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

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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

PTSD in Refugee and Unaccompanied Children:

By: Luz Melendez

Post-traumatic stress disorder (PTSD) is a disorder that can occur to someone after being exposed to one or more traumatic events. These traumatic events can vary from a natural disaster, war/combat, serious injury, sexual violence, and/or exposure to death threats. After experiencing a trauma there can be an emotional reaction to these events which can include fear, helplessness, and even horror. There may also be distressing memories of the traumatic event which can be recurrent and involuntary. In order to be diagnosed with PTSD, symptoms have to last for more than a month and be persistent. (American Psychiatric Association, 2013).

One population that is less talked about when it comes to PTSD is children, but more specifically refugee or asylum seeking children. The current population of children with PTSD in the U.S. is about 5% and among refugee children in the U.S. it’s about 54%. These children are experiencing hunger, extreme poverty, bombings, abductions, sexual assault, and even witnessing deaths. These stressors can often co-occur making everyday life very difficult for them. The effects of these events are causing developmental regression, clinginess, repetitive play of the trauma/s, anxiety, depression, ACES, and mood changes. One effect that is very important is how the brain is being affected by these traumas. PTSD is developed in two key regions of the brain, the amygdala and the prefrontal cortex. The amygdala reacts too strongly while the prefrontal cortex impedes the ability to regulate a threat response. It’s the perfect storm that leads to hyperarousal, hyper vigilance, and sleep deprivation which are big issues when it comes to children. Children’s brains are growing and developing and these traumas are stunting the global developmental growth of these children’s brains.

Often PTSD in refugee or asylum seeking children, if left untreated/undiagnosed, can and will lead to life long-lasting effects. In the situation these children are in, it’s difficult to not only diagnose them but to properly treat them. Many if not all have witnessed one or more of the stressors mentioned above and these children are out in the world not only having their lives completely change but having their mental health deteriorate. Thankfully some host countries who take in refugees, screen them and try to help them adjust to their now new lives and overcome barriers that come with accessing physical and mental health care. This also includes overcoming the stigma that refugees have of seeking mental health care. Like mentioned before only some host countries do this, others are still fixing their processing of refugees.

 

If you or someone you know is struggling with PTSD, Arista Counseling and Psychotherapy can help. Please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, 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/ .

 

Reference:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Arlington, VA: American Psychiatric Association.

Post-Traumatic Stress Disorder

See the source image

Post-Traumatic Stress Disorder

by Sam Matthews

Post-Traumatic Stress Disorder develops after one experience either an isolated traumatic event, or recurring traumatic events. Around 8 million people in the United States are living with PTSD, yet about 70% of US adults have reported they have experienced at least one traumatic event in their lifetime. This discrepancy is due to the fact that being exposed to a traumatic event does not in any way mean that you are going to develop PTSD. Factors that contribute to the likelihood of someone developing post-traumatic stress disorder include: a preexisting mental or physical health condition, dissociation during trauma, type of trauma, gender (women are 2x as likely to develop PTSD), age, marital status, support systems, and experience of additional stressors after the trauma. One type of PTSD is classified as dissociative, which includes the presence of persistent depersonalization or derealization symptoms. Depersonalization is like dissociation, where one experiences something as if they are an observer. Derealization on the other hand refers to feeling as if the things around you are not real, and you are disconnected from the world around you. PTSD can also have a delayed onset aspect, which means that one could develop PTSD years after the traumatic event has occurred.

PTSD has four main symptom groups which are as follows:

  1. Intrusive Symptoms
    1. Frequent thoughts or memories of the event
    2. Recurrent nightmares
    3. Flashbacks
    4. Strong feelings of distress
    5. Increased heart rate or sweating when reminded of the event
  2. Avoidance
    1. Avoiding thoughts, feelings, or conversations about the event
    2. Actively avoiding places or people that remind you of the trauma
    3. Keeping yourself too busy to have time to think about the traumatic event
  3. Hyperarousal
    1. Difficulty falling asleep
    2. Irritability
    3. Outbursts of anger
    4. Difficulty concentrating
    5. Hyperactive startle response
  4. Negative Thoughts and Beliefs
    1. Difficulty remembering important aspects of the trauma
    2. Loss of interest in important and positive activities
    3. Feeling distant from others
    4. Inability to have positive feelings
    5. Feeling as though your life may be cut short

For information regarding the treatment of PTSD, please refer to the article titled, PTSD Treatment.

Sources:

https://www.webmd.com/mental-health/post-traumatic-stress-disorder#1

PTSD Treatment

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PTSD Treatment

by Sam Matthews

When treating PTSD, there are a few different evidence based therapies that can be used, including psychotherapy and medications. This article will focus on those that are classified as cognitive behavioral therapies.

