Obsessive Compulsive Disorder (OCD) / Tics

Tourette Syndrome

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By: Dianna Gomez

Tourette Syndrome is a type of tic disorder. A tic can be classified as an involuntary, repetitive movement or vocalization. Those diagnosed with this disorder will either suffer from vocal/phonic tics or motor tics. In general, vocal/phonic tics produce a sound. Examples of vocal/phonic tics include things such as sniffing, throat clearing, grunting, and shouting. Examples of more complex vocal/phonic tics include full words or phrases. These words or phrases are always out of context and may or may not be recognizable. In 10-15% of cases, words blurted out may be inappropriate such as curse words, ethnic slurs, or other words or phrases that are not viewed as socially acceptable.

Motor tics, generally, are movements. Examples of motor tics include eye blinking, shoulder shrugging, head jerking/bobbing, facial grimacing, etc. More complex motor tics include movements that involve multiple muscle groups at once. Examples of these movements are things such as hopping, jumping, twirling, etc.

While the exact cause of Tourette Syndrome is unknown, it has been confirmed that it is hereditary so genetics may play a role. There are, however, some treatment options that are available to help ease the symptoms. Medications for tics include Haloperidol, Pimozide, and Aripiprazole. Speech therapy is also another form of treatment for those with tics. Lastly, Deep Brain Stimulation (DBS) is another method of treatment for tics. DBS is a relatively new procedure that utilizes an implantable electrode to alter the activity of brain circuitry.

If you or someone you know is suffering from Tourette Syndrome, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can help you. 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 us at https://www.counselingpsychotherapynjny.com/.

Assertiveness and Anxiety: How Expressing Yourself Can Lead to a Happier Self

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By: Sanjita Ekhelikar

“Communication is key” is a phrase we are all familiar with, yet many struggle with actually acting on it. The most effective form of communication is through assertiveness, which involves expressing one’s views in a straightforward manner, and in standing up for one’s needs while still being considerate of others. This differs from aggressiveness in that it does not involve being outwardly emotional or insulting to others, and differs from passivity in that the individual clearly states their feelings and desires. Being assertive involves open communication, which can be difficult to engage in, especially for people struggling with anxiety. However, through practicing and learning assertiveness, people with anxiety can actually feel less worry and more confident in themselves.

Anxiety describes the uncomfortable feelings of turmoil and dread that one might have in anticipation that results in physical sensations such as rapid heartbeat, sweating, and rumination. For many who struggle with anxiety, the thought of being assertive with others makes them anxious. They often worry that being assertive will come off as being mean, creating conflict, and being inconsiderate. Therefore, many choose passive communication, and never voice their views or feelings. This worsens their state of worry, as they are not properly understood by those around them and can easily be taken advantage of. They are often misunderstood which increases their worry. Others often take advantage of them because of their meek manner and visible anxiety.

Contrary to what those with anxiety believe, assertiveness can actually help them feel better. Often times, those with anxiety create situations in their mind about everything that will go wrong if they voice themselves to another person. However, such a form of open communication can create a better understanding between two people. It allows the person with anxiety to be properly understood, to dispel the fearful thoughts in their head, and become more confident in themselves and their views.

How can people with anxiety begin working towards being more assertive? By stating their views using “I,” individuals can avoid putting blame on others by expressing their own opinions. In addition, reminding themselves that their fears are not rational and that it is their anxiety talking to them can help them become increasingly comfortable with being assertive. Finally, practice makes perfect – keep trying and speak up!

If you or someone you know is suffering from anxiety, 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/.

Body Image: Body Dysmorphic Disorder Treatment

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By Samantha Glosser

Body dysmorphic disorder, sometimes referred to as body dysmorphia or BDD, is a mental disorder characterized by preoccupation with imagined or markedly exaggerated imperfections or defects in one’s physical appearance. Those suffering from body dysmorphic disorder spend a significant amount of time every day obsessing over their appearance and engaging in repetitive compulsive behaviors in an attempt to avoid anxiety, distress, and hide their imperfections. Signs and symptoms include constantly checking one’s appearance, excessive grooming, over-exercising, picking skin, pulling hair, using makeup or clothing to camouflage one’s appearance, or even getting plastic surgery. Body dysmorphic disorder leads to significant impairment in daily functioning and quality of life. However, there are treatment options available.

