Depression is the the absence of being able to envisage that you will ever be cheerful again. It is the absence of hope. Sad hurts but it’s a healthy feeling. It is a necessary thing to feel. Depression is very different. - J.K. Rowling

Depression reduces the quality and sense of life. Depression can seriously impair a person’s ability to function in everyday situations. But the prospect of recovery for depressed individuals is very good. By working with a qualified and experienced therapist, anyone suffering from depression can help regain control of their lives.

Many depressed individuals also suffer from anxiety. Depression and Anxiety are sometimes called “fraternal twins.” One can think as anxious person as someone that has high level of negative (anxious) emotion, that clearly leads to avoidance and paralyzing. While depression is manifested in low positive emotions. The results of low positive emotions is lack of motivation and no interest/no incentive in doing anything. Clearly depressed individuals want to enjoy activities and life, but it is hard for them to do so as physiologically the depression is a highly stress state. Depression is not a weakness nor is it something that you simply just “snap out of.” You can deal with depression or deal with its consequences.

spiral2grow utilizes proven psychotherapy methods such cognitive behavioral therapy, CBT and Dialectical Behavioral Therapy, DBT and can teach you the necessary skills to prevent, resolve or manage depression. It helps you enjoy better relationships and quality of life, while emphasizing durable-fulfillment. spiral2grow of New York City offers depression management treatment in a variety of formats: Individuals Counseling, Group Counseling and Workshops.

About Depression

spiral2grow, an expert about depression in New York City, has depression psychotherapists and counselors, who provides treatment about depression while building skill and confidence in managing depression. spiral2grow, located in midtown Manhattan at 260 Madison Avenue #8023, New York, NY 10016, offers proven depression treatment and counseling in a variety of formats: individual depression counseling, depression counseling group and workshop.

Once depression gets a grip on your life, it may feel like it is impossible to break free. It can feel hopeless. But it is important to know that it is not hopeless. Depression can hijack your life like no other condition or disease can. As such, it can rob you of your own happiness, and may leave you overwhelmed. But the worst part about depression is that it is so difficult to control. Yet again, today more than ever before, there are many ways to assist you in overcoming the depression. It won’t be easy, but clearly possible.

About Depression

Depression is categorized by the mental health profession as a mood disorder, but its symptoms can vary widely from one person to another. It is also accurate to think of depression as a complex problem that can affect many different aspects of the sufferer’s life. It can affect the body, and generate such physical symptoms as insomnia, fatigue, appetite disturbances, diminished sex drive, and anxiety. It can affect the mind, interfering with the ability to think clearly, notice and remember details, and make good decisions. It can affect emotions, causing feelings of sadness, despair, guilt, worthlessness, and apathy. It can affect behavior, leading to alcohol or drug abuse, suicide attempts, and other socially or self-destructive behaviors. It can affect interpersonal (social and family) relationships, leading to aggression, withdrawal, or marital and family distress.

The main forms of depression are: major depressive disorder, also called “unipolar” for its affecting only one end of the mood continuum — depression; and bipolar disorder, formerly called manic-depressive illness, (“bipolar” for its affecting both ends of the mood continuum — depression and euphoria, or mania.) Depression can also present itself as dysthymia, a less intense and more chronic form of depression. Major depression is far more common than bipolar disorder, and has a much wider range of contributing factors.

Throughout the course of our lives, we all experience episodes of unhappiness, sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy or difficulty such as divorce or loss of a job, we may feel depressed (some people call this “the blues”). Most of us are able to cope with these and other types of stressful events.

Over a period of days or weeks, the majority of us are able to return to our normal activities. But when these feelings of sadness and other symptoms make it hard for us to get through the day, and when the symptoms last for more than a couple of weeks, we may have what is called clinical depression. The term “clinical depression” is usually used to distinguish “true” depression from the blues.

Clinical depression is not just grief or sadness. It is an illness that can challenge your ability to perform even routine daily activities. At its worst, depression may lead you to contemplate or commit suicide. Depression represents a burden for both you and your family. Sometimes that burden can seem overwhelming.

