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    October 23, 2023

    Depression: understanding depression and its treatment.

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    October 23, 2023

    Part I: Understanding Different Types of Depression and How They Are Treated

    Depression is something many of us have heard about, and it’s more common than you might think. But did you know that there are different types of depression, each with its own features and ways of being treated? In this article, we’ll explore these various types.

    Types of Depression:

    1. Major Depressive Disorder (MDD):
    This is what often comes to mind when we think of depression. It’s when someone feels intensely sad, loses interest in things they used to enjoy, struggles with sleep and eating, and often feels worthless. It is not merely a fleeting case of the blues but a pervasive and often debilitating condition.

    Individuals with MDD may find it challenging to engage in their daily lives, affecting their work, relationships, and overall quality of life. Treatment for MDD typically involves a combination of psychotherapy and pharmacotherapy.

    2. Persistent Depressive Disorder (Dysthymia):
    Persistent Depressive Disorder, also known as Dysthymia, presents a different facet of depression. Unlike the acute onset of MDD, Dysthymia is characterized by a chronic, low-grade depressive state that persists for at least two years. It may not be as severe as MDD, but its chronicity can lead to substantial impairment in daily functioning and a pervasive sense of dissatisfaction.

    3. Seasonal Affective Disorder (SAD):

    Seasonal Affective Disorder, or SAD, exhibits a unique pattern of depressive symptoms that occur seasonally, often during the winter months when there is reduced exposure to natural sunlight. This condition underscores the influence of environmental factors on mood regulation.

    Comprehensive Therapeutic Approaches:

    1. Psychotherapy:
    Psychotherapy remains a cornerstone in the treatment of depression across its various forms. Its flexibility allows therapists to tailor interventions to the individual’s specific needs.

    – Cognitive-Behavioral Therapy (CBT): CBT is an evidence-based approach that focuses on identifying and challenging negative thought patterns and behaviors. It equips individuals with practical coping strategies and skills to manage depressive symptoms effectively.

    – Interpersonal Therapy (IPT): IPT concentrates on improving interpersonal relationships and communication. It helps individuals identify and address conflicts or difficulties in their interactions with others, which may contribute to their depressive symptoms.

    – Dialectical Behavior Therapy (DBT): DBT is particularly beneficial for individuals with mood disorders and emotional dysregulation. It emphasizes mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance.

    2. Pharmacotherapy:
    Antidepressant medications play a crucial role in managing depression, especially in cases where symptoms are severe or significantly impacting an individual’s functioning.

    – Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are a class of antidepressants that increase the availability of serotonin in the brain. They are often considered a first-line treatment due to their effectiveness and relatively mild side effects.

    – Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs, like SSRIs, affect neurotransmitters in the brain and are another option for individuals with depression.

    – Atypical Antidepressants: This category includes medications with diverse mechanisms of action. They may be prescribed when other antidepressants are not effective or cause intolerable side effects.

    3. Lifestyle Modifications:
    Encouraging individuals to make positive lifestyle changes can significantly impact their experience of depression.

    – Exercise: Regular physical activity has been shown to release endorphins, which are natural mood lifters. Exercise also promotes overall well-being and can help alleviate depressive symptoms.

    – Diet and Nutrition: A balanced diet rich in essential nutrients is crucial for optimal brain function. Omega-3 fatty acids, found in fish and certain nuts, have been associated with improved mood.

    – Sleep Hygiene: Maintaining a consistent sleep schedule and creating a conducive sleep environment can help prevent sleep disturbances associated with depression.

    4. Alternative Therapies:
    While not typically considered primary treatments, some individuals find relief from depression through alternative and complementary therapies.

    – Mindfulness Meditation: Mindfulness practices, such as meditation and deep breathing exercises, can help individuals manage stress and improve emotional regulation.

    – Acupuncture: Some people report reduced depressive symptoms with acupuncture, although its effectiveness varies from person to person.

    – Herbal Supplements: Certain herbal supplements, such as St. John’s Wort, have been studied for their potential antidepressant effects. However, it’s essential to use caution and consult with a healthcare provider before trying any herbal remedies, as they may interact with other medications.

    – Light Therapy: Light therapy, or phototherapy, involves exposure to a bright light source that replicates natural sunlight. This therapy is particularly effective in mitigating the symptoms of SAD and restoring a more stable mood.

