Welcoming in April: Carmen Avendano, MA, LMFT

Carmen has fifteen years of experience as a Mental Health Professional, twenty-five years of experience as a cross-cultural trainer and over thirty years of experience as a teacher, including the past ten years as an assistant professor for Counseling Psychology, Health and Human Services, and Marriage & Family Therapy graduate programs at St. Mary’s University of Minnesota.

Carmen is passionate about helping her clients achieve their goals and finding effective ways to deal with life’s challenges. It is her goal to help clients heal, achieve their fullest potential, have mutually supportive relationships and improve their overall well being. Carmen offers client centered care and understands the power of diversity, equity, and inclusion. 

Welcoming in May: Austin Koester

Austin (He / Him) joins us from Saint Mary’s Master’s in Counseling and Psychological Services Program. He is working on becoming a Licensed Professional Clinical Counselor (LPCC). Austin received a Bachelor’s degree in Psychology from St. John’s University. Currently, Austin works at St. David’s Center for Child and Family Development where he helps to facilitate positive interactions and promote the social development of his clients.

Austin was drawn to the helping profession through his personal experiences and a deep desire to understand emotional processes and healing. He has a passion for emotional healing that improves relationships and the overall quality of daily experiences for each individual and their family.

 Austin enjoys working with teens and adults from all walks of life who are experiencing low self-esteem, anxiety, low mood, substance use challenges, and trauma-related symptoms. His goal is to serve others and make a difference as he assists in navigating the life challenges clients may face and aid them in finding wholeness for themselves and in their relationships.

 Austin believes that therapy, in part, is taking time to learn “why do I feel the way I feel, and what can I do to change how I feel.”  He deems therapy a forward-looking process of what can be done now in order to be more effective in our lives and relationships. His commitment is to have a safe and trusting relationship without judgment and for you to feel heard, understood, and respected. He’s driven by making sure you’re okay, you got what you need, and you are growing into a better version of yourself. He incorporates several approaches to his person-centered counseling, including cognitive behavioral therapy, acceptance, commitment therapy, and solution-focused therapy.

 In his free time Austin enjoys playing music, reading, running, and spending time with family and friends.

Announcing Men's Support Group: Swinging from Birches

We are pleased to announce the beginnings of a new support group, which will be facilitated by Birch Counseling provider Brian Rose, MA, LADC. This group is welcoming men who are facing questions about substance use as well as other pertinent life problems. The group will be held on Monday evenings, 5:00 - 6:30pm at our Hopkins location (904 Mainstreet, #200). If you are interested in becoming a member, please contact our front office at (866) 522-2472, ext. 0. They will be happy to schedule a pre-admission meeting with Brian, who will make sure you are a good fit for the group. This men’s group will be limited to a maximum of 8 active members.

Below is Brian Rose’s description of the group:

The pandemic has been tough. It has broken our connection with many sources of support and the routines that anchored us. This group’s purpose is to connect with other men for support to help answer questions about issues that have arisen in our lives, such as questions about substance use, interpersonal relationships, as well as anxiety and depression. While such issues may have predated the pandemic , the isolation of the lock-downs has made these concerns more visible and pressing for many.

Some of the topics discussed in this group will cover substance use, improving communication in our relationships, repairing connections with friends and family, coping with symptoms of anxiety and depression, and the facing lonliness that has increased with isolation. This will be a process group with a strong focus on learning to connect and trust others.

The group will meet Mondays, from 5:00pm to 6:30pm, in person. 

