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Identifying Schizophrenia and Developing a Treatment Plan

Identifying schizophrenia can be difficult, given the diverse symptoms. Schizophrenia is an often debilitating disorder that impairs one’s ability to think and behave rationally. Individuals with schizophrenia have a difficult time differentiating fantasy from reality. These symptoms manifest in a variety of ways, and no known method can cure the disorder. This article will look at how schizophrenia impacts individuals in five different categories.

The disorder affects the cognitive, behavioral, mood, phycology, and speech of the individual. While this disorder requires lifelong care, there are effective methods of treatment that can improve the quality of life and alleviate symptoms. Alter Behavioral Health has established an intricate network of healthcare professionals dedicated to providing specialized care for individuals who have schizophrenia.

Identifying Schizophrenia: Causation

A whole host of conditions are believed to increase the risk of developing schizophrenia. Although, researchers have not identified any one specific cause for the disorder. It is widely believed that a combination of developmental, psychological, genetic, and environmental factors contribute to potential psychotic episodes. Because there are so many factors that play into the foundation of the disorder, treatment is lifelong.

Individuals with schizophrenia have exhibited traits that suggest an increased risk for the development of the disorder. Some of these risk factors are family history, complications at birth, drug use, and differences in brain development. Schizophrenia tends to be passed down genetically. Many individuals with the disorder have a family history of the condition.

Identifying schizophrenia can often start at birth. Studies have also shown that individuals that are underweight, premature, or experience a lack of oxygen during birth have the potential to develop the disorder.

Brain development has also been brought into the conversation of schizophrenia. Individuals with the disorder show subtle differences in the structure of their brains, suggesting that the disorder originates there. Drug use has also been linked to the development of schizophrenia. Certain narcotics can produce side effects that mimic symptoms of schizophrenia and can even trigger psychotic episodes in some who may be susceptible to the disorder.

Identifying Schizophrenia Symptoms

This disorder affects individuals in several different ways. Schizophrenia affects the cognitive, behavioral, mood, phycology, and speech of the individual. The nature of the impact of this condition makes treatment long-term.

Cognitive Impairment

Schizophrenia has a profound impact on cognitive functions. Many individuals will experience confusion, disorientation, slowness in processing, and even distorted beliefs about themselves. Schizophrenia tends to create feelings of superiority and uniqueness. Some individuals even exhibit beliefs that normal events or interactions have special meaning. There is sometimes a grandiose way of thinking and interpreting information.

Behavioral Symptoms

Complications centering around behavior and interpersonal interactions are some of the most apparent symptoms of schizophrenia. Isolation is common among individuals with this disorder, as they often have a difficult time connecting with others. Individuals also exhibit increased irritability, compulsive behavior, aggression, self-harm, and difficulty restraining themselves. Behavioral symptoms prove to be some of the most disruptive and destructive difficulties that individuals with schizophrenia struggle with.

Mood Dysregulation

Individuals who have schizophrenia experience severe difficulty regulating their moods. This may look like outbursts of strong emotions and a propensity to become easily dysregulated. Schizophrenia can produce strong feelings of anger, apathy, irritability, detachment, and inappropriate emotional outbursts. Difficulties regulating mood can make public interaction difficult and increase the need to isolate and detach from relationships.

Psychological Complications

The impacts of schizophrenia on an individual’s psychology are profound. These symptoms are usually what come to mind for most people when they think about the disorder. One of the primary symptoms of schizophrenia is visual and audible hallucinations. These hallucinations are often comprehensive and make it difficult to differentiate the hallucinations from reality. Other psychological symptoms include depression, paranoia, and anxiety.

Identifying Schizophrenia: Treatment

As previously mentioned, treatment for schizophrenia is a lifelong commitment and requires a dedicated team of care providers. Alter Behavioral Health offers several methods of treatment for individuals diagnosed with schizophrenia. Considering there is no known cure for schizophrenia, a combination of different treatments is most recommendable. To begin the treatment process, a cohesive group of healthcare providers needs to be assembled.

One of the most effective methods for treatment is the use of medications such as antipsychotics. One of the most difficult symptoms to treat is visual and audible hallucinations. Using antipsychotics to help mitigate these particular symptoms provides a good foundation for helping the individual engage with reality. Often individuals with schizophrenia have a hard time separating the hallucinations from real life. Regulating this system is incredibly valuable in the therapeutic process.

