Understanding Depression

There are currently 300 million people in the world living with depression; yet so many are struggling alone.  People with depression often have distorted and unhealthy views of themselves and their depression. This makes it confusing and difficult to seek help. In fact, about 2/3 of people with depression never reach out for help. They suffer in silence, despite that fact that 80% of people treated for depression show an improvement in symptoms within four to six weeks of starting treatment.

So what stops people from seeking help? There is still a stigma attached to mental health in the United States and there is a lack of education regarding how to properly care for one’s mental health. Some people do not understand that what they are experiencing is depression.

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes depression as “A period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities, and had a majority of specified symptoms, such as problems with sleep, eating, energy, concentration, or self-worth.”

The DSM-5 also outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

If you are reading over this checklist and realizing that some of these symptoms seem familiar, you are not alone. The 2015-2016 Berks County Community Health Needs Assessment indicated that 57% of Berks County residents reported one or more days with depressive symptoms in the past two weeks. Additionally, more than 175,000 adults in Berks County experienced one or more days with depressive symptoms in the two weeks preceding the survey.

If you or someone you care about may be suffering from depression, we encourage you to reach out for more information from one of our experienced therapists at Reading Counseling Services.



Addiction is a complex set of different disorders (substance use disorders and other types of addictions like compulsive gambling) that must be addressed in a multidimensional manner. What this means is that people with addictions will benefit from the use of medications prescribed to them by a physician, from support and encouragement from family and friends, and from counseling to help them adjust their way of thinking and to prevent relapses.

Counseling is particularly important in helping a person with an addiction to overcome their issues. While a person can use medications to help them control withdrawal symptoms from dangerous drugs like opiates and to reduce cravings or urges to use drugs or alcohol, the use of medications alone is not sufficient to help you if you are suffering from an addiction. Over the long-term you will need to be able to resist urges/cravings that can lead to relapse, adjust your way of thinking, and learn to live your life without relying on drugs, alcohol, or other types of addictive behaviors.

The key component in a recovery plan for addiction is the use of a behavioral intervention like counseling (either individual or group counseling). The National Institute on Drug Abuse reports that the effective components of a recovery program should:

-Be based on research evidence that has determine what types of approaches are effective in treating specific types of addictions.
-Be adjusted to fit the specific needs of the person in recovery.
-Be readily available for the person.
-Include family members and friends when possible.
-Make the person accountable for their own behavior, but at the same time help them to adjust their behavior.
-Include an educational component that helps the person to understand the nature of their actions.

When you enter counseling for an addiction you will learn:
-The reasons that you develop an addiction.
-How your addictive behavior not only affects you, but how it also affects everyone in your life.
-Strategies to assist you to understand how to function in the world without engaging in your addiction.
-Strategies to deal with urges and cravings.
-How to adjust your beliefs and attitudes to be realistic regarding how you view your addictive behavior.
-To develop confidence in yourself so that you do not need to worry about relying on drugs, alcohol, or other addictive behaviors to live a fulfilling life.

If you are seeing a physician and are taking medications to help you with withdrawal symptoms, cravings, or other issues surrounding your addictive behavior the counselor will also strengthen the effects of these interventions by helping you to understand yourself better and to benefit from your overall treatment.

If you are required to attend 12 step groups like Alcoholics Anonymous or Narcotics Anonymous the counselor will assist you in getting the maximum benefit from these types of peer support groups, but the approach that your counselor uses will be different and much more effective than simply attending these types of groups alone.

If you suffer from an addiction that is leading to issues with the legal system, financial problems, or relationship issues you should not wait to get help. Moreover, very often people that suffer from addictions think that they can recover from their addictive behaviors on their own; however, major organizations like the National Institute on Drug Abuse consistently state that people that suffer from addictions need professional help. The sooner you get help, the sooner you can be on the road to recovery.


Grief & Loss

Grief and loss are experienced universally as a part of the human condition. We have all experienced the death of a loved one, the loss of a romantic partner, or some other life altering event that leaves us devastated. It is normal to be unsure of exactly how to pick up the pieces of our broken hearts and move forward with a “new life” when we still long for “the way our lives used to be”. This process becomes even more difficult if you have experienced a sudden loss or multiple losses in a relatively short time frame.

