CBT for Depression
and Bipolar

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Understanding Depression and Bipolar Spectrum Disorders

Each person may experience mood symptoms in their own way. Treatment starts with understanding your unique symptoms and situation.

Clinical depression generally falls into two categories. Major Depression is an episode of depressed mood and related symptoms lasting at least two weeks. Dysthymia, also called Persistent Depressive Disorder, is a chronic, lower-grade depression — at least two years — with fewer symptoms than Major Depression, but no less real. Common symptoms across both include a sad or "empty" mood, loss of interest in activities you once enjoyed, fatigue, feelings of hopelessness or worthlessness, and changes in sleep or appetite.

Bipolar Spectrum Disorders describe a continuum of mood conditions involving both depressed mood and mania or hypomania, or a mixed mood state. Bipolar I Disorder (sometimes called Manic Depressive Illness) includes a fully manic episode — it's the most well-known but least common form. Bipolar II Disorder involves a hypomanic, or "smaller," manic episode. A mixed mood state combines depressive symptoms — low interest, feelings of worthlessness — with hypomanic symptoms like irritability, high energy, or reduced sleep. As with depression, each person experiences these conditions in their own way.

For additional information: NIMH on Major Depression | Hopkins Medicine on Dysthymia | Mood Spectrum Diagnosis by Jim Phelps, MD

Together, We’ll Work To:

  • Identify your values and priorities, and set goals around them

  • Understand how your thoughts, sleep, and activity levels influence your mood

  • Identify vulnerabilities and triggers that contribute to mood instability

  • Establish daily routines that support mood stability

  • Notice and shift thoughts or behaviors that worsen mood symptoms

  • Engage in behavioral activation when depressed, and limit striving during elevated mood states

  • Learn skills for self-compassion, mindfulness, and emotion regulation

  • Support you in your goal of improved mood

  • Identify your strengths and how to draw on them

  • Learn additional DBT skills like opposite action and wise mind

  • Coordinate with a psychiatrist when medication may be part of your care

Most clients meet weekly until symptoms improve (typically 10–20 sessions), then taper to less frequent sessions to maintain their progress.