Pairing antipsychotic medications with cognitive-behavioral therapy (CBT) adds another layer of care to the equation. CBT helps the individual engage with their thoughts and belief system. Considering the impact schizophrenia has on the mind and thought patterns, a professional must intervene and help establish boundaries for the individual. Professional counselors can also help the client engage with their trauma and develop coping skills for regulating strong emotional outbursts.

Schizophrenia is a serious and often debilitating mental illness. Although there is no way to cure this disorder, there are methods for treatment that can significantly improve the quality of life for the individual. Treatment needs to be holistic and consistent over the course of the individual’s life. Alter Behavioral Health has a dedicated plan for treatment and a broad community of professionals that are ready to provide the care needed to help individuals with schizophrenia. For inquiries, contact us at (866) 691-4386. Even though there is no cure for this illness, there is space to dramatically improve the lives of the individuals who are struggling and help equip family members and friends to provide further support.

How Can Medicine Help Schizophrenia?

Schizophrenia is a condition that affects how an individual thinks, feels, and behaves. It is considered a spectrum disorder because its symptoms can vary in intensity from mild to severe. In other words, every individual with schizophrenia is affected differently. 

Due to decades of misinformation, schizophrenia is a highly stigmatized disorder. However, contrary to what many individuals may believe, those with schizophrenia are capable of living happy and healthy lives. Typically, managing life with schizophrenia requires a variety of treatment interventions, including medication. Medication can help reduce and, in some circumstances, eliminate symptoms of schizophrenia. It therefore allows individuals to go about their daily lives without symptoms interfering with their ability to function. 

What Is Schizophrenia?

According to the World Health Organization (WHO), schizophrenia affects nearly 24 million individuals worldwide. The National Institute of Mental Health (NIMH) explains that schizophrenia is a serious mental illness characterized by symptoms that cause an individual to lose touch with reality. As mentioned previously, it is a spectrum disorder, which means that specific symptoms, as well as the intensity of those symptoms, vary from person to person. 

Signs and Symptoms

Although they vary, individuals with schizophrenia often experience symptoms that fall into three categories: psychotic, negative, and cognitive. Psychotic symptoms interfere with the way an individual thinks, behaves, and experiences the world. Some examples of psychotic symptoms include:

  • Hallucinations: Seeing, hearing, smelling, or feeling things that are not actually there – for instance, many individuals with schizophrenia hear voices 
  • Delusions: Strong beliefs that are untrue or may seem irrational to others – for instance, individuals with schizophrenia may believe that newscasters are sending special messages to them 
  • Thought disorder: Unusual or illogical thought patterns – for instance, individuals with schizophrenia may struggle to organize their thoughts and speech
  • Movement disorder: Abnormal body movements – for instance, individuals with schizophrenia may experience “tics” or repeat certain body movements compulsively

Negative symptoms reduce functions that are necessary for operating normally in daily life. Oftentimes, negative symptoms are mistaken for symptoms of depression. Examples of negative symptoms may include:

  • Loss of motivation
  • Loss of interest or enjoyment in activities
  • Withdrawing from social life
  • Reduced facial expressions
  • Low energy
  • Issues with planning

Finally, cognitive symptoms shed light on issues with attention, concentration, and memory. Such symptoms may make it difficult to follow conversations and learn new things. Examples of cognitive symptoms include:

  • Issues processing information to make sound decisions
  • Issues using information immediately after learning it
  • Issues keeping focus or paying attention

Addressing Stigma

The common stigma surrounding schizophrenia causes individuals to believe that those with the condition are dangerous, “crazy,” or unable to recover. It is important to understand that these stigmas have developed from misinformation and a lack of understanding.

According to the NIMH, individuals with schizophrenia are more likely to be victims of harm and violence rather than perpetrators. Additionally, schizophrenia can be treated, allowing individuals with it to achieve manageable recovery. 

Treatment Options for Schizophrenia

The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that individuals with schizophrenia can “pursue their goals, have relationships, keep jobs, and be productive members of their communities” when they utilize medication and therapy. Living well with schizophrenia means continuing these treatment interventions long-term, possibly for life. 

