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Freedom In Choices is a community mental health agency in Twin Falls, ID offering psychotherapy and counseling for adults suffering from Anxiety, Mood and Thought disorders such as Bipolar, Depression, and Schizophrenia, as well as Addiction issues with the adults population. This includes individuals with anxious or depressive symptoms related to relationships, life stressors, trauma, temporary crises, chronic pain, transitions, substance abuse or occupational issues.

Anxiety Disorders

  • Panic Disorder
  • Generalized Anxiety Disorder (GAD)
  • Obsessive Compulsive Disorder (OCD)
  • Social Anxiety
  • Phobias
  • Agoraphobia

Social Anxiety, Panic Disorder, Phobias, Generalized Anxiety Disorder, Agoraphobia

Persistent worry, racing ruminating thoughts that won't turn off, feeling overwhelmed, muscle tension, irrational fears, sleeplessness......These are symptoms of anxiety. Like every other mental disorder, anxiety symptoms fall on a continuum ranging from mildly controlling to devastating and crippling, preventing some people from even leaving their house. Most people however find themselves somewhere in the middle of the spectrum; physically, emotionally and mentally exhausted by unrelenting worries, negative self-talk and recurring thought patterns that pervade their relationships, jobs, school and normal life activities.

We can help. Psychotherapy focuses on re-educating and reshaping behavior and thought processes by teaching strategies that can help you cope with anxiety-producing thoughts and behaviors. Cognitive behavioral therapy and exposure therapy are two types of evidence based therapies that are particularly beneficial. The basic premise of Cognitive behavioral therapy is that our thoughts—not external events—affect the way we feel. It is our perception of a given situation that determines how we feel —not the situation per se. The Cognitive component of the theory examines how negative thoughts contribute to anxiety, while the Behavioral component addresses negative patterns and distortions in the way we look at the world and ourselves.

Exposure therapy is a process for reducing fear and anxiety responses. Using this method, a person is gradually exposed to a feared situation or object, learning to become less sensitive over time. After multiple exposures, the object or situation will evoke less and less anxiety each time, and patients then usually move up to more difficult or anxiety-producing objects or situations.

The outcome of treatment is determined by several factors, including the severity of diagnosis, level of functioning prior to onset of symptoms, degree of motivation for treatment, level of social or family support and one's ability to comply with medication and/or psychotherapeutic regimen. With proper treatment, many people with anxiety disorders can lead normal, fulfilling lives.

Therapy is tailored to your specific symptoms and concerns. The length of therapy will depend on the type and severity of your anxiety disorder. Many people improve significantly within 10 to 14 therapy sessions.

How do you know what is considered normal anxiety?

 Anxiety disorders differ from normal feelings of nervousness or anxiousness and involve excessive fear or worry that is seemingly uncontrollable and overwhelming. While the following can be symptoms of many disorders, including certain medical issues (which should be ruled out first), in an anxiety disorder all of the symptoms tend to cluster around irrational, excessive fear and dread:

  • Constant and unsubstantiated worry that causes significant distress and dysfunction in everyday life activities.  
  • Anxiety negatively affecting your sleep or your eating patterns because you are worried or agitated and your mind won’t calm down.
  • Avoiding social situations for fear of being judged, embarrassed, or humiliated
  • Seemingly out-of-the-blue panic attacks and the preoccupation and anticipation of future attacks.
  • Irrational fear or avoidance of an object, place, or situation that poses little or no threat of real danger. Overwhelming fear that is disproportionate to the risk.
  • Recurring nightmares, flashbacks, or emotional numbing related to a traumatic event that did not occur in the recent past.

Mood Disorder Treatment

Major Depressive Disorder, Bipolar, Persistent Depressive Disorder (formerly Dysthymic Disorder, Cyclothymic Disorder)

Clinical Depression

Major Depressive Disorder (MDD)

To have a clinical diagnosis of MDD a person must have a depressed mood or a loss of interest or pleasure in daily activities for more than two weeks. This mood represents a change from the person's normal mood state. The mood state would also impair functioning in the social, occupational and educational areas of the person's life.