    In conclusion, depression is a very real and treatable ailment.  Often it requires a combination of the above approaches.  Consulting with a mental health care provider is the first step toward healing.

    – Claudia Coxx, LMSW

    Claudia Coxx , LMSW is a clinical therapist at Marsh Psychology Group.  She can be reached at 248-860-2024, ccoxx@marshpsychologygroup.com or https://marshpsychologygroup.com/claudia-coxx-lmsw/.

    https://marshpsychologygroup.com/1835-2/

    Filed Under: counseling, Depression, mental health

    Things to Say to Someone Going Through a Mental Health Crisis

    May 10, 2023

    Navigating the Delicate Terrain: Things to Say to Someone Going Through a Mental Health Crisis     As a licensed social worker, I understand the importance of offering support and guidance to individuals facing a mental health crisis. When interacting with someone experiencing such a crisis, it is crucial to remain empathetic, compassionate, and patient. […]

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    Things to Say to Someone Going Through a Mental Health Crisis

    May 10, 2023

    Navigating the Delicate Terrain: Things to Say to Someone Going Through a Mental Health Crisis

     

     

    As a licensed social worker, I understand the importance of offering support and guidance to individuals facing a mental health crisis. When interacting with someone experiencing such a crisis, it is crucial to remain empathetic, compassionate, and patient. Here are some key phrases and ideas to help you provide support and reassurance during these difficult moments.

    1. “I’m here for you.”
    Let the person know that they are not alone. Express your availability, both physically and emotionally, to provide support. This simple statement can be incredibly powerful in assuring someone that they have a shoulder to lean on and someone to listen to their concerns.

    2. “I care about you.”
    Sometimes people going through a mental health crisis might feel as if nobody cares or understands their pain. Letting the individual know that you genuinely care about their well-being helps create a sense of safety and trust. This statement provides reassurance that they are valued and not alone in their struggles.

    3. “It’s okay to feel this way.”
    Validate their emotions by acknowledging that it is normal to experience feelings of distress, anger, sadness, or fear during a crisis. Avoid attempting to dismiss or minimize their emotions. Instead, show acceptance of their feelings, emphasizing that it is a natural part of the healing.

    4. “You don’t have to go through this alone.”
    Encourage the person to seek professional help. As a supportive friend or family member, there is only so much you can do. A mental health professional is trained to provide appropriate coping strategies, therapy, and, if needed, medication management. Encourage them to reach out for help and let them know you will support them in finding the appropriate resources.

    5. “Take your time.”
    In a mental health crisis, it is essential to give the person the time and space they need to process their emotions. Avoid pressuring them to “snap out of it” or “get over it.” Instead, emphasize that healing is a journey that takes time and patience.

    6. “What can I do to help?”
    Offer specific forms of assistance that might alleviate some of the burden they are facing. This could include helping with daily tasks, offering to find mental health resources, or simply being there to listen. By asking how you can help, you are giving the person a sense of control and agency in their situation.

    7. “You’re not a burden.”
    When someone is going through a mental health crisis, they may feel guilty or believe they are causing trouble for those around them. Reassure them that their feelings and experiences are not a burden on you or anyone else. Emphasize that you are there to help and support them in their journey towards healing.

    8. “You are strong and resilient.”
    Remind the person of their inner strength and resilience. This can help foster a sense of hope and confidence that they can overcome their current challenges. Share examples of times when they have faced adversity and emerged stronger.

    9. “You matter.”
    People in crisis can often feel hopeless or like they don’t matter. Reiterate the importance of their life and existence, emphasizing their unique qualities and the positive impact they have on others.

    Approaching someone going through a mental health crisis requires empathy, patience, and compassion. Keep these phrases in mind when offering support, but remember that every individual’s experience is unique. Tailor your approach to their specific needs, and most importantly, be a consistent presence in their life as they navigate the complex road to recovery.

