Healing Panic Attacks in Pasadena
Anxiety

Panic Attacks Can Take 3-12 Months to Recover, Research Says

“How long will these panic attack episodes last? When will peace return?”

It can be overwhelming to have panic attacks. They’re unexpected, scary, and can impact your social and work life dramatically. Part of the concern is not knowing why the panic attacks happen or what is needed to heal from panic attacks. The good news? Panic attacks can be treated, and many people recover within 3-12 months, when treated.

So what makes the difference for those who are able to resolve panic attacks?

In this article, you’ll learn about the treatment process for panic attacks. By the end, you’ll have a map of what recovery looks like and what exactly will give you the best chances of success. We provide therapy for people with panic attacks in Pasadena and Los Angeles, and we’ve seen first hand how people can experience freedom from panic attacks when they engage in self-exploration and self-care. Let’s dig in and help you get a clear idea of the road to healing for panic attacks.

60-80% of People Achieve Significant Recovery from Panic Disorder with Proper Treatment

Research demonstrates that with targeted therapies such as EMDR, somatic therapy, or psychodynamic approaches, 60-80% of individuals with panic disorder experience substantial symptom reduction or full remission, marked by fewer attacks, restored confidence, and improved quality of life. Without intervention, recovery rates hover at 20-40%, with symptoms often persisting chronically or escalating to include avoidance behaviors. Early engagement and trauma-informed care enhance outcomes, shifting recurrent terror into manageable experiences and fostering lasting resilience.

Panic Attacks Inflict Deep Trauma-Like Pain on Individuals and Their Loved Ones

Panic attacks assault the core of one’s sense of safety, transforming ordinary situations into visceral onslaughts of fear, disconnection, and exhaustion. This acute distress echoes trauma responses, frequently heightened by fears of recurrence, leading to hypervigilance, isolation, or somatic complaints. The aftershocks ripple through relationships, breeding frustration and helplessness, but recognizing this as a trauma-like ordeal unlocks pathways to empathetic, body-centered healing.

Panic Attacks Arise from Genetic, Environmental, and Contextual Factors

Panic attacks, often part of panic disorder, originate from a tangled web of genetic vulnerabilities, environmental stressors, and contextual disruptions, especially amid life’s transitional pressures.

Genetic Factors

Genetically, a substantial heritable link exists, with family history raising susceptibility through inherited neurochemical imbalances, brain circuitry variations, and predispositions to anxiety responses—genetics may contribute 30-50% to panic disorder risk. Individuals might carry sensitivities that, when triggered, amplify fear signals.

Environmental Factors

Environmentally, influences like chronic stress, caffeine or substance use, major life changes, and cultural pressures to suppress emotions heighten risk, often interacting with genetics to precipitate attacks. People frequently link triggers to overwhelming situations.

Contextual Factors

Contextually, interpersonal and situational elements are key: family conflicts or overprotectiveness can instill insecurity; control dynamics, where unpredictability breeds hyperarousal; and disruptions like sudden losses (e.g., bereavement, job loss, or abuse) correlate with onset, as unresolved distress manifests somatically.

Common Signs of Panic Attacks Often Mimic Medical Emergencies

Panic attacks manifest abruptly and intensely, frequently mistaken for heart attacks or other crises, with research noting their hallmark physical and emotional surges that peak within minutes. These symptoms arise from the body’s fight-or-flight overactivation, affecting 2-3% of adults annually, and can include dissociation (feeling detached from reality), surges of anger or irritability post-attack, and withdrawal to avoid triggers. The table below details key signs with descriptions and research backing:

Panic Attack SymptomDescriptionResearch Support
Racing Heart/PalpitationsSudden pounding or fluttering heartbeat, often feeling like a heart attack.Core symptom in 80-90% of attacks; triggers medical fears.
Shortness of BreathFeeling smothered, rapid or shallow breathing, or choking sensation.Reported in up to 70% of episodes; mimics respiratory distress.
Sweating/TremblingProfuse sweating, shaking, or chills despite normal temperature.Physical hallmarks in 60-80%; tied to adrenaline surge.
Dizziness/NauseaLightheadedness, vertigo, stomach upset, or faintness.Occurs in 50%; contributes to fear of fainting or dying.
Fear of Dying/Loss of ControlIntense dread of impending doom, going crazy, or dying.Psychological peak; dissociation may follow as detachment.
Post-Attack Withdrawal/AngerEmotional numbness, avoidance of triggers, or irritability after episodes.Leads to agoraphobia; anger from frustration in 20-30%.

Therapy Halves Panic Attack Recovery Timeline

Full recovery from panic disorder may span 1-5 years without support, but therapies like EMDR, somatic, or psychodynamic can shorten this to 3-12 months, with remission rates up to 70-80%. This guide spotlights validated methods to expedite healing, underscoring the importance of immediate, body-aware intervention; medication considered only if clinically appropriate.

Key Factors Shape Panic Attack Healing Timelines

Recovery timelines for panic attacks vary by factors like attack frequency (infrequent episodes resolve quicker), age of onset (earlier may prolong), comorbidities such as PTSD or depression, support networks, commitment to therapy, and access to specialized somatic care. Rapid response to treatment and unpacking triggers like trauma further customize and accelerate the path to freedom.

Treatment Boosts Recovery Rates and Speeds Healing Compared to No Intervention

Determination supports every route, but structured therapy outperforms untreated paths, boosting recovery from 20-40% to 60-80% and compressing timelines from 1-5+ years to 3-12 months for many. The table below contrasts core aspects:

AspectWith Treatment (e.g., EMDR, Somatic, Psychodynamic)Without Treatment
Recovery Rate60-80% significant remission20-40% spontaneous recovery
Timeline3-12 months for many, up to 2 years for full1-5+ years, often chronic
Relapse RiskLower (20-30%, reduced with maintenance)Higher (up to 50% recurrent)
Mortality/ComplicationsReduced with early interventionElevated, including agoraphobia or suicide risk
Quality of LifeRestored mobility, reduced fear, better functioningPersistent dread, avoidance, exhaustion

This illustrates therapy’s essential role in quicker, more robust recovery.

The Treatment Pathway Accelerates Healing from Panic Attacks

Approaches like EMDR, somatic therapy, or psychodynamic yield 70-80% improvement in weeks to months for acute relief, leading to 3-12 months for enduring remission via personalized, trauma-sensitive support. Therapy addresses manifestations and origins, including genetics, environmental loads, or contextual traumas, through phased development; medication if indicated by a clinician.

Beginning Stages: Building Safety and Stability (First 1-3 Months)

Early therapy stresses acute stabilization and somatic grounding, often starting with EMDR to process initial triggers while mapping attack precursors like genetic sensitivities or stressors. Individuals may dread sessions, but they provide a secure space to recount episodes—e.g., identifying dissociation patterns and introducing breathwork to regulate arousal, forming a base for trauma exploration.

Middle Stages: Unpacking and Rebuilding (3-6 Months)

As equilibrium builds, psychodynamic inquiry delves into underlying dynamics, reframing fear narratives from roots like control losses or environmental pressures via dialogue and body scans. If contextual events like grief sparked attacks, somatic techniques release stored tension, paired with relational work to mend isolation. Achievements include shorter episodes and gradual exposure, with lapses building tolerance for uncertainty.

Later Stages: Integration and Long-Term Growth (6-12+ Months)

Later phases embed resilience and forestall recurrence by weaving insights into existence. People resolve enduring sources, such as genetic traits through awareness practices or environmental shifts like stress buffers. Focus on embodiment, redefining safety beyond absence of attacks, and cultivating networks yields autonomy—e.g., navigating crowds calmly, deeper connections, and joyful pursuits—with follow-ups securing sustained ease. This evolves acute fear into empowered navigation.

Frequently Asked Questions About Panic Attacks

What Are the Common Signs of a Panic Attack?

Sudden intense fear with physical cues like rapid heartbeat, sweating, trembling, breathlessness, dizziness, chest pain, nausea, or dread of dying; may include numbness or detachment.

How Can Loved Ones Support Someone with Panic Attacks?

Offer calm presence, validate experiences without minimizing, encourage professional help softly, and practice grounding together. Steer clear of overprotecting; prioritize listening and joint coping.

What Are the Most Effective Treatments for Panic Attacks?

EMDR, somatic therapy, and psychodynamic approaches excel, often with lifestyle tweaks; group settings combat isolation. Severe cases may need inpatient support, with peak efficacy from early integration; meds if suitable.

Can Panic Attacks Be Prevented?

Fostering stress resilience, body awareness, supportive environs, and early trauma processing can lessen risks. Mitigating triggers like caffeine or isolation aids, though genetics temper total prevention.

Do Panic Attacks Resolve on Their Own?

Occasionally for mild cases, but typically they recur or intensify without aid, risking chronicity. Therapy profoundly betters prospects, reshaping episodic crises into surmountable hurdles.

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pre-adoption psychological evaluation
Testing and Assessment

Pre-Adoption Psychological Evaluation Checklist: 7 Tips for a Quick and Easy Adoption Assessment

Adopting a child is an exciting yet complex journey, and one key step for many prospective parents is the pre-adoption psychological evaluation – also commonly known as an adoption psychological evaluation. This process helps ensure you’re emotionally and mentally ready for the responsibilities of parenthood, especially in cases like international adoptions where additional scrutiny is required.

While it can feel daunting, proper preparation can make the experience smoother and less stressful. In this guide, we’ll cover practical tips to help you get ready that most families miss, from self-reflection to managing anxiety, so you can approach your evaluation with confidence. We provide pre-adoption psychological evaluations throughout California and can help your family complete this important step in the adoption process efficiently.

We’ll also cover the step-by-step process you can expect from your psychologist.

6 Tips to Prepare for Your Pre-Adoption Psychological Evaluation

1. Understand the Purpose of the Pre-Adoption Psychological Assessment

The adoption psychological evaluation is designed to assess your readiness for parenting an adopted child. Agencies use it to confirm emotional stability, coping skills, and your ability to handle the unique challenges of adoption, such as potential attachment issues or cultural adjustments. For international adoptions, it often meets specific country requirements, while domestic ones might focus more on general family dynamics. Knowing this upfront helps shift your mindset from fear of “failing” to viewing it as a supportive step in building your family.

2. Review Your Personal and Family History in Advance

One of the core components of the evaluation is a thorough interview about your background. Take time to reflect on your upbringing, relationships, mental health history, and any past challenges like therapy or stress management. Jot down key events or patterns—this not only prepares you for questions but also helps you articulate your growth. If applicable, gather medical records or notes from previous counseling sessions to bring along, as they can provide context without you having to recall everything on the spot.

The more honest you can be, the more your assessment will help you. While it’s understandable to want to make the process smooth by not talking about difficult aspects of your history, current circumstances, or your self, attempting to appear more favorably can backfire and make the process less helpful, and in some cases can extend the process.

3. Discuss Expectations and Motivations with Your Partner

If you’re adopting as a couple, schedule dedicated time to talk openly about why you’re pursuing adoption, your parenting styles, and how you’ll handle potential stressors like sleep deprivation or behavioral issues. This alignment can make joint interview sessions flow better and demonstrate your teamwork to the evaluator. For single parents, consider journaling or talking with a trusted friend to clarify your motivations, ensuring you’re honest about any apprehensions, which is perfectly normal and even encouraged.

