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.

 

Changes to the Brain

 By: Katie Connell

                For a long time, scientists believed that changes to brain structure only occurred during infancy and childhood. By the time one became an adult, it was thought that brain structure would remain largely permanent and that no more changes could occur. However, in the 1960’s, scientists discovered that changes to the adult brain were indeed possible. One thing that verified this were brain changes that occurred to patient’s brains that were damaged in injuries and accidents. Damage that occurred in certain parts of one’s brain resulted in healthier parts taking over. With this discovery came insight into other ways that the brain could be changed, specifically in the realm of psychotherapy. Cognitive Behavioral Therapy (CBT) is a great example of a type of psychotherapy that can lead to long lasting changes to the brain. During a process called synaptic pruning, extra neurons (which transmit information) and synaptic connections (which permit neurons to transmit info) are eliminated to increase the efficiency of neural transmissions. One way this happens is by neurons being used more frequently. Those that aren’t used as much get eliminated, which improves the transmission of information. By repeated exposure and engagement in CBT (including thought shifting techniques and cognitive restructuring), neurons become strengthened, meaning less synapses and better transmission of neurons. Through the use of routine CBT, critical neural networks are able to change how we think and feel.

If you or a person you know is seeking CBT or other forms of therapy, the psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help. Please contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920. 

Source:

https://www.verywellmind.com/what-is-brain-plasticity-2794886

 

 

Social Anxiety Disorder

Social Anxiety Disorder

Social Anxiety Disorder

By: Julia Keys

It is typical to feel a bit nervous before public speaking or maybe a little anxious before a performance, however, for those with Social Anxiety Disorder, or SAD, even the smallest interactions with others can provoke feelings of extreme anxiety. Social Anxiety Disorder is characterized by a strong and persistent fear of humiliation and embarrassment that could be caused by social situations. People with Social Anxiety Disorder struggle with feelings of self-consciousness that are produced by the possibility of judgement in social interactions. Oftentimes the distress caused by social situations can become so overwhelming for those with SAD that they begin to avoid everyday activities and responsibilities such as going to work, going to school, or picking up the phone.

Signs of Social Anxiety Disorder:

  • Anxiety about being with other people
  • Difficult time interacting with others, stuttering, trailing off, and reserved behavior are common
  • Self-consciousness in front of other people and feelings of embarrassment
  • Fear of being judged
  • Difficulty making and keeping friends
  • Blushing, sweating or trembling around other people
  • Other physical symptoms such as disorientation, shallow breath, diarrhea, muscle tension and upset stomach

Social Anxiety Disorder can be treated with psychotherapy, medication, or both. A common affliction for those with SAD is the rumination that follows social interactions. New types of therapy are being developed to help those with SAD deal with this common symptom: post-event processing or PEP Mindfulness based therapies are aiming to target the feelings of shame, worry, and embarrassment that are caused by overanalyzing personal performance in social situations. Cognitive-Behavioral therapy helps people with SAD change unhealthy thought patterns that may be contributing to their anxiety. Medications such as antidepressants and anti-anxiety meds are often used in conjunction with psychotherapy. Social Anxiety Disorder affects over 19 million people across the US; however 35% of those suffering with social anxiety waited over ten years to seek treatment. Don’t hesitate to reach out and get the help you need.

If you or a loved one is struggling with social anxiety, do not hesitate to seek help by contacting 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.anxiety.org/social-anxiety-disorder-sad

https://www.psychologytoday.com/us/blog/fulfillment-any-age/201904/the-one-dose-approach-help-social-anxiety-disorder

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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

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Self Esteem: Low Self Esteem and Comparison

Self Esteem: Low Self Esteem and Comparison

Self Esteem: Low Self Esteem and Comparison

By: Julia Keys

It is easy to fall into the trap of comparing ourselves to others. We compare ourselves to others so often that they rarely even notice it. A social psychologist named Leon Festinger first proposed the social comparison theory in 1954 stating that humans look to others in order to evaluate their own self-image. Comparison is a necessary part of human cognition. We need to compare things in order to make choices. For example, imagine you are choosing between two different new cars to buy. One must compare the different traits of each car in order to make a well-rounded decision. Unlike cars, humans have unique and complex sets of experiences and genes, so comparing yourself to others isn’t logical. Unfairly comparing yourself to others is an unhealthy habit that can lead to low self-esteem, feelings of anxiety, and feelings of depression. Everyone has compared themselves to someone else at some point, but some people seem unusually preoccupied with it.