Medication Options

The most common medications prescribed for schizophrenia are antipsychotics. Antipsychotics help reduce the severity of psychosis symptoms, “making them less intrusive and disturbing,” according to SAMHSA. Oftentimes, individuals will need to try a variety of different medications — and doses — before finding the most effective prescription for their unique symptoms. 

Antipsychotic drugs target and regulate important brain areas that are responsible for producing symptoms of schizophrenia. These medications can produce side effects as the individual’s brain reacts and adjusts to their presence. Therefore, it is vital that individuals starting any new medications are closely monitored by a physician. Likewise, individuals must take their medication exactly as prescribed by their doctor.  

In some cases, antidepressants or other mood stabilizers may be prescribed to help with the negative and cognitive symptoms of schizophrenia. Participating in professional treatment can ensure that individuals are prescribed the type of medication that will benefit them the most. Likewise, it encourages individuals to utilize therapy in combination with medication to make treatment as effective as possible. 

Therapeutic Options

Engaging in additional therapeutic options, such as individual psychotherapy or group psychoeducation, can also be beneficial for those with schizophrenia. These treatment options allow individuals the opportunity to recognize the patterns and links between their thoughts, emotions, and behaviors. Additionally, they will be equipped with stress reduction techniques and coping mechanisms that can further reduce the stress that may potentially trigger an episode. 

Individuals with schizophrenia can benefit from knowing treatment options are available to help them manage their symptoms long-term. Utilizing personalized, professional treatment from an accredited facility like Alter Behavioral Health can strengthen lasting symptom management and recovery. 

Schizophrenia is a serious mental health condition that interferes with the way an individual thinks, feels, behaves, and experiences the world around them. Contrary to common stigma, schizophrenia can be well managed with medication and therapy. Alter Behavioral Health is a mental health treatment center that focuses on treating the whole person. We utilize individualized care in addition to stressing the importance of psychoeducation and a strong community. We can provide medication in tandem with psychotherapeutic approaches to ensure lasting symptom management for our clients. If you are struggling with schizophrenia, we want you to be in good hands for treatment. To learn more about our programs, call us at (866) 691-4386.

Understanding the Complexities of Schizophrenia

The National Institute of Mental Health (NIMH) defines schizophrenia as “a mental health disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and social interactions.” It results in an internal struggle to differentiate between reality and false perceptions of reality. The inability to distinguish between the two can become so severe that it interferes with daily activities and makes life particularly challenging.

Understanding Schizophrenia

Up to 24 million people worldwide are affected by schizophrenia. This disorder is one of the most misunderstood and complicated mental health disorders, which often contributes to harmful stigma to those affected by it. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) now considers schizophrenia to be a spectrum disorder. Previously it was categorized into five different subtypes, shades which now exist on a sliding scale. These include:

Paranoid Schizophrenia

This subtype is characterized by high levels of suspicion without cause and distorted sensory function. Those who struggle with paranoid schizophrenia may experience hallucinations and hear voices that are not there. They may also either be preoccupied with a single delusion or experience frequent auditory hallucinations.

Residual Schizophrenia

When experiencing residual schizophrenia, individuals encounter hallucinations, disorganized speech, delusions, or catatonic behaviors, as are typically associated with schizophrenia but on a smaller scale than more extensive subtypes. Despite the lesser severity, residual schizophrenia should be taken seriously. If left untreated, it can worsen or progress.

Disorganized Schizophrenia

The symptoms of this subtype include rambling speech and behavior. When severely disorganized speech is involved, it can be challenging to follow the affected individual’s speech as it may be incoherent.

Additionally, inappropriate affect is involved with disorganized schizophrenia. The American Psychological Association (APA) defines inappropriate affect as an emotional response that is not in keeping with the situation or is incompatible with expressed thoughts or wishes. For example, an individual with this subtype may smile when told about the death of a friend.

Catatonic Schizophrenia

On the more advanced end of the scale, catatonic schizophrenia has been believed to be the result of untreated schizophrenia. Symptoms of this disorder include refusal to move, change position, and extensive immobility. Alternatively, individuals may experience excessive, unnecessary movement for no reason, echolalia — the meaningless repetition of words or phrases heard by someone else — or echopraxia – the meaningless repetition of movements seen by someone else.

