Susan L Crum, Ph.D. 


Behavioral Medicine,


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Is Stress Affecting Your Health?

Posted by cfln4646 on January 6, 2014 at 4:50 PM Comments comments (161)

Is Stress Affecting Your Health?

The holidays are over, and many now give a sigh of relief that all the hustle and bustle is at an end. But, one out of four of us continue to struggle with the effects of stress. Many don’t even realize it because we hold internalize our stress. Take a moment and see if you may be showing signs of stress. For instance, do you find your heart racing, notice that you are breathing rapidly, perhaps your muscle are tight or your blood pressure is running a bit high. These are all signs of stress.

There are a number sign that you may need some help coping with stress. These include low energy, frequent headaches, upset stomach including diarrhea, constipation, or nausea. Ache, pain and tense muscles are all signs to pay attention to as are insomnia and frequent cold or infections. Loss of sexual desire or ability may also be a red flag. Additionally, ringing in your ears, cold or sweaty hands and feet, nervousness, shaking, dry mouth and difficulty swallowing may all be clues pointing to the effects of stress on your health. In fact, even a clenched jaw, TMJ and teeth grinding can be an effect of stress.

There are cognitive symptoms that are also associated with stress. These include racing thoughts, forgetfulness, disorganization, impaired focus and concentration, as well as poor judgment. You may find it harder to complete tasks on times and more challenging than usual to learn new skills. Behaviorally, you may have noticed changes in your appetite. You may find yourself procrastinating and avoiding responsibilities. You may have increased your consumption of alcohol, drugs (including prescribed medications) or cigarettes. You may also be fidgeting, pacing or engaging in nail biting. You might also notice yourself avoiding social situations. Emotionally , stress can manifest itself in terms of irritability, frustration moodiness. You may feel overwhelmed and having difficulty relaxing or quieting your mind. You may begin to feel lonely, worthless and even depressed.

If you find yourself evidencing signs of stress, pursue help now. While a little occasional stress is not something to worry about, ongoing chronic stress can exacerbate or cause significant health problems. Chronic stress is associated with obesity and eating disorders, it can contribute to cardiovascular disease including heart attacks, high blood pressure and abnormal heart rhythms. It can be a contributing factor in menstrual prolbmes, and contribute to erectile dysfunction and or premature ejaculation. Both hair problems and skin problems such as eczema, acne and psoriasis or alopecia can be caused by stress. GERN, gastritis, ulcerative colitis and irritable colon can also be a function of stress.

So if you want to maintain long term health and are experiencing symptoms of stress, now is the time to pursue help. Your therapist can’t wave a magic wand and eliminate the stress in your life because stress is a part of life. But, what affects your mental and physical health are the skills that equip you to handle stress productively. This is where a therapist can be a valuable asset. Instead of giving you a pill for your insomnia or gastritis, your therapist can help you identify which stresses you can eliminate or minimize and how, as well as how to build resilience to the effects of stress and keep yourself emotionally and physically healthy.

Most of us get an annual physical examination. But, most of us forget that many of our health problems are a result of chronic stress not being well managed. So, remember to include a mental health screening this year. Check out your cognition, you emotional coping skills, and your resilience tools. If they are not sufficient, work with your therapist to improve your health long-term.

For those with New Year’s Resolutions to deal with the stress in their lives, I’m offering low-cost mental health screenings both in person and on-line. If interested, call 866-448-1965 to schedule an appointment.

Apps to Support Therapy

Posted by cfln4646 on January 2, 2014 at 4:50 PM Comments comments (1)

Apps to Support Therapy

While I thoroughly enjoy face to face sessions with my patients as we partner to help them brainstorm solutions to the life challenges they are facing, we live in a fast paced society where it is sometimes hard for individuals to come to my office or to come as frequently as they would like. Because of this, I offer supplemental on-line secure face to face sessions for my patients when then cannot make it to the office. In addition, for those who regularly use smart phones, I recommend a range of mental health apps that can keep them on track in between sessions. For those who are interested, here are some you may want to check out.

BellyBio Interactive Breathing for the I phone is a simple biofeedback device which monitors your breathing and plays sounds similar to ocean waves when your relax. This is a great tool for patients who have learned to use diaphragmatic breathing to alleviate their anxiety and stress.

Also for the iphone Previdence is an assessment tools that allows you to check for symptoms of depression, anxiety, relationship issues, drug and alcohol issues, and other problems and makes recommendations for action which we can then follow up on in our next session.

For individuals with PTSD, I suggest PTSD coach which is helpful for symptoms of combat related post traumatic stress. This is available for both iphones and androids.

A good tool for those struggling with anxiety is Mindshift which is also available for both the iphone and androids. This app teaches relaxation skills, helps you develop new thought patterns and suggests healthy activities. It is particularly good for youth.

Positive Action Jackpot is an augmented reality tool that combines pleasant event scheduling, which is a behavioral health therapy for depression with activities in our location mapped via GPS. Sorry iphone users, this is only available for Androids.

One difficulty many of my patient’s have is taking time to relax; and if they do they often don’t know how to relax and instead just fall asleep. If this describes you, I suggest Take a Break! Guided Meditations for Stress Relief. This free aps lets you listen to a seven-minute Work Break or to a 13 minute Stress Relief Break either with or without music. It is available for both the iphone and for androids.

