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 http://www.counselingpsychotherapynjny.com for more information.

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

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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 http://www.counselingpsychotherapynjny.com/.

 

Information taken from: https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

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 http://www.counselingpsychotherapynjny.com for more information.

Good Grief: Part 4

By: Sam Reiner

Over the last few parts we have been discussing the 5 stages of grief, using Zelda to further explain each stage. Now that we are done with the stages and Zelda we must now move on to the next topic, “How long does grief usually last?” Seems simple, but really this is an extremely difficult question to answer for the simple fact that people experience grief in different ways. Some people are able to feel better after 6 weeks while others can take up to 4 years to really get over a loss. In reality, the only one that really knows when you should be done with grieving is you. It is a process whose time table only you can decide. That being said there are ways to help you get through the grieving process a bit quicker. Some ways include:

  • Talk about how you’re feeling with others.
  • Try to keep up with your daily tasks so you don’t feel overwhelmed.
  • Get enough sleep, eat a well-balanced diet and exercise regularly.
  • Avoid alcohol. Alcohol can make you feel more depressed.
  • Get back into your normal routine as soon as you can.
  • Avoid making major decisions right away.
  • Allow yourself to cry, to feel numb, to be angry, or to feel however you’re feeling.
  • Ask for help if you need it

Now before I wrap this part up I have to mention that it is important to tell the difference between normal grieving and depression. Although they share very similar symptoms, the feelings associated with grief should be temporary. If you don’t start to feel better over time, it is very likely you have depression. But how long is too long? Again, that’s up to you as when you are grieving it is important to be self-aware of your emotions. The only way to know it’s been to long is when you feel that it’s been too long.

If you or someone you know is grieving, 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 http://www.counselingpsychotherapynjny.com/

Good Grief: Part 3

By: Sam Reiner

(once again to understand what I am talking about read the first 2 parts)

Despite all your bargaining, you eventually realize that there is nothing you can do to stop or reverse what happened. With the realization that there is no escaping fate comes the desire to disconnect and retreat inward, which leads to stage 4: Depression. The sadness sets in as you begin to understand the loss and realize its effect on your life. This is when you will feel overwhelmed, regretful, and lonely and in the game, this can be seen at the Great Bay. It is here that you me Lulu, a Zora who has lost her egg, simply standing in silence gazing out to the sea. The loss of her eggs has caused her to retreat inward and become depressed, which is very common for people who have just lost a loved one.

However, as the old saying goes “This too shall pass.” Stage 5: Acceptance. This is when you finally accept the reality of your loss, and although you may still feel sad you can now begin to move forward with your life. In game, this is signified by the Land of the Dead, Ikana Valley. It is here that you meet Sharp, a ghost you help reach acceptance with his mistreatment of his brother. A very literal representation of acceptance, but a more symbolic example is the Stone Tower, where you climb up towards the heavens. As you climb you will also need to create 4 twin statues (one for each town) with the 4 being symbolic of the past 4 stages of grief. Much like these statues, during the stages of grief you feel dull and lifeless but they are essential in order for you to go through the grieving process. This is even shown in game as you must leave the statue behind when you go up to the next floor, symbolizing passing though the stages of grief. By leaving them behind you can make your way to the top in order to obtain enlightenment and then flip the tower putting the heavens at your feet, solidifying your acceptance. You even have to fight the Garo Masters, beings literally described as “Emptiness cloaked in darkness.” These are clear symbols to the internal battle between light and darkness on the road to acceptance and also shows your victory over the empty feelings that come with grief. By overcoming the darkness and emptiness inside you and reaching the top, you show that you have accepted the past and are ready to face the future.

And with that, we have reached the end of the 5 stages of grief. Now that you know what to expect when faced with grief, it now becomes a question of how long with it last? Unfortunately this is getting pretty long so I’m going to have to save that for next time.

If you or someone you know is grieving, 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 http://www.counselingpsychotherapynjny.com/.

Good Grief: Part 2

By: Sam Reiner

(Read part 1 first to learn why I am talking about Zelda)

The 1st stage of grief is Denial. When you first learn of a loss it’s normal to think that it isn’t real or that it can’t be happening. It’s a way for you to deal with the torrent of overwhelming emotions. This is exactly what you experience in Clock Town, the 1st town in Majora’s Mask. In this game, you have 3 days to stop a giant moon from crashing down and destroying everything. However, even with this moon clearly inching closer every minute, no one seems to care. In fact, they are actually planning a carnival, openly laughing at the idea that the moon will fall. One person even goes as far to say that he’ll simply cut the moon to pieces with his sword.

Denial can only be temporary however, and when it is no longer possible you get angry. Stage 2: Anger. When reality starts to set in you may feel frustrated and helpless which later turn to anger, causing you to lash out at anything whether they deserve it or not. This is extremely prevalent in the game’s second location, Woodfall. Here you discover that the swamp has been poisoned, the Deku princess is missing, and the king is dead set on punishing a monkey who he believes kidnapped her. The problem is, the monkey is innocent. The king is just angry because of the poisoned swamp and his missing daughter and is lashing out at anyone.

Once the anger settles you then start to feel desperate which leads to stage 3: Bargaining. It’s during this stage you attempt to do anything that can either postpone or reverse the loss. In the case of Majora’s Mask, bargaining is on full display at Snowhead. Here is where the player encounters the Gorons, who are in the middle of mourning the recent loss of their chief, Darmani. Eventually you actually meet his ghost who then literally begs you to bring him back to life with your magic. This is a textbook example of bargaining as he is trying everything to delay the inevitability that is death. This can also be seen in the area itself. The paralyzing cold of Snowhead is basically a metaphor to how in this stage of grief you feel unable to move on, emotionally frozen. And for now, I’ll stop there, so for the next part we will be discussing the last two stages of grief.