    Sincerely,
    Claudia Coxx, MSW, LMSW
    248-860-2024 Ext. 505
    Office Hours: Tu 3p-6p, W-Th 11a-7p; Fri 11a-5p; Sat 10a-1p

    Filed Under: Anxiety, counseling, mental health, mental health awareness, Uncategorized

    Signs you Need to Take a Mental Health Day

    January 27, 2023

    Do you ever get up in the morning and wonder if it would be okay for you to take a mental health day? If so, you’re definitely not alone. In fact, research from the American Psychological Association shows that today’s workforce is experiencing job burnout at alarming rates.   What are Mental Health Days Exactly? […]

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    Signs you Need to Take a Mental Health Day

    January 27, 2023

    Do you ever get up in the morning and wonder if it would be okay for you to take a mental health day? If so, you’re definitely not alone. In fact, research from the American Psychological Association shows that today’s workforce is experiencing job burnout at alarming rates.

     

    What are Mental Health Days Exactly?

     

    The good news is that taking a mental health day every once in a while can absolutely help you cope with work-related stress. But mental health days should not be confused with sick days.

     

    Mental health days are simply those times when you need to take a break from anything work related. These personal days are used to reset your mind by focusing on activities that rejuvenate and reenergize you.

     

    Signs it’s Time for a Mental Health Day

     

    The following are some red flags that are letting you know you need to put your mental health first:

     

    You Feel Run Down

     

    Being stressed and overworked can take a toll on your mind and body. If you’ve been feeling run down for a period of time, take a break.

     

    You Feel Angry More Often

     

    When we feel stressed and burned out, we become angry far more easily and far more often. If you find you have been getting easily irritated, this is a sign it may be time for a mental health day.

     

    You’re Having a Hard Time Focusing

     

    When we’re stressed, our mental faculties take a hit and we can’t focus as easily. This makes it incredibly hard to get any work done. Which of course just makes us feel more stressed.

     

    If you notice your cognitive abilities have declined a bit, may be time to call off work for a day of destressing.

     

    If you have been experiencing any of these signs, I encourage you to put your mental health first and take a mental health day. And if you would like to speak to someone about how you’re feeling, please reach out to me. I’m a great listener and have numerous tools for coping with stress that I can share with you.

     

    SOURCES:

     

    https://info.totalwellnesshealth.com/blog/mental-health-day-from-work

     

    https://www.talkspace.com/blog/signs-you-need-a-mental-health-day/

     

    https://www.livestrong.com/article/13767705-how-to-take-mental-health-day/

    Filed Under: mental health

    When is it Time to Ask for Help?

    December 30, 2022

    Depression is a complex mental health issue that varies widely between individuals. This is why it can be difficult for some people to recognize what may be a situational discomfort that may pass on its own, and what may be more serious and require professional help.   The Difference Between Mild and Serious Mental Health […]

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    When is it Time to Ask for Help?

    December 30, 2022

    Depression is a complex mental health issue that varies widely between individuals. This is why it can be difficult for some people to recognize what may be a situational discomfort that may pass on its own, and what may be more serious and require professional help.

     

    The Difference Between Mild and Serious Mental Health Issues

     

    In order to measure the seriousness of a mental health issue, most mental health professionals look at what impact it has on the person’s everyday life. They also take into account the events that led to the issue.

     

    Mild mental health issues are typically less persistent as well as less disruptive to an individual’s everyday life. Serious mental health issues, on the other hand, are often so severe that they negatively impact that person’s relationships and performance at school and work.

     

    As an example, feeling pressure at work about an upcoming deadline will make just about anyone feel stressed and anxious. But if your anxiety becomes so great that you begin calling in sick to work to avoid the project and responsibilities, that would be seen as a disruption in your everyday life. Severe anxiety can lead to panic attacks and that is definitely a reason to seek support.

     

    Something else to keep in mind is the context around the mental health issue. It is perfectly normal to grieve after losing a loved one or to feel anger and resentment after discovering your partner’s infidelity. While it can definitely be helpful to speak with someone during these times, you may not necessarily be experiencing a severe mental health crisis that would warrant help.

     

    It is important to mention that the events of one’s life need not be “serious” in order for you to reach out for help. Whatever it is that you are going through and whatever feelings you are experiencing, they are valid.

     

    Warning Signs of a Serious Mental Health Crisis

     

    The following are some red flags of a mental health crisis that warrant asking for help:

     

    • Feeling sad or “down” for long periods of time (particularly without an inciting incident)
    • Noticeable mood swings from very high, like euphoria, to very low, like deep sadness or depression
    • Excessive worry
    • Feeling empty or apathetic about life
    • Engaging in self-harming behaviors, like cutting
    • Withdrawing from friends and family
    • Changes in appetite, sleep or sex drive
    • Constant fatigue
    • Thoughts of suicide

     

    If you or a loved one are experiencing any of these symptoms, it’s time to reach out and ask for help. While the days seem dark right now, they can and will get brighter. I’d love to help you get there, so please get in touch with me so we can set up a time to speak.

