Persistent Depressive Disorder (Dysthymia)

Persistent Depressive Disorder (Dysthymia)

By: Gisela Serrano

Although Major Depressive Disorder (MDD) is the most commonly diagnosed depressive disorder, Persistent Depressive Disorder (PDD), also known as Dysthymia, is the second most common diagnosis. PDD is known to be mild and less severe than MDD, however, it is more chronic – that is, it is longer-lasting and recurring.

When diagnosing a patient with PDD, it must be ruled out that the symptoms the patient is experiencing cannot be better explained by a psychotic disorder or attributed to substance abuse. The symptoms must also cause distress to the patient and interfere or cause disturbances in their everyday life. Patients experience a “low” mood and feel down for most of the day, for a majority part of the time than not, for at least two years or more.  The patient cannot be without symptoms for more than two months; otherwise, he or she cannot be diagnosed with PDD.

As listed in the DSM-5, patients must experience two or more of the following symptoms, along with depressed symptoms, to receive a medical diagnosis of PDD:

  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

Treatments for Persistent Depressive Disorder include talk therapy or medication such as antidepressants and Selective Serotonin Reuptake Inhibitors (SSRIs) which increases the levels of serotonin in the brain. If you feel like you might be suffering from Persistent Depressive Disorder, it is important that you seek professional help as this disorder is highly treatable. At Arista Counseling & Psychotherapy center, we have qualified professionals that may be able to help you. You can reach us at our office in Paramus, NJ at 201-368-3700 or visit our website https://www.counselingpsychotherapynjny.com/ for more information.

Advertisements

Self-Harm

By Samantha Glosser

Self-harm, also known as self-injury, is becoming far more common than it used to be. Studies have shown that around two to three million Americans engage in self-harm every year. However, despite the growing number of people who inflict harm on themselves, self-harm is still a topic that many people do not want to talk about. It can be a scary and uncomfortable topic to discuss, but avoiding conversations about this topic creates a cycle of stereotypes and misinformation that will make people who harm themselves feel alone and that they cannot ask for help. In opening up the discussion about self-harm, there are a few important things to note.

What is self-harm? Self-harm can be defined as the act of inflicting deliberate injury onto oneself. This includes, but is not limited to, the following: cutting, burning, bruising, pulling hair, and breaking bones. Self-harm is not a sign of suicidality, it is a coping mechanism individuals have adapted to deal with various types of deep emotional distress.

Why do people self-harm? Like most mental health issues, the cause of self-harm cannot be attributed to one factor. There are numerous different reasons that someone might turn to self-harm as a coping mechanism. These reasons include, but are not limited to, the following: loss of control over emotions, feeling numb or empty, confusion about sexual or gender identity, bullying, and physical, emotional, or sexual abuse. Self-harm allows sufferers to turn emotional pain into physical pain, or it allows them to feel something when they are numb and empty.

Who engages in self-harm? Self-harm does not discriminate. It can affect you no matter your age, race, or gender. However, there are a few groups who are at a higher risk for self-harm according to recent research. These groups include the following: LGBTQ+ individuals, people aged 12-25, individuals battling addiction, and individuals diagnosed with borderline personality disorder and eating disorders. Often times you will not even know that someone is struggling with self-harm, because those who harm themselves commonly go to great lengths to keep their behavior a secret.

Can self-harm be treated? Although self-harm is not considered a mental disorder, there are still treatment options available. Treatment consists of psychotherapy which helps the individual to identify what causes them to self-harm and teaches them coping mechanisms that do not rely on bodily harm.

If you or someone you know appears to be suffering from self-harm, 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/


Sources: Grohol, J. M. (n.d.). Cutting and Self-Injury [Web log post]. Retrieved from https://psychcentral.com/blog/cutting-and-self-injury/

Lyons, N. (n.d.). Self-Harm: The Myths & the Facts [Web log post]. Retrieved from https://blogs.psychcentral.com/embracing-balance/2015/07/self-harm-the-myths-the-facts

What is Self Injury (SI)? (2016, July 17). Retrieved from https://psychcentral.com/lib/what-is-self-injury-si/

Sexual Assault: Why Survivors Don’t Come Forward Sooner

By Samantha Glosser

If you watch the news or are an avid social media consumer, you have probably heard about various claims of sexual assault against public and political figures, where the victim did not immediately come forward. We recently saw this with Dr. Christine Blasey Ford, who publicly accused U.S. Supreme Court nominee, Brett Kavanaugh, of sexually assaulting her as a teenager. Situations like Dr. Ford’s have opened up a discussion about one important question: why do survivors wait so long to report an assault? Research shows that it is a normal response for survivors of sexual assault to take time before reporting the assault, if they report at all. This may not make sense to you, as you are probably wondering why they wouldn’t want justice or revenge on their abuser. However, there are numerous reasons that compel survivors to prolong or withhold disclosing that they were sexually abused.

