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 http://www.counselingpsychotherapynjny.com/

 

Sources:

https://www.nimh.nih.gov/health/statistics/major-depression.shtml

https://www.caregiver.org/caregiver-depression-silent-health-crisis

 

Bipolar Disorder vs. Borderline Personality Disorder

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Bipolar Disorder vs. Borderline Personality Disorder

by Sam Matthews

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

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

Sources:

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

Post-Traumatic Stress Disorder

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Post-Traumatic Stress Disorder

by Sam Matthews

Post-Traumatic Stress Disorder develops after one experience either an isolated traumatic event, or recurring traumatic events. Around 8 million people in the United States are living with PTSD, yet about 70% of US adults have reported they have experienced at least one traumatic event in their lifetime. This discrepancy is due to the fact that being exposed to a traumatic event does not in any way mean that you are going to develop PTSD. Factors that contribute to the likelihood of someone developing post-traumatic stress disorder include: a preexisting mental or physical health condition, dissociation during trauma, type of trauma, gender (women are 2x as likely to develop PTSD), age, marital status, support systems, and experience of additional stressors after the trauma. One type of PTSD is classified as dissociative, which includes the presence of persistent depersonalization or derealization symptoms. Depersonalization is like dissociation, where one experiences something as if they are an observer. Derealization on the other hand refers to feeling as if the things around you are not real, and you are disconnected from the world around you. PTSD can also have a delayed onset aspect, which means that one could develop PTSD years after the traumatic event has occurred.

PTSD has four main symptom groups which are as follows:

  1. Intrusive Symptoms
    1. Frequent thoughts or memories of the event
    2. Recurrent nightmares
    3. Flashbacks
    4. Strong feelings of distress
    5. Increased heart rate or sweating when reminded of the event
  2. Avoidance
    1. Avoiding thoughts, feelings, or conversations about the event
    2. Actively avoiding places or people that remind you of the trauma
    3. Keeping yourself too busy to have time to think about the traumatic event
  3. Hyperarousal
    1. Difficulty falling asleep
    2. Irritability
    3. Outbursts of anger
    4. Difficulty concentrating
    5. Hyperactive startle response
  4. Negative Thoughts and Beliefs
    1. Difficulty remembering important aspects of the trauma
    2. Loss of interest in important and positive activities
    3. Feeling distant from others
    4. Inability to have positive feelings
    5. Feeling as though your life may be cut short

For information regarding the treatment of PTSD, please refer to the article titled, PTSD Treatment.

Sources:

https://www.webmd.com/mental-health/post-traumatic-stress-disorder#1

PTSD Treatment

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PTSD Treatment

by Sam Matthews

When treating PTSD, there are a few different evidence based therapies that can be used, including psychotherapy and medications. This article will focus on those that are classified as cognitive behavioral therapies.

  1. Trauma-focused CBT
    1. Challenging and changing automatic unhelpful, inaccurate thoughts (cognitive distortions)
    2. Gradual and safe exposure to trauma
  2. Cognitive Processing Therapy
    1. Challenging and changing upsetting thoughts that perpetuate the trauma
    2. Includes writing a detailed account of the trauma and reading it in front of the therapist and at home
    3. Therapist helps you challenge problematic beliefs around safety, trust, control, and intimacy
  3. Cognitive Therapy
    1. Challenges and reframes pessimistic thoughts and negative interpretations of the event
    2. Work through the trauma and suppressed thoughts
  4. Prolonged Exposure
    1. Gradual and safe exposure to the trauma by discussing the details of what happened
    2. Recording of your recount so you can listen to it later
    3. Involves facing situations, activities, or places that remind you of the trauma
    4. Done slowly and systematically
    5. Breathing techniques learned to alleviate anxiety
  5. Eye Movement Desensitization and Reprocessing
    1. Imagining the trauma while the therapist asks you to track their fingers as they move them back and forth in your field of vision
    2. Allows you to pull everything out of your memory in a controlled manner and then back in the way non-traumatic memories are stored
    3. Does not require you to describe the trauma in detail, spend an extended time on exposure, challenge specific beliefs, or complete assignments outside of therapy sessions
  6. Brief Eclectic Psychotherapy
    1. Combines CBT with psychodynamic psychotherapy
    2. Discuss the traumatic event
    3. Teach various relaxation techniques to decrease anxiety
    4. Therapist helps to explore how the trauma has affected how you see yourself and the world
    5. Encouraged to bring someone who supports you to your sessions
  7. Narrative Exposure Therapy
    1. Create a chronological narrative of your life
    2. Helps to recreate an account of the trauma in a way that recaptures your self-respect
    3. You receive a documented biography written by your therapist at the end of treatment
    4. Typically done in small groups