If you or someone you know is grieving, 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 http://www.counselingpsychotherapynjny.com/.

 

Good Grief: Part 1

By: Sam Reiner

Grief is something that is inevitable in everyone’s life. It is an emotion that can come from the loss of a loved one, moving to a new home, suffering a chronic illness, or even the end of a relationship. It is a feeling that hits hard and can make you feel completely empty inside. Although we all must face grief at one point or another, no one knows what to expect when they are actually faced with it. What will I feel, how long will I feel it, and how can I move on? Over the next few blogs I will try my best to answer these questions.

So, let’s go down the list and start with what exactly will you feel when you are face with grief. Although the process is different for everyone, doctors have identified 5 common stages of grief: Denial, Anger, Bargaining, Depression, Acceptance (DABDA). Now in order to explain it further I’m going to once again use a video game, this time Legend of Zelda: Majora’s Mask. I swear I didn’t even plan this but when it comes to examples of the 5 stages of grief this is probably the best example of it in pop culture as you actually play through all 5 stages of grief via the 5 locations. But I’m going to have so go into more detail on it another day. This is going to take a while to explain and deserves its own blog. In the next part I will be discussing the first three stages of grief.

If you or someone you know is grieving, 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 http://www.counselingpsychotherapynjny.com/.

Phobias: Specific Phobias

Phobias: Specific Phobias

By: Christina Mesa

Ever had a strong fear of something in particular? Ever try everything in your power to avoid a certain stressor? You may have a specific phobia.  A phobias is a type of anxiety disorder in which the individual has an irrational fear of something that poses little or no actual danger.  A phobia is associated with enormous distress which can interfere with daily life.  Individuals with phobias tend to go to great lengths to avoid their stressor.  Specific phobias are slightly more common in women than in men and also seem to run in families.  They usually begin in adolescence or adulthood as well, however the cause is unknown.  Types of specific phobias include social phobia, the fear of being in crowded places, claustrophobia, the fear of tight spaces, and arachnophobia, which is the fear of spider.  Physical symptoms include nausea, sweating, trembling or shaking, problems with breathing, and feeling dizzy or lightheaded.  Around 19 million Americans have specific phobias, so you are not alone.

If you or a loved one is suffering from a specific phobia, 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/

Anxiety, Depression, Isolation

By: Emily Mulhaul

Are you struggling to maintain relationships with a family member, friend or significant other? Does the idea of being connected to or trusting another person make you anxious or scared? Did something in your past cause you to have this reaction to others? Sometimes we find it easier to avoid a situation, opposed to acting upon a situation. After running a half marathon, I can attest that the effort and maintenance necessary for a meaningful relationship, is just that of training for a half marathon. Depending on your personality, the previous statement could have been viewed rewardingly because you compare the euphoric feeling of crossing the finish line of the half marathon to that of laughter with friends on a Saturday. The alternative reaction could have been that neither relationships nor half marathons are worth the effort, so you proceed with simply going through the motions of your work or school day, followed by isolating yourself in front of the TV at night. If the second scenario reminds you of yourself or someone you know, the avoidant behavior may potentially be a catalyst for anxiety and depression. People do not want to be alone all the time, but they may lack the motivation to continue otherwise due to an experience with a past relationship, lack of confidence, etc. As opposed to avoiding relationships, at Arista Counseling and Psychotherapy we want you or a loved one to avoid anxiety, depression, and isolation.

If you or a loved one are struggling with anxiety, depression, or isolation and are experiencing difficulty with the following:

Presence (both mentally and physically; may be feeling lethargic)

Maintaining or seeking relationships

Sleep (insomnia)

Motivation

Daily Energy

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.

Trauma Turned Positive

How My Most Traumatic Experience Became My Most Humbling

By: Emily Mulhaul

When you go through a traumatic experience, the time it takes to recover is immeasurable and flooded with uncertainty. Overtime, everything around you begins to fade and you find yourself zoning in on your bedroom wall, for a leave of absence from reality. The previous night was spent in a pillow soaked with tears and the following night is expected to be the same. You are alone because you feel as though are burdening others with your pain, and now are trying to reassemble yourself on your own. You’re trying but right now you are physically and mentally exhausted. A couple of days pass by and maybe you’ve gotten up for something to eat or to take a shower, but in the end you always find your way right back to your bedroom. What you may be feeling now is numbness, opposed to the pain you initially felt.

Remember the pain that wasn’t ever going to go away? Although feelings inconveniently come and go as they please, they are only temporary. Happiness is not forever, but neither is pain and sadness. In the moment though, forever is exactly what it feels like.

Now that the initial, emotional pain has subsided you are left to feel nothing. Nothingness provides you with opportunity. This is the time to rewrite your story. The numb feeling is a blank slate and a new beginning; let’s celebrate this new beginning with an empty journal. It may be interesting to begin by writing where this emotional journey has taken you and where you would like to go. Write what you learned about life, about yourself, and about your emotions. You can even describe in detail the undeniable comfort your quilted blanket has provided you with throughout this emotional journey.

We’d love to help you rewrite your story and make this your most humbling experience.

The experienced 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.