     

    SOURCES:

     

    https://www.counseling.org/news/aca-blogs/aca-counseling-corner/aca-counseling-corner-blog/2018/03/01/knowing-when-to-ask-for-help#:~:text=If%20you’re%20facing%20a,to%20seek%20out%20professional%20help

     

    https://jedfoundation.org/resource/mental-health-warning-signs-and-when-to-ask-for-help/

     

    https://www.columbiatribune.com/story/sponsor-story/burrell-behavioral-health/2022/05/02/mental-health-matters-knowing-when-ask-help/9558636002/

    Filed Under: counseling, mental health

    4 Tips for Reducing Stress While Moving

    September 11, 2022

    Whether it’s across town or across country, moving is one of the most stressful experiences a person can go through. Everything takes longer and weighs more than you initially thought, and the internet provider never seems to have any openings to come out to your new place and get you hooked up!   It’s no […]

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    4 Tips for Reducing Stress While Moving

    September 11, 2022

    Whether it’s across town or across country, moving is one of the most stressful experiences a person can go through. Everything takes longer and weighs more than you initially thought, and the internet provider never seems to have any openings to come out to your new place and get you hooked up!

     

    It’s no wonder people absolutely dread moving.

     

    If you have a big move coming up, here are some tips to help you reduce the stress:

     

    Accept Reality

     

    No move in the history of mankind has ever gone off without a hitch. It is important to expect the unexpected and to go with the flow as best you can.

     

    Give Yourself Plenty of Time

     

    One of the biggest reasons people get stressed while they’re moving is because they didn’t give themselves enough time. While a small apartment may take two days to fully pack up, a three or four bedroom house you’ve lived in for over a decade may take closer to a week or two. It’s always best to give yourself more time and not less.

     

    Be sure to give yourself plenty of time with other aspects of moving as well. For instance, setting up the utilities in your new home, researching the right moving company, and giving your old home a thorough clean. These projects will all take time as well.

     

    Stay Organized

     

    Keeping stress at bay will require you to stay organized. From buying moving supplies to labeling boxes to packing, organization will help you stay in control when things could easily spin out of control. So make lists and use a day planner to stay on top of your tasks.

     

    Ask for Help

     

    Don’t feel you need to do everything by yourself. If you need help, ask for it. Sometimes even just having some company from a friend or family member while you pack can lift your spirits. And try and plan ahead. Give your loved ones a heads up a week out so there is more of a chance they can say “yes.”

     

    Is moving fun? Nope. But if you give yourself plenty of time, stay organized, ask for help and accept the fact that sh*t happens, your move will go much more smoothly.

     

    SOURCES:

     

    7 Tips on How to Make Moving Less Stressful

     

    https://www.psychologytoday.com/us/blog/living-the-questions/201703/ten-simple-tips-manage-the-stress-moving

     

    https://www.bustle.com/p/13-ways-to-make-moving-less-stressful-10031771

    Filed Under: mental health, reducing stress

    Mental Health Effects of COVID on Teachers

    September 9, 2022

    The Covid pandemic disrupted the lives of everyone on the globe. But without question, certain professions got hit the hardest. Teachers definitely belong in this category. Numerous teachers were laid off without notice; the rest were forced to adapt quickly and begin teaching remotely. While the pandemic is behind us, the mental health affects on […]

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    Mental Health Effects of COVID on Teachers

    September 9, 2022

    The Covid pandemic disrupted the lives of everyone on the globe. But without question, certain professions got hit the hardest. Teachers definitely belong in this category. Numerous teachers were laid off without notice; the rest were forced to adapt quickly and begin teaching remotely.

    While the pandemic is behind us, the mental health affects on teachers are lingering. As these professionals head back to school this fall, it is important that they recognize they may be feeling stressed and mentally exhausted.

    If you are a teacher heading back to the classroom, here are some thing you can do to look out for your own mental health:

    Put Your Needs First

    Teachers tend to be the kinds of people who always put their students’ – and other people’s – needs first. But now is the time to put your needs first, so you have the energy and mental clarity to give to your students throughout the rest of the year. Ask yourself, “What do I need to feel my best so I can be an effective and supportive teacher?”

