What Not To Say To Your Grieving Friend

By: Tehila Strulowitz

After hearing the tragic news of a death, there are three possible reactions the bereaving person could have to our response: feel even sadder, become angry, or feel reassured that things will be okay. We, as the reactor who is not directly experiencing their exact loss, want nothing more than to miraculously attain Merlin’s wand, and magically make their sadness, pain, confusion, and grief disappear. We just want to make it better. But for some reason, a completely inoffensive, caring response seems like it’s a fictional, fantastical possibility.

With a response that knocks us loving, caring people to our knees, Litsa Williams, licensed clinical social worker and creator of an online grief community called What’s Your Grief, says that none of our well-thought-out poignant phrases, earnest lamentations, or solemn sorrow at the beginning of the grieving process “can’t make it even a little bit better.” To prove her point, Williams brought some examples of common, pithy sayings that people say and the counterexamples of the griever’s possible thoughts in response:

Well-meaning person: “He/she is in a better place now.” Grieving person: I couldn’t care less! I want them here with me now!

  • What we learn: Closely following the death, a grieving person won’t find comfort in other people telling them that their loved one is “in a better place.” At that moment, they just want them back, and think there is no “better place” than being right here on Earth with them. It can also perpetuate confusing thoughts they are having about an afterworld, and it may induce guilt because they believed their whole lives that Heaven is a good place, but right now they don’t want that loved one to be in Heaven – they want them here.

Well-meaning person: “I know how you feel.” Grieving person: No losses are the same. Stop trying to compare your pain to my current pain. You can’t possibly feel exactly what I am feeling.

  • What we learn: Comparing grief doesn’t get anyone anywhere. Even if you might think that it’s rational that you lost your loving mother and so did your friend, your friend isn’t in the headspace to start having that conversation. They want to be comforted – not told that their grief is comparable to yours, or anyone else’s, for that matter.

Well-meaning person: “It will get easier.” Grieving person: It’s impossible for me to forget the person I love, and will never move on from this strong, intense grief! It would be wrong to do that to them and their memory!

  • What we learn: Williams points out, “Remember, this list is not about things that aren’t true.  It is about things that aren’t helpful to say.” Rationally, we know that most people learn to live with the grief, and the pain doesn’t feel as strong or new over time, but when that bereaved person is still processing the death and feeling the fresh, raw sting of the loss, they want nothing other than for someone to recognize, accept, and hold their hand through their current reality. Additionally, they may feel like it’s unjust or cruel to start healing and “moving on” from the one they are grieving. They probably won’t want to even imagine the possibility of letting go of that pain to some extent. Giving them the space to feel their grief at the moment is crucial so that they know that your intentions are to be there if they ever need a shoulder to cry on, a hand to squeeze, or some more tissues delivered, and not to be imposing or offering what you think to be wisdom but they think to be insulting, hurtful, or condescending.

Well-meaning person: “God has a plan,” “It was God’s will,” or “Everything happens for a reason.” Grieving person: Why would God plan or will something so painful to someone? Why would God make us suffer and feel pain like this? I don’t care if this is God’s plan or not – it sucks.

  • What we learn: Many do find it comforting to think that there is a greater plan that God has for them. However, the grief and intense pain they feel now might cause them to doubt, or even hate, God, religion, or even their faith and beliefs as a whole. These troubling thoughts can even occur in the minds of very religious people. Williams says that it can even cause faith-based doubts in the minds of those who do not consider themselves religious. To sum up, Williams says, “Better safe than sorry – steer clear.”

Essentially, grieving people are uninterested in comparing or doubting anything. They just want to be listened to. Williams suggests doing things to remove stress and help them feel at ease during the process, whether that be sending over meals, arranging for childcare, or helping financially by collecting funds for the funeral costs, just to name a few. Frequently, those grieving don’t remember what you said, so don’t worry about possibly hurting a grieving friend or loved one in the past. Just focus on listening, being sympathetic, and loving.

While experiencing feelings of grief, some may have difficulties such as trouble sleeping, concentrating, eating, anger, extreme sadness, difficulty socializing, drinking alcohol, smoking, or using drugs, just to name a few. Some disorders related to grief or losing a loved one include acute stress disorder, depression, generalized anxiety disorder, panic disorder, post-traumatic stress disorder, prolonged grief disorder, and substance use disorder.

