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Overcoming Treatment-Resistant Depression with Transcranial Magnetic Stimulation (TMS)

Treatment-Resistant Depression with Transcranial Magnetic Stimulation (TMS)

Kartiki Churi, M.D., Family Care Center Regional Lead for Transcranial Magnetic Stimulation

Major Depressive Disorder (MDD) is a debilitating illness that significantly impacts daily activities, quality of life, cognitive function, employment status, and work productivity. As of 2020, approximately 8.4% of adults in the U.S. had at least one major depressive episode, representing an estimated 21 million Americans. At its worst, MDD can be life-threatening due to the high suicide rates.

Treatment-resistant depression (TRD) is a subset of MDD that does not respond to traditional and first-line therapeutic options. Although there is no formal consensus on the definition of TRD, it is commonly considered an inadequate response to at least two trials of antidepressant pharmacotherapy.

9 Factors that Increase the Risk of Treatment-Resistant Depression (TRD)

There is no single reason for TRD, but several factors could increase the risk of TRD, either individually or in combination.

  1. Co-occurring medical or psychiatric illness
  2. Side effects or incorrect medications
  3. Difficulty with treatment compliance / skipping medications
  4. Incorrect diagnosis
  5. Failing to engage in therapy
  6. Alcohol, cannabis, or other substance use, drug interactions
  7. Lack of Access to mental health services
  8. Genetic / Familial components
  9. Multiple psychiatric inpatient admissions

Risks of Untreated Depression

Research shows that depression that does not respond to typical treatment interventions carries an even higher burden of decreased quality of life, functional impairment, higher risk of relapse, increased self-harming behaviors, and suicidality. An estimated 44% of patients do not respond to two consecutive antidepressant therapies, and 33% do not respond to four. Thirty percent of patients with TRD attempt suicide at least once during their lifetime, which is at least double the lifetime rate in non-resistant depression.

Various treatment tools can be offered and utilized for TRD, including psychotherapy, adjunct pharmacological treatments like lithium, and intensive outpatient treatment or hospitalization in severe cases. Electroconvulsive therapy (ECT) is also known to treat severe depression with acute suicidality. However, this invasive treatment may not be right for many individuals and poses more risks and potential side effects.

Transcranial Magnetic Stimulation (TMS) Treatment for Depression

There has been increasing research and data supporting Transcranial Magnetic Stimulation (TMS) as an effective and well-tolerated treatment option for TRD. TMS therapy uses painless, repetitive pulsed magnetic fields, similar technology to an MRI. These pulses are usually applied to the Dorsolateral Prefrontal Cortex (DLPFC), a focal region on the superficial cortex of the brain, over several weeks of treatment sessions. This treatment helps alleviate depression and anxiety and improves cognition, energy, and motivation. Clinical studies support several areas of the brain which could alleviate symptoms.

As TMS treatment progresses, energy levels and sleep patterns initially improve. Then feelings of hopelessness and worthlessness associated with depression start dissipating, and for a significant number of patients, they remain in substantial remission thereafter. A recent study has shown that about 1 in 4 people with treatment-resistant depression may achieve full remission with repetitive transcranial magnetic stimulation treatment. Due to our training and experience, FCC providers for TMS have routinely achieved higher response and remission rates.

At Family Care Center, we provide psychotherapy, medication management, and TMS treatment options provided by a top-notch team that collaborates and roots for your treatment and recovery from depression. If you or someone you love has struggled with treatment-resistant depression and would like to know more about TMS, we invite you to schedule a no-cost TMS consultation with our experts to learn about treatment, insurance, and scheduling options.

Reference:; published on Jan 30, 2023; updated January 2022

Four Important Steps to Improve Your Mental | Mental Health Awareness Month

Mental Health Awareness Month Family Care Center
Mental Health Awareness Month Family Care Center

Four Important Steps to Improve Your Mental Health 

May is Mental Health Awareness Month, and here at Family Care Center, our team wants to help you learn more about how you can improve your mental health.

While severe mental illness is a real issue, millions of people live each day with mild to moderate levels of mental health conditions or illnesses, such as anxiety, depression, relationship challenges, coping with traumatic experiences, and chronic pain or illnesses.

