Feeling sad, down or lethargic is a natural and expected experience in life that most people will encounter at one time or another. However, when someone is diagnosed with a depressive disorder it means that the sadness and lethargy has turned into a more pervasive condition in which a person’s outlook on life narrows, their daily performance is limited or stops and their bodily functioning is constricted, sometimes in a very profound way. In other words, someone suffering from a depressive disorder can appear as if the life has literally been sucked out of them.
Depressive disorders are one of the most prevalent mental illnesses affecting our current society. They impact the lives of children and adults, couples and families. As the causes for depressive disorders vary, it is important to consider an individual’s genetic, physical and dispositional factors as well as the environmental and human nurturing they received. The most common types of depressive disorders include major depressive disorder, dysthymia, substance/medication-induced depressive disorder, depressive disorder due to another medical condition and premenstrual dysphoric disorder, all of which differ in terms of duration, severity and timing and cause.
The typical symptoms one experiences while depressed are listed below and best remembered by the mnemonic, SIGE CAPS. Often five or more of these symptoms for a period of two weeks is a significant indicator for a major depressive disorder:
S – Suicidal ideation
I – Lack of interest in doing things which once were perceived as pleasurable
G – Guilt and feeling worthless
E – Lack of energy
C – Difficulty concentration and reduced cognitive functioning
A – Lack or significant increase in appetite
P – Psychomotor retardation and/or agitation
S – Increase or decrease in sleeping
Although mood disorders may manifest as a symptoms of a straight depressive disorder, a bipolar mood disorder must also include symptoms of mania. Mania is characterized by a persistently elevated and/or irritable mood with an abnormal increase in energy and goal-directed activity accompanied by: distractibility, racing thoughts (going from one thought to another in rapid pace), decreased need for sleep, being more talkative than usual, thoughts of grandiosity and inflated self-esteem (“I am Jesus”) as well as excessive involvement in an activity that has the potential for painful consequences (extensive shopping sprees, hyper-sexuality or novel promiscuity). A manic episode typically lasts at least one week and may cause significant impairment in one’s family, social and occupational functioning. In extreme situations, a manic episode may also result in a hospitalization for the individual. Usually at the time of the manic episode, the person has poor awareness of his/her manic behavior and the way it is impacting their functioning, often even enjoying their destructive behavior , leading them to more potential destructive behaviors and consequences. One episode of mania is sufficient to warrant a diagnosis of bipolar disorder, type 1.
An individual may also experience a hypo-manic episode which is a “milder” form of mania and may include all of the aforementioned symptoms listed under a manic episode, with the difference in duration being only 4 days instead of one week and with less severe overall impairment in social and occupational functioning. When an individual experiences a history of hypo-manic and depressive episodes he/she is diagnosed with bipolar disorder, type 2.
A mnemonic to remember the diagnostic features of bipolar is DIG FAST:
D – Distractibility
I – Indiscretion, excessive involvement in pleasurable activity
G – Grandiosity
F – Flight of Ideas
A – Activity increase
S – Sleep Deficit, decreased need for sleep
T – Talkativeness, pressured speech
Depressive and mood disorders can be treated with a myriad of methods and interventions including cognitive behavioral therapy, psychodynamic methods, problem solving, solution focused, Gestalt and family systems methods. Depressive and mood disorders need to be treated immediately. The earlier a person who has a depressive or mood disorder engages in treatment the better the outcome may be. At NYC Therapy Group we strive to create a best fit approach between the client’s unique needs and personality structure and the intervention utilized. We work to equip our clients with effective tools to manage their depressive and mood disorders and gain greater sense of mastery and control of their symptoms. The therapeutic relationship is the cornerstone of all the interventions we utilize where clients can feel safe, supported, accepted and understood.