Medication Bergen County NJ

Facilitating Medication Compliance

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Facilitating Medication Compliance

By: Irene Tussy

No matter how effective a medicine is, it will only work for a patient if it is taken properly. Patient health outcomes are evaluated based on the eradication or recurrence of symptoms, emergency room visits, hospitalization, readmission rate, morbidity, and mortality. Medication noncompliance contributes to all these factors, as well as an increase in the cost of healthcare and increased spending on healthcare.

Education is the most effective tool to combat medication noncompliance, and it is equally important that all involved in a patient’s care are educated. The responsibility for compliance is shared by both patient and doctor. Prescribers need to be aware of the importance of communicating clearly with their patients about the medicines they prescribe.  This includes having a conversation about what they are treating and why, as well as addressing not only the side effects of the medicine but the effect of not taking the medicine as well. Prescribing instructions need to be clear and should be reviewed with the patient before dismissal, in writing if at all possible. 

Another important factor for prescribers to review with their patients is the dosage regimen. Patients may be more likely to adhere to a single-dosing approach than they are to a multi-dosing approach. Extended release medications are a great option to consider. If a single-dosing regimen is not possible or is more efficacious, the prescriber needs to make sure that the patient understands the potential repercussions of missing doses.

Pharmacies also play an important role in medication compliance. Automatic refills or refill reminders should be offered to all patients. Text messaging or automated phone calls are viable options. If a patient cannot afford medicine, pharmacies should make available patient information pamphlets from drug companies that often provide a sliding scale or other options to make their drugs more available to those in need. For their part, drug companies need to offer price reductions or sliding scale options to their patients from all socioeconomic backgrounds.  They should also evaluate dosing schedules and try to offer more extended release options on a regular basis. Creating multiple formulations may be useful, such as pills, capsules that tend to be easier to swallow, or liquid for those with dysphagia.

Ultimately, the responsibility for medication compliance lies with the patient, after all, it is their health and well-being that is at risk. A regular medication regimen needs to be set up at home, while on vacation, or on a business trip. Patients should never leave their doctor’s office with unanswered questions about their medications, and if any arise after the visit, a phone call needs to be made to the office as soon as possible, before the question is forgotten. 

If you or someone you know is struggling with medication compliance, 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 Psychotherapy & Psychiatric Services. Contact our Manhattan, NY or Paramus, NJ offices respectively at (201)368-3700 or (212)722-1920 to set up an appointment. For more information, please visit https://counselingpsychotherapynjny.com

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498383/

Understanding medication adherence: Why is it important?

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Understanding medication adherence: Why is it important?

By: Irene Tussy

Doctors prescribe medication all the time, yet actually taking medication as instructed may not be as common for patients. So, what does it mean to be prescribed medication with specific instructions, and why is it important to take the medicine we are prescribed? What will happen if the medications we are prescribed are not taken properly? These questions can all be answered by focusing on one main idea: medication adherence. Medication adherence is the act of taking medications as they are prescribed and following the medication plan that you and your doctor(s) have made.

The concept of medication adherence is important for a multitude of reasons, all of which will allow your medication treatment plan to be as effective as possible. Most importantly, adherence allows your medications to work properly. Most medications take about 4-6 weeks to start working. Therefore, it is important to be patient, keep taking your medication, and allow it to have the proper time to perform as expected.

There are many reasons for non-adherence, including denial, embarrassment, or simply just forgetting to take your medication. Failing to take your medications as prescribed by your doctor increases the risk of your condition becoming worse, can diminish your quality of life and can increase the possibility of your return to a clinic or hospital. So, it is important to make a medication plan that may be easily implemented into your daily life and to make a conscious effort to adhere to it!

Now that you have a better understanding of the importance of medication adherence, there are many easy habits you can form to be consistent with your meds. These habits include (but are not limited to) pairing medications with something you do every day, using a weekly pill box, enrolling in an automatic refill program, and having prescriptions mailed to your home. Being consistent with these habits will decrease the chance of non-adherence and allow you to find success in your medication plan.

If you or someone you know is struggling with medication adherence, 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 Psychotherapy & Psychiatric Services. Contact our Manhattan, NY or Paramus, NJ offices respectively at (201)368-3700 or (212)722-1920 to set up an appointment. For more information, please visit https://counselingpsychotherapynjny.com
Reference: https://www.nami.org/About-Mental-Illness/Treatment/Mental-Health-Medications/Medication-Adherence

Social Anxiety: Struggling to Reach Out

GalleryJudy Gurfein Leave a comment
By Melissa Schwartz

            It’s okay to want to be alone, but many people around the world resort to solidarity because they fear they’ll be judged by others in a social scene. Social anxiety disorder, or social phobia, is a mental illness categorized as a type of anxiety disorder that consists of an intense, persistent fear of being watched and/or judged by others. No matter what the situation is, if it involves other people, things become more challenging for them. It feels as though all eyes are on them and they’re terrified of making a spectacle of themselves in front of those around them, even friends and family. That’s why it tends to be a struggle for many sufferers of social anxiety to maintain any healthy relationships because they would rather push people away and avoid conversation than take the risk of feeling humiliated through judgment.

