Life sucks

What to Do When You Think Your Life Sucks? 

What to Do When You Think Your Life Sucks? 

 

Today, we are explaining how we help clients when they say “my life sucks”.

Life sucks is a common thing heard in sessions these days and clients often ask us “why does my life suck,” in hopes that they can shift their life around.

Life Sucks in a Pandemic

First off, we are living in a pandemic that has turned our world and our way of living upside down. 

That is a legit piece of why “life sucks” right now. 

As humans, we are wired to NEED connection. The pandemic has created shifts in how we get connection and the way we can access closeness with others. 

Additionally, the pandemic has increased loss globally. 

There has been a massive loss of life, health, connection to others, employment, and even privacy. This is because many are stuck in their homes with the same people for over a year now. 

Loss and grief have continued to become a more prominent part of our day-to-day lives, and that has certainly impacted why you may think your life sucks right now.

The pandemic has caused many of us to feel hopelessness, disconnected, under-resourced – emotionally, physically and financially – and fearful. These feelings have contributed to increased rates of depression, anxiety, and other mental health issues.

Lifes sucks

Taking a look at the above chart, we see mental health rates were on the incline for millennials prior to the pandemic hitting. Now, imagine a crisis where most providers are at capacity for taking new patients. 

Individuals are needing more and more certainty in their lives, because the pandemic has increased the amount of uncertainty in our households, communities, country, and world.

Creating Certainty in Uncertain Times

Outside of the pandemic, I encourage people to focus on what they can control and ways that they can create certainty. 

Although it is incredibly important to look at the contextual and systemic factors at play, it is vital for each to reflect on accountability and ways that you yourself are contributing to why your life sucks. 

It is critical to empower ourselves to address what we can change rather than focusing on what we cannot. 

Parts of the “suckage” are within our control and require us to focus on the things we can create certainty in – what we can control vs. what we cannot control. 

Similarly, taking a cue from the serenity prayer, individuals must recognize the difference of what they can and cannot change.

Many clients are working hard to find ways to empower themselves in what they can do to help create more certainty in their lives. 

Here are some strategies to consider: 

  • Acknowledge your feelings and recognize WHAT you are feeling. When we ignore our feelings, it does not help in the long run.
  • Notice your most common thoughts. If you are constantly thinking negatively or focusing on things you cannot control,you are depleting yourself of valuable energy..
  • Shift negative thoughts. To be clear, it is shifting the WAY or the PROCESS of the message or way that you are thinking, rather than DISMISSING those thoughts.
  • Take APPROPRIATE responsibility. . Recognize what piece of the circumstances are yours to own. I work with so many people who take on MORE responsibility than is appropriate and also have seen people deflect responsibility completely. RECOGNIZE the difference and be fair to yourself and to others.
  • Create something. For some, that is through building, painting, art, gardening, etc. For others, it is creating certainty and predictable structure (including meals or bedtimes). Create community or connection! When we focus on creating we are OPENING our mind to new possibilities and building ways for us to feel empowered.
  • Focus on that which is in your control.We can only control ourselves, our reactions, and the way we do things. You do not have control over the pandemic, your partner,and to some extent your kids, etc. When we focus on controlling things outside of ourselves it creates POWERLESSNESS, because we cannot control others. Focus on what you can do, which is empowering. 
  • Find the good, find the beauty, find the pleasure in your life. In our group practice, we share each day on a group chat something that brought us pleasure. For some it is about connection, others it is about love or sex. It can be something simple, or something huge, but whatever it is, sharing openly  has created a pleasure-centered culture in our practice of self care..

 

Instead of asking yourself why your life sucks, find ways to empower yourself. 

Find a voice and ways to connect. Also find ways to grow and ways to create. Find ways to love yourself and others. Find ways to build mastery. 

When you try to attend to your underlying needs, life sucks a little less each day. Does this solve all the suckage? No. Will it help if you are willing? Absolutely. 

LCAT can help you transform your problems and start experiencing a pleasure centered, self accountable, empowering life.

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do.

How to Deal With Loneliness

How to Deal With Loneliness

 

Many people ask how to deal with loneliness, especially during times of extreme stress and pandemics. 

Even though the number of people who experience loneliness is more than usual, we can all understand the feeling of being alone. 

Loneliness can cause emotional pain and affect people in many other ways by:

  • Affecting your physical health
  • Causing anxiety and depression
  • Leading to physical pain

 

How To Deal With Symptoms of Loneliness

Several studies support that loneliness does affect your general well-being. 

When loneliness and depression affect your emotional health, it is time to seek services. Studies show that the part of the brain that processes social exclusion is also responsible for processing physical pain. So, if you’re lonely, that part of the brain will react by causing physical pain.

Similarly, one study has shown that lonely people tend to suffer more from depression than others. They also tend to be less social and fear social interactions.

 

Signs of Loneliness

When a person is lonely, they may experience the following:

  • Mental health problems
  • Believing that no one cares about them
  • Withdrawing from those they care about
  • Reporting suicidal thoughts

Loneliness is a common issue right now, and many lonely people are looking for ways to connect to you and others online. 

 

How to Deal with Loneliness

1. Radical Acceptance that loneliness is a part of a pandemic

Accepting that loneliness is normal, and many people experience it. It doesn’t make it easier to deal with loneliness, yet it makes you normalize the experience instead of thinking you’re odd. 

About 40% of people admit to experiencing loneliness at some point in their lives. Similarly, anyone can experience loneliness, regardless of their social class, marital status, financial situation, or social cycle. You may even know a person with lots of friends and family, yet they still say they’re lonely. Honestly, loneliness is subjective so it’s important to remember you’re not the only lonely person in the world.

 

2. Join a Group

Joining any class or online group will help you meet people. Instead of avoiding, it’s important to lean into conversations with those whom you share common interests. 

