10 Clinical Pearls for Treating Mood Disorders

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SPECIAL REPORT: BEST PRACTICES

Treating mood disorders, such as depression and bipolar disorder, involves a comprehensive approach that combines therapeutic modalities. Incorporating new information enhances outcomes. Here are my top 10 recommendations for treating patients with mood disorders.

1. Ensure accurate diagnosis. An accurate diagnosis requires a comprehensive evaluation, including a detailed patient history, symptom documentation, and noting potential cooccurring disorders.

2. Carefully manage medication. In doing, it is important to have a current understanding of the available antidepressants and mood stabilizers. Likewise, use careful monitoring to assess efficacy, adverse effects, and consider potential adjustments.

3. Consider psychotherapy. Whether cognitive behavioral therapy, interpersonal therapy, dialectical behavior therapy, or remote, psychotherapy intervention can benefit patients. Digital-based interventions can also be leveraged to aid patients.

4. Talk to patients about lifestyle modifications. Regular physical and mental activity can alleviate symptoms of depression and anxiety. Diets that are balanced and include fruits, vegetables, and whole grains with an appropriate amount of ω-3 fatty acids can improve mood. Sleep hygiene is another facet that is often neglected; encourage patients to establish a regular sleep schedule—mitigating sleep disruption is essential for appropriate physical and mental well-being.

5. Provide psychoeducation. Informing patients and families about mood disorders, treatment options, and coping strategies can enhance treatment adherence and offset bias and stigma. Support groups provide additional resources, and shared experiences can provide a soothing salve for many.

6. Do not forget to follow up. Monitoring is a crucial element of good psychiatric care. Regular, consistent check-ins to monitor progress and adverse effects can make or break the therapeutic alliance. Assessing risk of suicidality or symptoms that may need immediate attention are of paramount importance.

7. Incorporate integrated care. These approaches evoke the need for coordination with other health care providers including primary care, therapists, and other professionals to accrue a more holistic approach to treatment. It is important to address comorbidities such as anxiety disorders, substance abuse, and physical health issues that might aggravate the condition we are attempting to placate.

8. Be aware of advanced treatments. An awareness of neuromodulation including transcranial magnetic stimulation, electroconvulsive therapy, and vagal nerve stimulation, as well as rapid acting antidepressant effects from specialized medications including intranasal esketamine, intravenous ketamine, and zuranolone in postpartum depression, can expand treatment options for patients.

9. Utilize applications. Apps for mood tracking, medication reminders, and therapeutic exercises could be an area of additional enhancement.

10. Take note of clinical trials. Educate patients about the possibility of upcoming potential treatments. Every medication was once in a clinical trial, and enhancing the educational base of our patients is of paramount importance based on availability of all potential treatment modalities.

The treatment of mood disorders is best approached via a multifaceted plan that addresses the individual’s needs and evokes a collaborative involvement with the clinician. Through a combination of medication, psychotherapy, lifestyle changes, and continued support, we as health care providers can collectively enhance treatment outcomes and improve the quality of life for individuals with mood disorders.

Dr Alva is a board-certified psychiatrist, a paid consultant of Otsuka America Pharmaceutical, Inc, and Lundbeck, and Mood Disorders Section Editor for Psychiatric Times.