          The toll social anxiety has on some of its sufferers can lead to avoiding school and work as well as dropping many hobbies/activities all together because they’re simply too terrified to engage. In such instances, the disorder becomes a hindrance to everyday life because if they miss school and work, they’re losing out on education, money, and many other key things to sustain healthy living. Some signs that you may be suffering from social anxiety disorder are: when having to be around others; feeling nauseous or sick to your stomach, blushing, sweating or trembling, making little eye contact and speaking very softly, staying away from places where you see other people, etc. In this case, treatment comes in the form of psychotherapy, medication, or both. Cognitive behavioral therapy (CBT) is perhaps the most common form of treatment and teaches patients better ways of thinking and reacting to anxiety-inducing scenarios in order to best keep those unwanted emotions under control.

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

OCD: Exposure Therapy and Medication

GalleryJudy Gurfein 5 Comments
By Melissa Schwartz

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: Difference between Unipolar and Bipolar Depression

GalleryJudy Gurfein 1 Comment

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

GalleryJudy Gurfein Leave a comment

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/ .

 

Pain: Chronic Pain is a Fundamental Health Issue

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By Gabriella Phillip

According to The International Association for the Study of Pain, pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. When someone is injured, pain sensors immediately send signals to the brain. Although regular pain, like cramps or a headache, can be relieved in a rather short period of time, chronic pain involves the brain receiving pain signals a while after the onset of pain or the original injury.

One in five people live with chronic pain and the frequency of chronic pain increases as we get older. Many elderly people are experiencing pain that oftentimes goes undiagnosed. In addition, research shows that patients with dementia are being severely untreated for their experience with pain. Even though it’s a fundamental human right to have proper access to pain management, most elderly people are receiving quite inadequate care from health facilities, making it harder for them to cope and go about their daily lives with severe chronic pain.

Chronic pain can strongly impact or contribute to the formation of serious mental health issues including anxiety and depression. Current research from Neuroscience Research Australia shows that patients living with chronic pain have lower levels of glutamate, a significant chemical messenger that aids emotional regulation. Therefore, it’s possible for people with chronic pain to undergo certain personality changes like being more tired than usual, feeling unmotivated, or worrying on a more frequent basis than before. Around half of people suffering from chronic pain also have mental health conditions. The daily demands of learning to live with chronic pain can help generate anxiety, depression and other mood disorders.

If you or someone you know is struggling with Chronic Pain and its mental health effects, 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

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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:

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Dementia: 5 Facts You Need to Know

GalleryJudy Gurfein 2 Comments

By Stephanie Osuba

Everyone fears that they, or their family members, will fall victim to a degenerative neurological disease when they age. Dementia is considered a syndrome, a series of symptoms that often appear together, and is caused by damage to the brain cells. Symptoms include memory loss, cognitive impairment, and diminishing language. Here are five facts that you need to know about dementia.

  1. Alzheimer’s is a type of dementia; they aren’t interchangeable: As stated above, dementia is a syndrome and more of an umbrella term for other types of dementia, like Alzheimer’s, Parkinson’s and vascular dementia. Different types of dementia correlate with different types of brain damage. Alzheimer’s is mainly a result of abnormally high protein levels in and around brain cells that inhibit communication between them. This eventually leads to the death of the nerve cells and loss of brain tissue. Alzheimer’s is the most common form of dementia.
  2. Dementia is not just a “memory loss” disease: Dementia also affects a wide range of cognition processes including: learning, language, executive and motor function, attention, and social cognition. For example, two thirds of diagnoses of Alzheimer’s are given to women primarily because they exhibit the symptom of memory loss more than men.
  3. Cognitive decline doesn’t always lead to dementia: Memory and other cognitive issues can be a result of other things such as: delirium, mild cognitive impairment, or normal changes due to age. According to a study done by the Mayo Clinic, even mild cognitive impairment only lead to dementia in 29% of cases within the next five years.
  4. Not all types of dementias are progressive: Underlying causes such as vitamin B12 deficiency, underactive thyroid syndrome, and normal pressure hydrocephalus can be reversed with treatment. Even medications like antidepressants, narcotics, and antihistamines can have dementia-like side effects.
  5. Lifestyle changes can help reduce the risk of dementia: Exercise has proven to be a great defense to cognitive decline through increased heart rate and blood flow to the brain. Maintaining a healthy diet and engaging in social activities is also a huge help.

 

Source: Ph.D., M. C. (2017, December 7). 5 Facts You Need to Know About Dementia. Retrieved from https://www.psychologytoday.com/us/blog/the-fifth-vital-sign/201712/5-facts-you-need-know-about-dementia 

If you or someone you know needs help coping with the dementia of a family member, 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/.

Self-esteem

GalleryJudy Gurfein Leave a comment

By: Charleene Polanco

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

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

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

Sources:

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

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