Dr. Abigail H. Benudis, MD, MPH

Episodes may be a mixture of both manic and depressive symptoms. In such an episode, individuals with bipolar disorder may feel sad, empty, and hopeless but have a high level of energy at the same time. Sometimes, changes in mood are less dramatic. For example, individuals may feel happy and think everything is fine, but people around them may notice their mood changes. Episodes like this are called hypomania. If an individual is hypomanic and does not receive proper treatment, their condition will likely worsen.

Generally considered a lifetime illness, the disorder begins in the late teen or early adult years. Bipolar disorder has no known cause, but research has shown that it tends to run in families. To diagnose it, a psychiatrist carefully assesses an individual's moods and behavior patterns. They may also be asked to keep a daily record of their moods and other factors that can help with diagnosis and determining the right course of therapy. Counseling is a typical form of treatment, as is a group of medications that can control symptoms, called antipsychotics.

We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.

Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.

Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.

OCD frequently revolves around themes such as the fear of contracting germs or the fear of death. Common obsessions include:

• Fear of getting contaminated by people or the environment
• Extreme concern with order or precision
• Fear of death or behaviors perceived as risky
• Fear of accidents, disasters, and traumatic incidents

These obsessions and compulsions often contribute to anxiety, depression, and recurring emotions of fear and disgust. People with OCD cannot "turn off" their patterns of thought or behavior, and thus must continually grapple with urges to behave or think in a certain way, as well as the emotions associated with these urges. Some OCD patients describe their entire life as revolving around their obsessions and compulsions and this can result in their missing out on important school and social activities, travel, and family time. The impact of OCD is extensive and can even make daily activities like drinking, reading, sleeping, and eating extremely difficult.

The obsessions manifest in compulsive behaviors that can have negative implications on one's life. Some examples of compulsive behaviors include, among others:

• Excessive hand washing or showering
• Constant reordering or arranging of items
• Refusal to fly, drive, or participate in other activities
• Refusal to leave one's residence

Obsessive-compulsive disorder affects adults, adolescents, and children. OCD has been observed in children as young as five or six years of age, usually through sensitivity issues, obsessions about dirt or germs, or repeated doubts. The cause of obsessive-compulsive disorder is unknown. However, a person's likelihood of developing the condition may be increased by a number of variables such as family history, stressful life events, and pre-existing mental health disorders.

OCD is diagnosed based on a patients' reported symptoms. For example, a pediatrician or child psychiatrist may ask children (or their parents) how often they wash their hands or experience behavioral urges. Psychiatrists will evaluate patients for other symptoms and may instruct patients to describe their mental processes, thought patterns, and previous traumatic experiences.

While there is no cure for OCD, treatment can greatly improve patients' functioning in daily routines and activities. A common treatment for OCD is cognitive behavioral therapy (CBT), which helps patients identify negative patterns of thought and behavior and learn how to adjust them. Aversion therapy may also help those who have a fear of germs or contamination by forcing them to confront their fear and slowly overcome it. Many patients also benefit from counseling to address the anxiety, stress, and trauma that may accompany OCD. Other treatments for OCD include oral medications such as selective serotonin reuptake inhibitors (SSRIs, which are antidepressants) to normalize levels of a brain chemical called serotonin, which may improve OCD symptoms. Medications such as fluoxetine (Prozac) and sertraline (Zoloft) can help alleviate OCD-related behavioral urges, anxiety, and depression. Many OCD patients also find OCD support groups helpful to learn new coping strategies, to socialize, and to verbalize their emotions and experiences.

It is important to note that while OCD is a common mental health disorder, it is not a personality trait. The term "OCD" is sometimes used to informally describe someone having a tendency towards organization or orderliness. This usage is pervasive but inappropriate - OCD is a severe, life-altering condition. Some people with OCD who successfully manage their symptoms find that they may benefit from other traits that may be associated with OCD, such as high attention to detail and precision.