Birches

Poem by Robert frost

When I see birches bend to left and right
Across the lines of straighter darker trees,
I like to think some boy's been swinging them.
But swinging doesn't bend them down to stay
As ice-storms do. Often you must have seen them
Loaded with ice a sunny winter morning
After a rain. They click upon themselves
As the breeze rises, and turn many-colored
As the stir cracks and crazes their enamel
Soon the sun's warmth makes them shed crystal shells
Shattering and avalanching on the snow-crust —
Such heaps of broken glass to sweep away
You'd think the inner dome of heaven had fallen.
They are dragged to the withered bracken by the load,
And they seem not to break; though once they are bowed
So low for long, they never right themselves:
You may see their trunks arching in the woods
Years afterwards, trailing their leaves on the ground
Like girls on hands and knees that throw their hair
Before them over their heads to dry in the sun.
But I was going to say when Truth broke in
With all her matter-of-fact about the ice-storm
I should prefer to have some boy bend them
As he went out and in to fetch the cows —
Some boy too far from town to learn baseball,
Whose only play was what he found himself,
Summer or winter, and could play alone.
One by one he subdued his father's trees
By riding them down over and over again
Until he took the stiffness out of them,
And not one but hung limp, not one was left
For him to conquer. He learned all there was
To learn about not launching out too soon
And so not carrying the tree away
Clear to the ground. He always kept his poise
To the top branches, climbing carefully
With the same pains you use to fill a cup
Up to the brim, and even above the brim.
Then he flung outward, feet first, with a swish,
Kicking his way down through the air to the ground.
So was I once myself a swinger of birches.
And so I dream of going back to be.
It's when I'm weary of considerations,
And life is too much like a pathless wood
Where your face burns and tickles with the cobwebs
Broken across it, and one eye is weeping
From a twig's having my lashed opened.
I'd like to get away from earth awhile
And then come back to it and begin over.
May no fate willfully misunderstand me
And half grant what I wish and snatch me away
Not to return. Earth's the right place for love:
I don't know where it's likely to go better.
I'd like to go by climbing a birch tree,
And climb black branches up a snow-white trunk
Toward heaven, till the tree could bear no more,
But dipped its top and set me down again.
That would be good both going and coming back.
One could do worse than be a swinger of birches.

Joining us July 1: Laura Linner, MA, LICSW

Laura (she/her) genuinely loves this work and brings authenticity, hope and humor to sessions with individuals and families. She considers it an honor to have the opportunity to walk alongside others in recognizing, accessing, and developing their own resiliency, and in building a rich, full and meaningful life (as they define it!). Laura is mindful of creating a non-judgmental, anti-oppressive, anti-racist, LGBTQIA-affirming space for the clients with whom she works. She views therapy as a collaborative process and values feedback from clients.

Laura’s foundational clinical training is in non-directive Rogerian client-centered therapy from her time as a clinical intern then post-graduate psychotherapy fellow in a group practice in Chicago. This humanistic approach continues to serve as the clinical underpinning of her work with clients. That being said, Laura takes an eclectic approach and aligns with concepts of clinical pragmatism – offering and using what therapeutic intervention works - tailored to each individual. Laura sees therapy as an opportunity to pause, reflect, and take an inventory of how our lives are going, identify what’s working and what isn’t, and make effective change in moving closer to the life we hope for ourselves. Laura brings an attitude of openness, curiosity and compassion with clients. She has benefitted greatly from her own therapy over the years and strives to provide a similarly beneficial experience to those with whom she has the honor of working with.

Laura is trained in, integrates, and draws from a number of therapeutic approaches including Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, trauma-informed therapy (TF-ACT and TF-CBT), CBT for psychosis (CBT-p), ACT for psychosis, psychodynamic theory, polyvagal theory, motivational interviewing, harm-reduction, and also employs a neuroscientific lens to reinforce concepts of regulation, zones of optimal functioning and neuroplasticity/opportunity for growth and change. Laura is also trained in child-centered play therapy from when she worked with youth impacted by domestic violence.

Laura completed her graduate degree in clinical social work at The University of Chicago’s School of Social Service Administration. For the past four years, Laura has worked for the University of Minnesota Department of Psychiatry as an individual and family therapist specializing in first-episode psychosis and schizophrenia spectrum disorders. She has a passion for working with individuals and families in processing new diagnoses and identifying ways of being that work for all who are impacted in their own unique ways. Prior to this, Laura has experience providing therapy and support to individuals in life transitions, relationship challenges, identity exploration and development, finding a sense of meaning and purpose, working through grief and loss, coping with the impact of domestic violence and trauma, and effectively coping with life stressors. She has also worked both internationally and stateside in violence recovery services and human rights work. Diagnostically, Laura has experience working with individuals who have been diagnosed with anxiety, depression, PTSD, OCD, disordered eating, substance use disorders, mood disorders, dissociative disorders, and schizophrenia spectrum disorders.

