Depression: Difference between Unipolar and Bipolar Depression

By Gabriella Phillip

Eliciting a history of brief periods of improved mood is the key to differentiating between unipolar and bipolar depression. Bipolar spectrum disorders typically begin earlier in life than unipolar depression; the usual sign of bipolar disorder in young children could be depression and/or a combination of depression and states of mania/hypomania. It’s significant to ask the patient how old they were when they first experienced a depressive episode. Men have a higher rate of bipolar disorder than women, but the rates for unipolar depression in men and women are more equal.

Some patients with bipolar spectrum disorder can go from normal to severely depressed technically overnight whereas unipolar depressive episodes tend to occur more gradually. Patients with bipolar spectrum depression tend to experience weight gain and crave carbs, while those with unipolar depression usually experience weight loss or loss of appetite. Patients suffering from bipolar depression tend to show irregular responses to antidepressant monotherapy, including switching into mania. Bipolar spectrum disorder is an inheritable mental illness, so it’s vital to take family history into consideration. While patients diagnosed with unipolar depression usually note that their symptoms fluctuate in a more stable, regular pattern, those with bipolar depression have moods that can vary unpredictably, usually with no cause.

When treating bipolar depression, antidepressants are used in combination with some sort of mood stabilizer. Treatment for unipolar depression can include medication like SSRIs and antidepressants, often in combination with cognitive behavioral therapy (CBT) and psychotherapy. Screening instruments including the Bipolar Spectrum Diagnostic Scale and the Mood Disorders Questionnaire can be effective and helpful tools in differentiating unipolar from bipolar depression.

If you or someone you know is struggling with Bipolar Disorder or Unipolar Depression, Arista Counseling and Psychotherapy can help. Please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit .




Body Dysmorphic Disorder

By Gabriella Phillip

Body Dysmorphic disorder, or BDD, is a psychiatric disorder in which a person is preoccupied with an imagined or minor physical defect that other people usually don’t notice. BDD has various features that are similar to that of obsessive-compulsive disorders and eating disorders. Patients diagnosed with obsessive-compulsive disorder, or OCD, have distressing thoughts and images that they aren’t able to control. Emotional distress that can result from this can cause a person to perform particular rituals or compulsions. Regarding BDD, the person’s persistent preoccupation with his/her perceived physical defect can lead to ritualistic behaviors including constantly looking in the mirror or skin picking. Similarly to eating disorders, like anorexia nervosa and bulimia nervosa, Body Dysmorphic Disorder involves a concern with body image. However, while eating disorder patients are concerned with body weight, those diagnosed with BDD are worried about a specific area or part of the body.

Body Dysmorphia affects approximately 2% of the general population; however, BDD usually goes undiagnosed so the number of people who actually have the disorder could potentially be much greater. Those with body dysmorphia oftentimes feel a significant amount of shame regarding their perceived flaws which may hinder them from seeking treatment. BDD prevalence differs by gender, as women are reported to have higher rates of this disorder than men. Factors such as living with a pre-existing mental condition like depression or anxiety or experiencing bullying or abuse during childhood or adolescence can increase the risk of Body Dysmorphic Disorder. The typical onset for BDD is between the ages twelve and seventeen, around the time when adolescents go through puberty and certain bodily changes.

Social media platforms like Instagram oftentimes feed us an interminable supply of filtered and unrealistic depictions of different people and their lives. It’s easy to compare yourself to well edited pictures of models, celebrities, and even friends online, making you feel as though you don’t measure up as you are. Also, various forms of bullying like body shaming or slut shaming can occur online and can easily result in distorted body image and low self-esteem. Those with BDD sometimes choose to socially isolate themselves due to high level of shame related to their bodily appearance. While social media doesn’t necessarily cause body dysmorphia, it can serve as a trigger for those already predisposed to the disorder, or could possibly worsen existing symptoms. The main treatments used for BDD are cognitive behavioral therapy (CBT) and antidepressant medication, specifically serotonin reuptake inhibitors (SSRIs). Many patients use therapy and medication simultaneously. These treatments are meant to help reduce obsessive compulsive behaviors, improve stress level management involved in these behaviors, and aid patients in viewing themselves in a more loving and less judgmental light.

If you or someone you know is struggling with Body Dysmorphic Disorder, Arista Counseling and Psychotherapy can help. Please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit .


Pain: Chronic Pain is a Fundamental Health Issue

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 .


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By: Vanessa Munera

When it comes to psychotherapy, there are different types. Psychotherapy is also known as “talk therapy”. According to the American Psychiatric Association, “Psychotherapy is a way to help people with a broad variety of mental illnesses and emotional difficulties”. This is when an individual speaks with a therapist or psychologist in a safe and confidential environment. During these talk sessions, you are able to explore and understand your feelings and behaviors, and develop coping skills. In fact, research studies have found that individual psychotherapy can be effective at improving symptoms in a wide array of mental illnesses, making it both popular and versatile treatment. There are different types of psychotherapy that can assist people. The most common types of psychotherapy are Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).