Clinical depression always requires attention from a medical or mental-health professional. The good news is that depression can be diagnosed and treated effectively in most people. The biggest barrier to overcoming depression is recognizing that someone is depressed and seeking appropriate treatment.

Depression Symptoms

spiral2grow, a leading depression counseling center in New York City (NYC), has depression psychotherapists and depression counselors, who are expert in providing treatment for depression symptoms while building skill and confidence in managing depression. spiral2grow, located in midtown Manhattan at 260 Madison Avenue #8023, New York, NY 10016, offers proven depression treatment and counseling in a variety of formats: individual depression counseling, depression group counseling, depression classes and workshops.

Depression Symptoms

Depressed people will likely experience unpleasant moods, thoughts and self-perception. A depressed person may have difficulty making decisions – day-to-day tasks of paying bills, caring for children, meeting people and making telephone calls may seem overwhelming.

If the following symptoms are present each day for a few weeks; and interfere with daily activities such as work, self-care, child-care, sleep or social life; please consider getting professional help:

• Preoccupied with death or suicide
• Insomnia and/or major sleep changes
• Appetite and/or major weight changes
• Decreased energy, fatigue – always tired
• Feeling hopeless, helpless or pessimistic
• Feeling guilt, worthlessness, helplessness
• Loss of interest or pleasure in work or profession
• Little pleasure in activities that were once enjoyed
• Sadness, anxiety, emptiness, restless and irritable
• Little interest or pleasure in romance or sexual activity
• Difficulty concentrating, remembering, making decisions

The symptoms of depression described above make it clear: To be depressed is to suffer. The hopelessness and helplessness that people experience when they are depressed is more than just a frame of mind at such times — it is an entire way of being. People stop trying, they stop caring, they withdraw from life, and of course, this makes them feel even worse. Their lives deteriorate, and it affects others as well. Parners and family members are not immune to the depressive’s negativity — the never-ending complaints, the steady stream of criticisms, the lack of emotional closeness, and the loss of the ability to have fun together. Spouses can feel hurt and alienated, and children may feel guilty, resentful, and as if they are to blame. In turn, family relationships can also exacerbate depressive symptoms.

Depression Causes

spiral2grow, a leading provider of depression and anxiety counselling  in New York City (NYC), employs depression psychotherapists and depression counselors, who are expert in understanding depression causes and treating depression and mood disorder. spiral2grow, located in midtown Manhattan, offers depression control treatment and anger control counseling in a variety of formats: individual counseling for depression, depression group as well as workshop.

Some of the more common factors involved in depression are:

• Family history. Genetics play an important part in depression. It can run in families for generations.
• Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.
• Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).
• Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.
• Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and especially, substance abuse often appear along with depression

Depression Treatment in NYC

spiral2grow, expert in depression treatment in New York City (NYC), has depression counselors and psychotherapists, who treats depression disorder while building the necessary skills for managing depression. spiral2grow, located in midtown Manhattan at 260 Madison Avenue #8023, New York, NY 10016, offers proven depression treatment and counseling in a variety of formats: individual depression counseling, depression group counseling and workshop.

Depression treatment

If your symptoms indicate that you have clinical depression, it is strongly recommended to seek treatment. Treatment may include supportive therapy, such as changes in lifestyle and behavior, psychotherapy, complementary therapies, and may often include medication. Without treatment, your symptoms will last much longer and may never get better. In fact, they may get worse. With treatment, your chances of recovery are quite good.

Psychotherapy and antidepressant medications are the two most commonly used treatments for managing depression. Many people use a combination of the two. People’s responses vary, of course, but these approaches hold good promise for providing relief.

Most people have already heard of the popular antidepressant medication, Prozac. It is only one of the many “newer generation” medications that do, in fact, help the majority of people who take them. Medication is a valuable tool for reducing symptoms and “raising the floor” on depression. Speaking to a psychiatrist about the use of medications in your particular case is the best way to explore whether medications are viable for you. A psychotherapist can also help you with this decision.