Undifferentiated Schizophrenia

Those who don’t meet the criteria for the previous four subtypes may fall into the undifferentiated category. When individuals experience this sub-type, they will experience hallucinations, delusions, disorganized speech, or catatonic behavior. However, these symptoms are neither consistent nor similar enough in pattern and severity to be considered one of the above subtypes.

Colors of Schizophrenia

Because of the complexity of schizophrenia and the vast range of symptoms and severity levels, the above disorders are now only considered to be specifiers of this spectrum disorder. Similar to a broad spectrum of colors, regardless of the shade, each is still classified as a color. No matter how minor or severe, each case of schizophrenia is still considered to be on the schizophrenia spectrum.

The Spectrum of Schizophrenia

The word “schizophrenia” combines the Greek skhizein, “split,” and phren, “mind.” This name for the disorder misrepresents what it truly is. This results in a severe misunderstanding among the general population. People tend to believe that schizophrenia involves split personalities when it does not. Consequently, it is often mistaken for the condition dissociative identity disorder — sometimes referred to as multiple/split personality disorder.

Schizophrenia falls under the umbrella of psychotic disorders as it typically involves episodes of psychosis. It is recognized as the most common psychotic disorder. An individual can, however, be diagnosed with psychosis but not schizophrenia, as it is its own disorder under this umbrella. Bipolar disorder is another condition that has been known to involve psychosis.

Symptoms of Schizophrenia Spectrum Disorder

While the previously recognized subtypes of schizophrenia have distinct qualities, they are now combined under one diagnosis. The symptoms can vary greatly on the schizophrenia spectrum and include, but are not limited, to the following:

  • Hallucinations that involve hearing/seeing things that don’t exist outside of the mind
  • Delusions from unusual beliefs based on false perceptions of reality
  • Jumbled thoughts due to hallucinations or delusions
  • Loss of interest in everyday activities
  • Decreased personal hygiene
  • Avoidance of people including friends and family

One common misconception of schizophrenia includes violence. This spectrum disorder does not result in violent behavior.

When to Seek Treatment

If you believe you or a loved one may be experiencing schizophrenia, reach out right away. Obtaining a diagnosis will be the first step in the treatment process. The primary method of treating schizophrenia is medication in the form of antipsychotics. In addition, cognitive-behavioral therapy (CBT) may be used, as it has also been proven effective in treating the condition.

With the right guidance, you can thrive despite your schizophrenia in bright and beautiful ways. There is a big and exciting world out there just waiting for you to fully live and experience it. Don’t let your disorder hold you back. Seek treatment today.

Facing schizophrenia can be challenging and confusing. With our help, you can conquer the obstacles in your path and thrive in ways you didn’t know were possible. At Alter Behavioral Health, we believe in you and the flame you hold within. Let us guide you and ignite your fire to the roaring potential you deserve. Proper guidance and care can help you overcome your schizophrenia and live a life free of the challenges you face. We can help you achieve a brighter and happier future where your inner light can shine brighter than the sun. Call us today at (866) 691-4386 for more information and to get started on the first step to the rest of your life. 

Which Type of Schizophrenia Do I Have?

When facing an unknown mental health disorder, life can be a burdening uphill battle. Gathering the right information and seeking proper care can erase the challenges that not knowing can cause in your life. If you believe you or a loved one may have schizophrenia, this information may be of value to you. Reaching out for a proper diagnosis and treatment plan is an essential step to living life free of the burdens of schizophrenia.

What Is Schizophrenia?

Schizophrenia is a mental illness in which you struggle to differentiate between reality and false perceptions of reality. This challenge can make life particularly difficult. Schizophrenia has been known to be so severe that it interferes with daily activities. This can result in you being unable to complete day-to-day tasks and function properly.

Schizophrenia affects 24 million people worldwide (one in 300 individuals or 32%). It is one of the most misunderstood and complicated mental health disorders recognized today. While the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) now considers schizophrenia to be a mental illness on a spectrum, it has previously been categorized into five different subtypes. These include:

#1. Paranoid Schizophrenia

This subtype has been characterized by high levels of suspicion without cause and distorted normal function. If you struggle with paranoid schizophrenia, you may experience hallucinations and hear voices that are not there. You may also either be preoccupied with a single delusion or experience frequent auditory hallucinations.