  1. Trauma-focused CBT
    1. Challenging and changing automatic unhelpful, inaccurate thoughts (cognitive distortions)
    2. Gradual and safe exposure to trauma
  2. Cognitive Processing Therapy
    1. Challenging and changing upsetting thoughts that perpetuate the trauma
    2. Includes writing a detailed account of the trauma and reading it in front of the therapist and at home
    3. Therapist helps you challenge problematic beliefs around safety, trust, control, and intimacy
  3. Cognitive Therapy
    1. Challenges and reframes pessimistic thoughts and negative interpretations of the event
    2. Work through the trauma and suppressed thoughts
  4. Prolonged Exposure
    1. Gradual and safe exposure to the trauma by discussing the details of what happened
    2. Recording of your recount so you can listen to it later
    3. Involves facing situations, activities, or places that remind you of the trauma
    4. Done slowly and systematically
    5. Breathing techniques learned to alleviate anxiety
  5. Eye Movement Desensitization and Reprocessing
    1. Imagining the trauma while the therapist asks you to track their fingers as they move them back and forth in your field of vision
    2. Allows you to pull everything out of your memory in a controlled manner and then back in the way non-traumatic memories are stored
    3. Does not require you to describe the trauma in detail, spend an extended time on exposure, challenge specific beliefs, or complete assignments outside of therapy sessions
  6. Brief Eclectic Psychotherapy
    1. Combines CBT with psychodynamic psychotherapy
    2. Discuss the traumatic event
    3. Teach various relaxation techniques to decrease anxiety
    4. Therapist helps to explore how the trauma has affected how you see yourself and the world
    5. Encouraged to bring someone who supports you to your sessions
  7. Narrative Exposure Therapy
    1. Create a chronological narrative of your life
    2. Helps to recreate an account of the trauma in a way that recaptures your self-respect
    3. You receive a documented biography written by your therapist at the end of treatment
    4. Typically done in small groups

For more information on Post-Traumatic Stress Disorder, please refer to the article titled, Post-Traumatic Stress Disorder.

Sources:

https://www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder#1

 

Bullying: Impact of Bullying on Children’s Mental Health

Bullying: Impact of Bullying on Children’s Mental Health

By Lauren Hernandez

            National media has created a frenzy of coverage surrounding Wisconsin’s controversial ordinances which fine parents if their children are bullies in school. Some may disagree with this new policy; however, others believe this harsh measure will help to eliminate bullying among school children.

Bullying can be physical, emotional, or verbal, and is a pattern of harmful, humiliating behaviors directed towards people who seem vulnerable to the bully. Oftentimes bullying happens in school, but with the rise of technology, cyberbullying is also becoming a problem. Children who are victims of bullying are typically vulnerable to mistreatment because they may be smaller, weaker, younger, and fearful of the bully; however, this description is general and does not apply to everyone. Bullies use their power, whether that is physical strength, popularity, or intimidation to harm others. Bullies tend to demonstrate signs of aggression or hostility beginning around 2 years old. It has been found that bullies have mental health issues such as lack of emotional understanding, lack of prosocial behavior, and increased rates of hostility as well as insecurity. Additionally, bullies typically have difficult relationships with their parents, teachers, and peers.

Victims of bullying not only suffer from physical consequences, but being bullied negatively impacts their mental health and overall well-being.  These detrimental social and emotional abuses can foster the development of mental health disorders such as anxiety or depression.  Victims of bullying often experience feelings of low self-esteem, isolation and loneliness. Some children create somatic symptoms such as headaches, stomachaches and other complaints which might not be valid, in order to prevent attending school. Victims of bullying generally stop liking school because they associate it with the threat of a bully. Incidents of bullying should immediately be reported to a school official, parent, or other adult that can help the victim and resolve the situation.

It is important to recognize that in most cases both the bully and the victim are suffering from mental health issues and they would benefit from treatment by a school counselor, psychologist or psychiatric nurse practitioner.

If you or someone you know who may be suffering from bullying, depression, or 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:

https://www.psychologytoday.com/us/basics/bullying

https://www.psychologytoday.com/us/blog/resilience-bullying/201906/can-wisconsin-get-rid-bullies-fining-their-parents

https://www.psychologytoday.com/us/articles/199509/big-bad-bully

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Antidepressants

Antidepressants

By: Lauren Hernandez

            If you or someone you know has been seeing a psychiatrist or psychiatric nurse practitioner for treatment of depression, there are various types of antidepressants a mental health provider can prescribe. It is important to be familiar with different types of antidepressants in order for you, as the patient, to understand what the medication actually does on a neurological level.