Here are four important steps you can take to improve your mental health:

  1. Be Aware of Your Stress Levels

Stress is a common response to stressors such as financial issues, work, family, and parenting. One of the first steps towards building your awareness of your own mental wellness is to look at your stress levels. Ask yourself:

  • Do you have time to relax and recharge each week?
  • How do you care for your physical body? Are you eating well and getting enough sleep?
  • Are there at least one or two areas of your life that are deeply meaningful and bring happiness to you?

If you answered ‘no’ to the above questions, it might be a good time to consider seeking extra support.

  1. Seek Professional Help

The Family Care Center has many talented behavioral health professionals ready to support your mental wellness. Depending on your needs, you may receive care from one or more of the following professionals:

  • Psychiatrist providers
  • Psychologists
  • Social workers
  • Counselors
  • Marriage and Family therapists
  • TMS care

Types of Professional Help for Mental Wellness

Talk therapy is provided by psychologists, social workers, counselors, and marriage and family therapists, while psychiatric providers handle medication needs. Other professional supporters and staff provide TMS services.

  1. Educate Yourself

Expanding your knowledge and increasing comfort in talking about mental health is a fantastic way to improve your mental health. Consider receiving training in Mental Health First Aid, which covers a range of topics and can be helpful to individuals and agencies in understanding mental health conditions and how to talk about mental health.

  1. Try One New Thing

If you're not ready to seek out extra support, you can still create change on your own. Here are some suggestions:

  • Start a daily gratitude practice by writing down three things you're grateful for now.
  • Incorporate meditation or prayer into your daily routine. This can be done each morning or at a time that works for you.
  • Start doing one activity a week that helps you relax and recharge, such as reading a book, taking a leisurely bath, playing with your children, or walking your dog.
  • Seek out nature on a weekly basis for at least 15 minutes. Take a walk, sit in a park, or do some cloud watching – whatever feels easiest to start, then increase to one or more days a week.

You can improve your mental health and overall well-being by taking these steps. Remember that seeking help is a sign of strength, and it's never too late to start.

Family Care Center's clinicians include psychiatrists, psychologists, and licensed therapists ready to support you. We offer both in-person and telehealth appointments, so you get the care you need in the format that serves you best. We also accept most insurance plans, allowing you to get the most from your personalized care plan.



Family Care Center is here to help. Learn more about our services and therapy options.

Erika McElroy is a licensed psychologist offering mental health services at Family Care Center. She is passionate about educating others about the myths and stigma of mental health conditions. She spends her free time reading, enjoying the beautiful Colorado weather, and being creative.

Early Intervention in Outpatient Mental Health Care

Early Intervention in Outpatient Mental Health Care
World Bipolar Day

The Importance of Early Intervention in Outpatient Mental Health Care

As the CEO of one of the fastest growing outpatient behavioral health companies in the United States, I have developed a keen understanding of the profound impact that early intervention in mental health care can have on individuals, families, and communities.

The benefits of early intervention in mental health care are well-documented. By identifying and addressing mental health issues in their initial stages, we can improve patient outcomes, prevent long-term complications, and promote faster recovery. Early intervention is also cost-effective, as it often reduces the need for more intensive, expensive treatments later on.

At Family Care Center, we prioritize early intervention in several ways. We collaborate with primary care providers, employers, schools, and community organizations to facilitate early identification of mental health concerns. By developing strong partnerships, we can ensure that individuals at risk for mental health issues are identified and referred to appropriate care as soon as possible.

We also invest in training our clinicians in evidence-based practices that are proven to be effective in addressing mental health issues in their early stages. This includes providing ongoing professional development opportunities and supporting our staff in staying current with the latest research and best practices in the field.

Lastly, we work to reduce barriers to accessing mental health care by offering flexible scheduling, advanced patient/provider matching and telehealth services. By making mental health care more accessible, we can ensure that individuals receive the support they need when they need it most.

Finally, we recognize the crucial role that public awareness and education play in promoting early intervention. We actively engage with our local communities to raise awareness about the importance of mental health and reduce the stigma that often prevents people from seeking help.

