Anxiety: Exposure Therapy Helping Teens Combat Anxiety

By Hannah Pierce

Exposure therapy is a cognitive-behavioral therapy technique in which a person is exposed to a feared object or situation to overcome their anxiety. A majority of researchers and clinicians believe that exposure therapy is the most effective treatment for many anxiety disorders. One study even found that people improved more using this technique than taking antidepressants.

Although exposure therapy is proven to be very effective, it is not frequently used with teens. Many teens suffering with anxiety are prescribed medication rather than receiving therapy. It is difficult for people to consent to exposure therapy because they do not want to do something that will make them feel even more anxious.

One article documented teens’ experiences with exposure therapy. A 14-year-old suffering from social anxiety, depression, OCD, and binge-eating agreed to tackle his social anxiety through exposure therapy. On a busy college campus he sat on a bench next to a stranger and initiated a conversation. To some people this may seem simple but to a teen suffering from social anxiety, the task is very daunting. He sat on the bench and tried to talk to the stranger but the stranger just kept texting and playing with his phone. Although the exchange did not turn into a conversation, at least the teen faced his fear and realized it wasn’t that bad.

Another teen’s exposure involved him holding a sign that read “I’ve been bullied. Ask me.” Thomas hoped to combat his anxiety while also educating people on bullying. Most students on the campus walked by him without giving him a second glance. After a while, a couple stopped to talk to Thomas. The man empathized with him, sharing that he had been bullied as well and the woman applauded Thomas for his bravery.  After the exchange Thomas was very pleasantly surprised and realized he did not have much to be so anxious about.

If you or someone you know may be experiencing anxiety, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.

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


Depression: How Exercise can help Part 2: The Exercise Influence

Depression has a variety of causes and these causes are not easily eliminated despite their detrimental effects on a person’s life and relationships. Moderate to severe cases may only be manageable by pharmacology and therapy, which includes the therapy loved ones can also give by providing companionship, understanding, and love. For mild to slightly moderate cases, however, scientists have found through multiple research studies conducted on over 1 million patients, exercise alleviates some of the symptoms of depression in patients and also could potentially prevent depression developing from those not suffering yet. This means, to be clear, exercise is not a cure for depression, but it can help alleviate the symptoms.

Exercise is associated with endorphins. Endorphins are endogenous opioids naturally released by your body, which have a similar chemical structure and composition to morphine. Endorphins, like morphine, attach to opioid receptors within our body and block pain transmission while also producing euphoria. Euphoria is a rushing sensation of happiness, energy, and joy. This can be seen when runners experience the “runner’s high” after running for an extended period of time without feeling fatigued or pained. The bodies of those who exercise rigorously release these endorphins.

Not only are chemicals affected but so is the brain’s anatomy. Researchers at Harvard University contrasted patients with major depression before and after exercising. One major change researchers and doctors have found a noticeable size difference in the hippocampus of those with depression and those without. Patients with depression have a smaller hippocampus, which regulates mood. Dr. Michael Craig Miller has found that exercise helps increase nerve growth and connections within the hippocampus. This, he explains, has led to alleviation of some of the symptoms.

Another study done by conglomerating data on over 1,140,000 adults of different ethnicities and ages found that there was significant data indicating that there was a considerable link between mental health and exercise. The subjects were divided into 3 groups pertaining to their aerobic fitness. After studying depression diagnosis within these groups, the scientists found that those who were in the lowest tier (the least fit/active) were 75% more likely to be diagnosed with depression than those in the “fittest” tier. The second tier was 25% more likely to be diagnosed with depression than those in the “fittest” tier.

Additionally, researchers found, from collecting data from 25 studies, that subjects who were forced to do some moderately strenuous exercise (ex. Brisk walking) benefitted mentally from it as opposed to the control group where they were did not exercise. Researchers believe that concentrating on the exercise allowed subjects to stop ruminating and thinking negatively during that time, improving their mental health. Blood samples, drawn from patients with major depression before and after their exercise regimen, showed that subjects who exercised had different concentrations of inflammatory agents and hormones. A recent study conducted by the Norwegian University of Science and Technology with nearly 800 six year old children over a span of four years found that children who exercised moderately showed fewer depressed symptoms than their counterparts.