Cognitive-behavioral therapy (CBT). CBT is short-term, goal-oriented therapy. In body dysmorphic disorder, CBT is used to decrease compulsive behaviors and the negative thoughts about one’s appearance. This is achieved through techniques such as cognitive restructuring and mind reading. Cognitive restructuring teaches the patient to challenge irrational thoughts about their bodies and replace them with more realistic and adaptive thoughts. In addition to their own negative thoughts, individuals diagnosed with body dysmorphic disorder also believe others hold the same negative thoughts about them. Mind reading allows patients to understand that other people do not share these thoughts about them and provides realistic alternatives. For example, that person staring at them at the mall was probably admiring their outfit. Another frequently used technique is exposure therapy. This requires patients to create a hierarchy of anxiety-provoking situations which they are then exposed to in order to overcome anxiety and distress.

Psychiatric medications. Research has also shown that antidepressant medications are an effective treatment for body dysmorphic disorder, specifically selective serotonin reuptake inhibitors (SSRI’s). SSRI’s that are commonly used for the treatment of body dysmorphic disorder include Lexapro, Prozac, Paxil, and Zoloft, among others. SSRI’s help to reduce obsessional thinking, compulsive behaviors, and depression, a common comorbid disorder among individuals diagnosed with body dysmorphic disorder.

If you or someone you know appears to be suffering from body dysmorphic disorder, or other problems associated with negative body image, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. 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 http://www.counselingpsychotherapynjny.com/

 

Source: Tartakovsky, M. (2016, July 17). Demystifying treatment for body dysmorphic disorder. Retrieved from https://psychcentral.com/lib/demystifying-treatment-for-body-dysmorphic-disorder/

Insomnia

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By: Dianna Gomez

Insomnia is a condition that makes it very difficult for a person to fall asleep and stay asleep throughout the night. Insomnia can be caused by medical conditions such as hyperthyroidism, or for psychological reasons such as anxiety, depression or intrusive thoughts. In addition to these possibilities, the type of lifestyle an individual chooses to live can also be responsible for creating symptoms of insomnia. There are a few things that people who experience insomnia tend to do that may be worsening their symptoms without them even knowing. Some examples of these lifestyle habits include:

  1. Taking Mid-Day Naps
  • Whether it is short or long, sleeping in the middle of the day can increase a person’s chances of having difficulty sleeping through the night. If you can, try to avoid taking naps all together.
  1. Sleeping In Late
  • When a person is lacking sleep, it isn’t uncommon for them to attempt to fix the problem by sleeping in later the next morning to make up for their “lost hours.” However, by doing so, you are confusing your body clock which then makes it difficult to fall asleep at a regular time again the following night. This can quickly create a vicious cycle that is even harder to break.
  1. Taking Your Work Home With You
  • Regardless of what your occupation is, almost everybody has hectic daily schedules. When people are feeling behind on their work, they often decide to put in a little “over-time” by bringing their work home with them. By doing this, you make the process of “winding down” at night harder as your mind is kept wide awake and pre-occupied when it shouldn’t be.
  1. Using Electronics
  • Especially in today’s generation, it is extremely common for people to use their phones or laptops while lying in bed right before they intend to fall sleep. The problem with this, however, is that bright screens like those on our electronics actually stimulate the brain more and cause you to stay awake. This then makes it more difficult to fall asleep for the night.
  1. Working Irregular Hours
  • If you have a job that has you on various different “shifts,” sleeping may become a problem for you. If a person doesn’t stay on a regimented time schedule, their body clock cannot decipher when it should be waking up to take on a new day or winding down to get ready for bed.

 

If you have already tried reversing these lifestyle habits and still regularly experience symptoms of insomnia, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can help you. 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 us at https://www.counselingpsychotherapynjny.com/.