4. Practice Self-Reflection and Emotional Preparedness

Evaluations often include personality tests, like the Personality Assessment Inventory (PAI), and questions that might touch on sensitive topics such as your marriage, family conflicts, or feelings about the child’s biological parents. To prepare, practice self-reflection exercises: Ask yourself, “What are my fears about parenting?” or “How do I manage stress?” This builds emotional resilience and helps you respond thoughtfully. Remember, the goal is honesty—admitting vulnerabilities shows self-awareness, not weakness.

5. Manage Anxiety and Create a Comfortable Mindset

It’s common to feel nervous, so incorporate relaxation techniques like deep breathing or mindfulness apps in the days leading up. Schedule your evaluation at a time when you’re well-rested, and treat it as a conversation rather than an interrogation. Choose a qualified psychologist who specializes in adoption assessments, perhaps by booking a free consultation to discuss the process and costs upfront (schedule a call with our care coordinator here). Understanding that insurance typically doesn’t cover this can help you budget accordingly.

6. Address Variations for Domestic vs. International Adoptions

Preparation can differ based on your adoption type. For international adoptions, familiarize yourself with country-specific requirements, such as extended timelines or additional cultural sensitivity questions. Domestic evaluations might emphasize local support systems or home studies. Research your agency’s guidelines early to tailor your prep—resources like adoption forums or books on parenting adopted children can provide targeted insights.

7. Gather all requirements from the Country of Origin (Bonus Tip)

This tip is in a category on its own. Gathering all requirements before your consultation with a psychologist makes the biggest difference in how smooth and timely the process is for you.
Make sure you communicate with the adoption agency and the child’s country of origin about what they require for a pre-adoption psychological evaluation. Every country is different. Some require notarization, and sometimes specific psychological assessments are required, like the MMPI-3. Arranging for these specific requirements for the adoption assessment can require additional preparation time.

The Step-by-Step Process of a Pre-Adoption Psychological Evaluation

Understanding the typical workflow of the pre-adoption psychological evaluation can demystify the experience and help you prepare effectively. While processes may vary slightly by psychologist or agency, most follow a structured approach involving multiple sessions and a feedback period. Here’s what to expect with the pre-adoption psychological evaluation process:

Step 1: Initial Interview for Information Gathering

The process begins with an initial meeting, which is typically a comprehensive interview lasting approximately 2 hours, depending upon how many adoptive parents are being evaluated. During this session, the psychologist will gather relevant background information about you (and your partner, if applicable), including your personal history, family dynamics, relationships, mental health, and motivations for adoption.

This is a conversational step where you’ll discuss topics like your upbringing, career, support systems, and any past experiences with therapy or stress. The goal is to build a holistic picture of your life and readiness for parenting, so come prepared to share openly.

Step 2: Testing Session with Psychological Measures

Following the interview, there’s usually a second meeting for psychological assessment. This session involves completing standardized psychological assessments, such as the MMPI-3 (Minnesota Multiphasic Personality Inventory-3) to evaluate personality traits and emotional functioning, along with another personality test tailored to adoption contexts.

These measures help identify strengths and any areas needing support. The testing typically takes 3 hours and is done in a relaxed environment, often with breaks if needed. This meeting can often be done virtually if needed. No special preparation is required beyond being well-rested, as the tests are designed to capture your natural responses.

Step 3: Report Preparation and Feedback Session

After the testing session, the psychologist analyzes the results and compiles a detailed report. This document summarizes your strengths, any potential concerns, and recommendations for the adoption process.

Once ready, you’ll have a feedback meeting (often virtual or in-person) where the psychologist reviews the findings with you. They’ll discuss insights, suggest any changes or preparations you might need—such as additional counseling or parenting classes—and answer your questions. This step emphasizes growth and support, ensuring you’re equipped for a successful adoption.

Schedule a Consultation Call for Adoption Assessment

FAQ: Common Questions About Preparing for an Adoption Psychological Evaluation

What should I bring to my pre-adoption psychological assessment?

Bring identification, any required forms from your agency, and relevant records like medical history or previous therapy notes. It’s also helpful to have a list of your own questions for the evaluator.

How long does the adoption psychological evaluation typically take?

The entire process can take 4 weeks. For the meetings, the interview takes approximately 2 hours, while the assessment session takes approximately 3 hours.

What if I have a history of mental health issues?

A past diagnosis isn’t automatically disqualifying—evaluators look at how you’ve managed it and your current stability. Be open about treatments or coping strategies to show proactive self-care.

Is the evaluation different for single parents?

It may place more emphasis on your support network and independent coping skills, but the core focus on readiness remains the same.

Book a pre-adoption psychological evaluation today

Here Counseling provides timely and effective pre-adoption psychological evaluations in California. This process is incredibly important to the growth of your new family. Not only will we satisfy the adoption requirements, but we believe the insights you’ll gain from our process will help you have the best chance of creating a healthy, thriving family.

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Misattunement
Anxiety, Healthy Relationships

Misattunement: Understanding, Healing, and Restoring Connection

Misattunement occurs when a caregiver, partner, or important figure in someone’s life fails to recognize, respond to, or accurately interpret emotional needs. While occasional misattunement is normal and often repairable, repeated or unresolved misattunement in childhood or adult relationships can create lasting effects on emotional regulation, attachment, and self-worth.

At Here Counseling, we see misattunement as a central theme in therapy because it directly shapes how people experience safety, intimacy, and trust. This article explains what misattunement means, how it affects relationships and mental health, and how therapy can help repair its impact.

What Is Misattunement?

Attunement describes the ability to sense and respond to another person’s emotional state with accuracy and empathy. When attunement is present, people feel understood, validated, and safe. Misattunement happens when those signals are missed, dismissed, or inaccurately interpreted.

Examples of misattunement include:

  • A parent laughing when a child is distressed.
  • A partner minimizing feelings instead of listening.
  • A caregiver being physically present but emotionally unavailable.

Misattunement is not simply neglect or abuse. It can occur in subtle, everyday moments when someone’s emotional needs are not met or are misread. Over time, repeated misattunement—especially in early childhood—can create patterns of insecurity and disconnection.

Misattunement in Childhood Development

Infants and young children rely on caregivers to regulate emotions and provide a sense of safety. When caregivers respond consistently and accurately, children develop secure attachment. When misattunement happens repeatedly without repair, it can lead to:

  • Anxious attachment: The child becomes hypervigilant, constantly seeking reassurance.
  • Avoidant attachment: The child withdraws, learning not to rely on others.
  • Disorganized attachment: The child experiences confusion, fear, or ambivalence toward caregivers.

Research in developmental psychology shows that early misattunement can affect the brain’s stress response, making it harder to regulate emotions later in life. Adults who experienced frequent misattunement as children may struggle with intimacy, fear rejection, or feel chronically unseen.

Misattunement in Adult Relationships

Misattunement does not end in childhood. It shows up in romantic partnerships, friendships, and professional settings. Common signs include:

  • Feeling dismissed when expressing emotions.
  • Arguments escalating because partners misinterpret intent.
  • A sense of “never being on the same page.”
  • Loneliness despite being in a relationship.

While everyone experiences occasional misattunement, repeated patterns can erode trust. For example, a partner who consistently overlooks emotional cues may unintentionally reinforce feelings of abandonment that originated in childhood.

Repair is possible when both people recognize the pattern, communicate openly, and work toward new ways of responding.

The Psychological Impact of Misattunement

Unresolved misattunement can contribute to a range of difficulties, including:

  • Low self-esteem: Feeling “too much” or “not enough.”
  • Difficulty regulating emotions: Overreacting or shutting down.
  • Interpersonal struggles: Fear of closeness or dependency.
  • Symptoms of trauma: Anxiety, depression, or dissociation.

Clients often describe misattunement as a sense of being invisible or unheard. Over time, this can shape identity, leading individuals to doubt their needs or suppress emotions to maintain connection.

How Therapy Helps Repair Misattunement

Therapy provides a corrective emotional experience where attunement is prioritized. A skilled therapist tracks both verbal and nonverbal cues to respond in ways that foster safety and understanding. This process can gradually repair the impact of past misattunement.

Key therapeutic approaches include:

1. Attachment-Based Therapy

Therapists explore early attachment patterns and how they affect current relationships. Recognizing these patterns helps clients understand why certain triggers or relational dynamics feel so powerful.

2. Trauma-Informed Care

For those who experienced chronic misattunement or emotional neglect, therapy may address trauma responses such as hypervigilance or emotional numbing. Trauma-informed approaches prioritize safety, pacing, and empowerment.

3. Emotionally Focused Therapy (EFT)

EFT is particularly effective for couples experiencing misattunement. The therapist helps partners recognize negative cycles and practice responding with empathy and presence instead of defensiveness.

4. Mindfulness and Somatic Work

Since misattunement often disrupts the connection between mind and body, practices that integrate awareness of physical sensations, breathing, and emotions can restore regulation and resilience.

Repairing Misattunement in Relationships

Healing misattunement is not only an individual process but also a relational one. Steps toward repair include:

  • Noticing cues: Paying attention to tone, body language, and facial expressions.
  • Clarifying intentions: Asking instead of assuming.
  • Acknowledging misses: Saying, “I think I misunderstood you—can we try again?”
  • Practicing presence: Putting aside distractions to be emotionally available.

Repair does not mean achieving perfect attunement. Instead, it means recognizing moments of misattunement and working to reconnect. Relationships become stronger when repair is possible.

Misattunement, Trauma, and Complex PTSD

For individuals with complex trauma, misattunement is often part of a broader history of neglect, emotional unavailability, or inconsistent caregiving. In these cases, misattunement may feel less like occasional misunderstanding and more like a deep, pervasive wound.

Symptoms may include:

  • Persistent feelings of emptiness.
  • Fear of abandonment or rejection.
  • Difficulty trusting others.
  • Intense shame or self-criticism.

Therapy in these cases focuses on building safety, slowly re-establishing trust, and helping clients reconnect with their authentic emotions.

How Here Counseling Can Help You Heal Misattunement

At Here Counseling, we understand how painful and isolating misattunement can feel. Many of our clients come in saying, “I don’t think my needs matter” or “I’ve never really felt understood.”

Our therapists create a compassionate space where your feelings are welcomed—not dismissed. We use approaches like somatic experiencing, attachment-focused therapy, and trauma-informed care to help you:

  • Reconnect with your emotions safely
  • Recognize and unlearn old patterns of disconnection
  • Build healthier, more secure relationships
  • Experience what it feels like to be deeply attuned to

Healing doesn’t happen overnight, but with gentle guidance, you can move from feeling unseen to truly known and valued.

FAQs on Misattunement

What is misattunement and how is it different from neglect?
Misattunement is when emotional needs are misunderstood or mismatched, while neglect is when needs are ignored altogether. Both hurt, but misattunement is often subtler and harder to recognize.

Can misattunement in childhood cause problems in adult relationships?
Yes. It can lead to difficulty trusting, fear of rejection, or a tendency to hide emotions in order to “keep the peace.”

What does “repairing misattunement” look like in therapy?
Repair means being accurately seen and understood, sometimes for the first time. A therapist helps rebuild trust in yourself and others through consistent attunement.

Can misattunement be healed without therapy?
Some healing can happen through supportive relationships, self-reflection, and self-compassion practices—but therapy often accelerates the process by offering intentional repair.

Are somatic techniques helpful for misattunement?
Yes. Since misattunement often impacts the nervous system, somatic approaches help release stored tension and increase feelings of safety.

How long does it take to feel safer after misattunement?
Healing timelines vary. Many clients notice subtle shifts within weeks, but deeper repair often takes months to years of consistent support.

