By: Jessi Kiefor, MA, LMHC, NCC | Pillars of Wellness

Most people don’t walk into a therapist’s office and say, “I think I have OCD.” They walk into a dermatologist’s office with cracked, bleeding hands, thinning hair, skin that won’t heal—and nobody connects the dots.

When OCD Shows Up on the Skin

OCD and body-focused repetitive behaviors don’t always look like what people expect. OCD doesn’t always look like someone checking locks or counting tiles. Sometimes it looks like a dermatology referral.

Some of the most common physical presentations include:

• Excessive Handwashing — Contamination OCD can drive someone to wash their hands dozens, sometimes hundreds, of times a day. The result can be cracked, raw, damaged skin that dermatologists see regularly without ever knowing the cause.
• Skin Picking (Excoriation Disorder) — A body-focused repetitive behavior closely related to OCD, skin picking involves compulsive picking at skin, scabs, or perceived imperfections. It may cause significant scarring and can be extremely difficult to stop without the right treatment.
• Hair Pulling (Trichotillomania) — Compulsive hair pulling that results in hair loss. Like skin picking, it falls under the OCD-related umbrella.
• Psoriasis — Stress is a known trigger for psoriasis flares, and compulsive picking at plaques is common in people with OCD and body-focused repetitive behaviors.

These clients are sitting in dermatology waiting rooms right now receiving treatment for the physical symptoms while the underlying driver goes unaddressed.

Why the Gap Exists

OCD is one of the most misunderstood and underdiagnosed mental health conditions. Many people living with OCD have never been told what it actually is. They may feel shame, hide behaviors, and spend years being treated for the consequences rather than the cause.

Dermatology providers are uniquely positioned to change that. A patient with chronically damaged hands from washing is not just a skin-care issue. A patient losing hair from pulling is not just a cosmetic concern. These are clinical presentations that point directly to a behavioral health need, one that evidence-based treatment can actually address.

When dermatology and mental health work together, clients get the full picture of care they deserve.

What Effective Treatment Looks Like

OCD and body-focused repetitive behaviors respond well to Exposure and Response Prevention (ERP), the gold-standard treatment for OCD. ERP helps clients gradually reduce compulsive behaviors by facing the urge without acting on it, breaking the cycle that keeps the behavior going.

Treatment is structured, skills-based, and clinician-guided. It is not about willpower. It is not about just stopping. It is about rewiring the brain’s response to discomfort through direct, supported practice.

Many clients who have struggled for years see meaningful progress once they finally receive the right kind of care.

Closing the Gap

If you are a dermatology provider and you are reading this, you may already be thinking of patients this applies to. Connecting with a specialty mental health provider who understands OCD and body-focused repetitive behaviors can be one of the most impactful referrals you make.

If you are a client who has been treated for skin or hair concerns and something here feels familiar, you are not alone. What you are experiencing has a name, and effective treatment exists.

OCD & Anxiety Exposure Services at Pillars of Wellness provides specialized, evidence-based care for OCD and related disorders. We welcome referrals from medical providers and are available to consult on clinical fit.

info@pillarsinspires.com

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By: James Shuler, MRC, LPC, CRC, ADHD-RSP | Pillars of Wellness

Let’s start here—no labels, no pressure. Just you and a few honest questions:

• Do you finish things… or mostly start them?
• Does your brain feel “on” all the time—but not always on the right thing?
• Are you known as capable, but secretly feel like you’re working twice as hard just to keep up?

If any of that hits a little too close, stay with me.

Some adults experience difficulties that they or others perceive as laziness, internal restlessness, irresponsibility, or a lack of discipline—character flaws, rather than signs that something else may be going on. Many don’t want a diagnosis, in part because of the stigma around mental health that, while slowly shifting, hasn’t fully lifted. Adults may internalize feelings of shame or self-doubt that quietly build resistance to seeking the kind of support that can improve work performance, deepen relationships, and raise their overall sense of well-being.

“I Have a College Degree… I Can’t Have ADHD”

This common—and understandable—thought comes up often, but success tends to conceal underlying executive functioning challenges rather than eliminate them. Many high-achieving adults develop compensatory strategies that sustain performance on the outside while quietly increasing cognitive and emotional strain. That can look like relying on last-minute pressure to get things done, working longer hours to offset inconsistent focus, or avoiding complex tasks and depending on memory instead of structured systems.

