Post Traumatic Stress Disorder: Understanding the Diagnostic Criteria

By: Abby Erasmus

Post- traumatic stress disorder is a psychiatric disorder that individuals can develop after experiencing a traumatic event. Traumatic events are defined by incidents that have the capacity to provoke fear, helplessness, or horror in response to the threat of injury or death. Further, as stated in the Diagnostic and Statistical Manual of Mental Disorders (5th ed; DSM- 5; American Psychiatric Association, 2013), one must display 4 types of symptoms to be diagnosed with post- traumatic stress disorder.

The first type is symptoms of re-experiencing the event in which the individual has unwanted recollections of the event (i.e. nightmares). The second type is symptoms of avoidance that include avoiding thoughts and feelings in regard to the incident as well as external reminders of the event (i.e. people, places). The next type of symptoms is symptoms of negative alterations in cognition and mood associated with the traumatic event (i.e. exaggerated negative beliefs/ expectations about oneself). Lastly, individuals will experience marked alterations in arousal and reactivity associated with the event (i.e. exaggerated startle response). Additional criteria includes length of symptoms in which symptoms should persist for longer than one month, severity of symptoms in which they should cause significant clinical distress, and cause of disorder such that symptoms should not be linked to the effects of drugs or substances.

It is also important to note that individuals can have a “delayed expression” of post-traumatic stress disorder (PTSD), which, according to the DSM-5, occurs when the “full diagnostic criteria [of PTSD] are not met until at least 6 months after the event” (APA, 2013). To restate, symptoms can manifest long after this 6 month window. The DSM-5 also states that having had a prior psychiatric disorder such as depression, and emotional problems such as anxiety problems, serve as risk factors in developing PTSD after one experiences a traumatic event. This relationship also works in reverse; experiencing a traumatic puts one at an increased risk for developing other psychiatric disorders such as generalized anxiety disorder (GAD), and at risk for the worsening of GAD symptoms if they had been diagnosed prior to the PTSD diagnosis.

If you or someone you know is seeking therapy for post- traumatic stress 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/          

Sources:

https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/

https://www.nejm.org/doi/full/10.1056/NEJMra012941

Munchausen’s Syndrome

By Charlotte Arehart

Munchausen’s syndrome is a factitious disorder where the individual continuously pretends to have various ailments and illnesses to seek medical attention for them. There are several other versions of Munchausen’s syndrome, including Munchausen through proxy as well as Munchausen through the internet. Munchausen’s syndrome is a mental illness that often comes along with other mental difficulties such as depression and anxiety.

Since Munchausen’s syndrome is a factitious disorder, it can be difficult to diagnose sometimes. After all, the patient is likely to be lying about their symptoms and illnesses. There are a few things that may hint that a patient has Munchausen’s syndrome, such as inconsistent medical history, constantly changing or unclear symptoms, predictable relapses, extensive medical knowledge, new symptoms after a negative test or undesired test results, symptoms are only present when the patient is being watched or is near people, and seeking treatment in many different places.

Many times in the news we hear about cases of Munchausen’s syndrome by proxy, which is when a caregiver or parent pretends that their child is afflicted by ailments. There are many famous cases of Munchausen’s syndrome by proxy, such as the case of Gypsy Rose Blanchard. In cases of Munchausen’s syndrome by internet, the individual attends online support groups pretending to be afflicted with the struggle that those who are attending the meetings are actually experiencing. This could be either to mock those who are attending, or simply for attention.

It is important that medical staff keeps an eye out for those who may be experiencing Munchausen’s Syndrome, since it can be difficult to spot. Those who are suffering from Munchausen’s Syndrome or Munchausen’s Syndrome by proxy should seek mental health treatment as soon as possible.

If you or someone you know is struggling with Munchausen’s syndrome, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://www.webmd.com/mental-health/munchausen-syndrome

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554979/

https://10faq.com/health/munchausen-syndrome-symptoms/?utm_source=7017173049&utm_campaign=6449781305&utm_medium=78641056298&utm_content=78641056298&utm_term=munchausen%20syndrome&gclid=CjwKCAjwieuGBhAsEiwA1Ly_nQk9C1zizAwKaVlu7DhBKde8bnBOPK7v4QhwG7rYBc-ZZj3av-254BoCzqAQAvD_BwE

Image Source: https://healthproadvice.com/mental-health/An-Understanding-of-Munchausen-Syndrome

Low Maintenance Might be a Bad Thing

By Katie Weinstein

In our society low maintenance is always seen as a good or neutral thing. People who are low maintenance are seen as flexible, nice, and easy going. If you are low maintenance meaning you can walk out the door without spending an hour doing your hair and makeup that is great, but if you are a low maintenance friend or partner out of fear of asking people to meet your needs, it is time to set boundaries and begin advocating for yourself.