It actually may help you develop a sense of belonging, thus improving your creativity and ability to innovate. 

 

3. Volunteer

You can also volunteer to be part of a cause you believe in. There are animal shelters and soup kitchens in Connecticut that are looking. That means other states and countries may have this opportunity too! By doing this, you can get satisfaction to live a healthy lifestyle.

For those who have never done it, offering a hand to those who need it does provide a sense of gratitude within you for contributing. 

 

4. Be Mindful Of Your Thoughts

Remember, loneliness can be a state of mind. Spending time alone is not a problem, yet if you drift into loneliness, it may become one. 

Be mindful of your thoughts when you’re alone and remind yourself that you’re more clever than what your inner critic may say. 

 

5. Practice self-kindness

When you’re feeling lonely and depressed due to challenges, practice self-love. Take care of yourself by taking a walk, having fun, dancing, moving your body in a way that feels joyous, or something else! 

 

6. Pay attention to what makes you lonely

If you do not pay attention, you may not discover the reason for your loneliness. Identify times of day that are more lonely and notice what leads to those moments. 

So, how you deal with loneliness is the opposite action! Find connection, support, and friendship from those online, and share any information in a journal so you feel like you can go through some of your thoughts. 

 

7. Strengthen Existing Relationships

Try to strengthen your relationship by calling or texting others more often and asking if you could send each other voice or video messages. 

 

If none of these work in dealing with loneliness, see a therapist

If you don’t get fulfillment from engaging in activities like your hobbies, you may decide to seek psychotherapy. Sometimes, overcoming loneliness doesn’t just happen; you need to put in the effort to make it work. 

If you find it challenging to overcome loneliness and depression after trying out the tips above, you may want to consider seeking advice from a psychotherapist. 

You can also seek the help of an online therapist, and they’ll be more than happy to help you out. 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

 

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do

 

Crippling Anxiety

Solutions for Dealing with Crippling Anxiety

Solutions for Dealing with Crippling Anxiety

Have you ever felt overwhelmed with heart palpitations, as if you were dying due to crippling anxiety?

If you’ve ever experienced nervousness with a shortness of breath, those may be signs of an anxiety disorder.

Anxiety is tricky, so if you know anyone who has it or think you are experiencing anxiety, look out for the following symptoms:

  • Aggressiveness
  • Isolation or social withdrawal
  • Agitation or irritability 
  • Insomnia
  • Suicidal thoughts
  • Substance abuse

The most common signs of anxiety are often seen by the one experiencing the anxiety.

So when someone tells you that they are struggling with anxiety, be compassionate. They aren’t asking for you to argue with them about it. Instead, they are wanting empathetic connection.

What Causes Anxiety?

As humans, we respond to everyday stressors through a somewhat automatic stimulus and response. This is from our evolutionary “monkey brain,” but our excessive worry leads to anxiety disorders.

So, anxiety is a mental health disorder ranging from nervousness to fear, and an anxiety disorder is used by a therapist to submit a bill to the insurance company. Unfortunately, if there is not a diagnosis, your insurance will not cover your therapy sessions.

If you didn’t know, anxiety comes in many forms of fear and worry within our daily lives. A quick overview for those of you who want to understand the “diagnosis” part. There are a few types of anxiety that are most common.

Some anxiety disorders include: 

  • Generalized Anxiety Disorder (GAD)
  • Social Anxiety
  • Obsessive Compulsive Disorder (OCD)

Have you ever heard of these? They are common and there are many videos on YouTube and TikTok made on the concept on how to solve these symptoms. In case you are curious about what these anxiety disorders are, here is a quick overview:

Generalized Anxiety Disorder (GAD)

A more common type of anxiety that LCAT sees often is GAD. Generalized anxiety disorder includes an irrational fear and excessive worry. Please take note if your anxiety results in sweating, shortness of breath, short-term memory loss, or dizziness.

Additionally, if you are having concentration and sleep problems., you may notice that anxiety is affecting your work life balance. Furthermore, those who report having GAD state issues within their interpersonal relationships, which may then lead to folks with social anxiety disorder.

Social Anxiety

Social anxiety is when a person has an intense fear of what others may say. This then leads to a negative effect on the person, as they will start to avoid social events. Think about those who had social anxiety, and then covid19 happened. With no more social events to attend, they could go right into their disordered behavior. Sometimes, in place of social events, a person with social anxiety will use habits and rituals to replace social connection.

Obsessive-Compulsive Disorder (OCD)

As noted, OCD is a type of anxiety that features irrational thoughts or fear that need managing. Instead of understanding the cause, a person with OCD may exhibit compulsive and repetitive behaviors that help them manage their fears. For those with OCD, nervousness is alleviated, yet they are not getting better yet. 

 

How to Treat and Recover from Crippling Anxiety

Listed above were just a few types of anxiety disorders, yet how you solve anxiety and recover is most important! The use of an anxiety treatment plan helps you have better control over your life. If you use a treatment plan with your therapist, it alleviates the crippling anxiety symptoms, instead of having more complications in the future.

So how do you get better from these anxiety symptoms and find your ability to cope? If what you have been doing isn’t appearing to work, create a new plan. Therefore, begin the search, as you may need new skills sets and quality care by a psychiatrist and/or a licensed therapist.

At our practice, Life Coaching and Therapy (LCAT), treating and recovering from anxiety is possible with evidence-based therapies.

Your treatment will be customized and based on previous treatment history and an assessment of you as a client. We will take special care of your needs when deciding which type of approach may work for you. 