“If It Were That Bad, Wouldn’t It Be Obvious?”

This assumption often overlooks how adult ADHD actually presents—subtly, internally, and frequently masked by outward competence. Rather than matching common stereotypes, it tends to emerge through patterns of inconsistency, overwhelm, and self-regulation challenges that others may never notice. Chronic procrastination, difficulty organizing thoughts, losing track of time, strong starts that are hard to sustain, and a persistent undercurrent of quiet self-doubt are far more typical than the picture most people have in mind.

“Other People Seem to Handle This. Why Is It So Hard for Me?”

That question often carries a lot of weight—but it can be reframed in a way that promotes clarity and self-compassion. Rather than asking “What’s wrong with me?”, consider whether the systems you’ve been using are actually aligned with how your brain works. The issue is less about effort and more about fit. Persistent struggles may reflect a mismatch, not a deficiency, and shifting away from self-judgment toward evaluating what’s actually working is often where things begin to change.

The “I’ll Just Push Through It” Cycle

Many high-performing adults recognize a recurring pattern: initial delay gives way to mounting pressure, followed by a burst of last-minute productivity, then completion—and then exhaustion, paired with a renewed promise to do better next time. While this cycle can be effective in the short term, it is rarely sustainable. Over time it tends to produce burnout, lingering frustration, and the quiet, persistent question: Why is this still so hard?

“I Don’t Want to Make Excuses.”

This is not about making excuses—it is about developing effective, individualized strategies. Understanding how your brain works allows for more intentional approaches. Working with a therapist trained in executive functioning focuses on building practical systems rather than assigning labels. That means creating structures that reduce overwhelm, breaking tasks into manageable steps, strengthening attention and emotional regulation, and replacing the cycle of “try harder” with more sustainable ways to try differently.

A Different Place to Start

If any part of this resonated, it may be worth a closer look—not at your effort, but at the systems you’ve been relying on. Sustainable change often begins with a simple shift in perspective: from self-judgment to self-understanding. You don’t need to keep running the same cycle to prove you’re capable. The goal is to find approaches that actually work for you.

A therapist won’t “fix” you—but the right support can help you understand your patterns, challenge what isn’t working, and build systems that truly fit your life. That shift, from ongoing frustration to meaningful clarity, is often where real, lasting change begins.

The post ADHD in Adults: Do I Really Need to Get Tested? appeared first on Pillars of Wellness.

By: Karmyn Boller | PILLARS OF WELLNESS

It’s that time of year where it feels like there’s a little more hope in the air. Something about the sun still shining after work and the ability to touch some grass makes everything feel more doable. For some moms that means outdoor playdates have returned, for others it means outdoor sports are back. For moms with school-age kids it means coordinating upcoming summer activities and camps. It seems no matter what the spring brings, moms are making it happen for those around them.

It often doesn’t happen without sacrifice though, and as a mom who works with other moms, I see all too often that the sacrifice is our own self-care. As moms we are up against so many pressures. Sometimes it’s the internal pressure of what it feels like we should be able to make happen. Other times it’s the external pressure of what society says we should be able to complete in a day. Throw in the pressure to keep up with the perfectly curated image of moms on social media, and it feels like there just aren’t enough hours in the day to prioritize ourselves.

Self-Care Is Not Selfish

Self-care often gets written off as a big extravagant luxury that mom guilt can quickly dismiss as selfish. When really, self-care is the fuel that allows moms to continue making it happen for those around them. Just like motherhood is not one-size-fits-all, there are different kinds of self-care.

What Self-Care Can Look Like

Physical self-care means making sure you’ve had some water alongside the caffeine (or maybe instead of it), making yourself a real plate instead of surviving on your kids’ leftovers, prioritizing rest when you can, and remembering to schedule your own doctor’s appointments. Physical self-care allows your body to keep going.

Emotional self-care can look like labeling your emotions, journaling, setting boundaries, or going to therapy. In the times where it feels like emotions are running the show, emotional self-care helps you process what you’re feeling and allows logic to return to the driver’s seat.

Mental self-care can be reading a book, doing a puzzle, or replacing negative self-talk with self-compassion. The mind is a powerful tool, and tending to it allows you to face the day’s challenges from a healthy, grounded place.

