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Outline

The Mood Spectrum: Diagnosis in the DSM-5™ Era

• Major Depressive Disorder
• Persistent Depressive Disorder
• Depression with Mixed Features
• Cyclothymic Disorder
• Bipolar II Disorder
• Bipolar I Disorder

• Specifiers: Anxious distress, melancholic, atypical, seasonal & peripartum moods
• Mania, hypomania, mixed states: How to recognize each
• Differential diagnosis: Anxiety, addiction, ADHD, eating disorders, substance abuse
• Bipolar Disorder or Borderline Personality Disorder?

Assessment: Practical Tips, Evidence-Based Tools, and Subclinical Features

• How to avoid over-diagnosing
• Evidence-based measures: MINI-7; PHQ-9, MDQ, Bipolarity Index, & Hypomania Checklist
• Why traditional mood charting doesn’t work – and what to do instead
• Affective temperaments: Depressive, Hyperthymic, Cyclothymic and Irritable
• Rumination, cognitive deficits, and early warning signs
• Conceptualizing mood through the lens of energy, not emotion
• Classic v. atypical Bipolar Disorder
• When mood is shaped by trauma

THERAPY FOR MOOD DISORDERS: FROM EVIDENCE-BASED TREATMENTS TO A PERSONALIZED PLAN

Mood Disorder Must-Haves for Every Treatment Plan

• Psychoeducation – reduce stigma, identify causes, focus on prevention
• Psychotherapy – how to match mood with the approach
• Concrete interventions – create a “menu” the client can choose from
• Positive psychology: the unique strengths of mood disorders
• Family therapy – communication skills, boundaries, crisis plans
• Remediation strategies for building back cognitive skills deficits

Behavioral Activation: More Than Building a Busy Schedule

• Neuroscience: Turning down the brain’s default mood network
• Integrating values and meaning in behavioral change
• How behavior challenges depressive beliefs
• Strategies: Opposite action, approach-avoidance, mindful media

Rumination-Focused CBT (RF-CBT)

• How is RF-CBT different from traditional CBT?
• Useful v. dysfunctional rumination
• The benefits of rumination
• Shift from avoidant rumination to absorbing action
• The neurobiological basis of RF-CBT
• Strategies: Chain analysis, habit changing, immersion, mindfulness and compassionate thought

Cognitive Behavioral Analysis System of Psychotherapy (CBASP)

• An attachment-based approach to treating mood disorders
• Preoperational thinking: Why chronic depression is slow to change
• Positive and negative reinforcement in chronic depression
• Evidence to support CBASP for chronic depression
• Strategies: Interpersonal inventory, situational analysis, interpersonal discrimination

Social Rhythm Therapy

• Therapy with a biological basis
• Four routines that stabilize the biological clock
• Circadian rhythms, neurohormones and neuroplasticity
• Strategies: Brisk awakening, zeitgebers, social rhythm chart

Cognitive Behavioral Therapy for Insomnia

• How a therapy for sleep treats depression
• Sleep drive and circadian rhythms
• The vicious cycle of anxiety and insomnia
• Basic steps: Sleep hygiene
• Advanced moves: Bed restriction
• Special situations: Screen time, jet-lag, napping, night owls, and shift work

An Antidepressant Lifestyle

• Nutrition: The MediMod Diet, probiotics, caffeine, alcohol and sugar
• Physical Activity: When, where, how much
• Environment: Dawn simulation, light and dark therapies, nature, music, aromatherapy and air ionization

Medication

• Why a clear diagnosis is crucial before starting any medication
• Anti-depressants and mood stabilizers: New classes, old standards
• Benefits, risks, side effects; how to recognize problems
• How medication impacts therapy: State-dependent learning
• The Medication Interest Model: A Motivational Interview for Medication Adherence
• Top supplements for mood disorder
• Beyond medication: Transcranial Magnetic Stimulation, Electroconvulsive Therapy, esKatamine

Crisis Intervention

• The therapeutic relationship with the suicidal client
• A collaborative approach to risk assessment
• Which symptoms warrant hospitalization?
• CBT for Suicidality: How therapy can present suicide
• Strategies: Hope box, coping cards, and distress tolerance skills
• Emergency planning

Clinical Considerations

• Countertransference issues in depression and mania
• Staying within your scope of practice
• Children and adolescents: DMDD v. Bipolar Disorder
• Multicultural considerations

Faculty