Article on Managing Mood Disorders

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Managing Moods
by Bob Murray and
Alicia Fortinberry

Understanding and overcoming mood disorders.

I hate you! Linda screamed one second before the plate of spaghetti flew from her hand towards her husband's head. Paul ducked just in time, but the next missile, a wet dishtowel, hit its mark and blinded him temporarily.

In the ten years of their marriage, Linda and Paul had survived numerous such incidents. Linda would fly into uncontrollable rages, sometimes, it seemed, as a result of Paul's equally frequent depressive episodes, when he would disappear for hours, occasionally overnight. In reality the origin of both their emotional problems lay in childhood experience, which is the root cause of most mood disorders.

Paul and Linda are not alone in suffering from these kinds of problems. Recent research suggests that the incidence of depression alone is doubling every twenty years.

In our latest book, Creating Optimism: A Proven Seven-Step Program for Overcoming Depression (McGraw-Hill, 2004 ), we show how people like Linda and Paul can understand and overcome their mood disorders. In fact, almost any relationship can be made so supportive that it becomes an important part of the healing process.

Mood disorders come in many forms, some of them deeply disguised. Depression, for example, can manifest itself as a physical illness. Studies show that 80% of people who visit physicians suffer from depression. Unfortunately, less than half of all doctors are able to recognize "somatized" depression for what it is, leading to increased suffering and large bills for the wrong kind of treatment.

The cause of this depression pandemic lies in a highly dysfunctional society that puts huge stressors on families and makes it nearly impossible for children to get their developmental and personal needs met.

Linda's outbursts are a direct result of violent abuse by her father, and Paul's depression can be traced to a childhood environment so critical that several times he ran away from home to escape it. Their genetic makeup may partially explain their moods; however, most studies have shown that the genes that influence emotions lie dormant unless triggered by some outside stressor, such as abuse or childhood trauma.

Whatever the cause, the good news about all mood disorders is that they can be managed and, for the most part, controlled without drugs. (We are not against drug therapy; there are people who do well on antidepressants or medications to control manic depression or anxiety. These pharmaceuticals, however, are grossly over-prescribed and many have toxic side effects. In addition, they can be highly addictive and may only work for a limited number of people. Antidepressants, for example, help about 50% of people at best.)

Here are a few things that you can immediately begin to do to control your moods.

Realize that your moods are not your fault. You can't help being depressed or anxious (or both since the one is merely the neurochemical flip-side of the other and sometime they rotate). You did not choose to be depressed and you can't turn the mood off just because other people find it inconvenient to be around you when you're down.

Discover the root cause of the problem. (You may need some help either from a professional therapist or from a friend that you really trust.) The child within is angry, anxious or depressed about something . Almost all ongoing mood disorders have their origins in childhood stresses. Some of the most common are: parental divorce, fear of abandonment, parental alcoholism, criticism and, of course, verbal, physical and sexual abuse. The incidence of childhood abuse in the U.S. has increased 70% over the last thirty years.

Discovering the source of your problems is not a "blame game." Parents mostly do their best under difficult circumstances. Nor is it an attempt to get at "hidden" memories that can be "recovered." You can usually deduce what happened in your childhood from the pattern of your relationships in later life. If you gravitate toward people who don't praise you or who criticize you, then you can be fairly sure that criticism or lack of praise was a feature of your childhood home, even if you've forgotten the actual incidents. There's an old saying that we "only marry our mother, our father or both." There's a lot of truth to that - especially if you broaden it to include all the significant adults in your early life, bearing in mind that to a four-year-old, a five-year-old is an adult.

Identify the triggers in the present situation that are provoking the inner child to become anxious, depressed or angry. Linda's anger was provoked by Paul's depression, because when her father got down about anything he lashed out at her. Her rage was at the abuse. At these times, in her unconscious mind, Paul became her father. The trigger for Paul's depression was his feeling that whatever he did for Linda was never enough; there seemed no praise, no recognition for his efforts. Just like home.

Ask yourself (perhaps along with your friend or therapist): "What about this situation reminds me of the past?" Sometimes the trigger can be very small: a tone of voice, the clothes someone wears, an implied criticism, a raised hand, an unexpected touch or a demand for sexual intimacy when you're not ready.

Work out how you can avoid these triggers. Of course, you can't ask somebody to change his or her mood. You can, however, tell others what you need them to do in order to avoid situations that provoke or trigger you. These "needs" must be very specific and describe actions rather than feelings or thoughts. Otherwise, people won't be sure what you want them to do. One of Paul's needs of Linda was, "I need you to praise me when you think I've done something right." One of hers was, "I need you to tell me what is bothering you and talk to me about it."

Relationships are all about giving and receiving needs. They go astray when we're forced to second-guess what is required of us. Mood disorders are the result of relationships gone wrong in childhood and can be corrected by relationships that go right.

Both Linda and Paul agreed to take the necessary steps to save the relationship - and help each other manage their mood disorders - by recognizing each other's triggers and devising concrete actions they could take to avoid them.

The important thing to remember is that you can't change yourself, by yourself . Despite what pop-psychology and many self-help books tell you, there's no mechanism in our brain for self- improvement. Human beings are social animals; we learn by observing and reacting to others. You learn how to form relationships by the way your parents (or other significant adults) related. You learn parenting skills in the same way.

But we can also change our moods and our behaviors by changing the basis of our relationships in all aspects of our lives. By basing our relationships on our concrete, doable and action-oriented needs, we undo the "programming" of the past and become the people we were meant to be.

We can't always control our moods, but we can teach others to help us to do so. That's the human way.

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