Laura believes an individual is not their diagnosis, and joins alongside clients to explore meaning of diagnosis in a way that is adaptive and feels authentic to them.

Laura believes life and humans can be messy, confusing, amazing, doubtful, inspired, worried, scared, brave, determined, hopeless, hopeful and many more things all at the same time. Laura is inspired by people’s willingness and ability to move into discomfort, try new ways of being and make change in ways that feel valuable to them, and she is grateful for being able to provide support along the way.

When Laura isn’t working she enjoys reading, spending time with family and friends, snuggling her two cats, needlepointing, watching cooking shows, trying to learn to cook herself, playing outside and learning.

Welcoming in April: Katie O'Dowd, MA

Katie O’Dowd (she/her)

Katie enjoys working with adults, older adolescent populations, and has a particular affinity for clients that are emerging adults (“20-something”s), college students, and graduate students. She strives to create a therapy space that is non-judgemental, culturally responsive, anti-oppressive, anti-racist, LGBTQIA+ affirming, and sex positive. Katie has experience working with clients in addressing relationship challenges, family concerns, life transitions, identity exploration, academic and career concerns, perfectionism, body image/body acceptance, anxiety, depression, trauma, existential concerns, and self-compassion. 

Katie believes that everyone comes to therapy with different hopes for and expectations of the experience, and wants to work with her clients to create an experience that feels right for them. Katie uses a person-centered, interpersonal, and psychodynamic approach to therapy, while remaining adaptive to the unique needs of each individual client. She finds it important to examine and gain insight into the impact that relationships, past experiences, societal expectations, and other factors have had on us, so that we are better able to work through present day concerns. She draws from multiple different approaches to help you gain insight into your experiences, see your strengths, build your skills, support you in the tough moments, celebrate your wins, and hopefully laugh a bit along the way too.  

Katie graduated from the University of Minnesota - Twin Cities with her Bachelors degree in Psychology and Masters degree in Counseling and Student Personnel Psychology. She is currently pursuing licensure as a Licensed Professional Clinical Counselor. Outside of the office, she enjoys spending time with family and friends, exploring Minneapolis, traveling, cooking, hiking, playing cribbage, learning how to crochet, and tending to her many house plants.

Welcoming in September: Alison Campbell, MSW, LICSW

We are very excited to announce the newest addition to the Birch Counseling Team: Alison Campbell, MSW, LICSW!

Alison enjoys working with both adult individuals and couples across the lifespan from all walks of life. She uses a holistic, mind-body perspective and recognizes that a wide range of past and present influences effect both our individual well being and our relationships. With a collaborative, kind and practical approach, Alison helps people explore patterns that may not be serving them and offers guidance and tools for better coping, balance and resiliency so that they can feel more empowered to make the changes they desire. She uses a strengths based, person centered approach with evidence based practices informed by a blend of frameworks. She has had extensive training in mindfulness and somatic practices.

Alison has experience addressing depression, anxiety, stress reduction, trauma, health issues, substance use, relationship difficulties, grief and loss and personal growth. She has lived on both coasts of the US and has worked with people in a variety of settings including low-come housing, correctional facilities, long term care facilities and hospice and community counseling centers. She received her Master’s degree in Social Work from Washington University in St Louis.

Alison has two children, enjoys good books, good cooking, meeting new people and being in the outdoors. She is also a certified yoga teacher.

Spotlight with Brian Borre: Metacognitive Therapy

Before we get into theory, or how this approach might apply to you, let’s take a detour into language. When used as a prefix in the English language, “meta-”, stemming from the Greek for “after” or “beyond”, means something that goes beyond, to be all-encompassing, or become transcendent. When “Meta” and “Cognitive” are put together, the result essentially means “thinking about thinking.” For example, have you ever had an experience where you’re certain you know the name of something--a person, product, or place--but you can’t recall it? This “tip of the tongue” experience is just one example of how metacognitions work to inform our everyday lives--we’re thinking about how we’re thinking. While most of our meta-processes aren’t so conscious, our metacognitions are in the background actively controlling and influencing our conscious experience of the world, 

Metacognitive Therapy (MCT) focuses on targeting and modifying our deeply held beliefs--the thinking about our thinking--that fosters states of perpetual worry, rumination, and/or fixation. For example, if you say to yourself, “worrying about this keeps me safe,” or “I have no control over my thoughts,” you are both observing your own thinkingand having thoughts about thinking. The goal of MCT is simple: identify, challenge, and reduce what they dub, “Cognitive-Attentional Syndrome” (CAS). CAS is an umbrella term that refers to the kinds of beliefs that imply: we need worry, are incapable of stopping worry, and would be better off if we hyperfocus on tackling each individual worry.  