Exercise can’t and won’t fix all problems that depressed patients endure; sometimes, it might not even help those who are suffering from severe depression and those with hormonal imbalance. However, if these studies show something, it is that exercise can help people not only physically but also mentally. So take a brisk walk one day when you’re feeling blue. It’s good for you!


If you find yourself depressed or becoming depressed or if you know someone who suffers from depression contact our psychotherapy offices in New York or New Jersey to speak with one of our therapists. Arista Counseling & Psychological Services  (201) 368-3700.

Depression: Why Exercise Can Help (part 1: what is depression?)

Eve Bae

With around 16.1 million Americans affected by major depressive disorder and around 3.3 million American adults affected by persistent depressive disorder1, it is imperative for health care professionals to figure out how to help patients suffering with their disorder. These statistics even exclude children and those under the age of legal adulthood, making the number of afflicted patients most likely greater. With the different types and degrees of severity of depression, it is difficult to state that there is one encompassing solution for this multifaceted diagnosis.

Depression is a state of being characterized by multiple symptoms such as depressed mood, diminished interest or pleasure, fatigue, negative feelings of worthlessness, difficulties with concentration or thinking which impair the patient’s daily life activities. The patient must have been feeling this way for at least the same 2 week period and all symptoms must be caused solely by this disorder. This condition can have a biological, social, or even environmental base. Researchers have found that people suffering from depression have a smaller hippocampus and other biological differences, which differentiate them from those who do not suffer from this condition. Another area explored and hypothesized is the role neurotransmitters play in this disorder. Harvard researchers, doctors, and psychologists acknowledge that the brain is a dynamic system with no one neurotransmitter as the sole cause for all patients but there may be different problematic neurotransmitters for each patient. When the fragile balance of serotonin, norepinephrine, dopamine, glutamate, and/or GABA is disrupted, it affects the brain and ultimately the patient, influencing their moods, emotions, and behavior.

If you or someone you know is suffering from depression, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit

So how can exercise help this difficult disorder? Onto Part 2!

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Depression: Signs and Symptoms

Depression: Signs and Symptoms

By Daisy Lee

One of the most common mental health or mood disorders is one known as major depressive disorder, or more simply, depression. Although depression is not rare in the general population and awareness of it has been increasing, many people still struggle to spot depression. A lot of times, people can mistake depression for simply being tired or sad.

Depression can encompass many different characteristics, not all of which may manifest in a single person. For example, one person who is clinically depressed may have significant weight loss without intention while another person who is clinically depressed may have significant weight gain. The symptoms of depression are not always clear-cut. Here are a few common symptoms of depression:

  • Diminished interest or pleasure in activities
  • Significant weight loss or weight gain; increase or decrease in appetite
  • Insomnia (inability to sleep or stay asleep) or hypersomnia (sleeping too much)
  • Psychomotor agitation or retardation (slowed down movements)
  • Fatigue, lethargy, or loss of energy
  • Feelings of worthlessness or excessive/inappropriate guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death or suicidal ideation

As mentioned before, depression can be difficult to spot, even if you are familiar with the symptoms and what depression encompasses. If you or someone you know might be struggling with depression, speak with one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists. Contact us at our Paramus, NJ or Manhattan, NY offices at (201) 368-3700 or (212) 722-1920 respectively to set up an appointment. For more information, visit



Anxiety, Depression, Isolation

By: Emily Mulhaul

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

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

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

Maintaining or seeking relationships

Sleep (insomnia)


Daily Energy

The psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Logotherapy: The Search for Meaning


4ca1c28dce143e607ec4f0768683ea1e[1].jpgLogotherapy is a form of psychotherapy formed by Dr. Victor Frankl. It is based on the belief that the primary force of motivation in humans is our need to see meaning in our lives. Frankl believed that even in the darkest situations, humans will strive to create meaning out of their experience. Frankel developed this theory after he spent years in a Nazi concentration camp during World War II. There was no freedom in the physical sense, but Frankel realized that he still had the freedom to choose how he existed mentally in such a difficult situation. Frankl and some of his fellow inmates found that by making it their mission to help fellow prisoners in need, they found meaning in what seemed like a helpless position and a hopeless situation.