Early intervention in mental health care is a critical component of our organization's mission and commitment to improving the lives of those we serve. By prioritizing early intervention, we can make a meaningful difference in the lives of individuals, families, and communities, and contribute to a healthier, more resilient society.

Family Care Center is here to help, learn more about our services and therapy options HERE.


World Bipolar Day 2023

World Bipolar Day
Shauna Ruda, MA, LMSW

One of my best friends from childhood, Jenny, describes her bipolar disorder like being on a swing.

She tells me that during her manic episodes she feels like she’s on the swing going as high as she can go and then the metal latches just release her to the sky flying upward with no end in sight. She describes that the resulting depression feels like a quick downward force pulling her down, back onto the latches, and then deep into the ground beneath the earth. She gets stuck there.

As many as 5.7 million U.S. adults – the same amount as Colorado’s entire population – are living with bipolar disorder.

Chances are, if you are reading this, like me there someone in your life that has been diagnosed with bipolar disorder. As a mental health practitioner committed to deepening and visibilizing an understanding of this diagnosis,, I am sharing facts and real reflections from people with bipolar disorder. Names are changed for privacy, including above.

What is bipolar disorder?

Bipolar disorder is a mood or affective disorder meaning that a person’s emotional state or mood is distorted or inconsistent with life circumstances.

Bipolar disorder causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar experience high and low moods—known as mania and depression—which differ from the typical ups-and-downs most people experience. The average age of onset is about 25, but it can occur in the teens, or more uncommonly, in childhood.

Types of Bipolar Disorder

Bipolar I Disorder, Bipolar II Disorder, Cyclothmic Disorder, or Bipolar unspecified.

To be diagnosed, a person must have experienced at least one episode of mania or hypomania. Mental health care professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose the “type” of bipolar disorder a person may be experiencing. We assess the pattern of symptoms and how impaired the person is during their most severe episodes.

How Does Bipolar Feel?

There is not one answer. Everyone’s experience with bipolar disorder is different, and the signs and symptoms vary. Many people undergo distinct periods of stability, mania, and depression. Others can feel both depressed and manic at the same time—simultaneously feeling very sad and energized.

What are the Signs and Symptoms?

Mania and Depression

Mania is defined by an elevated state of mood which is a change from the usual self and can typically be noticed by others. Symptoms include feelings of invincibility, lack of sleep, racing thoughts and ideas, rapid talking and having false beliefs or perceptions.

Sara, a 32-year-old with bipolar disorder described, “Being manic is like having five minds functioning at once. I feel like I have no control and also simultaneously love relinquishing control.” For Sara becoming hyper fixated on a tasks like cooking, cleaning, working on her TikTok page caused her to lose sleep for days.

A manic episode may include these symptoms:

  • Intense feelings of euphoria, excitement, or happiness
  • Appearing abnormally jumpy or wired
  • Having excessive energy
  • Insomnia or restlessness (a decreased need for sleep)
  • Speaking fast or being unusually talkative
  • Having racing or jumbled thoughts
  • Distractibility
  • Inflated self-esteem
  • Doing impulsive, uncharacteristic, or risky things like having unsafe sex or spending a lot of money
  • Increased agitation and irritability

For many, the manic cycle of bipolar disorder is what defines the illness. Indeed, what distinguishes it from depression is those defining moments of mania.

Still, it is the depression that will often dominate and disrupt life – it lasts longer and occurs more frequently. A study at the University of California published in the Archives of General Psychiatry found that people with bipolar I experience depression three times as often as mania. For bipolar II disorder, the astounding ratio of time spent in depression versus mania is 40:1.

Dan, a 27-year-old, share about the depressive episodes she experiences that, “I was so debilitated that I would feel physically stuck in bed for days, catatonic, unable to move… I would commit to a week of plans before my depression and then cancel all of them.”

A depressive episode may include these symptoms:

  • Feeling down, sad, worried, worthless, anxious, guilty, empty, or hopeless
  • Lack of interest, or no interest, in activities
  • Feeling tired, low energy
  • Forgetfulness
  • Indecisiveness
  • Difficulty concentrating
  • Changes in sleep, either sleeping too much or too little
  • Changes in appetite, either eating too much or too little
  • Thoughts of death and/or suicide

People with bipolar disorder also experience high suicide rates — up to 19% of those with bipolar disorder die by suicide and up to 50% make a non-fatal suicide attempt. Suicide risk is strongly associated with depressive phases (NAMI, 2023). If you or a loved one is need of someone to talk to, please call or text the national suicide hotline at 988. If you or a loved one are in immediate danger call 911 or go to your nearest hospital.