  1. Fear of being victimized a second time. Reporting a sexual assault often leads to new and added traumas from peers, family members, police officers, lawyers, etc. This feeling often comes from having to relive the experience or from people indicating that the victim caused the sexual assault by asking questions like, “What were you wearing at the time of the attack?”
  2. Lack of support. Lack of support is a multi-faceted issue. Survivors find it hard to report if they are not surrounded by loved ones who support them. However, even with this support, individuals still refrain from reporting because they know that our society has a tendency to blame the victim for the sexual assault. A lack of support can even come from other survivors of sexual assault. Typically, other survivors are seen as a source of comfort. However, some will dismiss another person’s assault with statements like, “What’s the big deal? It happens to all of us. Get over it.”
  3. Decline in functioning after the assault. Survivors of sexual assault experience intense feelings of shame, worthlessness, and self-loathing which can quickly bring on depression and anxiety. It is difficult for survivors to contemplate a course of action after the assault when they can barely figure out how to make it through the day. In the midst of these emotions, survivors want to forget and pretend that the assault did not occur.
  4. Vague memories of the attack. In some cases, victims of sexual assault were drugged by their abuser or previously inebriated. Both of these situations can lead to victims only having a vague memory of the attack. In addition, the trauma endured by some victims is so severe it causes them to dissociate, which also leads to vague memories. When individuals do not have a vivid recollection of the event, they may be scared to come forward because they fear others will not believe them, or in some cases because they do not believe their own memories.

If you or someone you know is a survivor of sexual assault, 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: https://blogs.psychcentral.com/psychology-women/2018/10/6-big-reasons-women-dont-report-sexual-abuse-right-away/

Nightmares: Normal or Disorder?

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

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/

Bipolar Disorder: What Is It and What Treatments Are Available

By Stephanie Osuba

Bipolar disorder is classified as a mood disorder with cycling emotions of highs (mania) and lows (depression) by the Diagnostics and Statistical Manual of Mental Disorders (DSM-5). Periods of mania can last for as little as two days and as long as fourteen days at a time. It is this period of elevated mood and heightened irritability that sets bipolar disorder apart from the diagnosis of clinical depression. During a manic episode, people experience elevated moods of extreme happiness, decreased need for sleep, hyperactivity, and racing thoughts which manifest in pressured speech. Because mania makes people feel like they are on top of the world, people also tend to engage in risky behavior of sexual nature or even substance abuse to maintain the high. Manic episodes can also bring on an intense and easily irritable mood, which can also lead to a risk of violence. Besides one manic episode, in order to be diagnosed with bipolar disorder one must have had a depressive episode as well. This period can last from a few days to even months and is characterized by extreme sadness, disinterest in pleasurable activities, lack of energy, and feelings of helplessness and hopelessness.

There are two kinds of bipolar disorder, one being more manic and the other being more depressive. Bipolar I is characterized by one fully manic episode, that must last at least a week, and a depressive episode. Bipolar II is characterized by a period of depression and a period of hypomania. Hypomania has all the symptoms of a manic episode; however it usually doesn’t last as long, only about a few days. The speed at which people cycle through emotions largely depends on the person. Treatment for this disorder can either psychotherapy or medication. Most people seem to benefit greatly from a combined treatment of both. A common medication prescribed for this disorder is a mood stabilizer and even sometimes an antidepressant or other psychotropic medication. It’s best to talk to a professional in order to find the best individual treatment plan.

Source: Grohol, J. M., Psy. D. (2018, May 18). Bipolar Disorder – What is it? Can it be treated? Retrieved from https://psychcentral.com/disorders/bipolar/ 

If you or someone you know is struggling with bipolar disorder, 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/

Self-Esteem and Shaming Parents

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/

Bipolar Disorder

By: Dianna Gomez

Bipolar Disorder, also known as “Manic-Depressive,” is a disorder of the brain that causes a person to experience sudden shifts in mood, energy/activity levels, and disrupts their ability to function fully each day. The changes in mood range from a person feeling extremely “up” and energized which are known as manic episodes to feeling extremely “down” and sad which is known as depressive episodes. There are multiple forms of Bipolar Disorder, however, the two main types of the disorder are Bipolar I and Bipolar II. Regardless of the type a person has, he or she still suffers from very similar symptoms. Bipolar I Disorder is defined by manic episodes/symptoms that are either so severe the individual needs to be hospitalized immediately or the episode itself has lasted for at least 7 days. Depressive episodes occur in people with this type of Bipolar as well and these episodes can last up to at least 2 weeks at a time. Bipolar II Disorder is defined by a certain pattern of depressive episodes followed by some hypo-manic episodes. The only difference between manic and hypo-manic is that hypo-manic episodes are not as intense as full on manic ones. More specifically, when a person is having a manic episode they can experience the following symptoms:

  • Feeling “jumpy” or “weird”
  • Having trouble sleeping
  • Talk really fast about a lot of different things
  • Racing thoughts
  • Participating in risky behaviors (ex: spending all your money)

On the other hand, when a person is going through a depressive episode, he or she can experience the following symptoms:

  • Sleeping too much or not enough
  • Not being able to enjoy things
  • Trouble concentrating
  • Eating too much or not enough
  • Thinking about death and/or suicide

Luckily, there are several forms of treatment that a person suffering from Bipolar Disorder can seek out to help them live a more normal and stable lifestyle. Methods of treatment include: medications (mood stabilizers, sleep medications, antidepressants, and atypical anti-psychotics), psychotherapy (cognitive behavioral therapy, family-focused therapy, and interpersonal therapy), or a combination of both. Even while taking medications some mood swings may still occur. This makes it especially important that there is a close and honest patient-doctor relationship in order to manage the disorder in the most efficient way possible. In addition to these, there is also electroconvulsive therapy or “ECT,” and keeping a lifestyle chart. When keeping the lifestyle chart, the patient records their daily symptoms, sleep patterns, and other important life events.

 

If you or anyone you know may suffer from either Bipolar I Disorder or Bipolar II Disorder, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit us at http://www.counselingpsychotherapynjny.com/.

Depression in Children

By Samantha Glosser

Depressive symptoms in children are often not apparent to parents and teachers. In fact, a new study at the University of Missouri demonstrated that although 30% of 643 children reported feelings of mild to severe depression, parents and teachers often failed to notice symptoms in these children. This could be detrimental to children, because not noticing depressive symptoms can lead to long-term problems caused by depression. In addition, children with depressive symptoms, and depression, can be up to six times more likely to have deficits in social and academic areas.

If parents and teachers identify depressive symptoms as early as possible, it allows the child to work through their academic and social difficulties and prevent further development of depression. To better help our children, it’s important to first understand why symptoms often go unnoticed. This could be because depression in children can appear as irritability, rather than the typical sad mood most people associate with depression. Another reason is that parents and teachers see children in different settings, thus they often come to different conclusions about the presence of depressive symptoms (could be present in school, but not at home). Next, it’s important to become familiar with symptoms of depression. Parents and teachers should be looking for the following signs: feelings of sadness or loneliness, feelings of hopelessness, lack of energy, loss of pleasure and interest in activities, difficulties eating or sleeping, difficulties concentrating, feelings of guilt/worthlessness, and even thoughts of death or suicide.

If you or someone you know appears to be suffering from depression, 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: Pedersen, Traci. “Depressed Kids Far More Likely to Have Social, Academic Deficits.” Psych Central, 30 Aug. 2018, psychcentral.com/news/2018/08/30/depressed-kids-far-more-likely-to-have-social-academic-deficits/138292.html.

Postpartum Depression

By Samantha Glosser

“I thought postpartum depression meant you were sobbing every single day and incapable of looking after a child. But there are different shades of it and depths of it, which is why I think it’s so important for women to talk about. It was a trying time. I felt like a failure.” -Gwyneth Paltrow

Postpartum depression can begin as early as a few weeks after giving birth, and it affects one in seven women. Symptoms of postpartum depression include the following: depressed mood or mood swings, excessive crying, difficulty bonding with the baby, withdrawal from loved ones, loss of appetite or an increased appetite, inability to sleep or sleeping too much, fatigue or loss of energy, anxiety, fear of not being a good mother, thoughts of harming yourself or your baby, and recurrent thoughts of death and suicide. These symptoms typically interfere with your life and your ability to raise and connect with your child. Although it is not certain what causes postpartum depression, it is most likely due to a combination of hormones and emotional processing deep in the brain.

As noted by Gwyneth Paltrow, an actress using her fame to shed light on the severity of this disorder, postpartum depression is not one size fits all; every woman experiences it differently and experiences symptoms at different severities. This is why it is important for women to be open and honest about their experiences with postpartum depression. Women often feel a lot of shame when they have postpartum depression, because they do not understand why they are feeling this way or what they are feeling. They feel like they are alone in these feelings. However, this is not the case. Other famous mothers such as Brooke Shields and Marie Osmond, like Paltrow, are using their platforms to share their struggles with postpartum depression and let women know that they are not alone and that they should not feel ashamed, which is opening up the doorway to treatment for all women. Postpartum depression can be effectively treated with psychotherapy, support groups, and psychiatric medication if needed. These treatments are the most efficient way for you to feel better and connect with your child.

If you or someone you know appears to be suffering from postpartum depression, 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: Layton, M. J. (2016, January 26). Task force urges doctors to screen new moms for depression. Retrieved from http://www.northjersey.com/story/news/2016/01/26/task-force-urges-doctors-to-screen-new-moms-for-depression/94422958/