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Chris Aiken, M.D.
14 Hours 49 Minutes
Dec 15, 2020
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Chris Aiken, MD, is a psychiatrist and psychotherapist whose work focuses on natural and lifestyle approaches to mood disorders. He is the director of the Mood Treatment Center, Editor-in-Chief of The Carlat Psychiatry Report, the bipolar Section Editor for Psychiatric Times, and an instructor at the Wake Forest University School of Medicine. He hosts the weekly Carlat Psychiatry Podcast with Kellie Newsome, PMH-NP.
Dr. Aiken’s interest in mood disorders came from experience with close friends who suffered from depression. He began his career as a research assistant at the National Institute of Mental Health and went on to complete medical school at Yale and residency at Cornell and Duke Medical Centers. He remains active in research, and his work has appeared in peer-reviewed journals and books. He lives in North Carolina with his wife Lisa and twin children, David and Eleanor.
Financial: Dr. Chris Aiken is the director and founder of the Mood Treatment Center. He is a published author and receives royalties. Dr. Aiken receives a speaking honorarium, book royalties, and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Chris Aiken is a member of the North Carolina Psychiatric Association and the International Society for Bipolar Disorders. He is the president of the Forsyth County Psychiatric Association and a member of the board for Transformed Minds. He is a Distinguished Fellow of the American Psychiatric Association.
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- Conduct a collaborative assessment that avoids the stigma clients often associate with mood diagnoses.
- Differentiate among the affective temperaments of dysthymic, cyclothymic, hyperthymic, and irritable types.
- Assess how psychological trauma affects mood disorders differently.
- Distinguish between borderline personality disorder and bipolar disorder.
- Catalogue the more common cooccurring disorders of the depressed client.
- Demonstrate how to create a more effective and practical mood chart for clients to complete as homework.
- Analyze how to improve behavioral activation results by incorporating the client’s values.
- Evaluate how ruminative thinking drives depression.
- Categorize the evidence-base for the Rumination Focused CBT model.
- Apply techniques that mange countertransference to mania and depression.
- Appraise the therapeutic alliance and ethical issues around including family members in therapy sessions.
- Devise an emergency plan with clients and family in readiness for mania, hospitalization and suicidality.
- Create an attainable treatment plan that derived from Social Rhythm Therapy.
- Summarize the neuroscience of inflammation and insomnia with depression and bipolar disorder.
- Integrate the known risks and often contraindicated use of antidepressants in the treatment of bipolar disorder.
- Manage behavioral approaches that address medication adherence.
The Mood Spectrum: Diagnosis in the DSM-5™ Era
- Major Depressive Disorder
- Persistent Depressive Disorder
- Depression with Mixed Features
- Cyclothymic Disorder
- Bipolar II Disorder
- Bipolar I Disorder
- Specifiers: Anxious distress, melancholic, atypical, seasonal & peripartum moods
- Mania, hypomania, mixed states: How to recognize each
- Differential diagnosis: Anxiety, addiction, ADHD, eating disorders, substance abuse
- Bipolar Disorder or Borderline Personality Disorder?
Assessment: Practical Tips, Evidence-Based Tools, and Subclinical Features
- How to avoid over-diagnosing
- Evidence-based measures: MINI-7; PHQ-9, MDQ, Bipolarity Index, & Hypomania Checklist
- Why traditional mood charting doesn’t work – and what to do instead
- Affective temperaments: Depressive, Hyperthymic, Cyclothymic and Irritable
- Rumination, cognitive deficits, and early warning signs
- Conceptualizing mood through the lens of energy, not emotion
- Classic v. atypical Bipolar Disorder
- When mood is shaped by trauma
THERAPY FOR MOOD DISORDERS: FROM EVIDENCE-BASED TREATMENTS TO A PERSONALIZED PLAN
Mood Disorder Must-Haves for Every Treatment Plan
- Psychoeducation – reduce stigma, identify causes, focus on prevention
- Psychotherapy – how to match mood with the approach
- Concrete interventions – create a “menu” the client can choose from
- Positive psychology: the unique strengths of mood disorders
- Family therapy – communication skills, boundaries, crisis plans
- Remediation strategies for building back cognitive skills deficits
Behavioural Activation: More Than Building a Busy Schedule
- Neuroscience: Turning down the brain’s default mood network
- Integrating values and meaning in behavioural change
- How behaviour challenges depressive beliefs
- Strategies: Opposite action, approach-avoidance, mindful media
Rumination-Focused CBT (RF-CBT)
- How is RF-CBT different from traditional CBT?
- Useful v. dysfunctional rumination
- The benefits of rumination
- Shift from avoidant rumination to absorbing action
- The neurobiological basis of RF-CBT
- Strategies: Chain analysis, habit changing, immersion, mindfulness and compassionate thought
Cognitive Behavioral Analysis System of Psychotherapy (CBASP)
- An attachment-based approach to treating mood disorders
- Preoperational thinking: Why chronic depression is slow to change
- Positive and negative reinforcement in chronic depression
- Evidence to support CBASP for chronic depression
- Strategies: Interpersonal inventory, situational analysis, interpersonal discrimination
Social Rhythm Therapy
- Therapy with a biological basis
- Four routines that stabilize the biological clock
- Circadian rhythms, neurohormones and neuroplasticity
- Strategies: Brisk awakening, zeitgebers, social rhythm chart
Cognitive Behavioral Therapy for Insomnia
- How a therapy for sleep treats depression
- Sleep drive and circadian rhythms
- The vicious cycle of anxiety and insomnia
- Basic steps: Sleep hygiene
- Advanced moves: Bed restriction
- Special situations: Screen time, jet-lag, napping, night owls, and shift work
An Antidepressant Lifestyle
- Nutrition: The MediMod Diet, probiotics, caffeine, alcohol and sugar
- Physical Activity: When, where, how much
- Environment: Dawn simulation, light and dark therapies, nature, music, aromatherapy and air ionization
- Why a clear diagnosis is crucial before starting any medication
- Anti-depressants and mood stabilizers: New classes, old standards
- Benefits, risks, side effects; how to recognize problems
- How medication impacts therapy: State-dependent learning
- The Medication Interest Model: A Motivational Interview for Medication Adherence
- Top supplements for mood disorder
- Beyond medication: Transcranial Magnetic Stimulation, Electroconvulsive Therapy, esKatamine
- The therapeutic relationship with the suicidal client
- A collaborative approach to risk assessment
- Which symptoms warrant hospitalization?
- CBT for Suicidality: How therapy can present suicide
- Strategies: Hope box, coping cards, and distress tolerance skills
- Emergency planning
- Countertransference issues in depression and mania
- Staying within your scope of practice
- Children and adolescents: DMDD v. Bipolar Disorder
- Multicultural considerations
- Social Workers
- Case Managers
- Marriage & Family Therapists
- Advanced Practice Nurses
- Physician Assistants
- Addictions Counselors
- Occupational Therapists
- Other Mental Health Professionals
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