As we go through our fast-paced, everyday lives, it can feel like a challenge to manage and navigate all the intense emotions and unexpected incidents that we’re faced with along the way. 

In response to these challenges, Dr. Marsha Linehan created dialectical behavior therapy (DBT) as a road map for individuals struggling with their mental health and emotional wellness. Throughout this blog, we’ll explore how DBT works and how it can benefit you.

What is DBT?

DBT is a specific type of cognitive behavioral therapy (CBT). DBT helps individuals accept and manage the world around them rather than reacting to uncomfortable situations in a harmful way. DBT is a long-term therapeutic practice that’s often used to help work through suicidal ideation or self-harm, complex life difficulties, PTSD, bipolar disorder and other mental health disorders and challenges. 

There are four core strategies DBT aims to teach individuals: Mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. In particular, DBT can help those who may feel emotions intensely. The “dialectical” portion of DBT means to try and understand how two things that seem opposite could be true at the same time. DBT teaches individuals how to master the art of finding a balance between both change and acceptance of oneself and one’s own environment.

Benefits of DBT

DBT serves several purposes and provides many benefits to individuals  seeking help and solace. It’s an incredibly valuable therapeutic approach for individuals struggling with their mental health. 

Benefits of DBT Include:

1. Strengthens relationships with others. DBT teaches individuals to think before abruptly reacting, and how to build a balanced perspective (middle ground in the case of opposing viewpoints). DBT increases self awareness and decreases destructive behavior which can lead to the nourishment of close supportive relationships.
2. Raises self esteem. DBT can use validation techniques that validate one’s emotions and experiences. As this can boost one’s confidence in their emotions, this also translates into personal self esteem as feelings of shame are often lessened. DBT challenges an individual to go against their negative thoughts which in turn negates a lot of negative self talk.
3. Enhances emotional regulation. DBT will teach an individual how to manage their emotions rather than be managed by their emotions. These learnt skills will assist in the development of reducing negative emotions and one’s vulnerability to them and help see a more positive outlook on stressful situations.
4. Promotes a change in behavior and positive thinking. Because DBT builds an individual’s distress tolerance, it assists in managing anxious or depressive tendencies. It allows individuals to not feel defined by stressful or tumultuous situations and rather work through them with emotional intelligence which makes it easier to have a positive outlook on changes and ones thinking. 

What skills can DBT teach me?

DBT is broken up into four different modules: Mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. 

Mindfulness, when referring to DBT, helps with talking through, being aware and accepting the present moment without judgment. These practices help build awareness skills that teach us to relax our body and mind in times of distress—ultimately, strengthening our mind-body connection. Mindfulness also helps us learn to let go of negative thoughts and intrusive thought patterns. 

DBT also focuses on emotional regulation and changing one’s undesired emotions to reduce vulnerability to them. Emotional regulation skills help one examine their distortions and patterns of thinking, and work on emotional urges. These emotional regulation skills are an important part of improving problem solving and coping strategies. 

Another skill this type of therapy focuses on is distress tolerance. Improving distress tolerance is important when it comes to our ability to work through crises situations without escalating them. It helps us to understand the distinction between acceptance and approval. Distress tolerance exercises include cost-benefit analysis, grounding techniques and practicing radical acceptance. 

Lastly, DBT focuses on building interpersonal effectiveness, which means learning how to apply effective strategies for managing conflict, setting boundaries and communicating our needs to those around us.

DBT at Valera Health

Is it time to try DBT? 

Here’s how to know if DBT is right for you:

1. You’re experiencing feelings of loneliness and hopelessness that feel insurmountable.
2. You seem to lose people quickly or suddenly due to fallouts.
3. You struggle to maintain positive relationships with partners, family and friends.
4. Your emotions interrupt with work, goals and relationships. 
5. Your emotions feel debilitating and overwhelming.

Valera Health offers a wide range of virtual DBT therapy groups, both in New York and Arizona. Currently, our DBT skills groups are open to established patients that are 18+ years of age. The majority of Valera’s DBT groups include four modules that run for a total of six months. While participants only need to commit to at least 8 weeks, it is recommended they complete all four.

