OCD: Exposure Therapy and Medication

OCD stands for Obsessive Compulsive Disorder and is a chronic, long-term disorder in which a person has uncontrollable reoccurring thoughts and/or behaviors that take over and are constantly repeated. These repetitions can take over one’s life; all they can focus on are one’s obsessions and nothing else. Obsessions are defined as “repeated thoughts, urges, or mental images that cause anxiety,” while compulsions are “repetitive behaviors that a person with OCD feels the urge to do in response to their obsessions.” It’s a common disorder affecting about 1% of the U.S. on any given year, with a lifetime prevalence of OCD among U.S. adults falling at 2.3%. Symptoms can present themselves in a range of mild to serious, with about ½ of OCD cases falling under serious.

Exposure and Response Prevention, also known as ERP therapy, is a common form of treatment for individuals with OCD, but it can be very harsh and relentless. In simple terms, ERP therapy takes the OCD patient and places them at the forefront of their fears so that they confront them head on, with no protection. However, when doing this they’re guided by a trained therapist to ensure they don’t resort to their compulsive behaviors. An example of this type of therapy would be having a patient who suffers from germaphobia stick their hands in dirty water without washing their hands after. Over time they’re usually able to adapt to and overcome their fears, but it takes a lot of hard work. Unfortunately, this type of therapy doesn’t work for everyone and many individuals fighting OCD need medication instead, or a combination of both. Some common OCD medications are Zoloft, Prozac, and Luvox. These are all anti-depressants approved by the FDA to treat OCD.

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

Sources: https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml https://www.psychologytoday.com/us/therapy-types/exposure-and-response-prevention

Depression: Social Depression

By: Nicolette Ferrante

Social Anxiety and Depression are two of the most commonly diagnosed mental disorders in the United States.  Social Anxiety Disorder is the fear of being rejected or embarrassing oneself in a social setting. Depression is a mood disorder that causes a persistent, deep feeling of sadness and loss of interest in things someone once enjoyed.  Although these are two separate diagnoses, they can co-occur.

            Social symptoms of depression include avoiding any type of contact with friends/family, not wanting to attend activities involving social interaction and neglecting normal behavior and interests that were once enjoyed. People with social anxiety disorder are six times more likely to develop a mood disorder such as depression. Social Phobias prevent people from making friends, applying for jobs, pursuing relationships and being a part of any social setting at all.

            Avoidance is the only way to cope with social anxiety. They withdraw out of fear of embarrassing themselves or not fitting in. Those with Social Anxiety disorder want to socialize, but the fear is far too much to bring them to. The uncontrollable anxiety and inability to socialize often leads to the feelings of hopelessness, isolation and frustration. Neglecting themselves from social interactions, sometimes leads to depression, due to the loneliness. Not everyone with SAD will experience depression.

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

Sources:

Social Anxiety and Depression

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

By: Sarah Cohen

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

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

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

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

https://www.mentalhealth.org.uk/publications/supporting-someone-mental-health-problem

https://www.mentalhealth.gov/talk/friends-family-members

Depression: How to Support a Spouse with Depression

Depression: How to Support a Spouse with Depression
By: Isabelle Siegel

Depression can cause immense pain and suffering for more than just the individual diagnosed. The partners/spouses of individuals with depression commonly report feeling hopeless and helpless, unsure how to provide necessary support to their partner/spouse. Attempts to help may be met with apathy or even anger, further complicating a seemingly simple question: How can I support my partner/spouse with depression?

Develop an understanding of depression and how it manifests in your partner/spouse. It can be helpful to research depression, taking note of its symptoms and causes. Understand that depression is an illness and not a choice. You may want to create a list of your partner’s/spouse’s particular symptoms and triggers for depressive episodes in order to better understand his/her experiences.

As simple as it sounds, just be there. Depression may have your partner/spouse doubting that you love him/her and may make him/her feel as though he/she is a burden to you. Assure your partner that you are there for him/her and that you love him/her despite his/her illness.

Encourage him/her to get help. Depressive symptoms can interfere with one’s motivation and ability to get help, so continuously encourage treatment. Help your partner/spouse find a therapist and/or psychiatrist, bring him/her to appointments, and cheer him/her on as they undergo treatment.

