What Are the Causes of Manic Depression?

A manic depression is different from a normal depression in the fact that a person not only has periods where he feels very sad, he also has periods of time where he feels himself abundantly well. Although this may sound good, this is not the case as people loose reality of who they are and what they can do. Some people for instance think they are superman or god and will act in the same way.

Their are many possible causes that are the root of this order but the truth is we do not know exactly how a disorder like Manic Depression is caused. However, from what we do know scientific research has shown that there is a genetic link. The incidence of this disorder is higher among patients where their father or mother also had manic depression. This does not explain the whole process why some people do and others will not get this disorder.

The threshold theory says that everybody has a chance on manic depression, but for one person the chance is much higher than for the other. If you will get a certain disorder like manic depression would depend on the amount of stressful life events. So this theory states that it is a combination between sensitivity and stressful life events.

Although this theory has some very strong points, it also has some flaws as it is a very general one not pointing to the very complicated structure of the brain. More research is needed on this topic before we can fully understand what are the causes of manic or bipolar depression.

Watching For the Dark Signs of Depression

All of us have had some kind of encounter with depression. That is, a continual state of extreme sadness or pain whether or not it is founded or particularly directed at someone or something.

You may suspect someone you know of suffering from depression. If so, check the warning signs below to see if they are exhibiting.

If you have noticed that a person becomes easily irritated or agitated over minor issues, you may be observing the beginning signs of depression, especially if this is not typical of their behavior. Attempt to gently talk with this person to see if they might need help.

Occasional feelings of emptiness are familiar to all of us. If, however, you know someone who can seem to talk of nothing else, you should encourage him to speak to a professional who can help him deal with his emotions of despair.

Watch for sudden changes in lifestyle, including oversleeping or sleep deprivation. This may be contributing to the individual's heightened irritability and be a sign that he is suffering from emotional turmoil.

Sudden or unexplained bodily aches and pains also point to depression. If a doctor is unable to medically pinpoint the root of chronic headaches or chest pains, it may be an indicator that a visit to the psychiatrist is in order.

If someone has recently undergone some kind of trauma, like a bad breakup, divorce or loss of a loved one, it is almost certain that this is the source of his depression. As a friend or family member, you need to be gentle and patient in offering as much support as possible so that the individual battling depression can sort through his issues and overcome his problems.

These are the classic symptoms that persistently recur in most confirmed cases of depression. If you have noticed a number of these symptoms in someone you know, talk to them. Let them know that they matter to you and that you are worried about their wellbeing. Your care and concern may save their life and discourage them from doing something regrettable.

The Early Signs of Depression Can Be As Straightforward As Fatigue and Insomnia

A large percentage of people may not even realize they are depressed. Being down mentally, whether from loss of a job, divorce or even moving can cause stress which then can lead to a mild form of depression in many people causing the early signs of depression like fatigue, lack of energy, irritability, insomnia or even sleeping too much. Some people can develop short tempers and cannot handle the daily stresses of life if overloaded with responsibilities; this too can lead to depression in some people.

If your feelings or the cause of depression are not dealt with these feelings can escalate to feelings more intense such as feeling sad, life can seem meaninglessness or hopeless. Hobbies or activities that once were fun have no interest to you. It might also be difficult to focus or make decisions.

Feeling sad or having bleak thoughts are also early signs of depression but when feelings start to turn towards drinking alcohol in excess to feel better or thoughts of suicide then consider these warning signs of depression. Symptoms can also include physical ailments like headaches and vague symptoms that never go away or cannot be diagnosed by a doctor.

Most everyone will deal with some form of depression in their life so do not feel alone. There is help out there from many sources; whether just talking to a family or church member, friend or a counselor. If you think you might be experiencing the warning signs of depression go see your doctor especially if severe thoughts are consuming you.

If you have a mild case of depression or just in one of the slumps in life there are other alternative remedies and medicines to treat your symptoms which have been around for many years and can be just as effective as pharmaceutical medicines.

Depression During Menopause

Menopause is a disease associated with biological factors. It occurs in every woman as they grow old. This makes it difficult to deal with it. There are many beliefs associated with menopause depression. Some people associate menopause with depression. Some believe that menopause and depression occur simultaneously. The symptoms of menopause and depressions are similar. They include hot flashes, irritability, sleep disorders, anxiety, change in food habits, and lack of interest in any activity. Women are more prone to depression during menopause than men.

