What are the symptoms of mood disorders?

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DEPRESSION

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Depression symptoms may be situational because something happened that made you feel very sad.  For example, you may have a problem at work or school or with another person in your life.  COVID19 may certainly be a situation that causes sadness and depression.  This typically doesn't meet the criteria for a diagnosis of depression otherwise known as major depressive disorder.  Therapy can certainly help with processing feelings, hurts, and emotional upsets.  You can learn skills to help eleviate the sadness and maybe even learn to become more resiliant to those situations that caused those sad feelings in the first place.

 

However, a clinical diagnosis of Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living. More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with psychotherapy, medication or both.

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MANIA

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What is a manic episode? A manic episode is not a disorder in and of itself, but rather is diagnosed as a part of a condition called bipolar disorder.  A manic episode is an emotional state characterized by a period of at least one week where an elevated, expansive, or unusually irritable mood exists. A person experiencing a manic episode is usually engaged in significant goal-directed activity beyond their normal activities. People describe a manic mood as feeling very euphoric, “on top of the world,” and being able to do or accomplish anything. The feeling is like extreme optimism — but on steroids.

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Sometimes the manic mood is more irritable than it is elevated, especially if the person’s wishes are curtailed or denied altogether. Often a person in the midst of mania will engage in multiple projects at the same time, with little premeditation or thought going into them, and finishing none of them. They may work on these projects at all hours of the day, with little regard for sleep or rest.

A person’s change in mood is typically associated with manic symptoms that should be observable by others (e.g., friends or relatives of the individual) and must be uncharacteristic of the individual’s usual state or behavior. In other words, they’re acting in a way that isn’t typical of themselves, and other people recognize it.

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The manic feelings the person experiences should be severe enough to cause difficulty or impairment in their ability to function at work, with friends or family, at school, or other important areas in their life. Symptoms also cannot be the result of substance use or abuse (e.g., alcohol, drugs, medications) or caused by a general medical condition.

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bipolar mania can be diagnosed if you experience at least three of the following symptoms for no less than a week:

• Reduced need for sleep

• Increased rate of speech

• Flight of ideas

• Being easily distracted

• High self-esteem

• An increased interest in goal-oriented activities

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What kind of therapies do you use for Mood/Bipolar Disorders

I use a custom treatment plan for every patient, but often choose from Cognitive Behavior therapy, Dialectical Behavior therapy, Hypnotherapy, Mindfulness and stress management techniques. I begin by helping you to become aware of signs that you are experiencing stressful symptoms and then help to identify areas in your life that are triggers and stressors of those symptoms. I also offer specific therapies such as those indecated below:

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Family-Focused Therapy 

Family-focused therapy (FFT) includes both the individual and their parents, spouse, or other family members. FFT typically lasts about 12 sessions (depending on the family’s needs). Early sessions focus on education about the condition: its symptoms and how they cycle over time, its causes, how to recognize the early warning signs of new episodes, and what to do as a family to prevent the episodes from getting worse. Later sessions focus on communication and problem solving skills, especially to address family conflicts. Research indicates that people with bipolar disorder who take part in FFT and medication after an episode have less severe mood symptoms and better functioning over 1-2 year periods than those who get medications and briefer treatments or case management.

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Interpersonal and Social Rhythm Therapy

IPSRT is an individual therapy in which the person with BD keeps daily records of their bed times, wake times, and activities, and the effects of changes in these routines on their moods. The therapist coaches the person on how to regulate their daily routines and sleep-wake cycles as a way to stabilize moods. The person and his/her therapist identify one or more interpersonal problem areas (e.g., conflicts with coworkers; difficulty sustaining friendships) and discuss potential solutions to prevent similar problems from emerging in the future. 

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Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is an individual therapy focused on the relationship between a person's thoughts, feelings and behaviors. CBT teaches people to:

• Identify negative assumptions and thinking patterns, and challenge themselves to rehearse more adaptive ways of thinking. 

• Monitor their activity levels to make sure they are engaged with rewarding aspects of their environment when depressed, and are not overly stretched when manic.   

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Dialectical Behavior Therapy

Dialectical behavior therapy is a skill-based approach that includes both individual and group therapy. It teaches mindfulness and acceptance skills, such as the ability to experience moment-to-moment thoughts, emotions and their accompanying physical sensations from an observer’s stance, without negative judgment. It also teaches distress tolerance, emotion regulation and interpersonal effectiveness. 

How often do I need to come to therapy?

Frequency and duration of therapy will depend on the individual.  Typically therapy is one session per week, but an individual experiencing more intense symptoms would benefit from 2 or more sessions per week.  It may be suggested to join a group for a more well-rounded therapy experience. Most people feel better ever after the first session, and notice significant change within 2 to 3 months of therapy.

 

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