Anxiety

Nightmares: Normal or Disorder?

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By: Sanjita Ekhelikar

We all know the horrible sensation of waking up in the middle of the night after a nightmare, a terrifying dream that occurs during the rapid eye movement (REM) stage of sleep. These dreams are a normal response to stressors in our life, and occur both during childhood and in adulthood. However, when nightmares occur regularly and lead to impairment of one’s cognitive and social functioning, they can develop into Nightmare disorder.

Nightmare disorder is characterized by frequent occurrences of fearful dreams which can interfere with development, functioning, and sleep. People with the disorder are constantly woken up with the detailed recall of dreams that feel like a threat to their survival or security. In addition, such individuals tend to awaken very easily, and have difficulty functioning throughout the day. They are not taking any substances which could lead to the increase in nightmares and, therefore, show signs of the disorder.

Many of the likely causes of Nightmare disorder include mental illnesses such as anxiety and depression, which cause people to stress throughout the day which can interfere with their sleep. In addition, any major life trauma can result in this growing distress. Finally, any sleeping disorder, such as narcolepsy, sleep apnea, or sleep terror, can cause increased nightmares.

If you are experiencing extreme, recurrent nightmares, do not hesitate to reach out for help and seek treatment. You can speak to a psychologist or take anti-depressant medication to address the issues behind these dreams and to better reduce the unpleasant symptoms. Aside from this, setting a routine during bedtime, making oneself comfortable, exercising during the day, doing meditation before bed, and sleeping until sunrise are ways to better relax and try to prevent nightmares. It is important to take care of yourself and your health, both when you are awake and alert AND when you are asleep.

If you or someone you know is suffering from nightmares, 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/

Self-Esteem and Shaming Parents

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By Stephanie Osuba

We have all felt, in one way or another, like we weren’t good enough or even felt embarrassed after making a mistake at work. This is healthy in that we are expressing sadness or just reflecting on a situation that could have been handled differently, but we move on and eventually feel valued and confident again. However, for some, that feeling of shame and guilt never goes away. Some believe they are inherently flawed, worthless, and inferior to everyone else. These negative emotions and lack of self-esteem are largely rooted in repeated childhood and adolescence trauma that is often left unprocessed. Internalization of this emotional abuse leads to a conditioning of sort, usually by the primary caregiver, that the negative emotions constantly felt reflect who one is as a person. This person comes to genuinely believe that he or she is a bad person, unlovable, never good enough, and deserves to be treated with disrespect.

The constant shame is also accompanied by a constant feeling of guilt. Everything is his or her fault, regardless of the context. There is a sense of unjust responsibility for other people’s emotions and the outcome of all situations. Its no wonder why low self-esteem can manifest itself in anxiety, self-harm or poor self-care, or on the other extreme, narcissism and antisocial tendencies. Here are some behaviors that can be a manifestation of low self-esteem:

  • Lack of healthy self-love: poor self-care, self-harm, lack of empathy, and inadequate social skills
  • Emptiness: loneliness, lack of motivation, and finding distractions from emotions
  • Perfectionism: this is often a behavior that manifests as adults because of the unrealistic standards these children were held to by their parents and were punished for not meeting
  • Narcissism: grandiose fantasies of who they want others to perceive them to be; even if they do succeed however, this protective personality doesn’t numb the negative emotions they truly feel.
  • Unhealthy relationships: people with low self-esteem are incapable of building and maintaining a relationship with others, largely because they don’t know what a healthy relationship looks like. Both parties are usually extremely dependent.
  • Susceptibility to manipulation: the constant self-doubt, shame and guilt make it too easy to bend a person with low self-esteem to an experienced manipulator’s will.

Source: Cikanavicius, D. (2018, September 03). A Brief Guide to Unprocessed Childhood Toxic Shame. Retrieved from https://blogs.psychcentral.com/psychology-self/2018/09/childhood-toxic-shame/ 

If you or someone you know is struggling with self-esteem, 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/

ADHD in Teens: Why Adult Support is Essential

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By Stephanie Osuba

Common symptoms of ADHD lead people to believe that students that have been diagnosed willingly choose to not complete assignments or be inattentive during class. However, symptoms like forgetfulness, procrastination, distractibility, poor time management, and having a difficult time writing are exactly what prohibits a student from achieving academic success. By definition, these teens cannot manage their time on their own, not even with all the motivation in the world. And although these students want to be treated normally, it is important to intervene in order to teach them how to manage their ADHD and their lives.

Wanting to be “normal” often prevents these students from seeking the help that they need with assignments and time management. While school counselors mean well with their open office doors, it’s important to recognize when a student with ADHD is falling behind. The student, even if a need for help is stated, will often not follow through with appointments due to the lack of executive control and interfering symptoms like distractibility and impulsivity. Setting up a comprehensive academic plan with the teen takes the efforts of parents and teachers who constantly check in to make sure he or she is on track. How you can support a student with ADHD:

  • Promote independence: the end goal is to have the teen be able to keep track of assignments, organize himself, be able to take notes, study well, and mange his time by being able to break down projects. Have the student come up with his own plan for the school year and check in if it seems off base. Once a well-oiled routine is put in place, check in regularly.
  • Intervene early: always prompt students to solve academic problems immediately. It’s better to catch small mistakes and setbacks early on than to wait until they snowball out of control.
  • Provide guidance: you should aim to collaborate with the teen in finding solutions to any problem that arises, however, most need direct instruction at first. They need to be shown exactly what the outcome needs to be before they can decide on the best way to arrive at the desired solution.
  • Take the lead: students should be under adult supervision at all times. At school, it’d be teachers and counselors and at home it’s their parents or guardians.
  • Gradually withdraw supports: adult supervision shouldn’t be completely withdrawn until the student proves capable. Symptoms can cause poor executive function well through college because it largely interferes with academic skills no matter their age.