The visible depression symptoms and menopause symptoms in women are dejection, feeling extremely sad, melancholy, and worthlessness. This is caused by the less secretion of the hormone 'serotonin' in the body which is responsible for the mood fluctuations. They also experience extreme sadness and confusion. It may also trigger the feeling of suicidal tendencies in them. These things are quite normal in women. Care should be taken to handle this situation otherwise it would lead to severe health problems.

The first step that should be considered is that you should clearly understand the problem. Women, most susceptible to the disease, are those women, who had undergone some surgery, smoking, had managed many children, or had a stressful life. Apart from these, women with premenstrual syndrome and postpartum depression are also highly vulnerable to depression. Depression during menopause can be effectively treated with the help of doctor's treatment.

Some physical problems are also associated with depression during menopause. They include stressful relationships, divorce, and anxiety about the life when you grow old.
Tips for managing menopause depression are enlisted below:

Basically, there is no cure for menopause. Some doctors recommend hormonal therapy as a treatment. We can undertake some simple steps as a strategy to cope depression during menopause. They are enlisted below:

Undergo regular medical examination. It would help you to keep a track all the changes taking place in the body and take necessary precautions:

- Regular exercise and right nutrition
- Relax using meditation and yoga
- Opt for other herbal medicines and therapies that help you to curb its effects
- There are many tests available online that can be utilized to find out whether you are depressed or not
- Adopt changes in lifestyle that will foster the treatment of depression
- Join social groups wherein you can share and discuss your problem. It would help you to control your anger and frustration
- You can also bring out your feelings by jotting them down in a dairy. This would help you to overcome the mood swings
- Family members could support the patient by giving him/her a hearing to his/her problems and also helping him/her to overcome the depression
- Make a trip to a nearby garden or tourist place. Take a break from the stressful life
- Counseling sessions of psychologist may also help to overcome it

The most common symptoms of menopause are depression and frequent bouts of anger. Fighting depression is possible when proper care and support is provided to women during menopause. You can adopt different coping strategies and bring down the effect of depression. There is another option available of using antidepressants for depression treatment for women.

The most common mistake made by women is they consider menopause as a normal thing in the process of aging and don't treat them or even consult a doctor. Misconceptions related to depression during menopause should be removed and by adopting simple techniques you could easily cope up with depression. You should also change your attitude towards these bodily changes. It would assist you to deal with its effects and also bring you out of depression.

The Therapeutic Relationship Is the Most Important Ingredient in Successful Therapy

"Maybe if I have this client blink his eyes at an increased speed, while exposing him to his past, and add some cognitive behavioral therapy while sitting next to a waterfall, he may be able to function more effectively in his life!" Yes this is rather exaggerated, however it demonstrates the idea that as professionals in the field of therapy, we often seek complex theories, techniques, and strategies to more effectively treat our consumers. A large amount of our precious time is spent seeking new theories and techniques to treat clients; evidence for this statement is shown by the thousands of theories and techniques that have been created to treat clients seeking therapy.

The fact that theories are being created and the field is growing is absolutely magnificent; however we may be searching for something that has always been right under our nose. Clinicians often enjoy analyzing and making things more intricate that they actually are; when in reality what works is rather simple. This basic and uncomplicated ingredient for successful therapy is what will be explored in this article. This ingredient is termed the therapeutic relationship. Some readers may agree and some may disagree, however the challenge is to be open minded and remember the consequences of "contempt prior to investigation".

Any successful therapy is grounded in a continuous strong, genuine therapeutic relationship or more simply put by Rogers, the "Helping Relationship". Without being skilled in this relationship, no techniques are likely to be effective. You are free to learn, study, research and labor over CBT, DBT, EMDR, RET, and ECT as well as attending infinite trainings on these and many other techniques, although without mastering the art and science of building a therapeutic relationship with your client, therapy will not be effective. You can even choose to spend thousands of dollars on a PhD, PsyD, Ed.D, and other advanced degrees, which are not being put down, however if you deny the vital importance of the helping relationship you will again be unsuccessful. Rogers brilliantly articulated this point when he said, "Intellectual training and the acquiring of information has, I believe many valuable results--but, becoming a therapist is not one of those results (1957)."

This author will attempt to articulate what the therapeutic relationship involves; questions clinicians can ask themselves concerning the therapeutic relationship, as well as some empirical literature that supports the importance of the therapeutic relationship. Please note that therapeutic relationship, therapeutic alliance, and helping relationship will be used interchangeably throughout this article.