Because bipolar and major depressive disorder or depression can seem similar, psychiatrists have to take into account family histories and ask patients if they have ever experienced symptoms of mania or hypomania. Treating only depression for someone with bipolar disorder can cause serious harm, including the potential to induce mania.

Cycles of Bipolar

According to Very Well Mind, there is no definitive answer to the duration or frequency of bipolar cycles since they are as varied as the people who experience them. A change or "mood swing" can last for hours, days, weeks, or even months.

Bipolar Disorder and Relationships

One of the most difficult aspects of bipolar disorder is that it precipitates feelings of being unlovable, hinders the ability to give love, and sometimes causes destruction. Experiencing bipolar symptoms simultaneously is the moment when the most comfort and love is needed. It’s impossible to do everything right with a loved one experiencing bipolar disorder, but there are some stand out repetitive themes around “the don’ts of supporting those with bipolar disorder”.

Here are the top three: 

  1. Do not manage care. The biggest and most consistent request from people with bipolar is to maintain boundaries between loved ones and their own medical management. Sara shared, “I do not want you to ask if I'm taking my meds or when the last time I had therapy… Maintaining the boundary between loved one and medical professional is really important.”
  2. Do not make someone feel badly for not showing up. Chances are the person you love with bipolar disorder wants to be there. Pressuring them creates more feelings of shame, guilt, and self-loathing. Jenny told me that when people express disappointment when she doesn’t show up “it’s the most gut wrenching don’t of all. I already know I’m a disappointment to myself. To be that for others is a whole other level of self-hatred.”
  3. Do not define people by their diagnosis. When someone shares that they have been diagnosed with bipolar disorder they are making themselves vulnerable. Be aware of the impact on bringing it up in normal interactions. Dan shared, “Before I was diagnosed, I was always a loud, vibrant, and outgoing person. I was out with some friends and one friend asked if I was having a manic episode. I was completely crushed.”

Living with Bipolar Disorder

Stigma and its twin internalized shame compound the challenges that prevent healing. They are so powerful that more than half of adults with mental illness go untreated. It is entirely possible to live well with bipolar disorder with a team of medical experts, the right medication, living a healthy lifestyle, maintaining a consistent routine, avoiding substance use, minimizing stress, and a reliable support network.

Jenny and I were discussing this article together. I wanted to be able to capture the complexity of bipolar disorder while also providing clarity. Jenny reassured me. She wanted anyone reading to know “if you’re confused by the end of reading this – then it’s the first successful step in understanding what it feels like to be inside of the mind of someone with bipolar disorder”. 

Big thank you to her and others who were willing to share their experiences.

Additional resources:


Self, What Exactly is Bipolar Disorder?


Gabe Howard + Dr. Nicole Washington, Inside Bipolar:


Psych Central, Fact Sheet:

Very Well Mind, How Often Do People Cycle?

Mind, Supporting Someone with Bipolar Disorder:

[Courses for Family and Friends]

National Alliance on Mental Illness (NAMI), Family to Family Support:

Family Care Center is here to help, learn more about our services and therapy options HERE.

Shauna Ruda (she/ her) is a mental health therapist at Family Care Center. She enjoys conversations that push her out of her comfort zone, Rocky Mountains at sunrise, ukulele, and her incredible community of friends and family.

Mental and Behavioral Health

Mental and Behavioral Health
Mental Health and Behavioral Health
Family Care Center,

Mental Health and Behavioral Health

Mental health and behavioral health are often used interchangeably, but they can refer to slightly different concepts.

Mental health refers to a person's overall psychological well-being. It is the state of being emotionally and cognitively healthy, and it is an essential part of overall health and well-being. Mental health includes a person's ability to manage their emotions, thoughts, and behaviors, and it can be affected by a wide range of factors, including genetics, environment, and life experiences.

