assistant Professor, Department of Psychiatry & Behavioral Neuroscience University of Cincinnati College of Medicine

 

 

Alcohol detoxification, commonly referred to as detox, is the initial phase of treatment for individuals with Alcohol Use Disorder (AUD). It involves the process of eliminating alcohol from the body while managing withdrawal symptoms that arise when alcohol consumption is abruptly stopped. Detoxification is a critical step in the recovery journey, as it lays the foundation for long-term sobriety and prevents potentially life-threatening complications associated with alcohol withdrawal.

The Importance of Alcohol Detox
For individuals physically dependent on alcohol, detox is often necessary to restore physical stability and address the physiological effects of prolonged drinking. Chronic alcohol use alters brain chemistry, particularly in neurotransmitters like gamma-aminobutyric acid (GABA) and glutamate, which regulate relaxation and excitability. When alcohol is suddenly removed, the brain struggles to rebalance, leading to withdrawal symptoms. Detox helps mitigate these effects, ensuring the individual can begin recovery safely.

Symptoms of Alcohol Withdrawal
Alcohol withdrawal symptoms can range from mild to severe, depending on factors such as the duration and intensity of alcohol use, overall health, and co-occurring conditions, such as physical and mental conditions.

Mild Symptoms: Anxiety, tremors, sweating, nausea, headaches, and difficulty sleeping.

Moderate Symptoms: Rapid heartbeat, increased blood pressure, confusion, and irritability.

Severe Symptoms (Delirium Tremens): Hallucinations, seizures, severe agitation, and life-threatening cardiovascular instability.

The most severe form of withdrawal, delirium tremens (DTs), occurs in about 5% of individuals undergoing detox and requires immediate medical attention due to its high mortality risk.

The Detox Process
Detoxification typically occurs in one of three settings: home detox (for mild cases under medical supervision), outpatient clinics, or inpatient facilities. The process involves three main phases: evaluation, stabilization, and preparation for treatment.
1. Evaluation: A medical team assesses the individual’s physical and mental health, addiction history, and risk factors for severe withdrawal. Blood tests may be conducted to identify deficiencies or complications.
2. Stabilization: Medications are often used to alleviate withdrawal symptoms and prevent complications. Commonly prescribed drugs include:
Benzodiazepines: Reduce anxiety, prevent seizures, and promote relaxation.
Anticonvulsants: Address seizure risks.
Vitamins (e.g., thiamine): Prevent Wernicke-Korsakoff syndrome, a neurological complication of chronic alcohol use.
3. Preparation for Treatment: Once withdrawal symptoms are managed, the individual is encouraged to transition into long-term treatment, such as counseling or rehabilitation programs.

Benefits and Challenges of Detox
Detox is a vital step, but it is not a standalone cure for AUD. Its primary benefit is ensuring physical safety while preparing individuals for comprehensive treatment. However, it can be physically and emotionally challenging. Individuals may experience intense cravings, mood swings, and feelings of vulnerability during this period.

Conclusion
Alcohol detoxification is a critical and often life-saving process in the treatment of AUD. By managing withdrawal symptoms and stabilizing the individual, detox provides a safe starting point for recovery. With proper medical supervision and a transition to ongoing treatment, detox serves as the gateway to long-term sobriety and improved quality of life.

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managing bipolar disorder, self-compassion mental health, bipolar disorder medication adherence, bipolar and sleep, bipolar and alcohol, warning signs bipolar relapse, bipolar therapy and self-care.

Understanding Bipolar Disorder: The Key to Long-Term Wellness

Managing bipolar disorder requires a combination of medical treatment, lifestyle adjustments, and emotional self-care. Whether you are a patient, family member, or healthcare professional, understanding the role of self-compassion in treatment adherence and daily stability can significantly improve mental health outcomes. Below are three essential pillars for maintaining balance and well-being.

  1. Stay Consistent with Medication: A Foundation for Stability

managing bipolar disorder, self-compassion mental health, bipolar disorder medication adherence, bipolar and sleep, bipolar and alcohol, warning signs bipolar relapse, bipolar therapy and self-care.Why It Matters:
Taking prescribed medications every day without missing doses is one of the most critical steps for mood stabilization. If you and your psychiatrist or mental health provider have identified an effective medication regimen, consistency is key to preventing mood swings and relapse.