Trauma From an Assassination Attempt and the Effects of Social Media

By: Tehila Strulowitz

On July 13th of this year, a shot was witnessed around the world when a skinny, pale 20-year-old with an AR-15-style rifle climbed onto a roof facing former President Donald Trump’s rally and fired. After the crowd got up from the ground when police said it was safe, but before paramedics could arrive, millions of people already had photos and videos of the incident on their devices and were chasing the story for updates.

Research outlines how witnessing these events through such graphic and detailed media not only makes us afraid and panicked, but also leads us to doubt our society. We start to think that if we scoured the dark web enough, we’d be able to prevent shootings, or that our children’s classmates who are on the fringes of the social scene might just shoot them one day. We may even convince ourselves that we need a gun for our personal safety and survival.

Universally, we consider leaders to be among the most protected and secure people in our country. When we witness political violence firsthand or through videos and photos, we automatically begin to fear for our own safety and security. As psychologist Dr. Zachary Ginder points out, witnessing a violent attack on a government authority—whether in real-time or via video—leads us to question and doubt our “sense of social order, control, trust, safety, and security.”

One thing that the boom of social media has demonstrated, validated by numerous studies, is that we easily obtain extensive video and photo coverage of violent attacks, whether they involve shootings, terrorist attacks, assassination attempts, or others. The ability to see every single moment from every angle of a violent incident, due to continuous media coverage and the ease of sharing on social media, serves to sustain our trauma and panic, according to Roxanne Cohen Silver, a professor of psychological science, medicine, and public health at the University of California, Irvine.

Experts suggest several ways to relieve anxious feelings: avoid listening to and perpetuating conspiracy theories by ensuring that you’re getting your news from reliable sources; take time to establish and maintain regular habits that support your self-care; channel your energy into advocacy and “positive action,” which can help many feel more in control; focus on kindness and positivity; and seek help when needed to process trauma in a healthy way rather than remaining in a traumatic mindset.

If one’s reaction to trauma is intense, they may experience difficulties such as trouble sleeping, concentrating, irritability, anger, lashing out, or paranoia. Disorders related to traumatic reactions—whether the experience was direct or indirect—include acute stress disorder, depression, generalized anxiety disorder, panic disorder, post-traumatic stress disorder, and substance use disorder.

Depression: Do Genetics Play a Role in Depression

Depression: Do Genetics Play a Role in Depression

By: Josette DeFranco

Major depressive disorder is a condition that affects many individuals. Major depressive disorder can range from being clinically mild and short-lasting to recurring over and over again, to being highly chronic and treatment-resistant. Depression is known to run in families indicating that there are genetic factors. It can be a combination of life experiences and environment. Genetics plays a mild role in depression. Also, families with certain genetic patterns lived eight years shorter than average. As depression may range from transient to debilitating it is expected that many different sets of genetic alterations are involved. Some genes are associated with weight and body, neuron development, and brain inflammation and another group is associated with proteins that tell the immune system which cells are friendly and which are not. This means that our genetics can not only influence our physical characteristics but also how our brain functions and our immune system interacts and identifies with different cells in the body. Your environment can modify the genetic factors that play a role in depression.

If you are concerned about a strong history of depression in the family and are scared about it affecting you or your future children a study suggests that even with a high tendency for depression, psychotherapy or behavioral activation therapy can reduce it. Individuals need to understand the life-changing impact their environment can have on their mental health. Our emotions are generated by our thinking which may serve as an influence on our behaviors. You may have had genetic roots of depression, a difficult upbringing, or a terrible tragedy that has currently occurred but if you change your thinking then your emotions will change as well.

If you or someone you know is struggling with their mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit https://aristapsychiatrypsychotherapy.com/

Sources:

https://www.psychologytoday.com/us/blog/the-athletes-way/201603/depression-new-research-shows-genetics-are-not-destiny

https://www.psychologytoday.com/us/blog/psychiatry-the-people/201804/massive-study-clarifies-genetic-risks-major-depression

https://www.psychologytoday.com/us/blog/the-three-minute-therapist/202007/overcoming-genetically-based-depression

Sleep Deprivation Psychosis

Sleep Deprivation Psychosis

By Madison Gesualdo

Remember that episode of Law and Order: Special Victims Unit where Sarah Hyland gave us an Oscar-worthy performance as a genius prep school student, Jennifer Banks, who attacked her roommate because of their academic rivalry? During the trial, the defense was able to prove diminished capacity on Jennifer’s behalf, meaning that Jennifer’s impaired mental state at the time of the crime prevented her from fully controlling her violent actions. Jennifer, who had been taking a form of modafinil that allowed her to stay awake for six consecutive days before she committed her crime, was suffering from sleep deprivation psychosis. Because the defense was able to prove this, she was able to plead guilty to her crime on a lesser charge and was only sentenced to seven years in prison at the conclusion of the episode.