Veterans and current military may wish to consider Operation Reach Out. This app which is available for both the iphone and Androids was developed by the military. It provides recorded videos and menu options to help you evaluate your thinking and reach out for help when in crisis.

Relax with Andrew Johnson Lite provides guided meditation sessions for relaxation which helps with sleep, anxiety and stress. It is available for both the iphone and for androids.

Relax and Sleep well with Glenn Harold provides a twenty minute guided mediation with music that you can use to help fall asleep. This app is also available for both the iphone and for android.

The SAM App (Self-Help for Anxiety Management) developed by the University of West England helps you track your anxiety levels and provides a useful toolkit for management of anxiety.

T2 Mood Tracker helps you track symptoms of depression, anxiety, traumatic brain injury, PTSD, stress and general well-being. It provides useful charts for you to share with your therapist

e CBT Calm is an app that provides a set of tools to help you evaluate personal stress and anxiety, challenge distorted thoughts, and learn relaxation skills that have been scientifically validated in research on Cognitive Behavioral Thearpy. It gives you useful background and information as well as step by step guides that will keep you moving forward with your progress in between sessions.

Getting enough quality sleep is essential to mental health This app, Deep Sleep with Andrew Johnson, guides you through a progressive muscle relaxation session into sleep

Based on Dialectical Behavior Therapy (DBT) the DBT Diary Card and Skill Coach , this app provides self-help skills, reminders of the therapy principles, and coaching tools for coping. Like all the other apps presented here, this is not intended to replace professional therapy, but to reinforce what you learn in therapy.

With iSleepEasy a calm female voice helps you quell anxieties and take the time to relax and sleep. This app offers separately controlled voice and music tracks, flexible lengths, and an alarm.

Susan L. Crum, Ph.D.

Licensed Psychologist

• Voice: 866-448-1965 Fax: 888-242-1396 

• Mobile: 863-273-3461   

• Address: 4646 Nadena Drive, Sebring, FL 33872 

• Mail: PO Box 7365, Sebring, FL  33872 

• • [email protected]

• Patient Website:

• Online Therapy site 





Avoiding The Holiday Blues

Posted by cfln4646 on December 12, 2013 at 7:30 PM Comments comments (0)

For Christians with a strong faith and for those with close supportive family ties, Christmas can be a meaningful time of the year. It can represent God’s effort to reach out to us and the bonds of love that bind us not only to Him but also to family and friends. But, others find Christmas a stressful time of the year.

This is true for those who are homeless. Those who don’t have family or who have been rejected by their families due to addiction, mental illness or criminal behavior. For some people Christmas represents a time of embarrassment when their financial struggles are highlighted when they cannot afford to buy gifts for those who are important to them. It can be a time of regret, a time when people feel estranged from God. For some worrying about preparations, finances, shopping, and family relationships during this time can lead to feelings of depression or anxiety, as well as stress, irritability, insomnia, fatigue, and difficulty concentrating.

So, it is important to look after your mental health during the holidays. Here are some suggestions to help you get through the holidays with less stress”

Money: Don’t over extend yourself. If you can’t afford to buy gifts, try making something or giving a coupons for something special. For instance, you might give you teenager a coupon to drive them to the movies with a friend one weekend, or dad a coupon to help him clean out the garage. If you prefer to buy gifts, set personal boundaries on how much you will spend.

Relationships: If you have a problem with someone you will be seeing at Christmas send them a note and offer to meet to resolve the issue before the holiday. If that doesn’t work, you might choose not to invite them to your home or pick a day and time to visits others when you know that individual wouldn’t be present. To avoid overloading yourself, set personal boundaries on the number of social events you will attend.

If you are alone, consider becoming a volunteer. Helping others through the holidays can often dispel the feeling of loneliness and help you recognize the blessings in your own life. Put up a small tree in your room and each time you walk by it write down something you are thankful for then hang that on your tree. It may be a good childhood, having food for dinner that day, having a job to go to, having a friend, good health, your pet, a trip you really enjoyed. Being grateful for what you have and focusing on that rather than upon what you don’t have, will help combat feelings of depression. Try to take positive action – perhaps go Caroling with a local church, or head to the Humane Society to pet some cats, or make a few cards to drop off at a nursing home. View this time of year as an opportunity to engage in acts of loving kindness, and generosity. When, you see the guy with the sign asking for a dollar, give him two. You never know how much you may lift your own spirit in doing so.

Moderation: Overindulgence can lead to accidents and holiday visits to the ER. So indulge in a treat, but try to focus on fruits and vegetables so you maintain your health. If you enjoy a glass of wine, please do. But, be careful not to drink to numb pain or reduce anxiety. Drinking excessively is detrimental to your body, can contribute to sleeping problems, and can lead to fatigue and irritability.

Exercise is a boon. It promotes both physical and mental health. So, try to park your car as far from the mall and you can and walk the extra distance. Participate in an after dinner dance contest and you’ll not only feel more energized but also boost your mood.

Relax: Remember that a holiday is a day of festivity when no work is done. So, try to cook ahead of time, order in, or go out for dinner. Skip the China and indulge in paper plates. Avoid the urge to answer emails or to ‘get caught up’ on work or homework. Instead, give yourself permission to relax.