Characteristic of the Therapeutic Relationship

The therapeutic relationship has several characteristics; however the most vital will be presented in this article. The characteristics may appear to be simple and basic knowledge, although the constant practice and integration of these characteristic need to be the focus of every client that enters therapy. The therapeutic relationship forms the foundation for treatment as well as large part of successful outcome. Without the helping relationship being the number one priority in the treatment process, clinicians are doing a great disservice to clients as well as to the field of therapy as a whole.

The following discussion will be based on the incredible work of Carl Rogers concerning the helping relationship. There is no other psychologist to turn to when discussing this subject, than Dr. Rogers himself. His extensive work gave us a foundation for successful therapy, no matter what theory or theories a clinician practices. Without Dr. Rogers outstanding work, successful therapy would not be possible.

Rogers defines a helping relationship as , " a relationship in which one of the participants intends that there should come about , in one or both parties, more appreciation of, more expression of, more functional use of the latent inner resources of the individual ( 1961)." There are three characteristics that will be presented that Rogers states are essential and sufficient for therapeutic change as well as being vital aspects of the therapeutic relationship (1957). In addition to these three characteristics, this author has added two final characteristic that appear to be effective in a helping relationship.

1. Therapist's genuineness within the helping relationship. Rogers discussed the vital importance of the clinician to "freely and deeply" be himself. The clinician needs to be a "real" human being. Not an all knowing, all powerful, rigid, and controlling figure. A real human being with real thoughts, real feelings, and real problems (1957). All facades should be left out of the therapeutic environment. The clinician must be aware and have insight into him or herself. It is important to seek out help from colleagues and appropriate supervision to develop this awareness and insight. This specific characteristic fosters trust in the helping relationship. One of the easiest ways to develop conflict in the relationship is to have a "better than" attitude when working with a particular client.

2. Unconditional positive regard. This aspect of the relationship involves experiencing a warm acceptance of each aspect of the clients experience as being a part of the client. There are no conditions put on accepting the client as who they are. The clinician needs to care for the client as who they are as a unique individual. One thing often seen in therapy is the treatment of the diagnosis or a specific problem. Clinicians need to treat the individual not a diagnostic label. It is imperative to accept the client for who they are and where they are at in their life. Remember diagnoses are not real entities, however individual human beings are.

3. Empathy. This is a basic therapeutic aspect that has been taught to clinicians over and over again, however it is vital to be able to practice and understand this concept. An accurate empathetic understanding of the client's awareness of his own experience is crucial to the helping relationship. It is essential to have the ability to enter the clients "private world" and understand their thoughts and feelings without judging these (Rogers, 1957).

4. Shared agreement on goals in therapy. Galileo once stated, "You cannot teach a man anything, you can just help him to find it within himself." In therapy clinicians must develop goals that the client would like to work on rather than dictate or impose goals on the client. When clinicians have their own agenda and do not cooperate with the client, this can cause resistance and a separation in the helping relationship (Roes, 2002). The fact is that a client that is forced or mandated to work on something he has no interest in changing, may be compliant for the present time; however these changes will not be internalized. Just think of yourself in your personal life. If you are forced or coerced to work on something you have no interest in, how much passion or energy will you put into it and how much respect will you have for the person doing the coercing. You may complete the goal; however you will not remember or internalize much involved in the process.

5. Integrate humor in the relationship. In this authors own clinical experience throughout the years, one thing that has helped to establish a strong therapeutic relationship with clients is the integration of humor in the therapy process. It appears to teach clients to laugh at themselves without taking life and themselves too serious. It also allows them to see the therapist as a down to earth human being with a sense of humor. Humor is an excellent coping skill and is extremely healthy to the mind, body, and spirit. Try laughing with your clients. It will have a profound effect on the relationship as well as in your own personal life.

Before delving into the empirical literature concerning this topic, it is important to present some questions that Rogers recommends (1961) asking yourself as a clinician concerning the development of a helping relationship. These questions should be explored often and reflected upon as a normal routine in your clinical practice. They will help the clinician grow and continue to work at developing the expertise needed to create a strong therapeutic relationship and in turn the successful practice of therapy.

1. Can I be in some way which will be perceived by the client as trustworthy, dependable, or consistent in some deep sense?

2. Can I be real? This involves being aware of thoughts and feelings and being honest with yourself concerning these thoughts and feelings. Can I be who I am? Clinicians must accept themselves before they can be real and accepted by clients.

3. Can I let myself experience positive attitudes toward my client - for example warmth, caring, respect) without fearing these? Often times clinicians distance themselves and write it off as a "professional" attitude; however this creates an impersonal relationship. Can I remember that I am treating a human being, just like myself?

