Bipolar One Vs. Bipolar Two

By: Yael Berger

Bipolar, also known as manic depression, is a mood disorder characterized by extreme highs and extreme lows. Extreme highs are called mania while the extreme lows are called depression. It is seen in both adults and children and tends to run in the family. If you have a close relative with Bipolar disorder, you have an increased chance of developing the disorder. According to the national institute of mental health, “an estimated 4.4% of U.S adults experience bipolar disorder at some time in their lives.” There are two different types of Bipolar that are often difficult to distinguish between.

Bipolar I patients commonly present with these symptoms:

  • An episode of extreme mania lasting at least one week and usually an episode of severe depression lasting at least two weeks
    • Mania is characterized by irritability, mood swings, and possibly excessive spending, drinking, excessive sexual behavior etc.
  • Less need for sleep
  • Increased self-esteem, speech, thoughts, distractibility
  • Rapid mood swings
  • Can have a break with reality
    • Hallucinations, delusional or paranoid thoughts
  • Usual onset: around 18 years old

Bipolar II patients commonly present with these symptoms:

  • An episode of hypomania lasting at least four days and always accompanied by an episode of extreme depression lasting at least two weeks
  • Hypomania is a milder form of mania but it is still noticeable to others
  • Typically are prescribed antidepressants with mood stabilizers
  • Usual onset: around mid-20s

There are a few key differences between bipolar I and bipolar II. The main difference is that Bipolar I often begins with mania while Bipolar II often begins as a depressive episode that is later diagnosed when an episode of hypomania occurs. Bipolar II is sometimes wrongly diagnosed as depression at first because it often starts as a depressive episode. Bipolar I is usually obvious and severely disrupts a patient’s life while Bipolar II can be less noticeable. However, once a hypomanic episode in Bipolar II patient causes severe impairment it would then be categorized as Bipolar I. Bipolar I can lead to hospitalization more often than Bipolar II because of the extreme mania that occurs. A combination of medication and therapy can help both Bipolar I and II.

If you or someone you know has any type of Bipolar 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 https://www.counselingpsychotherapynjny.com/

Sources:

https://www.healthline.com/health/bipolar-disorder/bipolar-1-vs-bipolar-2#symptoms

https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml

https://www.psychologytoday.com/us/blog/two-takes-depression/201901/10-things-know-about-bipolar-disorder

Image:

https://www.medicalnewstoday.com/articles/319280.php

Passive Aggressiveness: Origins and How to Respond

Passive Aggressiveness: Origins and How to Respond

By Crystal Tsui

At one point or another, we have all seen or engaged in passive aggressive behaviors, whether it’s giving the silent treatment, making subtle insults, or sending one of those “as per my last email” emails. We do this because we are suppressing our anger or frustration from someone or something. Fear and anger are controlled by a region in the brain called the amygdala. Passive aggressiveness stems from that basic emotion of anger.

Anger is neither good nor bad. It is a basic, spontaneous, neurophysiological part of human emotion. As children, we were often scolded or punished for expressing anger. For example, throwing a temper tantrum is considered unacceptable. So at a young age, we started to perceive anger as taboo. As a result, we learned to suppress our feelings and engage in an indirect expression of hostility through subtle acts.

Children are most likely to act in a passive aggressive manner. Nonetheless, children are the most susceptible to change. Teaching our children that anger is just like every other emotion and directing their anger towards a positive, productive activity will help the child grow into an adult knowing how to manage their emotions properly. Some positive activities may include writing, exercising, drawing, meditating, and listening to music. These activities provide a form of distraction that can alleviate one’s mood, by stimulating another part of the brain that is not associated with the amygdala.

However, adults act this way as well because it’s easier to be passive than to be assertive and emotionally open. When children are taught to suppress their anger and they mature into an adult, it’s harder for them to stand up for themselves and to confront their source of anger.

It is best to avoid raising your voice, lecturing, or knee-jerk consequences that can exacerbate the situation. If an individual is trying to express their anger through communication, it is best to listen instead of reprimanding them for being angry.

When someone is passive-aggressive towards you, fight the urge to mirror their behavior. Instead confront the behavior because when passive-aggressive behavior is confronted directly and assertively, the hidden anger is weakened. Assertive communication and being emotionally open, no matter how hard it is, is the most effective way to acknowledge and accept anger. This builds a foundation for lifelong emotional intelligence and strong, secure relationships.