According to the National Institute of Health Christmas is a time when American’s experience a high incidence of depression and both hospitals and police report high rates of suicide attempts and suicidal deaths. Part of this may be attributed to the fact that the decrease in light during winter increases the indicidence of Seasonal Affective Disorder. Part of the problem is that we set unrealistic expectations expecting a flawless holiday and then becoming depressed when are expectations are not met. Some people find Christmas hard because they are uncomfortable with social gatherings, others feel lonely or are saddened by the loss of employment or ongoing financial struggles. Regardless of the cause, depression can be serious and if the suggestions above don’t help, seek out professional help.

Most regions have psychologists locally who can assist you. But, if you don’t , go online and seek some help. One good resource for this is:

Meanwhile, post yourself a daily stress prevent checklist:

I exercised for at least 1t minutes today.

I ate well without overindulgence and with dieting.

I showed compassion for myself and others

I took 15 minutes by myself just to relax, listen to music, breath slowly or soak in the tub

I laughed, watched a comedy, read some jokes, or hung out with upbeat people.

I did the most important things first today and didn’t sweat the rest.

Presented as a Community Service

By Susan L. Crum,Ph.D.

Licensed Psychologist


Tips for Dealing with Trying Teens

Posted by cfln4646 on November 14, 2013 at 9:25 AM Comments comments (0)

Tips for dealing with Trying Teens

Sometimes we look at our teenagers and wonder where that child went, the one who loved, adored and obeyed us. Their smart remarks, failure to do the things we believe are important combined with the fact that the suddenly know everything and we nothing, can make parenting a teen challenging to say the least. So, here are some tips to help you cope with this challenge.

Begin by asking what they want. Then, try to negotiate a win/win solution. For instance, your sixteen year old wants a later curfew than you feel comfortable with, you might negotiate a “call-in time” at your preferred curfew time and add thirty to sixty minutes. Or, you might agree to a later curfew only for special events. This lets your teen feel listen to and valued, and lets you worry less. The important factor is to keep the lines of communication open. This means listening more than you talk. Listen to find out what is important to your teen. Listen to find out who the respect and who is influencing them. Listen to understand their feelings. Listen to show respect for them.

If you have raised your teen well, they have a good sense of right and wrong. So, when setting ground rules, you might ask them to write down what they feel is reasonable. You may be surprised to find you are very comfortable with what they develop. If not, you can begin the process of negotiation to move the limits in a direction your feel are more acceptable. Make certain, however, that you are setting limits based upon helping your teen develop important values and upon protecting their safety; not simply based upon what your parents did or the fact that you are the one in control.

A crucial step is to model the behavior you want. If you want your child to attend church regularly, do so yourself. If you want your child to be alcohol free, choose non alcoholic drinks yourself. If you want your teen to avoid smoking, use alternative methods of self-calming yourself. If you want your child to be kind, next time you see a homeless person, stop buy them a meal. If you want them to listen to you, listen to them. If you want your teen to be community minded, find a volunteer opportunity to do with them. If you want them to show respect and let you know where they are, show them the same courtesy when you are out or running late.

A difficult part in this process is letting go of your expectations and dreams. Your teenager is a separate person with his or her own expectations and dreams. Perhaps you always planned for your teen to go to an Ivory league college, but, they just want a certificate to be a nail technician. If you have concerns, you may share them to help your teen make an informed decision. But, let them invest in their own dreams, they need to learn to make their own way in the world.

When your teen is doing less than you wanted or expected, suspend your judgment. Let them make mistakes. Permit them to be different from you. Don’t make your love conditional on good behavior. When consequences are appropriate, provide them. But, make certain they are related to the misbehavior. For example, if you teen refuses to take out the garbage, taking the iphone away is not a natural consequence. Putting the garbage pails in your teens room so they are the one who has to deal with the natural consequences of their lack of responsibility is. On the other hand, if your teen is texting when they should be studying, timing the iphone out for a week would be appropriate.

Give your teen responsibility. This should not be a chore than only benefits themselves such as doing their laundry. Rather it should be something for which the entire family depends upon them; perhaps cooking dinner every Friday night, or, planning and obtaining all the supplies for a family and friends night.

In the midst of all the cold shoulders, smart remarks and misbehaviors, remember to love your teen. Show them , tell them, spend time with them. Let them know they can be as obstinate as they like, you will still love them. Focus on love, respect and appreciation. Empower your teen to explore all they can be. Discipline, that is teach your child what is important, with love and respect.

Presented as community service,


Susan L. Crum, Ph.D.

Licensed Psychologist



Are You Spoiling Your Special Needs Child?

Posted by cfln4646 on November 8, 2013 at 12:45 AM Comments comments (0)

Are You Spoiling Your Special Needs Child? 

Sometimes parents of special needs children are so worried about their child that they find it hard to expect them to assume normal age appropriate responsibilities. Sometimes they are afraid of stressing their child. Sometimes they feel sorry for the way their child has to struggle. Sometimes, they feel guilty that they may have smoked or drank during their pregnancy and contributed to their child’s problems. Sometimes, they can’t figure out which behaviors is a result of the disability and which are normal childhood behaviors. For these reasons and many others, parents often make the unintentional mistake of adding to their child’s handicapping condition by spoiling them. This results in a child who not only has a disability to cope with, but who also has a sense of entitlement that causes other to dislike them. By spoiling our special needs child, we are adding an extra burden to their lives by making it hard for them to maintain good relationships with peers, spouses, co-workers and employers in the future. We inadvertently communicate that it’s not their fault and they are owed special treatment; which others don’t appreciate.