Here are some reasons why certain people tend to compare themselves to others frequently:

  • They feel like they have a lack of control over their life
  • Low self-esteem, low self-confidence, or low self-worth
  • History of being compared to a family member
  • Lack of self-knowledge/self-reflective skills

Ways to stop comparing yourself to others:

  • Limit social media use and when using, seek connection, not comparison
  • Take note of how often you compare yourself to others and mentally tell yourself to stop
  • Keep a journal with your own goals, aspirations, and self-reflections. Many times, people become so attached to certain ideals that they adopt from others that they forget to develop their own ideals. For example, if a child was told by his mother all his life that he must pursue a certain profession, they may be ignoring other career paths that they want to pursue. It is important to self-reflect so one can align their goals and behaviors to the wants and needs of their true selves.
  • If you do compare yourself, try to compare yourself to someone/something that is just slightly out of reach and well defined. When comparisons are general, one can get stuck in a rut of constant unfair comparisons instead of taking action and being able to achieve specific goals. Additionally, comparing yourself to something that is so out of reach can be discouraging. For example, if a woman compares body to an Olympic athlete, she is not setting a defined goal in order to be more like the athlete. In this case, it would be more helpful for the woman to aspire to be like her active friend who walks every day and schedule daily walks so she can exercise more.
  • Practice gratitude for your mind, body, spirit, and relationships
  • Only compare yourself to yourself, which is also known as internal validation. Internal validation is beneficial to your well-being and self-esteem.

If you or someone you know is struggling with low self-esteem or confidence issues, 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://blogs.psychcentral.com/childhood-neglect/2019/05/5-reasons-you-compare-yourself-to-others-and-how-to-stop-it/

https://www.psychologytoday.com/us/articles/201711/the-comparison-trap

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Relationships: The Impact of Attachment Styles

Relationships: The Impact of Attachment Styles

Relationships: The Impact of Attachment Styles

By: Julia Keys

Did you know that the way one develops an attachment to their mother as an infant has a profound effect on their adult relationships? Attachment styles were first studied in detail by the developmental psychologist Mary Ainsworth in her experiment called “the strange situation”. In the strange situation, Ainsworth had a mother and a child play together for about three minutes and then the mother left the room. Next, a stranger would enter the room and play with the child for about three minutes and then they would leave. Finally, the child’s mother would re-enter the room and resume playing with their child. Ainsworth was most interested in observing the child’s behavior when their mother re-entered the room.

Upon careful examination, Ainsworth found three distinct patterns of behavior in infants when their mothers re-entered the room. If the child was upset, but then easily soothed by their mother upon re-entry, Ainsworth deemed them as having a secure attachment style. If the child was indifferent to their mother upon re-entry, Ainsworth would label them with an insecure avoidant attachment style. Finally, if the infant shows conflicting behavior upon the mother’s re-entry such as clinginess and then subsequent rejections of affection, Ainsworth would say they had an insecure ambivalent attachment style. Insecure ambivalent children are unpredictable in terms of their parental reactivity.

Ainsworth hypothesized that children’s reactions were a result of how their parents responded to their needs. Hypothetically, infants with secure attachment styles have their basic needs met consistently by their parents. This leads the secure infant to show a healthy dependence on their parents. Infants with an insecure avoidant attachment have their needs minimally met by their parents, which leads them to be independent and self-soothing. Infants with insecure ambivalent attachment styles have their needs met inconsistently from their caregivers, which results in confusion and conflicting behaviors.

So how does this “strange situation” relate to people later on in life? Researchers have found that attachment styles follow infants into adulthood and impact their behavior in relationships. While the behavior infants exhibited in the experiment relied on whether or not basic needs such as food, water, or comfort were met, attachments styles in adults tend to manifest themselves in more complicated ways.  Secure adults tend to have healthy and satisfying relationships where they can receive and offer support as needed.  Avoidant adults seek independence in relationships and oftentimes can appear a bit callous to their own emotions. Avoidant adults aren’t likely to offer support to their partners because they rarely depend on it themselves. Finally, ambivalent adults fear being either too close or too far from their partner, causing them to feel confused by their feelings and act in unpredictable ways in the relationship.