Psychotherapy is an non-drug alternative that is generally as effective as medication, and in some ways is even superior (though not quite as fast-acting). For example, people who receive therapy tend to have a lower relapse (recurrence) rate, and tend to feel better as an active participant in the recovery process. Psychotherapy can help individuals and families who are dealing with depression. The most effective psychotherapies are called cognitive therapy (which teaches how to identify and correct distorted thinking), behavior therapy (which teaches how to behave more effectively), and interpersonal therapy (which teaches relationship skills). All of these are short-term therapies, and all focus on changing things in the present.

The fact that long-term research shows the effectiveness of medication and psychotherapy for treating depression can be wonderfully reassuring for depression sufferers and their families. Depression is highly responsive to good treatment, and good treatment is available from a variety of sources.

Psychotherapy

Psychotherapy involves working with a trained therapist to figure out ways to solve problems and cope with depression. Three major approaches are commonly used to treat clinical depression. In general, these therapies take weeks to months to complete. Each has a goal of alleviating your symptoms. More intense psychotherapy may be needed for very severe depression or for depression with other psychiatric symptoms.

Cognitive behavioral therapy (CBT)

CBT helps to alleviate depression and reduce the likelihood it will come back by helping you change your way of thinking. CBT uses three techniques to accomplish these goals.

Didactic component: This phase helps to set up positive expectations for therapy and promote your cooperation.

Cognitive component: Helps to identify the thoughts and assumptions that influence your behaviors, particularly those that may predispose you to being depressed.

Behavioral component: Employs behavior-modifying techniques to teach you more effective strategies for dealing with problems.

Clinical depression always requires attention from a medical or mental-health professional. The good news is that depression can be diagnosed and treated effectively in most people. The biggest barrier to overcoming depression is recognizing that someone is depressed and seeking appropriate treatment, and then find an effective treatment by professional and licensed psychotherapist.

When to Seek Depression Help

spiral2grow, a leading expert in helping depression in New York City (NYC), has depression psychotherapists and counselors, who are expert in providing help for depression while building skill and confidence in managing depression. spiral2grow, located in midtown Manhattan at 260 Madison Avenue #8023, New York, NY 10016, offers proven depression help treatment and depression counseling in a variety of formats: individual depression help, depression group help and depression workshop.

When to seek help for Depression

As a general answer, you should seek help when depression is starting to affect your life (your family, your job, your outlook) in negative ways, and you are not very clear about what you need to do to prevent things from getting worse. You should seek help — for yourself, loved ones, or both — long before things get really bad.

To be more specific, take into account the following factors when deciding to seek professional treatment.

• Suicidal thoughts or feelings: Suicide is a terrible and irreversible solution to specific problems. The depressed person and his or her family need to think preventively, and get help immediately if someone is suicidal.
• Acute depression turning chronic: Before settling into “life as a depressed person,” the depressed person, and family if possible, should do all they can to resolve it early on. Every day spent suffering is too costly.
• Lifestyle disruption: The depressed person, and his or her family, can prevent bad circumstances from getting worse by acting quickly. The depressed person does not have to ignore his or her health, lose a job, or hurt or alienate family and friends.
• Reality testing: If a family and their depressed member do not have someone good to talk to, someone with whom they can share their private thoughts, then how will they know whether what they are thinking makes sense? A good therapist is a valuable partner for “reality testing.”

Depression Support and Self Help

spiral2grow, a leading expert about depression, located in midtown Manhattan at 260 Madison Avenue #8023, New York, NY 10016, has depression psychotherapists and counselors, who are expert in providing treatment for depression while building skill and confidence for managing depression. spiral2grow offers proven depression treatment and counseling in a variety of formats: individual depression therapy, groups for depression as well as classes and workshops.

Depression support and self help

Once you are being treated for depression, you can make lifestyle changes and choices that will help you through the rough times and may prevent depression from returning:

• Try to identify and focus on activities that make you feel better. It is important to do things for yourself. Don’t isolate yourself. Take part in activities even when you may not want to. Such activity may actually make you feel better.
• Talk with your friends and family and consider joining a support group. Communicating and discussing your feelings is an integral part of your treatment and will help with your recovery.
• Try to maintain a positive outlook. Having a good attitude can be beneficial.
• Regular exercise and proper diet are essential to good health. Exercise has been found to increase the levels of the body’s own natural antidepressants called endorphins.
• Try to get enough rest and maintain a regular sleeping pattern.
• Avoid drinking alcohol or using any illicit substances.

