Sleep Difficulties? Here are 5 questions that will Help You Figure Out Why.

By Sally Santos

We all have gone through this. We have had a long day and we can’t wait to get in to bed to rest. But the moment you rest your head on the pillow you find yourself wide awake and staring at the ceiling. So then you ask yourself “why can’t I fall asleep?” Consider these 5 questions:

Do you take your phone to bed?

  • We spend all day with our phones tending to every notification that we receive. That can become a habit. So when you bring your phone to bed and you see your phones light up you are going to want to see what it is. So every night before you go to bed try to keep your phone away from your bed or at least set it on Do Not Disturb Mode. This ensures that your phone won’t ring for every notification

How much caffeine are you drinking?

  • If you are someone who consumes a lot of caffeine during the day and find yourself not being able to sleep at night consider consuming less caffeine or stop completely.

What do you do during the evening?

  • Avoid having a late meal. If you eat right before you go to bed that might keep you awake because your body is working on digesting your food.
  • If you are someone who works out try working out earlier because after you work out you may have increased energy and that may prevent you from sleeping at night.
  • If possible try avoiding difficult conversations before bed.

How are you using your bed?

  • If you are someone who works or studies in bed, you may be confusing your body. Instead of your body associating your bed as a place for rest it is associating it as a place of work.

Is there something specific that you are worried about?

  • Maybe you are going through a stressful situation and the thought of it is keeping you up at night. Try learning a relaxation method such as breathing gently or meditation.
  • If the situation is serious seek professional help you problem-solve the situation. You might be helped by relaxation techniques, hypnosis or sleep medication.



If you or someone you know is having sleep issues, speak with one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists. Contact us at our Paramus, NJ or Manhattan, NY offices at (201) 368-3700 or (212) 722-1920 respectively to set up an appointment. For more information, visit


Abuse: Emotional Abuse Warning Signs (Part 2)

manipulation-bergencountyIn the world of relationships, balance is one of the core key factors to a successful one. Unfortunately in an emotionally abusive relationship, the healthy balance of trust, communication and fairness is deeply disturbed. There is a dominating partner who has manipulative tendencies and a submissive partner who has codependent tendencies. The manipulative partner usually tries to have total power by controlling the victim’s actions, thoughts, and emotions. Often victims do not even realize that they are being manipulated. The victims of these relationships need to be what the manipulators want them to be or they will deal with emotionally damaging consequences.

There are five main signs that can help you determine if you are in an emotionally abusive relationship:

  1. The manipulator makes you feel guilty for things you should not feel guilty about. He will make you feel guilty for actions that you should not feel guilty about so you will be more likely to do what he asks. For example, he would make you feel guilty for hanging out with your friends instead of with him. Of course it is normal for your significant other to want to spend quality time with you, but an abuser will see your other close relationships as threats and prevent you from having them.
  2. The manipulator makes you doubt yourself by making you feel bad. He will be point out your weaknesses and insecurities and tell you how he can do things better. He will say condescending comments or try to put you down. If you are insecure, have low self-esteem or are in a state of self-doubt, you will eventually believe in everything he says. By trying to convince you that his way is better, he is trying to control you. He will make you think he is thinking about what is best for you, but in reality, he is only thinking about himself.
  3. The manipulator will use his insecurities in order to get what he wants from you. He will tell you all the past suffering he has been through with past relationships to define the current one. For example, he will tell you that he has been cheated on and lied to, so he will ask you to understand that you cannot have any male friends. Does that make sense to you? You are not the cheater, his past girlfriends were. It is understandable that he is insecure, but his past should not define what you can and cannot do in the present.
  4. The manipulator will give ultimatums to prove your love and loyalty to him. He will give you the “if you love me you will do this” statement because if don’t do what he wants, you do not truly love him. As a result of these crazy requests, you will ultimately abandon your wants and feelings to please your partner’s. A healthy relationship is based on compromise and reasoning, not accommodating to everything your abusive partner wants.
  5. The manipulator will threaten himself or others when everything else fails. When you do not comply with any of his manipulative requests, he will resort to harming himself to force you to do what he wants. Extreme manipulators that show these harmful qualities may need to seek professional help from psychotherapists and counselors.