#2. Residual Schizophrenia

If you struggle with residual schizophrenia, you do not experience frequent hallucinations, disorganized speech, delusions, or catatonic behaviors. Instead, you will experience two or more of the aforementioned symptoms on a smaller scale than more extensive sub-types. Despite the lesser severity level, residual schizophrenia should be taken seriously. If left untreated, it can worsen or progress.

#3. Disorganized Schizophrenia

The disorganized symptoms of this subtype include disorganized speech and behavior. When severely disorganized speech is involved, it can be challenging to follow as you may be incoherent.

Additionally, inappropriate affect is involved. The American Psychological Association (APA) defines inappropriate affect as an emotional response that is not in keeping with the situation or is incompatible with expressed thoughts or wishes. For example, you may smile when told about the death of a friend.

#4. Catatonic Schizophrenia

As mentioned in residual schizophrenia, when left untreated, this disorder can progress. Catatonic schizophrenia has been believed to be the result of untreated schizophrenia. Symptoms of this disorder include refusal to move, change position, and extensive immobility.

Alternatively, you may experience excessive, unnecessary movement for no reason, echolalia, and echopraxia. Echolalia is the meaningless repetition of words or phrases heard by someone else. Echopraxia is the meaningless repetition of movements seen by someone else.

#5. Undifferentiated Schizophrenia

If you don’t meet the criteria for the previous four subtypes, you may fall into the undifferentiated category. When you experience this sub-type, you will experience hallucinations, delusions, disorganized speech, or catatonic behavior. However, these symptoms are not consistent nor similar enough in pattern/severity level to be considered one of the subtypes mentioned above.

What Does Treatment for Schizophrenia Look Like?

Treatment for schizophrenia looks similar across all subtypes and includes the following options:

Medication

Antipsychotic drugs are a primary treatment form for treating this mental health disorder. These medications alter the brain’s chemistry to assist in reducing psychotic symptoms like hallucinations, delusions, and disordered thinking. However, antipsychotics may have side effects. Trial and error will help determine the best prescription for your personal needs for optimal treatment.

Cognitive-Behavioral Therapy

Medication is generally paired with cognitive-behavioral therapy (CBT). While medication is the primary treatment option, coping with schizophrenia is still challenging and difficult to navigate without guidance.

Through CBT, you will receive help from trained therapists to assist in understanding your mental health. You will learn coping mechanisms that can help reduce stress and improve thought processes. These tools can ultimately help you live a much happier and less stressful life.

Continued Education

In addition to CBT and medication, you also have a lot to gain from continued education on your mental health disorder. Through psychoeducation, both individually and in a group setting, you and your loved ones are able to learn all there is to know about this widely misunderstood disorder. You will be well equipped with the knowledge and understanding needed to cope with schizophrenia. Both parties will learn that this mental health disorder is not to be stigmatized as dangerous.

Find Schizophrenia Treatment Today

It is important to reach out as soon as possible if you or a loved one may be struggling with schizophrenia. Your life can be wonderful and full of happiness with the right guidance and care. You need only to reach out, and someone will be there to take your hand. Your life matters. You matter. Don’t wait to put yourself first. You deserve happiness, and proper treatment can bring just that.

At Alter Behavioral Health, we understand how difficult life must be with the questions of not knowing. Facing schizophrenia can be extremely challenging when you aren’t sure what type you have or what to do about it. However, schizophrenia of any type is treatable. You can get help today so that tomorrow and each day going forward are days of happiness. You deserve all that life has to offer, just like everyone else does. Don’t let your schizophrenia hold you under. Rise above it and live your life the way you deserve to. Call us today at (866) 691-4386, and let us guide you to a happy life free of the burdens of schizophrenia. 

Which Type of Schizophrenia Do I Have?

Do you sometimes feel out of place mentally? Are you having disorganized thoughts and feelings, or present odd behavior that you do not understand and feel you could not possibly explain what is going on to others? Do you sometimes feel like others are out to get you? Are your symptoms causing you to have impaired relationships? Your everyday life may even be challenging to tackle with the symptoms that are present.

Speaking with a professional can help you find the diagnosis you are searching for to gain relief. With treatment, professionals will educate you on your condition and help you overcome the obstacles schizophrenia brings to your life. Exploring the facts about your mental illness, finding your diagnosis, journaling symptoms, and moving forward with professional help can make a difference.