You might be thinking to yourself, “Birch Counseling, this is starting to sound a lot like CBT,” (Cognitive Behavioral Therapy). The truth is, you aren’t exactly wrong. In CBT, we are dealing with our thoughts. For example, if we were to use CBT to challenge our social anxiety, we might ask ourselves, “how likely will this outcome be, and will it be as bad as we’re thinking it will be?” Essentially, we identify an irrational thought and we challenge it with a more realistic lens. 

In comparison, with MCT, we are dealing with how we think about our thinking. We don’t give a lot of attention to the individual thoughts. Instead, we challenge the thinking around the thoughts themselves by asking ourselves, “should I spend my time worrying if the worry doesn’t make it less likely to happen? And if I already worried about it and made a decision, why am I re-worrying about this when I don’t have any new information?” This process, which encourages us to refuse to engage with unhelpful thinking, is called “Detached Mindfulness.” It works because it isn’t avoidance--it challenges people to view their worry and irrational beliefs as something that is outside of their core, observe the thoughts, stay non-reactive to them, and choose to respond without the preoccupation with worry about worried thinking. 

Why does Brian like it? Besides being a philosophical guy interested in all things “meta” (emotions, beliefs, and communication), Brian saw that CBT wasn’t always helpful with anxious, depressed, or addiction-driven thinking. From his perspective, it can be equally harmful to hyper-focus on our worry if we feel utterly incapable of controlling or changing it. He thinks about it like “giving in to a screaming toddler you know is just seeking attention because they want something from you, and you don’t know how to handle the upset anymore. Ultimately, it doesn’t help you, or them, to keep caving in or feeling totally helpless to stop it.” Instead, you can learn how to provide the tantruming child in your brain--the anxiety, depression, or addiction monster’s voice--the reassurance that you know what’s best, have a plan, can essentially “pivot” yourself out of the situation, or rebound if you make a mistake. It deflates the tantrum in your brain. And that’s a powerful tool. 

If you think Brian might be a fit for you, or have any additional questions about metacognitive therapy, please feel free to reach out to our team at BizOffice@birchcounseling.com. 

References:

1. https://mct-institute.co.uk/therapy/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6246690/#:~:text=Conclusions%3A%20Our%20findings%20indicate%20that,psychotherapies%2C%20including%20cognitive%20behavioral%20interventions.

3. https://mental-health-matters.com/what-is-metacognitive-therapy-and-how-can-it-help-anxiety/

4. https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00031/full

Spotlight with Pam Hyatt: Self-of-the-Therapist

If you’ve ever been in a position where you are trying to get to know someone, such as a kid or someone shy, it’s not an unusual tactic to try to open up a little to them. The hope is, of course, that by making a disclosure about ourselves, that they will reciprocate in kind. Even though it’s used as a common intervention between teachers and students, spiritual leaders and practitioners, and in various professional settings, it’s often considered taboo for a therapist to disclose about themself during a client session. After all, no client comes to therapy to listen to their therapist talk about themself!

Self-of-the-Therapist isn’t used by therapists to update you about their life, confide in you about the drama in their relationship, or process their past. It’s when a highly skilled therapist is able to use the work they have done on themself, insight they have gained or skills they have learned along the way, and share it intentionally with a client to create a teachable moment, joining opportunity, or as a measure of sorts to assess a client’s morals, values, and idiosyncrasies. If done correctly, a shared understanding of the world starts to develop from the shared--and contrasting--experiences of the world. From there, a certain degree of comradery starts to develop between the client and the therapist, a feeling like, “okay, we’re really in this together... we get and want to talk about this thing that not everyone else does or can!”

