Feeling and time: the phenomenology of mood disorders, depressive realism, and existential psychotherapy.

Full Abstract

Phenomenological research suggests that pure manic and depressive states are less common than mixtures of the two and that the two poles of mood are characterized by opposite ways of experiencing time. In mania, the subjective experience of time is sped up and in depression it is slowed down, perhaps reflecting differences in circadian pathophysiology. The two classic mood states are also quite different in their effect on subjective awareness:
manic patients lack insight into their excitation, while depressed patients are quite insightful into their unhappiness. Consequently, insight plays a major role in overdiagnosis of unipolar depression and misdiagnosis of bipolar disorder. The phenomenology of depression also is relevant to types of psychotherapies used to treat it. The depressive realism (DR) model, in contrast to the cognitive distortion model, appears to better apply to many persons with mild to moderate depressive syndromes. I suggest that existential psychotherapy is the necessary corollary of the DR model in those cases. Further, some depressive morbidities may in fact prove, after phenomenological study, to involve other mental states instead of depression. The chronic sub-syndromal depression that is often the long-term consequence of treated bipolar disorder may in fact represent existential despair, rather than depression proper, again suggesting intervention with existential psychotherapeutic methods.

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Author information

Author/s: Ghaemi, S Nassir (SN);

Affiliation: Emory Clinic, 1365 Clifton Road, Atlanta, GA 30322, USA. nghaemi@emory.edu

Grants: MH-64189 (Agency:United States NIMH)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Schizophrenia bulletin (Schizophr Bull), published in United States. (Language: eng)

Reference: 2007-Jan; vol 33 (issue 1) : pp 122-30

Dates: Created 2006/12/21; Completed 2007/03/19; Revised 2007/12/03;

PMID: 17122410, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Awareness
Bipolar Disorder - diagnosis; psychology; therapy
Circadian Rhythm
Cognition Disorders - diagnosis; psychology; therapy
Cognitive Therapy - methods
Depressive Disorder - diagnosis; psychology; therapy
Diagnostic Errors
Emotions
Existentialism - psychology

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