Valera Health’s DBT program can benefit adults and adolescents experiencing emotional dysregulation, relational issues, poor impulse control and anxiety and depression symptoms. 

For those seeking more intimate one-on-one sessions, our providers are well-versed in individual DBT therapy. 

Whether you’re interested in a DBT group or individual DBT therapy, you can request a free consultation with Valera Health. We also offer other forms of group and individual therapy, psychiatry and medication management—all from the comfort of your own home.

The best way to know if DBT is for you: You are ready for change and committed to making yourself better. 

Though it can be intimidating, reaching out for more information regarding DBT therapy can be one of the most rewarding things you can do for yourself. Whether you have a specific mental health condition or are just looking to improve your life, anyone can benefit from DBT therapy.

Works Referenced:

Dialectical Behavioral Therapy. (2022, November 5). Distress tolerance. DBT. https://dialecticalbehaviortherapy.com/distress-tolerance/ 

Emotion regulation. DBT Self Help. (2023, September 27). https://dbtselfhelp.com/dbt-skills-list/emotion-regulation/#:~:text=Emotion%20Regulation%20is%20the%20Dialectical,and%20build%20positive%20emotional%20experiences 

Schimelpfening, N. (2023, May 1). How dialectical behavior therapy (DBT) works. Verywell Mind. https://www.verywellmind.com/dialectical-behavior-therapy-1067402 

Transtrum, T. (2023, May 3). Anxiety & depression are on the rise-here’s what you need to know. Valera Health. https://www.valerahealth.com/anxiety-and-depression-are-on-the-rise/

Despite the fact that ADHD is one of the most common childhood disorders, a growing number of adults are getting diagnosed. You may be asking, “Why the sudden uptick?”

Well, oftentimes signs of attention-deficit/hyperactivity disorder (ADHD) in children can go unnoticed by teachers and parents—especially when we factor in how ADHD can present itself differently in girls vs. boys. 

As knowledge about ADHD expands, so does our understanding of this disorder and its signs. So what does ADHD look like later in life? Keep reading to find out.

What is ADHD?

Also known as attention-deficit/hyperactivity disorder, ADHD is a neurodevelopmental disorder, which is a category of disorders marked by conditions that affect growth and development of the brain and how it functions. 

ADHD can cause certain brain regions to become hyperactive (highly active beyond standard levels) and others to become hypoactive (less active than standard levels). 

As Medical News Today puts it: “A person with ADHD may be unable to suppress brain activity in the default attention network, especially as a task becomes more difficult. This may link to more distractibility.”

Signs of ADHD in Adults

ADHD doesn’t just affect children and teens. It’s estimated that close to 10 million adults have ADHD, according to recent numbers from Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). 

For those whose ADHD went undiagnosed during childhood, the following reasons may have been at play:

• Parents or teachers may not have noticed signs of ADHD, or may not have known the signs of ADHD to look out for in the first place
• The severity of their ADHD could have been mild
• Despite having ADHD, they performed well academically
• Masked signs of ADHD
• Signs of ADHD can differ by genders

Another possible reason for delayed ADHD diagnosis is that the stresses of adulthood—such as work, higher education, and increased responsibilities (finances, family, less support, etc.)—can exacerbate ADHD symptoms and make them harder to manage.

Signs of ADHD in Adults Include:

• Regular hyperactivity, which can look like:
  • Restlessness or an inability to sit still
  • Stimming or fidgeting, as in repeating certain sounds or body movements unconsciously (for example, rocking back and forth, pacing around, grinding teeth, doodling, nail biting, etc.)
• Zoning out or daydreaming
• Trouble paying attention for long periods of time or becoming easily distracted
• Disorganization, such as constantly having a cluttered home, car or desk
• Having trouble finishing tasks
• Becoming easily overwhelmed
• Making careless mistakes on tasks, such as work projects
• Losing interest in tasks easily, especially with things you find to be boring or repetitive
• Hyperfocusing or fixating on interesting tasks or subjects
• Struggling with motivation
• Forgetfulness 
• Procrastination
• Poor time management
• Reacting strongly to relatively small stressors or inconveniences
• Impatience
• Sudden shifts in moods
• Angry outbursts 
• Indecisiveness or feelings overwhelmed when faced with choices
• Overstimulation
• Excessive talking, blurting things out, and unintentionally interrupting others

ADHD Signs in Women vs. Men

During both childhood and adulthood, ADHD can look different according to gender. 