So, ask yourself are you spoiling your special needs child. If you answer yes to 3 or more of these questions, you probably are.


1. Have you made your child the center of the world?

Our children are important to all of us, and special needs children usually hold a special place in our hearts. But, if you make your child’s wishes the top priority to the neglect of the needs and wishes of others, you are failing to teach your child to be emphatic, and to give as well as receive.

2. Do you ignore positive behavior?

Are you so busy that you don’t notice when you child plays quietly while you work on the computer, or doesn’t interrupt you while you are on the phone. If you don’t stop to comment on your child’s good behaviors when they happen, you will fail to reinforce those behaviors and fail to increase their frequency of occurrence. Remember; give your child attention when they are being good. An excellent way to do this with young children is to carry around a pocket full of chip and give one along with a comment whenever you “catch your child being good”

3. Do you accidentally reward negative behavior?

Conversely, if you stop what you are doing to tend to a child who interrupts while you are on the phone, or talks while you are reading, or try to calm down a child who whines, you are reinforcing those undesirable behaviors. A better way to handle these situations is to establish expectations before you begin your project, and let them know the consequence of interrupting during your project. For instance, “Bob, I’m going to be on the phone for twenty minutes. If you interrupt, when I get off the phone you will have a time out”.

4. Do you fail to set clear limits?

If you don’t tell your special needs child exactly what you want in terms of good behavior, you are likely to have a child who is rude, uncooperative, annoying and disrespectful. For instance, before going into the grocery store you might want to review the rules: Hold onto the cart. Only touch the squeeze ball I’ve given you. Only speak softly. We only get items on the list.

5. Do you fail to enforce rules consistently?

If you are mushy or inconsistent in enforcing rules by telling them “no” and then giving in, children learn that it is profitable to beg, plead, bargain, and harp. Choose your rules carefully. But, once you choose them enforce them unless there is a specific reason to make an exception. If there is such a reason explains the reason and that this is an exception not a modification of the rule. For instance, if bedtime is 8pm, it should always be 8pm. But, if there is going to be a Christmas parade that you are treating your children to, you can say: “Tonight because we are going to the Christmas parade we are making a rare exception to the bedtime rule, and you may stay up until 9pm”. But, if your rule is don’t play with your food; you have to enforce this 24-7 even when you are tired. Don’t argue. Give one reminder. If the rule is not followed give a natural consequence such as removing the food.

6. Do you fail to hold your child accountable?


This is the area I see most parents of children with special needs struggle with. For instance, the homework is too hard. So, the parent argues with the school for modifications or accommodations, and the child learns: “Mom, will rescue me”. To avoid this I recommend a different approach: tell your child to do any parts of the homework they are able to without accommodations in one color ink, then let them do whatever they can with accommodations in another color ink. For instance, the child might do all the math problems they can in pencil. Then, do some more in blue ink using a calculator (so the teacher can differentiate). But, problems still remain. At this point, let the child put away the homework, but tell them, they are responsible to explain to the teacher they did not know how to do these, and need a review of the material. This helps your child learn both accountability and self-advocacy skills.


I remember one time I had to hold my son accountable. He was studying Karate to improve his attention and concentration, but began practicing in the house. I told him all practice had to be outside. Despite this, he and a friend practiced kicks in the bedroom, and kicked a hole in the wall. I did not yell. I did not lecture. I told my son to get his piggy bank and get into the car. We went to the store and he had to buy spackle and paint. We went home and he and his friend had to spackle the wall that night, and paint it the next day. Neither ever practiced Karate in the house again, though both had ADHD.


7. Do you give into temper tantrums?

I can’t say this strongly enough. Never give into tantrums, and never avoid enforcing a rule because you expect a tantrum. To do so, permits your child to become a tyrant. Relenting because of temper tantrum, communicates to your child that temper tantrums are an effective way to get what they want, and increases the likelihood of their occurrence. No matter how tired you are. If you said “No” and the child has a tantrum, stick by your rule. If the child throws things, or makes a mess, hold them accountable to clean up after their tantrum is over.


8. Do you ask others to excuse your child because of his/her disabilities?

I recently went to a restaurant for breakfast, where a mother and father sat with their two boys; probably eight and ten years of age. The eight year old couldn’t make up his mind about what he wanted, no matter what his mother suggested. He began talking louder and louder until he was shouting and shouting: “It’s your fault. Why did you pick this restaurant? I hate it here.” His behavior was disturbing all the patrons, and finally his father said: “I’m sorry, he has ADHD”. Well, that doesn’t cut it. I said: “He needs to learn how to behave in a restaurant. If not, he needs to leave.” His mother was appalled. But, his father, shook his head up, got up and left the restaurant. Everyone there was relieved, and this boy learned a valuable lesson. Having a disability is not an excuse to be rude to others. After ten minutes outside the boy had gained control over himself, and his father brought him back into the restaurant, where he proceeded to order a meal and eat appropriately. Be careful not to excuse bad behavior because your child is disabled. If your child is not behaving appropriately, remove them from the situation and give an appropriate consequence.