Although attachment styles are habits that people have probably been practicing subconsciously for all their lives, they are not permanent. Individual or couples therapy can help those struggling with their own emotions or communication skills.

If you or someone you know is struggling in a relationship, 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.simplypsychology.org/mary-ainsworth.html

https://www.psychologytoday.com/us/blog/compassion-matters/201307/how-your-attachment-style-impacts-your-relationship

Source for Picture:

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Low Self Esteem: Imposter Syndrome

Low Self Esteem: Imposter Syndrome

Low Self Esteem: Imposter Syndrome

By: Julia Keys

        Do you ever feel like no matter how much you accomplish, you still are inadequate compared to others around you? Feeling fraudulent about one’s achievements is so common that psychologists have given it a name: Impostor Syndrome.  People with Impostor syndrome doubt their own accomplishments and have a fear of being exposed as a fraud among their colleagues.  Despite the fact that people with Impostor Syndrome have great external evidence for their accolades, they still cannot be convinced that they deserve what they have accomplished.Those with Impostor Syndrome often attribute their success to external factors such as luck or good timing.

Impostor Syndrome can be caused by perfectionism and fear of failure. However, if you are afraid you won’t be perfect or that you will fail, then you will be discouraged from going after new goals! The constant pressure found in those with Impostor Syndrome can cause feelings of guilt, shame, embarrassment, and at its worst, depression and anxiety.

One group of people that are especially prone to Impostor Syndrome are highly successful women.  The discrepancy between external achievement and internalization of achievement within successful women may be caused by our society’s standards. Gender roles have greatly shaped what it looks like to be a successful man versus what it looks like to be a successful woman. Successful men are stereotypically in positions of power while successful women are stereotypically in caretaker’s positions.  The type of achievements that constitute success in our culture, such as obtaining a high degree, being financially successful, or being promoted to a leadership position are more aligned with the stereotypes of male achievement, which may explain why when women achieve such goals, they feel like frauds.

No one should have to feel like a fraud, especially if they prove to be very high achieving. If you or someone you know can relate to the information above, 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/blog/the-scientific-fundamentalist/200912/why-do-so-many-women-experience-the-imposter-syndrome?collection=59879

https://www.psychologytoday.com/us/blog/the-scientific-fundamentalist/200912/why-do-so-many-women-experience-the-imposter-syndrome?collection=59879

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Self-Harm

Self-Harm

Self-Harm

By: Julia Keys

        Self-harm is the act of intentionally injuring oneself without intending suicide. Self-harming behaviors may include, but are not limited to: cutting, scratching, burning, banging/bruising or interference with an injury so that it cannot heal. Self-harm has become a huge concern within the adolescent demographic. Research shows that girls are more likely than boys to self-harm. A recent study shows that up to 17% of teenagers self-harm. To many others who do not self-harm, the act of intentionally hurting oneself may be perplexing, however there are many reasons why people self-harm.

The root of self-harming behavior stems from a lack of healthy coping mechanisms. Oftentimes people turn to self-harm when they have overwhelming feelings of anger, anxiety, depression, or guilt that they do not know how to express. Some self-harm as an act of release, similar to crying or screaming. Once they self-harm, the body releases endorphins which are the body’s natural painkillers, giving the individual feelings of relaxation or happiness. Sometimes people self-harm because they “feel numb”, and harming themselves makes them feel alive.

Here are some signs someone you love may be self-harming:

  • Unexplained cuts, bruises or marks
  • Patterns of parallel cuts or scars
  • Sudden change in mood
  • Wearing clothing inappropriate to the weather in an attempt to cover certain parts of the body
  • Secretive behavior
  • Self-isolating behavior

While self-harm is usually not an attempt at suicide, it is a very serious sign of emotional distress. If you are struggling with self-harm or know someone struggling with self-harm, here are some resources you may find helpful.

Self-Harm Hotline: 1-800-DON’T-CUT (1-800-366-8288)

Self-Harm Text Hotline: Text CONNECT to 741741 in the United States.

