psychology Bergen County

Schizophrenia: The Debilitating Disease

GalleryJudy Gurfein Leave a comment
By: Arianna DiRaggio

Schizophrenia, one of the most debilitating of mental illnesses, is a serious mental disorder that affects the way one thinks, feels, and behaves. Typically first diagnosed around ages 20-25, Schizophrenia affects about 1% of the US population. Though it is uncommon, Schizophrenia may be genetic, making it a common issue in families who may suffer from it. If a parent has Schizophrenia, the child has a 10% chance of also developing it. 

Contrary to popular belief, Schizophrenia is NOT defined as multiple or split personalities but instead may include:

  • Positive Symptoms: (Those that are abnormally present)
    • Delusions
    • Hallucinations
    • Disorganized speech
    • Trouble thinking
    • Lack of motivation
  • Negative Symptoms: (Those that are abnormally absent)
    • Lack of pleasure
    • Inability to perform daily tasks
    • Becoming distant from friends and family

Unfortunately, there is no known cure for Schizophrenia. However, antipsychotic medications and injectables are available to help suppress symptoms and allow those suffering to live a normal life. Over the years of research we have found that Dopamine plays a large role and has a connection to Schizophrenia, which will hopefully lead to more information regarding the disorder. 

If you or a loved one is suffering from Schizophrenia, 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.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

https://psychcentral.com/schizophrenia/schizophrenia-overview

https://www.psychologytoday.com/us/conditions/schizophrenia

Photo Source:

https://www.psycom.net/schizophrenia

Body Image: Body Dysmorphic Disorder

GalleryJudy Gurfein Leave a comment

Body Image: Body Dysmorphic Disorder
By Kaitlyn Choi

Body dysmorphic disorder is a type of obsessive-compulsive disorder that is marked by fixation on one’s imaginary or minor physical flaws. People who have body dysmorphia are overly worried about what are perceived as overt imperfections in their appearance. They continue to experience negative and anxious thoughts about their face, hair, and/or body. However, in reality, these perceived flaws are hardly noticeable by other people; there may not be any “defect” in their physical appearance at all. The amount of concern experienced by the individual is considerably disproportionate to the flaw they are obsessing over.

Symptoms of body dysmorphic disorder include preoccupation to the point of significant distress, impairment in functioning, or isolating oneself due to self-consciousness and insecurity. Moreover, people with body dysmorphia exhibit performance of repetitive behaviors such as mirror checking, excessive grooming, and skin picking. They may also seek reassurance from other people and compare their appearance with that of others throughout the day. Because they believe their physical flaw is so gross and noticeable, they may constantly try to “fix” these flaws by consulting with plastic surgeons or cosmetic professionals.

Primary treatments for body dysmorphic disorder include cognitive behavioral therapy and antidepressant medication. The goal of treatment is to recognize the triggers of the behaviors/thoughts, to improve management of the stress experienced, and to help patients learn to view themselves in a non-judgmental way.

In a society that glorifies only certain face and body types, many individuals can feel overwrought about their appearance and consequently experience symptoms of body dysmorphic disorder. It is crucial that individuals learn to love themselves and perceive themselves in a self-encouraging manner.

If you or someone you know is struggling with body image or body dysmorphia, 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/conditions/body-dysmorphic-disorder
https://my.clevelandclinic.org/health/diseases/9888-body-dysmorphic-disorder

Image Source:
https://www.additudemag.com/adhd-related-body-dysmorphic-disorder/

Teens During COVID-19

GalleryJudy Gurfein Leave a comment

    Teens During COVID-19

    By: Alexa Greenbaum 

    The COVID-19 crisis, social distancing, and government-mandated lockdowns have taken a toll on teenagers. For teenagers and young adults, friends are hugely important, and separation from their peers can be very challenging as bonding with peers is one of the essential developmental tasks of adolescents. During this time, parents need to understand and acknowledge their frustrations over being cut off from seeing friends. To help teens during this difficult time, adults should listen to what they’re feeling, validate those feelings, and then be direct about how you can work together to make this situation bearable. 

    For most teens, it can be painful to lose experiences such as sports seasons, proms, plays, and graduations. Parents can help their teen children by loosening rules to help compensate for the socializing time lost with the school closing. For example, parents can allow their children to spend more time on social media, have more downtime, and allow teens to socially distance with their friends.

    Teenagers can also benefit from getting adequate sleep, keeping a consistent sleep schedule, eating healthy meals, and exercising regularly. Healthy habits can increase and maintain positive moods. Healthy habits also help teens who are struggling with mental illnesses such as anxiety and depression and improve their ability to fulfill academic expectations. 

    Parents who give teens room to share their feelings, listen to them without judgment, reassure them that everything will work out, and help them look forward to future plans and goals are other ways to support teens.  Parents should also watch for signs if their teenage child is struggling and may need additional support.

