Depression: Difference between Unipolar and Bipolar Depression

By Gabriella Phillip

Eliciting a history of brief periods of improved mood is the key to differentiating between unipolar and bipolar depression. Bipolar spectrum disorders typically begin earlier in life than unipolar depression; the usual sign of bipolar disorder in young children could be depression and/or a combination of depression and states of mania/hypomania. It’s significant to ask the patient how old they were when they first experienced a depressive episode. Men have a higher rate of bipolar disorder than women, but the rates for unipolar depression in men and women are more equal.

Some patients with bipolar spectrum disorder can go from normal to severely depressed technically overnight whereas unipolar depressive episodes tend to occur more gradually. Patients with bipolar spectrum depression tend to experience weight gain and crave carbs, while those with unipolar depression usually experience weight loss or loss of appetite. Patients suffering from bipolar depression tend to show irregular responses to antidepressant monotherapy, including switching into mania. Bipolar spectrum disorder is an inheritable mental illness, so it’s vital to take family history into consideration. While patients diagnosed with unipolar depression usually note that their symptoms fluctuate in a more stable, regular pattern, those with bipolar depression have moods that can vary unpredictably, usually with no cause.

When treating bipolar depression, antidepressants are used in combination with some sort of mood stabilizer. Treatment for unipolar depression can include medication like SSRIs and antidepressants, often in combination with cognitive behavioral therapy (CBT) and psychotherapy. Screening instruments including the Bipolar Spectrum Diagnostic Scale and the Mood Disorders Questionnaire can be effective and helpful tools in differentiating unipolar from bipolar depression.

If you or someone you know is struggling with Bipolar Disorder or Unipolar Depression, 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/ .

Sources

https://www.psychiatrictimes.com/special-reports/major-depressive-episode-it-bipolar-i-or-unipolar-depression

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850601/

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/unipolar-and-bipolar-depression-different-or-the-same/AE364DFBFFBAF1F66A9294A55120C64E/core-reader

 

 

Depression: Have a Case of the Winter Blues? Understanding Seasonal Affective Disorder

 

By: Keely Fell

Can’t seem to shake the winter blues? Nearly five percent of adults are experiencing symptoms that align with major depressive disorder with recurring seasonal pattern, which is more commonly known as Seasonal Affective Disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), an individual who is experiencing “two major depressive episodes in the last two years” that show relations to the time of year, and experience full remissions at other times they may be experiencing Seasonal Affective Disorder (SAD).

It is also important to understand what is happening in the body and why an individual is experiencing such symptoms. When an individual is experiencing these symptoms, often it can be as a result of the lack of natural light due to the shorter periods of daylight during the winter season. With the lack of light, the human brain slows down the production of serotonin, and increases the production of melatonin which leaves individuals feeling drowsy. Melatonin production increase is caused by darkness, which is why we get sleepy when the sun goes down. The regulation of these chemicals is what helps create your body’s specific circadian rhythm. When this system is affected it can cause a feeling of lethargy and or restlessness.

Here are some tips and tricks to shaking those winter blues:

  1. Take a few minutes during your day to get outside Whether that’s during your lunch break or walking to pick up the mail, going outside during daylight will increase the serotonin production in your brain.
  2. Light Therapy During the dark winter months, if these symptoms are taking over you can try light therapy. Light therapy allows for the brain to think it’s being exposed to sunlight. People who use light therapy typically invest in a light box (if interested Harvard Health has many they recommend) which delivers around 10,000 lux, compared to a standard sunny day that ranges 50,000 lux or above. They recommend that, you sit in front of the light box for no more than 30 minutes a day. This allows for the brain to regulate its circadian rhythms by allowing the retinas to be stimulated. Light therapy does not work for everyone.
  3. Talk Therapy If these symptoms persist and are affecting your day talk therapy is also affective. Reaching out to a psychologist, psychiatrist, psychiatric nurse practitioner, or psychotherapist to come up with symptom relief is another big way to combat these symptoms. Symptom relief may include the use of antidepressants, or various therapeutic methods.

 

If you or someone you know has Seasonal Affective Disorder or seems to have the symptoms of SAD, and needs 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/ .

