Anxiety: Exposure Therapy Helping Teens Combat Anxiety

By Hannah Pierce

Exposure therapy is a cognitive-behavioral therapy technique in which a person is exposed to a feared object or situation to overcome their anxiety. A majority of researchers and clinicians believe that exposure therapy is the most effective treatment for many anxiety disorders. One study even found that people improved more using this technique than taking antidepressants.

Although exposure therapy is proven to be very effective, it is not frequently used with teens. Many teens suffering with anxiety are prescribed medication rather than receiving therapy. It is difficult for people to consent to exposure therapy because they do not want to do something that will make them feel even more anxious.

One article documented teens’ experiences with exposure therapy. A 14-year-old suffering from social anxiety, depression, OCD, and binge-eating agreed to tackle his social anxiety through exposure therapy. On a busy college campus he sat on a bench next to a stranger and initiated a conversation. To some people this may seem simple but to a teen suffering from social anxiety, the task is very daunting. He sat on the bench and tried to talk to the stranger but the stranger just kept texting and playing with his phone. Although the exchange did not turn into a conversation, at least the teen faced his fear and realized it wasn’t that bad.

Another teen’s exposure involved him holding a sign that read “I’ve been bullied. Ask me.” Thomas hoped to combat his anxiety while also educating people on bullying. Most students on the campus walked by him without giving him a second glance. After a while, a couple stopped to talk to Thomas. The man empathized with him, sharing that he had been bullied as well and the woman applauded Thomas for his bravery.  After the exchange Thomas was very pleasantly surprised and realized he did not have much to be so anxious about.

If you or someone you know may be experiencing anxiety, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.

Source: “The Kids Who Can’t” by Benoit Denizet-Lewis


OCD: What It’s Really About

By Miranda Botti

Obsessive-Compulsive Disorder, or more commonly referred to as OCD, is a psychological disorder in which those afflicted experience recurring distressing, intrusive thoughts, images or impulses (obsessions) and attempt to remedy and alleviate such thoughts with repetitive actions (compulsions).  Such intrusive, repetitive thoughts are often constant worries about one’s health or the health of family members or loved ones, as well as fears about bad things happening to loved ones. Common compulsions include but are not limited to: repeatedly checking things, such as if an oven is off or if a door is locked, excessively cleaning oneself and/or handwashing, and compulsive counting. Many OCD patients are able to understand that their thoughts are irrational and unlikely to be remedied by their compulsive actions but continue to struggle to control their obsessions. Most people are typically diagnosed with OCD in their late teens to early 20’s, although onset at any age is possible.

The knowledge of the causes of Obsessive-Compulsive Disorder is still yet to be discovered however, risk factors include: genetics, brain structure and functioning, and/or the environment. Treatments include medications that act to inhibit the reuptake of the neurotransmitter called serotonin (SRI’s and SSRI’s), as well as the less frequently prescribed antipsychotic medication; psychotherapy such as cognitive behavioral therapy (CBT); the approach of a combination of medication and psychotherapy. Research for treatment of OCD is up and running and clinical trials look to determine the effectiveness and safety of new treatments in order to help individuals in the future.


If you or someone you know is suffering from OCD, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and 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, visit


Information taken from:

What exactly is a “Panic Attack”?

by Sarah Moore

Panic Attacks: What are they?

We’ve all heard of panic attacks before, on television, in the movies and even in day-to-day conversation. In today’s age, people tend to use the term lightly, as an expression of a reaction to a stressful event or fearful encounter. One might say, “When I heard that the company was planning to downsize next year, I just about had a panic attack”. But to use the term this way does not describe what a panic attack truly is: a sudden, unexpected feeling of overwhelming and disabling anxiety, often with no premeditating cause.

So what exactly does a panic attack involve? The DSM-5 defines a panic attack as involving four (4) or more of the following symptoms:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • A feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Feelings of unreality (derealization) or being detached from oneself (depersonalization)
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensations
  • Chills or hot flushes

While it’s true that anyone can experience a panic attack, they are most commonly associated with Generalized Anxiety Disorder, Post-Traumatic Stress Disorder or Specific Phobias. Does this mean someone who experiences a panic attack has one of these conditions? Not necessarily. The DSM-V defines the diagnostic criteria for Panic disorder as suffering from frequent, often unexpected panic attacks. In addition, at least one attack must be followed by the fear that more attacks will occur, causing an individual to change his or her behavior in order to avoid triggering such attacks. It is important to note that other possible causes for panic attacks, such as side effects from drugs or medications must be ruled out before someone can be diagnosed with any of the above disorders. Panic attacks can be debilitating, but with the right treatment, recovery is possible.