9. Do you set a bad role model by acting like a spoiled demanding person yourself?

How you interact with everyone around you serves as a role model for your child. If you whine and complain in front of your child; about their teacher, principal or the next door neighbor, your child will emulate you. Let your child see you take appropriate actions when needed, and being flexible when something is not important. For example, when I discovered that my daughter had left the daycare at school without staff knowing, I contacted the principal and worked with them to revamp their after school program to provide more appropriate activities and levels of supervision. Conversely, when my daughter’s teacher raised her voice at her in frustration one day, I asked my daughter her teacher yelled often. When she said “No”, I asked if she knew what caused her teacher to do that, and she was able to tell me, “I was talking all the time, and not listening”. So, I explained to my child that we would not complain to the teacher because anyone could might their voice in frustration once in a while, and we had to be understanding over small things, and only complain about important things or things that happened over and over and formed a pattern.


10. Do you fail to ask your child to do for others?

This is the biggest faux pax of parents of special needs children. They are always fighting for their children to get what they need, but forget that their children need to learn to give to others. Every special needs child in a home needs to have chores that they do for someone else. For instance, if they take the garbage out, it should not just be their garbage, but everyone’s. If their chore is to polish shoes, it should be the shoes of all the family members. If they go for a walk and see litter, they should be encouraged to stop and pick it up. If they are bringing in your garbage pails from the curb and see their neighbor’s out, say: “Let’s take in Mrs. Smith’s too”. If they see their teacher struggling with a lot of books on the way to her car, they should be encouraged to give her a hand. If they notice another kid who is left out, they should be encouraged to invite that child over. If they read about a family whose house burned down, they should be encouraged to go through their toys and clothes to donate to the family. People, who know how to do for others, are the most valuable people in our society. Your child can learn these crucial skills even though s/he may struggle with disabilities. But, if you don’t teach your special needs child these skills, you will raise a child with a terrible sense of entitlement that will make it hard for your child to develop or maintain meaningful friendships.


Remember, your special needs child already had extra challenges in life. Do not add to them by spoiling your child.


Presented as a Community Service by,

Susan L. Crum, Ph.D.

Licensed Psychologist


Living Well With Adult ADD/ADHD

Posted by cfln4646 on November 6, 2013 at 6:35 PM Comments comments (0)


Living Well With Adult ADD/ADHD

Adult ADD/ADHD can present challenges throughout the lifespan affecting education, employment and interpersonal relationships. Symptoms may lead to procrastination, an impaired ability to meet deadlines, impulsive behavior; which in turn could even involve you in illegal activities and the criminal justice system.

Fortunately, there are ways you can get help for your ADD/ADHD. Many people mistakenly believe that medication is the only way to address ADD/ADHD. Medication may help some people manage symptoms. But, it may also bring unwanted side effects and raise the likelihood of substance abuse for those with addictive personalities. If utilized at all, it should be only one component in a complete plan of treatment. A well researched and effective treatment for ADD/ADHD which does not have the negative side effects of medication and offers long term improvement is neurofeedback. You may wish to ask you local neuropsychologist about this intervention or check it out through You can also pursue another well researched effective intervention: cognitive rehabilitation with attention and memory training.

ADD/ADHD does not mean that you are unmotivated, lazy or lacking in intelligence. You have a unique set of brainwave patterns that interferes with certain typical functions in modern society. For instance, because your brainwaves go slower than the average individual’s you have less inhibition and are more likely to take risks than the average person. In the past, when it was necessary to hunt for food for survival and confront dangerous animals, this attribute may have been an asset. Even today, it can help you function in certain occupations such as paramedics, or fire fighting where it is important to be calm under stress. On the other hand, if this lack of inhibition contributes to you driving a 100 miles per hour in a 50 mile per hour zone, you may be getting a free ride to the local jail.

The hallmark characteristics of ADD/ADD are inattention, distractibility and decreased impulse control. So, getting organized can be a real challenge. You may find that you miss appointments, forget to pay bills on time, lose your keys, misplace your wallet, totally miss that it is your anniversary. But, you can learn to break tasks down into small steps and follow a systematic approach to organization. A smart phone can be your best friend because you can put in reminders which have alarms and repeat until you have completed the task. You can also help yourself by setting up a consistent routine or schedule at home and at work so that you are less likely to miss important things. You can create a “dump box” right near the entrance to your home and immediately put in your wallet , keys and other items that you need, so they are convenient for you grab when leaving the house.

One way to help yourself maintain control is to create space. Get rid of anything you don’t need on a daily basis. Put the things you regularly need in color coded bins that are clearly labeled both in words and with a photo.

To avoid clutter and procrastination make it a habit to do any task that can be done in two minute or less on the spot. If you need to act on a paper do it. If not, toss it. Keep a shredder handy so you don’t accumulate junk. In fact, you may want to oput out of getting junk mail for the next five years. You can do this at or by calling 1-888-5-OPT-OUT. To avoid getting calls that take up your time go to or call 1-888-382-1222, To stop getting direct mail go to and opt out.

Most people with ADD/ADHD may try to set up filing systems. But, they tend to misplace papers before they are filed. I recommend purchasing NEAT scanner of something similar. Then, as you open an envelope, either act on the paper, put it in the shredder or if you need it for future reference immediately scan then shred. To make this process as manageable as possible deal with mail on a daily basis.

To improve your time management. Figure out how long you want to devote to a task. Then before starting set an alarm for 15 minutes before the task should be concluded. This will help you compensate for your tendency to hyperfocus on preferred activities and to cut short less preferred activities. You might even want to set an alarm to go off a intervals to help keep you productive and aware of how much time is passing.