    If you or someone you know is struggling during COVID-19 or another crisis, 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: 

    Supporting Teenagers and Young Adults During the Coronavirus Crisis

    https://childmind.org/article/supporting-teenagers-and-young-adults-during-the-coronavirus

    https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/Teens-and-COVID-19.aspx

    Image Source: 

    https://www.health.harvard.edu/blog/keeping-teens-home-and-away-from-friends-during-covid-19

    Race and Mental Health Treatment

    GalleryJudy Gurfein Leave a comment

      Race and Mental Health Treatment
      By: Isabelle Siegel

      Research demonstrates that individuals from racial and ethnic minorities are significantly less likely to receive treatment for mental health issues than White individuals. In 2015, nearly half (48%) of White individuals with mental illnesses received professional help while significantly smaller percentages of minority individuals—31% of Black individuals, 31% of Hispanic individuals, and 22% of Asian individuals—with mental illnesses received professional help. This begs the question: Why are people from racial and ethnic minority backgrounds less likely to receive mental health treatment?

      Financial Barriers. A report conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) reveals that the primary reason that people from racial and ethnic minority backgrounds are less likely to receive mental health treatment is due to the cost of services and/or lack of insurance coverage. People from racial and ethnic minority backgrounds are disproportionately likely to experience poverty and, as a result, to have difficulty accessing healthcare services.

      Stigma. Research suggests that mental illness stigma is more acute among certain racial and ethnic groups. For example, studies suggest that feelings of stigma are greater among Asian and Hispanic individuals as compared to among White individuals. This, in turn, renders Asian and Hispanic individuals less likely to seek out mental health treatment when in need.

      Lack of Culturally Competent Therapists. The majority of therapists are White and may not directly understand the experiences of people from racial and ethnic minority backgrounds. Becoming a culturally competent therapist requires education and effort that unfortunately does not always take place. In fact, 56% of mental healthcare providers report having no formal cultural competency training.

      Language Barriers. Many therapists speak only English, which poses yet another barrier for racial and ethnic minority individuals who wish to seek mental health treatment. As a result, it can be difficult for non-English speaking individuals to receive proper mental healthcare.

      It is imperative that we work to increase the accessibility to mental health treatment for all individuals. Regardless of race and/or ethnic background, socioeconomic status, and other demographic factors, all individuals have the potential to benefit from therapy and other forms of treatment.

      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:
      Mental Health Facts for Diverse Populations – American …www.psychiatry.org › Mental-Health-Disparities › Ment…
      https://www.nimh.nih.gov/news/science-news/2015/a-new-look-at-racial-ethnic-differences-in-mental-health-service-use-among-adults.shtml
      https://socialwork.simmons.edu/racial-disparities-in-mental-health-treatment/

      https://www.kff.org/other/state-indicator/poverty-rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568160/
      Image Source: Mental Health Facts for Diverse Populations – American …www.psychiatry.org › Mental-Health-Disparities › Ment…

      Mental Illness: How to Support a Spouse with Mental Illness

      GalleryJudy Gurfein Leave a comment

        Mental Illness: How to Support a Spouse with Mental Illness
        By: Isabelle Siegel

        Every relationship has challenges, but relationships in which one partner has a mental illness can be even more challenging. The presence of mental illness in a relationship can leave both individuals feeling alone and helpless. However, it is not impossible to be in a happy, healthy, and successful relationship with someone with a mental illness. If you are wondering how to support your partner/spouse with mental illness, know that it is possible. Although your partner’s/spouse’s mental illness may at times feel all-consuming, certain steps can ultimately help manage the overwhelming ups and downs.

        Develop an understanding of your partner’s/spouse’s diagnosis. It can be helpful to research the symptoms of your partner’s/spouse’s disorder in order to better recognize and label them as they arise. Having a basic understanding of what your partner/spouse is experiencing can help you to put yourself in his/her shoes and to gain insight into his/her struggles.

        Just be there. Having a mental illness oftentimes makes people feel alone and as though they are a burden to their loved ones. The single most powerful way you can support your partner/spouse with a mental illness is to be there for him/her. Communicate that you are there for the highs and lows, and be ready to love your partner/spouse through them.

        Do not let mental illness take over your entire relationship. Although it is important to communicate, try to keep your relationship balanced by limiting discussions about mental illness. Even when your partner’s/spouse’s mental illness feels all-consuming, continue to engage in activities that pull you and your partner away from thinking about his/her diagnosis and struggles.

        Communicate openly how you feel. Regardless of a mental illness diagnosis, open communication is a critical component of any relationship. Be honest with your partner/spouse about how you feel, communicating any emotions with the goal of productively working through them.