Cognitive-Behavioral Therapy (CBT)

CBT is a highly effective treatment method for many anxiety disorders. It involves the use of several strategies that work together to determine the possible causes and triggers you may have. Skills involved in getting CBT for anxiety include:

  • Recognizing and changing the related actions and thoughts that may lead to nervousness
  • Learning coping skills for deciphering various levels of anxiety 
  • Restructuring to assist clients in cognitive thinking errors to increase new behavioral choices

Prolonged Exposure Therapy

Prolonged exposure therapy is one of the best treatment for trauma-related anxiety. Why? Because it allows an individual to discuss how their anxiety started and then slowly helps them work through it somatically. 

Additional Techniques

Additional techniques that are used with therapy can improve your results. Some of our favorite include, yet aren’t limited to: 

  • Hypnotherapy
  • Art therapy
  • Medication management
  • Yoga or massage therapy
  • Guided meditation
  • Deep breathing techniques
  • Mindfulness training

If you’ve been experiencing the signs of crippling anxiety and it’s affecting your daily life, speaking with a mental health professional becomes imperative. 

If you have any questions, learn more about our Text Therapy Program to help. Life Coaching and Therapy (LCAT) is a practice focusing on anxiety for teenagers and adults, and we transforms our clients lives through our flexible, multi-technique approach.

 

 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do

Therapy Cat

Is it Time to Get a Therapy Cat? Emotional Support and Fur!

Is it Time to Get a Therapy Cat? Emotional Support and Fur!

 

Therapy Cat

Many people require multiple types of strategies to soothe their soul, and a therapy cat or therapy animals are no different. 

Think of it as assistance for a basic need to help the owner feel connected in a way that helps them in their life, such as with completing daily tasks 

Some people cannot live independently without the services of people and specially service pets. 

Others can simply benefit from a visit with an animal that provides them with a sense of calm and relaxation. Therapy animals provide a special service to people that humans cannot quite understand.

Not to be confused with a service dog or an emotional support pet, a therapy cat or therapy animals are socialized and trained to provide comfort and affection to people in various stressful environments. 

Therapy animals, and specifically a therapy cat, are most commonly seen in hospitals, nursing homes, schools, and disaster areas.

When I worked at the Sandy Hook shooting, there were many therapy animals there – classified as one of three types:

  • therapeutic visitation animals
  • animal assisted therapy animals
  • facility therapy animals
The most common type is a therapeutic visitation animal.

These are the pets that get brought to a facility to spend time with a person who might be missing their own pet. Bringing a therapy cat or dog to a Nursing home can spread cheer to all get a visit from the lovely therapy cat or pet. 

Although most pets who visit these facilities end up going back home with their owners each night.

I know people, even some of those on our staff, who have had family go through cancer and major surgery to remove a tumor that could have killed them. During the recovery time, two therapy cats took to snuggling a staff member’s family more during those recovery weeks. 

Similarly, their family therapy dog may also have their fair share of keeping them comfortable and in good spirits. Therapy animals and family pets help manage throughout difficult processes. 

When someone is going through chemotherapy, therapy cats and therapy dogs seem to know. And they all find a spot near the one who needs them. 

I genuinely believe that therapy animals, can help keep adults positive, boost their moods, and provide loving pressure when closeby. 

Sometimes, it is easy to grow into depression during times like coronavirus and the winter. 

Instead of diving into a further depression, it is nice to reframe the typical doom and gloom of the short days.

If you are healthy enough to caretake another, it is an amazing surprise to have a pet that is smart, healthy, and trained so that they emotionally attend to their owners.

Visit https://dollfacepersiankittens.com/
Therapy Cat

Romeo

Therapy Cat

Snowbelle

Let me share a story about a recent time… it was coronavirus and depression has set in. Being kept away from those that we care about for this long can take a toll on anyone. I realized it was time to propose a therapy cat or two of my own.

When my purebred babies were finally able to come home, 1/31/2021, it was like a light lit up in my heart again. A part I forgot was in there. 

Although the process of having cats, and to train them as therapy cats, is not easy, it is encouraging to know that in all the highs and lows I will go through. That the therapy cats will be there for me.

Once they are trained and we are out of quarantine, I will have the option of having them in the therapeutic room.

Through the lonely nights and days, therapy cats will be there. So will a therapy dog, or small hore. Even if you do not have a trained therapy animal, simply having a pet who loves you day in and day out, and is ALWAYS happy to see you, is the most magical thing in life. 

Also, no matter how bad my day was or is, my therapy cat is there to help cheer me up. Even though winter depression, they can curl up next to me, purr, and everything seems to be better.

To have an animal who is trained and able to help is a blessing. 

If you cannot take your therapy cat or pet out with you in public, because they are not a service animal. Do not worry. 

There are certain benefits to having an emotional support pet and a therapy cat or animal. That is not the same as having a trained service animal. For those who have trained service animals, that animal is just for them. It is not for those around them to be comforted by. 

So please know if you see a therapy dog or “service animal” sign, leave that animal alone. They are not a pet, and they are working. 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do.

How To Become

How Do Therapists Become Therapists?

How Do Therapists Become Therapists?

 

I am often asked how to become a therapist and what path I took to become one. There are often a lot of assumptions surrounding the process and so I wanted to offer some insight for people who either want to become one, have a therapist, or just are generally curious. 

 

There are several different paths to accomplish this. First and foremost, you have to complete a bachelor’s degree and at least a masters and in some cases a doctorate. By and large, most therapists have a Master’s degree in some specific type of therapy or counseling. 

 

Therapists who Prescribe

 

Although not as common, therapists that prescribe are usually Psychiatrists (MD) or Advanced Practice Registered Nurse (APRN) or Psychiatric Nurse. Some of these practitioners may engage in some counseling, but often it seems that they work in conjunction with a therapist to help support a client/patient in the medication therapy. In order to be in either of these roles requires various certifications and training and/or medical school (in the case of the Psychiatrist). Obviously time to accomplish these certifications varies based on trajectory but can be anywhere from 3 to 8 years. 