Cognitive Behavioral Therapy or CBT, is a form of therapy that consists of focusing on exploring relationships among a person’s thoughts, feelings and behaviors. This type of therapy helps patients gain control over and accept unwanted thoughts and feelings so that they can better manage harmful or unwanted behaviors. CBT is usually used to treat conditions related to anxiety, depression, substance abuse, eating disorders, and social skills. As a matter of fact, Cognitive Behavioral Therapy has been shown to be an effective treatment for these conditions, as well as improving brain functioning. CBT can benefit people at any age, such as a child, adolescent, and adult.

Dialectical Behavioral Therapy, or DBT, is a type of therapy that was originally designed to help individuals with borderline personality disorder (BPD). Over time, this type of therapy has been adapted to help treat people with multiple different mental illnesses, but it is mostly used to treat patients who have BPD as a primary diagnosis. Although DBT is a form of CBT, it has one big exception: it emphasizes validation and accepting uncomfortable thoughts, feelings and behaviors instead of struggling with them. DBT allows patients to come in terms with their troubling thoughts, emotions, or behaviors that they have been struggling with. Studies of Dialectical Behavior Therapy have shown effective long-term improvements for those suffering from mental illness. DBT also helps lower the frequency and severity of dangerous behaviors, utilizes positive reinforcement to promote change, and helps individuals translate what they learned in therapy to everyday life.



PTSD Researcher Finds Link between Stress and Trauma

By Diana Bae

Rachel Yehuda, PhD, is a distinguished researcher and Director of Traumatic Stress Studies Division at the Icahn School of Medicine of Mount Sinai. She has conducted numerous prominent post-traumatic stress disorder (PTSD) studies and treatment. One of her most well-known studies researched Vietnam War combat veterans with PTSD and found that they had significantly lower cortisol levels than veterans without PTSD. Cortisol is a hormone that controls stress and although it is thought that more cortisol resulted in more stress, Dr. Yehuda showed that that is not the case. Thus, there needs to be a sufficient amount of cortisol to handle stress and reduce the risk of developing trauma. Now, Dr. Yehuda plans to test a drug, oral hydrocortisone, to see whether it can replicate the cortisol naturally produced in the body. If this drug is successful, it may prevent PTSD and other similar disorders.

Arista Psychological and Psychiatric Services understands the problems caused by PTSD and are dedicated to provide proper attention and treatment. If you or someone you know would like to set up an appointment for our counseling services, contact us at our offices in Paramus, NJ (201) 368-3700 or in Manhattan, NY (212) 996-3939. For more information, please visit our website

Source: Inside, a publication of the Mount Sinai Health System, Issue: November 25 – December 15, 2019;  Picture Source: http:// www., https://

Changes to the Brain

 By: Katie Connell

                For a long time, scientists believed that changes to brain structure only occurred during infancy and childhood. By the time one became an adult, it was thought that brain structure would remain largely permanent and that no more changes could occur. However, in the 1960’s, scientists discovered that changes to the adult brain were indeed possible. One thing that verified this were brain changes that occurred to patient’s brains that were damaged in injuries and accidents. Damage that occurred in certain parts of one’s brain resulted in healthier parts taking over. With this discovery came insight into other ways that the brain could be changed, specifically in the realm of psychotherapy. Cognitive Behavioral Therapy (CBT) is a great example of a type of psychotherapy that can lead to long lasting changes to the brain. During a process called synaptic pruning, extra neurons (which transmit information) and synaptic connections (which permit neurons to transmit info) are eliminated to increase the efficiency of neural transmissions. One way this happens is by neurons being used more frequently. Those that aren’t used as much get eliminated, which improves the transmission of information. By repeated exposure and engagement in CBT (including thought shifting techniques and cognitive restructuring), neurons become strengthened, meaning less synapses and better transmission of neurons. Through the use of routine CBT, critical neural networks are able to change how we think and feel.

If you or a person you know is seeking CBT or other forms of therapy, the psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help. Please contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920. 




Burnout in College Students (Part 1)

Tatyana A. Reed

With school coming into full swing, before we can even get that deep, it’s time to look at burnout, particularly in students. Have you ever taken on way too many tasks and at the last minute realized it’s causing an overwhelming feeling of exhaustion and being stressed out? Or have you ever been so busy you feel like nothing is going to get done correctly or done at all? If you have felt like this, nine times out of ten you were experiencing burnout.

According to burnout is “a state of emotional, mental, and often physical exhaustion brought on by prolonged or repeated stress.” Burnout is not a widely talked about topic unless the causes have been detrimental to an individual. In this article, we will talk about the symptoms, affects, and how to avoid burnout.


Before we can talk about the signs of burnout, we first have to understand that there is a difference between burnout and stress. David Ballard, member of the American Psychological Association, describes burnout as “an extended period of time where someone experiences exhaustion and a lack of interest in things, resulting in a decline in their job [academic] performance.”


