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






By Crystal Tsui

Persuasion is the action or fact of convincing someone to do or believe something. It is used every day by individuals and even big corporations, whether it’s big adverts or a friend trying to get you to go see a concert with them. Persuasion and deception are often blurred; however, deception is the intent to “trick” someone into doing or believing something.

Some ways people persuade others are:

  • The authority bias: influenced by opinion or actions of people in a position of power.
  • Social proof: decide on how to behave by looking to what others are doing
  • Door-in-the-face technique: persuader begins with a large request and they will expect to be rejected. The persuader will ask for a smaller request (their intended goal) and rely on guilt for the victim to accept

Persuasion is used daily even if you are not aware of it. Adverts and sales people use persuasion for their job. However, you are the one doing the persuading and want to improve your skills; all you have to do is listen. Listening to the other person and always be on their side is the most important aspect of persuasion. Here are other ways to improve your persuading techniques:

  1. Be open to the recipient of the person you are trying to persuade. You want them to be relaxed
  2. Mirror their response. This gives the impression that their viewpoint has been fully received
  3. Understand their viewpoint on the subject
  4. Like the previous step, be more agreeable. People like agreeable people and they will be more willing to be accepting.
  5. Don’t use the word “but.” It negates all the previous effort on trying to be agreeable and open to their viewpoint.



Coping With Stress

By: Dianna Gomez


Whether you are a prestigious lawyer or currently unemployed, one thing that all people have in common is that, at one point or another, we have all felt what it’s like to be stressed. The stress may be caused by totally different situations, but at the end of the day those feelings have been felt by us all. You may be asking yourself, “So what simple steps can I take to help myself next time I do feel overwhelmed with stress?” Whether you are a busy college student with 4 exams to study for, an overworked single mom with 2 jobs trying to put food on the table, or a very successful business person with tons of responsibilities, stress can be an issue in anyone’s life.

Here are 5 things you can do to decrease the amount of stress in your life:

#1. Determine Where the Stress is Coming From

  • Is your stress work-related? Is it constantly being caused by the same people in your life? Finding the root of the problem gives you better direction when aiming to correct it.

#2. Eat Healthy

  • For some people, a typical reaction to stress is to “eat your feelings” and turn to comfort foods that are more often than not foods that are processed and high in fat, sugar, or carbs. Although doing this may help you feel better for the short term, it definitely doesn’t help you in the long term which is more important. In fact, it can create problems in the long term that not only don’t help your stress, but add to it as well.

#3. Exercise

  • Go for a walk in the park, take a kick-boxing class, do a few laps in the pool. Get those endorphins flowing!

#4. Make Time for Yourself

  • We all have busy lives – places to be, people to see but nothing is more important than how you feel mentally. Whether it is 10 short minutes or an hour each day, take the time you have to do something you love and to be away from the chaos.

#5. You Can’t Fix What You Can’t Control

  • While you can’t control how your boss acts, what your mother-in-law says, or the current state of the economy, you can control things that you do. If you can’t control it, don’t let it control you!


If either you or anybody you know may be suffering from excessive amount of stress, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can help 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 us at


Hoarding Disorder: It’s More Than Just Throwing Things Away

By: Emily Mulhaul

“You’re a mess!” “Just throw it away!” “How do you live like this?” These are some of the phrases individuals diagnosed with Hoarding Disorder receive one too many times. Meanwhile, their indecision to throw things away is more internal than most can understand. As proposed in the DSM-5, the National Institute of Mental Health (NIHM) characterizes Hoarding Disorder as an avoidance of decision making about possessions. Although the mess created by the perceived hoarder is tangible and visible, it can be understood that the avoidant behavior may result from the emotional attachment linked to these items. During an interview with an individual recovering from hoarding disorder she made a comment stating, “If I throw away these items, it’s as if I’m throwing away my memories, my childhood, and my mother.” She metaphorically relates throwing things away to ridding herself of her most cherished moments. This commonly occurs in individuals who have suffered the trauma of losing a family member. When the collection of items becomes excessive or interruptive to the progression of one’s life it may be possible this individual has developed a hoarding disorder. The grieving process is different for everyone and in the case of a hoarding disorder it is far more complex than merely throwing things away. Psychiatrists, psychologists, social workers, and counselors understand the depth of an emotional attachment and are compassionate towards helping those suffering or at risk of hoarding disorder.

If you or a loved one have a hoarding disorder the psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Comments Welcome

Source: National Institute of Mental Health


Personality: The Birth Order Effect

Have you ever wondered why you and your siblings are so different? Alfred Adler, an Austrian psychologist researched the effects of birth order on personality and concluded that the makeup of a family contributed to the personality of each member. In other words, the order in which one is born (first, second, last, etc.) could influence an individual’s psychological makeup. Perhaps you’re more responsible than your younger sibling because you were born first!

