Depression: Difference between Unipolar and Bipolar Depression

By Gabriella Phillip

Eliciting a history of brief periods of improved mood is the key to differentiating between unipolar and bipolar depression. Bipolar spectrum disorders typically begin earlier in life than unipolar depression; the usual sign of bipolar disorder in young children could be depression and/or a combination of depression and states of mania/hypomania. It’s significant to ask the patient how old they were when they first experienced a depressive episode. Men have a higher rate of bipolar disorder than women, but the rates for unipolar depression in men and women are more equal.

Some patients with bipolar spectrum disorder can go from normal to severely depressed technically overnight whereas unipolar depressive episodes tend to occur more gradually. Patients with bipolar spectrum depression tend to experience weight gain and crave carbs, while those with unipolar depression usually experience weight loss or loss of appetite. Patients suffering from bipolar depression tend to show irregular responses to antidepressant monotherapy, including switching into mania. Bipolar spectrum disorder is an inheritable mental illness, so it’s vital to take family history into consideration. While patients diagnosed with unipolar depression usually note that their symptoms fluctuate in a more stable, regular pattern, those with bipolar depression have moods that can vary unpredictably, usually with no cause.

When treating bipolar depression, antidepressants are used in combination with some sort of mood stabilizer. Treatment for unipolar depression can include medication like SSRIs and antidepressants, often in combination with cognitive behavioral therapy (CBT) and psychotherapy. Screening instruments including the Bipolar Spectrum Diagnostic Scale and the Mood Disorders Questionnaire can be effective and helpful tools in differentiating unipolar from bipolar depression.

If you or someone you know is struggling with Bipolar Disorder or Unipolar Depression, Arista Counseling and Psychotherapy can help. 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.psychiatrictimes.com/special-reports/major-depressive-episode-it-bipolar-i-or-unipolar-depression

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850601/

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/unipolar-and-bipolar-depression-different-or-the-same/AE364DFBFFBAF1F66A9294A55120C64E/core-reader

 

 

Body Dysmorphic Disorder

By Gabriella Phillip

Body Dysmorphic disorder, or BDD, is a psychiatric disorder in which a person is preoccupied with an imagined or minor physical defect that other people usually don’t notice. BDD has various features that are similar to that of obsessive-compulsive disorders and eating disorders. Patients diagnosed with obsessive-compulsive disorder, or OCD, have distressing thoughts and images that they aren’t able to control. Emotional distress that can result from this can cause a person to perform particular rituals or compulsions. Regarding BDD, the person’s persistent preoccupation with his/her perceived physical defect can lead to ritualistic behaviors including constantly looking in the mirror or skin picking. Similarly to eating disorders, like anorexia nervosa and bulimia nervosa, Body Dysmorphic Disorder involves a concern with body image. However, while eating disorder patients are concerned with body weight, those diagnosed with BDD are worried about a specific area or part of the body.

Body Dysmorphia affects approximately 2% of the general population; however, BDD usually goes undiagnosed so the number of people who actually have the disorder could potentially be much greater. Those with body dysmorphia oftentimes feel a significant amount of shame regarding their perceived flaws which may hinder them from seeking treatment. BDD prevalence differs by gender, as women are reported to have higher rates of this disorder than men. Factors such as living with a pre-existing mental condition like depression or anxiety or experiencing bullying or abuse during childhood or adolescence can increase the risk of Body Dysmorphic Disorder. The typical onset for BDD is between the ages twelve and seventeen, around the time when adolescents go through puberty and certain bodily changes.

Social media platforms like Instagram oftentimes feed us an interminable supply of filtered and unrealistic depictions of different people and their lives. It’s easy to compare yourself to well edited pictures of models, celebrities, and even friends online, making you feel as though you don’t measure up as you are. Also, various forms of bullying like body shaming or slut shaming can occur online and can easily result in distorted body image and low self-esteem. Those with BDD sometimes choose to socially isolate themselves due to high level of shame related to their bodily appearance. While social media doesn’t necessarily cause body dysmorphia, it can serve as a trigger for those already predisposed to the disorder, or could possibly worsen existing symptoms. The main treatments used for BDD are cognitive behavioral therapy (CBT) and antidepressant medication, specifically serotonin reuptake inhibitors (SSRIs). Many patients use therapy and medication simultaneously. These treatments are meant to help reduce obsessive compulsive behaviors, improve stress level management involved in these behaviors, and aid patients in viewing themselves in a more loving and less judgmental light.

If you or someone you know is struggling with Body Dysmorphic Disorder, Arista Counseling and Psychotherapy can help. 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/ .