        Understand that your partner/spouse is trying the best he/she can. It can be easy to assume that a person with mental illness would feel better if only he/she tried harder. Oftentimes, people with mental illness are coping with their struggles in the best way they can.

        Accept that it will be challenging at times. Being in a relationship with someone with a mental illness is going to pose challenges. It can arouse difficult emotions such as frustration, anger, resentment, sadness, etc. Allow yourself to feel these emotions and be willing to communicate them with your partner.

        Most importantly, take care of yourself. 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.nami.org/Blogs/NAMI-Blog/November-2018/How-to-Be-Supportive-of-Your-Partner-with-Mental-I
        https://www.nami.org/Personal-Stories/How-To-Love-Someone-With-A-Mental-Illness
        https://www.verywellmind.com/coping-with-a-mentally-ill-spouse-2302988

        Image Source: https://images.app.goo.gl/1XXGCnGttHazLixy5

        COVID-19: Divorce Rates

        GalleryJudy Gurfein Leave a comment

          COVID-19: Divorce Rates

          By: Alexa Greenbaum

          Quarantined married couples are causing an increase in divorce rates during the coronavirus crisis. While accesses to courts are limited at this time, many professionals believe that there will be a rush to the courthouse when operations resume. For example, New York divorce attorney Marcy Katz stated, “when restrictions are lifted, I do not doubt that there will be an overwhelming number of filings.” This has been consistent with recent data. According to reports from a multitude of cities, husbands and wives have begun filing for divorce since emerging from government-mandated lockdowns.  

          People, including spouses, are not accustomed to spending so much one-on-one time together. Through daily struggles, increases in fear, poor coping skills, and emotional and financial stress, these factors can take a toll on marriages, increase tensions, and ultimately negatively affect a relationship. Katz has also suggested that increases in divorce rates may also be because people are coming to terms with their mortality and want to make positive changes in their lives. Higher rates of domestic violence have also been reported from numerous sources during this time, which she explained is an additional component in many relationship breakups. This is because this time of uncertainty is causing conditions such as extreme stress and threaten the status quo, therefore encouraging many to make major life-changing decisions.

          In response to an increase in divorce predictions, the AAML is conducting a nationwide survey to yield figures on just how widespread the lockdown breakdown of marriages.

          If you or someone you know is experiencing conflict with their partner from COVID-19 or another crisis, 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://abcnews.go.com/US/surge-divorces-anticipated-wake-covid-19-quarantine/story?id=70170902

          https://www.bloomberg.com/news/articles/2020-03-31/divorces-spike-in-china-after-coronavirus-quarantines

          https://www.psychologytoday.com/us/blog/singletons/202004/more-babies-or-more-divorces-after-covid-19

          Image Source:

          https://lawlawfirm.com/rising-divorce-rates-during-the-coronavirus

          Rising Divorce Rates During the Coronavirus Crisis
          Rising Divorce Rates During the Coronavirus Crisis

          Dementia: What are the different dementia diagnoses?

          GalleryJudy Gurfein Leave a comment

          Dementia: What are the different dementia diagnoses?

          By: Keely Fell

          Dementia is among one of the most prevalent conditions in individuals over 60. In 2019, a record 50 million individuals, worldwide, were living with a diagnosis of some form of dementia. Dementia is defined as a syndrome where there is major deterioration in memory, behavior, and thinking, which limits an individual’s ability to perform everyday tasks.

          When diagnosing dementia, doctors will look at six areas of cognitive functioning. Those areas are:

          • Complex attention: Which is the area that refers to sustained focus and switching between tasks.
          • Learning and memory: This is the area that recalls recent and remote memory, as well as performing tasks.
          • Executive Function: This refers to skills such as prioritizing, paying attention, and planning.
          • Language: This refers to expression in written and spoken forms.
          • Perceptual-Motor Function: This understands shapes, directions, and locations.
          • And lastly, Social Cognition: Which refers to the ability to interact with others by recognizing facial expressions and body language.

          Dementia is used as an umbrella term for many different sub-dementia disorders. The most common in the United States is, Alzheimer’s disease. Alzheimer’s disease is when the neurons in the brain are slowly decaying overtime causing cognitive deficits in memory, and over time total mental ability. After Alzheimer’s the next most common dementia diagnosis is Vascular Dementia. Vascular dementia develops when the brain is deprived of essential nutrients and oxygen. Over time an individual with Vascular Dementia may experience mental slowness, aphasia, and trouble with basic functions such as, walking or urinating. This is different from Alzheimer’s because with Vascular Dementia, an individual is experience problems in memory retrieval. Dementia with Lewy Bodies is a type of dementia that has a combination of features of both Parkinson’s disease, and Alzheimer’s disease. Generally, an individual diagnosed with Dementia with Lewy Bodies may experience muscle symptoms that are accompanied by cognitive deficits as well. Less common than most other dementias is Frontotemporal Lobar Dementia. This dementia appears with behavior and language changes.  Frontotemporal Lobar Dementia is caused by progressive nerve cell loss in the brain’s frontal and temporal lobes.