Common Concerns:

    • “What if I don’t like the side effects?”
    • “How do I remember to take my medication daily?”

Tips for Success:

    • Use a daily pill organizer or medication reminder app.
    • Work closely with your doctor to adjust medications as needed.
    • Approach medication with self-compassion—understand that needing treatment does not mean weakness; it is part of managing a medical condition.
  1. Avoid Substance Use and Limit Alcohol: Protect Your Mental Health

managing bipolar disorder, self-compassion mental health, bipolar disorder medication adherence, bipolar and sleep, bipolar and alcohol, warning signs bipolar relapse, bipolar therapy and self-care.The Impact of Drugs and Alcohol on Mood Stability
Substance use—including recreational drugs and even medical marijuana—can significantly interfere with bipolar disorder treatment. Alcohol, even in moderation, may worsen symptoms or interact negatively with medications.

Common Questions:

  • “Is it okay to drink socially?”
  • “Does cannabis help or hurt bipolar symptoms?”

Practical Advice:

  • Prioritize your mental health over social drinking or self-medication.
  • Seek support if substance use is affecting your ability to stay stable.
  • Remember that managing bipolar disorder requires self-compassion—avoiding substances isn’t about restriction, it’s about self-care.
  1. Prioritize 8 Hours of Quality Sleep: A Non-Negotiable for Stability

managing bipolar disorder, self-compassion mental health, bipolar disorder medication adherence, bipolar and sleep, bipolar and alcohol, warning signs bipolar relapse, bipolar therapy and self-care.

Why Sleep is Essential for Mood Regulation
Sleep disruptions—whether caused by staying up too late, shift work, or traveling across time zones—can trigger mood episodes. Research has shown that consistent sleep is crucial for preventing both manic and depressive symptoms.

Tips for Better Sleep:

    • Maintain a regular sleep schedule, even on weekends.
    • Create a calming bedtime routine (e.g., reducing screen time, practicing mindfulness).
    • If you struggle with sleep, talk to your doctor about treatment options.

 

 

Additional Strategies for Bipolar Wellness

Recognizing Early Warning Signs of Mood Changes

Work with your healthcare provider to identify early symptoms of mania, depression, or mixed episodes. Write them down and share them with a trusted support person. This proactive step can help you get ahead of mood shifts before they escalate.

The Role of Therapy and Support Systems

Engaging in psychotherapy—such as cognitive behavioral therapy (CBT) or supportive therapy—can provide valuable coping tools and emotional support. A strong therapeutic relationship helps individuals navigate real-life challenges with greater resilience.

Final Thoughts: Practicing Self-Compassion in Bipolar Disorder Management

Managing bipolar disorder is an ongoing journey that requires patience, self-awareness, and a compassionate approach to self-care. Instead of viewing treatment as a burden, embrace it as an act of self-kindness. By staying consistent with medications, avoiding mood-destabilizing substances, and prioritizing sleep, you can create a strong foundation for stability and well-being.

If you or a loved one is struggling, reach out to a healthcare professional for guidance. You are not alone, and with the right support, stability is possible.

 

Paul Keck, MD, Senior Consulting Psychiatrist and Founding President and CEO – Emeritus is the author of this article. Dr. Keck is Emeritus Professor of Psychiatry and Behavioral Neuroscience at the University of Cincinnati (UC) College of Medicine. He is also Senior Consulting Psychiatrist and Emeritus Founding President and CEO of the Lindner Center of Hope, a state-of-the-science, UC-affiliated comprehensive mental health center in Mason, Ohio. Dr. Keck has conducted extensive research in bipolar disorder, depression and clinical psychopharmacology, supported by grants from the NIMH, NARSAD, the Stanley Foundation, the Marriott Foundation, and industry. Since 1996, he has been in the top 20 of the most cited scientists in the world publishing in the fields of psychology and psychiatry.