Here are just some of the early indicators of college burnout according to

  • Constant exhaustion
  • Lack of motivation
  • Constant frustration
  • Grades beginning to decline
  • Struggling to pay attention
  • Disengagement from friends and colleagues


A study conducted by University of South Maine in 2006 had 354 students answer questions that helped look at why burnout may be happening to college students. Here are the four most prevalent answers:

  • 13% said it was due to lack of motivation on their personal part
  • 25% attributed it to issues caused by their part time job ( finance and lack of time) and due to family issues
  • 5% said it was caused by a professor
  • And the most prevalent answer was because of having too many assignments on their plate


If you or someone you know is dealing with burnout, 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



Harrison, Mike. “Avoid College Burnout.” Great Lakes Christian College, 22 Jan. 2018, (PHOTO)

Jerry, Lisa M. “10 Signs you’re Burning Out — And What To Do About It.” Forbes, Forbes Magazine, 3 Jan. 2018,

Stephanie Cushman & Richard West (2006) Precursors to College Student Burnout: Developing a Typology of Understanding, Qualitative Research Reports in Communication, 7:1, 23-31, DOI: 10.1080/17459430600964638

Vaiana, Dominic. “Burnout in College: What Causes It and How to Avoid It.” College Info Geek, 5 Mar. 2019,

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



Social Anxiety Disorder

Social Anxiety Disorder

Social Anxiety Disorder

By: Julia Keys

It is typical to feel a bit nervous before public speaking or maybe a little anxious before a performance, however, for those with Social Anxiety Disorder, or SAD, even the smallest interactions with others can provoke feelings of extreme anxiety. Social Anxiety Disorder is characterized by a strong and persistent fear of humiliation and embarrassment that could be caused by social situations. People with Social Anxiety Disorder struggle with feelings of self-consciousness that are produced by the possibility of judgement in social interactions. Oftentimes the distress caused by social situations can become so overwhelming for those with SAD that they begin to avoid everyday activities and responsibilities such as going to work, going to school, or picking up the phone.

Signs of Social Anxiety Disorder:

  • Anxiety about being with other people
  • Difficult time interacting with others, stuttering, trailing off, and reserved behavior are common
  • Self-consciousness in front of other people and feelings of embarrassment
  • Fear of being judged
  • Difficulty making and keeping friends
  • Blushing, sweating or trembling around other people
  • Other physical symptoms such as disorientation, shallow breath, diarrhea, muscle tension and upset stomach

Social Anxiety Disorder can be treated with psychotherapy, medication, or both. A common affliction for those with SAD is the rumination that follows social interactions. New types of therapy are being developed to help those with SAD deal with this common symptom: post-event processing or PEP Mindfulness based therapies are aiming to target the feelings of shame, worry, and embarrassment that are caused by overanalyzing personal performance in social situations. Cognitive-Behavioral therapy helps people with SAD change unhealthy thought patterns that may be contributing to their anxiety. Medications such as antidepressants and anti-anxiety meds are often used in conjunction with psychotherapy. Social Anxiety Disorder affects over 19 million people across the US; however 35% of those suffering with social anxiety waited over ten years to seek treatment. Don’t hesitate to reach out and get the help you need.

If you or a loved one is struggling with social anxiety, do not hesitate to seek help by contacting 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 .


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Low Self Esteem: Imposter Syndrome

Low Self Esteem: Imposter Syndrome

Low Self Esteem: Imposter Syndrome

By: Julia Keys

        Do you ever feel like no matter how much you accomplish, you still are inadequate compared to others around you? Feeling fraudulent about one’s achievements is so common that psychologists have given it a name: Impostor Syndrome.  People with Impostor syndrome doubt their own accomplishments and have a fear of being exposed as a fraud among their colleagues.  Despite the fact that people with Impostor Syndrome have great external evidence for their accolades, they still cannot be convinced that they deserve what they have accomplished.Those with Impostor Syndrome often attribute their success to external factors such as luck or good timing.

Impostor Syndrome can be caused by perfectionism and fear of failure. However, if you are afraid you won’t be perfect or that you will fail, then you will be discouraged from going after new goals! The constant pressure found in those with Impostor Syndrome can cause feelings of guilt, shame, embarrassment, and at its worst, depression and anxiety.

One group of people that are especially prone to Impostor Syndrome are highly successful women.  The discrepancy between external achievement and internalization of achievement within successful women may be caused by our society’s standards. Gender roles have greatly shaped what it looks like to be a successful man versus what it looks like to be a successful woman. Successful men are stereotypically in positions of power while successful women are stereotypically in caretaker’s positions.  The type of achievements that constitute success in our culture, such as obtaining a high degree, being financially successful, or being promoted to a leadership position are more aligned with the stereotypes of male achievement, which may explain why when women achieve such goals, they feel like frauds.

No one should have to feel like a fraud, especially if they prove to be very high achieving. If you or someone you know can relate to the information above, 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 .


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