Spiritual self-care can include attending church services or getting involved in your faith community—but it doesn’t have to involve religion at all. Meditation and practicing mindfulness count too. Spiritual self-care is anything that allows you to feel connected to something bigger than yourself.

Social self-care can be arranging to meet a mom friend at the park for a playdate or catching up with a friend over coffee. Taking care of your social self helps challenge the isolating feelings that so often come with motherhood.

Small Habits Count Too

Some days self-care is the massage, the trip to the salon, or the weekend away. But self-care is also the small daily habits that keep fuel in the tank. We can’t always get away for extended time to ourselves, so sometimes it’s enjoying a solo trip to the store with your favorite podcast playing, or five quiet minutes to journal before the kids wake up or just after they go to bed.

Finding the ways that make sense for you to incorporate and prioritize caring for the different parts of yourself is just as important as caring for those around you. So take the time—and do something for you today.

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By: Miranda Sims, LMHC-A | PILLARS OF WELLNESS

“You’re doing great!” “You’ve got this!” “You make it look so easy!” “I know I can count on you!”

These are very common statements a high-achieving professional may hear on a daily basis. But internally, the thoughts that follow often tell a very different story:

I feel like I’m drowning. How do you even know I’m capable of that? My heart is racing—can they tell I’m barely holding it together? I can’t even count on myself… How can you?

Constant questions, constant doubt. You’ve already fought more internal battles getting to the office before even opening your email. You can’t truly relax because there’s always something you should be doing.

What Is High-Functioning Anxiety?

Anxiety is an experience for millions of people, often accompanied by symptoms that can significantly impact daily functioning, including in the workplace. This can lead to panic attacks and, in severe cases, an inability to work (Pederson, 2023). However, for some, anxiety remains hidden—its symptoms nearly undetectable from the outside. This is often described as high-functioning anxiety.

“High-functioning anxiety” is not a formal clinical diagnosis, but is used to describe individuals who experience the symptoms of anxiety while still maintaining a high level of functioning. They attend meetings prepared and present with composure, yet question everything they have to say. They are dependable, yet often agree to every request—even when it’s unrealistic. They are productive, efficient, and successful—but they don’t believe it, and they don’t think you do either.

As a result, those experiencing high-functioning anxiety tend to overcompensate. They work extra hours, set unrealistic expectations, and exhaust themselves searching for signs that they are not doing as well as others believe (Hubbard, 2023). Over time, productivity can become both a coping mechanism and part of the problem. The more you achieve, the harder it feels to slow down.

Many also experience intense fears of criticism, of appearing inadequate, or of losing control—a persistent sense that everything could fall apart at any moment. Ongoing high-functioning anxiety affects not only mental health but physical health as well, through symptoms such as headaches, gastrointestinal issues, muscle tension, increased heart rate, and difficulties with sleep and nutrition (Hubbard, 2023; Pederson, 2023).

How Therapy Can Help

Therapy can be a powerful starting point. It creates space to reflect, slow down, and begin identifying the beliefs that fuel anxiety. One common and effective approach is Cognitive Behavioral Therapy (CBT), which helps individuals recognize and reframe the thoughts that influence their emotions and behaviors.

It can look like this:

• “I can’t say no—they’ll think I can’t handle it” → Saying no to this project will allow me to show up more fully for the work that matters most.
• “I’m going to mess this up” → I might not do it perfectly, and that’s okay—I am learning, just like everyone else.
• “I should be able to handle this” → I have a stressful job; anyone in my position would feel overwhelmed.

Beyond shifting thoughts, change also happens through small, intentional behaviors. Setting boundaries—like committing to a realistic end time for your workday or practicing saying no to tasks that can wait—can begin to interrupt the cycle. Prioritizing rest and non-productive time is not a failure of discipline; it is a necessary part of sustaining well-being. Therapy also provides accountability for these small but meaningful shifts.

Success Without the Cost

High-achieving professionals are often told, “You’re doing great,” or “I can count on you,” while silently questioning if it’s true. But doing more was never the answer. Learning how to step back, set limits, and trust yourself is. In that shift, success no longer comes at the cost of your well-being—it becomes something that exists alongside it.

To work with a therapist who can assist in reframing thoughts and support you in your wellness journey, call Pillars of Wellness at (219) 323-3311.