A major depressive episode is also characterized by the presence of 5 or more of these symptoms:

  • Persistent sad, anxious or "empty" mood, most of the day, every day
  • Sleeping too much or too little, middle of the night or early morning waking
  • Reduced appetite and weight loss, or increased appetite and weight gain
  • Loss of pleasure and interest in activities once enjoyed, including sex
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
  • Difficulty concentrating, remembering or making decisions
  • Fatigue or loss of energy
  • Feeling guilty, hopeless or worthless
  • Thoughts of suicide or death

What is Bipolar Disorder?

A disorder associated with episodes of mood swings ranging from depressive lows to manic highs. Bipolar disorder can be extremely distressing and disruptive for those who have this disease, their spouses, family members, friends and employers. Although there is no known cure, bipolar disorder is treatable, and recovery is possible. Individuals with bipolar disorder have successful relationships and meaningful jobs. The combination of medications and psychotherapy helps the vast majority of people return to productive, fulfilling lives.

Bipolar I

The essential feature of Bipolar I Disorder is a clinical course that is characterized by the occurrence of one or more Manic or Mixed Episodes. Often individuals have also had one or more Major Depressive Episodes.

Bipolar II

Similar to bipolar I disorder, with moods cycling between high and low, in bipolar II disorder, the elevated moods never reach full-on mania. Bipolar II is characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for bipolar II disorder requires that the individual must never have experienced a full manic episode.

Rapid Cycling

In rapid cycling, a person with bipolar disorder experiences four or more episodes of mania or depression in one year. 

Mixed Bipolar

In most forms of bipolar disorder, moods alternate between elevated and depressed over time. But with mixed bipolar disorder, a person experiences both mania and depression simultaneously or in rapid sequence.


Cyclothymia (cyclothymic disorder) is a relatively mild mood disorder. Cyclothymia is considered to be a more chronic but milder form of bipolar disorder. For cyclothymic symptoms to be diagnosed, hypomanic symptoms and depressive symptoms must be present alternately for at least two years.

Persistent Depressive Disorder (formerly Dysthymic Disorder)

Persistent Depressive Disorder experienced as a less severe but more chronic form of major depression. Symptoms usually last for at least two years, and often for much longer than that. Dysthymia interferes with your ability to function and enjoy life. 

Symptoms of mania

The symptoms of mania, which can last up to three months if untreated, include:

  • Excessive energy, activity, restlessness, racing thoughts and rapid talking
  • Extreme “high” or euphoric feelings -- a person may feel “on top of the world”
  • Easily irritated or distracted
  • Decreased need for sleep – an individual may last for days with little or no sleep without feeling tired
  • Unrealistic beliefs in one’s ability and powers -- a person may experience feelings of exaggerated confidence or unwarranted optimism. This can lead to over ambitious work plans and the belief that nothing can stop him or her from accomplishing any task
  • Poor judgment -- a person may make poor decisions which may lead to unrealistic involvement in activities, meetings and deadlines, reckless driving, spending sprees and foolish business ventures.
  • Sustained period of behavior that is different from usual -- a person may dress and/or act differently than he or she usually does, become a collector of various items, become indifferent to personal grooming, become obsessed with writing, or experience delusions.
  • Unusual sexual drive
  • Abuse of drugs, particularly cocaine, alcohol or sleeping medications
  • Provocative, intrusive, or aggressive behavior -- a person may become enraged or paranoid if his or her grand ideas are stopped or excessive social plans are refused.

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout

How are Mood Disorders treated?

Your treatment plan for a mood disorder will depend on several factors: Are you willing to take medication, engage in therapy or try alternative methods? Depending on the severity and type of mood disorder, you may have no choice but to take medication to manage your symptoms. Have you ruled out a medical condition or current medication that you are taking that might be causing symptoms? The most efficacious treatment combines medication with psychotherapy. Antidepressant medications are often the first line of treatment used for clinical depression, and they are prescribed alone or in addition to therapy. Because there are so many different kinds of antidepressants, finding the one that works for you can sometimes take time. You will have to see how your body responds to the medication that your doctor prescribes and whether or not you can tolerate any side effects. 

Not all treatments will work for everyone.

Bipolar or Depression Support Groups can be a great way to engage with other people who may be dealing with similar situations. Here you can share and listen to other people's experiences and struggles in a way that helps reduce isolation and loneliness.

 And finally, don't underestimate the positive effects of exercise, diet, social support/engagement, yoga, or meditation on improving mental illness, especially with depression and anxiety disorders.

