Author: Judy Gurfein

PTSD Researcher Finds Link between Stress and Trauma

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By Diana Bae

Rachel Yehuda, PhD, is a distinguished researcher and Director of Traumatic Stress Studies Division at the Icahn School of Medicine of Mount Sinai. She has conducted numerous prominent post-traumatic stress disorder (PTSD) studies and treatment. One of her most well-known studies researched Vietnam War combat veterans with PTSD and found that they had significantly lower cortisol levels than veterans without PTSD. Cortisol is a hormone that controls stress and although it is thought that more cortisol resulted in more stress, Dr. Yehuda showed that that is not the case. Thus, there needs to be a sufficient amount of cortisol to handle stress and reduce the risk of developing trauma. Now, Dr. Yehuda plans to test a drug, oral hydrocortisone, to see whether it can replicate the cortisol naturally produced in the body. If this drug is successful, it may prevent PTSD and other similar disorders.

Arista Psychological and Psychiatric Services understands the problems caused by PTSD and are dedicated to provide proper attention and treatment. If you or someone you know would like to set up an appointment for our counseling services, contact us at our offices in Paramus, NJ (201) 368-3700 or in Manhattan, NY (212) 996-3939. For more information, please visit our website https://www.counselingpsychotherapynjny.com/

Source: Inside, a publication of the Mount Sinai Health System, Issue: November 25 – December 15, 2019;  Picture Source: http:// www. thesuburban.com/life/lifestyles/can-trauma-be-transmitted-intergenerationally-oct-dawson-college-peace-centre/article_ea2d7bb0-b063-11e7-aee3-5b0d013065f7.html, https:// askopinion.com/how-to-deal-with-ptsd-aka-post-traumatic-stress-disorder

Anger in Children

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By: Maryellen Van Atter

Children experience anger. This is an expected part of growing up and learning how to navigate life’s situations. However, when anger becomes overwhelming and distressing for your child and for your family it may be indicative of a greater issue. If your child has trouble controlling their tantrums or frequently experiences anger, you may consider addressing the emotion and helping your child control their anger.

Though every child is different, there are some warning signs that your child’s anger is out of control. These include the child displaying behavior that is dangerous to themselves or others, the child’s teachers reporting that the behavior is out of control, the behavior alienating the child from their peers at school and preventing social interaction (birthday party attendance, etc.), and the behavior disrupting home life. Additionally, parents should observe if their child feels badly about him or herself as a result of their inability to control their anger. This illustrates that the child is experiencing distress because of the lack of control over their emotions, and is a sign that their anger is beyond what is normal or expected for a child their age.

There are many different causes for this behavior. These causes may include anxiety, learning disabilities, trauma, sensory processing issues, or general distress. Triggers are also an important thing for parents to recognize if they are worried about their child’s anger. Identifying triggers or situations which result in anger can help discern the cause of the anger and ways in which it can be effectively managed. Psychotherapy and cognitive behavioral therapy are two treatment methods which professionals use to help a child manage their anger and teach the child coping mechanisms and emotional regulation.

 

If you or someone you know is struggling with a child’s anger expression, Arista Counseling and Psychotherapy can help. Please contact us in Paramus, NJ at 201-368-3700 or in Manhattan, NY at 212-996-3939 to arrange an appointment. For more information about our services, please visit http://www.counselingpsychotherapynjny.com/

 

Sources:

https://www.yalemedicine.org/conditions/anger-issues-in-children-and-teens/

https://www.psychologytoday.com/us/blog/growing-friendships/201806/children-s-anger-management-strategies-work

https://www.greatschools.org/gk/articles/anger-overload/

https://childmind.org/article/is-my-childs-anger-normal/

Family Therapy: How to Maximize Your Experience

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By: Maryellen Van Atter

Being a family member is a full time job, and sometimes it has the stress to match. Managing a family can be difficult and it is normal to sometimes feel lost and unsure of how to move forward. The goal of marriage and family counseling is to resolve these feelings and give family members the tools to communicate effectively with one another. It is not only a way to resolve problems, but an investment in the future wellbeing of your family.

A common reason for many to seek family therapy is behavioral problems of youth in the family. Research has shown that youth psychosocial problems are linked to the youth’s social systems, such as the family. By addressing concerns and miscommunications, youth often function better and learn healthy coping skills. Family therapy provides a safe space for all individuals to express their feelings with a trained professional who can mediate, interpret, and give plans for long term family success, rather than only resolving a specific problem.