If you or someone you know has difficulty managing their anger, 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/passive-aggressive-diaries/201712/the-angry-smile-responding-passive-aggressive-behavior

https://www.psychologytoday.com/us/blog/passive-aggressive-diaries/201709/how-respond-effectively-young-persons-anger

https://www.verywellmind.com/what-is-passive-aggressive-behavior-2795481

https://vignette.wikia.nocookie.net/pixar/images/7/7a/Io_Anger_standard2.jpg/revision/latest/scale-to-width-down/2000?cb=20150425021210

Autism vs. Disruptive Mood Dysregulation Disorder (DMDD)

Autism vs. Disruptive Mood Dysregulation Disorder (DMDD)

By Crystal Tsui

Autism and Disruptive Mood Dysregulation disorder are often diagnosed together. However, DMDD is a fairly new diagnosis that first appeared in the DSM-V in 2013. As per DSM-V, DMDD is typically diagnosed between the ages of 6 and 18 years old, but symptoms can begin before the age of 10. Before the child is diagnosed, symptoms should last about a year. DMDD goes even further than childhood “moodiness.” It can cause functional and emotional impairment.

Symptoms of DMDD include:

  • Irritability or angry most of the day, almost every day
  • Severe, explosive temper (verbal or behavioral) an average of 3x or more per week, not related to a situation and child’s developmental level
  • Trouble functioning in more than one place (e.g. home, school, and/or with friends)Autism Spectrum is a group of neurodevelopmental disorders. It has been categorized by patterns of repetitive behavior and difficulties with social interactions. Symptoms tend to be present in early childhood and affects daily life and functioning.

Symptoms of autism include:

  • Avoiding eye contact
  • Isolation
  • Obsessive interests
  • Resistance to physical contact
  • Word repetition
  • Little danger awareness

Individuals with these symptoms are not guaranteed to be autistic. Since autism is a spectrum disorder, each individual has their own strengths and challenges. Early intervention has shown to lead to positive outcomes later in life for individuals with autism.

Because both of these disorders are usually diagnosed together, there are no set ways to treat either disorder. If a parent or guardian is concerned about diagnosis or treatment plans, always feel free to get a second opinion.

If you or someone you know who may have Autism and/or DMDD, 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/ .

Citations:

https://www.autismspeaks.org/what-autism

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Disruptive-Mood-Dysregulation-Disorder-_DMDD_-110.aspx

https://www.nimh.nih.gov/health/topics/disruptive-mood-dysregulation-disorder-dmdd/disruptive-mood-dysregulation-disorder.shtml

https://www.healthyplace.com/parenting/dmdd/dmdd-and-autism-how-are-the-two-related

Image:

https://www.healthyplace.com/sites/default/files/styles/related_articles_tile/public/2018-07/Challenges_of_Parenting_a_Child_with_DMDD.jpg?itok=sueCdX4V

Depression in Children: What are the Signs?

By: Sally Santos

In children the most common mental health disorder is depression. When a child is going through depression it may affect their mental and physical health. As mentioned in a Psychology Today article the symptoms “must also interfere with the child’s functioning in normal daily activities.” Since children are still young they are not able to communicate their feelings well to others. Children with depression can be helped that’s why it is important for parents, caregivers and teachers to recognize the signs of depression. Some of the symptoms are:

  • Angry outburst
  • Anxiety
  • Decreased in energy
  • Feelings of hopelessness
  • Lack of concentration
  • Weight loss
  • Insomnia
  • Refusal to go to school

According to the National Alliance of Mental Health “Once a young person has experienced a major depression, he or she is at risk of developing another depression within the next five years.”

