Mood Disorders
Mood disorders, sometimes referred to as affective disorders, refer to a group of diagnoses whose main characteristic is a disturbance of mood. Over 40 million Americans suffer from some kind of mood disorder – most commonly depression and anxiety.
Mood disorders are caused by a complex dysregulation of the brain’s neurobiology. Environmental factors and substance abuse can also cause or exacerbate a range of mood disorders. Importantly, if the affected person is using alcohol or other mood-altering substances to medicate an unpleasant mood, this issue must be effectively addressed for the mood disorder to be successfully treated.
At Cottonwood, our board certified psychiatrists and master’s level counselors help patients to identify and change maladaptive attitudes, behavior, attitudes and beliefs that can undermine their ability to produce a calm, happy mood. In our clinical work we identify core issues, uncovering and resolving longstanding psychological problems that can cause problems with mood.
Proper diet and physical activity are also important in optimizing the brain’s ability to think clearly and maintain a confident, happy mood. Our behavioral health nutritionists work with patients to develop individualized eating plans that optimize their intake of key vitamins and amino acids that are important precursors to good mood biology. Exercise has also proven helpful in increasing serotonin, dopamine and norepinephrine – the brain’s primary mood-regulating chemical messengers. Please take a minute to read more about Cottonwood’s treatment of specific mood disorders.
Depression
Some people describe depression as a black, enveloping cloud that descends into their lives making everyday activities seem overwhelming and pointless. They may feel sad and hopeless or tense and restless – symptoms vary from person to person. Often, sleep and appetite are disturbed. Once a person suffers one depressive episode, they are quite likely to have other subsequent episodes. Depression can affect a person’s ability to earn a living, study or maintain important relationships.
More than just a low mood and sad feeling, clinical depression affects 15-18% of Americans and is really a brain disorder characterized by a dysregulation of the depressed person’s own neurotransmitters – the chemical messengers used by the brain to produce feelings, moods, and emotions. Depression can result from a genetic predisposition for the disorder, hormonal imbalances, stress and trauma or the use of mood-altering chemicals.
At Cottonwood, our board certified psychiatrists are skilled at using non-habit forming medications to gently re-regulate the depressed person’s brain functioning. Individual and group therapies are helpful in identifying behavioral and attitudinal components of depression and can help patients lighten and stabilize their mood and develop more adaptive ways of managing thoughts and feelings that may act as triggers to depressive episodes. Using Cognitive Behavioral Therapy (CBT) our therapists help patients to identify and challenge unhealthy or irrational beliefs that can cause emotional pain. Grief groups and trauma therapy and Eye Movement Desensitization and Reprocessing (EMDR) can help lessen the emotional resonance of painful memories help patients to explore and process the root causes of their depression.
Over time, depression can actually shrink key areas of the brain. At Cottonwood, our clinicians understand how the right kind of exercise can trigger the release of chemicals that stimulate the growth new brain tissue. We also know that physical activity is also key in optimizing the brain’s ability to think clearly and produce a happy, steady mood.
Good nutrition is an important, though often overlooked, component of recovery from depression. At Cottonwood, our behavioral health dieticians work with patients in developing nutritional plans aimed at ensuring that each person will have sufficient amounts of the right vitamins and amino acids to promote a stable, happy and confident mood.
Bipolar Disorder
Bipolar disorder – once known as manic depression - is serious and disabling brain disorder characterized by an unstable mood - with episodes of both high energy (manic episodes) and low energy (depressive episodes). A manic or hypomanic state is marked by a feeling of euphoria, pressured, grandiose speech, impulsive behavior and a decreased need for sleep. In a manic or hypomanic state, some people will gamble impulsively, spend large amounts of money or act-out sexually. Episodes can last for days, weeks or months – even years in rare cases. Symptoms vary widely from person to person and bipolar disorder can be difficult to diagnose – even by trained mental health practitioners. Over 60% of people who suffer from bipolar disorder were originally misdiagnosed. Left untreated, bipolar disorder usually gets worse – sometimes culminating in suicide.
At Cottonwood, we know that, with proper care, bipolar patients can live happy and productive lives. Our board certified psychiatrists are skilled at using non-addictive mood stabilizing medications to manage the symptoms of mania and depression. Counseling for bipolar patients usually centers on helping the person develop more adaptive mood stabilization skills while identifying attitudes, behavior or environmental stressors that can trigger mood instability or lead to non-adherence with their medication regime. Here too, our behavioral health dieticians can work with patients to design a skillful diet and exercise program can help those suffering from bipolar disorder optimize the conditions that best promote mood stability.
Anxiety Disorders
Anxiety is something we all feel from time to time. It’s normal to feel apprehensive or nervous when faced with a difficult situation at work, school or home. An anxiety disorder, however, is quite different. A true anxiety disorder is a brain disease – more precisely a dysregulation of the brain’s inhibitory chemical messengers. Anxiety disorders can paralyze the sufferer with constant fear and worry. There are actually a number of anxiety disorders, including: panic attacks, social anxiety disorder, phobias, posttraumatic stress disorder and obsessive-compulsive disorder. These conditions are characterized by feelings of fear, apprehension and panic; obsessive, ruminative thoughts; distressing intrusive thoughts and/or nightmares related to a past traumatic experience, difficulty sleeping, and counting or checking rituals.