If you feel like these warning signs may apply to your situation with your significant other, it is strongly recommended that you reconsider the relationship or seek marriage or relationship counseling. If you or a loved one live in Manhattan or Bergen County New Jersey and might be suffering from psychological abuse and manipulation, the psychiatrists, psychologists, psychiatric nurse practitioners amd psychotherapists at Arista Counseling can assist you. Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment. Visit for more information

Sex Addiction: What are the Signs?

By: Michelle J. Hong

Sexual addiction is when an individual has a[ File # csp0297286, License # 1699973 ] Licensed through in accordance with the End User License Agreement ( (c) Can Stock Photo Inc. / wackern unceasing desire to participate in sexual activities that intensifies as it progresses because the addict wants to achieve higher levels of euphoria. It is not about intimacy but about seeking pleasure or avoiding problems, so the addict usually does not try bond with his or her sexual partner.

Unfortunately, there is no one factor that can cause sexual addiction but there are possible biopsychosocial factors that can contribute to these disorders. Since sex affects the brain’s survival and reward systems, the brain sends distorted messages that sex is good to a sex addict the same way the brain tells you that food is good when we are hungry. This biological explanation can help people understand why anyone can be occupied with sexual addiction. A few psychological risk factors for this addiction include depression, anxiety, and obsessive-compulsive inclinations. Individuals with a history of addiction are more susceptible to develop sexual addiction as well. Individuals addicted to sex seem to have been sexually abused when they were young or come from broken families, and these families are more prone to substance abuse. Because of all these biopsychosocial factors, sex addicts have insecure, impulsive and compulsive personality characteristics and tend to isolate themselves from society. They have unstable relationships and have difficulty dealing with their emotions.

The DSM has yet to give definitive criteria for sexual addiction, but there are signs that people can recognize in which when to indicate whether an individual has this disorder. These signs may not be clear in the earlier stages of sexual addiction, but they will eventually become more prevalent and transparent.

Some of these signs include:

  • Compulsive masturbation or stimulation
  • Extra-marital affairs or multiple affairs in a non-married relationship
  • Multiple one night stands
  • Excessive and consistent use of pornography
  • Practicing unprotected, unsafe sex
  • Cybersex either over the phone or online
  • Prostitution or purchasing the services of a prostitute
  • Dating excessively in order to have multiple sexual partners
  • Voyeurism or watching others have sex
  • Rape, molestation, sexually harassing others

If you or a loved one live in Manhattan or Bergen County New Jersey and might be suffering from sexual addiction or sexual abuse, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can assist you. Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment. Visit for more information

Image copyright: (c) Can Stock Photo Inc.
“Sexual Addiction – AAMFT Therapy Topic.” Sexual Addiction. N.p., n.d. Web. 05 June 2015.
“Sex Addiction.” Addictions. N.p., 23 Oct. 2012. Web. 05 June 2015.
“What Causes Sexual Addiction?” Psych Central. N.p., n.d. Web. 05 June 2015.

Anorexia Nervosa is a Fatally Serious Illness


Anorexia nervosa is a restricting type of eating disorder that involves an unhealthy, severe reduction of food intake due to body dissatisfaction and extreme concern about weight. Individuals with anorexia nervosa see themselves as overweight even though they are dangerously thin. Women are more likely than men to develop an eating disorder and approximately 0.5 to 3.7 percent of women specifically suffer from anorexia nervosa in their lifetime.  It is the most common cause of death among young women. The mortality rate for anorexia is 0.56 percent per year, which is about 12 times higher than all other causes of death among females ages 15-24 in the general population. The course and outcome of this eating disorder vary across individuals; some individuals can fully recover after a single episode but some experience a continuing deterioration from this illness over years. Individuals with anorexia repeatedly check their body weight, avoid eating food or eat food in tiny quantities, and engage in various techniques to control their weight, such as intense exercise or abuse of laxatives. Adolescent girls with anorexia experience amenorrhea, which is an absence or delayed menstruation.