 

Therapists who Conduct Assessments

 

Most therapists conduct some level of assessments in their practice. These can range from intake assessments and ongoing assessments to identify appropriate diagnosis and course of treatment for their clients. 

 

Psychologists (Masters or Doctor of Philosophy) and Doctors of Psychology (PsyD or PhD) often specialize in various areas of standardized assessments or testing. This can include things like neuropsychological exams, learning disabilities, mental status and cognitive testing, etc. Commonly we see these types of therapists or psychologists connected with universities, school systems, or medical facilities (hospitals, etc). 

 

Psychology is a broad field, but in terms of therapy we typically see a Masters, Psychology Doctorate, or Doctorate of Philosophy connected to Clinical Psychology. Clinical psychology focuses on treatment and assessment of emotional, mental, and behavioral disorders. In order to engage in this type of practice, you must complete a masters degree of usually 3 years or a doctoral degree of 4+ years. 

 

Therapists and Counselors

 

When we think of therapists we more commonly think of therapists who received Masters or Doctorate Degrees in Social Work (LCSW),  Marriage and Family Therapist (LMFT), Clinical Psychologists (PsyD or PhD) or Professional Counselors (LPC). Each of these specialities focus on providing clinical services, therapy, and counseling to their clients. Many of these therapists have different specializations and certifications to support their practice whether that is in substance abuse treatment, trauma treatment, sex therapy, couples therapy, etc. Although, each may have specialties, generally, each degree allows for therapists and counselors to be able to practice individual, group, or relational therapy in a clinical setting. In addition to case management and assessment. 

 

Below I have described the most common types of therapists noted above. 

 

  • Licensed Clinical Social Worker (LCSW) 

      • A LCSW is someone who has completed their Masters or Doctorate degree in Social work. A licensed clinical social worker focuses on the clinical aspects of social work rather than other concentration areas of community organization, case management, or other social work tracks. Simply completing a social work degree does not necessarily mean that they are therapists or clinicians
  • Licensed Marriage and Family Therapist (LMFT)

      • I am totally biased on this one because this is what my degree and specialization is in. A person who is a LMFT has a Master’s Degree in Marriage and Family Therapy or in a related area with a concentration in MFT. This training focuses specifically on relational therapy and systemic thinking. This degree is predominately clinical and is often connected to family therapy or couples therapy.
  • Licensed Professional Counselors (LPC)

      • A person who is an LPC may have a Master’s Degree in various fields (school counseling, general counseling, psychology, etc). LPC’s are trained in a variety of clinical practices depending on their base degree, but are predominantly clinical professionals. Often specializing in individual, group, and substance abuse treatments. 

 

These tracks vary in requirements, however on average Master’s Levels Programs take about three years to complete and an additional two years to become licensed. In addition to our degrees, licenses, and certifications we are also required to take a certain number of Continued Education (CE) courses each year to be sure we are remaining up to date with our clinical practice. This is not the case for all practitioners. 

 

Typical Requirements to be a Licensed Practitioner

 

Although this varies state to state and is also dependent on the type of clinical degree you have. Generally the following criteria has to be met: 

  • Completion of Masters or higher degree
    • Practicum (supervised clinical experience)
    • Internship (a clinical experience unpaid in the field)
    • Specific amount of clinical hours (sometimes specified by individual, group, relational, and/or case management)
    • Specific amount of supervision by licensed professional
    •  Usually somewhere around 50-60+ credits hours
    • Coursework in clinical, developmental, and theoretical models of treatment
    • Thesis or Capstone presentation on your therapeutic methods and/or research
  • Post graduate Clinical Hours (usually about a year or two of clinical or case management experience)
  • Post graduate supervision hours (supervised by a licensed clinical practitioner within your field)
  • Successful Completion of Exam (Licensure or Board Certification) with passing score

 

State Licensure

 

Each state has different requirements for licensure and are also dependent on the type of clinician/therapist you are. Some licenses are more transferable than others across states. It is important before getting licensed in specific state that you research what your state requires in way of credits from masters, hours, and Continuing Education Credits, etc (see above). 

 

In Connecticut, we pay $320 per year to maintain a license and need a specific amount of Continuing Education Credits (CEs) per year. There are also certain types of CE’s that we are required to have. For instance, in MFT we need to get a certain amount of CE’s surrounding veterans and diversity. 

 

Insurances

 

As with other medical providers, in order to accept insurances therapists have to be paneled with each specific insurance company. Each insurance company has its own contracted rate for each provider based on credentials and area of service. Credentialing with insurance companies can be time consuming and arduous for therapists. 

 

Therapists can choose to contract with different insurance companies based on their access to patients, reimbursement rates, etc. If therapists do not want to contract with a specific company, they do not have to. They are still able to work with clients with that insurance company but charge a private pay rate and the client can bill their insurance for full or partial reimbursement or bill towards their deductible if they have one.

 

Associations

 

In addition to licensure and insurances, therapists also usually associate with various associations which require their own benefits and memberships. These can be general based on educational/certifcation background or specializations such as sexuality, trauma, addiction, couples, etc. 

 

Some of the most common ones are:

 

There are also associations for people based on their specialities, some of these include: 

 

These are some examples above, however there are many that have more specifications and more general. Each association allows various benefits, resources, and membership requirements. As therapists, we maintain various certifications and associations to support having the most up to date information within the mental health field. 

 

Obviously this is a broad overview on how to become a practicing therapist and clinician. Basically, we do a lot of work to become therapists and maintain our abilities to practice clinically. 

 

If you need help finding a therapist for you, feel free to reach out and we are happy to help you here at LCAT! We are a staff of LPC, LCSW, and LMFT’s (now you know what these mean!). 

 

Learn more about CE for therapists – learn unique couples counseling and sex therapy methodologies to help you with your clients.