Behavioral health, on the other hand, is a broad term that refers to the behavior of individuals and the impact of that behavior on their overall health and well-being. It includes mental health, as well as substance abuse and addiction. Behavioral health encompasses a person's behaviors, thoughts, and feelings that can affect their physical health, as well as their social, economic, and environmental well-being.

In summary, mental health refers to a person's overall psychological well-being, while behavioral health refers to the behaviors, thoughts, and feelings that can affect a person's overall health and well-being. Both mental health and behavioral health are important for overall health and well-being, and they can be interconnected. Family Care Center is proud to be the #1 provider of behavioral health outpatient services in Colorado, and we are  expanding our reach to the states of Tennessee and Texas!


Teen Mental Wellness Day 2023

World Teen Mental Wellness Day
World Teen Mental Wellness Day
Family Care Center,

World Teen Mental Wellness Day 2023

World Teen Mental Wellness Day is observed on March 2 every year to raise awareness about the mental health challenges faced by teenagers across the globe. Mental health is a crucial aspect of overall well-being, and it is essential to address mental health issues early in life to prevent them from escalating into severe problems later on. This day is dedicated to promoting the importance of mental health and wellness among teenagers, providing support and resources for those struggling with mental health issues, and reducing the stigma surrounding mental illness.

Adolescence is a crucial period in a person's life, and it is a time when teenagers undergo several physical, emotional, and psychological changes. Teenagers often find themselves navigating new environments, facing academic and social pressures, and dealing with personal issues such as identity, relationships, and self-esteem. All these factors can contribute to stress, anxiety, and other mental health issues, which can have a significant impact on their overall well-being.

According to the World Health Organization (WHO), approximately 10-20% of adolescents worldwide experience mental health conditions, such as anxiety, depression, and substance abuse. However, many of these conditions go undetected and untreated due to lack of awareness, stigma, and limited access to mental health services. This highlights the need to prioritize mental health and wellness among teenagers and provide them with the support they need to thrive.

World Teen Mental Wellness Day aims to achieve this by promoting mental health literacy, encouraging open and honest conversations about mental health, and providing access to resources and services. The day also focuses on empowering teenagers to take care of their mental health by developing healthy habits such as exercise, meditation, and mindfulness.

One of the primary goals of World Teen Mental Wellness Day is to reduce the stigma surrounding mental health issues. Stigma is a significant barrier to seeking help for mental health problems, and it can prevent teenagers from accessing the care they need. By raising awareness about mental health and promoting a culture of acceptance and understanding, we can break down these barriers and ensure that all teenagers receive the support they need to maintain their mental health and well-being.

Another important aspect of World Teen Mental Wellness Day is providing access to mental health resources and services. Many teenagers may not have access to mental health services due to factors such as cost, lack of availability, or social stigma. By providing access to affordable and accessible mental health services, we can ensure that all teenagers receive the care they need to manage their mental health.

World Teen Mental Wellness Day is an important occasion that highlights the significance of mental health and wellness among teenagers. By promoting mental health literacy, reducing stigma, and providing access to resources and services, we can ensure that all teenagers receive the support they need to thrive. As individuals and as a society, we must prioritize mental health and work towards creating a world where all teenagers have the opportunity to lead healthy, happy, and fulfilling lives.

If you, or anyone you know, needs to talk, Family Care Center is here. Click here to learn more about our mental health services. 


International Survivors of Suicide Loss Day

International Day of Suicide Loss
Dr. Kartiki Churi, M.D.

Grieving a Suicide Loss

International Survivors of Suicide Loss Day is held on Saturday before Thanksgiving each year. In the year 2022, it occurs on November 19th.  It is sponsored annually by The American Foundation for Suicide Prevention (AFSP). (1) It is the day when people affected by suicide loss gather at events in their local communities to find comfort as they share stories of healing and hope.  