References

Hubbard, L. (2023, July 11). Behind the mask: Managing high-functioning anxiety. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/managing-high-functioning-anxiety

Pederson, C. (2023, September 25). The hidden dangers of high-functioning anxiety in the workplace. Axiom Medical. https://www.axiomllc.com/blog/dangers-high-functioning-anxiety-workplace/

The post I’m Successful But Exhausted: Understanding High-Functioning Anxiety in Your Career appeared first on Pillars of Wellness.

By: Nicole De Young, LMHC-A | PILLARS OF WELLNESS

According to the Vital Statistics Rapid Release Report, there were 3,606,400 births in 2025. One in five of these mothers will experience a perinatal mental health disorder ranging from depression and anxiety to OCD. Awareness of these disorders is increasing, and yet there is still room for improved awareness, education, and crisis intervention. Although many women will experience a mood disorder during the perinatal period, many are unfamiliar with the signs and, therefore, will not reach out for help or support.

Support and access to resources is critical during the perinatal stages. Parenthood can often be an isolating experience, and isolation, sleep deprivation, and fluctuations in hormones are risk factors for developing a mental health disorder (Sharma et al., 2023). The increase of responsibilities can also be very overwhelming even with appropriate support.

Signs of Postpartum Mood Disorders

According to the DSM-5th edition, some common signs of postpartum mood disorders may include:

• Excessive worrying
• Lack of interest in things that you used to enjoy
• Feeling sad or hopeless
• Inability to sleep, or wanting to sleep all the time
• Inability to concentrate
• Intrusive thoughts
• Feeling disconnected from your baby
• Thoughts of hurting yourself or your baby
• Recurrent thoughts of death or suicide

If you or someone you know is experiencing these symptoms, reach out for assistance through a healthcare provider or by calling the National Maternal Mental Health Hotline. Remember, feeling this way does not make you a bad parent, and it is okay to ask for help.

How to Help

New parents need all the help and support they can get. If someone in your life is welcoming a new baby into their family, you can offer support by respecting their limitations with visitors, making meals for the family, offering to spend time with the baby so the mom can rest, taking on a few chores around the house to reduce the mental load, or simply listening to what the mom needs.

Small steps can also make a big difference for new parents navigating their own wellbeing. Finding someone to talk to, getting outside, building in some movement, making mindful food choices, staying connected to others, and creating a flexible routine can all help. Expecting that some days will be better than others is part of the process.

Resources Available

Everyone needs support. Not only is it okay to ask for help, it is important that you ask for it, for the wellbeing of you, your baby, and your family. From the moment a baby is born, your entire reality changes. Allowing yourself to create a new routine and embrace flexibility will be pivotal in your transition to parenthood.

Pillars of Wellness has a team of skilled therapists who specialize in maternal mental health. Whether you are seeking individual therapy, group support, or just looking for a bit of education, Pillars can support you. Additional resources include:

• Postpartum Support International — offers information about perinatal mental health and online support groups
• 988 Suicide & Crisis Lifeline
• National Maternal Mental Health Hotline

Also important to know: The Blue Dot is the symbol for maternal mental health, representing support and community for parents experiencing mental health struggles.

Community and Care

Having a community of support for new parents can help alleviate some of the stress that arises when welcoming a child into the family. It is important to note that each pregnancy and postpartum journey is different, and postpartum mental health disorders can arise after any pregnancy.

If someone you know is welcoming a new member into the family, a few practical ways to offer support include organizing a meal train, collecting gift card donations, offering to cut their grass, or taking their trash to the curb. If you see someone struggling with the transition, share the resources above and encourage them to seek help.

Motherhood can be challenging, but knowing that support is out there can make all the difference. During this Maternal Mental Health Awareness Month, take a few moments to offer encouragement to all the amazing moms in your life.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Sharma, V., Sharkey, K. M., Palagini, L., Mazmanian, D., & Thomson, M. (2023). Preventing recurrence of postpartum depression by regulating sleep. Expert review of neurotherapeutics, 23(8), 1–9. https://doi.org/10.1080/14737175.2023.2237194

Hamilton BE, Osterman MJK, Gregory ECW. Births: Provisional data for 2025. Vital Statistics Rapid Release. 2026 Apr;(43):1–7. https://dx.doi.org/10.15620/cdc/252434

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