It is important to note that clinical depression always requires attention from a medical or mental-health professional. Depression can be diagnosed and treated effectively in most people. The biggest barrier to overcoming depression is recognizing that someone is depressed and seeking appropriate treatment.

Bipolar Disorder

Bipolar disorder (manic depression) involves extreme swings in mood, ranging from the low depression to the high mania. The periods of severe high or low moods may negatively impact day-to-day functioning. Learning to live with your own bipolar disorder is not easy. However, a combination of psychotherapy and medicines can be effective treatment. spiral2grow of New York City can help people better manage their illness and reduce repeated experiences of mood episodes.

Effective psychotherapy, like Cognitive Behavioral Therapy (CBT) teaches patients to reduce the negative impact of extreme emotions and cope better in their reality. It helps them to decrease the extremeness of their mood swings (where possible), reduce the impact of their illness on their social and occupational relationships, improve their motivation to remain on medication, and generally function to help reduce their chance of catastrophic relapse.

Bipolar Disorder Overview

Bipolar disorder involves extreme swings in mood, ranging from the low depression to the high mania. When depressed, a person may feel sad, have problems with sleeping, eating, and loosing weight, have many negative thoughts about oneself (including thoughts about death and hurting oneself), and experience difficulties with attention and concentration. During periods of mania, the individual may experience euphoric or irritable mood, inflated self-esteem and over-confidence, increased talkativeness, distractibility, and boundless energy, including a decreased need for sleep.

In more severe forms, mania can be accompanied by psychotic symptoms such as hallucinations or delusions, and often requires hospitalisation. Hypomania, a milder form of mania, causes less impairment but can often go unnoticed for several years before receiving appropriate diagnosis and treatment.

Many people are not aware that there are two major types of bipolar disorder, – bipolar I and bipolar II (also known as bipolar 1 and 2), which are separate diagnoses.

There are major differences between these two types of bipolar disorder. Some of the information below is taken mostly from the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders). It might be that DSM V might revise this information. Here are the main points that describes the differences between bipolar I and II.

Individuals with bipolar I suffers from manic episodes, while individuals with bipolar II suffers from hypomanic episodes. The key difference between mania and hypomania is a level of degree. Hypomania (in bipolar II) is more elevated (more extreme) than mania and also is more sustainable (stay over longer of period). Mania is manifested over shorter period of time, yet it is much noticeable and considered abnormal. In Mania the level of energy and activity increased dramatically.

Other differences includes: Mania may include psychotic symptoms (delusions or hallucinations) while hypomania does not have it. In addition, mania dramatically impairs daily life and significantly affect the day-to-day functioning as compare to hypomania.

Untreated, bipolar disorder can result in damaged relationships, poor job or school performance, and even suicide. However, there are effective treatments: medicines and psychotherapy. A combination usually works best.

Bipolar Symptoms and Causes

Because the symptoms of bipolar disorder are expressed as moods, feelings, and actions, deciding what is the illness and what is part of your “personality” can be confusing. That can sometimes make it hard to accept a diagnosis of bipolar disorder.

There are specific criteria for diagnosing bipolar disorder, including the presence of at least one manic or hypomanic episode, but diagnosis can be challenging. Since the symptoms of bipolar depression are similar to those of other types of depression, it can take years for some people with bipolar disorder to get an accurate diagnosis.

An early sign of manic-depressive illness may be hypomania- a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior. Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.

And as with nearly all mental disorder diagnoses, the symptoms of manic depression must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Although we don’t know exactly what causes bipolar disorder, we do know that genes and chemicals in the brain play a strong role in making people vulnerable to developing the disorder. Stress alone does not cause bipolar disorder, but episodes of mania or depression are often triggered by stressful life events. Risk factors for relapse in bipolar disorder include abusing alcohol or drugs, not taking psychiatric medication as prescribed, and changes in routine leading to lack of sleep or irregular sleeping habits.