What should I expect in my first session about misattunement?
You can expect a safe, nonjudgmental space to share your story. The therapist will listen closely, validate your experience, and help you begin understanding patterns.

Is misattunement the same as emotional neglect?
Not exactly. Misattunement is often unintentional and subtle, while neglect involves a complete absence of care. But both can leave lasting emotional wounds.

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Dissociative Disorders
Anxiety

Dissociative Disorders: Symptoms, Causes, and Treatment

Dissociative disorders are mental health conditions where a person’s thoughts, memories, identity, and sense of reality become disconnected. While occasional dissociation is common—for example, daydreaming or losing track of time—dissociative disorders are more severe, persistent, and disruptive to daily life. At Here Counseling, we help clients understand these conditions, recognize symptoms, and begin treatment that supports healing and stability.

What Are Dissociative Disorders?

Dissociative disorders fall under a group of psychiatric conditions characterized by disruptions in memory, identity, perception, or awareness. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the primary types include:

  • Dissociative Identity Disorder (DID): Presence of two or more distinct identity states or “alters,” often accompanied by memory gaps.
  • Dissociative Amnesia: Inability to recall important autobiographical information, usually linked to trauma or stress.
  • Depersonalization/Derealization Disorder: Persistent feelings of detachment from oneself (depersonalization) or surroundings (derealization).

These conditions are usually linked to overwhelming stress, childhood trauma, or repeated exposure to abuse.

Common Symptoms of Dissociative Disorders

Symptoms vary depending on the specific type of dissociative disorder, but common experiences include:

  • Memory loss (amnesia): Gaps in recollecting events, personal history, or identity.
  • Identity confusion or alteration: Feeling like multiple identities exist within oneself or behaving as different “selves.”
  • Out-of-body experiences: Feeling detached from one’s body, voice, or actions.
  • Emotional detachment: Numbness, blunted affect, or feeling disconnected from emotions.
  • Unreal surroundings: Environments may feel dreamlike, foggy, or distorted.
  • Difficulty functioning: Impairments in relationships, work, or daily life tasks.

Because these symptoms overlap with anxiety, depression, or post-traumatic stress disorder (PTSD), dissociative disorders are often misdiagnosed or overlooked.

What are the Causes and Risk Factors of Dissociative Disorders?

Research indicates that dissociative disorders are strongly associated with trauma, particularly repeated or severe trauma in childhood. Other contributing factors include:

  • Chronic abuse or neglect: Physical, emotional, or sexual abuse during developmental years.
  • Exposure to war or natural disasters: Severe stressors that overwhelm coping mechanisms
  • Family instability: Growing up in an unsafe, chaotic, or emotionally invalidating environment.
  • Comorbid conditions: PTSD, borderline personality disorder, and major depression frequently co-occur.

Dissociation serves as a psychological defense mechanism, helping individuals distance themselves from overwhelming experiences. While protective in the short term, it becomes maladaptive when it persists into adulthood.

Diagnosis and Assessment

Diagnosis involves a comprehensive psychiatric evaluation. Clinicians use structured interviews, psychological testing, and diagnostic criteria outlined in the DSM-5. Tools often include:

  • SCID-D (Structured Clinical Interview for Dissociative Disorders)
  • Dissociative Experiences Scale (DES)
  • Trauma history assessment

Because symptoms can mimic neurological disorders (like seizures or brain injury), medical evaluation may also be necessary to rule out physical causes.

Treatment Options

Treatment focuses on increasing stability, reducing dissociative episodes, and addressing underlying trauma. The most effective approaches include:

1. Psychotherapy

The foundation of treatment is trauma-focused psychotherapy, which helps clients process memories safely and integrate fragmented parts of the self. Approaches may include:

  • Cognitive Behavioral Therapy (CBT): Targets maladaptive thought patterns.
  • Dialectical Behavior Therapy (DBT): Improves emotional regulation and distress tolerance.
  • Eye Movement Desensitization and Reprocessing (EMDR): Addresses traumatic memories.
  • Internal Family Systems (IFS) therapy: Helps reconcile and integrate different parts of the self.

2. Medication

While there are no medications specifically for dissociative disorders, antidepressants, anxiolytics, or antipsychotics may help manage associated symptoms like depression, anxiety, or insomnia.

3. Grounding Techniques

Clients often benefit from grounding exercises that reconnect them to the present moment, such as focusing on physical sensations, breathing techniques, or sensory cues.

4. Supportive Care

Building strong therapeutic alliances, supportive relationships, and healthy coping strategies is critical for recovery.

Living with Dissociative Disorders

Recovery is a gradual process. Individuals often need long-term therapy and consistent support. Key strategies that help include:

  • Routine and structure: Predictable daily habits reduce stress and confusion.
  • Psychoeducation: Understanding how dissociation works empowers clients to recognize early signs.
  • Crisis planning: Developing coping strategies for episodes of amnesia or depersonalization.
  • Support networks: Family therapy and peer groups can provide stability and validation.

Dissociative Disorders vs. Other Conditions

It is important to distinguish dissociative disorders from related conditions:

  • Schizophrenia: Unlike DID, schizophrenia involves hallucinations and delusions, not identity shifts.
  • Bipolar disorder: Mood swings differ from dissociative identity changes.
  • PTSD: While PTSD may include dissociation, dissociative disorders involve more persistent and pervasive disruptions.

Accurate diagnosis ensures that treatment addresses the right condition.

When to Seek Help

Persistent memory gaps, episodes of losing time, or a sense of living “outside your body” are signs to seek professional evaluation. Left untreated, dissociative disorders can interfere with work, relationships, and overall well-being. Early intervention improves outcomes significantly.

At Here Counseling, we provide evidence-based care tailored to each client. Our therapists are trained in trauma-informed approaches and work collaboratively to promote safety, trust, and healing.

FAQs About Dissociative Disorders

1. What’s the difference between dissociation and psychosis?
Dissociation involves feeling detached from your identity, memory, or surroundings while usually knowing the experience is internal. Psychosis, by contrast, involves losing reality testing, such as experiencing delusions or persistent hallucinations. If you’re unsure which applies, a mental health clinician can help clarify.

2. Can dissociative disorders be caused by trauma?
Yes. Severe, repeated, or early trauma—especially interpersonal trauma in childhood—is a common cause of dissociation. That said, trauma isn’t the only factor, and not everyone who experiences trauma develops a dissociative disorder.

3. Is dissociation the same as daydreaming?
No. Daydreaming is typically voluntary and harmless, while dissociation tends to be automatic, distressing, or disruptive to daily life. Many people describe it as zoning out in a way that feels beyond their control.

4. Can children experience dissociative disorders?
Yes. Children can show dissociative symptoms, though it’s important to distinguish between normal imaginative play and concerning dissociation. A trauma history and noticeable impairment in functioning are key factors professionals consider.

5. Will medication cure dissociation?
There’s no single medication that cures dissociation. However, medication can help address related conditions like anxiety, depression, or PTSD. Psychotherapy is usually the central treatment approach.

6. What should I ask a therapist if I suspect dissociation?
Good questions include:

  • Do you have experience treating dissociation and trauma?
  • How do you pace therapy and focus on stabilization?
  • Do you collaborate with psychiatrists or other providers if needed?
  • How do you approach building safety and trust in sessions?

How long does treatment take?
Treatment varies widely. Some people notice progress in a few months, while others—especially those with complex trauma or dissociative identity disorder (DID)—may engage in therapy for years. The pace should always align with your sense of safety and readiness.

Where can I find peer support?
Online communities such as Reddit’s r/DID and similar lived-experience forums can provide peer support and validation. These spaces are best used as complements to professional treatment, not as replacements.

Final Thoughts

Dissociative disorders are complex but treatable conditions rooted in trauma. Understanding their symptoms, causes, and treatment options can help individuals and families seek the right support. At Here Counseling, we focus on trauma-informed care that fosters integration, resilience, and lasting recovery.

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Healthy Relationships, Managing emotions

Trouble Communicating? Your Unconscious Could Be Why

Unconscious patterns can block communicating your needs and feelings in relationships

Many people have trouble communicating what they feel and want in their closest relationships. Instead, of sharing their honest selves they hide and experience relationships as frustrating and disappointing.

You might relate to how the pattern unfolds: Your partner or friend asks “Is something wrong?” At that moment you know that something is wrong. You feel angry, confused, or worried. Some part of you wants to find the words to communicate this, to draw close to your relationship by sharing what you truly feel. But instead–without even thinking about it–you force yourself to smile and reply, “No, I’m good. How are you doing?” 

Being unable to share what you truly want and need in relationships is a painful and frustrating pattern for many people. One important way to transform how we show up in relationships is by understanding unconscious patterns of thinking that automatically shape our interactions and act as an obstacle to real communication and closeness. Thankfully, by facing our unconscious we can change how we relate to other people and our experiences.

Understanding Our Unconscious Minds

Decades of neuroscience have confirmed that our brains and mental processes are incredibly complex. In fact, our minds often shape our behavior in relationships without our direct or conscious awareness. Below are three key ways that our minds automatically shape our relationships without our awareness1.

1. Relational learning

Think about how you have learned throughout your lifetime. Some things, like math and state capitals, were learned consciously. At school you intentionally memorized how to solve problems and facts like the capital of California is Sacramento. 

But how did you learn what your family valued most or what calmed your parents when they were anxious? This kind of learning was likely implicit or unconscious. You learned these core patterns by being immersed in relationships with people. In other words, you learned constantly just by being with others, making powerful connections without even realizing it.

Take someone who struggles with navigating conflict because they fear saying they are upset and want something different. That person was probably not taught in a classroom to fear conflict and deny their true wants and needs. Their parents probably never sat them down and gave a lecture on fearing conflict in relationships either. Instead, through key relational experiences with the most important people in their lives, they may have unconsciously taken in the message that conflict is unsafe and must be avoided at all costs.   

2. Interpreting others and ourselves 

Our minds also automatically and unconsciously make sense of behavior in relationships. If a loved one arrives late to meet you, you may automatically interpret their lateness as evidence that they don’t value the relationship as much as you do. 

However, a factor outside of their control, maybe traffic or a last minute meeting, may have impacted their ability to arrive on time. Despite knowing this possibility your mind may rapidly interpret the situation as a hurtful reminder about you as a person: “They’re late because I’m not really loved.”

On the other hand, our mind may automatically explain away the loved one’s actions with context, ignoring aspects of their personality and choices that shape the relationship. For example, a partner’s angry outbursts may always be explained, and perhaps even justified, because of a stressful job. In this case how the partner’s personality, feelings, and choices are shaping the relationship may automatically be ignored. Instead of facing the reality of conflict to heal and grow, unconscious patterns may automatically sweep it away.

Automatic patterns like these leave people in a state of constant self-criticism. But this isn’t a fair conclusion–and may itself be an unconscious attack on ourselves! After all, these patterns are automatic and unconscious, we don’t know that we are choosing them. That is, until someone helps us to discover them. 

3. Automatic action and triggers

Relationships are shaped by complex patterns involving feelings, thoughts, and actions that are triggered without our awareness. Like a big machine that is activated with just the flip of a switch, your mind and body may have learned ways of thinking, feeling, and acting in response to cues. 

One cue could be your co-worker casually commenting that they liked the work of someone on your team. Immediately, you might notice thoughts that your co-worker never liked you, feelings of self-criticism and worry, and  body sensations like getting tense and hot. With this complex pattern activated you would understandably take actions like withdrawing and avoiding the co-worker. 