Clinical studies suggest a correlation between anxiety disorders and dysfunction in the amygdala, a part of the brain involved in attaching emotional resonance to events occurring in a person’s environment. Also, a low level of gamma aminobutyric acid (GABA) a neurotransmitter that inhibits energy in the brain seems to contribute to heightened anxiety. The use of alcohol has also been shown to reduce GABA in the brain, making it harder for alcohol users to naturally calm their anxiety.
At Cottonwood, our board certified psychiatrists are experienced in using non-addictive mood-regulating medications to reduce anxiety. Our counselors know the therapeutic approaches anxiety sufferers respond to best. Cognitive behavioral therapy (CBT) works especially well with anxious patients, helping them to identify and change specific thoughts or patterns of thinking that tend to exacerbate their anxiety or undermine their ability to self-sooth.
As with other mood disorders, we know that the proper diet and regular exercise can have a powerful effect on reducing anxiety by influencing the biological component of anxiety disorders. Exercise puts a healthy amount of stress on the nervous system. For anxious people, this is a good thing, since stressing brain circuitry results in increased growth and durability.
Trauma and Posttraumatic Stress Disorder
Trauma occurs when a life event, usually one that threatens or causes great physical or emotional harm, overwhelms the brain’s inbuilt chemical and physiological defenses to stress. Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that sometimes develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. It’s normal to be afraid when you’re in danger, but if you feel upset and fearful weeks or even months later, you might be suffering from PTSD.
Symptoms of PTSD include frequent nightmares, recurrent flashbacks or intrusive thoughts related to the traumatic event, an exaggerated startle response, feelings of anger, guilt, loneliness and sadness, and abiding tension and sleeplessness.
Research has shown an association between PTSD and functional changes in the amygdala, a part of the brain involved in the formation of emotional memories, especially fear-related memories. Over time, trauma or even chronic stress can also decrease the number of neuronal connections in the brain.
At Cottonwood, we understand the neuroscience of PTSD, and treat the disorder in an environment of safety and support. Group therapy is helpful in reducing isolation and social stigma related to the disorder. Cognitive behavioral therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) can also help to reprogram brain circuitry so that patients can recall traumatic events with less emotional resonance.
And, as with other anxiety disorders, proper diet and regular exercise can have a powerful effect on reducing the symptoms of PTSD by influencing the biological component of post-trauma anxiety. Our behavioral health nutritionists and exercise therapists can help PTSD patients develop diet and exercise programs that can even facilitate neurogenesis – the growth of new brain tissue that can strengthen neuronal circuitry – thereby reducing symptoms and improving overall emotional health.
Complicated Grief
Grief is a normal and unavoidable part of human existence. We all will likely suffer the pain of grief at some point in our lives, usually with the death of a friend or loved one. When we suffer this kind of life event, we mourn and over time we accept our loss and – without forgetting - move on. But for some, it seems impossible to let go, and even years later, the pain of loss remains acute. If the process of grieving becomes stalled, pervasive sadness and stress can spiral into a debilitating depression in which the chemistry of the bereaved person’s brain becomes dysregulated and, in severe cases, brain tissue can actually shrink.
At Cottonwood, our experienced clinicians (including a certified thanatologist) use their understanding of the grief process and the neurobiology of depression to help bereaved patients develop new thought processes and behavior that reinforce neurological balance that can keep the brain healthy throughout the grief process. Individual and group therapies are helpful in identifying and removing behavioral and attitudinal components that can complicate the grief process while helping bereaved patients to develop more adaptive ways of managing thoughts and feelings that may complicate the process of grieving or act as triggers to depressive episodes. Grief groups, trauma therapy and Eye Movement Desensitization and Reprocessing (EMDR) can help lessen the emotional resonance of painful memories and help patients to adaptively negotiate and process their grief.
Eating Disorders
Most common in women, but also occurring in men, eating disorders are marked by self-destructive and even dangerous disturbances in eating behavior. The two main subtypes of eating disorders are Anorexia Nervosa – a disorder in which a person is unable or unwilling to maintain a minimally healthy body weight, is preoccupied and intensely afraid of gaining weight, and harbors a distorted perception of body shape and size, and Bulimia Nervosa – a disorder characterized by eating binges followed by unhealthy compensatory behaviors, like self-induced vomiting or the inappropriate use of laxatives, to prevent weight gain. Like those suffering from anorexia nervosa, people with bulimia nervosa are also preoccupied with body shape and weight. Both of these disorders seem to be desperate attempts by sufferers to cope with anxiety and gain some sense of control over their lives. Eating disorders are thought to be disturbances of the brain’s appetitive circuits, and may also be related to serotonin and dopamine metabolism.
At Cottonwood, our behavioral health dieticians consult with our psychiatrists and eating disorders therapists to design personalized, whole-person treatment plans that can bring safety and structure to our patients’ disordered eating. Evaluation of eating disorder patients includes a thorough psychiatric evaluation, comprehensive nutritional and exercise assessments, and a body composition analysis. Our clinicians can then use these assessments and in vivo experiential activities, like mindful eating meal sessions, to help Cottonwood patients establish a healthier relationship with food.
Our counselors also use cognitive behavioral therapies to identify and challenge a distorted body image and unrealistic or irrational beliefs related to body shape and size imposed on the patient by critical friends, family members or even society at large. At Cottonwood, our aim is to uncover and resolve possible psychological issues related to disordered eating. Trauma and grief therapy can also help eating disorder patients to address longstanding emotional issues that support or trigger distorted perceptions about body shape and size.