The most common type of antidepressant prescribed is a Selective Serotonin Reuptake Inhibitor, known as an SSRI. SSRIs mainly treat depression but they are also effective in the treatment of anxiety disorders, Obsessive-Compulsive Disorders, and Post Traumatic Stress Disorder. Serotonin is a neurotransmitter in the brain which impacts your mood, sexual desire, appetite, sleep, memory and learning as well as other similar functions. On a neurological level, SSRIs prevent serotonin reabsorption which builds up serotonin in the synapse. This allows receptors to receive the signal and react with the optimal amount of serotonin. People suffering from major depressive disorder and anxiety disorders typically have lower serotonin levels. By preventing reabsorption in the synapse via medications, symptoms of these disorders may decrease. In 1987 Prozac was the first approved for treatment of those with depression and became one of the most prescribed antidepressants. Other common SSRIs include Lexapro, Paxil, Zoloft, and Celexa.

Serotonin and norepinephrine reuptake inhibitors, SNRIs differ from SSRIs in that they block the reabsorption of serotonin and norepinephrine. Norepinephrine is a neurotransmitter that influences hormones and the “fight or flight” response in the brain. Approved SNRIs include Cymbalta, Pristiq and Effexor XR.

Some of the other common types of antidepressants prescribed include norepinephrine and dopamine reuptake inhibitors (NDRIs) which block the reabsorption of norepinephrine and dopamine. This is only seen to be effective in the medication bupropion, which is also known as Wellbutrin. Other types of antidepressants that are less common include Tetracyclics (TCA’s), Monoamine Oxidase Inhibitors (MAOI’s), and Serotonin Antagonist and Reuptake Inhibitors. These older medications are not prescribed as frequently because of the development of newer medications that effectively decrease symptoms and have fewer side effects.

Medication is helpful; however, it is most effective when used in combination with different types of psychotherapy or support groups. If you or someone you know is struggling with depression or any type of anxiety or mood disorder, it is important to seek professional help from a psychiatrist or psychiatric nurse practitioner who can provide antidepressants as well as support through talk therapy. If you or someone you know is currently taking antidepressants, it is extremely important to continue taking the medication and avoid discontinuations.

If you or a loved one is suffering from depression, anxiety, or a mood disorder, please contact Arista Counseling & Psychotherapy, located in New York and New Jersey to speak to licensed professional psychologists, psychiatrists, psychiatric nurse practitioners or psychotherapists. To contact the office in Paramus NJ, call (201) 368-3700. To contact the office in Manhattan, call (212) 722-1920. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

 

 

Sources:

https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970

https://www.webmd.com/depression/how-different-antidepressants-work#1-3

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Panic Attacks

Panic Attacks

By: Lauren Hernandez

Many people face anxiety on a daily basis. Panic attacks are an extreme form of anxiety that many people experience. Panic attacks are described as an immediate fear of dying, going crazy or losing control. People who experience panic attacks may feel intense fear despite no real danger. Attacks may last anywhere from about ten minutes to an hour or more. Panic attacks are categorized as either situational or unexpected. According to PsychologyToday, “situational panic attacks are triggered by a particular scenario while unexpected panic attacks seem as though they come out of nowhere.”  While general anxiety is the worry that bad things might happen in one’s life, panic attacks feel like a surge of imminent danger and often have physical symptoms.

Symptoms of panic attacks include:

  • Increased heart rate or palpitations
  • Sweating
  • Trembling or shaking
  • Shortness of breath or a feeling of being smothered
  • Choking sensations
  • Chest pain or discomfort
  • Nausea
  • Dizziness or lightheadedness
  • Feelings of unreality or being detached from oneself
  • Numbness or tingling sensations, particularly in the extremities or around the lips
  • Chills or hot flashes

Panic attacks are a terrifying experience; however, they are quite treatable and can be helped with a combination of therapy and medications. For people who experience situational panic attacks, it is best to leave the feared situation which will typically decrease anxiety and end the panic attack. For people who experience unexpected panic attacks, take note of where, when, and possibly why the panic attack began in order to analyze this occurrence further with a mental health professional. Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that is one of the most common methods of treating panic attacks and anxiety disorders. Additionally, medication such as Selective Serotonin Reuptake Inhibitors (SSRIs) can help relieve anxiety and prevent panic attacks. Immediate relief can be achieved when benzodiazepines such as Xanax and Klonopin are taken. These medications are potentially abusive so they must be used with caution. If you or someone you know is suffering from panic attacks or severe anxiety, contact a therapist, psychologist, or psychiatric nurse practitioner who can help.

If you or someone you know who may be suffering from panic attacks, 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: https://www.psychologytoday.com/us/blog/anxiety-help/201109/panic-attacks-what-they-are-and-how-stop-them-0

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Suicide Prevention: What Can You Do to Help?