Despite the fact that we all experience grief and loss throughout our lives, most of us are not taught how to grieve properly, nor are we educated regarding the stages of grief and loss. Even those that do have some knowledge regarding the grief process may still struggle due to the inability to regulate emotions effectively and think rationally in the face of devastation.

Seeking professional help from an informed and caring therapist early in the grieving process can be an effective strategy to keep you from getting “stuck in grief”. A therapist can support you through the process by helping you to understand your grief, make sense of your loss, and rebuild your life one step at a time in a safe and nurturing environment.

Your therapist will support you through the stages of grief and loss, the stages most commonly identified were first proposed by Elisabeth Kübler-Ross in her 1969 book On Death and Dying. The stages are: 1. Denial and isolation; 2. Anger; 3. Bargaining; 4. Depression; 5. Acceptance.

Aspects of these stages are experienced by everyone; however the stages may not be experienced in order listed. Some people skip stages or find themselves more heavily concentrated in one versus another. We move between stages before achieving peaceful acceptance of our loss. The stages should be viewed as a guide to grieving versus a set structure.

In order to support you in some education prior to your first therapy session– a brief description of each stage and some feelings you may experience are listed below.

1. Denial & Isolation
The initial reaction to death or loss is to deny the reality of the situation. Denial helps to numb our emotions and avoid the intense feeling of pain. It is common to feel in a state of shock and disbelief. You may think “this isn’t happening, this cannot be happening to me”. Isolation helps us to maintain our denial.

2. Anger
Once reality re-emerges, the pain we feel will re-emerge along with it. This leaves us vulnerable and it is common for us to process this as anger, frustration, irritation – these difficult emotions may be directed at almost anyone and anything. Anger is an uncomfortable but necessary stage of the healing process.

3. Bargaining
At this point in time, we are struggling to find meaning and to understand why this has happened. We may reach out to others and tell them our story. In order to regain our own sense of control we often use “if, then” thinking—If only I did “this” instead of “that” maybe none of this wouldn’t be happening. Guilt often accompanies bargaining because we start to believe there was something we could have done differently to prevent this loss.

4. Depression
Sadness and regret begin to take over your thinking. You find yourself worried about the negative impacts of the loss on your life. You may feel overwhelmed and helpless. You no longer feel the joy or motivation you felt prior to the loss. Life seems different and not in a positive way.

5. Acceptance
Although it may take time, the natural healing process will help you to arrive at acceptance. This does not mean we “get over” the loss. It is more about exploring our options for a new life. We have a new plan in place and begin to move toward a place of peaceful acceptance.

Coping with loss is a personal experience but a therapist can be there for you and help comfort you through this process. It is important to allow yourself to feel the grief as it comes in order to facilitate the natural healing process.

How to Choose a Therapist

Each individual’s journey to emotional and mental wellness is unique and choosing the right therapist to support you is important. It takes courage, trust, and vulnerability to reach out for mental health support and we thank you for taking the time to carefully consider this decision.

The purpose of this article is to provide you with information to make an informed decision. Our hope is that you will feel confident and empowered moving forward; knowing that you’ve chosen the right therapist for yourself or your loved one.

The Therapeutic Relationship:

Therapy is an interpersonal relationship in which you should develop a sense of trust and safety over time. Find a therapist that is empathic, insightful, understanding, and accepting. Your therapist should show a genuine interest in getting to know you and understanding your story. They should be invested in your progress and show you positive regard. You should feel safe and comfortable to communicate with your therapist no matter how disturbing or upsetting the topic without fear of judgment. Your therapist should also be attuned to understanding how your culture shapes your values in order to best support you.

Goal Setting:

Your therapist should help you to understand the current picture. What is happening and what are the key issues that are calling for change? They do this by listening to your story. Choose a therapist that is interested and shows empathy and investment in helping you with the problems you are facing.

Your therapist should help you to reframe problems and develop new perspectives. What do I want and what is the preferred picture? Helping you identify and shape the problem is a step toward managing goals and moving towards change. You should feel that you and your therapist have the same goal. In therapy we call this the “working alliance”.