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By Kelly Heitkamp, LISW-S 

 

 

 

 

Anxiety touches everyone at some point. Whether it’s a fleeting worry before a big event or a chronic struggle that feels all-consuming, it’s important to know there’s hope—and help. Let’s break down what anxiety really is and explore effective ways to manage it, blending professional insight with actionable advice for everyday life.

What Is Anxiety?

Anxiety is more than feeling nervous. It can show up as physical symptoms like a racing heart, tight chest, or stomach troubles; emotional distress like dread or irritability; and persistent, overwhelming thoughts.

Different types of anxiety disorders—like generalized anxiety disorder (GAD), social anxiety, or panic attacks—bring their own challenges, but they all share one thing: they’re treatable. Understanding the roots of anxiety is the first step to taking back control.

Why Does Anxiety Happen?

Anxiety is the brain’s way of trying to keep you safe. When the amygdala (our fear center) senses danger, it activates the fight-or-flight response, releasing stress hormones like cortisol. For some, this system works overtime, reacting to things that aren’t actual threats.

Other parts of the brain, like the prefrontal cortex (responsible for rational thinking), might struggle to calm things down. Add factors like genetics, past trauma, or chronic stress, and you’ve got a recipe for anxiety that can feel hard to shake.

What Can Help? 

  1. Cognitive Behavioral Therapy (CBT)

CBT is like a mental toolbox for managing anxiety. It helps you identify unhelpful thoughts and replace them with more balanced ones. Some key tools include:

  • Challenging Fearful Thoughts: What’s the evidence for this worry? Is there another way to see it?
  • Exposure Therapy: Facing fears gradually, in a safe way, can help reduce their power.
  • Building Confidence: By tackling small, manageable steps, you can create positive change.
  1. Medications
    For some, medication can offer the boost needed to make progress. Options like SSRIs (e.g., sertraline) can balance brain chemicals, while beta-blockers are great for taming physical symptoms like a pounding heart. Always consult a doctor to find the right fit for your needs.
  1. Mindfulness and Relaxation
    Sometimes, the best way to quiet the mind is to connect with the present moment. Techniques that work wonders include:
  • Meditation: Spend even five minutes focusing on your breath or a calming mantra.
  • Progressive Muscle Relaxation: Tense and release each muscle group, noticing the contrast.
  • Deep Breathing: Inhale slowly, hold, and exhale—it signals to your body that you’re safe.
  1. Lifestyle Tweaks
    Small changes can have a big impact on anxiety:
    Move Your Body: Exercise releases feel-good endorphins and reduces stress hormones.
    Eat for Stability: Balanced meals keep blood sugar steady, which helps manage mood swings.
    Prioritize Sleep: Create a routine that supports restful nights.
    Reduce Stimulants: Too much caffeine or nicotine can amp up anxiety.
  1. Emotional Healing
    For some, anxiety has roots in unresolved feelings or past experiences. Therapies that explore deeper emotions or relationship patterns—like psychodynamic therapy—can bring clarity and relief.
  1. Complementary Supports
    From yoga to herbal supplements like chamomile, there are many ways to enhance traditional treatments. Always check with a healthcare provider before trying something new.

How Professionals Can Help

Mental health professionals bring expertise and empathy to the table. They use tools like the Generalized Anxiety Disorder-7 (GAD-7) to assess symptoms and create customized treatment plans. Their goal? Empower you to feel understood, supported, and equipped to manage anxiety.

What Can You Do?

If anxiety feels like it’s running the show, here are some starting points:

  • Reach Out: Whether it’s a therapist, friend, or support group, you don’t have to go it alone.
  • Learn the Signs: Understanding your triggers can help you respond more effectively.
  • Be Kind to Yourself: You’re not failing; you’re facing something challenging—and that takes courage.

A Hopeful Future

Anxiety treatment continues to evolve, with exciting innovations like virtual reality therapy and digital tools making care more accessible. The more we understand about the brain, the better we can help it heal.

Whether you’re a professional supporting clients or someone seeking relief, remember: anxiety doesn’t define you. With the right tools and support, you can reclaim your life and find peace.