For more information on Post-Traumatic Stress Disorder, please refer to the article titled, Post-Traumatic Stress Disorder.

Sources:

https://www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder#1

 

Anxiety and Politics

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by: Sam Matthews

The political climate in today’s day and age could certainly cause fear and anxiety for anyone in America. It is important to note that both fear and anxiety activate one’s attachment system. Your attachment system has evolved in order to allow you to develop strong relationships with your parents and peers, not engage in modern day political battles. This is because the system cannot differentiate between actual physical threats and imagined ones, causing it to be triggered when thinking about politics. We most commonly think about attachment figures being real people who we come into physical contact with, but a political figure or institution can easily become a symbolic attachment figure. This political figure can psychologically come to represent something that can protect you from threats and decrease your anxiety. When attachment styles are activated, they can bring out the worst in the part of the population that is insecurely attached, which in America is 45%. This situation has the potential to damage relationships, and could even bring on even more destructive behaviors. As mentioned, these problems trigger the attachment systems, causing the conflict to become more than just a superficial argument about politics, but an emotional issue, which cannot be solved through rational arguments and debates. It is normal to have anxiety about what is to become of the country you reside in, but the best recommendation one could give is to take a step back and all time to pass, and yourself to explore.

 

Sources:

https://www.psychologytoday.com/us/blog/the-freedom-change/201811/attachment-theory-elections-and-the-politics-fear

https://www.sharp.com/health-news/how-stress-over-politics-affects-your-health.cfm

Drug Abuse: Preventing Teen Drug Abuse

By: Toni Wright

Many teens are curious and experiment with drugs, whether due to peer pressure, stress at home, or just curiosity. According to Drugrehab.com in 2016 about 1.9 million youths ages 12 to 17 used an illicit drug in the past month. In addition to that, in 2016 1.4 million teens needed treatment for an illicit drug abuse problem. What many young teens don’t know in hindsight, or thoroughly think about, is that trying those drugs can have lasting long term effects that can change their lives forever.

Warning Signs:

  1. Changes in choice of dress
  2. Loss of interest in what they enjoyed (hobbies or activities)
  3. Decline in academic performance (failing classes, poor grades, skipping class, etc.)
  4. Recurring arguments, unexpected mood changes, and unspecified violent actions.

Family Influence

Parents, prevention can start within the household:

  1. Ask your teens perspective on drugs – Don’t lecture. Actively listen to your teens views on drugs. Reassure them that they can be open and honest with you.
  2. Discuss the negative impact drugs use can have – Emphasize how drugs can impact the things your teen cares about. For instance, health, appearance, school performance, etc.
  3. Go over ways to not give into peer pressure – Come up with different ways your teen can say “no” to drugs.

Overall, parents, you play a crucial role in your teen’s life. Provide support for your teen. Having a solid foundation between you and your teen may make them less likely to use drugs.

