therapy

Nightmares: Normal or Disorder?

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By: Sanjita Ekhelikar

We all know the horrible sensation of waking up in the middle of the night after a nightmare, a terrifying dream that occurs during the rapid eye movement (REM) stage of sleep. These dreams are a normal response to stressors in our life, and occur both during childhood and in adulthood. However, when nightmares occur regularly and lead to impairment of one’s cognitive and social functioning, they can develop into Nightmare disorder.

Nightmare disorder is characterized by frequent occurrences of fearful dreams which can interfere with development, functioning, and sleep. People with the disorder are constantly woken up with the detailed recall of dreams that feel like a threat to their survival or security. In addition, such individuals tend to awaken very easily, and have difficulty functioning throughout the day. They are not taking any substances which could lead to the increase in nightmares and, therefore, show signs of the disorder.

Many of the likely causes of Nightmare disorder include mental illnesses such as anxiety and depression, which cause people to stress throughout the day which can interfere with their sleep. In addition, any major life trauma can result in this growing distress. Finally, any sleeping disorder, such as narcolepsy, sleep apnea, or sleep terror, can cause increased nightmares.

If you are experiencing extreme, recurrent nightmares, do not hesitate to reach out for help and seek treatment. You can speak to a psychologist or take anti-depressant medication to address the issues behind these dreams and to better reduce the unpleasant symptoms. Aside from this, setting a routine during bedtime, making oneself comfortable, exercising during the day, doing meditation before bed, and sleeping until sunrise are ways to better relax and try to prevent nightmares. It is important to take care of yourself and your health, both when you are awake and alert AND when you are asleep.

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

Body Image: Body Dysmorphic Disorder Treatment

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By Samantha Glosser

Body dysmorphic disorder, sometimes referred to as body dysmorphia or BDD, is a mental disorder characterized by preoccupation with imagined or markedly exaggerated imperfections or defects in one’s physical appearance. Those suffering from body dysmorphic disorder spend a significant amount of time every day obsessing over their appearance and engaging in repetitive compulsive behaviors in an attempt to avoid anxiety, distress, and hide their imperfections. Signs and symptoms include constantly checking one’s appearance, excessive grooming, over-exercising, picking skin, pulling hair, using makeup or clothing to camouflage one’s appearance, or even getting plastic surgery. Body dysmorphic disorder leads to significant impairment in daily functioning and quality of life. However, there are treatment options available.

Cognitive-behavioral therapy (CBT). CBT is short-term, goal-oriented therapy. In body dysmorphic disorder, CBT is used to decrease compulsive behaviors and the negative thoughts about one’s appearance. This is achieved through techniques such as cognitive restructuring and mind reading. Cognitive restructuring teaches the patient to challenge irrational thoughts about their bodies and replace them with more realistic and adaptive thoughts. In addition to their own negative thoughts, individuals diagnosed with body dysmorphic disorder also believe others hold the same negative thoughts about them. Mind reading allows patients to understand that other people do not share these thoughts about them and provides realistic alternatives. For example, that person staring at them at the mall was probably admiring their outfit. Another frequently used technique is exposure therapy. This requires patients to create a hierarchy of anxiety-provoking situations which they are then exposed to in order to overcome anxiety and distress.

Psychiatric medications. Research has also shown that antidepressant medications are an effective treatment for body dysmorphic disorder, specifically selective serotonin reuptake inhibitors (SSRI’s). SSRI’s that are commonly used for the treatment of body dysmorphic disorder include Lexapro, Prozac, Paxil, and Zoloft, among others. SSRI’s help to reduce obsessional thinking, compulsive behaviors, and depression, a common comorbid disorder among individuals diagnosed with body dysmorphic disorder.

If you or someone you know appears to be suffering from body dysmorphic disorder, or other problems associated with negative body image, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

 

Source: Tartakovsky, M. (2016, July 17). Demystifying treatment for body dysmorphic disorder. Retrieved from https://psychcentral.com/lib/demystifying-treatment-for-body-dysmorphic-disorder/

