Clinical Psychology
Mood Disorders
Major Depression
Depression is a common medical illness, with 10-25% of women and 5-12% of men developing depression over their lifetimes. Symptoms may include depressed mood, anhedonia (being unable to enjoy previously pleasurable activities), sleep disturbance (either too little or too much sleep), weight changes, fatigue or loss of energy, inability to think or concentrate, difficulty making decisions, and recurrent thoughts of suicide or death. Other symptoms may occur, including headaches, backaches, constipation, memory difficulties, and increased irritability. To make a diagnosis of major depression these mood changes must occur every day for at least two weeks.
Various medications and psychotherapies are also used to treat depression. Among the most effective psychotherapies are cognitive therapy and interpersonal psychotherapy. Cognitive therapy focuses on recognizing how one’s thinking becomes negatively distorted in the context of depression and then offers strategies to combat these distortions. Interpersonal psychotherapy is a brief (12-16 week) treatment which focuses on current interpersonal problems and utilizes techniques such as reassurance, clarification of feeling states, and improvement in interpersonal communication.
At New England Neurological Associates our psychiatrist is Marc Sadowsky, M.D., and our psychologist is Robert Moverman, Ph.D.
Manic Depression
Manic depression is a mood disorder characterized by moods which can range from profound elation to profound depression. The elated states are called mania while the depressed states are called depression. This illness is also referred to as bipolar disorder with the two poles being mania and depression.
Mania is characterized by elated or irritable mood, increased energy, racing thoughts, decreased need for sleep, and an increase in goal directed activities, including taking on more projects at work or at home. During a manic episode people may experience an increase in their sex drives leading to promiscuous behavior and they may engage in spending sprees, spending thousands of dollars on unnecessary items. In more severe cases of mania psychotic symptoms may develop in which the person believes that he is a famous, wealthy, or powerful person. Such beliefs are known as delusions of grandeur.
While mania can often feel very good, it often comes at a cost. Manic episodes are often followed by depressive episodes which can be severe and in which the person may become unable to function, depressed, unable to eat, and suicidal. Further, left untreated, these episodes can worsen over time, becoming more intense and frequent.
Manic depression is a medical illness treated with medications. Psychotherapy and family involvement are also very important elements in the treatment.
Psychiatrists specialize in the pharmacologic treatment of mood disorders. At New England Neurological Associates our psychiatrist is Marc Sadowsky M.D.
Anxiety Disorders
Anxiety disorders are common conditions in the US. According to a recent study, 24.9 percent of Americans will develop an anxiety disorder during their life, with women (30.5 percent) being more likely than men (19.2 percent) to develop such a disorder. Anxiety disorders include panic disorder, agoraphobia, generalized anxiety disorder, simple phobia, and social phobia, with social phobia being the most common at 13.3 percent of the population.
Panic Disorder
Panic disorder afflicts approximately 3.5 percent of Americans over their lifetimes, with women (5 percent) being more likely to develop panic than men (2 percent).
A panic attack is defined as a discrete period of intense fear or discomfort in which people experience the onset of at least four of these symptoms within ten minutes of onset: 1.) palpitations, pounding heart, or accelerated heart rate; 2.) sweating; 3.) trembling or shaking; 4.) sensations of shortness of breath or smothering; 5.) feeling of choking; 6.) chest pain or discomfort; 7.) nausea or abdominal distress; 8.) feeling dizzy, unsteady, lightheaded, or faint; 9.) derealization (feeling of unreality) or depersonalization (being detached from oneself); 10.) fear of losing control or going crazy; 11.) numbness or tingling sensations; 12.) chills or hot flashes.
Panic disorder is defined as one or more of panic attacks that were unexpected and not triggered by being the focus of attention of other people. Further, four of these attacks must occur in a four week period or one or more attacks followed by a one month period of persistent fear of having another attack.
Panic disorder is often a very disabling condition. People with panic attacks often feel as though they are having a heart attack and present to an emergency room where they undergo diagnostic tests which are all normal. This is often quite frustrating because the person knows that there is something wrong with them but may be told "it’s just a panic attack" or "it’s in your head."
Psychotherapy, particularly cognitive behavioral psychotherapy, is often a very effective treatment for panic. This therapy focuses on helping the person identify the symptoms of panic and recognizing that these are not dangerous symptoms but rather exaggerated responses to normal physiologic phenomena.
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