These patterns are rarely known to us. In fact, we might only realize we are operating in this unconscious pattern after the thoughts, feelings, body sensations, and actions collectively create some difficulty in our life. At times we might even experience suffering in the form of panic attacks, feeling hopeless, and struggling in our relationships without any awareness of why or how these patterns came to be. 

Thankfully, there is hope. By going back and consciously exploring what cued our unconscious relationship patterns, we can discover why we reacted like we did. 

Attachment: The Most Basic Relationship We All Learned 

These types of unconscious processes in relationships are shaped by our earliest bonds to parents and caregivers, also known as attachment relationships. Because these relationships began before we could speak or consciously make sense of the world, attachment began as purely implicit and relational learning. In other words, we intuited how to have relationship with our specific parents and caregivers by watching, listening, and feeling–all without consciously knowing it!

Our young minds unconsciously took in lessons to help us stay close, safe, and calm with our attachment figures. But as we’ve seen, some of the lessons that once served and protected us become barriers to healthy relationships in the present. Without truly understanding and facing this past, we easily repeat it without awareness in the present.   

Therapy Helps Make the Unconscious Conscious

While our minds and their unconscious processes are powerful there is reason for hope. Therapy provides a supportive relationship to gently and wisely explore why we struggle to truly share our desires and needs with others. By courageously looking at the places where you are stuck or trapped, therapy can be a journey together of tracing your journey back in order to finally move forward. 

Therapy to help you understand and overcome harmful patterns you are not fully aware of helps in several ways:

1. Discovering automatic patterns together 

We all have automatic patterns of feelings, thoughts, sensations, and actions that are activated quickly and without our awareness. Therapy is a special relationship to discover and identify these automatic patterns together. Having an outside perspective also allows you to figure out what cue or trigger brought on the pattern that has you stuck. 

Facing these unconscious parts of our minds can feel deeply vulnerable. The reality that we have been caught in some pattern may bring on strong emotions like embarrassment, guilt, or shame. Having a trusted therapist can be a tremendous help when courageously understanding yourself.

2. Facing grief and anger

Therapy is illuminating. Self-critical people may discover the relationship that taught them to be harsh with themselves, people struggling with fear and worry may understand the first time they felt unsafe, and people who can’t stop over-working may recognize powerful messages of accomplishment they once received. 

Attachment research tells us that difficult experiences may have once made unconscious patterns necessary. In order to stay close and connected to loved ones and parents, we may have taken on patterns that no longer serve us. Understanding your unconscious patterns to improve your relationships may also mean discovering past moments that bring on grief and anger.

In these moments, feelings of grief and anger are understandable and healthy responses that want to be felt and resolved. Having a supportive and expert therapist provides the help you need to face and resolve these feelings and the suffering they create in your relationships now.

3. Figuring out how to get un-stuck together

Finally, therapy is a unique relationship because unconscious patterns inevitably activate between the patient and therapist. Even if you are unsure of how you are getting stuck in frustrating patterns, the therapy relationship itself will shine a light on what is happening in other relationships.

For example, someone who feels dissatisfied in dating relationships might come to therapy and automatically begin to try and “become” the patient they think the therapist wants them to be, ignoring their own preferences. This pattern of hiding who they actually are can be faced together and understood. Chances are if it is happening in the relationship between patient and therapist it is also being triggered in other important relationships. 

Hope for Meaningful Relationships

Our minds and brains are extremely complex and powerful. When functioning well enough they help us to creatively face the challenges of our lives and develop meaningful relationships. But all too often unconscious and automatic patterns bring us to same outcomes over and over again without us knowing how we arrived there. Relationships that once seemed so promising wind up stuck and struggling in the same way that others did before.

You are not doomed to these automatic and frustrating patterns. When you are aware of unconscious patterns you can begin to make choices in relationships that actually lead to connection and joy. Your mind, body, and relationships are ready to heal and learn new ways of living. To deepen your self-understanding and heal your relationships from unconscious patterns, schedule an appointment with me today. 

Andrew Wong, Therapy for Depression and Men in Pasadena
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executive with Poor sleep hygiene
Anxiety, Managing emotions

Terrible Sleep Habits? How Executives Can Stop Destructive Late Nights and Actually Rest

You’re exhausted, but when bedtime rolls around, they just can’t let go. Instead of drifting off, you linger in the wee hours, scrolling through your phones or binge-watching shows that don’t even hold your interest. It’s not that you don’t know better—you do. You feel the pull to sleep, to recharge for the demanding day ahead.

You’re looking for a sliver of time that’s just yours, free from emails, meetings, or family obligations.

Poor sleep hygiene for executives often stems from that craving for autonomy. It’s like they’re carving out a secret space to breathe, to feel like themselves again—the version that’s not always adapting to everyone else’s needs or expectations.

Yet, the moment they start to enjoy time away from work, guilt creeps in. “I should be sleeping,” they think. “This is a waste of time.” And so begins the internal battle, leaving them stuck in a hazy middle ground where they get neither sleep nor real enjoyment.

High-Achievers Often Sleep Terribly

You push through long days, making decisions that affect teams or entire companies, all while juggling personal responsibilities. By evening, you’re wiped out, but that quiet time after everyone else has gone to bed feels like the only chance to unwind without interruption. Maybe you tell yourself it’s just a quick check of social media or one more episode, but hours slip away.

The problem isn’t the activities themselves; it’s that they’re not truly fulfilling. You’re not laughing with friends, pursuing a hobby that lights you up, or even just daydreaming freely. Instead, it’s this numb scrolling, half-hearted and laced with self-reproach. You end up feeling more drained, frustrated with yourself for “wasting” time, and then the cycle repeats the next night.

Sleep suffers, energy dips, and that sharp edge you need for your professional life starts to dull. Over time, this constant push-pull can leave you feeling fragmented, like parts of yourself are unraveling under the strain of always putting duty first:

Poor Sleep Hygiene is Costing You a Lot

SymptomStatisticReference
Diminished Focus and Decision-MakingAfter five consecutive nights of partial sleep deprivation, participants showed reduced data gathering before making decisions and increased risk propensity.Effects of Total and Partial Sleep Deprivation on Reflection … – https://pmc.ncbi.nlm.nih.gov/articles/PMC7261660/
Lowered Creativity and InnovationDeclines in sleep are associated with lower individual creativity and productivity, significantly impacting the elaboration process in innovation.Workforce sleep and corporate innovation – ScienceDirect.com – https://www.sciencedirect.com/science/article/pii/S0048733325000204
Increased Irritability and Mood SwingsPoorer sleep quality is directly associated with increased irritability (β = 0.25, p < .001).Associations between sleep quality and irritability – PubMed Central – https://pmc.ncbi.nlm.nih.gov/articles/PMC10978035/
Heightened Risk of BurnoutAt least 79% of UK employees experience burnout, with around 35% reporting extreme or high levels due to factors including lack of breaks.64 workplace burnout statistics you need to know for 2024 – Spill – https://www.spill.chat/mental-health-statistics/workplace-burnout-statistics
Strained RelationshipsPoor sleep leads to increased feelings of anger, which in turn negatively impacts perceptions of romantic partnerships.New psychology study uncovers the romantic consequences of poor … – https://www.psypost.org/new-psychology-study-uncovers-the-romantic-consequences-of-poor-sleep-quality/
Physical Health DeclineInsufficient sleep leads to increased incidences of cardiovascular morbidity and chances of diabetes mellitus, with about 1 in 3 US adults reporting not getting enough rest.What Are Sleep Deprivation and Deficiency?
Reduced Productivity and PerformanceFatigue from poor sleep costs US companies around $136.4 billion annually in productivity losses.The Link Between Sleep and Job Performance – Sleep Foundation – https://www.sleepfoundation.org/sleep-hygiene/good-sleep-and-job-performance
Elevated Anxiety and DepressionParticipants averaging 6 hours or less of sleep per night are about 2.5 times more likely to have frequent mental distress, including anxiety and depression symptoms.Effect of Inadequate Sleep on Frequent Mental Distress – CDC – https://www.cdc.gov/pcd/issues/2021/20_0573.htm
Hindered Career ProgressionNearly 25% of US adults suffer from insomnia, often experiencing excessive sleepiness that impacts work performance and career opportunities.When Insomnia Threatens Your Career: Finding Balance Between … – https://wesper.co/blogs/wesper-journal/when-insomnia-threatens-your-career-finding-balance-between-sleep-and-work
Compromised Overall Well-BeingLack of sleep is compromising the mental health of 78% of adults, contributing to reduced overall well-being.Lack Of Sleep Is Compromising The Mental Health Of 78% Of Adults – https://neurowellnesstms.com/lack-of-sleep-is-compromising-the-mental-health-of-78-of-adults/

Poor Sleep Hygiene Is the Result of Unmet Needs

What if we flipped the script and saw this late-night resistance not as a flaw, but as a signal from your innermost self? Deep down, you’re craving freedom. You want a moment to simply exist without the constant adjustments to please or perform for others. It’s a chance for your creative, spontaneous side to emerge uninterrupted.

This is called your “creative self” and it’s as essential to your brain as food is to your body. This is the impulse you feel, especially after a demanding week, to indulge yourself, to play, to do something that’s not for anyone else but you. Sometimes it’s wanting to create, explore, connect, or simply enjoy.

The “creative self” passively repairs your mind

Accessing the Creative Self is the way we flush out the content of the day, daydream, and often, we passively find solutions to hard problems. It’s a mode that restores our energy, and is essential for high level creativity and problem solving. It’s what some people call “active rest”, and neglecting it has detrimental consequences for your body and mind.

Connecting with this aspect of yourself is like coming up for air in competitive swimming. That breath might feel like it costs you speed in the moment. But skip it too often, and your form starts to falter. Your strokes weaken. Eventually, you’re gasping and collapsing from lack of oxygen.

Or think of an F1 driver eyeing a pit stop. To a rookie, it seems like a frustrating delay that slows the race. But a seasoned pro knows refusing to change those worn tires will lead to blowouts, spins, or worse. It could derail the whole lap.

Similarly, a marathon runner can’t skip hydration breaks thinking they’ll save time. Dehydration leads to cramps and slowdowns. It could mean dropping out of the race altogether.

In the same way, you might not realize just how much denying yourself that exhale—to play, to reward yourself freely—is costing you. It clouds your focus at work. It strains your relationships. That unmet need to create and enjoy doesn’t vanish. It builds up, and if not listened to, can create larger problems down the road like angry blow ups, burnout, avoidance of important problems, relationship stress and chronic pain.

Honor Needs Openly for Balance

Imagine honoring that need openly, without the sneakiness or shame. Picture building it right into your week—like scheduling an evening walk where your mind can wander, or dedicating time to a creative pursuit that brings a genuine smile.

Treat it as non-negotiable, just like a key meeting or a workout. As Winnecott, a British psychologist, once observed, “It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in being creative that the individual discovers the self.”

The Emotional Habit that’s Impacting Your Sleep

This pattern is a step-by-step emotional process where your drive to be always productive collides with a quieter, more authentic urge for down time, leading to an exhausting back-and-forth that gives you neither. This often traces back to early habits of always putting others first, shaping a pattern where your own needs feel secondary.