As we head into a busy holiday season, it is important to be aware that this time can be very challenging for people who have lost a loved one to suicide. Suicide is the 12th leading cause of death in the U.S. In the year 2020, 45,979 Americans died by suicide and there were estimated 1.2 million suicide attempts. (1) Current statistics indicate that each incident of suicide results in 135 acquaintances being impacted and 25 in the category of suicide survivors- these are individuals who are profoundly impacted and bereaved. Each loss leaves the family and friends grieving and struggling to understand and cope. Some individuals may feel guilty and wonder how they did not see the signs and what could they have done to prevent it. For others there could be feelings of extreme sadness and anger about their loved one loss.  Yet because of the stigma around suicide and mental illness, and difficult emotions surrounding suicide loss, many of us hesitate to reach out for support or get needed help to cope with the tragic loss. Most of us are not aware of the resources available and some of us may struggle with the motivation to seek support. This can lead to feelings of isolation and further complicate the grieving process.

The highly stressful ramifications due to losing a loved one to suicide, can put the survivors at high risk for developing anxiety and depression, including pathological complicated grief. Complicated grief is defined as prolonged, unresolved, or traumatic grief characterized by intense feelings associated with acute grief. (2) If unaddressed, complicated grief can cause significant distress and, persistent feelings of longing and yearning, eventually resulting in substantial deficiencies in their occupational, social, and interpersonal functioning. Furthermore, they may experience increased rates of psychiatric co-morbidities, increased medical issues, insomnia, and substance abuse. One may start to suffer from recurrent major depression, suicidal thoughts, and suicidal behavior.

A study completed in 2019, inferred that the interpersonal factors of belonging, self-disclosure, and social support play a very important role in facilitating growth for those who have experienced traumatic suicide loss of a loved one. (3)  Self-disclosure is the process of sharing one’s personal feelings and has been found to be an important component of dealing with grief.  Utilizing appropriate tools and support systems can help us identify and understand our emotions to promote a healthy healing journey. Talking to a network of people who you feel safe with, who will understand your sense of loss or connecting with a network who might have shared a similar experience of loss, can be immensely helpful. Not rushing yourself through the process of grief and allowing you the time, space and grace needed to address the trauma of suicide loss is important. If the grief persists for a prolonged period, and there are feelings of unrelenting anguish, depression, hopelessness, or suicidal thoughts, seeking professional help can be helpful and necessary. Selfcare, wellbeing, joy, or laughter do not mean less grief, but it means giving yourself the permission to heal and grow, despite the grief.

The 988 Suicide & Crisis Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States. 

Family Care Center is also here to talk. Please reach out with any questions, we are always here to help. 


  2. Levi-Belz Y, Lev-Ari L. "Let's Talk About It": The Moderating Role of Self-Disclosure on Complicated Grief over Time among Suicide Survivors. Int J Environ Res Public Health. 2019 Oct 4;16(19):3740. doi: 10.3390/ijerph16193740. PMID: 31590225; PMCID: PMC6801618.
  3. Levi-Belz Y. Growing together: interpersonal predictors of posttraumatic growth trajectory among suicide-loss survivors. Anxiety Stress Coping. 2022 May;35(3):284-297. doi: 10.1080/10615806.2021.1958791. Epub 2021 Jul 27. PMID: 34314267.

National Health Education Week

National Health Education Week
National Health Education Week
Dr. Kartiki Churi, M.D.

Observed in the third full week of October, for over twenty years, it has been celebrated as National Health Education Week (NHEW). The Society for Public Health Education, co-sponsors the week along with the U.S. Department of Health and Human Services. Mental health is integral part of our health and can be impacted by complex set of factors, including our demographics, genetics, biology, past experiences, and spiritual beliefs.  Mental Illness is highly prevalent with nearly one in five adults in the United States being diagnosed with some form of mental health disorder (52.9 million in 2020), this represents 21 percent of all the U.S adults. (1) Of these, anxiety disorders are the most common mental illnesses in the U.S., affecting nearly 40 million adults, representing 19.1 percent of the population. (1) The five commonly seen Anxiety Disorders are:

Generalized anxiety Disorder (GAD):

Generalized Anxiety Disorder is characterized by persistent worry or anxiety about various areas of life, with little or no reason to provoke it. There are times when these worries might not be all consuming, but still, you feel anxious for no reason and a general sense that something bad is going to happen. There can be physiological symptoms that accompany GAD, and these include fatigue, trouble falling or staying asleep, muscle tension, irritability, nausea, or diarrhea and feeling twitchy or getting easily startled. GAD affects 6.8 million adults, which is 3.1 percent of the U.S. Population, yet only 43.2 percent of those are receiving treatment. (1)

