Understanding Gender Dysphoria: Symptoms and Treatments

The term gender dysphoria “is defined by strong, persistent feelings of identification with another gender and discomfort with one’s own assigned gender and sex; to qualify for a diagnosis of gender dysphoria, these feelings must cause significant distress or impairment.” (Psychology Today, 2019)

Gender dysphoria as you can imagine can be challenging for the individual going through it and also the individuals family and peers. It is common for people who suffer from gender dysphoria to feel isolated and depressed, because of how misunderstood they feel.

Common signs of gender dysphoria in children, adolescents, and adults can be:

  • A strong desire to be of the other gender
  • A strong desire to be treated as the other gender
  • A firm conviction that one has the typical feelings and reactions of the other gender
  • Identifying more with the other gender
  • Strong rejection activities usual of one’s assigned gender
  • A strong dislike of one’s sexual anatomy
  • A strong desire for the physical sex characteristics that match one’s experienced gender

Those who suffer from gender dysphoria use a variety of treatments to help ease their symptoms. According to WebMD, “the goal is not to change how the person feels about his or her gender. Instead, the goal is to deal with the distress that may come with those feelings.” (WebMD, 2018)

Many people work through feelings of dysphoria with the help of a trained therapist or counselor. Individuals who wish to take hormones and/or pursue surgery to align physical characteristics with their gender better may find feelings of dysphoria begin to ease as they take these steps. These steps are offered after a year of therapy after making sure this is the best route. Some may merely live as their true gender without hormones or surgery.

Many individuals legally change their name and gender marker to reflect their true gender, and for many individuals, it may be the case that being socially recognized as a member of their actual gender and being addressed by the correct pronouns helps to ease feelings of dysphoria.


American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

National Institutes of Health—National Library of Medicine

“Gender Dysphoria.” Psychology Today, Sussex Publishers, www.psychologytoday.com/us/conditions/gender-dysphoria.

“Gender Dysphoria: Symptoms, Diagnosis, Treatment.” WebMD, WebMD, www.webmd.com/sex/gender-dysphoria.

If you think that you or your child might be struggling with symptoms of gender dysphoria, please contact us at 469-714-0006 or by emailing info@exulthealthcare.com. We offer compassionate services for all ages and are committed to your emotional health.

Written by Aly Bowles – Social Media Coordinator

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NeuroStar TMS

About NeuroStar TMS

NeuroStar Advanced Therapy (TMS) for depression has the largest clinical data set of any TMS treatment. Clinical studies with over 900 people have shown that NeuroStar may help achieve remission for people living with depression.

For many people, depression symptoms significantly improved or went away after 4 to 6 weeks of treatment with NeuroStar Advanced Therapy.

In a NIMH-funded, independent, randomized, controlled trial, people treated with TMS NeuroStar Advanced Therapy were four times more likely to achieve remission compared to patients receiving the placebo treatment!

Only NeuroStar Advanced Therapy (TMS) has durability over 12 months.













Source: NeuroStar TMS Therapy Clinical Results

Gabby Lundy, Exult Healthcare

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Alcoholism & the Holidays

For many people, the holidays are a time for sharing and giving. But for alcoholics, it can be dangerous because the urge to drink may be enhanced. This is especially true for the alcoholic in alcoholic families. Parties and holiday activities involve the use of alcohol and many people receive alcohol as a gift. People who are lonely may have the urge to drink.

We live in a drinking society with certain activities that promote the use of alcohol and are glorified in the media. Examples include sports: the Superbowl and the World Series to name a few. Many liquor ads show young people having fun with handsome actors and actresses. This is to promote the idea if we drink a certain brand or beverage we will be transported to an exotic backdrop where everyone is having a great time. Reality is much different. Holiday beer and beverage ads do not show all the problems that alcoholism and excessive drinking cause. People who are not alcoholic can enjoy a few drinks and the closeness that is a component of social drinking.

The holidays can be a dangerous time for the alcoholic. One can easily be fooled by the celebrating spirit of the holiday season and forget that alcohol has an adverse effect on them. Even people who don’t have a drinking problem can drink too much during the holiday season and get into trouble.
The alcoholic can still enjoy the holidays without drinking.

Here are some tips on having a sober, safe, and fun holiday season:

  • Do not go where others are drinking if you have the urge
  • Call a sober friend if you are feeling lonely
  • Go to a 12-step meeting
  • Go to a safe place if you are wanting to drink
  • Ask your host for a non-alcoholic drink or bring it with you
  • Give reasons as to why you don’t want a drink, you can give any reason you want
  • Go out with sober friends to support each other in drinking environments
  • Make sure you are not too hungry, angry, lonely or tired (HALT) when you go out
  • Go to a sobriety party -many 12-step clubs have sober Christmas parties

Your recovery must be your number one priority regardless of the time of the year. If you look back on other times when you drank during the holidays, you may find that drinking inhibited your ability to have fun. It is the alcoholic’s responsibility to live life on life’s terms without taking a drink.