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Heather Melena, MSN, APRN, PMHNP-BC

 

PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome and encompasses cases of strep induced neuropsychiatric presentations (PANDAS), as well as presentations brought on by other infections, toxins, or stress. To understand the mechanism in which this autoimmune response is triggered, we must understand how and what our immune system does. Our immune system (innate and adaptive) is responsible for several important roles in our bodies.  When our immune system wrongly identifies our own cells, which can resemble a pathogen’s cell, it attacks our own tissue and causes damage- otherwise known as molecular mimicry (Antoine, 2024). This is, very simply put, what evidence has shown to happen in autoimmunity. Autoimmune or autoinflammatory disease /illness (in PANS/PANDAS) is believed to be activated by exposure to several infectious pathogens that overthrow the immune system and/or generate abnormal reactions which then attacks neuronal cells, leading to inflammation and resulting symptoms (Pandas Physicians Network [PPN], 2024).

What are the hallmark signs and symptoms of PANS and PANDAS? Firstly, we see a very abrupt and severe onset of obsessive-compulsive disorder and/or severe restriction of food intake. With this initial onset, we usually see a rapid (which is unusual in most psychiatric conditions) onset of the following symptoms (PPN, 2024):

  • Severe separation and/or social anxiety (that is atypical for the person affected)
  • Severe mood lability
  • Irritability, aggression, or oppositional behaviors (that previously were not present)
  • Developmental regression
  • Significant and stark decline in school performance
  • Sensory integration dysfunction (to sounds, light, textures, smells
  • Tics or abnormal movements
  • Hypotonia, clumsiness, changes to fine motor skills
  • Enuresis (nighttime bedwetting)
  • Sleep disturbances (insomnia, night terrors)

It is important for people to understand that this is a very significant and drastic change that happens rapidly, if your child/adolescent is functioning normally, and then suddenly is struggling with these symptoms in a very severe manner that is out of character for their typical baseline, that is usually a tell-tale sign. If they have a history of psychiatric illness that ranges from mild to severe, and gets worse with an infection, that does not necessarily indicate PANS or PANDAS, though every case is unique. Approximately 88% of cases have a sudden onset, usually within 3 days (Antoine, 2024). Historically it was believed to have an onset from ages 3-11, though more recent evidence suggests that onset following puberty or even early adulthood, has been captured.

To diagnose, a very detailed and precise clinical picture must be obtained. We take a thorough history including past medical, surgical, and psychiatric history as well as understanding family history with an emphasis on autoimmune disorders. We complete a comprehensive physical exam and finally complete diagnostic studies to rule in/out other possible reasons for sudden and abrupt onset of symptoms as PANS & PANDAS is a diagnosis of exclusion. Lab studies including a complete blood count, complete metabolic panel, inflammatory markers, infectious disease, immune function, hormones, immunoglobins, nutritional deficiencies and autoantibodies are performed but is specific to the patient and their presentation.

How are PANS and PANDAS treated? Treatment is dependent on the severity of the case and at times can include a comprehensive treatment team to deliver care across several specialties including neurology, allergy/immunology, psychiatry, and more. More mild cases usually require antibiotics, steroids, anti-inflammatories, cognitive-behavioral therapy and very low doses of psychotropic medications (Neuroimmune Foundation, 2025). With more severe cases treatment can include IVIG, Plasmapheresis, longer courses of steroids, and other immunologic agents (Neuroimmune Foundation, 2025). It is important to help identify allergens, toxins, and environmental factors which could also be playing a role in the dysregulation of the immune system and continued inflammation.

References

Antoine, S. & Antoine, E. (2024). The comprehensive physicians’ guide to the management of PANS and PANDAS: An evidence-based approach to diagnosis, testing, and effective treatment. Forefront books.