The problem is: it’s considered taboo or unusual for a reason. For it to be an effective technique, the therapist doing it has to be well, having done (and continuing to do) the work on themself. They would also have to be able to be their most authentic and vulnerable self, present and dynamic, ethical and informative, all while tailoring the right disclosure, at the right moment, for the right person. Plus, they have to do it without having a formal class on it in graduate school! In short, it’s taboo because not all therapists do it well, and when done poorly, it can cause irreparable harm to the therapeutic relationship and/or the client.

Why does Pam like it? “It helps clients open up,” she says, and she believes it builds a trust that she “might be able to get it in a way that their past therapists, friends, or families don’t.” She uses her experiences as a mom, as a professional across different industries, experiences in different times or relationships, whatever might prove insightful, curious, or normalizing in the moment to the client. “It’s always about building that different understanding, that sort of magic moment when you both just get it, that can make this work so rewarding” to Pam.

It also helps that Pam is good at it. Whether in client sessions or consultation with other therapists, Pam is a wealth of knowledge and insight, warmth and grounding, as well as compassion and empathy, which translate whether you're in the office with her or having a virtual meeting. Her skill comes from her experiences doing her own work, and having had a therapist who “could talk about himself for a half hour without even noticing.” She wants to ensure clients never have to experience that, and welcomes the feedback if you find her “a little chatty sometimes.”

If you think Pam or another Self-of-the-Therapist provider at our practice might be a fit for you, or have any additional questions about this approach, please feel free to reach out to our team at BizOffice@birchcounseling.com. We look forward to introducing you to another team member in June!

References:

https://journals.sagepub.com/doi/10.1177/160940691201100504

https://www.psychologytoday.com/us/blog/experimentations/202001/how-thera pists-use-the-self-during-therapy https://www.wyomingcounselingassociation.com/wp-content/uploads/Lum-200 2-Self-Of-Therapist-Satir.pdf

Going Out On A Limb With: Mark Bartley, MA, LPC

Mark is a “Meat and Potatoes” kind of guy, both literally and metaphorically. In the literal sense, he’s definitely the kind of guy who enjoys a solid protein and an Idaho spud, and he’d probably do so wearing his flannel shirt after a day of ice fishing. He was, after all, born and raised in Blue Earth, so hunting, wood-working, and carpentry are part of the bloodline.

Sitting down with Mark evokes the kind of built-in comfort which is hard to quantify. It may be a bit like sitting down to a hearty beef stew on a cold winter night, or having a burger with fries in the summer with friends. Those kinds of foods and experiences, no matter where you go or how it’s prepared, feel familiar and tender, down-home and straight forward. Sitting with Mark helps you relax, be present, slow down, and appreciate the simple things in life. It just feels natural doing the work with him, and it very rarely feels like work. 

One thing you might find surprising about Mark: He actually enjoys Telehealth! Don’t get him wrong, he’s also excited to be back in the office again with real live people. When working Telehealth, he appreciates how a client can spontaneously grab a picture, book, or instrument that helps them explain their feelings or experience. As therapists, we don’t usually get that kind of spontaneity or context in our office.

On coping with the pandemic: Mark’s done his own work enough to realize that for him to cope effectively with any situation, he needs two things: variety and access to “doing stuff.” He identifies as a kinesthetic processor, or someone who does better with movement when processing. Things like woodworking, being out in nature, or throwing a ball back and forth, helps him digest what he needs about the world. True to form, there isn’t “one way” that works best for him all the time. That’s why he enjoys a variety of clients, activities, and approaches to life because it keeps him more engaged and motivated. 

 Walk-Up Song: If you’ve never heard Bishop Gunn’s, “Shine,” it’s a unique combination of Blues, Country, and Rock and Roll that sets the perfect backdrop for a care-free summer scene, like driving with the top down or being out at the beach with friends. While the vibe is relaxed, If you reflect on the lyrics, you’ll hear a clear call-to-action to: find peace of mind, ground yourself, and repair emotional wounds. In other words, the song’s deceivingly simple sound allows for it’s otherwise hyper-conscious lyrics to float out there for us to think about and fully appreciate at our own speeds. For that reason, we think it’s a perfect encapsulation of Mark’s style!

 Professional pet-peeve: Mark’s answer is succinct: “Therapists who don’t normalize feedback to their clients.” Mark doesn’t view feedback as a bad thing. Instead, he thinks feedback can make therapy, and most relationships, more productive because it creates an open dialogue on how it’s going and what can work better. By helping clients get more comfortable with feedback, he hopes clients will feel more comfortable advocating for themselves. 