Let’s talk about sleep deprivation psychosis from a clinical standpoint. On the show, it is mentioned that being awake for 17 hours is similar to having a blood-alcohol content (BAC) of 0.05% – that’s legally impaired in the state of Utah, even though the federal limit is 0.08%. The National Institute for Occupational Safety and Health corroborates this finding, adding that being awake for 24 hours is the equivalent of having a BAC of 0.10%. Now, imagine Jennifer’s psychological state after being awake for 144 hours without a minute of sleep, running off of a stimulant drug designed to block dopamine receptors and consequently increase the body’s overall levels of dopamine. It’s no wonder that her memory of the encounter with her roommate was hazy at best.

According to a 2018 study published in Frontiers in Psychiatry, sleep-loss developments such as hallucinations and perceptual distortions can occur in individuals with no history whatsoever of psychiatric issues. This study essentially found that the more time a person spends awake, the more he or she will progress towards a state of psychosis. Symptoms such as anxiety, disorientation, and depersonalization began after 24 – 48 hours without sleep, evolving into disordered thinking and complex hallucinations after 48 – 90 hours without sleep. Once a person reached the 72 hour-mark without sleep, the study claimed, his or her psychological state resembled that of toxic delirium or acute psychosis.

If an individual is experiencing insomnia, anxiety, depression, or any other conditions that can lead to a deficiency in proper sleep, he or she should seek help immediately. A wide variety of intervention methods and medications are available to help gradually regulate an individual’s sleep-wake cycle and prevent cognitive impairment resulting from sleep deprivation. Make sure to speak with a mental health professional to see what options are available to you.

If you or someone you know is struggling with sleep, anxiety, or mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit https://aristapsychiatrypsychotherapy.com/

References:

Davis, C. (Writer). (2009). Hothouse (Season 10, Episode 12). [TV series episode]. In D. Wolf (Executive producer), Law & order: Special victims unit. Hulu. https://hulu.com

National Institute for Occupational Safety and Health (2020, March 31). Impairments due to sleep deprivation are similar to impairments due to alcohol intoxication. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod3/08.html#print

Waters, F., Chiu, V., Atkinson, A., & Blom, J.D. (2018). Severe sleep deprivation causes hallucinations and a gradual progression toward psychosis with increasing time awake. Frontiers in Psychiatry, 9, 303. https://doi.org/10.3389/fpsyt.2018.00303

Anxiety and Learning in Children

Anxiety and Learning

By:Stefani Stojanoska

It can be difficult for anyone to learn when their anxiety takes over. Anxiety can make it difficult to focus and pay attention. An individual’s anxiety takes over concentrating on other things other than learning. An example of this is if someone’s loved one is feeling sick they can be worried about them instead of focusing on what they are supposed to learn. When people feel stressed their body goes into “fight or flight” mode. Anxiety makes memory difficult since people tend to “freeze” when feeling anxious. When this happens it is tough for individuals to process new information. When people are in these “fight or flight” modes they tend to make bad decisions such as worrying about other things which can slow down their learning and memory. Anxiety can also hold back creativity. They might be worried about what others will think about their ideas which might result in their holding back and sticking with an ordinary idea.

Ways parents can help children

  1. Get help as soon as possible. Parents can talk to their child’s teacher to learn ways to help their child. Consult a child psychologist who can recommend ways to help reduce their anxiety and improve their learning.
  2. Parents can talk to their children about what causes their anxiety. They can teach them ways to calm down before going to school. This topic should be discussed daily with children so that each day it can become easier for them to control their anxiety.
  3. Parents can do academic learning at home that way the child will be in a comfortable setting and will be able to improve. The parent can work on academic subjects with their child at home so that they can learn since their anxiety makes it difficult for them to learn in a school setting. The parent can get help from the teacher so they know what they have to learn.

If you or someone you know is struggling with anxiety or their mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ, Manhattan, NY offices respectively, at (202) 368 3700 or (212) 722 1920 to set up an appointment. For more information, please visit https://aristapsychiatrypsychotherapy.com/  

Depression: Let’s Talk About It

By: Nicole Cutaia

Depression: Let’s Talk About It

Depression is often times stereotyped through societal misconceptions and labels that portray individuals experiencing the condition as weak or even attention-seeking. But it is important to normalize depression, Having depression does not mean one is weak, a failure, or lazy, it simply means one needs mental health assistance. The stigma against mental health is a reason to why people battling with mental disorders such as depression, do not reach out for therapy or treatment.

