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Forum Name: Psychiatric Topics

Question: Is it SAD or bi-polar


 jloo74 - Tue Mar 18, 2008 2:37 pm

Hi,

I have been and on and off sufferer of depression and have begun to notice a pattern in my emotions. I tend to get depressed at around October - November (when fall changes into winter) and again during early Spring (March - April). This does not seem to be a classic case of SAD since that does not explain why I get depressed in Spring. I also lack the manic episodes that characterize bi-polar. I just feel normal the rest of the year.

I was wondering if this was common at all, and whether it might be due to the changes in my body's cicardian rhythm. Also, what kind of therapy would be most effective for this kind of depression; I do not want to be medicated. The symptoms I endure include crying easily, loss of motivation, general apathy towards people... the usual rundown. This is despite my being able to tell myself that I am behaving completely ridiculously and not being able to figure out why the hell I should be feeling this way.

Thank you!!

Jia
 Tim W Latsko - Tue Mar 18, 2008 11:37 pm

Jia Welcome to the forum,

Given your limited description, I would consider ruling out Major Depressive Disorder, Recurrent, with a Seasonal Pattern (winter and spring), given the abscence of a manic episode. That said, do not consider this your diagnosis without a face to face interview with a licensed professional.

As for the type of therapy, may I recommend first identifying the type of therapist you believe that you will be most comfortable with while exploring your symptoms. Is that therapist a male or female, what is their ethnic background, age, sexual orientation, spiritually based, I think you get the idea....The specific type of therpay most effective with the symptoms you presented, I believe is a cognitive behavorial approach.

Good luck this spring, and let us know how it goes.

Tim

One additional comment, you may want to have your Vitamin D levels checked, some symptoms of low Vitamin D levels mimic some symtpoms of depression.
 jloo74 - Thu Mar 20, 2008 9:59 am

Thanks for the feedback. I really appreciate it.

I do have some apprehension as to how I am supposed to open a conversation with a therapist. I'm not very good at expressing myself and have always felt it a little uncomfortable to be talking about my feelings. Anyhow, as a therapist yourself what kind of information would be most helpful when beginning therapy? Am I expected to provide my psychological history off the bat or should I let the therapist lead the conversation... any suggestions will be helpful here.

Also, what are the main differences between cognitive and psychodynamic approaches and is one more effective than the other? Are there drawbacks in either approach for treating depression and what should I consider before selecting one or the other? I am drawn the cognitive model because of its proven effectiveness but am also attracted to the spiritual dimension of psychodynamic approaches...
 Tim W Latsko - Fri Mar 21, 2008 11:25 pm

jloo,

In respone to your questions, emerging outcome based research suggests that the relationship shared between the patient and clinician is as equally important as the type of therapy chosen.

As for the type of therapy that is most suitable for you I recommend meeting with a therapist for 4-5 sessions and if you are not comfortable at that point ask for a referral to a therapist who uses a differing approach.

Even though you may be a bit concerned about talking, I think you will not find a problem engaging the therapist. However, just to give you a little something to start thinking about: symptoms, frequency, duration, how it is effecting your functioning, and what medications you are using; over the counter, prescription, and non-prescription medications; alcohol use; current illnesses....etc....the presenting problem also impacts the depth of exploration of developmental and other areas. As well, What do you want to accomplish in therapy?

Take care,

Tim
 jloo74 - Mon Mar 24, 2008 3:40 pm

Hi Tim,

Well, I finally took the plunge and made an appointment to see a therapist for next tuesday...hope everything works out well. *fingers crossed*

That's a good question.. i never thought about what I want to achieve from therapy. Up until now I guess finally getting myself to therapy was the achievement...

i guess i have some pondering to do.

thank you for your advice!

Jia

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