Suicide Prevention: What Can You Do to Help?

By Lauren Hernandez

                If someone you care about has recently expressed suicidal thoughts or has told you they have attempted suicide, it is important to offer support to that person and to seek professional help. Suicide attempts are often triggered when a person cannot handle the certain stressors and do not have stable coping mechanisms to overcome these obstacles. People considering suicide typically struggle with other mental illnesses such as depression, anxiety disorders, mood disorders, Borderline Personality Disorder, or Post Traumatic Stress Disorder as well as a variety of other conditions. If someone has shared their suicidal thoughts with you, provide them with close comfort by staying with them. Even if you are unsure of what to say, it is important for that person to know that they are not alone.

It is important to make a plan, that encourages at risk individuals to see a provider such as a psychologist or psychiatric nurse practitioner who can offer professional help. If they are overwhelmed by their workload, perhaps try to ease their worries by offering to help them complete specific burdening tasks. It is important to offer them a way in which they can surround themselves with supportive people, perhaps invite them to a relaxing and judgement free space with a few friends. Additionally, help them to find ways in which they can practice self-care, healthy eating, exercise, and sleep, as well as listening to music and other activities that help to boost mood.

It is important to recognize that although you are trying to help a loved one to the best of your ability, the person struggling with suicidal thoughts needs professional care and therapy. There is only so much you can do to help and that is why reaching out to safety networks is essential. Other resources you should find in your area include mental health providers such as a psychologist or psychiatric nurse practitioner who can work with the patient to create a plan and prescribe medication. If you or someone you know is in immediate danger, call 9-1-1 to request immediate assistance and hospitalization to prevent self-harm or a possible suicide from happening. The National Suicide Prevention Lifeline is a 24/7 confidential Lifeline which is available at any time for anyone in the United States to get support if you or a loved one is in crisis. The National Suicide Prevention Lifeline’s number is 1-800-273-8255. To find more information on how to help yourself or someone in crisis can be found on these websites:

https://suicidepreventionlifeline.org/help-yourself/

https://afsp.org/find-support/my-loved-one-made-attempt/loved-one-made-attempt/.

If you or a loved one is suffering from suicidal thoughts please contact Arista Counseling & Psychotherapy, located in New York and New Jersey to speak to licensed professional psychologists, psychiatrists, psychiatric nurse practitioners or psychotherapists. To contact the office in Paramus NJ, call (201) 368-3700. To contact the office in Manhattan, call (212) 722-1920. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

 

 

 

 

Sources:

https://suicidepreventionlifeline.org/help-yourself/

https://afsp.org/find-support/my-loved-one-made-attempt/loved-one-made-attempt/.

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Hoarding

Hoarding

By Lauren Hernandez

                Hoarding is a disorder characterized by the continuous inability to get rid of belongings that have no significant value. While Hollywood has made hoarding a spectacle for consumers, hoarding is a serious condition which threatens the safety and livelihood of many people around the world. People with hoarding disorder will accumulate random items they believe they have an emotional attachment to or because they think they might need the item in the future.

Typically hoarding begins in adolescence and the severity of the condition worsens over time. The cause is still unknown, however hoarding disorder can be prompted by experience of a traumatic event, if a family member has had the disorder, or if a person has difficulty making decisions. People who hoard may suffer from depression, anxiety, or obsessive compulsive disorder. If a hoarder continuously refuses to throw items away, their home will be covered in growing piles of random objects. This poses a serious threat to their health and to the health of the people around them. The clutter inside a home often deems the house unlivable, and there is a greater risk for falling and tripping over items. In addition, there is an increased risk of fires, and mold due to rotting food and other items that are wasting away. People who hoard also typically struggle with personal hygiene which can be associated with other mental illnesses such as depression and anxiety.

According to DSM-5, the following symptoms are diagnostic of hoarding disorder:

  • Persistent difficulty discarding or parting with possessions, regardless of their value or lack thereof
  • The difficulty in discarding possession is due to distress associated with getting rid of them
  • The difficulty in discarding possession leads to clutter of living spaces and compromises the use of living spaces
  • The hoarding creates clinically significant distress or impairment in functioning, including the ability to maintain a safe space

A person who hoards is unable to recognize that their hoarding activity is problematic and dangerous. If you or someone you know might have hoarding tendencies perhaps attempt to either clean the space, if it does not cause too much distress, or leave it. If attempting to clean causes too much distress, seek professional help. “The primary treatments used to relieve symptoms of hoarding disorder include cognitive-behavioral therapy and antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs). One or the other, or both, may be employed” (PsychologyToday).

If you or someone you know is engaging in hoarding activities, 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.psychologytoday.com/us/conditions/hoarding-disorder

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