​Questions and Answers

If you have questions about mental health wellness e-mail them to: julia@tarsacounseling.com.

My eleven year old son says he is depressed and wants to see a counselor.  Can a child that young even know what depression is?
Children are now being taught about the symptoms of depression and how to get help in their schools and through the media.   MRI's of the brain can now reveal where in the brain depression originates.  If your child asks for help or is exhibiting signs of depression then it is time to seek professional help.  Symptoms of depressioion can include:  lack of interest in things they usually enjoy,   sleeping more or less then usual,  eating too much or too little,  crying a lot or isolating.  

My wife wants us  to go to counseling but a friend of mine went and he and his wife ended up divorcing.  
When a couple comes to counseling communication has often shut down.  When I work with a couple my goal is to help open up communication so they can begin to gain clarity about what the issues are in their relationship.  If this can be accomplished we then talk about how to move forward.  In some cases couples come to me because one of them has already decided to leave and doesn't know how to tell the other.  Meeting with a therapist can open up communication and can also be a way to help the grieving process begin for those who don't stay together.  For those that do stay together therapy can provide support in this new stage of the relationship.    

My brother was just diagnosed with a mental illness.   I don't understand him.
In therapy we can explore the relationship you have with a mentally ill family member and how the illness has effected the family.  I encourage my clients to educate themselves about the particular type of mental illness their family member suffers from.  This is often very eye opening.  
I miscarried a child three months ago and I can't seem to pull out of the sadness I feel.  Very few people know about my loss.  My doctor said I  am depressed and recommended counseling.
When we lose a child, including through miscarriage,  we go through stages of grief.  It is important to get support during this time from family and friends.  We are fortunate because we have a support group locally for persons who have lost a child through miscarriage or still birth.  Therapy can help persons stuck in the grief process begin to heal again. 

I am a perfectionist.  My boyfriend said he feels like he isn't good enough for me because I am critical of him.  If he would just do things the right way there wouldn't be a problem.
Perfectionism is a sign of Obsessive Compulsive Disorder (OCD).  A therapist can ask you a series of questions to help determine if this is something you have and can help you learn how to manage it.  Persons with OCD pay attention to details which can be a real asset for many jobs and careers.  If it gets out of hand we can become critical of others and have unreal expectations of them.  You can get more information from the bookToo Perfect:  When Being in Control Gets out of Control.  It is listed in the resources section on this website.



Loving Persons Living with Bipolar Disorder

One Saturday night as a college freshman, my roommates and I were getting ready to go out for the evening. We were laughing in anticipation of the fun to come. Suddenly our happy and exuberant roommate Jenny burst into tears. Startled we asked what was wrong. She didn’t know. Unable to control her emotions she spent the rest of the evening in her room crying. A nurturing roommate named Wendy stayed with her and did so every time this happened. Jenny’s moods changed many times in a day and often did so suddenly. We tiptoed around her hoping not to upset her. She would spend hours and sometimes days in bed in depressive states.

Years later, I heard that Jenny was hospitalized while doing an internship her senior year. It turned out that she and generations of her family members, including two siblings, suffered from bipolar disorder. She finally received the medication and therapy she needed. After taking time off, she returned to school, graduated and went on to begin her career.

This may be a familiar story if you are a family member or friend of a person with bipolar disorder. In psychology we call mood changes “cycling” and it can happen as quickly as within minutes or over a period of months. Bipolar means opposite poles. Moods can swing between depression and mania for bipolar I disorder. With bipolar II disorder they swing between depression and hypomania. In therapy and with medication, medical professionals can help persons with bipolar disorder stabilize (modulate) their moods.

Mania can begin with a burst of energy and heightened creativity. Socializing can be easy. If questioned, persons in this state often deny that anything is wrong and blame others for even suggesting there might be a problem. It can last a week or more. Symptoms can include:     

    •decreased need for sleep                  •increased physical activity                   

    •sexual indiscretions                         •spending sprees    

    •racing thoughts                                •extreme optimism & self confidence     

     •impulsiveness                                   •rapid speech

   •inflated sense of self (big ego)      •jumping from one topic to another

   •distractibility                                      •reckless driving   

   •excessive irritability

Most persons with bipolar disorder are depressed more often than manic.

Depression lasts at least two weeks and can go on for months. It makes it difficult for the person suffering from it to function. Symptoms can include:     

   •changes in appetite or sleep           •fatigue      

   •restlessness                                          •inability to concentrate
    •indecisiveness                                   •feelings of worthlessness    

   •loss of motivation                            •thoughts of death or suicide    
   •loss of enjoyment in usual activities 

Physical pain, worry, anxiety, anger and nausea can be present for some people. If a person is planning on hurting themselves they need immediate medical assistance.

Hypomania is a milder form of mania. Symptoms are less severe and can include:

    •increased sexual drive                      •increased energy and activity

    •impulsiveness                                  •poor judgment     

    •inflated sense of self                      •irritability

    •sleeping less                                     •euphoria

Persons in close proximity notice the changes when the person themselves doesn’t.