Some people become high maintenance because their parents downplayed their feelings or were not able to meet the needs of their child for reasons such as working multiple jobs, having another child who was high-need, or suffering from an addiction problem. Other people become high need because peers labeled them as dramatic or they were excluded in school so learned to become an easy friend so they shut down their needs. As a result, people learn to be low maintenance so that they take up as little space as possible. In reality, if you’re low maintenance as a result of fear of asking people to meet your emotional needs and coming across as needy, it can take a toll on you.

It is important to first start with identifying what your needs are and what makes you happy. You also need to remind yourself that your needs are valid and it is normal to ask things of people. You are not being overly sensitive or dramatic. While it might seem horrifying to ask people for things, build up the confidence to set boundaries and tell people how you feel. True friends or partners will stick around even if it takes some getting used to. It is also important to tell yourself a new narrative about your needs. Instead of telling yourself that you are dramatic, tell yourself you are advocating for yourself. Once you stop being so low maintenance your confidence will improve, you will build better relationships, and people will stop using you. It is important to get as much in a relationship as you give. If you need help identifying your needs, building your confidence, or advocating for yourself, therapy might be a great option for you.

https://www.psychologytoday.com/us/blog/between-the-generations/202101/are-you-too-low-maintenance?collection=1151944

https://www.psychologytoday.com/us/blog/sexual-self/202104/why-some-people-feel-sad-after-sex

If you or someone you know is low maintenance and seeking therapy, 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/

Social Media: Self-Diagnosing

By Charlotte Arehart

For many people, it has become a habit to turn to the internet with any questions that one might have. While it is great to have the answers to the world at our fingertips, we have to keep in mind that just because we find an answer on the internet does not mean it is the correct one. Googling the answers to everything can be particularly harmful when it comes to physical and mental health. Searching a simple symptom such as a stomach ache may lead to answers that suggest the individual has appendicitis, when in reality they may only be having indigestion. With the internet becoming more powerful than ever, more people have been self-diagnosing with physical and mental health issues without seeking help from a professional.

Social media has played a huge role in the increase of self-diagnosing. Many influential social media users with a large platform use their platform to speak and educate viewers about mental illnesses. While this is great in terms of normalizing and reducing the stigma around mental health issues, it becomes harmful when viewers use this information to self-diagnose. I personally have seen many videos on platforms such as Instagram and Tiktok where the creator lists several widely general and common “symptoms,” such as sleeping in too much or having a short attention span, then follow up with something along the lines of “if you are experiencing these symptoms, you may have ADHD!” In the comments section, I see floods of viewers who are now concerned that they may have a mental disorder simply because they experience a few of the general symptoms listed. It seems that these videos create a lot of stress in people who do not actually need to be worried, since the symptoms listed are often so generalized. However, I do think that it is very beneficial for those who are struggling with mental health issues to receive support and a sense of community through social media. It can be very comforting to know that you are not alone going through something. If creators wish to speak about mental health issues on social media, it should be done in a very careful way. Addressing mental health on social media does present a wide variety of benefits, however it becomes an issue when people are self-diagnosing and becoming worried without speaking to a professional.

If you or someone you know needs mental health support, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://etactics.com/blog/problems-with-self-diagnosis

Image Source: https://dailytitan.com/opinion/column-self-diagnosing-mental-health-disorders-is-hazardous/article_d953ca7f-0eae-57d2-81fb-d0d339734788.html

The Importance of Mental Health

By Charlotte Arehart

When thinking about their health, most people only consider the physical state of their bodies. However, it is important that we take our mental health into consideration as well. Not only are these two aspects equally important, but they are actually very closely related. People who have poor mental health are at greater risk of having poor physical health. For example, people who experience depression are at a 50% increased risk of dying from cancer and a 67% increase for heart disease. Stress and anxiety also have a huge impact on the body, affecting the respiratory system, the cardiovascular system, as well as the gastrointestinal system.

Since mental health is so important, why do people usually disregard it? Many people are afraid of the stigma that surrounds mental health. Since you cannot always “see” mental health problems, some people view them as “not real.” Many people fear that others will look at them differently if they seek mental help. They do not want to be seen as emotionally weak. People are especially worried that seeking mental help with affect their careers, however this is not true. In fact, taking proactive steps to help mental health will reduce possible repercussions for the future. It is better to address the issue sooner rather than later, since unchecked mental health symptoms usually worsen over time. If you are experiencing mental health troubles, by no means are you alone. Many mental health issues are actually more prevalent than one would expect. By realizing that there are tons people who are experiencing something similar to them, people may feel better about reaching out for mental health.