Here’s what’s unfolding inside:

  1. Constant Demands Build Up: Your day starts with a whirlwind of responsibilities—leading teams, solving problems, supporting family—where you’re always tuning yourself to fit what others need. It’s like wearing a mask of efficiency and reliability, but over time, this nonstop accommodation leaves little room for your own unfiltered thoughts or whims. By nightfall, you’re craving a break from this role, a space where you don’t have to adjust or perform.
  2. Personal Space Rebellion Emerges: As the house quiets down, that suppressed part of you stirs—a need for autonomy, for time that’s purely yours to let your mind drift or explore without agenda. It’s not laziness; it’s your creative self pushing back, seeking a moment of uninterrupted being where you can feel whole and alive, not fragmented by constant demands.
  3. Self-Doubt and Fragmentation Intrude: Just as you start to relax into it, the critical voice kicks in: “You should be productive or sleeping—this is selfish.” This clash creates an inner fracture, where guilt amplifies the tension, turning what could be restorative into something anxious and draining. You feel scattered, like pieces of yourself are pulling in opposite directions, leading to that numb, unproductive limbo.
  4. Grey Zone Stalemate Persists: Stuck in the middle, you default to safe but empty habits like doom-scrolling, which mimic freedom without delivering real joy or rest. The tug-of-war drags on, eroding your energy and leaving you frustrated, as neither side “wins”—you don’t get the sleep you need, nor the genuine recharge your inner self is begging for.
  5. Guilt wins: You finally tell yourself you’ve really messed up, and that you need to be better about getting to bed at a good time. You chastise yourself, and head off to bed dreading how tired you’ll be tomorrow, wishing you hadn’t been so selfish… only to start at #1 again in the morning.

Guilt Blocks Progress, Not Your Need for Down Time

The biggest hurdle to your sleep?

It’s NOT your need for down time.

This is where we need to get it right. Your need to relax and recoup, to access your creative self, is not the problem. The problem is that you’re not respecting your valid need for a break to yourself, and when you do, it’s crowded out by guilt.

That nagging guilt. It whispers that taking time for yourself is indulgent, that real leaders push through without “frivolous” breaks. Maybe it stems from early lessons about hard work equaling worth, or from seeing colleagues who seem to never slow down. Whatever the root, it keeps you locked in the tug-of-war, afraid that embracing your need to just be means dropping the ball elsewhere. But here’s the truth: ignoring that need doesn’t make it go away; it just manifests in ways that harm you more, like poor sleep, burnout, and that sense of inner unraveling.

Guilt is that root problem. If you didn’t have guilt, you might plan a reasonable time to enjoy yourself. Even a half hour doing something you truly enjoy *without guilt* is rewarding. But waffling back and forth all night leaves you both unsatisfied and more exhausted.

Guilty Self-Talk vs. Healthy Alternatives

Guilty PhraseHealthy Alternative
“I should be sleeping instead of this.”“I deserve this moment to unwind and recharge.”
“This time is such a waste— I need to be more disciplined.”“Taking time for myself now will make me sharper tomorrow.”
“Why do I always sabotage myself like this?”“It’s okay to honor my need for autonomy.”
“Real professionals don’t need personal time; they just power through.”“Play and rest are essential for my long-term success.”

Depth Therapy Offers Support

Therapy offers a gentle path forward. In these conversations, you explore the origins of that inner conflict in a safe, supportive space—no judgments, just curiosity. It’s about uncovering why you’ve learned to prioritize accommodation over your own creative flow. It’s also about rediscovering the freedom to exist without constant interruption or self-reproach.

You’ll learn to quiet the critical voice and build a stronger sense of permission, allowing your true self to surface without the anxiety of fragmentation. Many find that as they delve deeper, sleep improves naturally, energy returns, and life feels less like a constant pull and more like a harmonious flow. Reaching out to a therapist could be the kindest step you take for yourself.

FAQ

What causes poor sleep hygiene for busy professionals?

For busy professionals who struggles to sleep at the end of the day, poor hygiene is often a conflict between daily demands and the need for personal autonomy, leading to guilt and unproductive habits that disrupt sleep.

How can professionals incorporate downtime without guilt?

Start by scheduling short, intentional breaks for enjoyable activities earlier in the evening, treating them as essential for overall well-being and performance.

When should someone consider psychotherapy for sleep issues?

Consider psychotherapy if guilt around self-care feels persistent and impacts sleep, work, or relationships, as it helps explore and resolve underlying conflicts.

What are quick ways to improve sleep hygiene?

Establish a consistent bedtime routine, limit screen time before bed, and create a calm sleep environment free from distractions.

How does poor sleep affect professional performance?

It can lead to reduced focus, decision-making errors, and increased stress, ultimately impacting productivity and relationships.

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Teen girl achieving success in school due to proven ADHD strategies
Managing emotions, Parenting

Screen Time Cripples Teen Girls’ Mental Health: How to Replace Social Media with Belonging

Imagine your teenage daughter scrolling endlessly on her phone late into the night, her face lit by the glow, but her mood darkening with each swipe. She seems more withdrawn, anxious about school or friends, and you’re left wondering if all that time online is taking a toll. If this scenario feels familiar, you’re not alone—many parents in Pasadena notice these shifts as screen time rises. Research increasingly links excessive screen use to mental health struggles in adolescent girls, from heightened depression to disrupted sleep.

In this post, we’ll explore research findings on screen time’s impact, categorize the top 3 negative effects on teenage girls with real examples, overview proven strategies to limit it, and highlight studies on replacing screens with in-person activities for positive change. Drawing from experts like Gabor Maté on trauma and disconnection, this can lead to less worry at home and healthier teens—let’s get started.

Research Findings on Screen Time’s Impact on Adolescent Girls’ Mental Health

Recent studies paint a concerning yet hopeful picture: Excessive screen time correlates with poorer mental health in teens, particularly girls, but awareness opens doors to change. As a parent watching your daughter navigate this digital world, it’s natural to feel a mix of worry and determination—let’s unpack what the data shows.

Key Studies Linking Screen Time to Mental Health Risks

A June 2025 APA study found each hour of screen time boosts depressive symptoms severity in adolescents, like a slow-building storm cloud over their emotional skies. CDC research from July 2025 linked high screen use to worse health outcomes, including mental distress, painting a vivid image of teens trapped in a cycle of scrolling and sadness. A 2025 meta-analysis showed screen time positively associated with depressive, anxiety, and stress symptoms, reminding us how these devices, meant to connect, can sometimes isolate our kids in invisible ways.

Girls’ Heightened Vulnerability in Screen Time Research

Girls appear more vulnerable: A UCSF study noted preteens with more screens face higher depression/anxiety later, especially girls, as if the constant comparisons act like mirrors distorting their self-view. Pew’s 2025 report tied social media to teen mental health woes, with girls reporting more negative impacts, evoking the heartache of seeing your daughter dim her light to match filtered ideals. Maté aligns this with healing emotional wounds through presence, fostering resilience against hypervigilance from rejection fears, offering hope that mindful interventions can turn the tide.

Broader Implications from Screen Time Studies

Overall, while moderate use may aid learning, over 2-3 hours daily—especially social media—heightens risks, per a 2025 BMC study, like a gentle stream turning into a raging river that erodes emotional stability. Girls show stronger links due to social comparison and cyberbullying. Maté warns, “Screens displace vital bonds,” compounding trauma through isolation, but this also highlights the power of real-world connections to rebuild what feels lost.

Top 3 Negative Impacts of Screen Time on Teenage Girls

From the research, three key negative impacts stand out for teenage girls, often more pronounced due to social dynamics. Here’s a breakdown with examples—think of these as warning signs, like storm clouds gathering, signaling it’s time for supportive action:

ImpactDescription & Examples
1. Increased Depression & Suicidal ThoughtsExcessive screens, especially social media, correlate with higher depressive symptoms and suicide risk in girls. A 2025 study found girls using phones 5+ hours/day 71% more likely for suicidal thoughts. Examples: Constant comparisons lead to low self-worth; one X parent shared, “My daughter cries over Instagram ‘perfect lives’—now she’s withdrawn and talks negatively about herself.” Maté links this to disconnection: “Trauma is…disconnection from ourselves,” fueled by virtual validation over real bonds.
2. Heightened Anxiety & StressScreens boost anxiety symptoms, with girls showing stronger associations. A 2025 analysis linked screen time to stress/depression in adolescents. Examples: FOMO from feeds causes restlessness; Reddit parents report, “My teen girl panics over unread messages, leading to sleep loss and school avoidance.” Maté notes addictive use as self-soothing gone awry, worsening emotional regulation.
3. Disrupted Sleep & Emotional ProblemsScreens interfere with sleep, linking to mood issues; a 2025 study showed addictive use triples suicide risk via poor rest. Examples: Late-night scrolling causes fatigue/irritability; X discussions highlight “grumpy mornings from TikTok binges.” Maté emphasizes this as compounding trauma through isolation: “High screen time…increases severity of depressive symptoms.”

These impacts create vicious cycles. Screens displace real interactions, deepening disconnection—Maté warns, “Close relationships are the center of a happy life,” yet screens often sabotage them.

Proven Strategies to Limit Screen Time Effectively in Teens

To counter these effects, parents can adopt research-backed strategies for limiting screen time, focusing on balance and alternatives. These approaches emphasize family involvement and positive replacements, creating a nurturing environment where teens feel supported rather than restricted.

Establish Family Agreements on Screen Limits

Set daily guidelines collaboratively, like 1-2 hours non-educational use, using apps for enforcement. A WHO report shows this aids mental health by reducing exposure. Maté supports: “Mindful limits foster presence.”

Make sure boundaries on screen time are co-created. Limits set by parents and communicated unilaterally to teens can create a power struggle filled with resentments. To avoid conflict, yet still create change, try including your teen in creating the screen time boundary:

  1. Present the problem. Tell your teen about the problem you see with the current arrangement with screens. Present the problem in light of your desire for their happiness and growth. For example, you might say, “I notice that you don’t do your normal hobbies after school much because of screens get in the way, then you get irritable when later you don’t have time to do these things that are really life-giving to you.”
  2. Connect with their goal. Ask your teen about how they feel about screen usage and if they were to make a change, what benefit it might have for them.
  3. Tell them your goal. Align with their goal while also stating what you’d like to change: “I agree and want you to grow in that way too. I feel it’s time we make a change with screen time so we can get there.
  4. Enlist their help. “Before I create a boundary, I thought I could get your ideas about the easiest way we could make a good change. What ideas do you have on how we could do screens differently that would make room for your hobbies and friends?”
  5. Negotiate. It’s ok to not just take their first idea. If it feels too mild or unrealistic, it can be intellectually engaging and respectful of their autonomy to be honest about concerns or questions you have, so they can adjust their idea with you: “Well I’m worried if we just limit screen usage after 9pm, we’re not making a change in the part of the day when it counts the most. How can we adjust it?”
  6. Make it pragmatic. Create a boundary that’s easy to remember and easy to enforce. Simple is better. Make a reminder next week on your calendar to check in about the new boundary and see what adjustments you need to make together.

Create Tech-Free Zones and Times

Designate bedrooms/meals as screen-free to improve sleep and interactions. Studies link this to lower anxiety; BMC research confirms reduced emotional distress. Imagine family dinners becoming warm havens of conversation, where laughter replaces notifications, helping your teen unwind naturally.

Model Healthy Screen Habits

Parents limiting their use sets examples—Pew notes teens mirror adults, aiding regulation. Encourage discussions on media’s “perfection” to combat comparison. Picture evenings where everyone plugs in devices together, modeling balance and opening doors to heartfelt talks about the day’s highs and lows.