Frankl survived the camps, citing the meaning he had found as a key factor contributing to his survival. He went on to apply his theory to his own system of existentially based psychotherapy. With depressed clients especially, who were struggling with both inner demons and tough situations like divorce or the death of a loved one, he encouraged them to search for something in their lives that could provide meaning. He introduced clients to the idea of inner freedom: their freedom to choose the stance they took in even the most destitute situations and the freedom they had to search for meaning in whatever they experienced.

If you are having difficulty finding meaning in your life, the psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Self-Sabotage: Getting In Our Own Way

Does it ever seem as if you’re working against yourself? Do you feel like your own actions are counterproductive? If so, you may be self-sabotaging without even realizing it. Below are 6 things you might believe or say which could be causing detriment to your everyday life.

  1. Diminishing your accomplishments and feeling that you are “beneath” others: This includes feeling like your successes are more from luck than personal accomplishment, and feeling inferior and incompetent in comparison to others.
  2. Constantly beating yourself up: Repetitively focusing on your weaknesses (no matter how trivial your shortcomings are) and wondering why anyone would truly like you as a person are red flags for self-sabotage.
  3. Believing that you don’t have the right to ask for what you want or need: Not standing up for yourself and/or denying gifts or help because you don’t feel worthy of them are only pernicious to yourself.
  4. Seeing yourself as an outcast: You might feel as if you don’t belong anywhere and that you are unable to fit in with any group. Though it’s true that you may not fit into your current environment, people with true self-sabotaging beliefs think of themselves as “abnormal” in any setting.
  5. Not being able to trust yourself: This includes thinking that your own perceptions and judgments cannot be trusted. You might tell others that your opinions don’t count.
  6. Believing that others’ wellbeing comes before your own: Catering to someone else’s needs and feeling responsible for their welfare more so than for your own is not a healthy way of living.

If any of these thought patterns, beliefs, or tendencies sound like ones you or a loved one do, it is important to break free of them so you are able to live a healthier and happier life. Consider reaching out to the psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Visit for more information.

Source: Seltzer, Leon F. “9 Ways Your Old Programming May Be Holding You Hostage.” Psychology Today. Sussex Publishers, LLC, 22 Jan. 2015. Web. 25 Mar. 2016.

By: Scout H



The Many Faces of a Major Depressive Episode


Whether things are going well in life, staying the same or taking a turn for the worse, a major depressive episode can occur in your life or the life of the ones you love. It is often difficult to tell, especially at first, whether you or someone you know is experiencing a Major Depressive Episode (MDE) or if they’re just having a rough week. Familiarize yourself with the following symptoms if you suspect something is amiss and understand that an MDE could present itself as many different combinations of these symptoms.

The two main criteria for a Major Depressive Episode are either a depressed mood and/or loss of interest or pleasure in activities that previously sparked interest or pleasure. These symptoms usually must remain present for at least a two week period. During these two weeks people experiencing an MDE may also experience a significant change in eating patterns. Increases or decreases in appetite and weight are among the easier symptoms to notice. Insomnia and hypersomnia and generally noticeable changes in sleeping patterns are also common. A generally lower energy level, chronic fatigue, and slower voluntary movement are symptoms that could be the result of a lack of sleep but can also be observed in patients that oversleep or have no changes in their sleeping patterns. Agitated mental state and agitated voluntary movement are also potential symptoms. Some symptoms that are not objectively observable but may reoccur daily are feelings of worthlessness, excessive or misplaced guilt, indecisiveness and decreased concentration. Frequent thoughts about death, – not just fear of dying– suicidal ideation with or without a specific plan or suicide attempts are additional symptoms of an MDE that are not necessarily present.