Although bipolar disorder is a serious condition, if it is diagnosed and treated appropriately, the symptoms can be effectively controlled, relapses can be prevented, and the person can live a happy and rewarding life.

Bipolar Treatment

Pharmacotherapy, or drug therapy, is essential for the treatment of bipolar disorder. It usually involves the use of one or more mood stabilizers, such as Lithium, combined with other medications. There is now strong evidence that Psychological Interventions can be added to drug therapy in order to help people better manage their illness and reduce repeated experiences of mood episodes.

Psychoeducation consists of giving patients and their relatives’ adequate knowledge about bipolar disorder and teaching illness self-management skills, so that people have a better understanding of their illness and its treatment. Psychoeducation is usually given in short-term (i.e., 5 to 10 sessions) group format.

Cognitive-Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) are short-term forms of psychotherapy that have been shown effective in the treatment of depression. In bipolar disorder, Cognitive-Behavioral Therapy (CBT) uses psychoeducation and mood monitoring to help people identify triggers of mood episodes and develop a written relapse prevention plan. Increasing activities in depression, reducing activities in mania, and correcting over-negative or over-positive thoughts are also strategies used in CBT. An adapted version of IPT, Interpersonal and Social Rhythm Therapy (IPSRT), has also been shown effective for bipolar disorder. The main goals of IPSRT are to help people better deal with relational difficulties, and learn how to maintain a stable and healthy daily routine, in order to regulate important biological rhythms, such as sleep, that can trigger mood episodes like mania.

Family Therapy interventions have been found to be helpful in bipolar disorder. In Family Focused Therapy (FFT), patients and their families learn how to better understand bipolar disorder by getting information on the disorder and its treatment (psychoeducation), and learning communication and problem-solving skills, in order to deal more effectively with the consequences of bipolar disorder. Finally, social support is also very important for people with bipolar disorder, and therefore joining local support groups for mood disorders may be helpful.

Benefits of Counseling for Bipolar:

• Improved relationships
• Fewer employment problems
• Avoid the extreme lows
• Set and achieve more realistic goal

Bipolar Depression

The distinguishing characteristic of Bipolar Disorder, as compared to other mood disorders, is the presence of at least one manic episode. Additionally, it is presumed to be a chronic condition because the vast majority of individuals who have one manic episode have additional episodes in the future.

Every individual with bipolar disorder has a unique pattern of mood cycles, combining depression and manic episodes, that is specific to that individual, but predictable once the pattern is identified.

Effective treatment is available for bipolar disorder. Without treatment, marital breakups, job loss, alcohol and drug abuse, and suicide may result from the chronic, episodic mood swings. The most significant treatment issue is noncompliance with treatment. Most individuals with bipolar disorder do not perceive their manic episodes as needing treatment, and they resist entering treatment. In fact, most people report feeling very good during the beginning of a manic episode, and don’t want it to stop. This is a serious judgment problem. As the manic episode progresses, concentration becomes difficult, thinking becomes more grandiose, and problems develop. Unfortunately, the risk taking behavior usually results in significant painful consequences such as loss of a job or a relationship, running up excessive debts, or getting into legal difficulties. Many individuals with bipolar disorder abuse drugs or alcohol during manic episodes, and some of these develop secondary substance abuse problems.

Early Signs of Bipolar Disorder

The following are early warning signs for bipolar depression, which can be difficult to detect:

• Reduced activity or/and low interest in activities you generally find enjoyable
• Loss of motivation, while being indifference and apathetic
• This that were easy to do feels to be difficult
• Sadness that won’t go away
• Decreased energy and overall weakness
• Isolation and social withdrawal
• Increased sleeping or not being able to sleep
• Lowered self-esteem and reduced confidence
• Heightened self-criticism, guilt and shame
• Irritability, anxiousness, and outburst of anger
• Physical pains aches without apparent explanation
• Dramatic change in appetite and weight
• Confusion and difficulty in making decisions
• Strong sense of hopelessness or despair
• Reduced cognitive capacity, slow thinking process and impaired memory
• Inability to focus with feeling of Chaos
• Suicidal thoughts or ideation – thinking about or planning to commit suicidal act or hurting oneself.