Source: M.D., M. B. (2018, September 24). The Pivotal Role of Adults in Teen ADHD Care. Retrieved from https://www.psychologytoday.com/us/blog/child-development-central/201809/the-pivotal-role-adults-in-teen-adhd-care 

If you or someone you know is struggling with ADHD, 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/

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/.

 

 

Anxiety: Social Anxiety Disorder

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By: Charleene Polanco

Social anxiety disorder is characterized by an intense fear of being rejected by people. Many people feel some level of anxiety when they are placed into unknown social situations. However, those suffering from social anxiety disorder may avoid socializing altogether, because they cannot handle being judged or seen in a negative way by others. A person with social anxiety disorder, can experience anxiety during many different situations like; going on a date, eating in front of people, making eye contact, public speaking, or going to parties. Some of the symptoms of social anxiety include:

  • Rapid heartbeat
  • Uneasy stomach/diarrhea
  • Muscle tension
  • Lightheadedness
  • Sweating

Social anxiety can cripple a person’s life, because normal everyday interactions are triggers of anxiety and discomfort. This is why many people who suffer from social anxiety disorder choose to isolate themselves from everyone. In order to reduce the fear of rejection, people with social anxiety disorder are encouraged to be exposed to social situations, not run away from them. Although being around others is what brings them distress, socializing is also what allows people with social anxiety to change the way they think about social engagements. Instead of having negative perceptions about the way people view them, the more they socialize and are accepted by others, the more socially anxious people see that those perceptions are not true.

If you or someone you know is suffering from social 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/.

Sources:

Anxiety and Depression Association of America. (2018). Social Anxiety Disorder. Retrieved October 01, 2018, from https://adaa.org/understanding-anxiety/social-anxiety-disorder

Nordqvist, C. (2018, February 05). What’s to Know About Social Anxiety Disorder? Retrieved October 01, 2018, from https://www.medicalnewstoday.com/articles/176891.php

WebMD. (2018). What Is Social Anxiety Disorder? Retrieved October 01, 2018, from https://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder#1

 

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/.

 

 

 

 

Anxiety: Test Anxiety

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By: Charleene Polanco

Have you ever had a moment of extreme panic, right before the beginning of a test? How about feeling like you are about to faint, or excessive sweat during an exam? If these symptoms describe your test-taking experience, then you might be suffering from test anxiety.

Test anxiety is defined as a psychological condition where people experience severe distress and anxiety during exams. Some causes of test anxiety are fear of failure and lack of preparation. A fear of failure can result from wanting to perform well. One who associates their self-worth with a test’s outcome, can feel devastated when the grade is not what he or she expected. This creates a vicious cycle, where because the person is afraid of feeling worthless, when they fail, they become anxious while taking the exam.  As a result, their performance level on tests drops. Lack of preparation is another cause of test anxiety, which occurs when students do not study properly for an exam. For those who like to wait until the night before an exam, to cram five chapters worth of information into their brain, tests are a constant source of anxiety and stress.

Symptoms of test anxiety can be split up into three categories; physical, emotional, and behavioral/cognitive symptoms. Some physical symptoms include headaches, nausea, excessive sweating, and rapid heartbeat. Emotional symptoms can be expressed as feelings of anger, fear, helplessness, and disappointment.  Behavioral/cognitive symptoms are difficulty concentrating and negative thinking.

To help manage test anxiety, here are some tips;

  • Properly prepare for exams
  • Develop good test-taking skills
  • Engage in relaxation techniques, like taking deep slow breaths
  • Keep a positive mindset

If you or someone you know is suffering from test 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/.

Source:

“Test Anxiety.” Anxiety and Depression Association of America, ADAA, Anxiety and Depression Association of America , 2018, adaa.org/living-with-anxiety/children/test-anxiety

Stress: The Detrimental Effects of Stress on the Body

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By: Charleene Polanco

Stress is something that everyone experiences at some point in their lives. Stress is defined as a physical, mental, or emotional strain or tension, and whether it is about taking a final exam for class, going off to college for the first time, or work-related, stress can affect the way we perform. If gone unchecked, stress can lead to a variety of negative consequences on the body, which will be discussed. Stress has been linked to a number of physical and emotional disorders, like depression, anxiety, heart attacks and stroke. A constant high level of stress, can lead to immune system disturbances, which can cause an increase in your body’s susceptibility to infections. Stress can also have direct effects on the skin leading to rashes and hives.

Unlike rashes and hives, which are visible, stress can affect various systems, organs, and tissues within the body, signs that are not seen, and are, therefore, much harder to notice. Some parts of the body affected by stress are the nervous and cardiovascular systems. When stressed, the nervous system signals the body’s adrenal glands to secrete adrenalin and cortisol. Since both of these hormones cause high blood pressure, a person who is under constant stress, also has elevated blood pressure which can lead to heart problems in the future. Even if a stress episode is considered to be minor, repeated minor stress episodes can negatively impact a person’s cardiovascular system by causing inflammations in the coronary arteries. This can eventually cause heart attacks. In order to prevent the negative consequences of untreated high levels of stress, it is important to recognize the symptoms. There are multiple symptoms of stress, some of which include, frequent headaches, cold hands/feet, dry mouth, heartburn, depression, forgetfulness, and rapid or mumbled speech.

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

Source:

“Stress Effects.” Common Signs and Symptoms of Stress, The American Institute of Stress, 4 Jan. 2017.