Sources:

https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml

https://www.health.harvard.edu/blog/seasonal-affective-disorder-bring-on-the-light-201212215663

https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder

 

CBT & DBT

Image result for cbt and dbt therapy

CBT & DBT

By: Vanessa Munera

When it comes to psychotherapy, there are different types. Psychotherapy is also known as “talk therapy”. According to the American Psychiatric Association, “Psychotherapy is a way to help people with a broad variety of mental illnesses and emotional difficulties”. This is when an individual speaks with a therapist or psychologist in a safe and confidential environment. During these talk sessions, you are able to explore and understand your feelings and behaviors, and develop coping skills. In fact, research studies have found that individual psychotherapy can be effective at improving symptoms in a wide array of mental illnesses, making it both popular and versatile treatment. There are different types of psychotherapy that can assist people. The most common types of psychotherapy are Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).

Cognitive Behavioral Therapy or CBT, is a form of therapy that consists of focusing on exploring relationships among a person’s thoughts, feelings and behaviors. This type of therapy helps patients gain control over and accept unwanted thoughts and feelings so that they can better manage harmful or unwanted behaviors. CBT is usually used to treat conditions related to anxiety, depression, substance abuse, eating disorders, and social skills. As a matter of fact, Cognitive Behavioral Therapy has been shown to be an effective treatment for these conditions, as well as improving brain functioning. CBT can benefit people at any age, such as a child, adolescent, and adult.

Dialectical Behavioral Therapy, or DBT, is a type of therapy that was originally designed to help individuals with borderline personality disorder (BPD). Over time, this type of therapy has been adapted to help treat people with multiple different mental illnesses, but it is mostly used to treat patients who have BPD as a primary diagnosis. Although DBT is a form of CBT, it has one big exception: it emphasizes validation and accepting uncomfortable thoughts, feelings and behaviors instead of struggling with them. DBT allows patients to come in terms with their troubling thoughts, emotions, or behaviors that they have been struggling with. Studies of Dialectical Behavior Therapy have shown effective long-term improvements for those suffering from mental illness. DBT also helps lower the frequency and severity of dangerous behaviors, utilizes positive reinforcement to promote change, and helps individuals translate what they learned in therapy to everyday life.

 

References:

https://www.nami.org/learn-more/treatment/psychotherapy

https://manhattanpsychologygroup.com/difference-dbt-cbt-therapies/

https://www.psychiatry.org/patients-families/psychotherapy

Postpartum Depression

By: Maryellen Van Atter

          Postpartum depression is the experience of depressive symptoms (such as fatigue, changes in eating habits, and a loss of interest in activities once found enjoyable) after giving birth. Though commonly known as postpartum depression, it is now often referred to by the new name of peripartum depression. This name change indicates that the depression can onset during pregnancy or after childbirth. In addition to symptoms of depression, parents may also suffer from feelings that they are a bad parent, fear of harming the child, or a lack of interest in the child. It is also important to note that both men and women can suffer from peripartum depression; fathers may struggle with the changes that come along with a new child, and the symptoms of peripartum depression are not contingent on giving physical birth to a child. It is estimated that 4% of fathers experience peripartum depression in the first year after their child’s birth and that one in seven women will experience peripartum depression.

            Peripartum depression is different from the ‘baby blues’. Many new mothers will feel despondent, anxious, or restless in the first week or two after giving birth; this is due to the variety of biological, financial, and emotional changes which occur after having a child. This is called the baby blues. However, these feelings will not interfere with daily activities and will pass within ten days. If these symptoms persist, or if they do interfere with daily activities and functioning, it is likely that the problem is something more serious such as peripartum depression. It’s important to seek treatment for these symptoms as soon as you’re aware of them. Many parents feel a stigma against reporting these feelings, but this should not be the case: experiencing peripartum depression does not mean that you are a bad parent or that you do not love your child. It is a psychological condition which many people experience and it can be resolved with proper treatment.

Peripartum depression can be treated through therapy and through medication. Common treatments include psychotherapy (also known as talk therapy), cognitive behavioral therapy, and antidepressant medication. Medication should always be managed by a professional, especially if being administered to a mother who may be breastfeeding. These treatments have been proven effective in many studies and are able to help with symptoms of peripartum, or postpartum, depression.