Promote Offline Hobbies and Monitoring

Introduce sports/arts; BMC studies show exercise mitigates harms. Monitor content gently to address cyber issues. Envision your daughter trading scrolls for a dance class, her energy channeled into joy, with you cheering from the sidelines—small steps fostering resilience and fun.

Positive Outcomes from Replacing Screen Time with In-Person Activities for Girls

Research shows swapping screens for in-person activities markedly improves mental health, especially for girls, like sunlight breaking through clouds after a storm. A 2020 UBC study found teens (including girls) with more extracurriculars and less screen time had better mental health, reducing depression by promoting belonging. A 2022 UK study linked replacing screens with exercise to lowered emotional distress in teens, with girls showing greater benefits from social bonds, evoking the warmth of real friendships over digital likes.

A PLoS One meta-analysis noted “green time” (outdoor social activities) countered screen harms, improving well-being in adolescents by fostering real connections, as if nurturing a garden where self-esteem blooms. For girls, in-person interactions mitigate comparison anxiety from social media—Maté notes this rebuilds self-connection: “Screens displace vital bonds.” Examples: Group sports reduced loneliness in a BMC study, with girls reporting 50% less depressive symptoms, painting a vivid scene of laughter on the field replacing solitary scrolls.

Guidelines for Implementing Screen Limits and Replacements Step-by-Step

To apply this with care, approach as a team effort, like guiding your daughter through a foggy path toward clearer skies:

  1. Assess Usage: Track screen time family-wide—discuss impacts openly, perhaps over ice cream, to make it feel supportive rather than accusatory.
  2. Set Boundaries: Agree on limits (e.g., no phones at dinner); introduce in-person alternatives like family walks, starting small to build enthusiasm.
  3. Monitor & Adjust: Use apps for enforcement; celebrate successes with group activities like board games, adjusting based on her feedback to ensure it feels collaborative.

Screen time’s toll on girls’ mental health is real, but limits and social replacements offer hope, like planting seeds for a brighter future. At Here Counseling in Pasadena, we help families navigate this through somatic therapy for embodied healing, addressing disconnection with warmth and tools tailored to your teen’s needs.

Ready to support your teen? Contact Here Counseling today—healthier habits await.

FAQ: Screen Time Impact on Adolescent Girls’ Mental Health

What is screen time’s impact on adolescent girls’ mental health?

Excessive screen time correlates with higher depression, anxiety, and sleep issues in girls; studies show social media amplifies comparison and stress.

Negative effects of screen time on teenage girls?

Top effects include increased depression/suicide risk, anxiety/stress, and disrupted sleep/emotional problems; research links 2+ hours daily to worsened symptoms.

How to limit screen time for teens?

Set family agreements on daily limits, create tech-free zones, and model behavior; encourage hobbies to replace screens effectively.

Benefits of replacing screen time with in-person activities?

Replacing screens with social activities reduces depression and boosts well-being; studies show extracurriculars cut emotional distress in teens.

Seek therapy if symptoms like persistent anxiety or withdrawal last over 2 weeks or disrupt daily life; early intervention prevents escalation.


Certified Somatic Therapy in Pasadena
Addy Sonneland, Somatic Therapy

Hi, I’m Addy. I work with teens and families to break cycles of anxiety, conflict, and miscommunication. Helping teens heal from anxiety means working on more than just thoughts—it’s also about teaching their bodies to feel safe and regulated. Using somatic therapy techniques, I guide teens in noticing and shifting what’s happening inside, so they can break free from old patterns and discover their innate strengths. We work together with their families to create new ways of relating and supporting each other, building patterns that serve them for a lifetime of confidence, resilience, and connection.

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Anxiety, Managing emotions, Parenting, Somatic Exercises

Your Teen Overwhelmed by Back-to-School Anxiety? 3 Signs, 3 Parenting Pitfalls, and 3 Ways to Help Your Teen Succeed

Picture your teen pacing the kitchen the night before school starts, clutching their stomach and snapping at small questions, their usual spark dimmed by worry. As summer ends and routines resume in Pasadena, anxiety surges, overwhelming many adolescents with restlessness or tears. Back-to-school transitions stir deep fears in teens, from social pressures to academic demands.

In this post, we’ll explore 3 common symptoms teens show from back-to-school anxiety, explaining each with real examples and internal dynamics via interpersonal neurobiology and adolescent development research. Then, we’ll cover common parent missteps that heighten anxiety and effective strategies to support without removing stressors. Understanding these can lead to less tension at home and more resilient kids—let’s begin.

Sign #1: Physical Complaints Signal Back-to-School Anxiety

Parents often notice teens complaining of headaches, stomachaches, or muscle tension as school approaches, turning mornings into battles of persuasion. One Reddit parent shared, “My 13-year-old woke up with stomach cramps every day last week, saying ‘I can’t face school’—it’s clearly nerves about new teachers.” Social media posts describe “teens faking sick to skip the bus,” with symptoms like nausea peaking during back-to-school prep, disrupting family flow. These physical signs can linger into afternoons, with teens rubbing temples or curling up, signaling deep unease.

These bodily responses reflect a nervous system on high alert. Anxiety triggers the body’s stress response, releasing cortisol that manifests as pain. This is partially because the brain’s prefrontal cortex, responsible for regulation, is still maturing. Research from a 2023 CDC study shows 1 in 3 teens experience somatic symptoms from school-related stress, as the developing brain prioritizes survival over comfort. Internally, they’re wrestling with perceived threats—new social hierarchies or academic rigor—needing a safe outlet to process.

Sign #2: Avoidance Behaviors Reflect School Anxiety Struggles

Some teens resist attending school, faking illness or begging to stay home, transforming daily routines into emotional standoffs. A parent on Reddit detailed, “My 15-year-old refuses to get out of bed, claiming ‘I’m too sick’—it’s really panic about cliques and tests every morning.” X examples include “teens melting down at drop-off,” with avoidance escalating to missed days, leaving parents torn between discipline and concern. This can extend to avoiding homework or social events, creating a ripple of tension.

From an interpersonal neurobiology lens, avoidance stems from the amygdala hijacking the brain’s executive functions, perceiving school as a danger zone due to unfamiliarity or past bullying. Adolescent development research from a 2023 McLean Hospital study indicates hormonal shifts heighten this fight-or-flight response in 5-10% of anxious teens, as the still-developing prefrontal cortex struggles to override fear. Internally, they’re stuck in a loop of dread, needing a bridge back to safety without force.

Sign #3: Irritability Means Hidden Back-to-School Anxiety

Anxiety often surfaces as irritability, with teens snapping at siblings or parents over trivial issues, disrupting home harmony. One Reddit parent recounted, “My 14-year-old explodes after school—yelling about homework or a messy room, but it’s really ‘what if I fail?’ fears spilling out.” Social media posts describe “teens slamming doors post-bus,” with daily “mood swings” from unspoken worries, leaving families navigating a minefield of emotions.

Interpersonally, this reflects an immature emotional regulation system, where the limbic system’s reactivity outpaces prefrontal control, per a 2023 APA study noting a 30% rise in teen irritability during school transitions. Developmentally, puberty’s hormonal surge amplifies this, turning anxiety into a pressure cooker that bursts with frustration. Internally, they’re overwhelmed by new demands, needing a release valve for pent-up stress.

Common Parent Missteps That Worsen Teen Anxiety Symptoms

Well-meaning parents can unintentionally heighten teen anxiety through reactive or protective responses, creating unintended harm. These missteps often stem from a desire to alleviate distress but end up reinforcing dependency or fear.

1. Over-Functioning and Babying Teens

Taking over tasks like completing homework or driving them to avoid school amplifies reliance, as a 2023 Mott Children’s study found 25% increased dependence when parents over-function. For example, a parent might say, “I’ll do your project—don’t worry,” leaving the teen feeling incapable, deepening anxiety about facing challenges alone.

2. Becoming Cold and Punitive

Responding with harshness, like “Stop whining and go to school!” triggers more fear, per a 2023 Bryson-led study showing 40% increased dysregulation with punishment. A parent might ground a teen for avoidance, escalating tension—imagine a teen retreating further, feeling rejected instead of supported.

3. Ignoring Emotional Cues

Dismissing complaints with “It’s just nerves, get over it” invalidates their experience, per a 2024 AACAP report linking ignored emotions to 30% higher stress. For instance, brushing off a stomachache might push a teen to bottle up fears, worsening internal chaos.

These pitfalls trap teens in anxiety loops, where overprotection or punishment erodes their ability to self-regulate, leaving parents frustrated and teens more overwhelmed.

Effective Parent Strategies to Support Anxious Teens Without Removing Stressors

Instead of fixing problems, parents can empower teens to navigate anxiety with supportive strategies, fostering resilience and independence while maintaining safety.

1. Offer a Calm Presence for Emotional Regulation

Be a steady anchor, modeling deep breaths during overwhelm to integrate their nervous system—try “Let’s breathe together when it feels big.” A 2024 Compass Health study shows 40% reduced avoidance with this co-regulation, helping teens feel secure to face school.

2. Validate Feelings and Co-Create Solutions

Sit with their emotions, saying “This is tough—how can we tackle it?” to co-create plans, per a 2024 AACAP guide cutting stress by 30% with autonomy. For example, brainstorm a morning checklist together, giving them ownership while easing transition fears.

3. Encourage Structured Outlets for Expression

Guide them to outlets like journaling or sports, offering “Want to write it out or kick a ball?” A 2024 Cedars-Sinai report notes 35% fewer outbursts with structured release, building skills to process anxiety independently.

Parenting StrategyExampleEffect on ChildReference
Offer a Calm Presence“Let’s take deep breaths when you feel overwhelmed about school.”40% reduced avoidance2024 Compass Health study
Validate Feelings and Co-Create“I see you’re worried—let’s plan your morning together.”30% stress reduction2024 AACAP guide
Encourage Structured Outlets“Want to journal or play soccer to unwind after school?”35% fewer outbursts2024 Cedars-Sinai study
Over-Functioning and Babying“I’ll do your project—don’t worry.”25% increased dependence2023 Mott Children’s study
Becoming Cold and Punitive“Stop whining and go to school!”40% increased dysregulation2023 Bryson-led study
Ignoring Emotional Cues“It’s just nerves, get over it.”30% higher stress2024 AACAP report

Guidelines for Seeking Therapy: When Teen Anxiety Warrants Professional Support

Normal anxiety fades; persistent symptoms need attention. Seek therapy if: Symptoms last over 2 weeks, disrupting school or sleep (e.g., refusal, insomnia); physical complaints persist; or self-harm thoughts emerge, per 2023 AACAP guidelines. Early intervention prevents escalation—Pasadena therapists like Here Counseling offer specialized support.

Supporting Teen Transitions: Therapy Eases Back-to-School Anxiety

These challenges are growth opportunities—understanding fosters empathy. At Here Counseling in Pasadena, we help families through somatic therapy for calm integration.

Ready to support your teen? Contact Here Counseling today—brighter days await.

FAQ: Teen Back-to-School Anxiety Symptoms

What are common anxiety symptoms in teens returning to school?

Common symptoms include physical complaints, avoidance behaviors, and irritability; they arise from anxiety overwhelming the nervous system during transitions.

How does anxiety cause physical symptoms in teens?

Anxiety triggers bodily distress like headaches as the nervous system overreacts; research shows this peaks during school stress, needing calm support to ease.

Why do anxious teens avoid school?

Avoidance stems from anxiety viewing school as a threat; developmental studies link this to fear responses, eased by gradual exposure with empathy.