 Favorite tool in the Therapist Toolbox: He’s about solutions, not particular skill sets. That’s why he borrows from modalities like Solution-Focused and Narrative approaches to therapy. But if there was one tool he had to identify with, he picked Cognitive Behavioral Therapy (CBT). When asked why, he said because “it’s the one most focused on going from unhelpful to helpful thinking,” and thinks he gets “a ton of energy” from collaborating with clients on finding and applying the right re-frame for them. 

If you think Mark might be a fit for you, or have any additional questions about his approach, please reach out to our team at bizoffice@birchcounseling.com.

Spotlight with Mark Bartley: CBT Therapy

To keep with the food analogies, if Mark is like “Meat and Potatoes,” then Cognitive Behavioral Therapy (CBT) is the “Bread and Butter” of modern psychology. In other words, it’s the Hallmark or cornerstone to a lot of the work clinicians do. CBT can be used with individuals, groups, or couples. It works to treat common issues, such as depression and anxiety, but also offers the option to specialize in a more concentrated scope, such as with Trauma (TF-CBT) or Insomnia (CBT-I). And it often works for people regardless of their age, race, or background. So why does a guy who likes variety borrow most heavily from one style? 

To provide some context for his rationale, Mark wasn’t especially interested in school growing up. Frankly, he found it boring. It wasn’t until he went to college and took his first psychology class that he even understood how to make learning work for him: it had to be applied. Experiences that had historically gone unnamed for him, things like “Automatic Thoughts” and “Cognitive Distortions” were now not only nameable, but also normalized enough that they were being taught in class. They were relatable. They had solutions. And the solutions made sense!

 What Mark liked about CBT roughly a decade ago is still what he likes about it today: it makes sense and it can be applied in the moment with clients. Having thoughts you can’t control? Experiencing distress that is out of proportion to the situation? CBT helps you re-author your thinking by helping you slow it down and more objectively assess how your thoughts, feelings, and behaviors are all interacting with each other. And it does so without judgement. In fact, one of the core assumptions is that almost all people experience distress from how we interpret ourselves, others, and our world. By teaching people how to recognize what’s helpful/unhelpful about their thinking, observe themselves, and challenge their assumptions through small behavioral experiments, we can increase our faith in our own ability to respond to stressors differently. 

 CBT has a variety of tools that can be used to get you from where you feel stuck to where you’re trying to go. That’s also part of why Mark likes it. If you’re the kind of person who does well with journaling? Great! Prefer experiential learning through debate or role plays? That works too! CBT isn’t about a tool-box, it’s an entire tool shed. That means that regardless of your issue or perceived level of distress, CBT can be tailored to meet the needs of any individual without losing it’s core principle: if we want your feelings and behaviors to change, we have to change how you think about things. For Mark, there’s a “best of both worlds” element to that: familiar and flexible, customized and generalized, both in theory and practice.

 Mark knows when CBT has been effective because clients “don’t need [him] to think of different ways they can interpret or respond to the situation anymore.” Essentially, he wants to teach you how to talk yourself out of needing him. Mark also realizes that new things come up over time, and the kinds of thinking you once had managed might come back with a vengeance. Don’t fret! He’ll be here to help you reflect, reframe, and re-work new adversities, should they arise along the way. 

Accepting what is versus chasing happy

Somewhere, somehow most of us have learned that a happy life means never having to feel anything other than positive emotions.  When sadness visits, or anger, or disappointment, it feels sick, like something is wrong with us. It feels as though we are not enough, our lives are not enough.  We try to distract from negatives and chase happy feelings, only to fall short again and again.

What if we could learn to work with these “negative” feelings in a way that better informs us?  Accepting and being curious about the entire range of our emotions can help us become more compassionate, healthy and ultimately more resilient.  

Help is available

If you believe a loved one is considering suicide, you should know that help is available.  In addition to Emergency rooms and crisis hotlines, every county in the metropolitan Twin Cities area has a mobile crisis team. Mobile crisis teams are trained to help.  They can talk to your loved one, offer transportation to a safe place, and connect them with resources and professional support. 

