Thursday, August 2, 2012

Highlights from the 8th Annual Mood Disorders Educations Day at Stanford




This past weekend, I went to Stanford’s 8th Annual Mood Disorders Education Day. I wasn’t sure if I wanted to go again this year because I didn’t think that there would be enough new information, but I was very wrong about that, this event was very different that last year or the year before. Last year the focus was mainly on the genetics of mood disorders but this year the focus switched to the therapy side as well as special features such as mood disorders in women. Unlike previous years, there wasn’t a special presentation on children, however, I wasn’t disappointed since we still had a breakout session for children and mood disorders where you could ask questions to the researchers in a small group, always my favorite part of this education day.

Here are some notes I took from the event:
(Please note that this is my interpretation of the information presented.)
In the opening presentation, Terence Ketter M.D., Chief of the Bipolar Disorders Clinic shared how there’s work underway for a National Network of Depression Centers that will be throughout the United States. The ultimate goal is to have such a center within 250 miles of every citizen in America to help treat depression and bipolar disorder. This system mimics the cardiovascular and cancer centers that are currently throughout the country. Right now it is still in progress and waiting for funding.

Next there was an update on the DSM-5 Guide for mood disorders. This next guide will reflect what psychiatrists see in the field, not just extreme cases. The goal of this update is to help decrease false diagnoses. There’s special attention on mixed episodes and energized depression (mix state with irritability, pacing, negative energy etc.) Bipolar NOS will be referred to as Bipolar NEC (Not Elsewhere Classified). They also mentioned that for a bipolar disorder diagnosis there must be a change of energy. The circadian rhythms must have a change.

In the presentation for women and mood disorders, attention was brought to the increased risks that exists for women who have the disorder. Women are twice as likely to have depression and are more likely to have atypical depression. They have increased risks with seasonal patterns than men and are more likely to suffer with physical pain. Women have an increase in bipolar 2 diagnosis and more likely to experience rapid cycles and mixed episodes. There is clear research that hormonal changes in women have an impact when it comes to mood disorders.

The next speaker focused on Cognitive Behavior Therapy (CBT). An interesting point made was that even in cases where individuals are treated with optimal meds, relapse is very common. Thus demonstrating the importance of therapy when it comes to long term care for mood disorders. They discussed how our thoughts, behavior and feelings are all connected and by helping to improve one’s thoughts, behaviors can be influenced in a positive way resulting in better feelings. For those with mood disorders, negative thinking is much worse than the typical person, they’re more likely to see things as “all or nothing”, to overgeneralize, disqualify positive, catastrophize or try to read the minds of others (in a negative way). In CBT, therapists work to identify distorted thinking patterns and correct the thoughts which as a result will lead to better behavior and a positive cycle can begin. Therapists can create strategies to problem solve or help the individual distance themselves from their thoughts so they don’t assume all thoughts are true. When it comes to behaviors, therapists can teach individuals how to overcome unwanted patterns through new skills or plan of actions. Then when it comes to feelings, therapists can teach individuals how to accept their feelings or at the least tolerate them. They can also teach relaxation exercises for coping and strategies for extreme emotions such as anger. 

Research has shown that those who participate in CBT have less episodes and hospitalizations and the effects are similar to good medication. It improves overall functioning. The downside is that it requires effort to find a good therapist and it doesn’t work for everyone. The best thing to do is to meet several therapists and interview them over the phone until you find someone you feel will work best for you. If you don’t feel like it’s a good match, try someone else. Don’t worry about hurting their feelings, it’s a natural part of their practice.

I have to admit that after hearing about CBT, I realized how lucky we are to have our son’s therapist. Through this presentation, I could see exactly how our therapist is putting these methods at work, it helped me to understand the steps we have taken, especially with regards to distorted thinking patterns and strategies for coping. It was nice to hear that we’re on the right track!

Check back for my next post when I share the latest research in triggers for bipolar disorder and the differences between depression and mania triggers that was presented at this event and my Q&A discussion with Dr. Kiki Chang, you’ll find this information very interesting!


2 comments:

  1. As always - thanks for sharing this information. My daughter with BP2 is off to college in a couple weeks- 1 1/2 hours away-scary but so proud of her. She is on a good mix of meds and doing well. We are also treating hormonal issues so I am not surprised at all to hear of this connection. I believe (hope?) that adolescent hormone changes play a big role so we just have to hold steady while their hormones reek havoc and then watch as they come out on the other side ready to face the world because of all the love and support they have received- right??? Saying some prayers for you and your son.

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    1. I’m so glad to hear that your daughter is doing well and off to college, what a big step!! You mentioned that the hormones reek havoc, I too heard that things may get more stable as they get older and out of this phase. I love what you said about them coming out on the other side ready because of the support and love they got through it. What a wonderful perspective!
      (Thanks for your prayers, things seem to be getting back to a good place)

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