Obsessive Compulsive Disorder (OCD)

OCD is a type of anxiety disorder and is characterized by pattern of unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Though obsessions are typically associated with compulsions, it is possible that that you might have only one of the symptoms. Commonly seen compulsive behaviors include hand washing, counting, checking, or cleaning, often performed with the hope of preventing or getting rid the distressing obsessions. However, these rituals offer only temporary relief. OCD can be very distressing, lead to feelings of shame and embarrassment, and impact day to functioning at home, school and in social settings. OCD affects 2.5 million adults, which is 1.2 percent of the U.S. population. One out three affected adults, first experience these symptoms in childhood. (1)

Panic Disorder

Panic disorder is a form of Anxiety Disorder characterized by repeated and unexpected bouts of overwhelming fear. It is accompanied by physiological symptoms which include chest tightness or pain, racing heart, shortness of breath, nausea, shaking, excessive sweating, lightheadedness, sense of choking and often feeling out of control. Panic attacks can last anywhere from few minutes to several hours. Panic disorder can be disabling and prevent you from leaving the home and participating at work, school, or the society. Panic Disorder affects 6 million adults or 2.7 percent of the U.S. population. (1)

Post-Traumatic Stress Disorder (PTSD):

Post Traumatic Stress Disorder is a mental health condition that is triggered after experiencing or witnessing a traumatic event.  PTSD can cause intense, intrusive thoughts and feelings related to the traumatic experience that last long after the traumatic event has occurred. You may relieve the event though flashbacks or nightmares. There may be disturbing emotions including sadness, fear, or anger, and avoidance of people and situations that remind you of the trauma. It may cause feelings of detachment or estrangement from other. PTSD affects 7.1 million adults or 3.6 percent of the U.S. population. (1)

Social Phobia (Social Anxiety Disorder):

Social Phobia is characterized by intense fear of talking with strangers or in a social setting, worry that you might embarrass yourself or may get judged negatively and fear that others will notice your anxiety. Social anxiety can significantly impact day to day function in the society as you may avoid new situations, events or speaking with people, due to fear of embarrassment.  Many times, anxiety may worsen just with the anticipation of social interaction. Social Phobia affects 15 million adults, which represents 7.1 percent of the U.S. population. Approximately 36 percent of these individuals wait for ten or more years before seeking treatment. (1)

Anxiety disorders can present in many other forms, for example, specific phobias, acute stress disorder, adjustment disorder, hoarding body dysmorphic disorder, trichotillomania or could be induced by substance use or a medical issue. Anxiety disorders co-exist with other mental health disorders, most commonly with depression and others such as ADHD, Bipolar disorder, Alcohol or Substance Use Disorder. Anxiety disorders also commonly co-occur with other medical illnesses such as diabetes, high blood pressure, cancer, thyroid, and other endocrine disorders. People with anxiety disorder are 3-5 times more likely to have a doctor’s visit in a year and 6 times more likely to be psychiatrically hospitalized. (1) It is important to identify and treat both the co-occurring illnesses and the anxiety. Anxiety disorders are very treatable utilizing various forms of therapy, psychotropic medications and in certain cases with Transcranial Magnetic Stimulation (TMS).

Despite the significant negative impact that anxiety disorders have on the suffering individuals physical, emotional, and social wellbeing, many of us hesitate to seek treatment. In fact, only 36.9 percent of people who struggle with anxiety receive treatment. This could be due to lack of awareness, stigma related to mental illness and poor access to mental health treatment services. Anxiety and other metal health disorders impede our wellbeing, decrease our productivity, and reduce our potential to participate fully in our community. Call us today at, 888-374-5066, and know your treatment options for anxiety and related mental health disorders!



Suicide Prevention in Adolescents

suicide prevention in adolescents
Suicide prevention in adolescents


I am Mary Lee Churchill, and I am a Licensed Professional Counselor at Family Care Center.  It is not an easy task for a parent, school official, therapist, or anyone that encounters a child who is struggling with suicidal thoughts. I would like to discuss Suicide Prevention in Adolescents. It is a scary topic for sure, however there are some things that we can look out for. Some kids are at higher risk than others for suicide. Let us look at who is a high risk, and what we can do to be more aware and offer support.