Common symptoms of anorexia include:

  • Resistance to maintaining body weight at or above a minimally normal weight for age and height
  • Intense fear of gaining weight, even though underweight
  • Disturbance in the way in which one’s body weight or shape is experienced
  • Denial of the seriousness of the current low body weight
  • Infrequent or absent menstrual periods
  • Picking out a few foods or carefully portioning food
  • Constant, ceaseless weight checking and obsession

Since many individuals with anorexia tend to conceal their unusual eating habits and wear baggy clothes to hide weight loss, this illness can advance to life-threatening stages before it is noticed by families, friends, and romantic partners. Fortunately, eating disorders can be treated and individuals can become healthy again. Anorexia nervosa treatment is a specific program that involves three main steps:

  1. Restoring weight lost to severe dieting and purging
  2. Treating distorted body image, low self-esteem and interpersonal conflicts
  3. Achieving long-term remission and rehabilitation

An early diagnosis of anorexia nervosa can increase a successful outcome of treatment and medication should be considered after a healthy weight gain has been reached. Certain SSRIs (serotonin reuptake inhibitors) have been helpful for weight maintaining and resolving mood and anxiety symptoms for this disease. Once individuals with anorexia have gained weight and malnutrition has been restored, psychotherapy can help them overcome deeply-rooted self-esteem issues and body image distortions.

If you or a loved one live in Manhattan or Bergen County New Jersey and might be suffering from eating disorders such as anorexia nervosa, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can assist you. Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment.  Visit for more information

Anxiety: The Gender Disparity

Anxiety: The Gender Disparity
By Catherine Ferreira


Studies have shown that gender differences in anxiety vary not only in prevalence, but in the severity of the disability. Anxiety disorders of almost every kind have been proven to have a more crippling effect on women than on men (McLean et. al. 2011). Potential reasons for this may include the responsibilities women have in addition to working—that is, taking care of children, home keeping and nursing the elderly. All this, combined with the stress of working a full-time job, has had a devastating effect on the state of women’s mental health. It is no surprise, then, that women, more than men, report greater levels of anxiety and depression.

This does not mean, however, that women are doomed to a life of misery. Measures can be taken to prevent or alleviate these mental health issues. If you or someone you know is suffering from anxiety or depression and need diagnosis or treatment, the licensed professional psychiatrists, psychologists, psychiatric nurse practitioners and psychotherapists at Arista Counseling and Psychological Services can assist you. Contact our NJ or NY offices at (201) 368-3700 or (212) 722-1920 to set up an appointment. Visit for more.

McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011). Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness. Journal of Psychiatric Research, 45(8), 1027–1035. doi:10.1016/j.jpsychires.2011.03.006

ADHD: Stimulant Drug Abuse

By: Nicole Bieniasz

Attention Deficit Hyperactivity Disorder (ADHD) is a very common disorder that is associated with symptoms of inattention, hyperactivity, and impulsivity. The most effective way of managing ADHD symptoms is through the intake of stimulants, typically known as Adderall, Vyvanse, or Concerta. As diagnosis of ADHD increase, the prescription of these stimulant drugs increases as well. Since ADHD is difficult to diagnose and understand, many individuals seek this opportunity to imitate symptoms of ADHD in order to retrieve stimulant prescriptions and abuse their use. The abuse of adderall by college students has always been common, but now stimulant abuse is entering the workplace as well. As the demands of jobs and personal lives increase, stimulants are being used to help people enhance productivity. Although this may sound ideal, taking stimulants when not necessary can lead to major health problems. The use of stimulants can easily turn into an addiction, where withdrawal from the drug can cause fatigue, depression, and disturbed sleep patterns. Use of high dosage of such drugs can also lead into very serious cardiovascular problems such as strokes. Various complications are likely to occur if stimulant drugs are being abused and taken with the oversight of a doctor.

Despite the abuse, those who are prescribed medication for ADHD or ADD have a very positive experience. With the appropriate dosage of medication, those who suffer from ADHD experience a reduced amount of fidgeting, impulsivity, and other hyperactive behaviors. The symptoms of ADHD lessen because stimulants allow brain chemicals to increase, such as dopamine and norepinephrine, producing a focused and calmed mindset. The benefits of these drugs are prominent when taken appropriately as directed by doctor. It is very important to understand how medications work and when they should and should not be used.