Self-esteem

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By: Charleene Polanco

Have you ever experienced a time in your life when you felt that, “you weren’t good enough?” If you have, self-esteem is at the core of this feeling, because it involves perceptions one has of oneself. These perceptions eventually become beliefs about self-worth and value. That is why self-esteem is so important in a person’s life, because how people think of themselves, is what drives them towards or away from certain actions. High self-esteem is often associated with multiple accomplishments in life. This is because people with high self-esteem, believe that they are worthy of the opportunities they get, and, therefore, make the most out of them. One the other hand, those with low self-esteem, constantly believe that they are not good enough. When an opportunity presents itself to them, people with low self-esteem feel like they do not deserve it, and do not perform their best. This is why low self-esteem is associated with depression and anxiety. If you are suffering from low self-esteem, here are a couple of tips available to raise self-esteem:

  • Identify triggers of low self-esteem: if you are able to recognize the places or people that lower your self-esteem, you are able to avoid or prepare for them. This way, learning experiences come from each event.
  • Avoid negative self-talk: if you do not think negatively about yourself, you are able to feel better and attempt things you would normally avoid.
  • Connect with loved ones: family members and friends can be great emotional support because people who care about you, will also make you feel loved and wanted. Nurture these feelings so that eventually you are able to see yourself as they do, and will slowly learn how to love yourself a little more each day.

If you or someone you know is suffering from low self-esteem, 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:

Gross, S. J. (2016, July 17). How To Raise Your Self-Esteem. Retrieved October 8, 2018, from https://psychcentral.com/lib/how-to-raise-your-self-esteem/

Mind for Better Mental Health. (2013). How to increase your Self-esteem. Retrieved October 8, 2018, from https://www.mind.org.uk/information-support/types-of-mental-health-problems/self-esteem/#.W9cKgY2WyM8

 

Bipolar Disorder

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By: Dianna Gomez

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

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

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

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

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

 

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

Alcohol Use Disorder

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By Samantha Glosser

Alcohol use disorder, more commonly known as alcoholism, is a pattern of alcohol use that results in impairment and distress in your daily life. Short term effects of alcohol use disorder include memory loss, hangovers, and blackouts. However, the long term effects are much more serious and include the following: stomach ailments, heart problems, brain damage, memory loss, liver cirrhosis, and cancer. Alcohol use disorder is also linked to increased chances of dying from automobile accidents, homicide and suicide, as well as increased rates of unemployment, domestic violence, and legal problems.

Cravings for alcohol, drinking in spite of it causing personal problems, an inability to stop drinking, and building up a tolerance to alcohol are common symptoms of alcohol use disorder. Alcohol use disorder can be diagnosed if two or more of the following are present in a twelve-month period (the severity of addiction is based on how many symptoms are present):

  • Drinking more or for a longer period than intended.
  • Feeling the need or trying to cut back on drinking.
  • Spending a lot of time drinking and recovering from the short-term effects of drinking.
  • Craving the use of alcohol.
  • Failing to perform responsibilities due to drinking.
  • Continuing to use alcohol even though it is creating relationship problems.
  • Ceasing participation in important activities to drink more.
  • Drinking before or during potentially dangerous activities (such as driving).
  • Continuing drinking despite its relation to physical and mental health conditions.
  • Developing a tolerance for alcohol.
  • Experiencing withdraw symptoms when reducing or stopping alcohol intake.

There are numerous treatment options available to individuals struggling with alcohol use disorder, such as detoxification, Alcoholics Anonymous (AA), inpatient/outpatient treatment programs, and medication. There are also different methods to recovery, such as abstinence (completely quitting) or just cutting down on alcohol intake. Finding the right treatment options depends on the individual, which is why it is recommended to seek guidance from a trained professional.

If you or someone you know appears to be suffering from alcohol use disorder, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

Source: Alcohol Use Disorder. (n.d.). Retrieved from https://www.psychologytoday.com/us/conditions/alcohol-use-disorder

Insomnia

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By: Dianna Gomez

Insomnia is a condition that makes it very difficult for a person to fall asleep and stay asleep throughout the night. Insomnia can be caused by medical conditions such as hyperthyroidism, or for psychological reasons such as anxiety, depression or intrusive thoughts. In addition to these possibilities, the type of lifestyle an individual chooses to live can also be responsible for creating symptoms of insomnia. There are a few things that people who experience insomnia tend to do that may be worsening their symptoms without them even knowing. Some examples of these lifestyle habits include:

  1. Taking Mid-Day Naps
  • Whether it is short or long, sleeping in the middle of the day can increase a person’s chances of having difficulty sleeping through the night. If you can, try to avoid taking naps all together.
  1. Sleeping In Late
  • When a person is lacking sleep, it isn’t uncommon for them to attempt to fix the problem by sleeping in later the next morning to make up for their “lost hours.” However, by doing so, you are confusing your body clock which then makes it difficult to fall asleep at a regular time again the following night. This can quickly create a vicious cycle that is even harder to break.
  1. Taking Your Work Home With You
  • Regardless of what your occupation is, almost everybody has hectic daily schedules. When people are feeling behind on their work, they often decide to put in a little “over-time” by bringing their work home with them. By doing this, you make the process of “winding down” at night harder as your mind is kept wide awake and pre-occupied when it shouldn’t be.
  1. Using Electronics
  • Especially in today’s generation, it is extremely common for people to use their phones or laptops while lying in bed right before they intend to fall sleep. The problem with this, however, is that bright screens like those on our electronics actually stimulate the brain more and cause you to stay awake. This then makes it more difficult to fall asleep for the night.
  1. Working Irregular Hours
  • If you have a job that has you on various different “shifts,” sleeping may become a problem for you. If a person doesn’t stay on a regimented time schedule, their body clock cannot decipher when it should be waking up to take on a new day or winding down to get ready for bed.

 

If you have already tried reversing these lifestyle habits and still regularly experience symptoms of insomnia, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can help you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201)-368-3700 or (212)-722-1920 to set up an appointment. For more information, visit us at https://www.counselingpsychotherapynjny.com/.

 

 

Anxiety: Social Anxiety Disorder

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By: Charleene Polanco

Social anxiety disorder is characterized by an intense fear of being rejected by people. Many people feel some level of anxiety when they are placed into unknown social situations. However, those suffering from social anxiety disorder may avoid socializing altogether, because they cannot handle being judged or seen in a negative way by others. A person with social anxiety disorder, can experience anxiety during many different situations like; going on a date, eating in front of people, making eye contact, public speaking, or going to parties. Some of the symptoms of social anxiety include:

  • Rapid heartbeat
  • Uneasy stomach/diarrhea
  • Muscle tension
  • Lightheadedness
  • Sweating

Social anxiety can cripple a person’s life, because normal everyday interactions are triggers of anxiety and discomfort. This is why many people who suffer from social anxiety disorder choose to isolate themselves from everyone. In order to reduce the fear of rejection, people with social anxiety disorder are encouraged to be exposed to social situations, not run away from them. Although being around others is what brings them distress, socializing is also what allows people with social anxiety to change the way they think about social engagements. Instead of having negative perceptions about the way people view them, the more they socialize and are accepted by others, the more socially anxious people see that those perceptions are not true.

If you or someone you know is suffering from social anxiety, 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:

Anxiety and Depression Association of America. (2018). Social Anxiety Disorder. Retrieved October 01, 2018, from https://adaa.org/understanding-anxiety/social-anxiety-disorder

Nordqvist, C. (2018, February 05). What’s to Know About Social Anxiety Disorder? Retrieved October 01, 2018, from https://www.medicalnewstoday.com/articles/176891.php

WebMD. (2018). What Is Social Anxiety Disorder? Retrieved October 01, 2018, from https://www.webmd.com/anxiety-panic/guide/mental-health-social-anxiety-disorder#1

 

What is Trichotillomania?

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By Stephanie Osuba

Trichotillomania is a hair pulling disorder categorized in the Obsessive Compulsive and Related Disorders section in the DSM-5. It is one of the other Body Focused Repetitive Behaviors (BFRBs) – along with excoriation (skin picking) and onychophagia (nail biting) – in which the individual will pull, pick or bite at various parts of the body resulting in damage.  Symptoms include recurring hair pulling, hair loss, and related stress and impairment because of the behavior. The disorder is not considered self-mutilation like cutting or burning because the behavior is not intentional and research suggests that there is no connection between the disorder and unresolved trauma. Often people are ashamed of the behavior and their resulting appearance because of it and try their hardest to stop. Comorbidities include, tic disorders, mood disorders, and anxiety disorders, although, trichotillomania can also occur in the absence of any other psychopathology.  The regular age of onset is between the ages of 11 and 13, however, baby trichotillomania is a rare phenomenon that seems to go away as the child grows older. Research also suggests that the disorder is primarily genetic as it appears in the first relatives of people with trichotillomania than it does in the general population.