If you believe that you or a loved one has or may be suffering from panic attacks, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.

Obsessive Compulsive Disorder: What is it?


Obsessive Compulsive Disorder: What is it?

By: Daniela Chica

Obsessive compulsive disorder (OCD) is characterized by prolonged intervals of repetitious and undesired thoughts and compulsions. About 2.2 million Americans live with OCD and 1/3 of people who develop the disorder first experience symptoms as children. Obsessive compulsive disorder can be a lifelong condition if left untreated and it can limit people’s ability to function in everyday life. Because OCD is an anxiety disorder, deviating from usual compulsions and obsessions can cause great distress. Some common symptoms of OCD are:

  • Having repetitive thoughts or urges about a wide range of issues such as neatness, germs or violence
  • Engaging in repetitious behavior such as washing one’s hands, hoarding, or locking doors
  • Getting no satisfaction from engaging in one’s repetitious behavior, but still getting some form of relief from the anxiety caused by obsessive thoughts
  • Spending at least an hour daily on repetitious behaviors and thoughts that affect one’s normal functioning

Although there is still much to know about obsessive compulsive disorder, researchers believe that biological factors increase the risk of developing the disorder. One is also more likely to develop the disorder if a first degree relative is diagnosed with the disorder. Abuse in childhood and trauma of any sort are often linked to OCD.

If you or someone you know has obsessive compulsive disorder and needs help, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and 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, visit


Snapchat Culture

By: Emily Mulhaul

Lights flashing, music blasting, society Snapchatting.

Unbeknownst to many, an external appearance doesn’t always match up with an internal experience. To further explain, just because on the outside someone seems they are having fun, does not always mean internally they are having fun. This knowledge can act as a relaxant to combat the initial jealousy of binge watching other’s Snapchat stories; However, if you find yourself “doing it for the Snapchat” (we all have) and are sensing incongruity with the way you appear on Snapchat and feel in reality, it may be time to look inside yourself. If “the struggle is becoming too real” and you’re at the point where you want to feel the way you appear on Snapchat, or experience the perceived feelings of other’s but have absolutely no idea where to start, talking it through with a licensed professional could guide you towards genuinely feeling these positive emotions.

The experienced psychiatrists, psychologists, psychiatric nurse practitioners, social workers, and psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.




Anxiety: College Students in Bergen County, NJ


By: Adrienne Sangalang

High schools seniors have conquered their SATs and college applications; however, they continue to face hurdles throughout life, especially during their first year at college. According to the National Alliance on Mental Illness, 1 in 2 students on college campuses have been so anxious that they struggled in school. These anxious moments may be more than just college jitters. They may be symptoms of an anxiety disorders such as panic disorder, obsessive-compulsive disorder or social anxiety disorder. Fortunately, a majority of colleges have on-campus mental health services with psychiatrists, psychologists and clinical social workers.

The Counseling, Alcohol and Other Drug Assistance Program and Psychiatric Services organization at Rutgers University promotes community-based mental health prevention, provides clinical care and supports the aftermath of critical incidents. The difficulty of applying to colleges is such a small amount when compared to balancing a social life, sleeping eight hours a night and getting good grades. College students refer to these three items on a triangle diagram in which they can only “choose” two of the three.

Though friends can act as a useful shoulder to lean on for stressful exams and bad professors, they don’t provide you with the necessary treatment. One advantage of mental health clinicians is that they can determine whether or not you need extra time for assignments and exams. This can be a crucial step in helping you achieve the grade you deserve! For high school seniors who are ready to embark on your college adventure, don’t be afraid to walk-in to your campus mental health clinic when you feel anxious about your new environment.