 

 

What is Trichotillomania?

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By Stephanie Osuba

Trichotillomania is a hair pulling disorder categorized in the Obsessive Compulsive and Related Disorders section in the DSM-5. It is one of the other Body Focused Repetitive Behaviors (BFRBs) – along with excoriation (skin picking) and onychophagia (nail biting) – in which the individual will pull, pick or bite at various parts of the body resulting in damage.  Symptoms include recurring hair pulling, hair loss, and related stress and impairment because of the behavior. The disorder is not considered self-mutilation like cutting or burning because the behavior is not intentional and research suggests that there is no connection between the disorder and unresolved trauma. Often people are ashamed of the behavior and their resulting appearance because of it and try their hardest to stop. Comorbidities include, tic disorders, mood disorders, and anxiety disorders, although, trichotillomania can also occur in the absence of any other psychopathology.  The regular age of onset is between the ages of 11 and 13, however, baby trichotillomania is a rare phenomenon that seems to go away as the child grows older. Research also suggests that the disorder is primarily genetic as it appears in the first relatives of people with trichotillomania than it does in the general population.

Available treatments include cognitive behavioral therapy (CBT) and habit reversal training (HRT) with adjunctive dialectal behavioral therapy (DBT) and acceptance and commitment therapy (ACT). These therapies help the person to be aware of the pattern of the behavior and helps to identify triggers to pulling. It also teaches methods to redirect that urge to pull into a new healthy pattern of behavior in order to reduce or eliminate the urge. While there is no FDA-approved medication specifically for BFRBs, research is being conducted. OCD medication such as selective serotonin reuptake inhibitors (SSRIs) and anafranil can help alleviate symptoms as well.

Sources: Deibler, M. W., Psy. D. (n.d.). Trichotillomania (TTM) and related Body-Focused Repetitive Behaviors (BFRBs). Retrieved from http://www.thecenterforemotionalhealth.com/trichotillomania-and-related-disorders

Zwolinski, R., LMHC. (2013, October 03). Cause And Treatment Of Trichotillomania. Retrieved from https://blogs.psychcentral.com/therapy-soup/2012/04/cause-and-treatment-of-trichotillomania/

If you or someone you know appears to be suffering from trichotillomania, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. 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 http://www.counselingpsychotherapynjny.com/.

Panic Attacks and Anxiety

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By: Dianna Gomez

Panic. Worry. Fear. Helplessness. What is wrong with me? Why am I feeling like this? Why is my heart beating out of my chest? Am I dying? Why can’t I make it stop?!

For some of us, these emotions are all too familiar. Anxiety can be a scary thing, especially when you’re not totally up-to-date on what exactly it is. What are you to do when you feel like your whole world is crashing down around you and there’s nothing you can do to stop it? Well, have no fear because I have a few helpful tips to share!

 

Here are 5 things that you can do to calm yourself down when suffering from an anxiety attack:

  • Take Deep Breathes

Inhale. Exhale. Tell yourself that although it may not feel like it right now, everything will be okay.

  •  Talk Yourself Down

Repeat a calming/kind phrase to yourself OUT LOUD. Remind yourself that you are safe, loved, and never alone.

  • Seek Help

Sometimes we tend to insist that we can get through tough times all on our own, but there is no shame in asking for help. Whether it be a neutral professional, a loved one or someone you trust, find someone with whom you can talk out your troubles.

  • Use Music and Visuals

Never underestimate the power of calming music and visuals. Whether it be classical music, peaceful nature videos/sounds, or your favorite John Mayer song – let the music play and your worries float away!

  • Put Your Anxiety on Ice

Create sensory stimulation by gently sticking both of your hands into a bowl of very cold water with ice. The more ice the better.

 

If either you or anybody you know suffers from anxiety, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can help you. 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 us at https://www.counselingpsychotherapynjny.com/.