The CDC reports that 13% of boys (ages 3-17) in the U.S. are diagnosed with ADHD, compared to 6% of girls (ages 3-17).  However, due to underrecognized and underreported signs of ADHD in females, the prevalence of ADHD among girls is likely higher than reported.

Signs of ADHD in Females*:

• Maladaptive daydreaming
• Anxiety
• Depression
• Spacing out during conversations
• Easily losing focus
• Auditory processing disorder
• Forgetfulness
• Eating disorders
• Hypersexuality
• Impatience
• Body-focused repetitive behaviors (e.g. skin picking, hair pulling, leg bouncing)
• Fatigue
• Insomnia
• Crying with deep emotion, anger, and feelings of guilt and shame
• Shyness due to social anxiety and sensory sensitivities
• Rejection sensitivity dysphoria (RSD) symptoms
  • Perfectionism
  • People-pleasing
  • Codependency
  • Body dysphoria
  • Low self-esteem
  • Overachieving
  • Underachieving 
  • Overwhelm
  • Intense emotional reactions

Hormone levels*—in particular estrogen levels—can also impact the severity and intensity of ADHD symptoms at different stages of life, including: puberty, monthly menstrual cycles, perimenopause and menopause.

Signs of ADHD in Males*:

• Hyperactivity (e.g. fidgeting)
• Disruptive behavior
• Frequently losing items
• Interrupting others during conversations
• Aggressive behaviors
• High risk behaviors (e.g., substance misuse, speeding, unhealthy sexual behaviors, excessive financial spending)
• Insecurity—more often presented externally as the following:
  • Anger
  • Apathy
  • Self-centeredness
  • Seeming insensitive to other people’s emotions
  • Teasing others or being sarcastic
  • Needing to be right or proving others wrong
  • Defensiveness

Due to the way ADHD presents itself in females and how they cope with symptoms, signs of this disorder may be brushed off as “perfectionism” or being “emotional.” Women and girls are also less likely to express hyperactivity and impulsivity externally. 

The signs of ADHD in males have historically been used as a standard for ADHD diagnosis—in part because males typically show symptoms in a more external manner, and in part due to gender bias. 

*Source: https://psychcentral.com/adhd/adhd-and-gender 

How is ADHD Diagnosed?

There are multiple tests used to diagnose ADHD in both children and adults. If you Google “ADHD testing,” you’ll find plenty of online self-diagnosis tests—however, licensed medical professionals like psychiatrists and primary care physicians (PCPs) are the only people who can provide an accurate ADHD diagnosis.

After speaking with your doctor, they may decide that it makes sense for you to do a psychological assessment, which will help determine if an ADHD diagnosis is fitting.

Popular ADHD Assessments Include:

1. The Test of Variables of Attention (TOVA)
2. Behavior Rating Inventory of Executive Functioning-Adult Version (BRIEF-A)
3. Barkley Adult ADHD Rating Scale-IV (BAARS)
4. Conners’ Adult ADHD Rating Scales (CAARS)

Treating ADHD

Therapy, medication and social support are three of the best ways to treat ADHD. At Valera Health, we happen to offer all three. Our virtual services include both individual and group therapy, psychiatry and medication management. Currently, we offer multiple ADHD support groups in New York, and other therapy groups in additional states (more to come soon!). Our Health Connectors are here to help you begin your treatment journey. Visit https://www.valerahealth.com/consult-today/ or click here to get started with a free consultation. For additional ADHD support resources, click here.

Thanks to the expansion of research on ADHD in adults, signs and symptoms of ADHD are becoming more widely understood. While we still have a ways to go, the future of ADHD treatment and diagnosis looks bright.