What causes teen irritability from school anxiety?

Irritability is anxiety’s overflow from stress; adolescent brain changes amplify this, requiring patience and outlets to restore balance.

When to seek therapy for teen back-to-school anxiety?

Seek therapy if symptoms persist 2+ weeks, disrupt daily life, or include self-harm; early help like counseling prevents escalation per AACAP guidelines.


Certified Somatic Therapy in Pasadena
Addy Sonneland, Somatic Therapy

Hi, I’m Addy. I work with teens and families to break cycles of anxiety. Helping teens heal from anxiety means working on more than just thoughts—it’s also about teaching their bodies to feel safe and regulated. Using somatic therapy techniques, I guide teens in noticing and shifting what’s happening inside, so they can break free from old patterns and discover their innate strengths. We work together with their families to create new ways of relating and supporting each other, building patterns that serve them for a lifetime of confidence, resilience, and connection.

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Teen back-to-school emotional issues
Managing emotions

7 Back-to-School Issues Teens Face, and How to Help

The backpacks are packed, schedules are set, but as your teen heads off to school, you notice the shift: sullen moods, short tempers, or withdrawn silence after a long day. The transition from summer freedom to structured routines hits hard, stirring up anxiety, irritability, and more. You’re seeing these signs and wondering what’s normal versus when to worry. Many parents report similar struggles as adolescents navigate this pivotal time.

We’ll explore 7 common emotional symptoms teens experience returning to school, using real parent examples and quotes from online forums. For each, we’ll describe the typical problem, then dive into what’s happening in this unique developmental stage, using adolescent neurological and social research. We’ll also discuss what your teen might need, given the emotional issue they’re facing. At the end, guidelines on when to seek therapy. Understanding these can lead to less tension at home and more supported teens.

1. Anxiety and Overwhelm in Teens Returning to School

The Typical Problem: Heightened Worry and Physical Distress

Parents often describe teens overwhelmed by the return to academics, social pressures, and routines, leading to physical symptoms like stomachaches, headaches, or avoidance behaviors. One Reddit parent shared: “My 14-year-old started having panic attacks the week before school—crying about ‘failing classes’ and ‘losing friends,’ even vomiting from nerves on the first day. It’s like summer erased her confidence.” Online posts expand on this, with examples of teens “freaking out over class schedules” or “begging to stay home because ‘everything feels too much.'” These worries can manifest in constant “what if” questions at home, disrupted sleep, or reluctance to discuss school, leaving parents feeling helpless as the anxiety spills into family dynamics.

What’s Happening Internally: Brain Remodeling Under Stress

During adolescence, the brain undergoes massive remodeling, making teens more sensitive to stress—Daniel Siegel calls this the “upstairs brain” (rational thinking) clashing with the “downstairs brain” (emotions), creating overwhelm like a “flipped lid” where logic shuts down: “When kids feel overwhelmed, their emotional brain takes over—it’s like a storm they can’t control yet.” Developmentally, hormonal changes amplify fears of failure or rejection, turning school into a high-stakes arena where overwhelm feels survival-level, often exacerbated by social media comparisons.

What Your Teen Needs to Recover: Safety and Co-Regulation

To recover, teens need a sense of safety through consistent routines and parental co-regulation. Labeling feelings like “I see you’re worried about fitting in” helps integrate brain functions. Developmentally, they crave validation of their emotions without dismissal, plus tools like journaling worries or short mindfulness breaks to rebuild resilience and reduce anxiety’s grip.

2. Irritability and Anger Outbursts in Back-to-School Teens

The Typical Problem: Sudden Snaps and Emotional Volatility

Teens may snap over small things post-school, like homework or chores, as exhaustion fuels outbursts that strain family interactions. A parent on Reddit described in depth: “My 15-year-old comes home raging about ‘stupid teachers’ or siblings touching their stuff—it’s like a switch flips after school, turning minor annoyances into full-blown tantrums that last hours.” X examples include “daily meltdowns over nothing,” with parents noting increased defiance from pent-up frustration, such as slamming doors or refusing dinner, leaving everyone walking on eggshells.

What’s Happening Internally: Heightened Reactivity from Brain Changes

Siegel highlights adolescent “emotional intensity” from brain pruning, where the limbic system amps up reactivity: “Teens feel emotions more strongly, leading to outbursts as the brain learns regulation.” In development, puberty’s emotional volatility combines with school stressors like peer dynamics, making anger a release valve for unprocessed overwhelm or unmet needs.

What Your Teen Needs to Recover: Empathy and Decompression Space

Recovery involves empathy and space—Siegel’s “connect and redirect” means first attuning (“I see school’s tough today”) before guiding behavior. This means your teenager needs to first see that you are feeling what they’re feeling from their perspective, before you suggest changes. We recommend “time-ins” for joint calming, like deep breathing together. Developmentally, teens need outlets like exercise or hobbies to process volatility, plus emotional flexibility that affirms “Your feelings are valid, how can choose how to best express them?”

3. Depression and Low Mood in Adolescents Starting School

The Typical Problem: Withdrawal and Persistent Sadness

Parents report teens seeming “down” or unmotivated, withdrawing from activities or family, which can mimic laziness but signals deeper distress. One Reddit thread shared a vivid story: “My daughter was excited for school but now she’s just sad all the time, sleeping through weekends, skipping meals, and saying ‘nothing matters’—it’s like the spark’s gone.” Social media posts mention “post-summer blues” worsening into “not wanting to do anything,” with examples of lost interest in hobbies or friends, worrying parents about long-term impacts.

What’s Happening Internally: Disrupted Reward and Connection Systems

Siegel describes teen depression as disrupted integration: “When the brain’s reward systems remodel, low mood can emerge from feeling disconnected.” Sadness is about unmet needs for connection and understanding. Developmentally, identity formation amid peer comparisons and academic demands can trigger hopelessness, especially if school feels like constant evaluation without support.

What Your Teen Needs to Recover: Purpose-Building

To recover, teens need belonging. Get your child outside engaged with other kids and adults who know them. They might benefit from an activity that requires their help to accomplish a shared goal, like cooking a family meal, being part of a team sport or musical, or engaging in a collaborative hobby with friends.

4. School Avoidance or Refusal in Back-to-School Teens

The Typical Problem: Resistance and Morning Battles

Some teens resist attending, faking illness or outright refusing, turning mornings into power struggles. A parent on Reddit detailed, “My son refuses school every morning—says it’s too much, hides under covers, and we’ve had tears and arguments daily since day one.” Social media examples include “teens begging to stay home” due to “bullying or overload,” with parents struggling to motivate without force, fearing truancy or emotional harm.

What’s Happening Internally: Fear Overriding Rationality

Siegel explains avoidance as “downstairs brain” dominance: “Fear overrides logic, making school feel like danger.” In adolescent development, autonomy clashes with structure, amplifying resistance when emotional regulation lags behind cognitive growth.

What Your Teen Needs to Recover: Gradual Exposure and Support

Recovery requires gradual exposure—Siegel’s “window of tolerance” expands by starting small, like partial days with check-ins. Developmentally, teens need autonomy in solutions, like counseling or schedule adjustments, to rebuild confidence and attendance. This means including your teen in making decisions about their schedule and priorities, as much as possible. Engage in negotiation in a way that takes seriously the conflict: “Let’s think about this: I hear you’re feeling exhausted by team practice, so what’s the best way to handle it that doesn’t make things harder for you down the line?”

5. Social Withdrawal and Loneliness in Returning Teens

The Typical Problem: Isolation from Peers and Family

Teens may isolate, avoiding friends or family post-school, which parents notice as “hiding in rooms” or declining invites. Reddit parents note, “My 16-year-old comes home and hides in their room—no more social life, even ignoring texts from friends.” Social media shares “loneliness after summer break,” with examples of “cyberbullying pushing kids inward” or “feeling outcast in cliques,” worrying about long-term effects on self-esteem.

What’s Happening Internally: Heightened Rejection Sensitivity

Siegel views withdrawal as integration failure: “Social brains crave connection, but remodeling can heighten rejection sensitivity.” Developmentally, peer focus intensifies, making social setbacks feel like identity threats amid brain changes prioritizing belonging.

What Your Teen Needs to Recover: Gentle Reconnection and Validation

To recover, teens need gentle reconnection—Siegel’s attunement means mirroring feelings: “It sounds lonely; I’m here.” Developmentally, they benefit from low-stakes social steps, like clubs or therapy groups, to rebuild belonging and reduce isolation. Consider talking with other parents about limiting screen or social media time and promote in-person non-screen-based activities. Often social media can act like a collective trap, and collaboration with other parents can help build healthy social connections for everyone.

6. Sleep Disturbances and Fatigue in School-Bound Teens

The Typical Problem: Insomnia and Daytime Exhaustion

Parents report insomnia or oversleeping disrupting moods and performance. One Reddit post said, “Teen can’t sleep from school worry, then crashes all weekend—grumpy and unfocused daily.” Social media posts mention “exhaustion from early starts,” with examples of “falling asleep in class” or “nighttime scrolling anxiety,” concerning parents about academic fallout.

What’s Happening Internally: Shifted Circadian Rhythms

Siegel links this to brain changes: “Adolescent sleep patterns shift later, clashing with school schedules and heightening fatigue.” In development, circadian shifts combine with stress, impairing emotional control and amplifying irritability.

What Your Teen Needs to Recover: Consistent Routines and Rest

Recovery involves consistent routines—Siegel recommends “brain hygiene” like dim lights pre-bed. Developmentally, teens need later bedtimes with screen limits, plus naps or therapy if fatigue persists, to restore energy and mood. Making changes to their routine can be difficult: consider, as we talked about in #4, co-creating a solution with your teen to help reduce the power struggle over their time.

7. Low Self-Esteem and Identity Struggles in Teens Back at School

The Typical Problem: Self-Doubt Amid Comparisons

Teens may doubt themselves amid comparisons, affecting motivation and interactions. A Reddit parent shared, “My kid feels ‘stupid’ after bad grades—self-esteem tanked, avoiding friends and activities.” Social media examples include “identity crises from cliques,” with “shame over fitting in” or “constant self-criticism,” alarming parents about withdrawal.

What’s Happening Internally: Remodeling Self-Concept

Siegel describes “identity remodeling”: “Teens question ‘who am I?’ amid brain changes, leading to self-doubt.” Developmentally, abstract thinking heightens self-criticism in evaluative environments like school, intensifying struggles.

What Your Teen Needs to Recover: Affirmation and Identity Support

To recover, teens need affirmation—Siegel’s “mindsight” encourages self-reflection: “Help them see strengths.” Developmentally, they benefit from identity-exploring activities like clubs or therapy, rebuilding esteem through successes and acceptance.

When Should I Consider Therapy?

While some back-to-school emotions are normal, persistent or intense symptoms warrant professional support. Consider therapy if: Symptoms last over 2 weeks, interfering with daily life (e.g., missing school); physical signs like eating/sleep changes accompany moods; teen expresses hopelessness or self-harm thoughts; or family dynamics worsen. Early intervention prevents escalation.

We have therapists who can help your teen recover to their normal self. In fact, these emotional changes can sometimes be important signals for needed change as they develop into a young adult. Our therapists can help you avoid painful arguments with your teen and create space for them to thrive.

Teen therapy in Pasadena for adolescents

Schedule Teen Therapy in Pasadena

I help teens in Pasadena recover from depression, self-harm, and panic attacks using somatic therapy. I’m Addy Sonneland and I’m a somatic therapist in Pasadena. I can help your teen recover and build on the strengths they need to thrive.