What Is Schizophrenia?

According to the Substance Abuse and Mental Health Services Administration, last updated in 2022, schizophrenia is a serious chronic brain illness that confuses reality for those living with it. It can be difficult for a person to decipher whether certain sights, experiences, or sounds are real. Is this part of my imagination, or is this reality?

Psychotic episodes can be isolating, frightening, and very confusing for someone who is struggling with schizophrenia. The onset of schizophrenia can occur in the early teen years into late adulthood. Ages 16-30 are common ages for diagnosis. Millions of Americans have this mental illness. The earlier you seek treatment, the better the outcome.

Historical Subtypes of Schizophrenia

Schizophrenia is an incurable yet comprehensive mental health condition that can display several different symptoms. According to the National Library of Medicine, last updated in 2022, prior to 2013, schizophrenia was classified under five subtypes:

  • Paranoid schizophrenia
  • Catatonic schizophrenia
  • Disorganized schizophrenia
  • Residual schizophrenia
  • Undifferentiated schizophrenia

Professionals understand that people with schizophrenia at times deal with consecutive symptoms in their lifetime. Therefore, the former subtypes are not always appropriate. The DSM-5 updated the criteria needed to develop a diagnosis of schizophrenia, and a person must exhibit 2 symptoms for at least six months. The subtypes still help people understand the different ways schizophrenia can affect people, but today the requirements for diagnosis are not determined by the type but by a person’s symptoms. Schizophrenia is mainly diagnosed alone.

Identifying Symptoms

According to the National Institute of Mental Health, last reviewed in 2022, schizophrenic symptoms can be different for everyone. The symptoms primarily represent three main categories; psychotic, negative, and cognitive.

Psychotic symptoms include differences in the way a person thinks, acts, and experiences the world. A person may feel:

  • Hallucinations: The five senses are felt when not there. Hearing voices is also a sign.
  • Delusions: A person may believe in somewhat irrational thoughts. For example, a person may strongly think they are in danger, or a sign from the media may be sending direct messages.
  • Thought disorder: A person might have difficulties organizing thoughts and speech. For example, a person may stop talking in mid-thought and abruptly change the topic or make up words.
  • Movement disorder: A person may present strange or repetitious body movements.

Negative symptoms include loss of interest or enjoyment in certain activities and loss of motivation. A person may withdraw from social interaction and present difficulty showing emotions, and struggles to function normally. This is often confused with depression. Symptoms include:

  • Having trouble finishing daily tasks such as running errands
  • Difficulty feeling satisfaction with everyday life
  • Trouble showing facial expressions
  • Avoiding social events and behaving awkwardly
  • Expressing catatonia

Cognitive symptoms consist of challenges with concentration, attention, and memory, such as:

  • Having trouble comprehending new information to make the best judgment
  • Struggling to retain information immediately after hearing the instructions
  • Experiencing trouble paying attention in general

Probable Causes

When we are diagnosed with any condition, the first thought that comes to mind is, how did I end up with this condition? What caused this? Who is to blame?

There is no exact cause of schizophrenia, although there are a few risk factors that come into play. Genetics, the environment, and our brain structure could be related to your diagnosis. While the cause could be unknown, the importance of seeking help is critical, especially early on.

Moving Forward in Good Health

If you are experiencing difficulties in your everyday life, it is essential to reach out for professional help. The right treatment plan moving forward can help you find clarity in all that you do. You can trust you will grasp onto reality when in treatment. Reaching out to a psychiatrist for a proper diagnosis, sitting down with a therapist, and joining a support group with others on the same journey can potentially change you or a loved one’s life for the better.

Seeking help may be difficult for a person with schizophrenia as the symptoms may make it hard to find guidance. Here at Alter Behavioral Health, we give our patients easy and careful direction. Our facility works hard to place you with the appropriate mental health professionals to assist you in overcoming your challenges. Our services consist of diagnosis, therapy, and support groups to help you get your life back on track. Our staff is dedicated to providing world-class support. We know your story is not an easy one to share, but we are here to listen to you every step of the way. If you feel you need professional help, reach out and contact us today by calling (866) 691-4386.