4. Can I give the client the freedom to be who they are?

5. Can I be separate from the client and not foster a dependent relationship?

6. Can I step into the client's private world so deeply that I lose all desire to evaluate or judge it?

7. Can I receive this client as he is? Can I accept him or her completely and communicate this acceptance?

8. Can I possess a non-judgmental attitude when dealing with this client?

9. Can I meet this individual as a person who is becoming, or will I be bound by his past or my past?

Empirical Literature

There are obviously too many empirical studies in this area to discuss in this or any brief article, however this author would like to present a summary of the studies throughout the years and what has been concluded.

Horvath and Symonds (1991) conducted a Meta analysis of 24 studies which maintained high design standards, experienced therapists, and clinically valid settings. They found an effect size of .26 and concluded that the working alliance was a relatively robust variable linking therapy process to outcomes. The relationship and outcomes did not appear to be a function of type of therapy practiced or length of treatment.

Another review conducted by Lambert and Barley (2001), from Brigham Young University summarized over one hundred studies concerning the therapeutic relationship and psychotherapy outcome. They focused on four areas that influenced client outcome; these were extra therapeutic factors, expectancy effects, specific therapy techniques, and common factors/therapeutic relationship factors. Within these 100 studies they averaged the size of contribution that each predictor made to outcome. They found that 40% of the variance was due to outside factors, 15% to expectancy effects, 15% to specific therapy techniques, and 30% of variance was predicted by the therapeutic relationship/common factors. Lambert and Barley (2001) concluded that, "Improvement in psychotherapy may best be accomplished by learning to improve ones ability to relate to clients and tailoring that relationship to individual clients."

One more important addition to these studies is a review of over 2000 process-outcomes studies conducted by Orlinsky, Grave, and Parks (1994), which identified several therapist variables and behaviors that consistently demonstrated to have a positive impact on treatment outcome. These variables included therapist credibility, skill, empathic understanding, affirmation of the client, as well as the ability to engage the client and focus on the client's issues and emotions.

Finally, this author would like to mention an interesting statement made by Schore (1996). Schore suggests "that experiences in the therapeutic relationship are encoded as implicit memory, often effecting change with the synaptic connections of that memory system with regard to bonding and attachment. Attention to this relationship with some clients will help transform negative implicit memories of relationships by creating a new encoding of a positive experience of attachment." This suggestion is a topic for a whole other article, however what this suggests is that the therapeutic relationship may create or recreate the ability for clients to bond or develop attachments in future relationships. To this author, this is profound and thought provoking. Much more discussion and research is needed in this area, however briefly mentioning it sheds some light on another important reason that the therapeutic relationship is vital to therapy.

Throughout this article the therapeutic relationship has been discussed in detail, questions to explore as a clinician have been articulated, and empirical support for the importance of the therapeutic relationship have been summarized. You may question the validity of this article or research, however please take an honest look at this area of the therapy process and begin to practice and develop strong therapeutic relationships. You will see the difference in the therapy process as well as client outcome. This author experiences the gift of the therapeutic relationship each and every day I work with clients. In fact, a client recently told me that I was "the first therapist he has seen since 9-11 that he trusted and acted like a real person. He continued on to say, "that's why I have the hope that I can get better and actually trust another human being." That's quite a reward of the therapeutic relationship and process. What a gift!

Ask yourself, how you would like to be treated if you were a client? Always remember we are all part of the human race and each human being is unique and important, thus they should be treated that way in therapy. Our purpose as clinicians is to help other human beings enjoy this journey of life and if this field isn't the most important field on earth I don't know what is. We help determine and create the future of human beings. To conclude, Constaquay, Goldfried, Wiser, Raue, and Hayes (1996) stated, " It is imperative that clinicians remember that decades of research consistently demonstrates that relationship factors correlate more highly with client outcome than do specialized treatment techniques."

References

Constaquay, L. G., Goldfried, M. R., Wiser, S., Raue, P.J., Hayes, A.M. (1996). Predicting the effect of Cognitive therapy for depression: A study of unique and common factors. Journal of Consulting and Clinical Psychology, 65, 497-504.

Horvath, A.O. & Symonds, B., D. (1991). Relation between a working alliance and outcome in psychotherapy: A Meta Analysis. Journal of Counseling Psychology, 38, 2, 139-149.

Lambert, M., J. & Barley, D., E. (2001). Research Summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38, 4, 357-361.

Orlinski, D. E., Grave, K., & Parks, B. K. (1994). Process and outcome in psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy(pp. 257-310). New York: Wiley.