Family is not limited to those who are genetically linked to you; it is often defined as anyone who plays a long term supportive role in one’s life. The support that family provides has an important role in keeping good mental health. Like many good things, family therapy is not always easy. Here are some tips to keep in mind to make it as beneficial as possible:

  • Give it a chance and be open to its success
  • Find a therapist who makes you feel comfortable
  • Have each family member prepare some questions or talking points prior to the session to ensure everyone gets to communicate

If you feel your family could benefit from family therapy, Arista Counseling and Psychotherapy can help. We have a wide network of professional help and experience. Please contact us in Paramus, NJ at 201-368-3700 or in Manhattan, NY at 212-996-3939 to arrange an appointment. For more information about our services, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://www.aamft.org/About_AAMFT/About_Marriage_and_Family_Therapists.aspx?hkey=1c77b71c-0331-417b-b59b-34358d32b909

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490859/

https://healthypsych.com/family-therapy/

 

Caregiver Depression

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Caregiver Depression

By: Maryellen Van Atter

Caring for another individual is no easy feat; just as parenting requires preparation, so does caring for a family member with an illness or disability. A seldom discussed topic is ‘caregiver syndrome’, also known as caregiver depression or caregiver burnout. It is estimated that 20% of family caregivers suffer with depression – in the general population, it is reported that 7.1% of all individuals suffer from depression. This means that caregivers experience depression at a rate more than double the average person. Despite the prevalence of this condition, it is rarely talked about and sometimes viewed as something shameful. This should not be: caregiving is a difficult job and the first step to feeling better is acknowledging that it’s okay to feel the way you do. Just as there is no ‘perfect’ way to parent, there is no ‘perfect’ or ‘right’ way to be a caregiver.

Everyone experiences depression differently, but a few common signs are a loss of interest in things that you once found enjoyable, a change in sleeping patterns, and feeling irritable, hopeless, or helpless. These symptoms can persist even if you have placed a loved one in a care facility. Psychotherapy has been shown to be effective at managing caregiver depression and helping caregivers to feel more satisfied with their lives. Additionally, antidepressant medications can provide symptom relief; combined with psychotherapy, this can allow caregivers to explore their feelings and manage their caregiving responsibilities.

        If you or someone you know is struggling with caregiving responsibilities, Arista Counseling and Psychotherapy can help. Please contact us in Paramus, NJ at 201-368-3700 or in Manhattan, NY at 212-996-3939 to arrange an appointment. For more information about our services, please visit http://www.counselingpsychotherapynjny.com/

 

Sources:

https://www.nimh.nih.gov/health/statistics/major-depression.shtml

https://www.caregiver.org/caregiver-depression-silent-health-crisis

 

Bipolar Disorder vs. Borderline Personality Disorder

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Bipolar Disorder vs. Borderline Personality Disorder

by Sam Matthews

Even though most people are aware that Bipolar Disorder and Borderline Personality Disorder are two different disorders, their differential diagnosis is often difficult due to many phenotypic overlaps between the two. Bipolar disorder often presents with three key features: mania, hypomania, and depression. It is one of the 10 leading causes of disability in the United States with a prevalence of 2.1% in the population. Bipolar disorder’s onset is usually during late adolescence or early adulthood, with cyclothymic temperament being the most common prodromal symptom. Borderline Personality Disorder, on the other hand, is categorized by impulsivity, instability in personal relationships, self-image, and affect. People with this specific personality disorder are often in problematic or chaotic relationships and become very suspicious, or even paranoid when faced with a stressful situation. This disorder can also present with depersonalization or dissociative symptoms, as well as suicide, or non-suicidal self-injury, which often leads to multiple hospitalizations during their lifetime. Their coping skills seem to be poorly developed and maladaptive, leading to even more problems in their daily life and relationships. About 15% of people living in the United States have been diagnosed with at least one personality disorder, however only 6% have one in Cluster B, which includes antisocial, borderline, narcissistic, and histrionic personality disorder.

When comparing the two disorders, it is imperative to make the distinctions as clear as possible. First, we can compare the suicide rates. For bipolar disorder, there is a 10% to 20% mortality rate from suicide, while there is an 8% to 10% mortality rate from suicide for those suffering from borderline personality disorder. Furthermore, bipolar disorder has an episodic course, meaning the symptoms come in waves, with different episodes of the disorder taking place over time. It is also categorized by gradual changes in mood (days to weeks). This differs from borderline personality disorder where the mood changes are often abrupt (hours). It is very common to see non-suicidal self-injuries in patients with borderline personality disorder, but uncommon in those with bipolar disorder, which could be why the suicide rate for those with bipolar disorder is double that of those with BPD. This is because those with borderline personality disorder have poor coping skills, and often want attention or just want to “feel something”, not actually die, due to their distorted way of thinking. Psychotic symptoms can be found in both disorders, however they are only present in bipolar disorder alongside the presence of mood symptoms, and only present in BPD during stressful situations. Another distinction between the two disorders is the way in which one develops it. Bipolar disorder has a genetic aspect, while BPD is usually caused by a significant history of trauma. Overall, these two disorders can often be confused due to the most obvious symptom: changes in mood, which is present in both, but it is important to look at both symptom profiles very closely when making a final diagnosis, in order to ensure that the course of treatment for the patient will be most beneficial and the greatest probability of a good outcome.