 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

 

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

 

 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

 

Learn more about how LCAT can help improve your life at What We Do

 

Do I have PTSD?

Do I Have PTSD? Behind the Scenes with Post-Traumatic Stress Disorder 

Do I Have PTSD? Behind the Scenes with Post-Traumatic Stress Disorder 

 

If you’ve experienced a traumatic event, or witnessed multiple trauma, you may ask yourself “do I have PTSD?” on the regular. 

 

If you feel you aren’t sleeping, having flashbacks, intrusive thoughts about trauma, and / or you wonder “do I have PTSD?” more than once a week, it would be good to see a therapist. 

 

Many people who have PTSD have had to deal with life-threatening situations like accidents, war, natural disaster, assault, sexual coercion, and / or any other event that gets stuck in the body triggers and responses. 

 

Generally, the fear and shock that comes with experiencing any of these events does fade over time. However, when you have PTSD, it gets replaced by constant flashbacks, shock, and fear… to name a few symptoms.

Do I have PTSD?

 

How to Answer “Do I have PTSD?” 

 

You can tell if you have PTSD when you notice the following:

  • You must have had a serious injury, sexual violence, near-death experience, been threatened with death, or experience rape. It could be a first-hand experience, or you might have witnessed a friend or family member go through such an experience.
  • You’re experiencing trauma in the form of nightmares, emotional distress, flashbacks, and other thoughts or symptoms that show when you’re thinking about the event.
  • You try as much as you can to avoid situations, thoughts, or feelings that will make you remember the trauma. For instance, if the event happened in a particular place, you try to avoid going to such a place.
  • You start having frequent negative thoughts or feelings that get worse by the day. You can not remember how the whole event unfolded, and you blame others or even yourself for the trauma even when you’re not at fault. Your favorite activities no longer interest you, and you feel lonely and alone.
  • Find it hard to see positivity in situations.
  • You become unreasonably angry and very irritable. You also engage in dangerous activities just to harm yourself or even have suicidal thoughts. Cannot enjoy sleeping like before, and staying focused becomes a problem. 

 

Treatment for Symptoms of PTSD

 

Psychology therapies and medication are the common treatments for Post-traumatic Stress Disorder. 

 

These methods are used because they help you come to terms with your feelings and seek professional help. There’s a treatment for PTSD regardless of how long you’ve been suffering from it so it’s not too late!

 

Before a professional recommends any type of treatment for PTSD, you will have to go through the assessment and watchful waiting process.

 

  • Assessment: Your doctor or a mental health professional will carry out a thorough assessment of your symptoms and the right treatment will be recommended. After that, you will meet a mental specialist for more assessment and treatments if your symptoms are severe or you’ve been experiencing it for over four weeks.
  • Watchful waiting: Your psychiatrist or APRN may recommend watchful waiting if you’ve only been experiencing the symptoms in less than four weeks. The process involves careful monitoring of your symptoms to know if it will improve or become worse. You will likely then be asked to do a follow-up appointment within 90 days. 

 

Psychological Therapies

 

If your PTSD will require treatment, the first treatment that your doctor or professional will recommend is the psychological therapies. If it’s a severe or persistent case of PTSD, a medication will be recommended alongside the psychological therapies.

Do I have PTSD?

 

Three types of psychological therapies used in treating people with PTSD include:

 

  • Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
    • It helps you deal with PTSD by helping you to change your thinking and how you act. 
    • For example, your therapist can help you face your fear and change what you think about what happened. You might have been blaming yourself for something that wasn’t your fault, and your therapist will help you see that.
    • Your therapist will also encourage you to start doing the things you’ve avoided since you had the traumatic experience. 
    • For instance, driving (if you’ve had a car accident), or other things you’ve avoided depending on your experience. The general period for Tf-CBT may be between 12 weeks or more. 
    • Each session usually lasts for 53-60 minutes.

 

  • Eye movement desensitization and reprocessing (EMDR)
    • This is a new treatment for PTSD that involves tracing your therapists’ finger by making side to side eye movement while remembering the traumatic incident. Also, therapists use theratappers, the light bar, or butterfly hugs and taps to get through. 
    • This method has been proven to reduce PTSD symptoms. It is a long and methodical process with amazing outcomes. Seek an https://www.emdria.org/ specialist today. 

 

  • Group Therapy for PTSD
    • Group therapy has shown to be helpful as people can easily speak about their experiences with other people regarding their PTSD symptoms. 
    • It can help you understand your condition better and find ways of managing it. 
    • Many charity organizations provide counseling and support to people with PTSD

 

If You Answered Yes to “Do I have PTSD?” Consider Medication 

 

Medications are recommended in severe cases or when psychology therapies seem not to work.

  • You can choose medication if you do not want to undergo the psychological therapies or if it hasn’t been effective.
  • If you also have an underlying condition like depression, you may not get the needed results from psychological treatment.
  • Medication is usually used for a minimum of one year before it will be gradually withdrawn. 
  • Your doctor will inform you of the possible side effects of taking any medication, and they’ll let you know if you have to continue or stop it at a point if the symptoms reduce or when there’s no improvement.

 

Why Treating PTSD is Important

 

Many people that leave PTSD untreated do so because of many reasons:

  • They may not be aware that they have the condition.
  • They may feel it’s a temporary feeling that will wear off with time.
  • They may be scared of undergoing the treatment due to the fear of their traumatic experience.
  • They may fear being labeled with a “mental health diagnosis” 

 

PTSD affects people of all ages, including in vitro babies whose parents are under constant emotional stress during pregnancy.

 

PTSD can have devastating effects on those who have it and the people around them. 

 

It affects the relationship with your friends, family, and people around you. If you have asked yourself “do I have PTSD?” chances are that you can seek an intake appointment with a therapist. 