We at Exult can help by giving you a safe place and encouragement. Please join our Sober Holidays support group if you are interested in having a group to talk to about holiday stress while in recovery. Our group will meet Wednesdays at 6pm. It is free to attend. If you are interested in signing up, please call 469-714-0006 or email us at info@exulthealthcare.com.

James Fox, Exult Healthcare

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ADHD & Sleep

The links between ADHD and sleep issues are still unclear, as is the cause of ADHD in general. Both the symptoms of ADHD and some of its medications can affect sleeping patterns. Also, “sleep deprivation…can worsen ADHD symptoms.” Nearly 50% of kids with ADHD suffer from some sort of sleep problem and nearly 75% of adults with ADHD reported suffering from insomnia.

Common Sleep Problems Associated with ADHD:

  • Anxiety or resistance about bedtime (in children)
  • Difficulty falling asleep at night
  • Difficulty waking up in the morning
  • Sleep-disordered breathing and sleep apnea
  • Interrupted sleep (waking up during the night)
  • Excessive daytime sleepiness
  • Restless legs syndrome (RLS)
  • Periodic limb movement disorder (PLMD)
  • Delayed sleep-phase disorder
  • Higher rates of nightmares
  • More likely than average to experience parasomnias like sleepwalking

Treatments for these ADHD-related sleep issues include cognitive behavioral therapy (CBT) and medication management. Contact Dr. Bharagava’s office to see if these treatments may help you or your child’s ADHD symptoms.

Source: “ADHD and Sleep” by Tuck.com

Gabby Lundy, Exult Healthcare

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Drug Take-Back Event

McKinney Drug Take-Back Event

On Saturday, October 27th, 2018 the City of McKinney Police Department and the Collin Count Sheriff’s Office will host their periodic DEA Nationwide Drug Take-Back event. From 10:00 am to 2:00 pm at the Public Safety Building, people “can safely dispose of all accumulated expired, unwanted, and unused prescription drugs. The service is free and anonymous. You do not have to be a resident of McKinney to participate.”

For a list of what they will or won’t take and other information, visit the event page here.

Date: October 27, 2018
Time: 10:00 AM - 2:00 PM
Location: Public Safety Building
2200 Taylor Burk Dr.
McKinney, TX 75071
Contact: 972-547-2844
Questions? Email us.
Cost: Free
Link: More information

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What Treatments Do Psychiatrists Use?

Treatment Types:

Psychotherapy is often the first step with patients. From there, a psych eval will be done and it will be determined if the patient would benefit from a medication plan.

Class of Medications:

  • Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders
  • Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder
  • Sedatives and anxiolytics – used to treat anxiety and insomnia
  • Hypnotics – used to induce and maintain sleep
  • Mood stabilizers – used to treat bipolar disorder
  • Stimulants – used to treat ADHD


These medications can “help correct imbalances in brain chemistry that are thought to be involved in some mental disorders.” Psychiatrists are one of the few mental health providers that can prescribe medication and are usually a necessary piece of long-term medication management for mental health issues.


Source: “What is Psychiatry?” American Psychiatric Association

Gabby Lundy, Exult Healthcare



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Mental Health & Chronic Illness: Selena Gomez

Last Wednesday, pop singer and television producer, Selena Gomez was admitted to a psychiatric hospital. She is told to have suffered a panic attack after a recent health setback related to her two recent hospitalizations for “low blood cell count” post-kidney transplant. Gomez has Lupus and underwent a kidney transplant in September of 2017 because of Lupus-related complications.

Selena Gomez has been open about her struggles with Lupus–a chronic illness that causes –and with mental health since 2015. Early in 2018, Gomez received outpatient psychiatric treatment to address anxiety. However, Gomez is not the only person whose mental health has suffered as a result of dealing with a chronic illness.

Chronic Illness and Depression

Chronic illnesses of all kinds can cause or worsen depression in the following ways:

  • Increased feelings of isolation
    • Taking off more time from work, school & social events for treatment and self-care
    • Feeling like no one understands your condition
  • Increased fatigue in some chronic illnesses may make depression-related fatigue worse
  • Inflammation symptoms (in some chronic illnesses such as Lupus) which have some evidence pointing to causing or worsening depression
  • Enhanced life, work, financial, and relationship stressors as a result of the chronic illness

Taking control of your mental health can be one piece of dealing with a chronic illness and your overall health. Doctor Heals Mind has a variety of treatments available for depression and other mental health issues. Please check out our depression treatment page to find a solution that best fits your needs.

Source: “Selena Gomez’s Hospitalization Highlights a Problem With The Way We Treat Chronic Illness and Mental Health” by Julia Metraux, The Mighty via Yahoo! LifeStyle

By: Gabby Lundy, Exult Healthcare

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Who Can Help Treat My Depression?