Do things you both enjoy. One important treatment step for depression is known as “opposite action,” in which individuals with depression act opposite to how they feel. If they feel like laying in bed all day, for example, they should get up and out of the house. As a partner/spouse, you can help by encouraging your partner/spouse to act opposite to their depressive urges by engaging in activities that you both enjoy.

Understand the warning signs of suicide. Individuals with depression are more vulnerable to suicide, so it may be important to know signs that your partner is considering taking his/her life. These may include talking about suicide, social withdrawal, giving away belongings, or obtaining means of attempting suicide. If you believe that your partner is at risk for suicide, seek immediate help.

Most importantly, take care of yourself and seek therapy. Research suggests that having a partner/spouse with depression increases one’s own risk of developing depressive symptoms. It is important to understand that your partner/spouse is not the only one who needs support. Never feel guilty for prioritizing your own needs, and consider seeking therapy or other support in order to take care of your own mental health.

If you or a loved one needs support, 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/

Sources:
https://www.mentalhealth.org.uk/blog/supporting-partner-depression
https://www.medicalnewstoday.com/articles/325523
https://www.psycom.net/help-partner-deal-with-depression/

Image Source: https://www.rewire.org/support-partner-depression/

Anger Management during COVID-19

By: Elyse Ganss

According to the New York Times, domestic violence rates have surged during the era of the coronavirus pandemic. Domestic and family violence rates typically increase when families have more time to spend with one another, a time that is usually reserved for holidays. However, with stay-at-home orders occurring nationally, families have been spending more time together and consequently, violence rates have increased worldwide.

Violence occurs as a result of out of control anger. Anger is an emotion that occurs on a spectrum from irritation to rage. Aggressive, out-of-control responses due to anger lead to abusive actions. Dealing with angry feelings in a positive way is crucial to maintaining healthy relationships. Expressing anger in a calm manner such as having a controlled conversation with whoever you may be angry with is a constructive way to address anger. However, if anger is not dealt with it can lead to passive-aggressive behavior or having a hostile personality.

The Mayo Clinic recommends various tips for keeping anger under control. These tips include thinking before you speak, expressing anger in a calm way, getting exercise to reduce stress, practicing relaxation techniques and receiving help from mental health professionals.

If your anger levels are out of control, feel unavoidable, or if you are often enraged, seeking help for anger management may be the best course of action.

A mental health professional, whether it be a licensed psychologist, psychotherapist, clinical social worker, psychiatric nurse practitioner, or psychiatrist, will work with the patient to develop a new way of thinking and behaving when faced with situations that induce anger. Although anger may currently feel overwhelming, a professional can help work with you to reduce your anger and to help heal and restore your relationships.

If you or someone you know is looking for support, 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.nytimes.com/2020/04/06/world/coronavirus-domestic-violence

https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/anger-management/art-20045434

https://www.apa.org/topics/anger/control

Image Source: https://www.mindful.org/feeling-angry-try-this/

Grief: What is it?

By: Elyse Ganss

Losing a loved one can affect your feelings, actions, and thoughts. Emotions like loneliness, sadness and anger can be felt after a loss. Grieving involves all of these components and is commonly referred to as the acute pain that one experiences after a loss. If long-term or prolonged grief occurs, seeking support and psychological services may be necessary. A common symptom of long-term grief is an inability to move forward in life. Grief is not only experienced with the loss of a person. Losing a pet, job, or a role in life can cause grief.

There are said to be five stages of grief. These stages include denial, anger, bargaining, depression, and acceptance. However, as grief is a very personal process, every person is different and may not linearly progress through the stages. If you know someone who is currently grieving, the best thing to do is be present and check in with them. Pushing a grieving person to find closure can be perceived as insensitive and may upset the person more. Listening, sharing memories, and simply talking to the person are good ways to support a grieving individual.

Grief counseling is a form of counseling or psychotherapy where loss is the primary thing discussed or focused on. The mental health professional, whether it be a licensed psychologist, psychotherapist, clinical social worker, psychiatric nurse practitioner, or psychiatrist, will work with the patient to find the best course of treatment pertaining to the individual’s loss. Returning to previous level of functioning and working through the grief are the main goals of treatment. Finding the right support system to be there for you on your grieving journey is essential.