Also develop the habit of estimating how long a task will take, then set aside twice that much time. This way you will not overload yourself and you wouldn’t be disappointed by constantly failing to complete tasks within the allotted time. If you finish early, you can reward yourself by using the extra time to relax or by pursing a preferred activity.

When you have an appointment, plan to arrive 20 minute early and set all your reminders accordingly. Make certain everything you need is in your “Outbox” by the front door the evening before, so you don’t waste time searching frantically for needed items.

Due to distractibility, individuals with ADD/ADHD often lose track of what they were planning to go and move from one task or idea to another without finishing the first. They also have a tendency to skip steps in a process or to complete less important tasks while neglecting more urgent ones. To address this, prioritize. Decide what is most important and do that first. Stay with one task and one step within that task until it is completed.

Those with ADHD./ADD can often over commit because they impulsively agree to too many projects or social engagements. This leads to a packed schedule, feeling over tired, feeling overwhelmed and as if you never get a break. So, don’t agree to anything unless you first check your schedule on your smart phone. Don’t agree to anything unless it fits in with your personal mission statement and priorities. Maybe someone wants you to give them a ride somewhere and you want to be a nice guy. But, your priorities in your mission statement are your relationship with God, your relationship with your spouse, your relationship with your children, your career, and your music. If so, before you say yes to giving someone a ride, make certain you have already scheduled adequate time for each and every one of your priorities.

With regards to bill paying, go paperless. Have all your bills sent electronically directly to your checking account. Then, make your payments electronically. In fact, if you have adequate funds in your account, set it up for bills to be paid in full for the exact amount on the date the bill is received. If you only get paid once or twice a month set up automatic bill payments to go out on those dates. Impulse purchases can really impact the budget of an individual with ADD/ADHD. To control this have your check direct deposited with the bulk going to your checking account – for which you should not have a debit card. Then, have your “allowance” direct deposited to a prepaid card like Amscot or Green Dot. Use this for all your purchases. It will avoid your tapping into funds meant for other purposes and give you a complete record of your spending. To avoid further problems, cut up all your credit cards. Open one secured credit card and stick only with that. This way you cannot get yourself in more debt than you can handle.

Begin organized at work is important. So, arrive early and spend the first 20 minutes organizing your desk. Use color coding bins, and reminders on your smart phone of meetings and important tasks. Just as at home, do the most important tasks first. Set deadlines for everything that are earlier than when your employer expects and have periodic alarms to help you track the passing of time. While working play fast paced classical music through earphones. This will improve your focus and your pace of work. If you find yourself getting a bit sluggish, get up and do a few stretches , run in place or do a few jumping jacks, then chew some gum. You can also spray your work area with a bit of peppermint to increase your level of alertness.

Make certain that you set up to work in an area without distractions. Put up a do not disturb sign and establish set times when others can call or stop by. Also set up a specific time of the day to check emails and voice mails. If great ideas pop in your head while you are working, write them down to look at after your work is done.

To improve your direction following, carry a digital voice recorder and record directions from supervisors. Whenever possible, ask for confirmation of expectations in writing. Move around productively. Take the stairs instead of the elevator because exercise improves attention. You can use a fitball chair to improve you attention as it requires more effort to balance and so stimulates your brain, thereby improving your attention and concentration.

Whether at home or work, don’t forget the value of exercise. If you can, take a walk during lunch. Physical activity is one of the most positive and efficient ways to reduce inattention because it increases blood flow and oxygenation of the brain. Find a sport or vigorous exercise that is fun and you will be likely to stick with. Exercise outdoors with others whenever possible because the sunshine and socialization combat feelings of depression which often accompany ADD/ADHD.

Good sound sleep is also essential for anyone with ADD/ADHD. So you will want to avoid caffeine late in the day. Exercise vigoeously and regularly several hours before sleep. Then, take a hot shower, have a high carb low sugar snack, and head into bed at a consistent time. To maintain your energy level and focus throughout the day eat frequent small low carbohydrate, low sugar, high protein meals.

Central Florida Neuropsychology offers affordable home based neurofeedback and cognitive rehabilitation programs for individuals with ADD/ADHD. For more information, contact us at: 866-448-1965 or [email protected]

Offered as a community service,

Susan L. Crum, Ph.D., A.B.M.P., A.B.P.S.

Licensed Psychologist

Central Florida Neuropsychology, LLC

4646 Nadena Drive

Sebring, FL 33872

Voice: 866-448-1965









Can You Tell Which Twin is a Smoker?

Posted by cfln4646 on November 4, 2013 at 5:00 PM Comments comments (70)

Most everyone is aware of the physical dangers of smoking cigarettes, but few consider the mental health effects. First, as can be seen even in photos of identical twins, smoking speeds up facial aging; which in turn decreases our self-esteem and our attractiveness to partners. The latter decrease in attractiveness, further erodes our self-esteem and can be a factor contributing to feelings of anxiety or depression.

Of course, one can use facial creams and plastic surgery to address the damage smoking does to your skin. You can also pay for tooth whitening. There is not much one can do about the decrease in body mass (muscle) which makes men look more effeminate and women appear older. So, even if you don’t believe the National Institutes of Health when they report that smoking kills more than five million people each year around the world, and is responsible for nearly 87 percent of lung cancer deaths, or the US Centers for Disease Control and prevention when it tells you that smoking increases the risk for cancer by up to 23 times for men and 13 times for women, you might be vain enough to want to avoid faster aging and appearing less attractive to the opposite sex.