If you are a high school senior feeling anxious about your transition into college or a current college student overwhelmed by the stressors of college, the psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Comments are welcome

Obsessive Compulsive Disorder

If your daily life is hindered as a result of your obsessions and compulsions, you may have Obsessive Compulsive Disorder (abbreviated as OCD). A person with OCD experiences frequent upsetting thoughts (aka obsessions) that they try to combat and control by performing ritualistic behaviors (aka compulsions). It is important to note that healthy people who do not have OCD can also have rituals, but the difference in people with OCD is that their rituals cause them great distress and interrupt their daily life. Examples of common rituals that people with OCD perform include excessive hand washing, locking and unlocking their locks multiple times before leaving, skin picking, pulling out hair (trichotillomania) and combing their hair compulsively; as you can see, these compulsions can clearly hinder one’s daily life. These rituals, which are repetitive and uncontrollable, are carried out in order to get brief relief from the anxiety one’s compulsions can cause.

Although these repetitive behaviors occur as a result of one’s obsessions, scientists are not certain what the exact causes of OCD are. However, they do hypothesize that genetics do play a major role in the development of this disorder and possibly environmental stressors as well. OCD typically develops in the childhood/teenage years, as most people who have it are diagnosed by the age of 19. And although OCD tends to be a lifelong disorder if left untreated, the exact course varies. Most people do control it with the proper treatment. Since it is co-morbid with other disorders such as eating disorders, anxiety disorders or depression, one can also find great relief by getting the co-occurring disorder treated as well. As far as treatments for OCD go, similar to the treatments available and recommended for many other disorders, medications and the use of psychotherapy work best. If you suspect you or someone you know has OCD, it is urgent that you contact a mental health specialist to first determine whether or not you or your loved one has it, and second to find the best treatment option available.

If you believe that you are a loved one has or may have OCD, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Contact our Bergen County, NJ or Manhattan offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment. Visit for more information.


By: Shivani J. Patel

OCD: Obsessive Compulsive Disorder – What It’s Like to Live with a Neat Freak

obsessive-compulsive-disorder-neat-freakWe’re all aware of those three little letters that when put together can cause serious problems: OCD. Things that people do in their everyday life, like wash their hands and clean their rooms become harrowing tasks due to their intrusive thoughts and repetitive behaviors. OCD, or Obsessive Compulsive Disorder, is an anxiety disorder that traps people in obsessive thoughts and ritualistic behaviors that can be completely disabling. This, however, is very different from a neat freak.

Usually, neat freaks’ overbearing concern about order could be a “shadow syndrome” of OCD, a mild, indistinct expression of OCD. “Neat Freaks” often have certain areas in particular where they’ve set extremely high standards for neatness, and while they could be really aggravating to live with, their neatness does not impair or incapacitate them as it would someone suffering from OCD. For example, they could care less about the mess in the living room, but if one book is out of place in their office, it’s surely a sign of apocalypse and their impending doom.

Any sign of disarray in the areas that neat freaks hold dear troubles them because it signifies for the person a lack of control. Neat freaks are often synonymous with control freaks, and while their actions can be far less debilitating than those with OCD, it may be causing that person stress and anxiety. If you or a loved one live in Manhattan or Bergen County New Jersey and are suffering from unwanted stress or anxiety due to trying to maintain order and cleanliness, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can assist you. Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment.  Visit for more information.


By: Tiffany Moore


What is postpartum depression? Many mothers will feel anxious, restless, irritated and sad for the first few weeks after giving birth. However, when those symptoms do not go away it becomes postpartum depression, “Postpartum depression will usually occur within four to twelve weeks after giving birth, although it can take up to a year to develop.” This disorder can go untreated because of how fast or slow it can develop. Some women do not even realize that they are depressed still because they assume it is just their hormones.

Recent studies have shown that women, who have had previous disorders, are more likely to develop postpartum depression, “Two-thirds of women with postpartum depression had a comorbid psychiatric disorder. In more than 80% of these cases, the women also had an anxiety disorder.” Some women may develop postpartum depression if they have a disorder before having a child, will increase their likely hood of developing postpartum depression. Women who do have postpartum depression will have all the symptoms of depression, which include fatigue, isolation and even thoughts of suicide. Some have even attempted to commit suicide.