Sources:

https://www.medicaldaily.com/bipolar-vs-borderline-personality-disorder-differences-between-two-and-how-avoid-335314

Post-Traumatic Stress Disorder

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Post-Traumatic Stress Disorder

by Sam Matthews

Post-Traumatic Stress Disorder develops after one experience either an isolated traumatic event, or recurring traumatic events. Around 8 million people in the United States are living with PTSD, yet about 70% of US adults have reported they have experienced at least one traumatic event in their lifetime. This discrepancy is due to the fact that being exposed to a traumatic event does not in any way mean that you are going to develop PTSD. Factors that contribute to the likelihood of someone developing post-traumatic stress disorder include: a preexisting mental or physical health condition, dissociation during trauma, type of trauma, gender (women are 2x as likely to develop PTSD), age, marital status, support systems, and experience of additional stressors after the trauma. One type of PTSD is classified as dissociative, which includes the presence of persistent depersonalization or derealization symptoms. Depersonalization is like dissociation, where one experiences something as if they are an observer. Derealization on the other hand refers to feeling as if the things around you are not real, and you are disconnected from the world around you. PTSD can also have a delayed onset aspect, which means that one could develop PTSD years after the traumatic event has occurred.

PTSD has four main symptom groups which are as follows:

  1. Intrusive Symptoms
    1. Frequent thoughts or memories of the event
    2. Recurrent nightmares
    3. Flashbacks
    4. Strong feelings of distress
    5. Increased heart rate or sweating when reminded of the event
  2. Avoidance
    1. Avoiding thoughts, feelings, or conversations about the event
    2. Actively avoiding places or people that remind you of the trauma
    3. Keeping yourself too busy to have time to think about the traumatic event
  3. Hyperarousal
    1. Difficulty falling asleep
    2. Irritability
    3. Outbursts of anger
    4. Difficulty concentrating
    5. Hyperactive startle response
  4. Negative Thoughts and Beliefs
    1. Difficulty remembering important aspects of the trauma
    2. Loss of interest in important and positive activities
    3. Feeling distant from others
    4. Inability to have positive feelings
    5. Feeling as though your life may be cut short

For information regarding the treatment of PTSD, please refer to the article titled, PTSD Treatment.

Sources:

https://www.webmd.com/mental-health/post-traumatic-stress-disorder#1

PTSD Treatment

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PTSD Treatment

by Sam Matthews

When treating PTSD, there are a few different evidence based therapies that can be used, including psychotherapy and medications. This article will focus on those that are classified as cognitive behavioral therapies.

  1. Trauma-focused CBT
    1. Challenging and changing automatic unhelpful, inaccurate thoughts (cognitive distortions)
    2. Gradual and safe exposure to trauma
  2. Cognitive Processing Therapy
    1. Challenging and changing upsetting thoughts that perpetuate the trauma
    2. Includes writing a detailed account of the trauma and reading it in front of the therapist and at home
    3. Therapist helps you challenge problematic beliefs around safety, trust, control, and intimacy
  3. Cognitive Therapy
    1. Challenges and reframes pessimistic thoughts and negative interpretations of the event
    2. Work through the trauma and suppressed thoughts
  4. Prolonged Exposure
    1. Gradual and safe exposure to the trauma by discussing the details of what happened
    2. Recording of your recount so you can listen to it later
    3. Involves facing situations, activities, or places that remind you of the trauma
    4. Done slowly and systematically
    5. Breathing techniques learned to alleviate anxiety
  5. Eye Movement Desensitization and Reprocessing
    1. Imagining the trauma while the therapist asks you to track their fingers as they move them back and forth in your field of vision
    2. Allows you to pull everything out of your memory in a controlled manner and then back in the way non-traumatic memories are stored
    3. Does not require you to describe the trauma in detail, spend an extended time on exposure, challenge specific beliefs, or complete assignments outside of therapy sessions
  6. Brief Eclectic Psychotherapy
    1. Combines CBT with psychodynamic psychotherapy
    2. Discuss the traumatic event
    3. Teach various relaxation techniques to decrease anxiety
    4. Therapist helps to explore how the trauma has affected how you see yourself and the world
    5. Encouraged to bring someone who supports you to your sessions
  7. Narrative Exposure Therapy
    1. Create a chronological narrative of your life
    2. Helps to recreate an account of the trauma in a way that recaptures your self-respect
    3. You receive a documented biography written by your therapist at the end of treatment
    4. Typically done in small groups

For more information on Post-Traumatic Stress Disorder, please refer to the article titled, Post-Traumatic Stress Disorder.