The relationship with a family member or friend with bipolar disorder can be a challenging one. You can feel connected one moment and pushed away the next, sometimes devalued. It is not unusual to have mixed feelings such as joy and anger or excitement and frustration. These reactions can happen in any relationship but you may feel more vulnerable with someone who can be intense and unpredictable.

Having a family member or friend with bipolar disorder offers us the opportunity to get to know ourselves at a deeper level. How we react to that other person can give us insight in to our own personality. Certain behaviors of the bipolar family member or friend may resonate with you until they go “too far”. It is important to set guidelines for yourself so that when extreme behaviors happen you can respond versus react. If we react we can start to feel powerless and start to resent our family member or friend. If your loved one suffers from severe depression, be aware that it can trigger grief in those around them. This can then cause anxiety, pessimism and self-doubt in family members and friends. The more secure you feel in yourself the less impacted you will be. Relationships with persons with bipolar disorder are more intense and intimate.

Knowing yourself will allow you to see how you are impacted by the behavior of the bipolar person and to take steps to get your needs met. You can assess what part of the relationship you have control over and what part you don’t. Your expectations of the relationship may not be realistic. Armed with this knowledge you can respond and offer stability. Family members or friends who are not self aware can actually encourage the bipolar person to continue his or her destructive behavior (enabling). This can include: denying the diagnosis, failing to see or acknowledge symptoms, minimizing them or discouraging the person from taking their medication or going to therapy.

For family members and friends who are willing to acknowledge that their loved one has bipolar disorder it is important to have a support team. This could be through joining a support group (including on-line options), personal psychotherapy or counseling, connecting with other persons with bipolar persons in their lives or creating your own support system. Self care is critical. This could include: time to yourself, massage, hot baths, a long walk or food you enjoy. Reading information on bipolar disorder can be helpful too. The WebMD website is a reliable resource.

Since my freshman year in college I have come across many persons with bi-polar disorder including friends and family members. I now know how to recognize the symptoms, as a therapist how to help them and also how to take care of myself. My relationship with each of them has been interesting and rewarding and at times exhilarating. I hope the relationship you have with your bipolar family member or friend is also rewarding to you.

There are resources on bipolar disorder on my website. If you have questions, please call me at the number below or e-mail me at:   julia@tarsacounseling.com



Thank you to my clients and the Capital Area District Library for helping develop this list of resources to share with you.

Self Help:

Cain, S.  2012.  Quiet: The Power of Introverts in a World That Can't Stop Talking.  New York, NY: Crown Publishers.

Hallowell, E & Hallowell, J.  1995.  Driven to Distraction:  Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood.  New York, NY:  Simon and Schuster Inc.

Hyman, B. & Pedrick, C.  2005.  The OCD Workbook,  Your Guide to Breaking Free.  Oakland, CA:  New Harbinger Pub. Inc.  

Katherine, A.  1991.  Boundaries:  Where You End and I Begin.  New York, NY:  Parkside Publishing Corp.

Katherine, A.  2000.  Where to Draw the Line:  How to Set Healthy Boundaries Every Day.  New York, NY:  Parkside Publishing Corp.

Kubler-Ross, E. & Kessler, D.  Life Lessons:  Two Experts on Death and Dying Teach Us About the Mysteries of Life and Living.  2000.  New York, NY: Scribner.

Mallinger, A & DeWyze, J.  1992.  Too Perfect:  When Being in Control Gets Out of Control.  New York, NY:  Random House Publishing.

Williams, M., Tensdale, J., Segal, Z. and Kabat-Zinn, J.  2007.  The Mindful Way Through Depression:  Freeing Yourself From Chronic Unhappiness.  New York, NY:  Guilford Press.

Grief and Loss: 

www.dragonflyrocks--memorial items

www.myforeverchild.com--memorials for infant loss including stillbirthFor Family and Friends of the Mentally Ill:

Fast, J. A. & Preston, J. D. 2004. Loving Someone with Bipolar Disorder: Understanding & Helping Your Partner. Oakland, CA: New Harbinger Publications, Inc.

Morey, B. and Mueser, K. 2007. The Family Intervention Guide to Mental Illness: Recognizing Symptoms and Getting Treatment.Oakland, CA: Bodie Morey and Kim T. Mueser. 

Woolis, R. 2003. When Someone You Love Has a Mental Illness: A Handbook for Family, Friends and Caregivers. New York, NY: Penguin Group, Inc. 

Personality Disorders:

Brown, N.  2003.  Loving the Self-Absorbed:  How to Create a More Satisfying Relationship with a Narcissistic Partner.   Oakland, CA:  New Harbinger Publications, Inc.

Dolecki, C.  2012.  The Everything Guide to Borderline Personality Disorder:  Professional, Reassuring Advice for Coping with 
the Disorder and Breaking the Destructive Cycle.  Avon, MA:  Adams Media.

Martinez-Lewis, L. 2008. Freeing Yourself from the Narcissist in Your Life. New York, NY: Penguin Group. 

Mason, P. & Kreger, R.  2010.  Stop Walking On Eggshells:  Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder (Second Edition).  Oakland, CA:  New Harbinger Publications, Inc.