Neuroimmune Foundation. (2025). What are PANS/PANDAS? https://neuroimmune.org/patient-and-family-resources/what-are-pans-pandas/

Pandas Physicians Network [PPN]. (2024). What is PANS/PANDAS? https://www.pandasppn.org/what-are-pans-pandas/

 Stanford Medicine Children’s Health. (2025). Diagnosis and Treatment for PANS and PANDAS. https://www.stanfordchildrens.org/en/services/pans-pandas/diagnosis-and-treatment.html

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By Danielle Johnson, MD, FAPA
Chief Medical Officer, Lindner Center of Hope

Mood disorders have distinct disturbances in emotions. Low moods are called depression and high moods are called hypomania or mania. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) categorizes mood disorders into bipolar disorders and depressive disorders. Mood disorders include major depressive disorder, bipolar I and bipolar II disorder, disruptive mood dysregulation disorder, premenstrual dysphoric disorder, persistent depressive disorder, and cyclothymic disorder. In the U.S., almost 1 in 10 (9.7%) adults experienced any mood disorder in the past year, with past year prevalence of any mood disorder being higher for females (11.6%) than for males (7.7%). More than 1 in 5 (21.4%) U.S. adults will experience any mood disorder in their lifetime. Mood disorders are common in children and adolescents with an estimated 15% having any mood disorder. Major depressive disorder and bipolar disorder are the most common mood disorders with 8.3% of all U.S. adults experiencing at least one major depressive episode in the past year and 2.8% of U.S. adults having bipolar disorder in the past year.

When people experience symptoms of a mood disorder that do not look like major depression or bipolar disorder this can lead to a delay in diagnosis and treatment as they might have difficulty articulating their symptoms and healthcare professionals might not ask questions about other disorders. Although other mood disorders are less common and less severe, they still impact quality of life and functioning.

Persistent depressive disorder (dysthymia) was added to DSM-5 in 2013, combining some criteria of dysthymic disorder and chronic major depressive disorder. With PDD, depressed mood occurs for most of the day, for more days than not, for at least two years (one year for children and adolescents). During a two-year period (one year for children or adolescents), a person has never been without symptoms for more than two months at a time. A major depressive episode can occur before PDD, or people can experience “double depression” when major depressive episodes occur during PDD.

Symptoms can include poor appetite or overeating; insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; or feelings of hopelessness. PDD is associated with greater childhood adversity and maltreatment, childhood loss of a parent, earlier onset of depression, and higher rates of chronic depression in relatives. People with PDD also experience a higher number of traumatic events during their lifetime. The 12-month prevalence ranges from 0.5% to 1.5%.

Cyclothymic disorder consists of episodes of hypomanic and depressive symptoms that do not meet the full criteria for bipolar or major depressive disorder. The lifetime prevalence is approximately 0.4%-1%. Symptoms last two years, for more days than not with stability of mood for no longer than two consecutive months. Symptoms of depression can include depressed mood, irritability, hopelessness, helplessness, insomnia, fatigue, anhedonia, avolition, negativity of affect, and suicidal ideation. Hypomanic symptoms can include impulsivity, grandiosity, racing thoughts, increased sociability, excess physical activity, and increased speech production.

People with cyclothymia may experience emotional lability, hypersensitivity, recurrent interpersonal altercations, incidents of self-harming, episodes of excessive gambling, reckless sexual activity, multiple divorces, legal or financial problems, and recurrent job loss. The chronic and pervasive nature of cyclothymic disorder can lead to misdiagnosis with cluster B personality disorders.

There are no FDA-approved medications for PDD or cyclothymic disorder. Your psychiatrist or psychiatric nurse practitioner will take a thorough history including past medical history, previous medical trials, and other psychiatric diagnoses and work with you to develop a treatment plan and choose appropriate medications and psychotherapy to treat depressive and/or hypomanic symptoms.

Sekhon S, Gupta V. Mood Disorder. [Updated 2023 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558911/

https://www.nimh.nih.gov/health/statistics/any-mood-disorder

https://www.nimh.nih.gov/health/statistics/major-depression

https://www.nimh.nih.gov/health/statistics/bipolar-disorder

Patel RK, Aslam SP, Rose GM. Persistent Depressive Disorder. [Updated 2024 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK541052/

Patel RK, Aslam SP, Rose GM. Persistent Depressive Disorder. [Updated 2024 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK541052/

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By Shea Daniels Graham, LPCC-S, Outpatient Telehealth Counselor