Sources:

https://www.psychologytoday.com/us/blog/alphabet-kids/201009/20-signs-and-symptoms-childhoodteen-depression

https://www.psychologytoday.com/us/blog/alphabet-kids/201009/depressing-news-about-childhood-and-adolescent-depression

Image:

https://www.anxietymedications.net/childhood-depression-symptoms-and-signs-to-diagnose-stress-on-kids/

If you are a parent and are concerned about your child having depression call 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/

Bipolar Disorder: What Is It and What Treatments Are Available

By Stephanie Osuba

Bipolar disorder is classified as a mood disorder with cycling emotions of highs (mania) and lows (depression) by the Diagnostics and Statistical Manual of Mental Disorders (DSM-5). Periods of mania can last for as little as two days and as long as fourteen days at a time. It is this period of elevated mood and heightened irritability that sets bipolar disorder apart from the diagnosis of clinical depression. During a manic episode, people experience elevated moods of extreme happiness, decreased need for sleep, hyperactivity, and racing thoughts which manifest in pressured speech. Because mania makes people feel like they are on top of the world, people also tend to engage in risky behavior of sexual nature or even substance abuse to maintain the high. Manic episodes can also bring on an intense and easily irritable mood, which can also lead to a risk of violence. Besides one manic episode, in order to be diagnosed with bipolar disorder one must have had a depressive episode as well. This period can last from a few days to even months and is characterized by extreme sadness, disinterest in pleasurable activities, lack of energy, and feelings of helplessness and hopelessness.

There are two kinds of bipolar disorder, one being more manic and the other being more depressive. Bipolar I is characterized by one fully manic episode, that must last at least a week, and a depressive episode. Bipolar II is characterized by a period of depression and a period of hypomania. Hypomania has all the symptoms of a manic episode; however it usually doesn’t last as long, only about a few days. The speed at which people cycle through emotions largely depends on the person. Treatment for this disorder can either psychotherapy or medication. Most people seem to benefit greatly from a combined treatment of both. A common medication prescribed for this disorder is a mood stabilizer and even sometimes an antidepressant or other psychotropic medication. It’s best to talk to a professional in order to find the best individual treatment plan.

Source: Grohol, J. M., Psy. D. (2018, May 18). Bipolar Disorder – What is it? Can it be treated? Retrieved from https://psychcentral.com/disorders/bipolar/ 

If you or someone you know is struggling with bipolar disorder, 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/

What is Trichotillomania?

By Stephanie Osuba

Trichotillomania is a hair pulling disorder categorized in the Obsessive Compulsive and Related Disorders section in the DSM-5. It is one of the other Body Focused Repetitive Behaviors (BFRBs) – along with excoriation (skin picking) and onychophagia (nail biting) – in which the individual will pull, pick or bite at various parts of the body resulting in damage.  Symptoms include recurring hair pulling, hair loss, and related stress and impairment because of the behavior. The disorder is not considered self-mutilation like cutting or burning because the behavior is not intentional and research suggests that there is no connection between the disorder and unresolved trauma. Often people are ashamed of the behavior and their resulting appearance because of it and try their hardest to stop. Comorbidities include, tic disorders, mood disorders, and anxiety disorders, although, trichotillomania can also occur in the absence of any other psychopathology.  The regular age of onset is between the ages of 11 and 13, however, baby trichotillomania is a rare phenomenon that seems to go away as the child grows older. Research also suggests that the disorder is primarily genetic as it appears in the first relatives of people with trichotillomania than it does in the general population.

Available treatments include cognitive behavioral therapy (CBT) and habit reversal training (HRT) with adjunctive dialectal behavioral therapy (DBT) and acceptance and commitment therapy (ACT). These therapies help the person to be aware of the pattern of the behavior and helps to identify triggers to pulling. It also teaches methods to redirect that urge to pull into a new healthy pattern of behavior in order to reduce or eliminate the urge. While there is no FDA-approved medication specifically for BFRBs, research is being conducted. OCD medication such as selective serotonin reuptake inhibitors (SSRIs) and anafranil can help alleviate symptoms as well.

Sources: Deibler, M. W., Psy. D. (n.d.). Trichotillomania (TTM) and related Body-Focused Repetitive Behaviors (BFRBs). Retrieved from http://www.thecenterforemotionalhealth.com/trichotillomania-and-related-disorders

Zwolinski, R., LMHC. (2013, October 03). Cause And Treatment Of Trichotillomania. Retrieved from https://blogs.psychcentral.com/therapy-soup/2012/04/cause-and-treatment-of-trichotillomania/

If you or someone you know appears to be suffering from trichotillomania, 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/.