Listed below are certain characteristics that are found to be attributable to the different kinds of birth orders:

First child:

  • Achiever
  • Leader
  • Perfectionist
  • Responsible

Middle child:

  • Peacemaker
  • Social
  • Easy-going
  • Secretive

Youngest child:

  • Risk-taker
  • Outgoing
  • Creative
  • Sense of humor

Only child:

  • Leader
  • Perfectionist
  • Mature
  • Confident

Now remember, whether you were born first or last does not necessarily dictate how you will develop as a person. These are just tendencies. The youngest child may be more responsible than the first child. You don’t have to let your birth order determine your life!

If you believe that you or a loved one has or may be having family difficulties, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit for more information.


By: Jenny Barbosa

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

Traumatic Brain Injury: Signs of Depression

Traumatic Brain Injury“Brain Injury Can Change Your Life”

By: Jessica Ortega

The majority of survivors of moderate and severe traumatic brain injuries (TBI) have significant long-term neurobehavioral changes and increased rates of psychiatric illness. Cognitive deficits are the most common complaints of traumatic brain injury survivors. However, many of these injured individuals may not be aware of behavioral or emotional changes because they are focused on the changes in more concrete domains such as motor functioning. This can be devastating for both the injured person and the caregivers.

Over half of people who have suffered a traumatic brain injury experience depression. Physical changes in the brain due to injury and emotional response to injury can leave you struggling to adjust. Some symptoms of depression are:

  • Feeling down, sad, or hopeless
  • Loss of interest or pleasure in usual activities
  • Feeling worthless, misunderstood, lonely and frustrated
  • Disturbed sleep patterns and changes in appetite
  • Concentration difficulties
  • Tiredness and a lack of energy
  • Thoughts of death or suicide

Therapy can help you recover emotionally, if you are concerned that you or anyone you care about may be struggling with depression after suffering a traumatic brain injury, the licensed counselors and psychotherapists at Arista Counseling and Psychotherapy can assist you in feeling better about the present and hopeful about the future. 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

Marriage Counseling Can Lead to Enhanced Communication and a Successful, Fulfilling Relationship

Marriage Counseling and Enhanced Communicaton

Marriage Counseling and Enhanced Communication

“Effective Conflict Resolution”

By: Jessica Ortega

Most people enter marriage with the intent of establishing a happy union with a life partner. Sadly, it is not always the case that everything works out as planned. As time passes, marital strife due to conflict begins to deteriorate the once happy union. When couples finally seek help, the relationship is sometimes so broken it is just too late. Everyone clashes due to the negative feelings from differences between two people; it is part of what it means to be together. However, it is important to know how to fight.

Couples with poor conflict resolution skills are not successful at solving problems and letting go. Here’s what to consider when problems arise so that you and your spouse can become marital masters:

  • Self-awareness: get to know yourself, your wants and needs and ask for them in a non-threatening way instead of expecting them from your partner.
  • Forgiveness: if you forgive yourself for any wrongdoing you or your spouse may have caused the marriage, you can be on your way to forgiving your partner and letting go.
  • Empathic listening and responding: express yourself in an honest way so that your partner preserves his/her self-image without invoking defensiveness.
  • Efficacy: expect a successful marriage. Have the idea that as a unit, you and your partner can get through difficult times.
  • Feedback: when necessary, provide positive feedback without attacking or invalidating your spouse.

Remember: having good relationships is a skill and marriage is one of the most important of those learned skills. If you are concerned that you or anyone you care about may be having marital issues, the licensed counselors and psychotherapists at Arista Counseling and Psychotherapy can assist you. They have successfully helped many couples to get through hard times and achieve marital happiness. 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.

Anorexia Nervosa: How New Health Trends Can Make Eating Disorders Thrive


anorexia nervosa blog photo With all of the new trends regarding fitness, clean and organic eating, and juicing, it’s hard not to get caught up in society’s idea of what it means to be fit or skinny. For women, it’s always been about being thin and young looking, while men struggle to gain muscle and have six pack abs. While there is nothing wrong with wanting to exercise and eat healthier, there are still those who expect immediate results and, when they don’t get them, turn to extreme methods. So it’s no wonder that we also see an increase in eating disorders every time a new health craze hits.

There are several different varieties of eating disorders, but this blog will be primarily discussing Anorexia Nervosa and its effects on the youth of today. Anorexia Nervosa is an eating disorder characterized by refusal to eat and, according to the National Institute of Mental Health, it has the highest fatality rate of any psychiatric disorder and frequently coexists with other mental disorders such as anxiety, depression, and substance abuse. Here are some symptoms to be on the lookout for in case you or a loved one may be suffering from Anorexia:

  • Extremely low body weight
  • Severe food restrictions
  • Relentless pursuit of thinness and unwillingness to maintain a normal/ healthy body weight
  • Intense fear of gaining weight
  • Distorted body image and self-esteem that is influenced by perceptions of body weight or shape
  • Amenorrhea, or the absence of at least 3 menstrual cycles

Anorexia is a serious disease and could lead to other medical complications such as osteoporosis, low blood pressure, brittle hair and nails, mild anemia, and multi-organ failure, just to name a few. If you are concerned that you or a loved one may be suffering from Anorexia, the licensed counselors and psychotherapists 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.