    Adjust Your Expectations

    Everyone has been changed by Covid. You can’t expect yourself or anyone else to be the person they were before lockdowns. When you feel yourself judging yourself too harshly, try and adjust your expectations.

    Talk to Someone

    If your feelings of anxiety, depression or burnout don’t subside, even with making some adjustments to your life, then it’s important that you speak to someone. A mental health professional can help you work through the stress and emotions you have dealt with and may be holding on to. They can also provide coping strategies so you may get back to living a joyful life.

    If you or someone you know is a teacher whose mental health has been affected by the Covid pandemic, please reach out to me. I would be happy to discuss treatment options with you.

    SOURCES:

    ​​https://www.edweek.org/leadership/teachers-mental-health-has-suffered-in-the-pandemic-heres-how-districts-can-help/2021

    https://www.kaplanco.com/ii/mental-health-effects-on-educators

    https://www.unicef.org/eca/stories/ten-mental-health-and-well-being-tips-teachers

    Filed Under: COVID, mental health, teacher

    Mental Health Effects of Emotional Abuse

    August 10, 2022

    Emotional abuse is not as easy to spot as physical abuse, but oftentimes its effects can be just as traumatic. Emotional abuse can involve a wide range of tactics, including gaslighting, shaming and manipulation. All of these are intended to leave the victim feeling confused, powerless and hopeless. Typically people suffer from long-term or short-term […]

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    Mental Health Effects of Emotional Abuse

    August 10, 2022

    Emotional abuse is not as easy to spot as physical abuse, but oftentimes its effects can be just as traumatic. Emotional abuse can involve a wide range of tactics, including gaslighting, shaming and manipulation. All of these are intended to leave the victim feeling confused, powerless and hopeless.

    Typically people suffer from long-term or short-term emotional abuse, and depending on the length of time, there can be varying mental health effects.

    Long-term emotional abuse happens over many years. Examples are a child growing up in a home with an alcoholic parent or a sibling with anger issues. Someone may find themselves in a marriage with a narcissistic partner.

    Short-term emotional abuse can result from a nasty exchange with a stranger or micro-interactions with colleagues or neighbors.

    The following are some short-term and long-term effects of emotional abuse:

    Short-Term Effects

    • Isolation or a sense of deep loneliness 
    • Self-doubt
    • Shame
    • Confusion
    • Low self-esteem
    • Anxiety connected with social interactions
    • Feelings of powerlessness

    Long-term Effects

    • Neuroticism, or the tendency toward a depressed mood or negative emotions like anger
    • Chronic stress
    • Physical health issues like muscle tension and shortness of breath
    • Attachment issues
    • Apathy
    • Eating disorders
    • PTSD (post-traumatic stress disorder) or CPTSD (chronic post-traumatic stress disorder)

    You Can Heal from Emotional Abuse

    With time, patience and plenty of self-compassion, it is very possible to heal from the trauma of emotional abuse. Working with a mental health professional who has been trained specifically to help people who have been the victim of emotional abuse is a great starting point.

    If you’d like to explore treatment options, please reach out to me.

    SOURCES:

    https://psychcentral.com/health/effects-of-emotional-abuse

    http://aware-ae.com/emotional-abuse-and-its-impact-on-mental-health/

    https://www.medicalnewstoday.com/articles/327080

    Filed Under: emotional abuse, mental health

    How Your Self-Esteem Affects Your Mental Health

    July 13, 2022

    Having a low self-esteem is something many people of all ages deal with. While a low self-esteem is not considered a mental health condition itself, the way we think about ourselves directly impacts our mental health and overall well-being.   What is Self-Esteem?   Self-esteem refers to the way people feel about themselves. Someone with […]

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    How Your Self-Esteem Affects Your Mental Health

    July 13, 2022

    Having a low self-esteem is something many people of all ages deal with. While a low self-esteem is not considered a mental health condition itself, the way we think about ourselves directly impacts our mental health and overall well-being.

     

    What is Self-Esteem?

     

    Self-esteem refers to the way people feel about themselves. Someone with a healthy or high self-esteem thinks positively about themselves and their abilities. They believe they are deserving of respect and have no problems setting healthy boundaries.

