top of page

Our Expertise

Insight Family Center, LLC is governed by high standards and is a member of the American Counseling Association (ACA) and American Medical Association (AMA) as well as part of many other professional organizations.


is more than just sadness. People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide”

Do you find it difficult to work, study, sleep, eat, and enjoy friends and activities?  Are you often called, “moody?”


The most important thing to know about the causes of depression is that we don’t really know the answer to this question. It is generally believed that all mental disorders are caused by a complex interaction and combination of biological, psychological and social factors. This theory is called the bio-psycho-social model of causation and is the most generally accepted theory of the cause of disorders such as depression by professionals.


Some types of depression run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.


In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major depressive disorder is often associated with changes in brain structures or brain function. People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. 


Depression in Women

Women experience depression about twice as often as men. So what kinds of unique concerns do women with depression face? How may treatment vary because of these concerns?


Depression in Senior Citizens 

Depression in older adults often goes undetected or is confused with a general health issue or the condition of aging. Yet depression is not a normal part of aging.


Depression in Children & Teens

Kids and teens can have depression just as readily as adults can. Often times it is missed and just chalked up to a normal part of being a teenage (“Oh, he’s just moody!”) when in fact it is clinical depression



an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.


People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.”

The “normal anxiety” people experience day to day. Do you constantly anticipate disaster? 

Worry excessively about health, money, family, or work? Are you unable to pinpoint the source of the worry?

Does simply thinking of getting through the day provoke anxiety? 

Do you suffer from any THREE or MORE of the following?

  • Restlessness or feeling keyed up or on edge

  • Being easily fatigued

  • Difficulty concentrating or mind going blank

  • Irritability

  • Muscle tension

  • Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)


People with GAD can’t seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.

Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too. Usually the impairment associated with GAD is mild and people with the disorder don’t feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don’t characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.


GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It’s more common in women than in men and often occurs in relatives of affected persons. It’s diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.

Specific Symptoms of Generalized Anxiety Disorder

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

The person finds it difficult to control the worry.


The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children do not need to meet as many criteria–only 1 is needed).

  • Restlessness or feeling keyed up or on edge

  • Being easily fatigued

  • Difficulty concentrating or mind going blank

  • Irritability

  • Muscle tension




or attention-deficit hyperactivity disorder, is a behavioral condition that makes focusing on everyday requests and routines challenging.

People with ADHD typically have trouble getting organized, staying focused, making realistic plans and thinking before acting. They may be fidgety, noisy and unable to adapt to changing situations.

Children with ADHD can be defiant, socially inept or aggressive.

Families considering treatment options should consult a qualified mental health professional for a complete review of their child's behavioral issues and a treatment plan

Attention-Deficit Hyperactivity Disorder (ADHD)

The new Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) has a number of changes to attention deficit hyperactivity disorder (ADHD, sometimes referred to as just attention deficit disorder). This article outlines some of the major changes to this condition.


According to the American Psychiatric Association (APA), the publisher of the DSM-5, the working groups decided to eliminate the DSM-IV chapter that included all diagnoses usually first made in infancy, childhood, or adolescence. Therefore ADHD was moved within the manual and can now be found in the “Neurodevelopmental Disorders” chapter to reflect brain developmental correlates with ADHD. The same primary 18 symptoms for ADHD that are used as in DSM-IV are used in the DSM-5 to diagnose ADHD. They continue to be divided into two major symptom domains: inattention and hyperactivity/impulsivity. And, like in the DSM-IV, at least six symptoms in one domain are required for an ADHD diagnosis.


However, several changes have been made in DSM-5 to the ADHD category, according to the APA:

  • Examples have been added to the criterion items to facilitate application across the life span

  • The cross-situational requirement has been strengthened to “several” symptoms in each setting

  • The onset criterion has been changed from “symptoms that caused impairment were present before age 7 years” to “several inattentive or hyperactive-impulsive symptoms were present prior to age 12”

  • Subtypes have been replaced with presentation specifiers that map directly to the prior subtypes

  • A co-morbid diagnosis with autism spectrum disorder is now allowed

  • A symptom threshold change has been made for adults, to reflect their substantial evidence of clinically significant ADHD impairment. For an adult diagnosis to be made, the patient only needs to meet five symptoms — instead of six required for younger persons — in either of the two major domains: inattention and hyperactivity/impulsivity

While much ado has been made about this last change, it seems unlikely there was this large population of adults who had sub-clinical ADHD who failed to receive a diagnosis and treatment. Rather, this change reflects clinical experience and real-world practice, where adults with ADHD often experience it in a slightly different way than teens and children do.