If you or someone you know needs mental health support, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources: https://www.mentalhealth.org.uk/a-to-z/p/physical-health-and-mental-health

https://www.pdhealth.mil/news/blog/reducing-self-stigma-mental-health-important-physical-health

Image Source: https://www.hrcsb.org/may-mental-health-awareness-month/

PTSD- Police Officers

By: Devorah Weinberg

Post-Traumatic Stress Disorder (PTSD) is a disorder in which a person has difficulty recovering from a traumatic event. Symptoms include: reliving the trauma, avoiding situations that trigger memories of the event, insomnia, and difficulty focusing. Those suffering from PTSD may experience nightmares and severe anxiety as well. They may have difficulties with relationships and feel hopeless about the future.

Being a police officer is extremely stressful. On average, a police officer will witness three traumatic events per every six months in service. Up to 35% of officers suffer from PTSD. Unfortunately, they tend to suffer from cumulative PTSD. This form of PTSD builds up over time, due to repeated exposure to traumatic events. Cumulative PTSD often goes untreated due to the difficulty of detection, since it slowly builds up. In addition, many police officers are afraid to seek treatment because they don’t want to be perceived as being weak by their peers.

 If the PTSD remains untreated, it may lead to substance abuse, aggression, or even suicide.

If you or someone you know is struggling with Post- Traumatic Stress 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/

Sources:

https://www.police1.com/health-fitness/articles/police-officers-face-cumulative-ptsd-tgd6zLqtGwdG3wg2/

https://nationalpolicesupportfund.com/police-officers-experience-high-rates-of-pt

Image Source:

https://www.wnycstudios.org/podcasts/takeaway/segments/police-and-ptsd

PTSD: Complex Post Traumatic Stress Disorder: What is C-PTSD? An overview of signs and symptoms of C-PTSD

PTSD: Complex Post Traumatic Stress Disorder: What is C-PTSD? An overview of signs and symptoms of C-PTSD

By: Zoe Alekel

The Mayo Clinic defines Post-Traumatic Stress Disorder (PTSD) as, a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Although overlapping with PTSD, Complex Post Traumatic Stress Disorder (C-PTSD) has additional symptoms and complications due to prolonged and repeated trauma over periods of time (i.e. domestic physical, emotional, or verbal abuse, childhood abuse, long-term torture, and long-term exposure to ongoing crisis conditions).

The US Department of Veterans Affairs defines C-PTSD as experienced chronic trauma that continues or repeats for months or years at a time. Some have suggested that the current PTSD diagnosis does not fully capture the severe psychological harm that occurs with prolonged, repeated trauma. Symptoms of C-PTSD can include: behavioral difficulties, emotional difficulties, cognitive difficulties, interpersonal difficulties, and somatization.

A person who has experienced a prolonged period (months to years) of chronic victimization and total control by another or other types of trauma, may also experience difficulties in the following areas:

  • Emotional regulation: Includes persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
  • Consciousness: Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one’s mental processes or body (dissociation).
  • Self-perception: Includes helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
  • Distorted perceptions of the perpetrator: Includes attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
  • Relations with others: Includes isolation, distrust, or a repeated search for a rescuer.
  • One’s system of meanings: Includes a loss of sustaining faith or a sense of hopelessness and despair.

If you or someone you know needs support with C-PTSD, please contact our psychotherapy office 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.counselingps.ychotherapynjny.com/

Image: https://cdn-images-1.medium.com/max/1600/0*LbDcZnejtTf0UC5F.jpg

Sources: https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp

https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

PTSD in Women

By: Catherine Cain

Experiencing trauma is common and sometimes it may develop into PTSD, or post-traumatic stress disorder. While PTSD does affect men and women, women are significantly more likely to experience it than men. So, what is PTSD?

Post-traumatic stress disorder develops after someone experiences or witnesses a traumatic event, and the symptoms caused by this trauma continue for more than a month. While PTSD usually develops in the month following the event, it may develop months or even years after. Symptoms of PTSD include intrusive memories, avoidance of anything or anyone that reminds them of the trauma, changes in mood or thinking, and changed in behavior.

Females are twice as likely to experience PTSD as men. Why is that? While exposure to trauma is lower for women than men the type of trauma is significant in the development of PTSD. Men experience traumas that result in injuries or death, such as accidents, combats, and physical assaults. Women, however, experience childhood abuse, rape, and sexual assault. The effects of sexual assault are so detrimental that in the 2 weeks following an incident of sexual assault, 94% of women experienced symptoms of PTSD.

Another key reason for this difference is the difference in coping strategies. Everyone has heard of the “fight or flight” response to dangerous situations, but it is found that women often use the “tend and befriend” response following an event. “Tending” is taking care of those around you, while “befriending” is reaching out to others for support. Because of this reliance on others, women become more vulnerable to PTSD symptoms if their support system fails them.