One of my favorite metaphors comes from Shift Journal and describes autism as being a hair-dryer brained person in a toaster-brained world. To paraphrase: If we think about the brain as a machine made of wires and gears we inherit, there is an imaginary world where most people are born with those wires and gears turned into a toaster. In this world where most people have toaster brains there’s going to be a lot of toast—white, wheat, rye, everything bagels, cinnamon raisin bread—but it’s all toast. Making toast is almost effortless for most people in this imaginary world so it becomes an integral, expected part of existing in society. Some people, though, are born with hair dryer brains, and while they can make toast—because you can make toast with a hair dryer, after all—it is going to fundamentally take them intentional effort, time, and skill building, to do what comes effortlessly for the toaster-brained…and even with that effort, time, and skill building, someone with a hair dryer brain is never going to be able to make toast as effortlessly as someone whose brain is a toaster. Now, if the roles were reversed, society would be created around having a hair dryer for a brain and those born with toasters for brains would have trouble drying hair. But in this imaginary world there are more people with toasters for brains, so people with hair dryer brains put a lot of time and energy into simply existing.

The National Institutes of Health estimates, as of 2020, that approximately 1 in 45 adults in the United States are living with autism spectrum disorder. Various studies indicate between 20% and 50% of adults living with autism are undiagnosed. Our understanding of autism has shifted drastically since the term was first used in 1911 by German psychiatrist Eugen Bleuler to describe a form of severe schizophrenia (Bleuler 1950 [1911]), Evans 2013). It wasn’t until the growth of child psychology in the 1960s that we begin seeing anything resembling modern autism criteria, such as Victor Lotter et. al’s 1966 epigenetic study to identify prevalence of autism in Britain’s children. Their screener, which significantly mirrors current autism diagnostic criteria, included 24 items related to social and pragmatic communication; vestibular, proprioceptive, and auditory sensory differences; and, repetitive behaviors. It is interesting to note, here, that Lotter et. al’s original screening tool was based on an earlier screening tool by child psychiatrist Mildred Creak (Evans, 2013). Creak’s screening tools included reports of internal experience which Lotter et. al. excluded due to concerns internal experience was too subjective to be useful.

This trend towards excluding diagnostic criteria based on internal experiences continues even today. Compared to other mental health and neurodevelopmental diagnoses in the DSM, Autism Spectrum Disorder is the only diagnosis not to include any report of internal experiencing (American Psychiatric Association, 2013).

Going back to the example above of toaster brains and hair dryer brains: some hair dryer brains are going to be more effective at making toast than others. Some people with hair dryer brains might be able to optimize their settings, the bread they use, etc., to make toast almost as well as someone whose brain is a toaster. They might even become so effective at making toast with a hair dryer than we wouldn’t know their brains weren’t toasters, if they didn’t tell us about how difficult it is to live with a hair dryer brain in a toaster world.

The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a short, reliable, accurate, valid, and current autism screener appropriate for outpatient clinical use. The CAT-Q is particularly special because it is the only such screener which measures the internal experience of autism. It includes 24 screening questions such as, “I rarely feel the need to put on an act in order to get through a social situation,” “I have developed a script to follow in social situations,” “In social situations, I feel like I am ‘performing’ rather than being myself,” and “in social situations, I feel like I am pretending to be ‘normal,’” each scored on a A-G scale from “Strongly Disagree” to “Strongly Agree.” The CAT-Q has a high internal consistency both for the total scale and for the three sub-scales of Compensation, Masking, and Assimilation. Test-retest reliability was good, as was the total stability of this screener (Jones, 2021). Results are normed by gender for women, men, and non-binary/transgender populations.

Identifying traits of autism in our patients is a crucial part of providing competent care. Regardless of whether or not a patient who scores above-threshold on the CAT-Q opts to pursue formal assessment for autism, for those patients with above-threshold results, we as clinicians can tailor our interventions to acknowledge the patient’s traits of neurodivergence.

At times, tailoring our treatment to account for diagnosed autism, or traits of autism, is simply best practices. For example, in their 2018 study Cooper et. al identified that “almost all” therapists found it necessary to adapt Cognitive Behavioral Therapy interventions due to the increased rigidity of thinking people with autism experience. Without adaptations, the CBT interventions did not produce comparable results for adults with autism compared to neurotypical adults engaged in comparable treatment protocols.