 

Don’t suffer any longer, as PTSD can also lead to severe emotional problems and health issues that may arise over time. Seek assistance today. 

 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

 

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

 

Learn more about how LCAT can help improve your life at What We Do

 

Winter Depression

Winter Depression During a Pandemic

Winter Depression During a Pandemic

 

For some people, winter weather seems like a magical scene out of a movie. Yet for others winter depression is a hard reality of the chilly season. 

 

When choosing where to settle down in life and deciding what place to call home, many factors come into play when picking a location.

 

For some living in an area of the country where it gets darker earlier in the day and the slushy, gloomy days seem to last forever is not ideal.  

 

Some though want to be able to experience all four seasons throughout the year, and winter depression comes with the regions.

 

Winter depression is also known as Seasonal Affective Disorder (SAD), which is how one is affected by light or lack thereof. 

 

Many studies have shown that people with seasonal affective disorder feel better after exposure to bright light. 

 

It seems simple enough: in higher latitudes, winter days are shorter, so you get less exposure to sunlight. Replace lost sunlight with bright artificial light, and your mood improves. 

 

Yet it’s actually far more complex. It’s not only a matter of getting light; it is about the right time too. The most important time to get light is in the morning, supposedly. 

Winter Depression

Some symptoms of Winter Depression but are not limited to:

  • Fatigue
  • Depression
  • Hopelessness
  • Social Withdrawal 

 

While some days seem better being that the sun is shining, the chilly fatigue can set in at any point in the day. Sometimes being awake for a short period of time is a struggle and your body just wants to rest. 

 

For some individuals with autoimmune diseases fatigue only seems to intensify during the winter months. Rheumatoid Arthritis is just one example where the winter months seem to cause more pain and fatigue for the clients that we serve. 

 

The more pain you feel the more fatigue you get being your body is over working to get through the day. When one bad day precedes the next, it might feel like a vicious cycle to get ahead of the tiredness and starting each day more tired than the next gets old.

 

Depression is something which can affect an individual throughout the year, regardless of the season. Many report that it intensifies to a winter depression in the colder months. Sunlight can do a world of wonders to the human body. The gloomy weather can affect a person’s mood from day to day. 

 

One might be more active one day due to the sun being out, and the next cloudy day could cause an individual to withdraw from wanting to do anything other than stay in bed. Hopelessness plays into depression, and one can lose faith things will get better. 

 

Seasonal Depression

Personally, it seems the colder the temperature gets and the earlier in the day the sun sets, some of my high motivation can get lost. I might have great plans to accomplish something after work. Yet by the time I get home, I may lose my excess energy. 

 

I am tender with myself, and I do not crawl into bed before 8pm, no matter how tired. Also I will not stay in bed past 11am ever. Sometimes, this can be a vicious cycle of going to bed early and waking up late. 

 

Social withdrawal is another battle in itself during the winter let alone during a pandemic. 

 

We have been cooped up for months on end and when we eventually go out for a night, we just want to retreat to the house. Sometimes, we do not want to deal with the conversations of people we meet or just not feeling up to socializing. 

 

Most nights even maintaining relationships via phone or texting can seem to be a struggle, especially while in a winter depression episode. 

 

Even though there are plenty of hours in a day to reach out, it seems like it is a huge burden or like climbing a mountain some nights to pick up the phone and check in on someone.

 

One thing that I have learned is that winter depression does not affect everyone the same. 

 

Some have mild cases where they can still carry on with day-to-day activities, where others need to seek extra therapy. There is no right or wrong answer to how to cope with winter depression. 

 

I prefer to give myself one day to relax or simply “do nothing” for others. Whether I read a book, spend all day in bed on a Sunday, or decide to order take in on a weeknight, self-care is important to stay healthy. 

winter depression

 

What methods do you prefer: 

  • Running? 
  • Going for a walk? 
  • Seeing your favorite therapist weekly? 
  • Doing a puzzle?
  • Moving your body?

 

Winter can be beautiful in many aspects. Just make sure that you seek help if your winter depression consumes you. If you feel it is too much, remember you are not alone.  

 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

 

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

 

Learn more about how LCAT can help improve your life at What We Do.

What is Seasonal Depression?

What is Seasonal Depression?

 

Seasonal depression, officially known as Seasonal Affective Disorder or SAD, is a kind of depression that happens when the seasons change. Usually, this happens during fall or winter and tends to be the same time of year consistently for each patient.

Seasonal depression can make it difficult to complete work, take exams, or feel like you are living your life with energy and purpose.

 

Symptoms

It is important to note that a lot of the symptoms for seasonal depression are similar to the symptoms of depression in general, with a distinctive difference: the depressive episode appears and disappears around the same time each year. Major depression’s symptoms will not appear and disappear according to a seasonal schedule or seasonal factors, though it may be amplified due to certain seasonal factors at times.

The symptoms for seasonal depression can include:

  •   Feeling sad, despairing for a period of more than two weeks
  •   Impedes your ability to function properly at work, school or in relationships
  •   Losing/gaining weight
  •   Insomnia/irregular sleep
  •   Low self esteem
  •   Fatigue
  •   Pessimism
  •   Irritability
  •   Hopelessness
  •   Feeling slowed down
  •   Feeling agitated
  •   Memory problems
  •   Difficulty Concentrating
  •   Crying without concrete reason (or feeling like you want to but can’t)
  •   Excessive guilt
  •   Loss of interest in work, hobbies
  •   Loss of libido
  •   Hallucinations or strange ideas (delusions)

If you are experiencing thoughts of suicide or self harm, it is important to find help right away. Either go to the hospital or call the National Suicide Prevention Hotline at 1-800-273- TALK(8255).

You may find that you experience a handful of these symptoms on occasion: this is normal! We all feel sad, uncertain and exhausted at times. What makes these symptoms a sign of seasonal depression is when it is ongoing for two or more weeks and seems to appear the same time of year or with the changing of the seasons.