Saks, E.R. 2007. The Center Cannot Hold: My Journey Through Madness. New York, NY. Hyperion. University Professor Elyn Saks writes about her life with schizophrenia. 


Gorman, J.  2007.  The Essential Guide to Psychiatric Drugs (Fourth Edition).  New York, NY:  St. Martin's Press.

Mood Disorders:

Antony, M. & Swinson, R.  2008.  The Shyness and Social Anxiety Workbook.  Oakland, CA.: New Harbinger Pub.

Basco, M.  2006.  The Bipolar Workbook:  Tools for Controlling Your Mood Swings.  New York, NY:  Guildford Press.

Cheney, T.  2008.  Manic:  A Memoir.  New York, NY:  HarperCollins Publishers.

Cronkite, K.  1994.  On the Edge of Darkness:  Conversations about Conquering Depression.  New York, NY:  Dell Publishing.

Fawcett, J.,Golden, B. & Rosenfeld, N. 2007.  New Hope for People with Bipolar Disorder.  New York, NY:  Three Rivers Press.

Hyman, B & Pedrick, C.  2005.  The OCD Workbook, Your Guide to Breaking Free.  Oakland, CA:  New Harbinger Pub. Inc.

Jones, S., Hayward, P. & Lam, D. Coping with Bipolar Diorder: A Guide to Living with Manic Depression.


Chapman , G. The Five Love Languages: How to Express Heartfelt Commitment to Your Mate.

Engel, B. Loving Him Without Losing You: Seven Empowering Strategies for Better Relationships.

Evans, P. The Verbally Abusive Relationship.

Love, P & Stosny, S.  How to Improve Your Marriage Without Talking About It.

Neuman, G.  The Truth About Cheating.  He also has a website: www.beyondaffairs.com.

Snyman, L.  2011.  Getting Ready for the Rest of Your Life:  Preparing for A Strong Christian Marriage.  U.S.A. www.awakeningsfamilytherapy.net.  Written by a Lansing therapist.

Springs, J.A. 1996. After the Affair: Healing the Pain and Rebuilding Trust When a Partner has Been Unfaithful. New York, NY: Harper Collins.

The Ending of Relationships:

Anderson, S. 2000. The Journey from Abandonment to Healing: Surviving Through- and Recovering from- the Five Stages that Accompany the Loss of Love. New York, NY: Berkley Books.

Murphy-Milana, S. Moving Out, Moving On: When a Relationship Goes Wrong Workbook.

Children and Teens:

Beyer, F. & Winchester, K. 2001. Speaking of Divorce: How to Talk with Your Kids and Help Them Cope. Minneapolis, MN: Free Spirit Publishing, Inc. 

Frost, Jo.  2006.  Ask Supernanny:  What Every Parent Wants to Know.  New York, NY.: Hyperion.

Mepfiled, M. & Bakalar, N. Understanding Teenage Depression: A Guide to Diagnosis, Treatment and Management. 

Evans, D. & Andrews, L. W. If Your Adolescent Has Depression or Bipolar Disorder: An Essential Resources for Parents. Adolescent Mental Health Initiative. 

Fristad, M. & Goldberg-Arnold, Jill S. Raising a Moody Child: How to Cope with Depression and Bipolar Disorder.

Jamieson, P.E. 2006. Mind Race: A Firsthand Account of One Teenager's Experience with Bipolar Disorder. New York, NY: Oxford University Press. 

Koplewiez, H.S. 2002. More than Moody: Recognizing and Treating Adolescent Depression. New York, NY. G. P. Putnam's Sons. 

Roberts, E. Shoud you Medicate Your Child's Mind? 

Loss of a Pet:

Sife, W.  1998.  The Loss of a Pet:  A Guide to Coping with the Grieving Process When a Pet Dies.  New York, NY:  Wiley Publishing Inc.

Coping with Illness:

Groopman, J. The Anatomy of Hope: How People Prevail in the Face of Illness.

LeShan, L.  1994.  Cancer as a Turning Point:  A Handbook for People with Cancer, Their Families and Health Professionals.   New York, NY:  Penguin Putnam Inc.



Adult Children:

Adams, J. 2004. When Our Grown Kids Disappoint Us: Letting Go of Their Problems, Loving Them Anyway, and Getting on with Our Lives. New York, NY. Free Press: Simon & Schuster.

Davitz, L. L. & Davitz, J. Getting Along Almost With Your Adult Kids. 

Nemzoff, R. Don't Bite Your Tongue: How to Foster Rewarding Relationships With Your Adult Children. 

Financial Challenges:

Bridgforth, G. Girl, Get Your Credit Straight! A Sister's Guide to Ditching Your Debt, Mending Your Credit and Building a Strong Financial Future. 

Economides, A. & Economides, S. America's Cheapest Family: Gets You Right on the Money.

Roth, G.  2011.  Lost and Found:  One Woman's Story of Losing Her Money and Finding Her Life.  New York, NY: Penguin Group.

Substance Abuse:

Jay, D & Jay, J.  2000.  Love First:  A Family's Guide to Intervention.  Hazeldon,  Center City, MN.

Content copyright 2016. Julia Tarsa MA LLC. All rights reserved.

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