Always keep in mind that symptoms do not have to look the same; a depressed person may report feeling “nothing” — neither sadness nor pleasure. While many symptoms are recognizable objectively, subjective feelings of sadness, emptiness or anhedonia should also raise a warning flag. The symptoms listed above can combine and affect each other in many ways, presenting different “faces” of depression. It is important to understand how differently an afflicted individual may act and that certain symptoms do not necessarily mean a more or less serious case.

If you believe that you are a loved one has or may be experiencing a Major Depressive Episode, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Contact our Bergen County, NJ or Manhattan offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment. Visit for more information.


By: Anna Straus



“Depression and Obesity: The Double Epidemic”

By: Chana Kaufman

Depression and obesity seem to be phenomena that occur together, however, akin to the case of the chicken and the egg, it is unclear which precedes or causes the other. Studies have established that there definitely is a link between the two, and many patients within these spectrums often exhibit symptoms for both. According to Marina Williams, LMHC, “In fact, the two conditions are so intertwined that some are calling obesity and depression a double epidemic.” Furthermore, Williams establishes that, “Studies have found that 66 percent of those seeking bariatric, (weight loss) surgery have had a history of at least one mental health disorder.”

The question begs, why do depression and obesity fit so neatly and often occur simultaneously? In her article on this topic, Williams offers a simple explanation for the correlation between the two. Depression makes one lose willpower in life, resulting in decisions such as healthy eating or exercise to be sidelined or eliminated completely. Additionally, certain foods, mostly unhealthy choices, are what we associate with as comfort food and often resort to when feeling kind of blue. According to Williams, “Eating something unhealthy is much easier than fixing the problem or dealing with what’s causing us to feel unhappy”. Williams emphasizes that seeking help and learning how to deal with issues such as depression and sadness will oftentimes lead to an overall healthier lifestyle, and positively affect the issue of obesity as well.

If you believe that you or a loved one has or may have depression, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.


Depression: Social Isolation Increased by Social Media


Depression: Social Isolation Increased by Social Media

While most adults today grew up before cell phones and the internet existed, the younger generations are learning about the world from behind a screen. Adolescence has always been an important time for developing key social skills, but as today’s youth does more interacting online than face-to-face, they are experiencing a new kind of socialization with different consequences, such as depression. With 75% of teens having cell phones and 20% of teens experiencing depression, it is important to know the role of social media usage.

The internet’s over-sharing culture easily creates an environment for inaccurate social comparison, which can create low self esteem. Social media users emphasize the positive while hiding the negative, creating an illusion that their lives are “perfect.” While a teen sees every good and bad detail of her own life, she is being bombarded by positive details from her friends’ lives. She is essentially comparing her behind-the-scenes footage with everyone else’s highlight reel. It can be difficult for adults to realize that these comparisons are unfair, so teens fall victim to the illusion because they don’t realize they aren’t getting the full picture. A teen obsessing over her friend’s “perfect” profile could start to feel that her own life is inadequate. Multiply this by the hundreds of friends’ profiles she accesses, and low self-esteem and depression become a concern.

Texting provides users with a sense of security because it lacks the personal aspects of face-to-face communication, resulting in more negative social interactions. When arguing in person, teens experience nonverbal cues that guide them as they try to express their feelings without damaging their relationships. Texting is much less personal, so it is much easier for teens to be cruel without regard for the consequences. As a result, teens end up texting things they would never say in person, causing irreparable damage in the process. If a teen says something cruel in a face-to-face interaction, it would be near impossible not to deal with his friend’s reaction – he can’t just walk away after making his friend cry. Since digital communication is so impersonal, even if his friend does express his reaction to the cruel words, it is extremely easy for the teen to simply ignore the messages and stop responding. For the victim of the cruelty, this can be devastating. The lack of communication can lead to confusion regarding the appropriateness of their reaction and their relationship with the sender, leaving them wondering if the sender really meant the words and whether or not they are still friends. Negative social interactions and loss of friends are both major contributors to the development of depression in adolescents, and these can both be facilitated by social media and texting.

If you or a loved one is struggling with depression, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Contact our Bergen County, NJ or Manhattan offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment. Visit for more information.

By: Evagelia Stavrakis