Available treatments include cognitive behavioral therapy (CBT) and habit reversal training (HRT) with adjunctive dialectal behavioral therapy (DBT) and acceptance and commitment therapy (ACT). These therapies help the person to be aware of the pattern of the behavior and helps to identify triggers to pulling. It also teaches methods to redirect that urge to pull into a new healthy pattern of behavior in order to reduce or eliminate the urge. While there is no FDA-approved medication specifically for BFRBs, research is being conducted. OCD medication such as selective serotonin reuptake inhibitors (SSRIs) and anafranil can help alleviate symptoms as well.

Sources: Deibler, M. W., Psy. D. (n.d.). Trichotillomania (TTM) and related Body-Focused Repetitive Behaviors (BFRBs). Retrieved from http://www.thecenterforemotionalhealth.com/trichotillomania-and-related-disorders

Zwolinski, R., LMHC. (2013, October 03). Cause And Treatment Of Trichotillomania. Retrieved from https://blogs.psychcentral.com/therapy-soup/2012/04/cause-and-treatment-of-trichotillomania/

If you or someone you know appears to be suffering from trichotillomania, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/.

Anxiety: Test Anxiety

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By: Charleene Polanco

Have you ever had a moment of extreme panic, right before the beginning of a test? How about feeling like you are about to faint, or excessive sweat during an exam? If these symptoms describe your test-taking experience, then you might be suffering from test anxiety.

Test anxiety is defined as a psychological condition where people experience severe distress and anxiety during exams. Some causes of test anxiety are fear of failure and lack of preparation. A fear of failure can result from wanting to perform well. One who associates their self-worth with a test’s outcome, can feel devastated when the grade is not what he or she expected. This creates a vicious cycle, where because the person is afraid of feeling worthless, when they fail, they become anxious while taking the exam.  As a result, their performance level on tests drops. Lack of preparation is another cause of test anxiety, which occurs when students do not study properly for an exam. For those who like to wait until the night before an exam, to cram five chapters worth of information into their brain, tests are a constant source of anxiety and stress.

Symptoms of test anxiety can be split up into three categories; physical, emotional, and behavioral/cognitive symptoms. Some physical symptoms include headaches, nausea, excessive sweating, and rapid heartbeat. Emotional symptoms can be expressed as feelings of anger, fear, helplessness, and disappointment.  Behavioral/cognitive symptoms are difficulty concentrating and negative thinking.

To help manage test anxiety, here are some tips;

  • Properly prepare for exams
  • Develop good test-taking skills
  • Engage in relaxation techniques, like taking deep slow breaths
  • Keep a positive mindset

If you or someone you know is suffering from test anxiety, 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:

“Test Anxiety.” Anxiety and Depression Association of America, ADAA, Anxiety and Depression Association of America , 2018, adaa.org/living-with-anxiety/children/test-anxiety

Stress: The Detrimental Effects of Stress on the Body

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By: Charleene Polanco

Stress is something that everyone experiences at some point in their lives. Stress is defined as a physical, mental, or emotional strain or tension, and whether it is about taking a final exam for class, going off to college for the first time, or work-related, stress can affect the way we perform. If gone unchecked, stress can lead to a variety of negative consequences on the body, which will be discussed. Stress has been linked to a number of physical and emotional disorders, like depression, anxiety, heart attacks and stroke. A constant high level of stress, can lead to immune system disturbances, which can cause an increase in your body’s susceptibility to infections. Stress can also have direct effects on the skin leading to rashes and hives.

Unlike rashes and hives, which are visible, stress can affect various systems, organs, and tissues within the body, signs that are not seen, and are, therefore, much harder to notice. Some parts of the body affected by stress are the nervous and cardiovascular systems. When stressed, the nervous system signals the body’s adrenal glands to secrete adrenalin and cortisol. Since both of these hormones cause high blood pressure, a person who is under constant stress, also has elevated blood pressure which can lead to heart problems in the future. Even if a stress episode is considered to be minor, repeated minor stress episodes can negatively impact a person’s cardiovascular system by causing inflammations in the coronary arteries. This can eventually cause heart attacks. In order to prevent the negative consequences of untreated high levels of stress, it is important to recognize the symptoms. There are multiple symptoms of stress, some of which include, frequent headaches, cold hands/feet, dry mouth, heartburn, depression, forgetfulness, and rapid or mumbled speech.

If you or someone you know is suffering from stress, 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:

“Stress Effects.” Common Signs and Symptoms of Stress, The American Institute of Stress, 4 Jan. 2017.