Graciela Jimenez - Health Channel

Meet the Experts

Graciela Jimenez

Graciela Jimenez, Psychotherapist with Care & Counseling, and Amy Exum, Psychotherapist with Care & Counseling at Baptist Health South Florida explain about the meaning of cognitive behavioral therapy.

They say cognitive behavioral therapy brings different tools about the thought-stopping techniques and the way how to help the patient to change them. “How to intercede into that,” Jimenez says. Graciela Jimenez, Psychotherapist with Care & Counseling, and Amy Exum, Psychotherapist with Care & Counseling at Baptist Health South Florida, say it is necessary to try to put ourselves in the other person’s shoes to understand his depression.

They recommend not using phrases like “everything is going to be OK” or “It is not a big deal” because it increases the patient’s anger and sadness. The news shown by social media can cause anxiety and mental health disorders. For example, shootings at schools have become one of the main fears which both people and specialists must deal with. Psychotherapists agree that people just want to talk about how shootings have impacted them.

“The fear that now arises inside of them, the things that they are worried about, sending their own children to school or just going to the mall. People’s brains don’t turn off because they are worried about what may happen to them,” says Graciela Jimenez.

Amy Exum recommends connecting with ourselves and disconnecting from everything else. Teenagers are more susceptible to irritability, which can be associated with depression and bad mood. As a result, they tend to be isolated, are not communicative and have long periods of sadness.

Psycotherapist Graciela Jimenez explains the differences between irritability, depression and moodiness. She describes that when there is irritability in somebody who is depressed, there is a lot of more snappiness and irritability all the time. “In case of moodiness the person has periods of snappiness, sadness or is excited about things,” she adds.

In teenagers’ cases, normally, they have irritability. However, when they are depressed, it could be more than happiness in their daily life, because these episodes can be happening at home or at school.

The specialist says they’re isolating more, prefer not to talk, be under the computer or be isolated at home. Family support is very important when the first depression’s symptoms appear, says Amy Exum, Psychotherapist with Care & Counseling at Baptist Health South Florida.

The specialist also says the relatives have to get professional help with primary care physicians, psychiatrists and therapists in order to guide the patient.

Knowing the patient’s feelings is very important too, because everybody’s depression is different and it is imperative to know what’s going on with the patient, says Graciela Jimenez, Psychotherapist with Care & Counseling. According to the World Health Organization, one in five Americans will have an episode of major depression at some point in their life and more than 300 million people worldwide suffer from this illness.

Graciela Jimenez, Psychotherapist with Care & Counseling at Baptist Health South Florida, explains depression is not only sadness. “Not everybody has the same sadness,” she says.

Amy Exum, Psychotherapist with Care & Counseling at the same center, adds that change weight, sleep problems, decreased energy and concentration and self-destructive and suicidal behavior are other depression’s symptoms. There are many factors that contribute to depression and the brain could be one, says Amy Exum, Psychotherapist with Care & Counseling at Baptist Health South Florida.

One of these factors is a chemical imbalance, associated with neurotransmitters and receptors in the brain, but the specialist adds it is also necessary to observe the events in the patient’s life.

Graciela Jimenez, Psychotherapist with Care & Counseling at the same place, talks about the family factors that contribute to depression. Graciela Jimenez, Psychotherapist with Care & Counseling, and Amy Exum, Psychotherapist with Care & Counseling at Baptist Health South Florida, agree about how activity can help and improve the adolescent behavior.

Exercise is such a big component to helping with depression, because it improves the mood, helps release endorphins and the chemicals that the body needs, she says.

Also drawing, writing, making puzzles, dancing and singing are good activities to avoid depression, they explain. Diagnosing a mental illness is not easy, because blood test or other tests are not used, but the symptoms and signs that the medical literature has considered.

In that sense, Graciela Jimenez agrees with the fact that specialists (psychologists, psychiatrists, mental health counselors and others) look at previous experiences, how changes begin, “We talk about mental health because we’ve moved away so much from the word illness, from mental illness to mental health because mental illness has a stigma attached to it. A stigma that you’re ill”, she said.

Nowadays, specialists are looking at behaviors. “Behaviors are symptoms of the mental health issue,” Amy Exum adds.
Sometimes, parents don’t understand why teenagers just stay in the room. That can be a sign of a mental health issue”, she said. Amy Exum, Psychotherapist with Care & Counseling at Baptist Health South Florida, affirms family therapy is really important with adolescents. “With adults we may not necessarily include other family members. But, having parents involved is going to be extremely important,” she says.

Therapists find that teens have more anger and irritability than adults. That’s why they work with the family to help them understand about that anger and irritability and what depression is, explains Graciela Jiménez, a Psychotherapist with Care and Counseling. Suicide is the third leading cause of death in young people ages 15 to 24 according to the CDC and now the specialists use some tools, like screenings to understand what’s going on with depression and how they can help patients.