Normalizing depression also allows individuals to become exposed to and educated on the mental disorder. Some people are genuinely not aware of what specific mental illnesses or disorders are so having an open discussion is very important.

Common symptoms of depression are constantly experiencing sadness or feeling the need to cry, feeling remorseful; life beginning to seem meaningless, having a negative attitude, decreasing activities you used to enjoy, changes in sleep, and experiencing irritability.

Life can get very busy and overwhelming; putting your mental health first is a priority. If you or any loved ones you know are experiencing symptoms of depression, it is vital to talk to someone.

If you or someone you know is having mental health difficulties and/ or experiencing symptoms of depression, please contact our psychotherapy offices in New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our offices at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Stress: Does Job Stress Contribute to Mental Illness

Stress: Does Job Stress Contribute to Mental Illness

By Josette DeFranco

Work stress is not often addressed. We tend to take on many tasks, leading to feeling overwhelmed physically and mentally. For some, work is a routine and many find working under stress helps them concentrate. On the other hand, some people don’t work as much and try to maintain a slower pace. In either circumstance, work can cause severe stress. Stress in the workplace can lead to decreased productivity and burnout. It is important to note how our body feels so we can find signs earlier that our mental and physical health needs a break.

Some negative effects of stress in the workplace manifest in various ways such as a lack of motivation, reduced job satisfaction, physical and mental health problems, and interpersonal conflicts. If you notice you are feeling more fatigue, irritability, or apathy it may be best to give yourself a break. Job stress can lead to some mental illnesses like depression and anxiety. Stress prepares your body for a defensive action, like an alarm for the brain. It impacts your nervous system releasing hormones that help sharpen your senses and tense your muscles. You may have heard of something called the “flight or fight response.” This is important because it helps you defend against situations your body finds threatening. If stressful situations go without being addressed it will keep your body in a state of activation. Some ways to help alleviate job stress are to ensure that the workload is in line with workers’ capabilities and resources, allow yourself to take a break, create boundaries, provide opportunities for social interactions among workers, and establish work schedules that accommodate your responsibilities outside the job.

If you or someone you know is struggling with their mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit https://aristapsychiatrypsychotherapy.com/

Resources:

https://business.talkspace.com/articles/the-negative-effects-of-stress-in-the-workplace#:~:text=The%20effects%20of%20work%20stress,%2C%20interpersonal%20conflicts%2C%20and%20more.

https://www.cdc.gov/niosh/docs/99-101/default.html#Job%20Stress%20and%20Health

Tardive Dyskinesia

Tardive Dyskinesia

By Madison Gesualdo

Tardive dyskinesia is a syndrome in which a person exhibits repetitive, involuntary muscle movements. This syndrome directly affects the central nervous system and is typically seen in patients who are prescribed antipsychotic drugs, usually for bipolar disorder and schizophrenia. Tardive dyskinesia is chronic, with the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition mandating that symptoms must persist for at least a month after an individual discontinues his or her medication in order to be officially diagnosed.

Neuroleptic drugs, also known as antipsychotics, are the most common inducers of tardive dyskinesia. Antipsychotics are often prescribed to patients with bipolar disorder and schizophrenia in order to reduce symptoms such as hallucinations, delusions, and disorganized thinking. These drugs successfully work by blocking receptors in the nervous system – specifically D2 dopamine receptors in the midbrain and forebrain – and consequently lowering dopamine levels within an individual. This is crucial for individuals diagnosed with bipolar disorder or schizophrenia because overactivity of dopamine in the brain can alter brain chemistry, leading to many of the psychotic symptoms associated with these disorders. Thus, antipsychotic medications are able to help assuage some of these symptoms by regulating an individual’s dopamine levels.

Like most medications, neuroleptic drugs have the potential for negative side effects. A person who has been taking neuroleptic drugs for an extended period of time may start experiencing abnormal involuntary movements, contractions, tics, tremors, and restlessness. All of these actions, in the context of long-term antipsychotic use, encompass tardive dyskinesia. These symptoms occur as the result of dopamine receptors having been blocked for too long; blockade of these receptors prevents fluid communication between nerve cells, resulting in a lack of stable movements in an individual.

