Navigating the Dark & The Light:
Mood Disorders Guide
Depression isn't just sadness, and Bipolar isn't just "moodiness." Understanding the biology behind your mood is the first step to stabilizing it.
Medically Reviewed by David Glenn, PMHNP-BC
Real Psychiatric Services • Columbus, OH
"Just snap out of it." "Look at all the good things in your life."
If you could "just be happy," you would be. At Real Psychiatric Services, we understand that Major Depressive Disorder and Bipolar Disorder are not choices. They are biological conditions involving the complex regulation of neurotransmitters like Serotonin, Dopamine, and Norepinephrine.
Depression is Physical, Not Just Mental
We often think of depression as crying or feeling sad. But clinically, depression is a "whole body" shut down. It affects your sleep architecture, your appetite, and your pain receptors.
In our Columbus clinic, we screen for the symptoms that patients often miss:
Anhedonia
The inability to feel pleasure. It’s not that you are "sad"—it’s that the things you used to love (hobbies, music, food) feel like nothing. You are going through the motions in grayscale.
Psychomotor Retardation
Feeling physically heavy, as if you are moving through molasses. Your speech might slow down, and getting out of bed requires a Herculean effort.
Bipolar Disorder: It's Not Just "Mood Swings"
The term "Bipolar" is often misused in casual conversation to mean "moody." Medically, Bipolar Disorder is a serious condition defined by distinct cycles of energy.
Bipolar I vs. Bipolar II
Bipolar I: Defined by full "Manic" episodes. This is dangerous elevation where you might feel invincible, need zero sleep for days, spend money you don't have, or experience psychosis (a break from reality).
Bipolar II: Much harder to spot. It involves "Hypomania"—a milder elevation. You might just feel incredibly productive, charismatic, and energetic for a few days. However, the "crash" into depression that follows is often severe, long-lasting, and dangerous.
Seasonal Affective Disorder (SAD) in Ohio
"In Columbus, the gray skies from November to March aren't just gloomy—they are a biological trigger."
Seasonal Affective Disorder is highly prevalent in Ohio. The lack of sunlight disrupts your circadian rhythm and serotonin production. If you find yourself functioning well in July but completely shutting down in January, this is not a coincidence. We treat SAD aggressively with a combination of light therapy protocols and seasonal medication adjustments.
Stabilizing the Cycle: Tech & Science
Treating mood disorders is an art and a science. What works for anxiety can sometimes make Bipolar disorder worse (e.g., antidepressants triggering mania), which is why accurate diagnosis is critical.
1. Medication Management
- For Depression: We use SSRIs, SNRIs, or atypical antidepressants like Wellbutrin. We prioritize medications that have the lowest risk of side effects like weight gain or fatigue.
- For Bipolar: We use "Mood Stabilizers" (like Lamictal or Lithium). Think of these as guardrails—they prevent you from swerving too high into mania or too low into depression, allowing you to drive straight.
2. GeneSight® Testing (The Tech Advantage)
Are you tired of the "medication roulette"?
At Real Psychiatric Services, we offer GeneSight® Genetic Testing. This is a simple cheek swab that analyzes your DNA to see how your liver metabolizes psychiatric medications. It gives us a report that tells us:
- Which medications you might metabolize too quickly (making them ineffective).
- Which ones you metabolize too slowly (causing high side effects).
This data-driven approach allows us to "fast track" you to the right medication, saving months of trial and error.
Treatment-Resistant Depression (TRD)
If you have tried two or more antidepressants and still feel stuck, you may have Treatment-Resistant Depression. You are not "untreatable"—you just haven't found the right key for your lock.
Our specialized providers at 4770 Indianola Ave are experts in TRD. We look at the whole picture—hormones, vitamin deficiencies, sleep apnea, and trauma—to find the root cause that others may have missed.
Patient FAQ
Is depression curable?
Depression is treatable and manageable. Many patients experience full remission of symptoms. For others, it is a chronic condition that requires ongoing management, similar to diabetes or asthma. Our goal is to get you to "remission"—where symptoms no longer control your life.
If I start medication, will I be on it forever?
Not necessarily. Many patients take medication for 6-12 months to stabilize their brain chemistry while they learn coping skills in therapy. We will work with you to create a safe plan for tapering off when the time is right. For Bipolar Disorder, long-term medication is often recommended to prevent relapses.