If you or a loved one live in Manhattan or Bergen County New Jersey and might be suffering from drug abuse, the psychiatrist, psychologists, psychiatric nurse practitioners and psychotherapists at Arista Counseling and Psychological Services can assist you. Contact our Bergen County, NJ or Manhattan, NY offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment. Visit for more information.

Bipolar Depression vs. Depression: Accurate Diagnosis

Bipolar Disorder is a difficult diagnosis to make at any age. In childhood it is often misdiagnosed as Attention Deficit Disorder (ADHD) or Oppositional Defiant Disorder (ODD). It is often difficult to diagnose bipolar disorder at any age in particular, because the first episode often appears as depression. Should an episode of depression occur before the age of 30, it is particularly important to consider that it might be the depressive phase of a bipolar condition and not merely unipolar depression. According to Dr. Henry A. Nasrallah, paying close attention to the person’s history of mood swings, hypomanic symptoms, and family history can be very helpful in arriving at the correct diagnosis. Since anti-depressant medication can precipitate a manic episode, accurate diagnosis is very important.

If you or a loved one live in Manhattan or Bergen County New Jersey and might be suffering from bipolar disorder or depression, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can assist you. Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment.  Visit for more information.

Current Psychiatry, April 2015, Volume 14, No. 4, S4, Sups often helps make the proper diagnosis.Iplement

Sleep Deprivation: What Inadequate Sleep Does to Our Body

By: Nicole Bieniasz

Are you sleeping eight hours every night? Consider yourself lucky! Our fast-paced environment has fooled us into believing we can successfully function with almost no sleep. What some people forget is that an adequate amount of sleep is necessary for maintaining positive mental and physical health because our bodies repair and restore themselves at that time. Interfering with this restoration by cutting back on sleep will eventually take a toll on an individual because the brain is not taking in new information or strengthening memories. Here are some examples of how shorter hours of sleep take a toll on our brains and affect functioning:

1. Slower Thought Process: Sleeping less than the 8 average hours necessary causes lower alertness and concentration, which impairs judgment. Making decisions and judging situations is very prominent and important in the workplace and at home.

2. Impaired Memory: When individuals do not allow their brains to restore during sleep, the nerve connections that are responsible for memories are not strengthened.

3. Difficulty Learning: Slower thought processing and difficulty learning restricts the individual from picking up any new information, which is essential for learning.

4. Problems with Mood: Lack of sleep not only hurts work performance and relationships, it is also capable of leading to problems with mood. Depression and anxiety are linked to poor sleeping habits.

To avoid these problems, here are some ways to get a good night sleep:

  • Keep a regular sleep/wake schedule
  • Avoid heavy meals before bed
  • Minimize caffeine intake especially 6 hours prior to sleep
  • Exercise
  • Minimize hot and cold temperatures, noise, and light when going to bed
  • Develop a regular bedtime

If you are concerned that you or a loved one may have trouble sleeping, the licensed professionals at Arista Counseling and Psychotherapy can assist you.  Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment.  Visit for more information.

Relationship Style: What Your Relationship Says About Your Parents

By: Nicole Bieniasz

Did you know your parents shape the relationship you are in today? The partners we select and the relationships we pursue are dependent on the attachment styles we develop as children. Parents are the first human beings to whom children develop an emotional attachment, which then dictates the different attachment styles they have. Attachment is a reinforced process that develops when parents respond and attend to a child’s emotional needs. Some parents will rush to their child the moment they cry, while other parents completely dismiss the action. The relationship the parents decide to have with their child determines the attachment style the child will have and grow into as an adult. There are four primary attachment styles that can be beneficial or detrimental towards an individual’s relationship as an adult. Here are the four attachment styles:

1. Secure Attachment: Children who develop a secure attachment see their parents as a secure base. The child feels independent and will continue to explore without the mother’s presence. Someone who is securely attached can easily be comforted in the absence of the mother even when it is clear the child only wants the mother. Relationships for this kind of individual reflect the mother-child relationship. A relationship with someone with a secure attachment is a healthy relationship where the person is honest, open, independent, loving, and empathetic.

2. Anxious/Ambivalent Attachment: A child who has an anxious/ambivalent attachment shows distress when the mother is not present and is not easily comforted upon her return. A child relies on their mother to fulfill constant needs and becomes clingy if their needs are not constantly met. A relationship with an individual like this is the opposite of a secure attachment. A person with this attachment faces frequent break ups and complains about cold/distant relationships. Anxious attachments cause a person to constantly seek a partner that will complete them.