If an individual finds that he or she is experiencing medication-induced tardive dyskinesia, he or she should consider talking to a doctor about stopping or switching the current medication that is causing it. Additionally, deep brain stimulation can also be utilized as a solution. This procedure employs a neurostimulating device that sends electrical signals into the brain to stimulate the blocked dopamine receptors and encourage movement.

Tardive dyskinesia should not be disregarded, as there are plenty of methods of intervention that can help reduce symptoms within an individual and make the condition more manageable. Make sure to consult with a healthcare provider about a treatment plan if you or a loved one is experiencing this condition.

If you or someone you know is struggling with their mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit https://aristapsychiatrypsychotherapy.com/

References:

Allarakha, S. (n.d.) Why do antipsychotics cause tardive dyskinesia? MedicineNet. www.medicinenet.com/why_do_antipsychotics_cause_tardive_dyskinesia/article.htm

Ameer, M.A., Patel, P., & Saadabadi, A. Neuroleptic Medications. [Updated 2024 Feb 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459150/

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Bhandari, S. (2023, January 12). What is tardive dyskinesia? WebMD. https://www.webmd.com/mental-health/tardive-dyskinesia

Cornett, E.M., Novitch, M., Kaye, A.D., Kata, V., & Kaye, A.M. (2017) Medication-induced tardive dyskinesia: A review and update. The Ochsner Journal, 17(2), 162-174. https://www.ochsnerjournal.org/content/17/2/162/tab-article-info

The Centre for Addiction and Mental Health. (n.d.) Antipsychotic medication. CAMH. www.camh.ca/en/health-info/mental-illness-and-addiction-index/antipsychotic-medication#header.

Vasan, S., & Padhy, R.K. Tardive Dyskinesia. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448207/

The Importance of Involvement: Special Needs

By: Nicole Cutaia

The Importance of Involvement: Special Needs

No one appreciates being left out. This applies to any age but especially has damaging effects on children. Children with special needs or intellectual disabilities are often left out in social settings. These environments range anywhere from school, sports, afterschool activities, and social gatherings

Growing up, we were taught to include everyone and never leave anyone out. But unfortunately, this ideology does not have value or significance to some. Kids can especially be mean or judgemental to others who may not look and act exactly like them. This is why bullying and stigma rates towards special needs individuals are so high.

I believe there are children who could benefit from learning about special needs and intellectual disabilities at school and at home so they are aware and knowledgeable on the topic. It is also very considerate to involve individuals who may not always have the opportunity to be included.

Everyone has a right to feel like they belong in their community and amongst their peers. Because they do belong.

It can be difficult to see a loved one or caretaker struggle with mental health. If you or a family member are struggling with mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ, and Manhattan, NY offices respectively at (201) 368- 3700 or (212) 722- 1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Caretaker: How to Take Care of Yourself When Taking Care of a Loved One

 Caretaker: How to Take Care of Yourself When Taking Care of a Loved One

By: Josette DeFranco

Participating in caregiving can come with a lot of stress and responsibility. Many individuals believe that they have to handle it all on their own which can lead to exhaustion and anxiety. Family caregivers at any age have reported that they experience a terrible sleep schedule, poor eating habits, failure to stay active, and failure to make medical appointments for themselves. If you are experiencing this, it is okay to let go of the load you are carrying and know that you are not alone. Caregiving can be an emotional roller coaster that may trigger the same hormonal and neural mechanisms that cause stress chemistry. However, it is noted that those who are caregiving for a loved one find this a rewarding experience.

Here are some tips to help you take care of yourself:

  • Prioritize sleep
  • Eat well
  • Acknowledge your feelings
  • Set boundaries
  • Take on fewer tasks
  • Ask for help
  • Practice Mindfulness
  • Treat yourself
  • Let go of guilt
  • Be honest with yourself

Here is a reminder that self-care isn’t selfish. To take care of others you have to take care of yourself first. Caring for you is the most important tip because we can’t share our assistance if we lack it in ourselves. Be kind to yourself. You may tell yourself “I never do anything right” or “There’s no way I can find time for myself.” Our brains are a reflection of us meaning your brain will start to believe what you are saying. Instead, try positive affirmations like “I am doing a good job at taking care of my parents” or “I will take at least 15 minutes for myself each day.”

If you or someone you know is struggling with their mental health, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit https://aristapsychiatrypsychotherapy.com/

Sources:

https://www.caregiver.org/resource/taking-care-you-self-care-family-caregivers/