Once you have identified what’s happening and what the preferred picture; it is time to develop strategies to reach these goals. It is okay to be curious with your therapist regarding interventions and strategies they will be using to support you. A well trained therapist will have a repertoire of strategies and evidence based interventions to use throughout the therapeutic process. Every individual is different and there is no singular approach to use. Be sure your therapist is flexible and able to develop strategies with you that feel most comfortable and effective for you.

As counseling progresses, both the therapist and client grow in their understanding of one another and the client’s problems. Through the dynamics of the interpersonal relationship, solutions or outcomes often begin to appear that seemed unreachable without the counselors support.

Ethics and Boundaries:

It is important to understand the ethical obligations that your therapist has to you and your treatment.
The American Counseling Association’s code of ethics can be found at


What is anxiety and why do I have it?

Experiencing certain levels of anxiety is completely normal; even beneficial at times, so how do you determine if your anxiety has crossed the line from protective to disruptive? When you experience anxiety in a dangerous situation; such as hearing a loud bang in your home when you’re home alone– anxiety will trigger a response to flee the situation or to stay and fight for your life. If you are driving your car in an ice storm, anxiety may trigger you to slow down. If you are with your child at the park and a suspicious stranger approaches; anxiety will prompt you to take action that could protect you and your child from danger.

In these instances, the extra cortisol that your brain releases in response to danger could save your life. This is helpful anxiety. However this may become problematic as the next time you hear a loud bang, get in your car, or play at the park with your child; your brain tells you that you are in danger, despite the fact that this time– you are not in any type of immediate danger.

It is very easy for anxiety to generalize to people, places, and things that pose no serious risk to us. Anxiety can trigger our brain and body to make us feel as if we are in danger- even when we are not. Repeated exposure to these “triggers” without the use of proper techniques to calm and soothe ourselves may lead to an anxiety disorder in which we are unable to function effectively in our day to day lives. This happens without us even recognizing it, until one day, we find ourselves constantly stressed and overwhelmed; struggling to manage day to day tasks. Your brain may feel foggy and you may exhibit signs of depression or feel angry at the demands others place on you. You may find yourself unable to remain calm and feeling constantly stressed out.

If you find yourself experiencing these types of feelings, a therapist can be helpful in supporting you to assess if this is related to anxiety, the severity of your anxiety, and what might be triggering your anxiety. There are several strategies that are helpful in managing anxiety such as lifestyle changes, mind-body approaches, psychotherapy, and medication when needed.

If you are concerned regarding the impact of anxiety on you or your family; allow us to help assess and figure out which techniques will work best for you. Allow a therapist to support you in the on-going maintenance of your anxiety in order to improve the quality of your life.


How do I help my child with their emotions?

Being a little person is tough but not as tough as being responsible for one. As a parent, it is difficult to know what to do when your child is screaming, crying, being aggressive, or shutting down. To make matters worse, every child is different and whereas some children externalize their emotions and act out; others internalize and shut down.

When your child is distressed, it is easy to get caught up in your own emotions and feel inadequate. We intervene and it doesn’t work. Even worse, sometimes we intervene and it upsets our child more.

If you find yourself unsure of how to handle your children’s emotions, it is important to seek professional help early. A professional can help you recognize the cues your child is giving you prior to them getting upset. They can support you to be curious with your child in the right ways; while teaching you how to provide a soothing and calm presence when your child is upset. Your therapist will support you to learn new ways to interact and communicate with your child in a nurturing and consistently structured way. This will lead to a more satisfying relationship for you both.

Maybe you’ve waited awhile to seek support and you’ve grown increasingly hesitant to move towards your child’s emotions. Maybe your child feels hesitant or even unsafe to come to you when they are experiencing a problem. Over time this pattern leads to conflict with you and your child and you find yourself doubting and questioning where you went wrong. If this pattern goes unchecked for years, the distance between you and your child grows and before you know it, you are struggling to connect with your teenager in any type of meaningful way. You watch them struggling with school and peers and are worried that they may be engaging in risk behaviors but do not know how to talk to them about your concerns without them pushing back or blowing you off.

If you are experiencing this type of dynamic, seek a therapist. It is never too late to shift these negative patterns and find ways to connect, support, and nurture your child. You are you child’s best ally against the difficulties they face and the most capable person to support them as they navigate through life.