          A dementia diagnosis can be hard, and understanding how it affects the brain can help with coping with a diagnosis.

          If you or someone you know is experiencing these symptoms, 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.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/frontotemporal-dementia                                                                                    https://www.asccare.com/5-interesting-facts-dementia/                                              https://www.who.int/news-room/fact-sheets/detail/dementia https://www.brightfocus.org/alzheimers/article/whatdementia?gclid=Cj0KCQiAkePyBRCEARIsAMy5Scsycdvh3p-rWx10ZmnEFZCbjdCY8f6JnSc4vJKHO9EO7qiuqshYqHMaAugEEALw_wcB

          Image Source:

          https://www.dfwsheridan.org/types-dementia

          Alcoholism: A Life Altering Disorder

          GalleryJudy Gurfein 1 Comment

          By: Charleene Polanco

          According to Mayo Clinic, alcoholism, also known as alcohol use disorder, is defined as an alcohol use pattern that involves the inability to control ones drinking. For many who are on track to become an alcoholic, it seems pretty easy to keep convincing themselves that they have the ability to quit whenever they want. However, when he or she realizes their alcohol tolerance has increased, and that he or she experiences withdrawal symptoms when not drinking, an alcohol use disorder has developed. The common symptoms of alcoholism include:

          • Uncontrolled alcohol consumption
          • Using alcohol in unsafe situations, such as driving
          • Failure to fulfill major school or work obligations because of repeated alcohol use
          • Craving/ urges to drink alcohol
          • Withdrawal symptoms like nausea, sweating, and shaking
          • Unsuccessful attempts to cut down on the amount of alcohol consumed

          Alcoholism is an important issue, because it affects a huge number of the American population. As many as 18 million Americans suffer from alcoholism, and about 100,000 die as a result. Alcoholism is also associated with other social and domestic problems, like job absenteeism and spousal/child abuse. With such a significant portion of the U.S. population suffering from this terrible disorder, and its effects on the individual and loved ones, it is imperative that a person seek help when afflicted with alcohol use disorder.

          If you or someone you know is suffering from alcohol use 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:

          Mayo Clinic. (2018, July 11). Alcohol use disorder. Retrieved October 9, 2018, from https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

          WebMD. (2018). Understanding Alcohol Use Disorder — the Basics. Retrieved October 9, 2018, from https://www.webmd.com/mental-health/addiction/understanding-alcohol-abuse-basics#1

           

          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

           

          Hoarding Disorder: The Psychology of Hoarding

          GalleryJudy Gurfein Leave a comment

          By: Heather Kaplan

          Hoarding is defined as the persistent difficulty discarding or parting with possessions, regardless of their actual value. This behavior brings about detrimental emotional, physical, social, financial and legal effects for the hoarder and their loved ones. Commonly hoarded items may be newspapers, magazines, plastic bags, cardboard boxes, photographs, food and clothing – items of little value to most but have extreme value to the hoarder. Even the mere thought of throwing these items away causes a hoarder extreme anxiety and distress. Hoarding ranges from mild to severe – often the hoarding can become so extreme that the home of the hoarder becomes almost inhabitable which results in increased risk of getting evicted.

          There are various reasons why hoarders exhibit the behavior they do. People hoard because they believe that an item will become useful or valuable in the future. They also may feel that the item has sentimental value or is too big of a bargain to throw away. Hoarders try to justify reasoning for keeping each possession that they own. It is still unclear what causes the disorder; genetics, brain functioning and stressful life events are being studied as possible causes. Studies show that there is hyperactivity in the area of a hoarder’s brain that involves decision-making, which explains the stress associated with discarding their possessions.

          Those who suffer from hoarding disorder experience a diminished quality of life. As stated before, a lack of functional living space is common amog hoarders. These living conditions can be so severe that they put the health of the person at risk. Hoarders also often live with broken appliances and without heat or other necessary comforts. They cope with these issues because of the shame they would feel if a person was the enter their home. Hoarding also causes anger, resentment and depression among family members and can affect the social development of children. Unlivable conditions may lead to separation or divorce, eviction and loss of child custody if applicable.

          It is important to distinguish the difference between hoarding and collecting. Collectors have a sense of pride about their possessions and experience joy in displaying and talking about them. Their collections are often well-organized and well-budgeted. A hoarder collects a multitude of items and organizes them in a cluttered way. They are ashamed of their accumulations and do not feel a sense of pride when showing their belongings to others.

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

          Sources:

          https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics

          https:/www.mayoclinic.org/diseases-conditions/hoarding-disorder/symptoms-causes/syc-20356056