At other times, tailoring our treatment to account for diagnosed autism, or traits of autism, is not only best practices—it is a critical component of not causing harm to patients. In his 2014 presentation to the EMDR Europe Association Conference, S. Paulson explained that due to the variety complex neurological differences individuals with autism present with, trauma processing using EMDR can be more difficult, or even harmful, without appropriate modifications to the standard treatment protocol. With appropriate accommodations, however, EMDR is an incredibly effective treatment for adults with autism who have a co-occurring trauma history. Lobregt-van Buuren et. al found that after 6-8 weeks of standard therapy followed by up to 8 EMDR sessions, at a 6-8 week follow up patients “showed a significant reduction of symptoms of post-traumatic stress (IES-R: d=1.16).”

Ultimately research tells us that compared to same-age peers, people entering mental health services who are later diagnosed with autism experience higher rates of depression, anxiety, and psychosis (French et. al 2023). Not only do people with undiagnosed autism experience higher rates of troubling mental health symptoms, but a 2022 study in Britain found 10% of people who died from suicide had evidence of elevated autistic traits indicative of likely undiagnosed autism—a number 11 times higher than the rate of autism in the general population. As research tells us people with autism, or traits of autism, are unlikely to respond as well to therapeutic interventions unless those interventions are adapted appropriately, screening for traits of autism becomes a crucial best practice.

As a clinician I tend to utilize the CAT-Q screener as readily as I use a PHQ-9 or GAD-7. I use the CAT-Q any time a patient presents with a combination two or more diagnoses whose symptoms may align with autism. I also utilize the CAT-Q screener when I have a patient reporting chronic social difficulties or difficulties with sensory input, with patients who report a chronic history of ineffective mental health interventions, and with patients who report wondering if they have autism. Not every person with autism struggles with mental illness—but every person with autism who does enter mental health services has a right to high quality care tailored to their brains.
After all, if we only provide toaster mechanics, how will the hair dryers ever get a tune up?

Citations
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
https://doi.org/10.1176/appi.books.9780890425596

Bleuler E. (1950[1911]) Dementia Praecox or the Group of Schizophrenias. New York: International Universities

Cassidy, S et al. Autism and autistic traits in those who died by suicide in England. BJPsych; 15 Feb 2022;
DOI: 10.1192/bjp.2022.21

Dietz, P. M., Rose, C. E., McArthur, D., & Maenner, M. (2020). National and state estimates of adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(12), 4258–4266. https://doi.org/10.1007/s10803-020-04494-4

French B, Daley D, Groom M, Cassidy S. Risks Associated With Undiagnosed ADHD and/or Autism: A Mixed-Method Systematic Review. J Atten Disord. 2023 Oct;27(12):1393-1410. doi: 10.1177/10870547231176862. Epub 2023 Jun 21. PMID: 37341291; PMCID: PMC10498662.

Jones, N. (2020, April 21). The CAT-Q. Embrace Autism. https://embrace-autism.com/cat-q/
Lobregt-van Buuren, E., Mevissen, L., Sizoo, B. B., & de Jongh, A. (2018, August).

Eye movement desensitization and reprocessing (EMDR) therapy as a feasible and potentia effective treatment for adults with autism spectrum disorder (ASD) and a history of adverse events. Journal of Autism and Developmental Disorders

Lotter V. (1966) ‘Epidemiology of Autistic Conditions in Young Children’, Social Psychiatry 1: 124–37 [Google Scholar]

Mary. (2010, October 11). A Hair-Dryer kid in a Toaster-Brained world.
https://www.shiftjournal.com/2010/10/11/a-hair-dryer-kid-in-a-toaster-brained-world/

Paulson, S. (2014, June). EMDR with autism. In EMDR clinical practice symposium (Marilyn Luber, Chair).
Symposium presented at the 15th EMDR Europe Association Conference, Edinburgh, Scotland

Rutter M. (1998) ‘Developmental Catch-up, and Deficit, following Adoption after Severe Global Early
Privation. English and Romanian Adoptees (ERA) Study Team’, Journal of Child Psychology and Psychiatry 39: 465–76 [PubMed] [Google Scholar]