Psychotherapy
Therapy can help you resolve problems, attain your goals, and improve your coping skills. While our therapists are trained in several different approaches, our primary specialty is Cognitive-Behavioral Therapy (CBT).
CBT was first developed over 50 years ago. It now has extensive scientific support. The research shows it can be helpful in the treatment of bipolar disorder, depression, anxiety disorders, anger problems, and trauma. CBT can also help people develop their strengths, improve relationships, and develop a healthier lifestyle. We want our patients to get the most out of life!
In CBT, the therapist and patient develop a partnership. We seek to work collaboratively to help you with the issues that matter to you. “Cognition” refers to thoughts, beliefs, attitudes, assumptions, images, and perspectives. We often help people to identify cognitions that are playing a role in their difficulties. Once this becomes clear, we devise ways of evaluating, modifying, or otherwise considering ways of thinking that might be more rational and helpful.
We also put considerable emphasis on “behavior”. Sometimes we think of ourselves as “coaches” or “psychological personal trainers”. Often, to live a more fulfilling life, people need to change what they are doing in some way. For example, many people who are prone to depression are not very assertive. We may train them in more effective communication skills.
Most people tend to like CBT. They like the fact that it is fairly structured. We try to stay on task and work on well defined goals. The therapist may recommend specific steps to take, or provide homework assignments. And, generally speaking, people usually appreciate instruction in practical coping skills that help them live more effectively. While there is a broad research base to draw from, each patient is treated as unique and the approach is tailored to an individual’s needs.
Medication Therapy
Your psychiatrist may prescribe one or more medications to help treat your mood symptoms. There are 3 classes of medications commonly used along with psychotherapy in the treatment of mood disorders.
The traditional antidepressants are used to make the symptoms of depression go away and stay away. These medications include drugs that inhibit the reuptake of neurotransmitters, serotonin, norepinephrine, and dopamine. Some of these mediations increase the presence of serotonin in the brain only, others increase the presence of both serotonin and norepinephrine, and others act on another neurotransmitter called dopamine.
The mood stabilizers are the ‘foundation’ for treatment of bipolar disorder’, and used to make the symptoms of both depression (‘the lows’) and mania or hypomania (‘the highs’) go away and stay away. The mood stabilizers include the use of medications like lithium, Lamictal (lamotrigine), and Depakote (divalproex). The latter two are actually anticonvulsants, medications normally used in the treatment of seizure disorders, but we now know that they stabilize mood in bipolar disorder as well.
Antipsychotic medications are used to control psychotic symptoms, such as hallucinations or delusions, which sometimes occur in very severe depressive or manic episodes. Even if you are not hallucinating or having delusions, these medications can help to treat depression, prevent new mood episodes from occurring, and slow the racing thoughts frequently associated with bipolar disorder.
You and your doctor need to work together to find the right treatment for you, but usually this involves a medication and psychotherapy.
Talk to your psychiatrist about your medications’ effects on you, especially side effects that bother you. You may wish to track these effects so you can discuss them fully. Together you and your psychiatrist can then review possible options: you may need to take a lower or higher dosage or different medication; you may need to switch the time you take your medication from morning to evening, or take on a full stomach. There are many options for you to try. Side effects can be reduced or eliminated. It is very important to talk to your psychiatrist first before making any changes to your medication or schedule.
Intensive Outpatient Program (IOP)
The Intensive Outpatient Program treats adults 18 years or older, with a mood disorder with a state-of-the-art combination of psychotherapy and pharmacology. Patient referrals begin with a comprehensive assessment to insure the individual’s needs can be met in an outpatient setting. Patients meet Monday through Friday for group therapy and are also seen by a psychiatrist or master’s prepared nurse for medication management. Each patient has an individual treatment plan and the length of stay is short term. Prior to discharge, treatment recommendations and appointments for follow-up care will be in place to assure continuity of care.
Please click here for more information on the IOP Program or contact Darlene Foth, ATR-BC, LSW, Clinical Coordinator at 216-844-2874.
Electroconvulsive Therapy (ECT)
Electroconvulsive Therapy is frequently used when medications have failed or simply stopped working. ECT is used to treat dangerously severe depression, mania – a condition where a patient continually has racing thoughts, pacing, and may not be sleeping or eating for days – catatonia, and some symptoms of schizophrenia.
ECT delivery has improved dramatically since the 1940s and 50s. Anesthesia is used, and the patient does not feel pain. The entire procedure takes about five to 10 minutes and can be done on an outpatient basis. ECT is very safe. It often decreases symptoms of depression in about two weeks, much faster than most of the antidepressants available today.
Please click here for more information on ECT services. |