 

 

 

 

OCD: Supporting a Loved one with OCD

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By: Sanjita Ekhelikar

It can be devastating to see a loved one suffer through a mental illness. This holds very true for loved ones of individuals afflicted with Obsessive Compulsive Disorder, or OCD. OCD is a ruthless anxiety disorder that traps people in repetitive thoughts or rituals. The disorder is characterized by irrational thoughts, or “obsessions,” that people have, which are addressed through “compulsions,” or behaviors to appease the thoughts. Obsessions and compulsions can range from concern over hygiene or safety, resulting in recurrent handwashing or checking locks on doors, or clarifying meanings with other people, which result in repeating words and phrases. An attempt to resist the compulsion leads to extreme feelings of anxiety, which are extremely unpleasant.

Individuals with OCD are constantly fighting their minds every single day, and fighting the urge to give in to the compulsions while also experiencing anxiety. As a family member or loved one of the effected individual, it can sometimes be difficult to know how to best be supportive and help the significant other overcome their OCD. Here are a list of tips to support a loved one struggling with OCD:

  1. Do not accommodate the OCD. A large part of this illness involves the individual asking for reassurance or wanting to continuously repeat an action or phrase until the OCD is “satisfied.” While it may seem like giving them the reassurance is the nice thing to do, this actually worsens the condition. Reassurance may remove anxiety for a short amount of time, but allows the OCD to continue to take over and keeps the individual under the control of OCD.
  2. Uncertainty is key. When presented with the previous situation about being asked reassurance, the best thing to do is leave the individual with uncertainty. This will result in them feeling anxiety, which may be hard to see, but is crucial in their resisting the compulsions and in the long run overcoming the OCD. When asked for reassurance, simply do not respond, or say “this could be true, but I don’t know for sure.” Uncertainty = anxiety = healing.
  3. Be compassionate. While you should be firm in not giving reassurances, be compassionate, empathetic, and understanding of your loved one. OCD is tiring, and the individual does not want to be asking you for reassurances or fighting with their mind. Be caring and loving to them.
  4. Educate yourself! The more you can learn about OCD, how it works, and its symptoms, the more effective you can be in helping your loved one and in tackling the illness together.
  5. Maintain your own life. It can be a natural thought to want to take time from work or school to help a loved one with OCD and to be around them. Do NOT do this – it is important to take care of yourself, have your own life and space, and not cater everything around the OCD. Your loved one will feel guilty if you are giving up things to take care of them, and you will soon tire out and not be effective in helping. OCD can be a trying disease to overcome, but with the correct treatments and proper support, it can be overcome. By knowing the best ways to be supportive of your loved ones, you can facilitate the process of their working towards a life free of OCD.

If you or someone you know is suffering from obsessive compulsive disorder, 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/.

Hypochondria: Somatic Symptom Disorder

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Alice Cordero

A condition once called Hypochondria now falls under the name Somatic Symptom Disorder. Somatic Symptom Disorder is characterized as extreme focus on physical symptoms. When one places extreme focus on physical symptoms – such as fatigue and pain- the individual usually experiences emotional distress and problems functioning in their daily lives.

Those diagnosed with somatic symptom or hypochondriasis disorder often consider the worst case scenarios about their symptoms, which often leads the individual to frequently seek medical care. The individual’s health concerns become such a crucial focus in their life that they in fact become disabled.

Symptoms of somatic symptom disorder may include:

  • Sensations in a specific area ( whether that be shortness of breath or pain) or more general sensations, like weakness and fatigue
  • Excessive thoughts, feelings, behaviors and worrying
  • Checking the body repeatedly for any sort of abnormalities

When one is diagnosed with somatic symptom disorder it is important to keep a positive outlook, because stress and negativity pave the way for the development of symptoms. Those with a history of substance abuse and high levels of sensitivity to pain are commonly seen with this condition.  Anxiety, depression, and OCD are conditions that are often diagnosed as accompanying somatic symptom disorder.

For somatic symptom disorder treatment normally involves cognitive behavioral therapy, mindfulness- based therapy, and medication such as antidepressants. With the proper treatment research has revealed that recovery is possible using the proper strategies to eliminate as much pain as possible.