 

Antidepressants: What Happens When You Stop Taking Your Medication

Antidepressants: What Happens When You Stop Taking Your Medication

Antidepressants: What Happens When You Stop Taking Your Medication

By: Julia Keys

Anti-depressant discontinuation syndrome occurs when a person suddenly stops taking their anti-depressants. Sometimes individuals decide to go off of their medication because of side effects such as weight gain, nausea, or sexual dysfunction. Another common reason why individuals stop their medication “cold turkey” is because they may feel as if the medication has changed their personality. Anti-depressants are not meant to change one’s personality, but sometimes they can cause fogginess or fatigue which can make the patient feel “not like themselves” or “out of it”. However, abruptly going off medication can cause symptoms that are more painful and severe than the side effects one might feel on an anti-depressant that is not right for them.

The effects of anti-depressant discontinuation can be felt as early as a couple hours to as late as a couple days after missing a dose depending on the type of anti-depressant. Symptoms are typically ameliorated within six to twenty four hours after taking the missed dose.

Symptoms of Anti-depressant discontinuation syndrome:

  • Nausea
  • Chills
  • Headache
  • Vomiting
  • Problems with balance
  • “brain zaps” or “brain shocks”, the sensation of a jolt of electricity running through the head, neck or limbs
  • Anxiety

Unlike illegal drugs, phasing out of anti-depressants can be a painless process if done correctly. In order to go off of anti-depressants successfully, one must slowly wean themselves off the medication with the help of a psychiatrist or psychiatric nurse practitioner.

Tips to prevent or minimize anti-depressant discontinuation syndrome:

  • NEVER stop taking medication without talking to your doctor
  • Follow your doctor’s directions exactly when going off your meds. If you start to feel any of the symptoms of anti-depressant discontinuation syndrome contact your doctor as soon as possible
  • Set a reminder on your phone or computer to take your medication each day
  • Always keep your medication in the same place
  • Make sure to keep on top of your doctor’s appointments by putting them in a calendar so that you will never run out of medication by accident

If you are struggling with mental health issues and are in need of treatment, 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.aafp.org/afp/2006/0801/p449.html

https://www.aafp.org/afp/2006/0801/p449.html

Source for picture:

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Antidepressants

Antidepressants

By: Lauren Hernandez

            If you or someone you know has been seeing a psychiatrist or psychiatric nurse practitioner for treatment of depression, there are various types of antidepressants a mental health provider can prescribe. It is important to be familiar with different types of antidepressants in order for you, as the patient, to understand what the medication actually does on a neurological level.

The most common type of antidepressant prescribed is a Selective Serotonin Reuptake Inhibitor, known as an SSRI. SSRIs mainly treat depression but they are also effective in the treatment of anxiety disorders, Obsessive-Compulsive Disorders, and Post Traumatic Stress Disorder. Serotonin is a neurotransmitter in the brain which impacts your mood, sexual desire, appetite, sleep, memory and learning as well as other similar functions. On a neurological level, SSRIs prevent serotonin reabsorption which builds up serotonin in the synapse. This allows receptors to receive the signal and react with the optimal amount of serotonin. People suffering from major depressive disorder and anxiety disorders typically have lower serotonin levels. By preventing reabsorption in the synapse via medications, symptoms of these disorders may decrease. In 1987 Prozac was the first approved for treatment of those with depression and became one of the most prescribed antidepressants. Other common SSRIs include Lexapro, Paxil, Zoloft, and Celexa.

Serotonin and norepinephrine reuptake inhibitors, SNRIs differ from SSRIs in that they block the reabsorption of serotonin and norepinephrine. Norepinephrine is a neurotransmitter that influences hormones and the “fight or flight” response in the brain. Approved SNRIs include Cymbalta, Pristiq and Effexor XR.

Some of the other common types of antidepressants prescribed include norepinephrine and dopamine reuptake inhibitors (NDRIs) which block the reabsorption of norepinephrine and dopamine. This is only seen to be effective in the medication bupropion, which is also known as Wellbutrin. Other types of antidepressants that are less common include Tetracyclics (TCA’s), Monoamine Oxidase Inhibitors (MAOI’s), and Serotonin Antagonist and Reuptake Inhibitors. These older medications are not prescribed as frequently because of the development of newer medications that effectively decrease symptoms and have fewer side effects.

Medication is helpful; however, it is most effective when used in combination with different types of psychotherapy or support groups. If you or someone you know is struggling with depression or any type of anxiety or mood disorder, it is important to seek professional help from a psychiatrist or psychiatric nurse practitioner who can provide antidepressants as well as support through talk therapy. If you or someone you know is currently taking antidepressants, it is extremely important to continue taking the medication and avoid discontinuations.