Specific Learning Disorder

Say goodbye to the list of specific learning problems from the DSM-IV — reading, math and writing, as well as learning disorder NOS. All gone. Replaced with a simple, nice category called “Specific Learning Disorder.”

Why? According to the APA, it’s because “learning deficits in the areas of reading, written expression, and mathematics commonly occur together, coded specifiers for the deficit types in each area are included. The text acknowledges that specific types of reading deficits are described internationally in various ways as dyslexia and specific types of mathematics deficits as dyscalculia.



is a condition in which the body must have a drug to avoid physical and psychological withdrawal symptoms. Addiction’s first stage is dependence, during which the search for a drug dominates an individual’s life. An addict eventually develops tolerance, which forces the person to consume larger and larger doses of the drug to get the same effect.


Do you have repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household?

Put yourself in physically hazardous situations, like driving while impaired?

Have recurrent legal problems, such as arrests for alcohol or disorderly conduct?

Persistent or recurrent social problems, such as arguments with spouse, physical fights, etc?


Characterized by a maladaptive pattern of alcohol or substance use leading to significant impairment or distress, as manifested by 1 or more of the following, occurring within a one year period:

  • Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home

  • Recurrent alcohol or substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

  • Recurrent alcohol or substance-related legal problems (e.g., arrests for alcohol or substance-related disorderly conduct)

  • Continued alcohol or substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol or substance use (e.g., arguments with spouse about consequences of intoxication, physical fights)


The symptoms must also have never met the criteria for Alcohol/Substance Dependence for this class of substance or alcohol.





is a serious mental illness in which common emotions become intensely and often unpredictably magnified. Individuals with bipolar disorder can quickly swing from extremes of happiness, energy and clarity to sadness, fatigue and confusion. These shifts can be so devastating that individuals may choose suicide.

All people with bipolar disorder have manic episodes — abnormally elevated or irritable moods that last at least a week and impair functioning. But not all become depressed. 


(also known as "manic depression") is a disorder that is often not recognized or misdiagnosed as simply depression by the patient, relatives, friends -- and even physicians. An early sign of bipolar disorder may be hypomania -- a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior. Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.


In its early stages, bipolar disorder may masquerade as a problem other than mental illness. For example, it may first appear as alcohol or drug abuse, or poor school or work performance.

If left untreated, bipolar disorder tends to worsen, and the person experiences episodes of full-fledged manic episodes and depressive episodes.


One of the usual differential diagnoses for bipolar disorder is that the symptoms (listed below) are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, orPsychotic Disorder Not Otherwise Specified.

And as with nearly all mental disorder diagnoses, the symptoms of manic depression must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Symptoms also cannot be the result of substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition.


Specific symptoms of the various types of bipolar disorder:

Bipolar I Disorder

Bipolar I Disorder represents a number of separate diagnoses, depending upon the type of mood most recently experienced.

  • Bipolar I Disorder, Single Manic Episode

    • Presence of only one Manic Episode and no past Major Depressive Episodes. 
      Note: Recurrence is defined as either a change in polarity from depression or an interval of at least 2 months without manic symptoms.

  • Bipolar I Disorder, Most Recent Episode Hypomanic

    • Currently (or most recently) in a Hypomanic Episode.

    • There has previously been at least one Manic Episode or Mixed Episode.

  • Bipolar I Disorder, Most Recent Episode Manic

    • Currently (or most recently) in a Manic Episode.

    • There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.

  • Bipolar I Disorder, Most Recent Episode Mixed

    • Currently (or most recently) in a Mixed Episode.

    • There has previously been at least one Major Depressive Episode, Manic Episode, or Mixed Episode.

Bipolar II Disorder

  • Presence (or history) of one or more Major Depressive Episodes and at least one Hypomanic Episode. Additionally, there has never been a Manic Episode or a Mixed Episode.




is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives. Psychologists can help these individuals find constructive ways of managing their emotions.


is a serious mental illness characterized by incoherent or illogical thoughts, bizarre behavior and speech, and delusions or hallucinations, such as hearing voices. Schizophrenia typically begins in early adulthood.