 

If you or someone you know is struggling with peripartum depression, Arista Counseling and Psychotherapy can help. Please contact us in Paramus, NJ at 201-368-3700 or in Manhattan, NY at 212-996-3939 to arrange an appointment. For more information about our services, please visit http://www.counselingpsychotherapynjny.com/

 

Sources:

https://www.aafp.org/afp/2016/0515/p852.html

https://www.psycom.net/depression.central.post-partum.html

https://www.webmd.com/depression/postpartum-depression/news/20190320/fda-approves-first-drug-for-postpartum-depression#2

https://www.webmd.com/depression/postpartum-depression/understanding-postpartum-depression-treatment#3

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039003/

https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression

Bipolar Disorder vs. Borderline Personality Disorder

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Bipolar Disorder vs. Borderline Personality Disorder

by Sam Matthews

Even though most people are aware that Bipolar Disorder and Borderline Personality Disorder are two different disorders, their differential diagnosis is often difficult due to many phenotypic overlaps between the two. Bipolar disorder often presents with three key features: mania, hypomania, and depression. It is one of the 10 leading causes of disability in the United States with a prevalence of 2.1% in the population. Bipolar disorder’s onset is usually during late adolescence or early adulthood, with cyclothymic temperament being the most common prodromal symptom. Borderline Personality Disorder, on the other hand, is categorized by impulsivity, instability in personal relationships, self-image, and affect. People with this specific personality disorder are often in problematic or chaotic relationships and become very suspicious, or even paranoid when faced with a stressful situation. This disorder can also present with depersonalization or dissociative symptoms, as well as suicide, or non-suicidal self-injury, which often leads to multiple hospitalizations during their lifetime. Their coping skills seem to be poorly developed and maladaptive, leading to even more problems in their daily life and relationships. About 15% of people living in the United States have been diagnosed with at least one personality disorder, however only 6% have one in Cluster B, which includes antisocial, borderline, narcissistic, and histrionic personality disorder.

When comparing the two disorders, it is imperative to make the distinctions as clear as possible. First, we can compare the suicide rates. For bipolar disorder, there is a 10% to 20% mortality rate from suicide, while there is an 8% to 10% mortality rate from suicide for those suffering from borderline personality disorder. Furthermore, bipolar disorder has an episodic course, meaning the symptoms come in waves, with different episodes of the disorder taking place over time. It is also categorized by gradual changes in mood (days to weeks). This differs from borderline personality disorder where the mood changes are often abrupt (hours). It is very common to see non-suicidal self-injuries in patients with borderline personality disorder, but uncommon in those with bipolar disorder, which could be why the suicide rate for those with bipolar disorder is double that of those with BPD. This is because those with borderline personality disorder have poor coping skills, and often want attention or just want to “feel something”, not actually die, due to their distorted way of thinking. Psychotic symptoms can be found in both disorders, however they are only present in bipolar disorder alongside the presence of mood symptoms, and only present in BPD during stressful situations. Another distinction between the two disorders is the way in which one develops it. Bipolar disorder has a genetic aspect, while BPD is usually caused by a significant history of trauma. Overall, these two disorders can often be confused due to the most obvious symptom: changes in mood, which is present in both, but it is important to look at both symptom profiles very closely when making a final diagnosis, in order to ensure that the course of treatment for the patient will be most beneficial and the greatest probability of a good outcome.

Sources:

https://www.medicaldaily.com/bipolar-vs-borderline-personality-disorder-differences-between-two-and-how-avoid-335314

Suicide: Suicidal Awareness, All Year and Every Year

By: Diana Bae

September is National Suicide Prevention and Awareness Month. Although today is the last day of the month, the awareness of suicide should not be limited to a single month. Instead, it is an issue that should be recognized every single day because in all cases, suicide is preventable.

2% of all deaths in the United States are due to suicide. The affected population is usually men of older age but as of recently, has also involved more teenagers and young adults (ages 15-24). The most common causes are due to feelings of hopelessness, loneliness, stress as well as the effects of psychological illnesses, like depression.

However, it is important to know that NO ONE IS ALONE WITH THIS STATE OF MIND. With the correct help, all of these difficulties can be helped when speaking with a psychologist. If you or someone you know has expressed these thoughts, including but not limited to: suicidal ideation, self-harm, extreme changes in behavior, and relying on substances, contact a therapist right away.