If you or a loved one is suffering from depression, anxiety, or a mood disorder, please contact 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.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970

https://www.webmd.com/depression/how-different-antidepressants-work#1-3

Image Source:

https://www.google.com/url?sa=i&source=images&cd=&ved=2ahUKEwjFgIeKmvPiAhVCnOAKHeFIDMkQjRx6BAgBEAU&url=https%3A%2F%2Fwww.verywellmind.com%2Fwhat-are-the-major-classes-of-antidepressants-1065086&psig=AOvVaw2C3kM7Q4RG9lVpyMGcv6xk&ust=1560953229169790

 

 

Mental Health Awareness

Mental Health Awareness

By Lauren Hernandez

               It is important to recognize how mental illness affects many people’s lives. Mental health awareness promotes the understanding and respect towards those who suffer from mental illnesses. It is important that we make attempts to normalize and destigmatize those struggling with mental illness. If you know of someone struggling with mental health issues, there are a multitude of resources that can help.

Available resources:

National Alliance on Mental Illness (NAMI): www.nami.org

NAMI StigmaBusters is “a network of dedicated advocates across the country and around the world who seek to fight inaccurate and hurtful representations of mental illness”. NAMI StigmaBusters

Suicide.org – Suicide prevention, awareness, and support: www.suicide.org

National Institute of Mental Health (NIMH): www.nimh.nih.gov

Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov

National Suicide Prevention Lifeline: 1-800-273-TALK (8255) www.suicidepreventionlifeline.org

Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD): www.chadd.org

Child and Adolescent Bipolar Foundation: www.bpkids.org

The Trevor Project (LGBT mental health/suicide prevention): www.trevorproject.org

Anxiety Disorders Association of America: www.adaa.org

National Eating Disorders Association: www.nationaleatingdisorders.org

Alcoholics Anonymous: www.aa.org

Narcotics Anonymous: www.na.org

Gamblers Anonymous: www.gamblersanonymous.org

Alzheimer’s Association: www.alz.org

Depression and Bipolar Support Alliance: www.dbsalliance.org

National Autism Association: www.nationalautismassociation.org

Veterans Crisis Line (U.S. Department of Veterans Affairs): 1-800-273-8255 (press 1)

U.S. Department of Veterans Affairs – Mental Health: www.mentalhealth.va.gov

Mental Health America: www.mentalhealthamerica.net

If you or someone you know is struggling with any type of 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 http://www.counselingpsychotherapynjny.com/ .

 

Sources:

https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201105/mental-health-awareness-month-resources

https://www.psychologytoday.com/us/blog/when-your-adult-child-breaks-your-heart/201705/mental-health-awareness-month

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Depression: Can it be Effectively Treated in Adolescents without Medication?

By Samantha Glosser

Although antidepressant medications are typically seen as the first course of treatment for adolescents diagnosed with depression, many families do not want their kids to begin taking medication. This could be because of personal values and beliefs or because they cannot afford medication. In addition, almost half of all adolescents who begin treatment with medications eventually discontinue use due to the side effects or because they feel that it is not benefiting them enough. If you decide that medication isn’t right for your child, there are other options that are effective. One clinically proven method used to treat depression in adolescents is cognitive-behavioral therapy (CBT).

CBT is a short-term, goal-orientated therapy that focuses on changing patterns of thinking and behaviors that contribute to the patient’s issues. For example, your teenager may feel depressed because they are distorting the importance of certain events. This could start as simply getting a D on their final. However, their thoughts soon begin to spiral, and they begin to think that with this D on their transcript they will never be able to get into college or get a good job. CBT works by challenging this maladaptive thought pattern and teaches patients to replace these thoughts and consider alternative viewpoints. Recent studies have shown that CBT can be just as effective in treating depression as antidepressant medications and will lead to increased moods in adolescents. If you and your child have come to the decision that medication is not right for them, cognitive-behavioral therapy is an effective treatment plan that just might be the right fit for your needs.

If you or someone you know appears to be suffering from attention-deficit/hyperactivity disorder (ADHD), 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, please visit http://www.counselingpsychotherapynjny.com/.

Martin, B. (2018, April 04). In-Depth: Cognitive Behavioral Therapy. Retrieved from https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/?li_source=LI&li_medium=popular17.

Wood, J. (2018, January 21). For Teens, CBT in Primary Care Can Be Cost-Effective Versus Meds. Retrieved from https://psychcentral.com/news/2018/01/20/cognitive-behavioral-therapy-cost-effective-for-teens-who-decline-antidepressants/131463.html.