If you feel that you are experiencing any symptoms of depression after having your child, tell your doctor. Also, if you do have any disorder ranging from anxiety to bipolar disorder, tell your doctor. Therapy and the right medication can help with postpartum depression once it has been diagnosed.


Joannides, P. (2013, March 22). Postpartum Depression Is Common and Often Untreated. Retrieved December 3, 2014, from


Obsessive Compulsive Disorder: The various ways in which OCD shows itself – Bergen County, NJ

By: Davine Holness

obsessive compulsive disorder bergen county new jersey

Obsessive Compulsive Disorder: Though excessive cleaning is a common and oft-publicized symptom
of OCD, the disorder can manifest in many other ways as well- Bergen County, NJ

Obsessive-Compulsive Disorder (OCD) is an anxiety disorder which has gained publicity from shows like “Monk” and “Girls,” as well as movies like “The Aviator” and “As Good as it Gets.”  OCD is characterized by intrusive thoughts causing uneasiness or fear (obsessions), accompanied by ritualized behaviors to alleviate that anxiety (compulsions).  Everyone has their quirks, and superstition is common.  However, an individual may be diagnosed with OCD if these symptoms fall out of the normal range of worry and superstition, if he or she is spending a lot of time on these behaviors, or if the symptoms have a significant negative impact on the individual’s performance and quality of life.  While people with the disorder share this basic framework, OCD comes in several different symptom subsets.  Some are less common and harder to recognize as Obsessive-Compulsive Disorder than others.  Here are some of the different types in which OCD presents itself.

Washing is one familiar kind of Obsessive-Compulsive Disorder, in which the affected individual fears contamination from some object or person.  This behavior is way out of proportion with the actual danger presented by the substance or individual that is the object of obsession.  Due to an obsession that contact will have an extreme adverse outcome, the individual’s behavior will include avoidance and/or compulsive washing.

Cleaning is like washing, but the obsession is directed at a place (such as a room) rather than an object or person.  The individual cleans (often in a ritualized manner) to reduce the stress that coming into contact with a particular place induces in them.

Checking, another well-known symptom subset, is preoccupation with making sure.  This can come in the form of checking that an action has been carried out (the gas range has been turned off, the door has been locked, etc.), but checking can be directed toward concepts as well.  Individuals may repeatedly ask if something is safe or if they still have the support of a loved one.

Hit and Run OCD is less common than the types previously mentioned, but its particular set of symptoms has presented commonly enough to warrant separate mentioning.  Individuals with this kind of Obsessive-Compulsive Disorder exhibit checking behavior, but the obsession is that they may have unwittingly hit someone while driving.  They repeatedly retrace the path they have driven to look for bodies or emergency vehicle activity.

Sexual obsessions make up another symptom subset.  The most common instances are when an individual with OCD experiences prevailing fear he or she they may be homosexual or a pedophile.  This is in the absence of any prior instances of sexual arousal, fantasies, or behaviors that might indicate such a sexual preference.  This type presents a particular problem, as it can be difficult to decipher whether the individual is truly grappling with their sexuality or if is it unwarranted anxiety due to an obsession.

Fear of loss of impulse control is a rare sort of Obsessive-CompulsionPeople with this sort of OCD are obsessed with the idea that they might have a spontaneous bout of temporary insanity.  This often presents itself as fear of jumping out of a moving vehicle, fear of blurting out something inappropriate in public, or fear of attacking a family member.  This fear is accompanied by safety behaviors such as steering clear of environments in which potentially embarrassing or dangerous situations could arise, or always having someone nearby to watch out for the affected person.

Obsessive-Compulsive disorder is an example of how one disorder can have varied clinical presentations.  The aforementioned symptom subsets are just a few of the ways a individual can experience OCD.  If you feel you may have OCD or another kind of excessive anxiety, feel free to contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists.  These, experienced therapists have successfully treated many patients suffering from Obsessive Compulsive Disorder.

Arista Counseling and Psychiatric Services (201) 368-3700 or (212) 722-1920

More detailed information can be found at



OCD. (2014, May 14). Wikipedia. Retrieved May 20, 2014

Weg, A. D. (2011, July 6). Living with OCD: The Many Flavors of OCD.Psychology Today. Retrieved May 20, 2014