Response time for a mobile crisis team can be a few hours.  

In immediately life-threatening or extremely dangerous situations, please call 911.

Examples of situations when the local county Mobile Crisis Team should be called:

1. When you think someone you know is in danger of committing suicide
2. When you notice disruptive, suddenly bizarre, or out-of-control behavior of an adult or child.
3. When you are a parent who needs to place your children in the Crisis Nursery.
4. When you need support in caring for someone who is struggling with mental illness or emotional disturbance.
5. When there has been a domestic or sexual assault.
6.  If you have general questions about handling a crisis or need to be referred to professional resources.

How to reach your local crisis team:

1. Anoka                  (763) 755-3801
2. Carver/Scott       (952) 442-7601
3. Dakota                 (952) 891-7171
4. Hennepin             (612) 596-1223 (adults)      (612) 348-2233 (children)
5. Ramsey                (651) 266-7900 (adults)      (651) 774-7000 (children)
6. Washington         (651) 777-5222

A Bipolar Diagnosis May Start as Depression

When a patient’s bipolar symptoms are extremely classic, we can diagnose quickly. However, there are a lot of cases in which the symptoms are not, and require us to dig a little deeper to correctly identify if bipolar disorder is the cause of mental health issues. 

For instance, many people with diagnosed bipolar disorder start with depression symptoms at treatment. For some, it will simply be depression. For others, it could indicate more, which is why we do our research to confirm or deny any possible conclusions. 

Because 60 percent of bipolar cases are hereditary, we review the family history and a number of other indicators that suggest the potential for mania may be present in a depressive episode.  This is important as treatment with some antidepressants might trigger manic episodes in vulnerable individuals.

Indicators can include symptoms occurring in adolescence; having family members with the condition; or a first episode of depression after giving birth--some women who develop postpartum depression turn out to have bipolar disorder. 

Additional red flags can include unsuccessful treatments with antidepressants or having undergone severe depressive episodes with symptoms like hallucinations.

As your mental health is our priority, we make sure to review and rule out possible issues that at first may not be evident. 

4 Types of Bipolar Disorder

5.7 million Americans or 2.6 percent of the population are affected by bipolar disorder, but their experiences are not exactly the same. Regarding bipolar disorder, there are four distinct types that help mental health care providers identify and treat patients. 

Bipolar I disorder
The one and only criterion for a diagnosis of Bipolar I disorder is having experienced at least one full manic episode. Manic episodes last at least one week or require hospitalization, and cause significant impairment in functioning. Mania is characterized by a dramatic increase in energy and a significantly reduced need for sleep.  There may be grandiosity, aggressive behavior and even a break from reality (psychosis). The manic episode may be preceded or followed by major depressive episodes. However, some people with Bipolar I disorder never experience a depressive episode.

Bipolar II disorder
There has been at least one major depressive episode lasting at least two weeks and at least one episode in which abnormally elevated mood and increased energy or irritation are experienced for at least four days (hypomania), but never at the level of the full manic episode that is characteristic for Bipolar I disorder. Major depressive episodes or the unpredictable changes in mood and behavior cause distress or difficulty in multiple areas of your life.

Cyclothymic disorder
At least two years — or one year in children and teenagers — of numerous periods of hypomanic symptoms alternating with periods of depression. During that time, symptoms occur at least half the time and never go away for more than two months. Mood symptoms don’t meet full criteria of major depression or hypomania, and cause significant distress in important areas of your life.

Other types
These include, for example, bipolar and related disorder due to another medical condition, such as Cushing's disease, multiple sclerosis or stroke. Another type is called substance and medication-induced bipolar and related disorder.

Research suggests bipolar disorder is 60 percent hereditary, and that it typically appears in adolescence or before the age of 25, but it can also emerge later in life. Biological differences in the brain and an imbalance of chemicals called neurotransmitters and hormones could also contribute. Stressors can act as triggers of an onset, like emotional or physical trauma. Bipolar I disorder is a life-long condition that requires use of medication.  Cognitive therapy can assist with early identification and management of symptoms that appear to be chronic or signal onset of a major mood episode. Family members of a person struggling with bipolar disorder often benefit from therapy as well, both in a group and individual settings.