Graciela Jiménez, Psychotherapist with Care and Counseling, and Amy Exum, Psychotherapist with Care and Counseling at Baptist Health South Florida explain the new tools can help parents speak the issue with their children and start talking about their problems. As a result, the family can help save the lives of their children. Pscychoterapists Amy Exum and Graciela Jimenez agree that when the child finishes school, it can be a time of stress and anxiety for them and their parents and it can cause depression. “Having an open conversation is so important, because a lot of times we can transfer or pass on our anxiety to other people,” says Exum.

Jimenez adds that child independence is a good thing, as if he’s accepted in a good college. “But there’s anxiety because you’re not going to be there and watch out for them and who’s going to help them,” she adds. The one-year rule, there is a place for everything, and redefining the junk drawer are the three simple steps to decluttering. Joanna Garcia, Psychotherapist with Care and Counseling at Baptist Health South Florida, says when you look at those hoarder’s rooms, there is a lot of stuff and it becomes overwhelming thinking, how I am going to tackle this. “Having a one-year rule is, in essence, breaking it down. Preemptively decluttering before it becomes excessive.”

Graciela Jimenez, Psychotherapist with Care and Counseling at Baptist Health South Florida, recommends making sure everything has a place for itself and that will help you maintain a little bit of organization. Any change in child’s behaviors is the first step to know if he’s overmedicated, according to the specialists’ opinion.

Also, they agree that It’s important to see the right kind of physician or psychotherapist. “They may be not going to see a primary care physician or a psychiatrist, making sure that they are seeing somebody who is specialized or housing individuals with attention deficit hyperactivity disorder. If the patient is having family issues, he should go to see counseling, who is able to treat anyone”, says Amy Exum.

Graciela Jimenez adds that if parents notice that their child is overmedicated they should go back to the physician that prescribed the medicine or find a different specialist. Joanna Garcia, Psychotherapist with Care and Counseling at Baptist Health South Florida, explains keeping things with the excuse of needing in the future is not a symptom of hoarding if the object is seasonal, like a generator, for example.

Graciela Jimenez, Psychotherapist with Care and Counseling at Baptist Health South Florida, says if there are items that might have a thick layer of dust, that you may not have looked at in three years or four years, like old laptop, they could be an indication that hoarding might be happening. Some symptoms of hoarding are when a person collects and keeps a lot of items, even things that appear useless or of little value to most people; when the items clutter the living spaces and keep the person from using the rooms as they were intended; and when a person is distressed with discarding the items.

Another sign is when the item causes distress or problems in day-to-day activities. Graciela Jimenez, Psychotherapist with Care and Counseling at Baptist Health South Florida, says the key is the distress that somebody suffers from when they do not want to let go an item, and they get angry and frustrated. Then you see there is more of an attachment to the particular item. Joanna Garcia, Psychotherapist with Care and Counseling at Baptist Health South Florida, says hoarding is recognized in the Diagnostic and Statistical Manual (DSM) as a mental health disorder, and there is often a genetic predisposition. She points out other causes can be neglecting childhood, and dramatic events growing up.

Graciela Jimenez, Psychotherapist with Care and Counseling at Baptist Health South Florida, says there is a little bit of perfectionism. “The person thinks ‘I need to keep this item and know that it is accessible to me'”. Hoarding threatens the health and safety of those living in or near the home, causing health problems, structural damage, fire, and even death. Another effect is the expensive and emotionally devastating evictions or other court actions can lead to hospitalizations or homelessness.

Another consequence is conflict with family members and friends who are frustrated and concerned. Graciela Jimenez, Psychotherapist with Care and Counseling at Baptist Health South Florida, says if your living room is so full of items and you can’t get to the door, you could have mold and little animals that have died. The smell will start to come out and it could affect the structure of your wall, and your neighbors as well. Graciela Jimenez, Psychotherapist with Care and Counseling at Baptist Health South Florida, says hoarding is an own disorder, but there are some aspects of OCD (Obsessive-Compulsive Disorder). “You have some of the obsessive nature of OCD, where you think about the items you are looking at, and your compulsion is that you keep the items.

She says, for example, people with this disorder may not be able to get to all of their cleaning products, because they are under the sink and all of the items are in front of the sink, so they are no able to use that part of the room.

Videos

DISCLAIMER: The information and opinions expressed in the programs on this channel and website are intended to address specific questions asked or situations described in each particular program, are for educational purposes only, and are not designed to constitute advice or recommendations as to any disease, ailment, or physical condition. You should not act or rely upon any information contained in these programs without seeking the advice of your personal physician or a qualified medical provider. If you have any questions about the information or opinions expressed, please contact your doctor or other medical professional.