High risk includes:

  • Adolescent males who use alcohol and/or drugs
  • Adolescents that have depression
  • Kids from rigid family backgrounds
  • Have experienced a recent loss (a break-up, parents’ divorce, death, etc.)
  • Have a misunderstanding of death
  • Know a suicide victim

Talking about suicide does not increase the risks. 

Here is what we can do to help adolescents with suicide prevention:

  • Listen empathetically
  • Ask directly about potential suicide
  • Break confidentiality in cases of actively suicidal child/or teenager
  • Hotlines/Suicide prevention hotlines
  • Drug Rehabilitation Therapy
  • Talk Therapy

Remember when a kid is contemplating suicide, don’t leave them alone until they are supported by those that are able to help, such as: emergency room personnel or an intake specialist at a facility that specializes in mental health crisis.

Together, by recognizing the risks and supporting the child/or teenager we can prevent suicide. 

If you, or anyone you know, is struggling with thoughts of suicide, please call or text 988.

The Intersection of Physical and Mental Health

Physical and Mental Health
Physical and mental health

Dr. Kartiki Churi, M.D. 

Mental and physical health are fundamentally linked.

People who struggle with serious mental illness are at an elevated risk of experiencing certain chronic physical ailments. Likewise, people living with chronic physical illness are at higher risk of experiencing depression, anxiety and other mental illness as compared to the general population. There are several factors that could explain this. Chronic physical illness can cause increased levels of psychological stress. Individuals with new onset or chronic medical illness may have to make several adaptations in their lifestyle, work, hobbies, and day to day functioning, thus impacting overall quality of their life. Repeated hospitalization and the worry of managing the medical diagnosis can trigger feelings of hopelessness and loss. 

There are several medical illnesses which are associated with abnormal levels of hormones and neurotransmitters. The chronicity of certain medical illnesses can cause the inflammatory stress to go up and that can increase the risk of depression and other mental illnesses. Receiving new diagnoses of cancer or other life-threatening diseases can be traumatic for the patient, as can receiving diagnosis of chronic medical illness be life altering. Symptoms associated with certain physical illnesses like pain, cognitive effects, impaired vision, decreased mobility, and others can lead to feelings of loss and prolonged grief. While some of these emotions are expected, there are many who develop protracted distress and get diagnosed with mental illness, most commonly depression and anxiety. Some medical diagnoses can inherently increase the risk of depression or other mental health diagnoses. Common examples of these are Diabetes, COPD (Chronic Obstructive Pulmonary Disease), Heart disease, Stroke, Parkinsonism, HTN (Hypertension), HIV/ AIDS, and Cancer. It is important to note that certain medications used to treat physical ailments, for example corticosteroids in rheumatologic disease, COPD or multiple sclerosis can impact mood and thoughts adversely. Likewise, certain medications used to treat psychiatric disorders, can lead to onset or worsening of physical symptoms like obesity, elevated glucose levels, increase in blood pressure, amongst others.

Despite this intersectionality between physical and mental illness, often mind and body are regarded as separate entities.  However, most evidence has shown that taking care of the whole person and keeping in mind the intersectionality between physical and mental aspects of our health are most likely to make a positive impact on the quality of life. It can maximize a person's ability to function to their maximum potential, despite the chronic physical illness.  It is important to know that an individual with healthy and positive mental health is more likely to have successful outcomes for other illnesses, is more likely to respond to treatment, have better prognosis and stay stable. There are many noted benefits of psychotherapy and psychiatric medication management. Some of these include, improved sleep and appetite, improved energy and motivation, higher self-esteem, increased focus and clarity in thinking. This in turn helps with increased ability to function despite illness, make decisions related to treating illness and overall improved resilience. 

Yes, indeed, it is time to start normalizing mental health conversations! If you or someone you care for is diagnosed with a chronic physical illness, give Family Care Center a call at (888)-374-5066 and let our providers help you live your fullest life.