 

Who Can Get Seasonal Depression?

Anyone can get seasonal depression, regardless of gender, race or social class, however some factors may increase your risk of seasonal depression.

Risk factors include:

  •   Being female/AFAB. Women are far more likely to be diagnosed with seasonal depression, though it is unclear if this is due to biological factors, social factors or both.
  •   Seasonal depression is more common amongst people who live either far north or far south of the equator, where the seasonal changes are most drastic.
  •   The younger you are, the more at risk you are for seasonal depression. Thankfully, the risk decreases with age.
  •   A family history of seasonal depression may increase your chances of experiencing seasonal depression yourself.

 

What Causes Seasonal Depression?

There is still some mystery surrounding depression in general as well as seasonal depression. Some prevailing theories believe that seasonal depression is triggered by the changes in daylight that occur with the changing of the seasons, particularly in the fall and winter when daylight hours are significantly reduced.

The thought is that the amount of daylight affects your biological clock, your circadian rhythm, and therefore disrupts your sleeping and waking patterns. It is also possible that the change in light affects your neurotransmitter functions.

Neurotransmitters like dopamine and serotonin are chemical signals that send messages from a nerve cell to a target cell to accomplish specific functions. For example, serotonin regulates functions like sleep, learning, appetite, and mood and may play a part in depression. This is of course a simplification for the purposes of this article, just know that certain neurological functions can be deeply affected by either too much or too little of specific neurotransmitters.

While we may not fully understand what causes seasonal depression (yet!), there are many treatments available with the help of a therapist, self care and perhaps even medication.

 

How Your Therapist Can Help

A therapist can help you find ways to cope with your seasonal depression by giving you techniques and tricks to break negative thought patterns, identify issues and learn to cope with your symptoms. Many find that talk therapy can help them eliminate symptoms altogether.  

Booking an appointment with a therapist is a great way to start your journey to feeling better. You don’t need to suffer alone or feel like your problem is unimportant, there is always something that can be done and your therapist can help you create an action plan.

If your symptoms are debilitating and severe, a psychiatrist can determine if medication is a good way to treat your seasonal depression.

 

What You Can Do

In addition to talking with a therapist, there are some things you can do that may help ease your symptoms.

  •   Light therapy. There are many lamps on the market that are created to help people with seasonal depression get more light exposure. It mimics daylight, and typically you use the light for 30 minutes to a couple hours during the day. Many people find this relieves their symptoms or improves their quality of life.
  •   Exercise can be a great way to increase circulation, get a boost of energy and get more light exposure if you choose to exercise outdoors.
  •   Meditation. Simple mind meditations can help you identify your feelings and better cope with the ebb and flow of emotions that can feel debilitating at times. Learning to acknowledge feelings without feeling victim to them can help with depression and anxiety.
  •   Try to cover the basics and celebrate small victories. Do whatever you can to ensure you have meals, maintain hygiene, and get to bed at a decent time. Covering your basic needs is a huge accomplishment when you are suffering from seasonal depression. So, be kind to yourself and celebrate small victories. Honestly, a therapist can help you create an action plan if needed.

It is also important (and easier said than done) to try and maintain some sort of social connection. This can be done by a simple phone call, texting, or a video chat if you can’t or don’t feel like leaving home.

Seasonal depression is nothing to be ashamed of, especially if you are in one of the high risk groups mentioned above. Book an appointment with a therapist to increase your quality of life during the cold, dreary months.

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do

PTSD for Nurses and Doctors

Systemic Impact of Coronavirus – PTSD for Nurses and Doctors

Systemic Impact of Coronavirus – PTSD for Nurses and Doctors

 

Covid-19 has wreaked havoc in our medical system. And the systemic effect of PTSD for nurses and doctors is being overlooked. 

In addition to the “normal” exposure of trauma that first responders “sign up for,”. We must consider that since the pandemic began, first responders have witnessed more loss, fear, and / or vicarious trauma than they have ever prepared for in their training. 

For those of you who live with and love doctors, nurses, CNAs, mental health workers, military, firefighters, EMS workers, etc. We thank you for being here to gather information on how to support the ones you love.   

 

What does Trauma Look Like for First Responders: 

I work with many people in the medical field (as do my colleagues) who are responding to the COVID-19 pandemic. One of the things I focus on in my practice is trauma – and it is really clear to me that this population is undergoing trauma.

  • lack of self care
  • hypervigilance (on edge, jumpy)
  • irritable
  • constantly tired
  • perseverating or not being able to let something go 
  • depression
  • anger
  • responses that appear more intense (something is mild and it is seen as highly stressful)
  • not engaging in taking care of basic needs
  • sleep issues (too much or too little)

 

The Trauma of Treating in the Age of COVID-19

Some of my clients do not see their families due to safety concerns. Some have watched patients dying and needing to sit with them as their families are not able to be with them, being inundated with cases without support, resources, and enough gear. 

One of the biggest struggles I have heard from my clients is the level of uncertainty experienced when this pandemic hit. 

Various medical professionals were scared of transmitting the illness and having more suffer the same fate of many. Seeing the lack of resources (beds, PPE, equipment, and information) lead to high levels of uncertainty and fear resulting in many medical professionals experiencing high levels of trauma.

As the statistics reduced in New York and Connecticut, and its surrounding areas, many first responders finally began to feel the up tick in stress.

When someone is going through trauma and in survival mode, it can be VERY difficult to be able to notice the level of stress. This pandemic and the impact on the medical field is an example of this because it is a chronic trauma. 

 

How Can We All Help?