If you or a loved one is struggling with self-harm, do not hesitate to seek help by contacting 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.psychologytoday.com/us/blog/evidence-based-living/201805/why-do-youth-self-injure

https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Self-harm

https://www.webmd.com/mental-health/features/cutting-self-harm-signs-treatment#3

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Gambling

Gambling

By Lauren Hernandez

              Gambling can be a fun occasional activity to do with friends or family. However, some individuals can develop a serious addiction known as Gambling Disorder. Through frequent compulsive, habitual impulses, a person who is unable to resist gambling can have extreme negative consequences throughout their life which may affect relationships, finances, and even be a stepping stone towards engaging in criminal behavior. Typically a person addicted to gambling will develop this pattern of behavior during adolescence or young adulthood.  Gambling Disorder may begin with occasional gambling and develop into habitual, problematic gambling episodes. An increase in gambling is associated with stress, depression, and substance use or abstinence. Patterns of problematic gambling may also include periods of long term remission.

According to the DSM-5 the symptoms of Gambling Disorder include:

  • Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the fol­lowing in a 12-month period:
  • Needs to gamble with increasing amounts of money to achieve the desired excitement.
  • Is restless or irritable when attempting to cut down or stop gambling.
  • Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
  • Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
  • Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
  • After losing money gambling, often returns another day to get even (“chasing” one’s losses).
  • Lies to conceal the extent of involvement with gambling.
  • Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
  • Relies on others to provide money to relieve desperate financial situations caused by gambling.
  • The gambling behavior is not better explained by a manic episode.

The treatment for Gambling Disorder is an eclectic approach. It is important to seek treatment early, before the individual poses any extreme risks to themselves or friends and family. Prevention may not always be possible; however limiting exposure to casinos, scratch off tickets, or other triggers is helpful. Compulsive gambling is best treated through psychotherapy in the form of therapy or support groups. In addition to psychotherapy, medications such as antidepressants or mood stabilizers are extremely helpful. If you or someone you know is struggling with Gambling Disorder or has problematic gambling habits, it is important to reach out to a mental health practitioner such as a psychologist or psychiatric nurse practitioner.

If you or someone you know who may have Gambling 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/

 

 

 

 

 

 

 

Source: https://www.psychologytoday.com/us/conditions/gambling-disorder-compulsive-gambling-pathological-gambling

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Habits: Body-Focused Repetitive Behaviors (BFRBs)

Body-Focused Repetitive Behaviors (BFRBs)

By Lauren Hernandez

            Body-focused repetitive behaviors (BFRBs) are a group of disorders composed of “self-grooming” behaviors in which a person might pull, pick, bite, or scrape one’s hair, skin, or nails. BFRBs can be considered “impulse disorders,” however; it is still undetermined whether they are either impulsive or compulsive behaviors. People suffering from BFRBs typically lack awareness towards engaging in the repetitive behavior. BFRBS are problematic when they occur repetitively and cause a person distress in their physical, social, and emotional lives. The cause of BFRBs is still being researched; however, for some, habitual behaviors such as biting nails, chewing on their cheeks, and pulling their hair may develop into an impairing pattern associated with other mental illnesses.

Most BFRBs are associated with anxiety disorders, impulse control disorders, and obsessive compulsive disorders because they are difficult for individuals for control. BFRBs not only have an emotionally distressing impact, as an individual may experience high levels of shame, but BFRBs can also cause physical injuries such as scarring, skin infections, or bald spots.

The most common BFRBs include:

  • Trichotillomania- compulsive hair pulling
  • Dermatillomania- Compulsive skin picking
  • Onychophagia- Compulsive nail biting

Treatment of BFRBs include cognitive behavioral therapy, medication, and supplements, however, there are lower rates of treatment success due to lack of research on the disorders and effective treatment methods. Treatment for BFRBs should be discussed with a psychologist or psychiatric nurse practitioner in order to tailor treatment for an individual.

If you or someone you know is struggling with a Body-focused repetitive behavior, 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/body-focused-repetitive-behaviors

https://www.psychologytoday.com/us/blog/touchy-subject/201805/habitual-behavior-or-bfrb-disorder

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