You might also want to consider the fact that nicotine is an anxiolytic. So, there is a good chance that you are suffering from unidentified and untreated anxiety; for which there are much more effective interventions.

Given this fact you might want to consult with your physician about a temporary prescription for a medication (such as Bupropion (Zyban) or Varenicline (Chantix) that will decrease your cravings for nicotine. Simultaneously consider using a Nicotine replacement patch or chewing gum and gradually decreasing your physiological dependence.

Finally, call a local psychologist who specializes in behavioral medicine. They can help you identify your anxiety triggers, figure out which you can reduce or eliminate, and how to go about it, as well as teach you effective techniques for stress management and anxiety reduction. Taking this last step, which will probably mean one session a week for about twelve to sixteen weeks, can be the crucial factor is remaining nicotine free.

Presented as a community service by,


Susan L. Crum, Ph.D.

Licensed Psychologist




Tips for Dealing with Adolescent Risk Taking Behaviors

Posted by cfln4646 on October 19, 2013 at 12:05 AM Comments comments (0)

Tips for Dealing with Adolescent Risk Taking Behaviors


The fact is that all teenagers take risks as a normal part of growing up and maturing. Parents naturally worry about these risk taking behaviors, but, in reality, risk taking is a tool employed to define and develop a youth’s identity. Thus, healthy risk-taking is a valuable experience.


Healthy risk taking behaviors which generally have a positive impact on an adolescent include volunteering, sports such as rock climbing, skiing or zip-lining, artistic endeavors, participation in student government, travel, taking on challenges through organizations such as Civil Air Patrol or Scouts. If your child is seeking risk taking behaviors, direct them towards these types of activities.


Negative risk taking behaviors run the range from unsafe sex to drinking, experimenting with drugs, reckless driving, self-mutilation, eating disorders, theft, and gang activity. Most parents interpret these behaviors as rebellion directed at the parents. When actually they are part of a teen’s attempt to figure out who, to separate from others and to define themselves.


Red flags that parents should watch out for include indications of anxiety or depression which exceed normal teenage moodiness, engaging in illegal activities, and a pattern of negative risk taking behaviors such as smoking, drinking, running away, stealing, self-mutilation, or disordered eating. As a parent, you need to help your child find healthy ways to take risks and define themselves as alternatives to negative risk taking behavior. If your teen appears to take risks regardless of the consequences, take them for a psychological evaluation as they may be struggling with a condition such as ADHD which impedes their impulse control.


Instead of hiding the foolish things you did as a youth. Share them. Let your child know which worked out well and which you learned to avoid. Let them understand that most mistakes are not fatal but they need to consider the consequences of their choices. Then, help them develop strategies for diverting their energy into healthy activities.


It is also important for parent to pay attention to their own risk taking behaviors. If you smoke, it is likely that your teenager will decide this is a safe activity. If you drink to excess, your teen may imitate this behavior. If you engage in illegal activities and haven’t been caught, your teen may assume the same will be true for them. In short, be a good role model. Finally, as the teenage years are a time when your children are attempting to separate from you, this is a good time to ask other positive role models to be more actively involved. This might be a grandparent, an aunt or uncle, a Scout master or a Chrisitan Youth Group Leader. But, remember not to trust anyone blindly with your teenagers development. Stay involved. Know who they are with, what they are doing, and join them as often as reasonable.


Presented as a Community Service by,

Susan L.Crum, Ph.D.

Licensed Psychologist


Are You Suffering from Depression?

Posted by cfln4646 on October 16, 2013 at 8:40 PM Comments comments (0)


Are you suffering from depression?

Most of us experience brief periods of depression at some point in our lives. This could be feeling “down in the dumps” or “blue”. It may be a time when we have lost interest in things that we use to find enjoyable. It may be a time when we are negative or pessimistic. Generally, we can pull ourselves out of this state and move on with life. But, when those feelings persist for a long time or interfere with our ability to work, manage our home, care for those in our lives, care for ourselves, or these feelings last for a long period of time, that’s when a “clinical depression” is diagnosed.

This can happen to anyone in any socioeconomic status, at any age, regardless of whether you are male or female and regardless of race. Unfortunately, many hesitate to ask for help because they are embarrassed. They think depression reflects weakness or a character. The truth is that this depression is an actual illness. In fact, it is the most common mental illness.

There are studies which indicate that rates of depression have increased throughout the world over the past several decades and that it is occurring at earlier ages than it used to. We don’t know the exact reasons for these trends. It could be related to urbanization, breakdown of cultural and religious support systems, changes in family structure or financial challenges.

While children and seniors can suffer from depression, we generally see it starting in the twenties and thirties. Sometimes symptoms appear suddenly, perhaps after a trauma such as loss of a loved one. But, it often starts slowly becoming gradually worse over a long period of time. If you are suffering depression you might feel gradually more confused , weak, lethargic, and unfocused.

Fortunately, there are a range of effective treatments available. Unfortunately, many people with depression are never diagnosed or treated. Research indicates that general physicians fail to recognize patients with depression in more than half the cases; and most patients don’t see a psychologist for an annual mental health checkups.