Arista Psychological and Psychiatric Services will be there to help those who are feeling suicidal and are dedicated to be a comforting source for those seeking for treatment. If you or someone you know would like to set up an appointment for our counseling services, contact us at our offices in Paramus, NJ (201) 368-3700 or in Manhattan, NY (212) 996-3939. For more information, please visit our website https://www.counselingpsychotherapynjny.com/

For emergency situations: National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

 

Sources:

https://www.apa.org/topics/suicide/

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

https://www.apa.org/topics/suicide/signs

Image source: http://www.webgranth.com/alone-wallpapers-download-latest-hd-alonesad-wallpaper-free

Seasonal Affective Disorder

Seasonal Affective Disorder (S.A.D)

By Tatyana A. Reed

As the weather seems to slow down and we shift from bright sunny days to cold winter nights, some of us may notice a sudden change of mood that comes with this weather shift. This change of mood is called Seasonal Affective Disorder (S.A.D). According to National Institute of Mental Health (NIMH), “S.A.D is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. Depressive episodes linked to the summer can occur, but are much less common than winter episodes of SAD.”

Signs & Symptoms

  • Feeling depressed most of the day, nearly every day
  • Feeling hopeless or worthless
  • Having low energy
  • Losing interest in activities you once enjoyed
  • Having problems with sleep
  • Experiencing changes in your appetite or weight
  • Feeling sluggish or agitated
  • Having difficulty concentrating
  • Having frequent thoughts of death or suicide.

Causes

  • People with SAD may have trouble regulating seratonin, which is one of the key neurotransmitters involved in mood.
  • People with SAD may overproduce the hormone melatonin.
  • People with SAD also may produce less Vitamin D.

 

Getting Treated

  • Medication: if someone suffers from S.A.D they can be helped by taking Selective Serotonin Reuptake Inhibitors (SSRIs). However, like all medication there are side effects, make sure to speak with your doctor about this first.
  • Light therapy: the feelings of S.A.D can be lessoned by sitting in front of a light box that emits 10,000 lux of cool- white- fluorescent light for 20-60 minutes. The light is said to replace the loss of light from daylight savings
  • Therapy: it is best to talk with a psychologist, counselor, or someone in the mental health field when feeling different types of emotions that may be negative such as sadness or anger. Seeking help is the first step to eliminating S.A.D.

If you or a person you know is struggling with S.A.D, it may be beneficial to contact a mental health professional and receive therapy. The psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.acenterfortherapy.com for more information.

References:

Koblenz, Jessica. “11 Things About Seasonal Affective Disorder That Psychologists Wish You Knew.” Reader’s Digest, www.readersdigest.ca/health/conditions/seasonal-affective-disorder-facts/. (PHOTO)

National Mental Health Institute. “Seasonal Affective Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, http://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml.

 

Bipolar One Vs. Bipolar Two

By: Yael Berger

Bipolar, also known as manic depression, is a mood disorder characterized by extreme highs and extreme lows. Extreme highs are called mania while the extreme lows are called depression. It is seen in both adults and children and tends to run in the family. If you have a close relative with Bipolar disorder, you have an increased chance of developing the disorder. According to the national institute of mental health, “an estimated 4.4% of U.S adults experience bipolar disorder at some time in their lives.” There are two different types of Bipolar that are often difficult to distinguish between.

Bipolar I patients commonly present with these symptoms:

  • An episode of extreme mania lasting at least one week and usually an episode of severe depression lasting at least two weeks
    • Mania is characterized by irritability, mood swings, and possibly excessive spending, drinking, excessive sexual behavior etc.
  • Less need for sleep
  • Increased self-esteem, speech, thoughts, distractibility
  • Rapid mood swings
  • Can have a break with reality
    • Hallucinations, delusional or paranoid thoughts
  • Usual onset: around 18 years old

Bipolar II patients commonly present with these symptoms:

  • An episode of hypomania lasting at least four days and always accompanied by an episode of extreme depression lasting at least two weeks
  • Hypomania is a milder form of mania but it is still noticeable to others
  • Typically are prescribed antidepressants with mood stabilizers
  • Usual onset: around mid-20s

There are a few key differences between bipolar I and bipolar II. The main difference is that Bipolar I often begins with mania while Bipolar II often begins as a depressive episode that is later diagnosed when an episode of hypomania occurs. Bipolar II is sometimes wrongly diagnosed as depression at first because it often starts as a depressive episode. Bipolar I is usually obvious and severely disrupts a patient’s life while Bipolar II can be less noticeable. However, once a hypomanic episode in Bipolar II patient causes severe impairment it would then be categorized as Bipolar I. Bipolar I can lead to hospitalization more often than Bipolar II because of the extreme mania that occurs. A combination of medication and therapy can help both Bipolar I and II.

