Depression is a serious and common medical condition. Almost everyone knows someone who has been affected by this illness, however many people go untreated. Depression can be experienced in many ways including profound sadness, a feeling of hopelessness, negative thoughts, insomnia, loss of appetite or overeating, poor concentration, irritability, decreased physical energy, and loss of interest and pleasure in activities. Sometimes a motivation to carry out the most basic daily tasks is minimal or absent. A person may experience physical complaints such as headache, abdominal discomfort, or other types of bodily pain.
Depression can have a profound impact on social and occupational functioning and can diminish a person’s ability to cope with life stressors. The most dangerous consequence of untreated depression is suicide. Thoughts of suicide and/or suicidal impulses may occur, along with overwhelmingly negative thoughts.
Depressive disorders are highly treatable with appropriate evaluation, medication, and psychotherapy. Transcranial magnetic stimulation (“TMS”) therapy (Hyperlink) is an additional outpatient treatment option for depression in certain cases.
Bipolar Disorder I
Bipolar I Disorder is characterized by changes in mood over time that move between depression and mania. A clinical diagnosis of Bipolar I Disorder is based on a person having experienced at least one manic episode, which in adults consists of days or weeks of feeling elated, racing thoughts, believing one has exaggerated abilities, not sleeping (but not feeling tired), and increased energy and activity that may or may not be productive and can often involve irritability.
At other times this same individual suffers from episodes of depression, involving negative self-assessments, hopelessness about the future, withdrawal from others, and decreased energy. People may lack the motivation to carry out ordinary activities, and may even have suicidal thoughts and plans. Untreated bipolar depression carries a significant risk for suicide.
Bipolar Disorder can be successfully managed with a comprehensive treatment plan. Treatment with maintenance medication called mood stabilizers is of great importance for those who are affected by BPDI. Psychotherapy is also helpful with stress management, improving coping skills, and medication adherence.
Bipolar Disorder II
BPDII is characterized by periods of depression and other time periods of being hypomanic. In hypomanic states, the individual has more energy, a decreased need for sleep, an elevated mood (a bit more excited and happy than circumstances warrant), and usually some impairment in judgment. This mood state, however, does not reach the level of intensity of a true manic episode as described under BPDI. Depressive states can be just as severe as those of BPDI.
BPDII can also be effectively treated with medication and as in BPDI, the importance of the person’s adhering to the prescribed medication regimen over time cannot be overstated. Psychotherapy is also very useful in treating this disorder and can help in preventing further episodes of illness once the patient is well.
Panic Disorder is a type of anxiety disorder involving short, sudden periods of intense fear that something disastrous is about to happen. People may feel that they will pass out, that they are “going crazy”, that they are having a heart attack, a seizure, or are dying. Some of the symptoms experienced during a panic attack are chest pain or tightness, dizziness, palpitations, nausea, sweating, and shaking. Typically, people go to great lengths to avoid another panic attack, and that avoidance can interfere with school, work, home life, and or social life. A person may develop agoraphobia, or a fear of going to a place where a panic attack may occur—a place from which it would be difficult to escape or where having a panic attack would be extremely embarrassing.
Panic Disorder is twice as common in women as in men. Both medication and psychotherapy are very effective in the treatment of Panic Disorder. Regular exercise, adequate sleep, regular meals, and avoiding caffeine and other stimulants may help reduce the frequency of panic attacks.
Obsessive Compulsive Disorder
OCD is a type of anxiety disorder that can cause an individual to experience disturbing, intrusive, and repetitive thoughts or images (obsessions). The thoughts are about an issue that gives the person great distress and anxiety. The idea or image is difficult or impossible for the person to banish from his mind, and over time may drive him to engage in ritualistic behaviors to try to make the idea go away or to reduce the degree of anxiety.
Some individuals who have OCD are primarily involved in checking or ritual behaviors (compulsions), all designed or intended to manage the anxiety surrounding disturbing thoughts. Examples of common compulsions are hand washing, checking and re-checking locks, and counting rituals.
Some people suffer primarily from obsessions, and some people primarily from compulsions; and many OCD sufferers live with a combination of both. Untreated, the disorder can be very disabling.
Fortunately OCD can be effectively treated and managed with cognitive behavioral therapy (CBT) in combination with anti-anxiety medications.
Social Anxiety Disorder is the third most common mental disorder in the U.S., after depression and alcohol dependence. The disorder usually emerges during adolescence or early adulthood, but can also occur in children. It is more common in women than in men (webmd.com). It is probably caused by a deficiency of the neurotransmitter serotonin, and there is evidence that this disorder, as with all anxiety disorders, runs in families.
A person with Social Anxiety Disorder becomes intensely nervous and self-conscious in social situations during which he or she will be watched and possibly judged or criticized by others. The person feels fear which is excessive and unreasonable in its intensity, and the anxiety many lead the person to avoid such experiences as public speaking, dating, eating or drinking in front of others, asking questions or giving reports in groups, or even using public toilets. People facing such situations may have heart palpitations, confusion, sweating, shaking, blushing, upset stomach, and diarrhea. And even though the person recognizes that his fear is unrealistic, he may worry for days or weeks prior to a social event (anticipatory anxiety).
Social Anxiety Disorder can be effectively treated with a combination of cognitive behavioral therapy (CBT) and anti-anxiety medications.