Mental health professionals distinguish among different types of depression such as Major Depression, Bipolar Disorder and Dysthymic Disorder. Major depression involves feelings of sadness, hopelessness, and a loss of pleasure or interest in things that once were pleasurable. Bipolar disorder is characterized by alternate periods of depression and mania. Dysthymia is a chronic form of depression which is milder than Major Depression. There is also Postpartum depression which occurs within four weeks of a woman giving birth. An individual can suffer from Reactive Depression in response to a stressful or traumatic event. Individuals who reside in the northern hemisphere sometimes experience Seasonal Depression during the fall or winter months when there is less sunshine.

Children with depression often complain of headaches and stomach aches, and are irritable or mopey. As a result, they are often mistakenly taken to the pediatrician instead of to a psychologist. Adolescents often evidence sleep disturbance, decreased motivation and energy, sadness and irritability. Seniors frequently complain of a range of physical aches and pains which lead to repeated visits to their primary care physician and failure to have their depression identified and treated.

Misbeliefs or irrational thoughts can play a significant role in maintaining depression. As psychiatrist, Aaron Beck, proposed depressed individuals tend to view the world, the future and their environment negatively. They focus on the negative aspects of any situation, misinterpret statements and facts negatively, make mountains out of molehills, jump to conclusions and blame themselves. Many of these people learn these self-defeating thought processes in early childhood; such thinking may be associated with situations where children felt helpless. For instance, when children are exposed to physical, emotional or sexual abuse, or perhaps live with a substance abuser or an alcoholic. It is possible that these individuals, as Martin Selgiman posited, have “learned helplessness” because early experiences where they could not control their environment lead them to believe that they can never control the outcome of events no matter what they do. As a result they are pessimistic, lack motivation and appear apathetic to others. In essence, these individuals appear to have lost hope. They assume blame for the negative things that happen in their lives, over generalize specific weaknesses to most areas of their life and view the causes of negative events as constant in the same way that a cloud of dirt always followed “Pig Pen” the Charlie Brown comic strips.

Genetics may play a role in the likelihood of your experiencing depression as it tends to run in families. Sometimes there are obvious environmental factors such as the death of a loved one, marital conflict or serious financial problems. There are genes that appear to cause abnormal activity in the brain in terms of the production and use of reuptake of norepinephrine, dopamine and serotonin that may lead to depression, as may an imbalance or low levels of certain hormones such as testosterone in men, or higher levels of cortisol in both sexes. Even an under or overactive thyroid can lead to depression as can deficiencies in Vitamin B6, B12, and C. Strokes, Huntinton’s disease, hepatitis and mononucleosis can all cause depression, as can medications like steroids.

Many people shy away from pursuing treatment because they don’t want to be dependent upon medications. While medications do help some people cope with depression, there are other equally effective interventions such as Transcranial electrotherapy. Psychotherapy, and Neurofeedback. Transcranial electrotherapy involves the use of a small portable unit similar to a tends unit expect that it helps set a healthy rhythm for your brain speeding up slow brain waves into the normal range. This is a painless and passive intervention. It is well researched and documented to be effective. Psychotherapy helps individuals identify and correct their negative thoughts and see solutions to life stressors that they may be missing. Neurofeedback is a specialized form of biofeedback that helps individuals suppress excessive slow wave activity and increase activity in the normal bandwidths. Any given individual might use one of these interventions or a combination of interventions. For those with mild or intermediate depression, psychotherapy is often considered the preferred first option, and there are a range of different psychotherapies that have been shown to work for patients.

If you or someone you know is experiencing depression, seek out help. You can find a local psychologist for face to face sessions. Alternately, if you lack providers within a reasonable commute, have significant financial limitations or uncomfortable with face to face therapy, you can consider online therapy. To investigate this option visit:

Presented as a community service by,

Susan L. Crum, Ph.D.

Licensed Psychologist



Online Therapy

Posted by cfln4646 on October 16, 2013 at 10:15 AM Comments comments (1)

For those who are who don’t live close enough to visit my office, or who lack the funds for face to face sessions, I offer the option of structured on-line therapy sessions so that you can receive help rather than struggling alone with mental health issues.

The program takes you through directed cognitive behavioral therapy and provides you worksheets to do at home which I can review and provide you feedback on. A major benefit of these sessions is that they permit you to work at your own pace, going faster or doing more intense work when you feel ready and progressing slower at other times. For those who are doing face to face session with me, it also reinforces what we discuss, and therefore, helps you generalize the benefit.

The programs available cover: Addiction, agoraphobia, anger, anxiety, bipolar disorder, Depression, Generalized Anxiety Disorder, Insomnia, Relationship Problems, OCD, panic attacks, Post Traumatic Stress Disorder, social anxiety, speech anxiety, stress and weight problems.

Advantages include:

Interactive online step-by-step course

Tools & guidance in each section

Daily therapist feedback

Brief Therapist live chat

Test, forum, mobile access & much

For more information check out these links:

2010-10-10 TV show about anxiety and online therapy shown on SBS (Australian Television).

Watch Online >>

2010-08-10 Panic disorder and depression can be treated over the Internet. Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet. >>

Your fee for using this service is $349.00 for eight weeks to do the sessions and worksheets. You can send me this payment through the site using paypal.


If you would like to enroll in this online program, please go to: Click on the “ Send Me A Payment tab on the left. Then, click on the “How It Works” on the top, and finally on the “Get Started” tab which is on the bottom of the How It Works page.


Susan L. Crum, Ph.D.

Licensed Psychologist