If you or someone you know has any type of Bipolar 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 https://www.counselingpsychotherapynjny.com/

Sources:

https://www.healthline.com/health/bipolar-disorder/bipolar-1-vs-bipolar-2#symptoms

https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml

https://www.psychologytoday.com/us/blog/two-takes-depression/201901/10-things-know-about-bipolar-disorder

Image:

https://www.medicalnewstoday.com/articles/319280.php

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder

By: Julia Keys

Obsessive Compulsive Disorder (OCD) has been normalized and trivialized in society as a need for everything to be meticulously clean and organized when in reality it is a serious psychological disorder that can cause significant distress for those who have it. Obsessive Compulsive Disorder is characterized by a pattern of uncontrollable reoccurring thoughts, known as obsessions, which can only be remedied by certain behaviors, known as compulsions. People with OCD are commonly depicted as being ultra-neat or afraid of germs, which is true for some people, but the way OCD expresses itself is unique to the individual.

There are several common themes that psychologists have determined when treating patients with Obsessive Compulsive Disorder. One common theme is contamination. This may take on the literal meaning in which an object or place can be perceived as dirty, but it can also mean that contact with a person, place, or object will cause great harm. Checking is another typical behavior. One may check if something is safe or turned off over and over again. Checking can also express itself in the need for constant verbal reassurance, so a person with OCD may ask the same question over and over. People with OCD may be worried that they will suddenly lose control and hurt themselves or someone else. In efforts to qualm these obsessions, one may avoid certain places or people or have plans set in place that could prevent them from acting out these thoughts.

Common obsessions may include, but are not limited to:

  • Fear of germs or contamination
  • Unwanted forbidden or taboo thoughts involving sex, religion, and harm
  • Aggressive thoughts towards others or self
  • Having things symmetrical or in a perfect order

Common compulsions may include, but are not limited to:

  • Excessive cleaning and/or handwashing
  • Ordering and arranging things in a particular, precise way
  • Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
  • Compulsive counting

When reading these lists one might think that these behaviors are relatively typical, however people with OCD spend an excessive amount of time and effort thinking about obsessive thoughts and preforming rituals to control them. A person with OCD may feel brief relief after preforming a compulsion, but they do not feel pleasure from such acts. Obsessions and compulsions are very difficult to control and may result in significant problems in one’s daily life or relationships.

If you or someone you know is struggling OCD, 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.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

https://www.psychologytoday.com/us/blog/living-ocd/201107/the-many-flavors-ocd

Source for Picture:

https://www.bing.com/images/search?view=detailV2&id=47C5DD3F1D65AD247FE6091E7A61190FA00E0683&thid=OIP.X50wPNnUfEvJHrY8IH6VyQHaFj&mediaurl=http%3A%2F%2Fwww.belmarrahealth.com%2Fwp-content%2Fuploads%2F2016%2F01%2FObsessive-compulsive-disorder-OCD-questionnaire-can-also-help-determine-the-risk-of-depression-and-anxiety.jpg&exph=2475&expw=3300&q=ocd&selectedindex=57&ajaxhist=0&vt=0&eim=1,2,6

 

 

 

Loneliness

Loneliness

By Lauren Hernandez

            Have you been feeling lonely? Feeling alone, like you have nobody to turn to, depend on or trust, is a very common experience, even if you do have a social support group. Social isolation and loneliness can affect people of all ages, races, and socioeconomic backgrounds. One of the most common groups to face loneliness include teenagers and adolescents due to social media and because they are figuring themselves out and are trying to fit in. The elderly are another at risk group due to increased rates of isolation and death of close family and friends caused by aging. Physical limitations, social anxiety, or other emotional or social barriers may also prevent an individual from seeking relationships with others. Loneliness is considered to be a risk factor for an increase in stress, chronic inflammation, Type 2 diabetes, arthritis, Alzheimer’s disease, as well as anxiety and depression. It has also been found that loneliness may increase drug use.

It is important to note that social media has been linked to the rise in feelings of loneliness especially among teens because these platforms create a false sense of connection. Rather than visiting a friend or speaking with someone in person, this communication has been digitized and allows for there to be limited physical interaction.

Loneliness creates feelings of anxiety, depression, and other mental health disorders and it is important to seek help. If loneliness has been overwhelming for you, it may be time to seek professional help.

If you or someone you know is feeling lonely, 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/ .