Adjustment Disorder - is a short-term condition that occurs when a person has great difficulty coping with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. Adjustment disorder is sometimes informally called "situational depression." The type of stress that can trigger an adjustment disorder/stress response syndrome varies depending on the person, but can include:

  • life transitions
  • relationship issues
  • losing or changing jobs
  • chronic pain or illness
  • having an accident
  • being a victim of a crime
  • retiring from a job
  • living through a disaster, such as a fire, flood, or hurricane

Schizophrenia Treatment

Schizophrenia is a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. Treatment is usually lifelong and often involves a combination of medications and psychotherapy. With strict adherence to medication, therapy, and social support, people can control their symptoms and lead meaningful, fulfilling lives. Understanding the illness, anticipating the triggers and risk factors for relapse, and figuring out what works for you will ensure a much better prognosis.

One of the most difficult issues to deal with is medication noncompliance. Not only with this population but with mental illness in general. The most common reason for noncompliance by patients with Schizophrenia is that they lack insight into their own illness. This incidentally is a symptom of the disease. Other reasons include, denial - they don't believe they have a problem or an illness, medication side effects, delusional beliefs about medication (they think it's poison), cognitive deficits, confusions, disorganized thinking, and fears of becoming addicted or dependent on the medication. Because medication is so important in controlling psychotic symptoms and improving insight, caregivers and loved ones must do everything they can to get the patient to take their medication regularly.

We can help. Psychological and social (psychosocial) interventions can help the patient manage their condition and their lives. Some of these include:

Individual therapy: Learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness. Regular sessions that focus on past or current problems, thoughts, feelings, or relationships will help the patient learn more about himself and be better able to differentiate between reality and delusions.

Used as an adjunct to a good medication plan, however, psychotherapy can help maintain the individual on their medication, learn needed social skills, and support the person’s weekly goals and activities in their community. This may include advice, reassurance, education, modeling, and limit setting. Encouragement in setting small goals and reaching them can often be helpful.

Social skills training: This focuses on improving communication and social interactions.

Family therapy: This provides support and education to families dealing with schizophrenia.

Most individuals with schizophrenia require some form of daily living support. Freedom In Choices offers programs to help people with schizophrenia with jobs, housing, self-help groups and crisis situations. A case manager or community based rehabilitation specialist on the treatment team can help find resources.

Consider our rehabilitation day program, peer support groups, Cognitive Behavioral Therapy and/or Group therapy as supplemental options to use in conjunction with medication.

What is Schizoaffective Disorder

Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and deregulated emotions. The diagnosis is made when the patient has features of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not strictly meet diagnostic criteria for either alone. The bipolar type is distinguished by symptoms of mania, hypomania, or mixed episode; the depressive type by symptoms of depression only. Common symptoms of the disorder include hallucinations, paranoid delusions, and disorganized speech and thinking.  

Signs and symptoms of schizoaffective disorder may include:

Delusions - having false, fixed beliefs

Hallucinations, such as hearing voices, seeing things

Major depressive episodes

Possible periods of manic mood or a sudden increase in energy and behavioral displays

Impaired occupational and social functioning

Problems with cleanliness and physical appearance

In addition to medication, Psychotherapy can help normalize thought patterns, teach social skills and reduce social isolation.

Psychotherapy and counseling - Building a trusting relationship in therapy can help people with schizoaffective disorder better understand their condition and feel hopeful about their future. Effective sessions focus on real-life plans, problems and relationships. New skills and behaviors specific to settings, such as the home or workplace, also may be introduced.

Group therapy - Treatment can be more effective when people with schizoaffective disorder are able to discuss their real-life problems with others. Supportive group settings can also help decrease social isolation and provide a reality check during periods of psychosis. 

Symptoms of Addiction:

All forms of addictions have some common symptoms, including;

Loss of Control. Addicts are unable to manage their behavior or their use of a substance. They may decide to quit the behavior or using the substance one day and then fall back into the habit the next day.

Tolerance. In most forms of addiction, a person needs more and more of the substance or behavior over time. A person may need only one "hit" of heroin a day in the early stages of addiction. Later he or she may need two, six, or a dozen "hits" to get the same response.

Impairment. Addicts often continue to use a substance or demonstrate a behavior even when they know the undesirable effects it may have. For example, a gambling addict may continue to wager money even though he or she has lost everything in previous gambling experiences.

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