3. Avoidant Attachment: This attachment differs from the two previously discussed. Avoidant attachment is seen in children when the child is indifferent about the parent’s presence. The way this person responds to parents and strangers is the same. Being in a relationship with this kind of individual is very difficult because this individual is emotionally distant. Avoidant individuals invest little or no emotional energy and find it very hard to connect with others.

4. Disorganized Attachment: This is a combination of anxious and avoidant attachments. The child has no definitive way of relating to those they love because this was never presented by the parent. Relationships for this person are very complicated because this individual experiences emotional storms due to the uncertainty of whether they want to be too close or too distant from the person. This individual trusts the same person they feel will hurt them the most.

Each of these attachment styles differ in their own way and are more complicated than others. If you are concerned that you or your partner are having problems, the licensed professionals at Arista Counseling&Psychotherapy can assist you. Contact our Bergen County, NJ or Manhattan offices of psychologists, psychiatrists, and psychotherapists at (201) 368-3700 or (212) 722-1920 to set up an appointment. Visit for more information.


Anxiety and Communication-How to prepare for a difficult conversation- Bergen County, NJ

By: Michelle Dierna

art of communication pic

Communicating can be very difficult when you are preparing to have a difficult conversation with an individual or group of people who you know most likely will have mixed reactions and emotions regarding the subject. Most People find it easier to avoid communicating something that they think is going to be controversial or unpleasant, which results in halting the communication and letting the situation linger. It’s usually embedded in people to avoid confrontation conflict and stressful situations.

“Learning how to have difficult conversations at work or in personal relationship’s boosts one’s confidence, increases one’s self-awareness, and gives one the sense of being in control of one’s own life. What stops us from having that difficult conversation we should have?”

Fear is usually what stops a person from confronting a difficult situation.  Fear can arise when facing a difficult conversation because you may be afraid that you will hurt someone’s feelings, fear losing people you love, or fear of incurring in those we love or want to impress, “we fear the consequences of engaging in a difficult conversation”.

 Some tips on preparing for a difficult conversation:

  • Don’t delay the conversation any longer and provide reasons for why it needs to happen: Delaying conversations just makes the situation more dramatic and can even lead to failing to ever resolve the conflict. Being honest and confronting the person/ group and giving them a reason to see why you would like to discuss the issue, this will optimistically lead to a respectful conversation between both parties.
  • Stay connected when communicating and encourage Questions: Each of us communicates in different ways; staying open-minded when communicating with the person or group and encouraging questions by the other person, may help the flow of communication and help to get a better understanding of how the individual or group feels about the subject at hand. It will encourage them to share their perspective. Do not focus the whole conversation on yourself; you should be interested in the other person’s opinions too. It is healthy to express your feelings but this is about you conversing back and forth, not one way.
  • Resist making fast assumptions; Think before speaking right away: Listen to the other person and assess the situation fairly. Many people have a hard time seeing things from the other person’s point of view. Before making assumptions about the situation, listen to the individual/group and then arrive at a conclusion because it could be that the situations that lead to the conversation was just a misunderstanding. Hopefully this will result in figuring out a solution to the situation/conversation or coming to a mutual agreement about what the future holds after the discussion.
  • Don’t Rehearse: Be genuine; if you are not you should not expect a sincere response. If you want to confront a situation that is bothering you, explain exactly how you feel honestly without sounding like your reading off a projector screen. Correct communication is the key to opening up new ways of approaching tough topics.

 If you are struggling with communication issues, problems confronting a difficult situation that may concern you or anxiety, feel free to contact our Bergen County, New Jersey or Manhattan offices of psychologists, psychiatrists, and psychotherapists for an evaluation.

Arista Counseling and Psychiatric Services (201) 368-3700 or (212) 722-1920

More detailed information can be found at



1.”Tips on Having Difficult Conversations.” Harvard Business Review. N.p., n.d. Web. 28 May 2014.

2. Aldo.Civico.Ph.D.“How to have difficult conversations”.psychologytoday/blog/turning-point/201405/how-have-difficult-conversations