A Self-Care Program for People with Mood Disorders


by Jan Stephen Maizler,LCSW

Mood disorders like depression or manic depressive illness affect as much as 8 per cent of the world’s population and account for billions of dollars worth of lost wages, salaries, and costs of treatment. No one knows the exact amounts, but the economic, social, and personal costs are staggering. Almost as staggering is the fact that most sufferers of mood disorders are insufficiently informed as to what they need to do to get well and stay well. This article addresses this very question. Finally, this article is devoted to people who suffer from ongoing painful mood states, not those people who have an occasional “blue” day.

DRUG THERAPY- Because bipolar (manic-depressive) and unipolar (depression) mood disorders are often and generally “chemical” in origin, it is essential that you are evaluated by a medical doctor skilled in the evaluation and treatment of mood disorders. This will generally mean seeing a psychiatrist skilled in psychopharmacology. If they are not available, talk with your primary care physician about their comfort and ability to help you with your mood disorder.When drug therapy is used to stabilize and maintain your mood, it is best for you to think of psychotropic medication as a “suit of clothes.” This is to say that you need to “try them out.” In addition, once they are chosen, they may need to be altered along with the inevitable changes inside you and your life. In any event, anti-depressant medication and/or mood stabilizing medication may take weeks to work, because it takes time for “meds” to build to a therapeutic level in your bloodstream. It is important for you not to give up hope during this period, although your suffering might be great: chances are great that some class of medication will work.

PROPER REST- Because mood disorders cause metabolic, and “sleep-wake” abnormalities, it is essential to try to get the proper rest. It is important for you to realize that rest does not need to mean deep sleep. Listening to relaxing tapes or watching fish in a bowl can be restful. People with active mood disorders may need more rest because of the exhaustion of the painful symptoms themselves, or the effort fighting those symptoms.Conversely, people with mood disorders need to avoid stress and over exertive activities, since exhaustion and the triggering of heightened symptoms can result. People with mood disorders need to give themselves regular predictable rest periods for healing and reenergizing: late nights out may simply be too harmful. It is important to realize it is not just the amount of rest-restoration, but the regularity of the rest cycle also that contributes to a balanced mood.

ACTIVITY-EXERCISE- Supplemental physical activity is as important as rest in the stabilization of mood, and healing affective suffering. Features of appropriate activity are that:
1. It is over and above the normal activities of daily living.
2. Be performed daily for at least 30 minutes.
3. Be of a moderate aerobic nature, which raises the heart rate, and involves the entire body, such as brisk walking.Check with your doctor or appropriate health care professional before you begin to exercise. Exercise has been proven to be inherently mood elevating, combats psychomotor retardation, and binds anxiety.

PROPER NUTRITION- An essential part of any self-care program is giving yourself adequate and thorough nutrition. In active mood disorders, nutrition is critical for many reasons.
1. People with active mood disorders are often not hungry and have no appetite.
2. Therefore less food is eaten, and malnutrition is more likely.
3. Malnutritive states can worsen pathological mood states, and also cause illness.
It is not uncommon for people suffering from depression to self-medicate with certain food groups because they may feel temporarily “better.” Common foods that are abused by affective sufferers are sugary foods (like ice cream, candy, cakes, and chocolate), coffee, starchy carbohydrates (like pasta), and wine. Although this may be a micro step above the self-starvation of other depressed people, it is still not adequate and thorough nutrition.The desired goal is for the establishment of proper diet and nutrition. This will ultimately be stabilizing for your mood disorder. Initially, this may mean forcing yourself to eat other foods, or to eat, period. It is important to seek help from your doctor and a nutritionist as well.

PSYCHOTHERAPY- Another essential pillar of self-care for mood-disordered people is psychotherapy, or as it is commonly known, therapy. The definition of therapy is a verbal means of ameliorating symptoms and/or promoting growth with an appropriately trained professional. Although you might be able to choose amongst clinical social workers, clinical psychologists, psychiatrists, psychiatric nurse practitioners, and mental health counselors, it is essential that you pick one that has extra training and experience in the evaluation and treatment of mood disorders. In addition, because psychotherapy complements drug therapy, it is extremely desirable for the therapist to have a thorough knowledge of all psychotropic medication. Sometimes an initial goal of therapy is to provide emotional support for your suffering during the drug stabilization process: imagine having a therapist that does not know it takes antidepressants at least a few weeks to show their possible benefits! My experience in over 25 years of private practice is that there are comparatively few mood disorder expert therapists. The most important thing in choosing your therapist is to inquire and ask!Some of the things you’ll be discussing and working with in therapy are:
1. Coping with the pain of your symptoms
2. Discussing get-well strategies
3. Working on changing your depression-feeding ideas into healthier ones
4. Venting your feelings
5. Discussing and managing your stressors
6. Learning to read your symptoms to prevent relapse
7. Discussing your family’s or marriages’ reactions to your suffering
8. Learning to avoid relapse-inducing situations or behaviors, such as any drug or alcohol use.Important qualities to look for in a mood disorder therapist are expertise, patience, and availability, amongst others.

SUPPORT GROUPS- Support groups differ from therapy groups in that they are frequently leaderless, cost nothing or little, and encourage active supportive relationships and friendships outside the group. Although support is the primary function of these groups, they also offer you a way out of your isolation, a sense of fellowship, and opportunities for education and insight about your mood disorder. It is important to add membership in a support group to your list of self-care “must-do’s.”People who suffer from mood disorders are much more likely to get better and stay well longer when they follow a cogent and effective self-care program.


Jan Stephen Maizler, MSW, LCSW is a veteran mood disorder therapist practicing in Miami for over thirty years. He is a highly published author with numerous books and articles to his credit. He can be reached at 305-940-1564