As we begin to see the numbers climbing again, I imagine our medical field will be re-traumatized. If you are a medical professional, first responder, or love someone who is here are some ways to consider supporting them:

  • Allow time to vent
  • Complete acts of service for the first responders (bringing them food or something to drink, running errands, etc)
  • Meditate 
  • Reduce stimulation at home
  • Focus on basic needs such as sleep, eating, and hydration
  • Hold compassion for the first responders
  • Focus on recharging and building a set of tools and resources to help
  • Try to be flexible and adaptive to allow your love one to check in with themselves and their needs
  • Ask for what you need and/or how you can support them
  • Do not bombard them with lots of information, try to slow things down 
  • Take care of yourselves!

These skills are important for everyone because if you are a first responder and experiencing trauma these tips will be useful for you. For those of you who support first responders, you are at risk of “vicarious” trauma or “secondary” trauma from hearing stories or experiences from your loved one. 

Please make sure you take care of yourself, knowing your limits, and communicating. Many client are seeking our support at LCAT to help learn ways to cope through this time. 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do

Why Am I Depressed?

Why Am I Depressed?

Why Am I Depressed?

 

If you have been asking yourself “why am I depressed?” you should know that with all of the curveballs 2020 has thrown at us, you are definitely not alone! 

When you ask yourself “why am I depressed?”, that is a strong sign that it is time to seek professional help from a therapist. Luckily, telehealth therapy during COVID19 has made access to counseling easier for individuals who need it. 

Don’t blame yourself if you are feeling depressed: you are not lazy, you are not a failure, and there is nothing “broken” about you that can’t be rebuilt. Let’s take a look at some reasons why you might be feeling depressed. 

 

The Pandemic

The pandemic has been a trigger for many circumstances that can cause depression. 

  • Isolation: if you are unable to see anyone in your social circle or family because they do not live with you, this quarantine will have been especially difficult. Feeling isolated from those you love can increase feelings of depression, and can make you feel far away from any support systems you had in place. 
  • The death toll: the COVID19 virus has resulted in a huge loss of life, and it is a sobering and depressing thought. Grief, fear, pessimism and rage may be some of the feelings you are experiencing around the sheer numbers of those affected by the virus. 
  • The nature of the news cycle: while it is important to stay informed, the news cycle can wreak havoc on your mental health. The constant changes, the bombardment of bad news and zero focus on positive stories can paint a bleak picture and make you feel hopeless. 
  • Losing your job: many businesses large and small have had to furlough their workforce or lay them off, or they’ve gone out of business entirely. If you have lost your job, you aren’t just losing income, you are potentially losing security, opportunities, plans and feel like your ability to survive and provide is at risk. You may also feel unimportant if you were laid off and other staff weren’t, or like your sense of self is pretty shaky when you aren’t working. 
  • Losing a loved one: grief is a natural response to the death of a loved one, and the circumstances around deaths by any cause during the pandemic have made it difficult to have closure. The inability to mourn with loved ones or pay respects at funerals or the inability to hold your loved one’s hand as they pass can be difficult to process. 
  • Cancelling plans: if you had a wedding, event or special trip that was meaningful it can be devastating to cancel plans. Non refundable deposits or constant rescheduling can make you feel stressed and depressed.Why Am I Depressed?

 

Physical Factors 

If you have been ill it can be a trigger for depression, either physically or due to having a new, foreign relationship with your body and its limitations. 

If you have gained or lost weight you may be feeling depressed based on how you perceive yourself and how your body has changed in quarantine. 

There are hormonal and neurochemical factors that can trigger depression in some individuals. These factors can be controlled with medication and therapy, so it is important to seek help if you are feeling off. 

 

World Events

On top of the immediate effects of the pandemic, there have been many world events that may make you feel depressed. 

  • Racial injustice: feeling like your life doesn’t have value because of the color of your skin or feeling helpless to change the injustices of the world. Viewing disturbing footage of violence, protests and riots, wanting to attend protests but can’t for health reasons. Feeling guilty about past or present actions.  
  • The election: no matter which party you plan to vote for, the constant rhetoric and worries about trying to get your vote counted and in on time can be overwhelming. Feeling like the world hangs in the balance if your candidate does or does not get elected or re-elected, or even just having arguments with family about politics can leave you feeling isolated, frustrated and sad. 
  • International tensions: China, Russia, Iran, sanctions, threats, Armenia, the explosions in Beirut, the mass shooting in Canada, the violence happening in Nigeria- the world has been a very busy place and it is easy to feel helpless. Why Am I Depressed?

 

What Should I Do?

It can be tempting to try to battle depression on your own and without outside intervention, however you deserve to have guidance and support! 

If you are feeling depressed to the point of suicidal, the National Suicide Prevention Lifeline can put you in touch with someone immediately by calling 1-800-273-8255, or go to your nearest hospital emergency room. 

If you are feeling depressed and you are not in immediate danger, book an appointment with a therapist. They can assess you and help you create a plan to tackle depression, and can refer you to other mental health professionals if needed. Finding a therapist is more convenient and accessible than ever as most are offering telehealth options. You can even find a therapist outside of your own state! 

By asking yourself “why am I depressed?” you have already taken an important first step, so take some time to care for yourself and open up to a loved one and a professional. 

If you have any questions, or for clients hoping to take their intimate lives to the next level through personalized sessions on YOUR terms, learn more about our Text Therapy Program.

Life Coaching and Therapy (LCAT) is a relationship coaching and sex therapy practice that transforms our clients lives through our flexible, multi-technique approach and pleasure-skills training provided by systemically-trained and licensed therapists! 

Our team of compassionate, licensed therapists and certified sex therapists help Millennials and Baby Boomers alike who visit us for a variety of relationship, intimacy and sex problems. 

LCAT provides on-site appointments, as well as video chat and text therapy programs. 

Learn more about how LCAT can help improve your life at What We Do

Call us at 203-733-9600 and press 0 to leave a message, or make an appointment.