Sources:

https://www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder#1

 

Anxiety and Politics

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by: Sam Matthews

The political climate in today’s day and age could certainly cause fear and anxiety for anyone in America. It is important to note that both fear and anxiety activate one’s attachment system. Your attachment system has evolved in order to allow you to develop strong relationships with your parents and peers, not engage in modern day political battles. This is because the system cannot differentiate between actual physical threats and imagined ones, causing it to be triggered when thinking about politics. We most commonly think about attachment figures being real people who we come into physical contact with, but a political figure or institution can easily become a symbolic attachment figure. This political figure can psychologically come to represent something that can protect you from threats and decrease your anxiety. When attachment styles are activated, they can bring out the worst in the part of the population that is insecurely attached, which in America is 45%. This situation has the potential to damage relationships, and could even bring on even more destructive behaviors. As mentioned, these problems trigger the attachment systems, causing the conflict to become more than just a superficial argument about politics, but an emotional issue, which cannot be solved through rational arguments and debates. It is normal to have anxiety about what is to become of the country you reside in, but the best recommendation one could give is to take a step back and all time to pass, and yourself to explore.

 

Sources:

https://www.psychologytoday.com/us/blog/the-freedom-change/201811/attachment-theory-elections-and-the-politics-fear

https://www.sharp.com/health-news/how-stress-over-politics-affects-your-health.cfm

Drug Abuse: Preventing Teen Drug Abuse

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By: Toni Wright

Many teens are curious and experiment with drugs, whether due to peer pressure, stress at home, or just curiosity. According to Drugrehab.com in 2016 about 1.9 million youths ages 12 to 17 used an illicit drug in the past month. In addition to that, in 2016 1.4 million teens needed treatment for an illicit drug abuse problem. What many young teens don’t know in hindsight, or thoroughly think about, is that trying those drugs can have lasting long term effects that can change their lives forever.

Warning Signs:

  1. Changes in choice of dress
  2. Loss of interest in what they enjoyed (hobbies or activities)
  3. Decline in academic performance (failing classes, poor grades, skipping class, etc.)
  4. Recurring arguments, unexpected mood changes, and unspecified violent actions.

Family Influence

Parents, prevention can start within the household:

  1. Ask your teens perspective on drugs – Don’t lecture. Actively listen to your teens views on drugs. Reassure them that they can be open and honest with you.
  2. Discuss the negative impact drugs use can have – Emphasize how drugs can impact the things your teen cares about. For instance, health, appearance, school performance, etc.
  3. Go over ways to not give into peer pressure – Come up with different ways your teen can say “no” to drugs.

Overall, parents, you play a crucial role in your teen’s life. Provide support for your teen. Having a solid foundation between you and your teen may make them less likely to use drugs.

If you or a teen you know abuses drugs, 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 http://www.counselingpsychotherapynjny.com/.

Sources:

https://www.centeronaddiction.org/addiction-prevention/teenage-addiction

https://www.drugrehab.com/teens/

https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-drug-abuse/art-20045921

Image Source:

https://www.palmerlakerecovery.com/blog/signs-of-drug-abuse-in-teenagers/

A Substance Abuse Guide for Parents

 

 

Grieving Vs Persistent Complex Bereavement Disorder

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Grieving Vs Persistent Complex Bereavement Disorder

By: Karime Herrera

Coping with grief can be difficult. You are in complete disbelief that your loved one, family or friend is no longer a phone call away. When grief begins to drastically disrupt your life, it is best to seek professional help.However, some people might not know when it is necessary to seek help. At what point does grief turn into persistent complex bereavement disorder? Persistent complex bereavement disorder is when an individual has been experiencing severe grief symptoms for over twelve months. Some symptoms that a person with PCBD encounters are trusting people, hallucinations of the person who has passed away, suicidal thoughts, loss of interest in preforming daily tasks, and constant feelings of sadness. If you are experiencing these symptoms for an extreme period of time it is best to see a psychologist in order to help you cope with your loss. A licensed practitioner can treat PCBD with cognitive therapy, mindfulness, psychotherapy or a combination.  Mediation might be helpful in relieving the symptoms and often helps individuals suffering from PCBD continue with their daily lives.