In our consultation call, you can tell me what you’re experiencing with your teen, and I can share how I can help.

Embracing Support: Therapy for Teen Transitions

These challenges are part of growth, but understanding helps. At Here Counseling in Pasadena, we support teens and families through somatic and relational therapy for smoother school starts.

Ready to ease the transition? Contact Here Counseling today—calmer days await.

FAQ: Teen Back-to-School Emotional Challenges

What are common emotional symptoms when teens return to school?

Common symptoms include anxiety, irritability, low mood, avoidance, withdrawal, sleep issues, and self-esteem struggles; they stem from readjustment stresses.

How does school start affect teen anxiety?

School start heightens anxiety through social and academic pressures; Siegel notes brain remodeling amplifies overwhelm, making routines key for regulation.

Why do teens get irritable after school?

Irritability arises from exhaustion and unmet needs; Bryson explains it’s nervous system overload, eased by co-regulation and empathy.

Signs of teen depression from school?

Signs like withdrawal or hopelessness signal depression; development research shows peer comparisons intensify low mood during transitions.

When to seek therapy for back-to-school issues?

Seek therapy if symptoms persist over 2 weeks, disrupt daily life, or include self-harm thoughts; early help prevents escalation.

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Therapy for healing self-criticism, judgement, and blame with self-compassion and hope
Managing emotions

Are You Your Own Worst Critic? How to Heal Self-Criticism

Whoever first realized, “I am my own worst critic” brilliantly described a painful and all too-common way many people relate to themselves. Self-criticism involves harsh or negative views and judgements of one’s self. This pattern of self-criticism is especially overwhelming because the critic is not someone “out there” that can be escaped, but emerges from within someone’s core beliefs and self-concept. Those who suffer from self-criticism feel as if a harsh judge follows right behind them, waiting to criticize any mistake or misstep, no matter how small 1

Self-criticism can be hard to identify, especially for people caught in relating to themselves harshly. Here are several examples of what self-critical thoughts sounds like and possible feelings tied to them:

  • I always make mistakes and I’ll never do better (Feelings: despair, fear)
  • I’m selfish and deserve to be treated badly for it (Feelings: shame, loneliness)
  • I’ll never be as good as her (Feelings: envy, embarrassment)

While self-criticism is a common and painful experience, it is not the most central truth of any person’s life. Beneath the self-criticism, and whatever pain made it necessary, is a living person that desires to heal. Through cultivating new ways of relating to themselves, people can experience self-compassion and understanding. In this article I explore self-criticism, how it contributes to suffering in our lives, why we adopted this relational pattern, and practices for healing harsh judgement with self-compassion. 

Self-Criticism or Healthy Standards?

Through my experiences helping people heal from self-criticism, it’s important to distinguish between holding healthy standards and punishing self-criticism. Below I share common ways people describe healthy standards as well as possible feelings that come along with relating to yourself with a healthy vision of who you want to be. 

Healthy Standards: Hope for the Future

  • I made a mistake but I genuinely want to learn from it and grow (Feelings: hope, strength, resolve)
  • I acted selfishly so I want to repair the relationship (Feelings: healthy guilt, compassion for others)
  • My colleague is so skilled, I want to keep growing too (Feelings: excitement, passion)

Healthy standards give us a vision of the person we want to become. These standards can be internalized from our religious and ethical values, our families, and the people we respect. High standards allowed us to see ourselves as someone on the way, neither perfect nor worthless, but capable of growth and worthy of respect. 

Self-Criticism: Trapped and Powerless

Quite differently, self-criticism creates a completely fixed sense of who we are. It is as if a judge has passed a life-sentence upon us. This harsh judgement communicates that we are bad, unworthy, and powerless to change. One of the easiest ways to determine whether you are holding high standards or self-criticism is to ask yourself: Do I feel hopeful about who I am becoming and my future? Or do I feel powerless and trapped in imperfections?

Being Your Own Worst Critic Leads to Suffering

When self-criticism plays a powerful role in how you understand yourself and navigate through life, it also places you at increased risk for adverse mental health outcomes.

Depression

Unrealistic and harsh judgement are frequently related to low mood, strong negative emotions, and even depression. Punishing self-criticism contributes significant stress to someone and places them at-risk of developing depression. For people actively experiencing depression, the common feelings of worthlessness and inordinate guilt can be sustained or worsened by self-judgement. 

Generalized and Social Anxiety

Anticipating that you will make mistakes and fail can contribute to anxiety disorders, which are characterized by overwhelming worry, restlessness, and fear. Many self-critical people report especially difficult anxiety brought on by social interactions. This is completely understandable since the self-critical person believes that the way they view themselves must be how others also see them. 

Control and Escape

Harsh self-criticism causes people to suffer in profound ways. Anyone caught in these patterns of self-judgement and rejection will understandably look for ways to control and soothe their pain. However, the person suffering from self-criticism often feels cut off from the compassion of others and even their own self-compassion.

This is where highly self-critical people, seeking some relief, may fall into stressful fixations. Seeking some order and relief from the punishing judge, self-critical people may over-control what they can. Unfortunately, their lives can easily become overwhelmed by concerns about:

  • The food they eat
  • What people think about them
  • The grades they receive
  • Their performance at work

Others who feel attacked by the self-critical voice may try to numb or distract themselves from harsh judgement through: 

  • Using alcohol and other substances
  • Seeking constant stimulation and interaction
  • Spending excessive time online

Despite these understandable attempts to find relief, the judge eventually re-emerges. Self-critical people then experience even more of this harsh judgement for dissatisfying attempts at self-soothing. 

Where Does Self-Criticism Come From?

People who suffer from self-criticism frequently share the deep desire to be free of their harsh judge and are puzzled by the ways they feel trapped by it. Oftentimes, someone suffering from self-criticism may not realize that the judge exists because it once helped us to survive and navigate the challenges of life. Below I explain common purposes that self-criticism plays in the lives of people.

Protecting Loved Ones By Taking the Blame

Growing up means building relationships with imperfect parents and caregivers. Even the best parents fail to connect with their children in every situation. Through early childhood experiences, you may have received the message that your parents or caregivers could not tolerate the inevitable challenges of being family. 

In these cases, you may have learned that by taking on all the blame (“It was my fault mom, I’m sorry I was so bad”) you protected your loved one and your relationship. For people who experienced harm from parents and caregivers through abuse or neglect, self-criticism and blame may be even more extreme.

Fitting In and Meeting Expectations

Our lives are also shaped by cultural and social expectations. We want to be “good” people, however that goodness is understood by our families, traditions, and cultures. Relationships with others in our lives also come with expectations. We want to please teachers and coaches, bosses and colleagues, friends and romantic partners. Over time we may embrace self-criticism as a way of meeting standards and maintaining these relationships. 

Controlling Uncontrollable Situations 

Each of our lives is touched by suffering and adversity, albeit in very different ways. At times, experiences feel uncontrollable and go beyond our ability to make sense of them. Trauma occurs when we experience something so stressful that it overwhelms our ability to describe it with words, contain it with feelings, and process it in our body.

Self-criticism is one way to maintain some sense of control amid stress and trauma. A harsh self-criticism (“It was all my fault that terrible event happened”) provides some sense of control and may feel less overwhelming than the truth (“No one could have stopped what happened, it was simply uncontrollable”).

Self-Criticism Came From Somewhere, It’s Time to Heal It

Like any psychological challenge or unhealthy pattern, self-criticism represents a way we learned to navigate the world. In many cases, it was once a brilliant and sadly necessary way to get through life. Healing from self-criticism means understanding the role you once needed it to play. With that recognition also comes the truth that there are other ways to relate to yourself, your relationships, and the challenges of life that do not harshly judge you. Self-compassion is one way forward.

Self-Compassion Heals Self-Criticism

While self-criticism may have been a key way of navigating the world, there are ways to begin healing your internal judge. Even patterns first established in early-childhood can be transformed. Below are three reflection exercises to help you grow in self-compassion today. 

Take a Long-Term Perspective

Growth and change take time. While the self-critic points out that you haven’t reached every one of your goals, self-compassion invites you to take a long-term view of your life and recognize the progress you have made. How have you already grown, changed, or healed? Can you take time to feel the emotions that rise in you as you consider your victories, successes, and perseverance? You may not be where you ultimately hope to be yet, but how far have you come already? 

Speak to Yourself Compassionately

Who has shown you love and acceptance in your life? Can you imagine that person looking you in the eyes and telling you some truth about who you are? If you don’t go immediately to the self-critic and judge, what does this loving relationship say about you? Linger in the feelings and images that emerge as you remain with this loved one and take in their words to you. 

Imagine Your Younger Self

As an adult, can you now tell your younger self what they needed to hear and know–that the hurt was not all their fault, that they were just a kid, that they are strong and will get through the adversity to keep living? While self-criticism keeps people frozen in time, self-compassion allows us to reach into the past and imagine the future from this present moment of compassion and strength. If this exercise brings on feelings that are too overwhelming or difficult, that is ok. The journey of self-compassion takes time and is not meant to be taken alone. 

Therapy for Self-Criticism 

Whether you have worked on self-criticism for years or are just beginning to recognize this pattern in your life, therapy is a powerful relationship to heal the judge and learn self-compassion. In my work with people from many life seasons and experiences, I have learned that the common factor for healing self-criticism is a compassionate and wise relationship. 

If you experience self-criticism and judgement as simply “who you are” a therapist can partner with you to disentangle this pattern from the reality of who you are. Others have gained tremendous insight about their self-criticism, but still don’t feel any differently. A therapist can provide insight into how your thoughts, feelings, and body can experience real healing and relief from judgement. You don’t need to face self-criticism alone. It is time to confront the pattern of harsh self-criticism and cultivate self-compassion in your life, schedule a complimentary consultation with me today.

Andrew Wong, Therapy for Depression

FAQ: Healing Self-Criticism

What is self-criticism?

Self-criticism involves harsh, negative self-judgments that create an internal critic, such as thoughts like “I always make mistakes” leading to feelings of despair or fear. It’s often internalized and can feel constant.

How does self-criticism differ from healthy standards?

Healthy standards are growth-oriented and inspire hope, while self-criticism feels fixed and powerless, focusing on flaws without room for improvement.

What are the effects of self-criticism on mental health?

Self-criticism can contribute to depression (low mood, worthlessness), anxiety (worry, fear of failure), and maladaptive coping like over-control, substance use, or escapism.

Where does self-criticism come from?

It often originates as a survival strategy, such as taking blame to protect relationships, meeting societal expectations, or attempting to control trauma and uncontrollable situations.

How can I heal self-criticism?

Healing involves cultivating self-compassion through reflection exercises and therapy, transforming judgmental thoughts into kinder, more supportive self-talk.

What is self-compassion and how does it help with self-criticism?

Self-compassion is treating yourself with kindness during struggles. It heals self-criticism by reducing suffering, fostering growth, and disentangling criticism from your identity.

What exercises can help practice self-compassion?

Try these: Reflect on long-term growth perspectives, imagine compassionate words from loved ones directed at yourself, or comfort your younger self in a visualization.

When should I seek therapy for self-criticism?

Seek therapy if self-criticism feels overwhelming, deeply ingrained, impacts daily life or mental health, or if self-help exercises aren’t enough for lasting change.

1 I am indebted to the work of Allan Abbas, MD for this image of the cruel judge and how it functions in the metapsychology of people.

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