Mood Disorder Center: Rigorous Evaluation and Individualized Care

Clinicians at the Child Mind Institute regularly treat mood disorders, including depression. The newly established Mood Disorders Center takes our commitment further, bringing a complete diagnostic evaluation and a variety of treatment options under one roof so that patients and families can better understand symptoms and how different treatments can help — now and in the future. The result is a thoroughly evidence-based approach that also recognizes the individuality of every child who seeks treatment, ensuring they get the highest quality care and the support they deserve.

Dr. Jill Emanuele directs the center, and stresses the importance of rigorous evaluation before any treatment decisions are made, as mood disorders in youth frequently go unrecognized or are misunderstood. “What happens out there in the world is that people get diagnoses that are wrong or do not explain the whole picture,” Dr. Emanuele says. “What we do here is nail down what is happening — effectively diagnose depression and whatever other disorders are co-occurring — so we can formulate a plan and recommend the best treatment.”

Within the Mood Disorders Center, the primary treatment options include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). Mindfulness based interventions, which have a growing evidence base for the prevention and treatment of depression, can be incorporated into treatment sessions when indicated. In addition, when medication may be warranted as part of the treatment, clinicians collaborate with board certified child and adolescent psychiatrists on the service to provide comprehensive care using both therapy and medication.

Overall, the specific treatment that is recommended depends on the specific needs of the child and the family. Every intervention takes into account that depression is often a chronic disorder. “If you have a first episode of depression, especially in adolescence, there is a strong possibility you may relapse and have a second episode,” says Dr. Emanuele. “Depression can become a lifelong problem.” With that critical understanding in mind — that these disorders often affect the wellbeing of children into the future — focusing on prevention is a central part of the service.

“What we’re trying to do is not only resolve the symptoms and the illness, but also teach skills to help prevent relapse,” Dr. Emanuele says. “These treatments have different components to help people not only recognize and understand their depression but to start thinking about what happens when the symptoms come back. For example, using skills in DBT and challenging your thoughts in CBT — these strategies can help people to improve and remain well.”

Bringing as many resources as possible into treatment, including the family itself, helps achieve that goal. “One thing we do really well is work with families,” Dr. Emanuele says. “The family is an essential component of the process.” This is particularly true for more intensive interventions like DBT, where family participation is a structured part of the treatment.

Above all, clinicians are attuned to the real pain and disruption that come from the symptoms that children, adolescents and young adults can experience, like persistent feelings of sadness, irritability or explosive anger, and impulsive decision-making, and to designing the appropriate intervention. “The focus on matching the right treatment to the right symptoms and life circumstances doesn’t just apply within the service,” Dr. Emanuele says, “but throughout the clinical services at the Child Mind Institute.” Clinicians constantly tailor interventions to the individual. What does someone get out of treatment at the Child Mind Institute? As Dr. Emanuele puts it: “Support, treatment and hope.”