UCH Psychiatry Outpatient Service
Mood Disorders Clinic
For Patients
The Mood Disorders Clinic is open to all adults who are patients of the UCH outpatient clinic. The clinic also accepts patients referred by their psychiatrists in the community. It is a gateway to complete assessment, systematic treatment and experimental approaches.
Depression is a problem marked by periods of feeling so sad, blue or lonely that it affects the person’s ability to relate to family and friends or work efficiently. The depression also affects things like sleep, appetite, concentration, and self-confidence.
Some people experience the opposite with periods of high energy and activity, less need for sleep and over-confidence that may lead to risky behaviors. If severe enough, this is called mania, which is the hallmark of Bipolar Disorder.
Mood disorders cause various combinations of mood symptoms over time. Some patients may have mainly irritable mood or confusing mixtures of depression, excitement, anxiety and irritability.
Hours of Operation
Mondays 1:00 p.m. - 5:00 p.m.
Tuesdays 1:00 p.m. - 5:00 p.m.
To Make an Appointment:
303-724-1005
What to Expect
First Appointment: As a patient at the Mood Disorders Clinic, your first appointment will take about two hours. You will be interviewed to see if there is a diagnosable mood disorder or whether your symptoms may be due to other psychiatric or medical conditions. Your lifestyle and personality will also be evaluated to determine whether they contribute to anxiety. To make this easier, you may be asked to complete a questionnaire about your past before the appointment.
Treatment: In the Mood Disorders Clinic, treatment is a partnership between the patient and physician. You will be educated about your condition and the physician will provide a variety of tools to manage it. The goal is the fewest, briefest and mildest symptom periods and a return, as much as possible, to life as it was before your mood disorder.
Under the supervision of a University of Colorado faculty psychiatrist, your physician (a psychiatry resident) will work with you to design a specialized treatment plan based on how severe your current problem is and how much your daily life is affected by it. In addition, your treatment plan will consider other medical problems that may be affecting your health or well-being. This plan may include more testing, gathering additional information, prescription medicines, education about the disorder, lifestyle suggestions or psychotherapy.
If your physician recommends psychotherapy, the type will be based on research showing that it is effective for most people as well as your learning style and preferences. Group treatments can be especially helpful because patients learn from both physicians and other patients. Often both psychotherapy and medication will be recommended. It is usually helpful to involve a family member or other partner as well. Recovery Inc., a community-based organization, offers a free weekly support group during clinic hours.
Your physician will track your progress using research tools such as mood charts. You and your physician may modify the plan over time as more or less intensive treatment seems needed.
Physicians and Staff
The Mood Disorders Clinic is directed by Dr. Michael Allen, an associate professor and national authority on the treatment of Bipolar Disorder.
Other physicians at the Clinic who are on the University faculty include Dr. Marshall Thomas, who runs the Bipolar Life Skills Group, Dr. Chris Schneck, voted one of the “Best Doctors in Denver” by 5280 Magazine, Dr. Neil Weiner, also one of the “Best Doctors in Denver”, who runs the Refractory Depression Clinic and Dr. Cheryl Chessick, who specializes in psychotherapy for Bipolar Disorder.
How to Get a Referral
Your primary care physician or psychiatrist can refer you to the Mood Disorders Clinic by contacting Tanjala Wilson at 303-724-1005 to alert her to the referral. Then you should contact Ms. Wilson directly to schedule an evaluation and mention the name of your referring physician.
You may also contact Ms. Wilson to request an evaluation in the Mood Disorders Clinic without a doctor’s referral.
For Medical Professionals
The Mood Disorders Clinic originated with the National Institute of Mental Health’s Systematic Treatment Enhancement Program for Bipolar Disorder and continues many of its principles including structured assessments and collaborative care.
Patient Assessment
The initial Mood Disorder evaluation takes two hours. A basic assumption is that vulnerability to mania must be thoroughly assessed using personal and family history. Unipolar depression is a diagnosis of exclusion. Important factors considered in the evaluation of the mood disordered patient include
- Age at onset
- Specific mood symptoms
- Episode pattern
- Psychotic symptoms
- Precipitants
- Comorbidity
- Pedigree
Particular attention is paid to social rhythms, substance use, anxiety and other factors that frequently affect the course of mood disorders. Lifestyle and personality are assessed as potential contributors and therapeutic targets.
After precise diagnoses are made, specific rating scales are adopted and used regularly to assess the severity of the disorder(s) and to monitor progress over time.
Treatment
Mood disordered patients are more vulnerable than most people to wider variations in mood that are more autonomous, ie, less tightly linked to or proportional to events in the external world. Regulation of mood often requires a multifactorial approach that includes modifications of the patient’s environment and adaptation to it assisted by pharmacologic treatments directed at reducing vulnerability to mood episodes. Psychiatry residents provide evidence-based psycho-pharmacologic treatments and assess the patient’s learning style and motivation for specific evidence-based individual and group psychotherapies effective for his/her mood disorder. Residents monitor the progress of improvement over time using standardized measures such as the Inventory of Depressive Symptoms (IDS) or the Young Mania Rating Scale (YMRS).
Patients are also provided with psycho-education and support for lifestyle modifications to reduce provocative stimuli such as poor sleep habits. In addition to the psychiatry residents, psychology interns are also involved in providing evidence-based psychotherapies including specific cognitive behavioral therapies, dialectical behavior therapy, interpersonal therapy and group therapies.
Physician Consultations
The clinic provides consultations to psychiatrists in the community. These consultations take place over two to three sessions and result in a consultative report and recommendations to the referring clinician. Physicians and patients may request consultations by contacting Tanjala Wilson at 303-724-1005.
Research
Research is a major focus of the Mood Disorders Program, which seeks not only to provide the best available treatments but also to develop new knowledge and treatments. Current research of program faculty includes efforts to understand suicide (Chessick, Allen), aggressive behavior (Nordstrom, Allen), rapid cycling (Schneck), smoking (Waxmonsky) and other phenomena in mood disorders. New treatments being studied include a modified Dialectical Behavior Therapy for BD (Chessick), Behavioral Activation (Damijian), Family Focused Therapy (Miklowitz) and medications (Thomas, Allen and others). A partial list of faculty publications is available at www.stepbd.org/referencelist.html
Education
The clinic will define a body of knowledge and a specific curriculum and create learning opportunities for psychiatry residents and psychology and social work interns, including classroom didactic sessions, computer guided literature review supporting evidence-based treatments, individual and group supervision, research opportunities and electives.
Psychiatry residents will be knowledgeable in differentiating mood disorders and identifying comorbid conditions. Residents will also be familiar with evidence-based psychotherapies studied for each disorder and the evidence supporting the efficacy of these treatments.
Community Involvement
We expect the Mood Disorders Program to have a leadership role in providing educational opportunities to community-based physicians. The faculty also supports the local Depression and Bipolar Support Alliance consumer group.
Faculty
Michael H. Allen, M.D., Director
Marshall Thomas, M.D.
Christopher Schneck, M.D.
Neil Weiner, M.D.
Cheryl Chessick, M.D.
