Depression and Bipolar

Depression is an illness which causes prolonged feelings of sadness, anxiety, hopelessness, helplessness; loss of interest and motivation in previously enjoyed activities; feelings of guilt for little or no apparent reason; difficulties in thinking, concentration or in making decisions; increased or reduced appetite along with a change in weight; difficulty sleeping or waking up; general feelings of being tired; feelings of low self-esteem or worthlessness; and thoughts, plans or attempts at suicide. A person may be diagnosed with depression when these types of symptoms are present for at least two weeks.

Depression -- also known as Major Depressive Disorder or Unipolar Disorder -- is often recurrent (multiple episodes) and can evolve into a chronic condition. This chronic condition, called Dysthymia, is characterized by the constant presence of depressive symptoms of moderate severity for period of several years with brief or no symptom-free periods.

Periods of depression may also be mixed with periods of greatly elevated and euphoric moods most commonly referred to as manic episodes or mania (in certain cases this may also come across as an irritable mood). The combination of depression and manic episodes is known as Bipolar Disorder.

For people with Bipolar Disorder, manic episodes are marked by prolonged feelings of extreme optimism and/or lack of judgment, dramatically increased activity levels, excessive planning, taking part in risky activities that may include the possibility of pain or injury, making overly ambitious and grand plans, greatly reduced need for sleep without feeling tired, racing thoughts and an increase in impulsive activities such as spending or sexual indiscretions, for example. It’s a common misconception that these periods of mania are “good times” when in fact they often cause severe damage to one’s life and relationships.

Mood disorders, including depression and bipolar disorder, are the most frequently occurring mental disorders. Factors that may contribute to the occurrence of a mood disorder include traumatic events during early development and life stressors; genetic predisposition; and biochemical changes. The belief that mood disorders may be related to a lack of willpower or other character flaws is not supported by research.

The Royal’s Mood Disorders Program serves people over the age of 18 with known or suspected depression, bipolar disorder, or dysthymia.  The program specializes in treating severe cases of mood disorders which require a higher level of service than may be offered by an acute care hospital. These cases are often treatment-resistant and recurrent or chronic.

Taking into account a wide view of the patient’s situation, the program’s philosophy is to regard care as a respectful partnership between the patient and staff.  This translates into treatment which takes in to account the patient’s personal story as well as their ideas and feedback. Each patient is cared for by a team of professionals including psychiatrists, psychologists, nurses, occupational therapists, dietitians, social workers and recreation therapists.  The program provides individual and group therapy to the client as well as family and marital therapy when require.  We also assess of each patient’s accommodation, financial, work, leisure and nutritional needs in order to support their overall wellbeing.

The Royal focuses on full psychiatric rehabilitation. The goal is to ensure that someone with a mental illness has the physical, emotional and intellectual skills they need to live, learn, and work in his or her own particular environment. The Royal Outpatient Clinic develops a comprehensive individualized strategy to help prevent relapses and ensure the patient receives proper ongoing care.

The Mood Disorders Program includes an inpatient service for individuals that require more intensive and prolonged care resources as well as an outpatient clinic.  The outpatient clinic develops comprehensive individualized strategies to help prevent relapses and ensure that patients receive proper ongoing care after discharge from the
inpatient unit.

The outpatient unit may also provide services to patients referred by other hospitals or directly by community psychiatrists or family physicians.  The clinic would work as a complement to the patient’s other mental health-care provider to help prevent relapse and recurrence; and to treat ambulatory, treatment-resistant depressed patients including those who also have a substance abuse disorder.

Referral
A physician referral is needed for assessment and/or follow-up in our Mood Disorders Program. For a referral or general inquiry please phone 613.722.6521 ext 6211.

Discharge
Each patient discharged from the inpatient unit of The Royal’s Mood Disorders Program has a discharge plan which is coordinated by the unit social worker and involves all members of the treatment team (including the patient). Depending on the individual patient’s needs, the discharge plan may also involve family members, the substitute decision-maker (if applicable) and community partners. Every effort is made to ensure a safe and sustainable transition from the inpatient setting to the community.

Throughout the time in hospital, each patient’s supports and resources are assessed in preparation for discharge. The treatment team focuses on areas such as social supports, housing, finances, vocation and/or employment, leisure activities and daily routine.

Prior to discharge, timely follow-up appointments are scheduled with the treating psychiatrist and other mental health service providers (where applicable).

Discharge from the outpatient program follows a similar process, except that psychiatric care is transitioned back to the referral source, often family physicians or community psychiatrists. Information about community resources is given and referrals are made where necessary.

The Royal’s Resources to Support Patients and Their Caregivers

  • Family Information and Support Groups -- 613.722.6521 ext. 6421
  • Patient and Family Resource Centre -- 613.722.6521 ext. 6899
  • Consumer and Family Advisory Groups -- 613.722.6521 ext. 6871

Community Resources
The following are some resources available in the Ottawa community for individuals with mood disorders: