Jesse Jackson Jr.’s treatment: What are mood disorders?

They used to be called “nervous breakdowns,” the mysterious disappearances of high-profile people who for whatever reason temporarily couldn’t cope with ordinary life.

That “Mad Men”-era term is long gone, replaced with phraseology that is more clinical and less visual. People don’t “break down” any more. They have acute depressive episodes, develop anxiety disorders, abuse substances, experience relapses or, in some cases, simply suffer from exhaustion.

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Rep. Jesse Jackson Jr. is under intensive medical treatment for a \

Rep. Jesse Jackson Jr. is under intensive medical treatment for a "mood disorder," his office said in a brief statement Wednesday, more than a month after the Chicago Democrat quietly went on a medical leave of absence.

The description of what’s happening to Rep. Jesse Jackson Jr. (D-Ill.) fits this medical view of adult timeouts. His office said the 47-year-old lawmaker “is receiving intensive medical treatment at a residential treatment facility for a mood disorder . . . and is expected to make a full recovery.”

Jackson’s exact diagnosis isn’t known. “Mood disorders,” however, come in two general types — depression and mania. Their combined occurrence in manic depression, now known as “bipolar disorder,” is an increasingly popular diagnosis. There are numerous subtypes of depression, such as “dysthymia” — a less-severe but longer-lasting form — as well as mood disorders associated with alcohol and drug use.

“For somebody in his position, hospitalization would be the last option because of all the publicity. So there must be a very good reason,” said Gary S. Sachs, founding director of the bipolar clinic at Massachusetts General Hospital in Boston.

The most common reason is safety--prevention of suicide or other self-harm, Sachs and several other experts said. But for a congressman, there may be other considerations.

“In this world of ours where people are observed moment-to-moment, it’s really very difficult to conceal depression,” said Samuel Barondes, director of the Center for Neurobiology and Psychiatry at the University of California in San Francisco. “His handlers may be concerned that he might do things or say things that won’t damage anybody but that will damage his reputation and the public’s perception.”

There was a time when a severely depressed person could expect to spend months in a psychiatric hospital, with daily psychotherapy and group activities. That era is also largely gone.

Today the goal is to begin treatment — usually with antidepressant or mood-stabilizing drugs — and create a plan for outpatient care. The latter usually consists of talk therapy with a psychologist or social worker and medication monitoring with a psychiatrist. The same is true for conditions such as severe anxiety that aren’t mood disorders, but often occur alongside them.

If the problem is alcohol or drug use, detoxification, education, and treatment with group therapy and 12-step programs are usually the goal.

“Hospital observation ensures that doctor and patient can read signs for triggers, make sure medication is working well, and combat damaging thoughts,” said Nada Stotland, former president of the American Psychiatric Association.

Often, however, simply taking a break is therapeutic. Rest, a rethinking of priorities, a temporary letting-go of daily responsibilities can be a form of what’s known as “milieu therapy”.

It is hard for people in the public eye to take such breaks. But it’s not unknown.

In 1994, Neil A. Rudenstine, the president of Harvard University, took a leave from his job because of “exhaustion.” He had been on the job for three years. An acting president stood in for him. Three months later, Rudenstine returned and served until 2001.

Alyssa A. Botelho contributed to this report.

 
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