Mood Disorders Health Article

Treatment

The most effective treatment for mood disorders is a combination of medication and psychotherapy. The four different classes of drugs used in mood disorders are:

• heterocyclic antidepressants (HCAs), like amitriptyline (Elavil)
• selective serotonin reuptake inhibitors (SSRI inhibitors), like fluoxetine (Prozac), paroxetine (Paxil), and sertra-line (Zoloft)
• monoamine oxidase inhibitors (MAOI inhibitors), like phenelzine sulfate (Nardil) and tranylcypromine sulfate (Parnate)
• mood stabilizers, like lithium carbonate (Eskalith) and valproate, often used in people with bipolar mood disorders

A number of psychotherapy approaches are useful as well. Interpersonal psychotherapy helps the patient recognize the interaction between the mood disorder and interpersonal relationships. Cognitive-behavioral therapy explores how the patient's view of the world may be affecting his or her mood and outlook.

When depression fails to respond to treatment or when there is a high risk of suicide, electroconvulsive therapy (ECT) is sometimes used. ECT is believed to affect neurotransmitters like the medications do. Patients are anesthetized and given muscle relaxants to minimize discomfort. Then low-level electric current is passed through the brain to cause a brief convulsion. The most common side effect of ECT is mild, short-term memory loss.

Alternative treatment

There are many alternative therapies that may help in the treatment of mood disorders, including acupuncture, botanical medicine, homeopathy, aromatherapy, constitutional hydrotherapy, and light therapy. The therapy used is an individual choice. Short-term clinical studies have shown that the herb St. John's wort

(Hypericum perforatum) can effectively treat some types of depression. Though it appears very safe, the herb may have some side effects and its long-term effectiveness has not been proven. It has not been tested in patients with bipolar disorder. St. John's wort and antidepressant drugs should not be taken simultaneously, so patients should tell their doctor if they are taking St. John's wort.

Prognosis

Most cases of mood disorders can be successfully managed if properly diagnosed and treated.

Prevention

People can take steps to improve mild depression and keep it from becoming worse. They can learn stress management (like relaxation training or breathing exercises), exercise regularly, and avoid drugs or alcohol.

BOOKS

Gold, Mark S. The Good News About Depression: Cures and Treatments in the New Age of Psychiatry. New York: Bantam Books, 1995.

Kramer, Peter D. Listening to Prozac: A Psychiatrist Explores Antidepressants and the Remaking of Self. New York: Viking Penguin, 1993.

"Mood Disorders." In Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994.

PERIODICALS

Jamison, Kay Redfield. "Manic-Depressive Illness and Creativity." Scientific American (Feb. 1995): 62-67.

Michels, Robert, and Peter M. Marzuk. "Progress in Psychiatry." The New England Journal of Medicine 329 (26 Aug.1993): 628-38.

Price, Lawrence H., and George R. Heninger. "Lithium in the Treatment of Mood Disorders." The New England Journal of Medicine 331 (1 Sept. 1994): 591-98.

Whybrow, Peter C. "Making Sense of Mania & Depression." Psychology Today (May/June 1997): 35-38, 71-72.

ORGANIZATIONS

American Psychiatric Association. 1400 K Street NW, Washington DC 20005. (888) 357-7924. <http://www.psych.org>.

National Depressive and Manic Depressive Association. 730 N. Franklin St., Ste. 501, Chicago, IL 60610. (800) 826-3632. <http://www.ndmda.org>.

National Institute of Mental Health. Mental Health Public Inquiries, 5600 Fishers Lane, Room 15C-05, Rockville, MD 20857. (888) 826-9438. <http://www.nimh.nih.gov>.

Robert Scott Dinsmoor

KEY TERMS

Cognitive therapy—Psychotherapy technique designed to help people change their attitudes, perceptions, and patterns of thinking.

Electroconvulsive therapy (ECT)—Therapy for mood disorders that involves passing electrical current through the brain in order to create a brief convulsion.

Neurotransmitter—A chemical that aids or alters the transmission of impulses between the points that connect nerves.

Serotonin—A chemical messenger in the brain thought to play a role in mood regulation.