     

    Individuals with low self-esteems do not feel very good about themselves. They constantly measure themselves against others and always come up short. They may not think they are worthy of love and respect and will typically not set healthy boundaries, allowing others to take advantage of them.

     

    How Does a Low Self-Esteem Affect Mental Health?

     

    The following are some ways a low self-esteem can impact a person’s mental health:

     

    Poor Relationships 

     

    Human beings are wired for connections. But when we have low self-esteem, we tend to not put ourselves “out there” socially and even tend to isolate, which can lead to poor relationships and loneliness.

     

    Addiction

     

    Studies have indicated low self-esteem in childhood can lead to addictions later in life. Mandy addicts use alcohol and other substances as a way to cope with negative feelings about themselves.

     

    Depression and Anxiety

     

    Living with low self-esteem day after day, week after week, can very much take its toll and eventually lead to the development of depression and anxiety.

     

    How to Build Your Self-Esteem

     

    Building self-esteem is important for mental health and to live a happy life. But it’s not necessarily easy to do it. It’s not like losing weight where you can say I am going to eat less and move more.

     

    That is why I recommend working with a trained therapist who specializes in helping people build their self-esteem. A therapist can help you identify your core negative beliefs and determine where they came from. He or she can then help you develop a new, realistic self-esteem that reflects who you truly are.

     

    If you or someone you know is suffering with low self-esteem and would like to explore treatment options, please get in touch with me.

     

    SOURCES:

     

    https://www.nami.org/Blogs/NAMI-Blog/July-2016/Why-Self-Esteem-Is-Important-for-Mental-Health

     

    https://www.hormona.io/why-self-esteem-affects-your-mental-health/

     

    https://fherehab.com/learning/self-esteem-mental-health

    Filed Under: mental health, self esteem

    How Finances can Impact Your Mental Health

    July 6, 2022

    Not since the great depression have so many people collectively been dealing with financial hardship. The Covid pandemic locked down nations and caused people to lose their livelihoods. It is not surprising, then, that we are also seeing increases in the rates of depression. There have been other studies that also linked depression and anxiety […]

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    How Finances can Impact Your Mental Health

    July 6, 2022

    Not since the great depression have so many people collectively been dealing with financial hardship. The Covid pandemic locked down nations and caused people to lose their livelihoods. It is not surprising, then, that we are also seeing increases in the rates of depression.

    There have been other studies that also linked depression and anxiety with financial burdens. In fact, this study suggests that individuals with depression and anxiety are three times more likely to be in debt.

    It’s a Vicious Cycle

    Solving any problem requires clear thinking and an ability to take action. The problem is, when financial burdens cause a person to become anxious and depressed, they live in an emotional state that makes it almost impossible to solve their financial problems.

    For instance, when people feel depressed, it is common for them to also feel overwhelmed and out of control. They tend to want to avoid problems because they simply can’t bear the weight of it all. 

    Depression and anxiety can also make it hard for people to get proper sleep. This, in turn, creates mental fog, making it incredibly hard to figure out a solution to any problem.

    Talking to Someone Can Really Help

    No, I’m not talking about a financial planner, I’m talking about speaking with a therapist. A licensed therapist can help you find some calm in the storm. Working with a therapist often brings the kind of clarity that can help you heal from depression and anxiety and get your financial life back in order.

    There is nothing to be ashamed of. Most of us have, at one point (if not currently), experienced trouble with our finances and felt depressed and anxious. It is a common part of living in these modern times when the economy seems to be going against us most of the time.

    If you or a loved one has been having a hard time financially and you are feeling stressed and overwhelmed, please get in touch with me. I would be more than happy to help you deal with your current situation.

    SOURCES:

    • https://psychcentral.com/blog/stressed-about-money-tips-to-cope-with-debt-depression
    • https://www.psychologytoday.com/us/blog/what-mentally-strong-people-dont-do/201909/how-your-mental-health-affects-your-financial-health
    • https://www.mind.org.uk/information-support/tips-for-everyday-living/money-and-mental-health/the-link-between-money-and-mental-health/

    Filed Under: finance, mental health

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    26711 Woodward Ave. Suite 306
    Huntington Woods, MI 48070

    (248) 860-2024
    info@marshpsychologygroup.com

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    (248) 860-2024

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