Mental health treatment can be found from a variety of professionals, especially for depression. Knowing your own symptoms and needs can help you determine what type of care provider is needed to best treat your depression. You may even see more than one of these professionals at a time to get the best care possible. Let’s break down some differences between these mental health care professionals.

Primary Care Doctors

Your general doctor may be the first person you see to access care. They can:

  • Recommend a behavioral health provider such as a therapist, counselor, psychiatrist, etc.
  • Prescribe and monitor medication
  • Monitor your progress and follow up over time


Psychiatrists have medical degrees (MD) and specific training in mental health conditions. They can:

  • Assess your symptoms to make an informed diagnosis
  • Assess the need for medication
  • Prescribe and monitor medication
  • Provide psychotherapy

Licensed Counselors, Therapist, and Social Workers

All three of these providers have a master’s degree (MS), a doctorate (Ph.D.), or another type of graduate-level certification. They have completed an internship and one (or more) years of supervised practice. They can:

  • Assess your symptoms to make an informed diagnosis
  • Provide talk therapy (also known as counseling)
  • Offer specialized counseling, such as family or marriage therapy


Psychologists have a master’s degree (MS) or a doctorate (Ph.D./PsyD) in psychology. They are not medical doctors nor can they prescribe medication (in most cases). However, they can:

  • Assess your symptoms to make an informed diagnosis
  • Provide talk therapy (also known as counseling)
  • Conduct psychological testing
  • Refer you to a psychiatrist for medication

Psychiatric Nurse Practitioners

Psychiatric nurses are register nurses (RN) that also have graduate-level education in mental health. They can:

  • Assess psychiatric conditions
  • Prescribe and monitor medication
  • Follow up with medication management and coordination of care

If you feel like medication may be part of your mental health treatment, Dr. Bhargava, a board-certified psychiatrist, may be able to help. Visit our Depression Treatment page for more information.

If you are more interested in talk therapy, Exult Healthcare has licensed therapists and counselors that have a variety of specialties. They also offer transcranial magnetic stimulation (TMS) treatment if therapy and medications are not working for you.


Source: https://www.aetna.com/individuals-families/mental-emotional-health/depression-care-providers.html

Gabby Lundy, Exult Healthcare

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Panelists from Judge Lela Mays' Honest Talk

Dr. B Speaks on “Honest Talk About Mental Health and Addiction” Panel

Dr. B with Judge Lela Mays

Last night, Dr. Bhargava spoke on a local panel discussing substance abuse, mental health, and local resources for support. The town hall event—moderated by Judge Lela Mays—featured panelists from a variety of government and healthcare services related to mental health and addiction to answer questions about community resources and funding issues.

Missed the discussion? Dr. B will be participating in the next panel which will be held on October 16th from 6:30-8:30 p.m. at UT Dallas ECS TI Auditorium. (See flyer for more details.)

Honest Talk Poster



By: Gabby Lundy, Exult Healthcare

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Suboxone Onsite

Suboxone (Buprenorphine/Naloxone) Onsite

Our facility provides Medicated-Assisted Treatment (MAT) for Suboxone (Buprenorphine/Naloxone).

Medicated-Assisted Treatment (MAT) is the use of FDA- approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.

We follow an integrated approach that includes med management, counseling and behavioral therapies.

Our physicians have taken the proper training and are approved to safely administer Suboxone to treat opiate addiction. We have trained counselors and therapists to offer behavioral therapies.

Medications Used in MAT

FDA has approved several different medications to treat opioid addiction and alcohol dependence.

A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.

Medications used in MAT for opioid treatment can only be dispensed through a SAMHSA-certified OTP. Some of the medications used in MAT are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse. Learn more about DEA drug schedules.

Opioid Dependency Medications

Methadone, buprenorphine, and naltrexone are used to treat opioid dependence and addiction to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. People may safely take medications used in MAT for months, years, several years, or even a lifetime. Plans to stop a medication must always be discussed with a doctor.


Methadone tricks the brain into thinking it’s still getting the abused drug. In fact, the person is not getting high from it and feels normal, so withdrawal doesn’t occur. Learn more about methadone.

Pregnant or breastfeeding women must inform their treatment provider before taking methadone. It is the only drug used in MAT approved for women who are pregnant or breastfeeding. Learn more about pregnant or breastfeeding women and methadone.


Like methadone, buprenorphine suppresses and reduces cravings for the abused drug. It can come in a pill form or sublingual tablet that is placed under the tongue. Learn more about buprenorphine.


Naltrexone works differently than methadone and buprenorphine in the treatment of opioid dependency. If a person using naltrexone relapses and uses the abused drug, naltrexone blocks the euphoric and sedative effects of the abused drug and prevents feelings of euphoria. Learn more about naltrexone.

Source: https://www.samhsa.gov/medication-assisted-treatment/treatment#medications-used-in-mat

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