If you or someone you know is looking for support, 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/basics/grief

https://newsinhealth.nih.gov/2017/10/coping-grief

Image Source:

https://tricy.cl/2t5Xyfq

Social Anxiety Disorder: More Than Just Being Shy

By: Gabriella Phillip

Social Anxiety Disorder, also known as social phobia, is a mental health condition involving an intense, persistent fear of being watched or judged by others. The fear that people with social anxiety experience in social situations is so strong that they often feel as though it is beyond their control. Social Anxiety Disorder affects around 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia.

Common symptoms for people with social phobia include

  • being extremely anxious around other people,
  • being self-conscious in front of others,
  • being very afraid of being embarrassed in front of other people
  • being the focus of other people’s judgment
  • worrying for days or weeks before a social event
  • having a difficult time cultivating friendships
  • avoiding places where other people will be present

Bodily symptoms for people with social anxiety include

  • heavy sweating
  • trembling
  • nausea
  • blushing
  • having difficulty speaking

Social phobia sometimes runs in families, but no one knows for sure why some people have it, while others don’t. When chemicals in the brain are not at a certain level it can cause a person to have social phobia. Social anxiety usually begins during childhood/ teenage years, typically around age 13. A doctor can tell if the person has this disorder if symptoms are present for at least 6 months. This disorder should be treated in a timely manner to help spare those diagnosed from years of unpleasant feelings and anxiety.

Treatment can help people with social phobia feel less anxious and fearful. Two types of treatments used for Social Anxiety Disorder are psychotherapy, or talk therapy, and medication that’s safe and effective, often used in combination. Cognitive behavior therapy is an effective type of psychotherapy used for anxiety related disorders. Medication used to treat Social phobia include selective reuptake inhibitors (SSRIs), antidepressants, anti-anxiety medicines, and beta blockers. It’s important to choose a method of treatment that is best suited towards your individual needs.

If you or someone you know is struggling with Social Anxiety 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. 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.nimh.nih.gov/health/publications/social-anxiety-disorder-more-than-just-shyness/index.shtml

https://www.verywellmind.com/difference-between-shyness-and-social-anxiety-disorder-3024431

 

PTSD in Refugee and Unaccompanied Children:

By: Luz Melendez

Post-traumatic stress disorder (PTSD) is a disorder that can occur to someone after being exposed to one or more traumatic events. These traumatic events can vary from a natural disaster, war/combat, serious injury, sexual violence, and/or exposure to death threats. After experiencing a trauma there can be an emotional reaction to these events which can include fear, helplessness, and even horror. There may also be distressing memories of the traumatic event which can be recurrent and involuntary. In order to be diagnosed with PTSD, symptoms have to last for more than a month and be persistent. (American Psychiatric Association, 2013).

One population that is less talked about when it comes to PTSD is children, but more specifically refugee or asylum seeking children. The current population of children with PTSD in the U.S. is about 5% and among refugee children in the U.S. it’s about 54%. These children are experiencing hunger, extreme poverty, bombings, abductions, sexual assault, and even witnessing deaths. These stressors can often co-occur making everyday life very difficult for them. The effects of these events are causing developmental regression, clinginess, repetitive play of the trauma/s, anxiety, depression, ACES, and mood changes. One effect that is very important is how the brain is being affected by these traumas. PTSD is developed in two key regions of the brain, the amygdala and the prefrontal cortex. The amygdala reacts too strongly while the prefrontal cortex impedes the ability to regulate a threat response. It’s the perfect storm that leads to hyperarousal, hyper vigilance, and sleep deprivation which are big issues when it comes to children. Children’s brains are growing and developing and these traumas are stunting the global developmental growth of these children’s brains.

Often PTSD in refugee or asylum seeking children, if left untreated/undiagnosed, can and will lead to life long-lasting effects. In the situation these children are in, it’s difficult to not only diagnose them but to properly treat them. Many if not all have witnessed one or more of the stressors mentioned above and these children are out in the world not only having their lives completely change but having their mental health deteriorate. Thankfully some host countries who take in refugees, screen them and try to help them adjust to their now new lives and overcome barriers that come with accessing physical and mental health care. This also includes overcoming the stigma that refugees have of seeking mental health care. Like mentioned before only some host countries do this, others are still fixing their processing of refugees.

 

If you or someone you know is struggling with PTSD, 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/ .

 

Reference:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed). Arlington, VA: American Psychiatric Association.

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/ .