Bipolar Disorder: Loving someone with bipolar disorder, the ups and downs

Bipolar Disorder: Loving someone with bipolar disorder, the ups and downs
By Zoe Alekel

Loving someone with bipolar disorder can be a challenge if you don’t have the right tools and knowledge to help both you and your loved one. The first step in loving someone with bipolar disorder would be to understand what it means to be bipolar. Although you may never know exactly how your loved one feels, it is important to understand and educate yourself about their behaviors and emotions. According to the Mayo Clinic, bipolar disorder is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). To understand what your loved one is going through, it is key to remind yourself that your loved one can’t always control these emotional mood swings—and more importantly it is not a reflection of you or how they feel about you.

It is understandable that it can be difficult to understand these seemingly sudden and intense mood swings, and your loved one struggling with bipolar disorder may already know this and feel bad about how it affects you. Make sure you approach them with kindness, and always ask them what you can do to help them. Sometimes space and understanding that the mood swing will pass is enough support for your loved one. No matter how involved or uninvolved they want you to be with their mental health, always respect their wishes.

One thing you can do to help you cope with your loved one’s bipolar disorder is to find others that have loved ones with bipolar disorder as well. Additionally, you can reach out to a therapist to share your feelings and the struggles that you experience as someone who has a loved one diagnosed with bipolar disorder. A way you can further educate yourself on bipolar disorder is to visit the National Alliance on Mental Illness (NAMI) website. NAMI provides credible information for those with loved ones diagnosed with bipolar disorder, and suggests you can try the following to help a family member or friend with bipolar disorder:

  • Recognizing and preventing serious mood episodes/ mood swings
  • Being able to recognize the warning signs of mania and depression
  • Making sure your loved one is taking their medication regularly and consistently (as directed)
  • Communicating and making time to talk to your loved one about their feelings when they feel ready
  • Remaining calm and rational with your loved one
  • Keeping a positive attitude and a clear mind to help your loved one the best you can
  • Reaching out for psychological support for you and your loved one

If you or someone you know is struggling with 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


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Anxiety, Depression, Eating Disorders, ADHD, Et al: How to Support a Friend with Mental Illness

By: Sarah Cohen

When helping a friend with a mental illness, the first step should be assessment of their symptoms. Sometimes they just might be going through a difficult time, but if certain common symptoms associated with mental health issues persist it is imperative to respond sensitively. Majority of the time, friends will just want to know they have your support and that you care about them. A good way to show your support is by talking to them. If you provide a non-judgmental space for them to speak about their issues it will help encourage them to be open with their problems. Let them lead the conversation and don’t pressure them to reveal information. It can be incredibly difficult and painful to speak about these issues and they might not be ready to share everything. If you aren’t their therapist do not diagnose them or make assumptions about how they are feeling, just listen and show you understand. If someone doesn’t want to speak with you, don’t take it personally, just continue to show them you care about their wellbeing and want to help as much as possible. Just knowing they have support can give them the strength they need to contact someone who can help them.

If a friend is having a crisis, such as a panic attack or suicidal thoughts, you must stay calm. Try not to overwhelm them by asking a lot of questions and confronting them in a public setting. Ask them gently what would be helpful to them right now or reassure them. If they hurt themselves, get first aid as soon as possible. If someone is suicidal, contact the suicide hotline at 800-237-8255 immediately.

The best way to help someone is by connecting them to professional help. By expressing your concern and support you can show them that they can get help and their mental health problems can be treated.

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

Anxiety and Bullying

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Anxiety and Bullying

By: Vanessa Munera

Being bullied is not an easy thing to handle. It can be a traumatic experience for teens that are being targeted. Those who are bullied experience impacts in their lives such as feeling lonely, anxious, isolated, and vulnerable. Unfortunately, when a bully moves on to the next target, these consequences of bullying linger longer for the victim. After prolonged exposure, victims of bullying can develop adverse effects. These victims will experience depression, eating disorders, and thoughts of suicide. In addition, victims of bullying can develop some sort of anxiety disorder. The top four major anxiety disorders victims of bullying can experience are Post-Traumatic Stress Disorder (PTSD), generalized anxiety disorder (GAD), panic attacks and social anxiety disorder.

  1. Post-Traumatic Stress Disorder (PTSD): this occurs after a traumatic or life-threatening event. PTSD can develop due to events such as a car accidents or losing a close relative. This disorder can also show up after repeated abuse or even bullying. Children who are bullied may experience nightmares, flashbacks, withdraw from others, or are easily startled. Kids, who undergo long term and abusive bullying, have increased chances of developing PTSD.

2. Generalized Anxiety Disorder (GAD): Kids with GAD are often tormented with worries and fear that distract them for their daily life activities. Those with generalized anxiety have a constant feeling that something bad is going to happen. This is not uncommon with victims of bullying. With GAD, physical symptoms may appear such as insomnia, stomachaches, fatigue, and restlessness.

3. Panic Attacks: Those who suffer from panic disorders must deal with unpredictable and repeated attacks. When suffering from a panic attack, the attack is usually with no warning and can cause physically symptoms. These symptoms include sweating, chest pain, and rapid or irregular heartbeats. In fact, a part of the brain called the amygdala plays a pivotal role in panic attacks. When left untreated, the sufferer will begin to avoid going out or things they once enjoyed, in order to prevent another panic attack.

4. Social Anxiety Disorder: People who suffer from social anxiety fear being humiliated or seen negatively by others. Those with this disorder often worry that the way they look or act cause others to mock them. This can cause sufferers to avoid social gatherings to avoid being humiliated. In fact victims of bullying often develop social anxiety due to the repeated shame and public humiliation they experienced.

If you or a loved one appears to be suffering from an Anxiety 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





Caregiver Depression

Caregiver Depression

By: Maryellen Van Atter

Caring for another individual is no easy feat; just as parenting requires preparation, so does caring for a family member with an illness or disability. A seldom discussed topic is ‘caregiver syndrome’, also known as caregiver depression or caregiver burnout. It is estimated that 20% of family caregivers suffer with depression – in the general population, it is reported that 7.1% of all individuals suffer from depression. This means that caregivers experience depression at a rate more than double the average person. Despite the prevalence of this condition, it is rarely talked about and sometimes viewed as something shameful. This should not be: caregiving is a difficult job and the first step to feeling better is acknowledging that it’s okay to feel the way you do. Just as there is no ‘perfect’ way to parent, there is no ‘perfect’ or ‘right’ way to be a caregiver.

Everyone experiences depression differently, but a few common signs are a loss of interest in things that you once found enjoyable, a change in sleeping patterns, and feeling irritable, hopeless, or helpless. These symptoms can persist even if you have placed a loved one in a care facility. Psychotherapy has been shown to be effective at managing caregiver depression and helping caregivers to feel more satisfied with their lives. Additionally, antidepressant medications can provide symptom relief; combined with psychotherapy, this can allow caregivers to explore their feelings and manage their caregiving responsibilities.

        If you or someone you know is struggling with caregiving responsibilities, 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




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.


  • 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 for more information.


Koblenz, Jessica. “11 Things About Seasonal Affective Disorder That Psychologists Wish You Knew.” Reader’s Digest, (PHOTO)

National Mental Health Institute. “Seasonal Affective Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services,


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. 




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 .


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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 .


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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


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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 .


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