If you or someone you know is struggling with Post Traumatic Stress 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/

Sources: https://www.nami.org/Blogs/NAMI-Blog/October-2019/PTSD-is-More-Likely-in-Women-Than-Men https://www.womenshealth.gov/mental-health/mental-health-conditions/post-traumatic-stress-disorder

Acute Stress Disorder: Reliving trauma

Acute Stress Disorder: reliving trauma
By: Zoe Alekel

It is not uncommon to experience a traumatic event in life. In fact, trauma related incidences range from experiencing a car accident, to experiencing an assault or witnessing a crime. All of these stressful situations can be lead causes to an anxiety disorder known as Acute Stress Disorder (ASD). According to the American Institute of Stress, ASD is defined by Post Traumatic Stress Disorder (PTSD)-like symptoms that occur for a short time after experiencing a trauma—an experience that can be emotionally distressful and painful, and that can cause mental and physical symptoms. After experiencing a traumatic event, it is not uncommon to develop ASD; in fact 5-20% of people that experience traumatic events will develop ASD.

Symptoms of ASD include intrusion symptoms, like involuntary distressing memories; negative mood symptoms, such as the inability to experience positive emotions like love and happiness; dissociative symptoms, like seeing yourself from the outside, the feeling that nothing is real and that time is slowed down; avoidance symptoms, such as avoiding thoughts, feelings, and places associated with the trauma; and arousal symptoms, such as trouble falling or staying asleep, irritable behavior, and difficulty concentrating.

This can be extremely overwhelming and invasive to someone who has experienced a traumatic event, and it is uncomfortable to feel as if you have to relive the event itself. However, ASD does not have to take over your life completely. By implementing an immediate therapeutic intervention right after the trauma, it decreases the likelihood of ASD becoming prolonged and turning into PTSD. Ways to manage the stress and anxiety that comes with ASD are mindfulness and relaxation, talking to a trained trauma specialist, and having a support system that you can confide in.

If you or someone you know is struggling with Acute Stress 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/ Sources: https://www.stress.org/acute-stress-disorder https://www.psychologytoday.com/us/conditions/acute-stress-disorder

Sources:

https://www.stress.org/acute-stress-disorder

https://www.psychologytoday.com/us/conditions/acute-stress-disorder

Image Source: https://www.bing.com/images/search?view=detailV2&ccid=pzmTf9qk&id=BA5B0BB1D4515DA5195D41BA6070603AE32437C7&thid=OIP.pzmTf9qkbMtGaFDdxylNNAHaD4&mediaurl=https%3a%2f%2fwww.elementsbehavioralhealth.com%2fwp-content%2fuploads%2f2017%2f01%2fptsd.jpg&exph=630&expw=1200&q=Post-Traumatic+Stress+Disorder+Acute&simid=608012514216510765&ck=9282692BACE02BB16355712947A1C3BA&selectedIndex=136&FORM=IRPRST&ajaxhist=0

Anxiety, Depression, Eating Disorders, ADHD, Et al: How to Support a Friend with Mental Illness

By: Sarah Cohen

When helping a friend with a mental illness, the first step should be assessment of their symptoms. Sometimes they just might be going through a difficult time, but if certain common symptoms associated with mental health issues persist it is imperative to respond sensitively. Majority of the time, friends will just want to know they have your support and that you care about them. A good way to show your support is by talking to them. If you provide a non-judgmental space for them to speak about their issues it will help encourage them to be open with their problems. Let them lead the conversation and don’t pressure them to reveal information. It can be incredibly difficult and painful to speak about these issues and they might not be ready to share everything. If you aren’t their therapist do not diagnose them or make assumptions about how they are feeling, just listen and show you understand. If someone doesn’t want to speak with you, don’t take it personally, just continue to show them you care about their wellbeing and want to help as much as possible. Just knowing they have support can give them the strength they need to contact someone who can help them.

If a friend is having a crisis, such as a panic attack or suicidal thoughts, you must stay calm. Try not to overwhelm them by asking a lot of questions and confronting them in a public setting. Ask them gently what would be helpful to them right now or reassure them. If they hurt themselves, get first aid as soon as possible. If someone is suicidal, contact the suicide hotline at 800-237-8255 immediately.

The best way to help someone is by connecting them to professional help. By expressing your concern and support you can show them that they can get help and their mental health problems can be treated.

If you or someone you know needs support with their mental illness, 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/

https://www.mentalhealth.org.uk/publications/supporting-someone-mental-health-problem

https://www.mentalhealth.gov/talk/friends-family-members