Mood Disorders

Mood disorder is a category of mental health problems that include all types of depression and bipolar disorder. Mood disorders are sometimes called affective disorders.

The following are the most common types of mood disorders:

• Major Depression – a two-week period of a depressed or irritable mood or a noticeable decrease in interest or pleasure in usual activities, along with other signs of a mood disorder.
• Dysthymia (dysthymic disorder) – a chronic, low-grade, depressed or irritable mood for at least one year.
• Manic Depression (bipolar disorder) – at least one episode of a depressed or irritable mood and at least one period of a manic (persistently elevated) mood.
• Mood Disorder due to a general Medical Condition – many medical illnesses (including cancer, injuries, infections, and chronic medical illnesses) can trigger symptoms of depression.
• Substance Induced Mood Disorder – symptoms of depression that are due to the effects of medication, drug abuse, exposure to toxins, or other forms of treatment.

Management of Bipolar Disorder

Bipolar disorder can be frightening to both people with the illness and their family members. In addition, because bipolar disorder often develops early in life and has disruptive effects on functioning, the illness can interrupt normal development and interfere with people’s desires to achieve their aspirations. However, there are very good reasons to be hopeful that through collaborative work among individuals, their families, and practitioners, bipolar disorder can be successfully managed and people can achieve their personal life goals. Many people with bipolar disorder are extremely bright, talented, and creative. For example, the writer Virginia Woolf, the artist Vincent van Gogh, and the actress Patty Duke all had bipolar disorder. With proper treatment and family help, individuals with bipolar disorder can pursue and fulfill their life goals and dreams.

Because the symptoms of bipolar disorder can be quite severe and can have a major effect on people whom the person is close to, family therapy can be very helpful in the management of the condition. The primary goal of family therapy for bipolar disorder is to teach the family, including the client, information and skills necessary to effectively manage this condition. Family therapy is provided in a collaborative, positive, educational fashion in order to inform all family members about bipolar disorder and to get everyone working together. Families can play a critical role in helping to monitor the symptoms of bipolar disorder, collaborating with the treatment team to prevent relapses, and working together to achieve personal and shared goals. To accomplish this, family therapy usually involves educating the family about bipolar disorder, improving communication skills, and teaching problem solving techniques so that families are able to solve problems on their own.

Resources

• Organizations
• Depression and Bipolar Support Alliance (DBSA), (800) 826-3632

The DBSA educates the public concerning the nature of depressive and bipolar illnesses as treatable medical diseases.

• Mood Disorders Society of Canada (MDSC)
• The Depression and Bipolar Support Alliance (DBSA)
• The Canadian Mental Health Association

Books

Berger, D., & Berger, L. (1991). We Heard the Angels of Madness: A Family Guide to Coping with Manic Depression. Written by the mother and sister of a person who developed bipolar disorder, this guide intersperses the telling of their family story with practical advice to families on how to cope with the disorder.

Burns, D. D. (1980). Feeling Good: The New Mood Therapy..

A classic self-help book that describes how to identify and challenge self-defeating, negativistic thoughts that underlie depression.

Duke, P., & Hochman, G. (1992). A Brilliant Madness: Living with Manic-Depressive Illness.

An autobiography by the actress about her experience of living with bipolar disorder, including excellent first-person accounts of many of the symptoms.

amison, K. R. (1996). An Unquiet Mind: A Memoir of Moods and Madness.

A moving autobiography by a noted psychologist and professor of her struggle with bipolar disorder, which is also the focus of her research.

Miklowitz, D. J. (2002). The Bipolar Disorder Survival Guide: What You and Your Family Need to Know.

This is a user-friendly guide for consumers and family members about how to manage bipolar disorder, written by a leading authority on family treatment for this disorder-very readable and helpful.

Wurtzel, E. (1994). Prozac Nation: Young and Depressed in America.

An excellently written memoir by a young woman who developed symptoms of bipolar disorder soon after graduating college.