If you or a loved one appears to be suffering from Somatic Symptom Disorder (Hypochondriasis), the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. 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 us at http://www.counselingpsychotherapynjny.com/

Neurofeedback

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Leah Flanzman

There has recently been a great deal of discussion on a psychological treatment called neurofeedback. Neurofeedback assists people in consciously controlling their brain waves by attaching subjects to an EEG machine that extracts various brain-activity components and feeds them back to the patient.  The most common protocols used in neurofeedback training are alpha, beta, theta, and alpha/theta protocols.  The way that you select the placement of electrodes on a patients head depends on their specific brain functions and specific symptoms.  The goal is to allow the subject to assess their progress and adjust their brain waves accordingly to achieve optimal performance.  However, the effectiveness and practicality of the treatment is under debate.

According to the Basic and Clinical Neuroscience journal, many studies conducted on neurofeedback therapy reveal methodological limitations that question its effectiveness. For example, with the alpha treatment protocols, it remains unknown exactly how many treatment sessions are necessary before patients can consciously possess the ability to control their alpha waves.  Once an optimal performance is achieved, it’s difficult to study the long-term effects of these treatments, in other words how long the effects last without feedback.

The pros of neurofeedback are that it’s a safe and non-invasive procedure that has been proven effective in treating certain disorders such as ADHD, anxiety, depression, epilepsy, insomnia, drug addictions, and learning disabilities. Despite this, more scientific evidence of its effectiveness must be conducted before we can consider it a valid treatment.  It’s also important to keep in mind that it’s a very expensive procedure that is not covered by many insurance companies, and is very time consuming to complete.

If you or someone you know thinks they have ADHD, anxiety, depression, or drug addictions, or learning disabilities, the psychologists, psychiatrists, and psychotherapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.counselingpsychotherapynjny.com for more information.

Hoarding Disorder: The Psychology of Hoarding

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By: Heather Kaplan

Hoarding is defined as the persistent difficulty discarding or parting with possessions, regardless of their actual value. This behavior brings about detrimental emotional, physical, social, financial and legal effects for the hoarder and their loved ones. Commonly hoarded items may be newspapers, magazines, plastic bags, cardboard boxes, photographs, food and clothing – items of little value to most but have extreme value to the hoarder. Even the mere thought of throwing these items away causes a hoarder extreme anxiety and distress. Hoarding ranges from mild to severe – often the hoarding can become so extreme that the home of the hoarder becomes almost inhabitable which results in increased risk of getting evicted.

There are various reasons why hoarders exhibit the behavior they do. People hoard because they believe that an item will become useful or valuable in the future. They also may feel that the item has sentimental value or is too big of a bargain to throw away. Hoarders try to justify reasoning for keeping each possession that they own. It is still unclear what causes the disorder; genetics, brain functioning and stressful life events are being studied as possible causes. Studies show that there is hyperactivity in the area of a hoarder’s brain that involves decision-making, which explains the stress associated with discarding their possessions.

Those who suffer from hoarding disorder experience a diminished quality of life. As stated before, a lack of functional living space is common amog hoarders. These living conditions can be so severe that they put the health of the person at risk. Hoarders also often live with broken appliances and without heat or other necessary comforts. They cope with these issues because of the shame they would feel if a person was the enter their home. Hoarding also causes anger, resentment and depression among family members and can affect the social development of children. Unlivable conditions may lead to separation or divorce, eviction and loss of child custody if applicable.

It is important to distinguish the difference between hoarding and collecting. Collectors have a sense of pride about their possessions and experience joy in displaying and talking about them. Their collections are often well-organized and well-budgeted. A hoarder collects a multitude of items and organizes them in a cluttered way. They are ashamed of their accumulations and do not feel a sense of pride when showing their belongings to others.

If you or a loved one suspects a hoarding disorder, the psychiatrists, psychologists, psychiatric nurse practitioners, social works and psychotherapists at Arista Counseling & Psychotherapy are here to help. Contact our Paramus, NJ and Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment.

Sources:

https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics

https:/www.mayoclinic.org/diseases-conditions/hoarding-disorder/symptoms-causes/syc-20356056