Roes, N. A. (2002). Solutions for the treatment resistant addicted client, Haworth Press.

Rogers, C. R. (1957). The Necessary and Sufficient Conditions of Therapeutic Personality Change. Journal of Consulting Psychology, 21, 95-103.

Rogers, C. R. (1961). On Becoming a Person, Houghton Mifflin company, New York.

Schore, A. (1996). The experience dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Development and Psychopathology, 8, 59-87.

Five Signs That You May Be Bipolar

Chances are if you're reading this article, you think you or your loved one is bipolar. One can only know for sure if they have bipolar disorder by seeing a licensed medical professional. While awaiting medical help, you can view this list to see if you have some of the common bipolar symptoms.

Five signs that you may have bipolar disorder, also known as manic depression:

1. Experiencing mood swings. Mood swings are the most common symptom of bipolar disorder as it is known as a mood disorder. If you have mood swings going from down to happy and back again frequently, you could have bipolar disorder.

2. Having suicidal thoughts. If you have suicidal thoughts, you could be suffering from the depression side of bipolar disorder. If you have other symptoms as well as suicidal thoughts at times, you could have bipolar disorder.

3. Racing thoughts. In the midst of bipolar mania, racing thoughts are common. If you're feeling restless and as though you can't concentrate because your mind is racing, this could be a sign that you have manic depression.

4. Acting impulsively. Another symptom of bipolar mania is acting impulsively and without thinking things through. If you get more impulsive at times, sometimes to your detriment, you could be bipolar.

5. Lose of interest. When a person has bipolar depression, they sometimes lose interest in things they were once excited about. This includes hobbies, sex and relationships. If you find yourself in this situation without much explanation, consider talking with a doctor for a diagnosis.

After you've read these five signs, you may find that most of them fit what you're experiencing. I would like to reiterate that the best way to know you have manic depression is to see a qualified therapist.

Leaving Depression Behind

Depression is more than that sense of feeling "down" or discouraged at times when things are not going well. Depression involves sadness, pessimism, a preoccupation with personal problems, and perhaps self-pity, anguish, crying, and hopelessness.

Symptoms of depression can range from mild versions such as temporary withdrawal, low energy, tiredness and sleeping problems over moderate forms such as feelings of inadequacy or worthlessness, decreased productivity, poor concentration or poor appetite to severe symptoms of recurrent thoughts of death or suicide.

There are many reasons why you might feel depressed. You may undergo major life changes such as divorce, separation, loss of a job, retirement or moving town. Or you may feel unhappy about your marital situation or fear physical and mental problems of old age. Or you may be sensitive to the change of seasons. As we enter the dark time of the year, you may suffer from the lack of light.

Depression may also occur without any outer trigger. Perfectionism, low self worth, mood swings, dissatisfaction with life, the chronic use of alcohol or other drugs or even prescribed medications may lead to depression.

There are many effective ways to deal with depression.

You can use exercises to increase the energy level which has a major impact in dealing with depression. Depressed people mostly use shallow upper breathing. The chest is collapsed and in breath seems to be difficult. The Latin word for "breathing in" is inspirare, a word which we find in inspiration and to inspire. If the breath is shallow, you may lack inspiration. Exercises help to increase the breath and in this way the level of inspiration.

You can learn to control your thoughts and feelings and replace the typical negative thought habits that focus on problems and faults with a realistic appraisal of the small successes and joys of life that we all experience no matter how challenging the conditions may be.

You may explore new activities and interests that give you satisfaction, help you to feel good about yourself, and keep the mind off problems and negative thoughts and emotions. On top of it, they open the door to meet like minded people, improve conversation skills and help in making and keeping friends.

You can replace bad habits of blaming, criticising and expecting the worst through assertiveness skills, good problem-solving skills, positive thinking and humour.

The most difficult part may be to get the first step and then keep walking towards a self-empowered life. To support you, I offer a range of options suitable for each pocket.

I offer on my website free articles and a free course with suggestions of how you can cope with depression. The eBook 'Beyond suffering' will help you to discover the four pillars of how to grow joy in your life and provide tools for transforming restrictive life patterns on the mental, emotional and physical level.

Sometimes, a depression may reach so deep that it may feel like a task too big to even start the journey out of it.

This deep-rooted resignation has to do with the underlying energetic structure that keeps depressive thought forms, habits and feelings in place. For basic shifts to happen the body-mind-system needs rewiring so that new options become available in order to successfully cope with depression.

The distance courses provide a continuous support by shifting the resonance with those energetic patterns that keep the depression in place