If you or a teen you know abuses drugs, 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.centeronaddiction.org/addiction-prevention/teenage-addiction

https://www.drugrehab.com/teens/

https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-drug-abuse/art-20045921

Image Source:

https://www.palmerlakerecovery.com/blog/signs-of-drug-abuse-in-teenagers/

A Substance Abuse Guide for Parents

 

 

Grieving Vs Persistent Complex Bereavement Disorder

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Grieving Vs Persistent Complex Bereavement Disorder

By: Karime Herrera

Coping with grief can be difficult. You are in complete disbelief that your loved one, family or friend is no longer a phone call away. When grief begins to drastically disrupt your life, it is best to seek professional help.However, some people might not know when it is necessary to seek help. At what point does grief turn into persistent complex bereavement disorder? Persistent complex bereavement disorder is when an individual has been experiencing severe grief symptoms for over twelve months. Some symptoms that a person with PCBD encounters are trusting people, hallucinations of the person who has passed away, suicidal thoughts, loss of interest in preforming daily tasks, and constant feelings of sadness. If you are experiencing these symptoms for an extreme period of time it is best to see a psychologist in order to help you cope with your loss. A licensed practitioner can treat PCBD with cognitive therapy, mindfulness, psychotherapy or a combination.  Mediation might be helpful in relieving the symptoms and often helps individuals suffering from PCBD continue with their daily lives.

Stress: Effects of Stress

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Stress: Effects of Stress

By: Vanessa Munera

When people talk about stress, what exactly is it? Stress is the body’s reaction to any change that requires an adjustment or response. With stress the body reacts to these changes with emotional, physical, and mental responses. Stress could either be presented as a positive or negative outcome in people’s daily lives.

According to Bernstein “Stress can occur in a variety of forms” (2016). Some stress can result in short events such as an argument with a loved one. Furthermore, other stress can manifest due to reoccurring conditions; for example, a demanding job, financial problems, and/ or long term illness. When reoccurring conditions cause stress to be both intense and sustained over a long period of time, it can be considered as “chronic” or “toxic” stress”. While all stress triggers physiological reactions, chronic stress is indeed to be considered a problematic issue that creates significant harm to the brain and the functioning of the body. In fact, “stress continues to be a major American health issue”.

If you have experienced a stressful event, a certain area of the brain called the amygdala, responsible for emotional processing, sends a distress signal to the hypothalamus. The hypothalamus functions as a command center in the brain, communicating with the rest of the body through the nervous system so that person has the energy to fight or flee”. The sympathetic nervous system is responsible for the “fight or flight” response because it provides the body with a burst of energy so that it can respond to perceived dangers. Some of the affects from the “fight or flight” response are increased heart rate, deeper intake of oxygen, heightened senses, and the rush of adrenaline – also known as epinephrine, a hormone secreted by the adrenal gland. Finally a hormone known as cortisol is released to help restore the energy that was lost during the response. When stress is no longer present, your cortisol levels to go back to normal as if nothing happened. In addition cortisol helps regulate metabolism and immune responses.

When dealing with chronic stress, cortisol levels are at a constant high, which eventually causes health problems. Although cortisol is a natural and healthy hormone in the body, constant high levels of it can be bad for your brain. High levels of this hormone can wear down the brain’s ability to function properly. As stated in the article, “it can disrupt synapse regulation, resulting in the loss of sociability and the avoidance of interactions with others” (Bernstein, 2016). In addition, chronic stress can kill brain cells and cause the brain to shrink in size. It has a shrinking effect on the prefrontal cortex which is responsible for memory and learning. Besides chronic stress having effects on the brain, it causes effects to the human body. This type of stress can increase the risk of heart disease, high blood pressure and diabetes. Furthermore, it can affect other systems in the body and cause them to stop working properly. This includes digestive, excretory and reproductive structures and exacerbates already existing illness. Fighting and managing chronic stress can be difficult; however it is not too late to learn how to manage it. Toxic stress can negatively affect the brain but the brain and body can recover from these effects.