Although the above symptoms must be present for at least one (1) month, there also needs to be continuous signs of the disturbance that persist for at least six (6) months.  During this period, the signs of the disorder may be present in a milder form, for instance as just odd beliefs or unusual perceptual experiences. During this 6 month period, at least two of the above criteria must be met, or only the criteria of Negative Symptoms must be present — if even just in milder form.


Onset of schizophrenia prior to adolescence is rare. The peak age at onset for the first psychotic episode is in the early- to mid-20s for males and in the late-20s for females. Though active symptoms typically do not emerge until an individual is in their 20’s, oftentimes prodromal symptoms will precede the first psychotic episode, characterized by milder forms of hallucinations or delusions. For example, individuals may express a variety of unusual or odd beliefs that are not of delusional proportions (e.g., ideas of reference or magical thinking); they may have unusual perceptual experiences (e.g., sensing the presence of an unseen person); their speech may be generally understandable but vague; and their behavior may be unusual but not grossly disorganized (e.g., mumbling in public).


Individuals with schizophrenia evidence large distress and impairments in various life domains. Functioning in areas such as work, interpersonal relations, or self-care must be markedly below the level achieved prior to the onset of the symptoms to receive the diagnosis (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).


Schizoaffective Disorder and Mood Disorder With Psychotic Features must be considered as alternative explanations for the symptoms and have been ruled out. The disturbance must also not be due to the direct physiological effects of use or abuse of a substance (e.g., alcohol, drugs, medications) or a general medical condition.


If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

0.3%–0.7% of individuals appear to acquire schizophrenia. although there is reported variation by race/ethnicity, across countries, and by geographic origin for immigrants and children of immigrants. The sex ratio differs across samples and population. Hostility and aggression can be associated with schizophrenia, although spontaneous or random assault is uncommon. Aggression is more frequent for younger males and for individuals with a past history of violence, non-adherence with treatment, substance abuse, and impulsivity. It should be noted that the vast majority of persons with schizophrenia are not aggressive and are more frequently victimized than are individuals in the general population.




People who have gender dysphoria feel strongly that they are not the gender they physically appear to be.


In children, the disturbance is manifested by six (or more) of the following for at least a 6-month duration:

  • repeatedly stated desire to be, or insistence that he or she is, the other sex

  • in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing

  • strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex

  • a strong rejection of typical toys/games typically played by one’s sex.

  • intense desire to participate in the stereotypical games and pastimes of the other sex

  • strong preference for playmates of the other sex

  • a strong dislike of one’s sexual anatomy

  • a strong desire for the primary (e.g., penis, vagina) or secondary (e.g., menstruation) sex characteristics of the other gender


In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex. 

The disturbance is not concurrent with a physical intersex condition.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.



Post-transition, i.e., the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is undergoing) at least one cross-sex medical procedure or treatment regimen, namely, regular cross-sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in a natal male, mastectomy, phalloplasty in a natal female).


Exhibit a strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex). In children, the disturbance is manifested by six (or more) of the following for at least a 6-month duration:

  • repeatedly stated desire to be, or insistence that he or she is, the other sex

  • in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing

  • strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex

  • a strong rejection of typical toys/games typically played by one’s sex.

  • intense desire to participate in the stereotypical games and pastimes of the other sex

  • strong preference for playmates of the other sex

  • a strong dislike of one’s sexual anatomy

  • a strong desire for the primary (e.g., penis, vagina) or secondary (e.g., menstruation) sex characteristics of the other gender



is essential for health and well-being. But millions of people don’t get enough, resulting in such problems as daytime sleepiness, poor decision-making, interference with learning and accidents. Cognitive-behavioral therapy, which helps people identify and change their thoughts and behaviors, can help. In fact, according to one study, cognitive-behavioral therapy does a better job of reducing insomnia than sleeping pills.


Sleep Disorders


can be a reaction to a short-lived situation, such as being stuck in traffic. Or it can last a long time if you're dealing with relationship problems, a spouse's death or other serious situations. Stress becomes dangerous when it interferes with your ability to live a normal life over an extended period. You may feel tired, unable to concentrate or irritable. Stress can also damage your physical health.



bottom of page