If you or someone you know is suffering from chronic stress and are seeking stress management, please 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.tuw.edu/health/how-stress-affects-the-brain/

 

Obesity and The Brain

obesity and the brain

by: Sam Matthews

The popular belief today is that nutrients such as fats, carbohydrates, or sugars are to blame for the obesity epidemic in this country; however, as recently reported in the Scientific American (October 2019), researcher Kevin Hall has a different idea. He believes that the change in the way food is made is at fault for people becoming more and more obese as the years go on. Hall has done studies to prove this, and he shows that ultra-processed foods disrupt “gut-brain” signals. An example of this would be when one eats something such as a nonnutritive sweetener, the brain expects to be taking in a lot of calories, when in reality, it does not. This confuses the brain since the energy you use does not match the energy you brain perceived it would have, causing you to eat more.

Furthermore, most people don’t take into account that all calories are not the same. Foods filled with fats and sugars can be the same amount of calories as a healthier food, but you will still tend to gain weight because the difference lies in its nutritional value. Another study showed that eating a lot of ultra-processed foods has the potential to change the circuitry of one’s brain and in turn, increase sensitivity to food cues. This study was done on rats, and rats that gained weight from eating junk food showed a change in their dopamine system, which caused them to become hypersensitive to food cues. These rats did not show more pleasure while eating junk food when compared to thinner rats, but did show more desire and food-seeking behavior. This shows that consuming ultra-processed foods does not lead to satisfaction, but more of a desire for food, much like drug addiction.

Overall, the obesity epidemic isn’t solely due to specific types of nutrients, but the fact that food is processed to an incredible extent in today’s day and age, causing chemicals in the brain to change, allowing one to be fooled into thinking they want/need more food than they actually do. Once you gain a little bit of weight, it is a vicious cycle due to the changes in your dopamine pathways causing you to be much more sensitive to food cues.

If you or someone you know appears to be suffering from weight related issues or an eating 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 and Psychotherapy. Contact our offices at 201-368-3700. For more information, please visit https://www.counselingpsychotherapynjny.com/.

Image: https://mappingignorance.org/2017/08/21/child-obesity-brain-function/

Source: The Scientific American: Obesity on the Brain

Abuse: Men in Abusive Relationships

By: Toni Wright

A relationship is supposed to be a union between two people where both parties feel safe and comfortable with one another. They are supposed to feel loved, accepted, and appreciated by one another. However, sometimes that is not the case. Oftentimes people talk about how the woman in the relationship is being abused by the man. However, we should not overlook the fact that men are often being abused in relationships. Though it may not be widely spoken about, the man can be and sometimes is the victim in the relationship.

Abuse is not always domestic; it can be verbal and/or emotional.

Your partner may show signs of:

Possessiveness:

  • They are constantly keeping track of your whereabouts i.e. wanting to know what you’re doing, where you are, and who you’re with most if not all of the time.
  • They try to control where you spend your time and who you spend it with and if you don’t listen to them, they get angry.

Jealousy:

  • They isolate you from your loved ones, family and friends
  • They accuse you of being disloyal to them or flirting with others.

Threats:

  • They threaten to leave you or threaten to hurt themselves if you leave.
  • They threaten to use violence against you or your loved ones.

 

Physical/Sexual Violence:

  • They hurt you or your loved ones.
  • They push, shove or punch you, or make you have sex with them or do something that you don’t want to do.

Humiliation:

  • They belittle you in front of family, friends, or even on social media by attacking your looks, intelligence, abilities, or mental health.
  • They blame you for the issues in your relationship and for their violent blowups.
  • They say hurtful things to you, such as, “No one else is ever going to love you.”

Men, it may be hard to leave an abusive relationship for numerous reasons such as you may feel as though they actually do love you despite their behavior, you feel ashamed, you want to protect your partner, have a lack of resources, the list goes on. However, help from your family, friends, and a therapist can aid you through this trying time. Being a battered partner is nothing to be embarrassed about. Please don’t ever be afraid to reach out to any/all of your resources for assistance.

If you or a male you know is suffering from any type of abuse 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 https://www.counselingpsychotherapynjny.com/

Sources:

Help for Men Who Are Being Abused

https://psychcentral.com/blog/21-warning-signs-of-an-emotionally-abusive-relationship/

https://au.reachout.com/articles/signs-of-an-abusive-relationship

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Battered Men – The other side of Domestic Violence