DBT has been researched and proven effective for treating people with intractable or med-resistant depression. DBT can also be helpful for those receiving psychotropic medicine for depression but want additional tools or life skills to help cope with everyday life.

People with clinical depression suffer from: - Fatigue or loss of energy almost every day - Feelings of worthlessness or guilt almost every day - Impaired concentration, indecisiveness - Insomnia or hypersomnia (excessive sleeping) almost every day - Markedly diminished interest or pleasure in almost all activities nearly every day (called anhedonia, this symptom can be indicated by reports from significant others) - Restlessness or feeling slowed down - Recurring thoughts of death or suicide - Significant weight loss or gain (a change of more than 5% of body weight in a month)

Major depression affects about 6.7% of the U.S. population over age 18 according to the National Institute of Mental Health. Overall 20-25% of adults may suffer an episode of major depression at some point during their lifetime.

DBT is an effective treatment for people who struggle with anxiety disorders. Research shows that mindfulness techniques help people who struggle with anxiety (Harvard Heath Blog, 2015) and mindfulness is an integral part of DBT treatment.

Anxiety disorders include generalized anxiety disorder, social anxiety, and panic disorders as well as post traumatic stress disorder (PTSD), obsessive-compulsive disorder and specific phobias.

Symptoms of panic attack include:
- Racing heart
- Weakness or dizziness
- Tingling or numbness in the hands and fingers
- Sense of terror or impending doom or death
- Cold sweat or chills
- Chest pains
- Breathing difficulties
- Feeling a loss of control

Anxiety disorders are the most common mental illness in the U.S., affecting 18.1% of adults, according to leading specialists in anxiety treatment. (Source: NIH, 2015).

DBT helps people with emotion regulation challenges to build mastery over the ups and downs of everyday life. With Bipolar I and II, many people struggle with the lows of depression and the highs of hypomania and mania. 2.6% of the adult population have Bipolar Disorder (NIMH). DBT skills help people learn about emotions and how they work, and provide tools to help people build resiliency to negative emotions and to shift out of emotions or be successful in riding out emotions.

DBT has been researched with people who have bipolar disorders. The sample sizes of the research studies have not been large enough to be statistically significant. There is preliminary evidence however, that DBT skills reduce depressive symptoms, improve affective control, and improve mindfulness self-efficacy in bipolar disorders. Its application warrants further evaluation in larger studies. (Journal of Affective Disorders, Van Dijk, Jeffry, Katz, 2013).

At Awake DBT, we have seen first-hand many individuals with bipolar disorders benefit from treatment.

DBT has found to be an effective treatment those struggling with eating disorders, specifically for those struggling with binging and purging, bulimia nervosa. When targeted, these behaviors have been proven to decrease with DBT treatment.

Bulimia nervosa is characterized by recurrent and frequent episodes of eating unusually large amounts of food (e.g., binge-eating), and feeling a lack of control over the eating. This binge-eating is followed by a type of behavior that compensates for the binge, such as purging (e.g., vomiting, excessive use of laxatives or diuretics), fasting and/or excessive exercise. Unlike anorexia nervosa, people with bulimia can fall within the normal range for their weight. But like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Bulimia nervosa affects 0.3% of the adult population (NIMH).

DBT has been proven affective with substance abuse issues. One relevant study was published in the American Journal on Addictions from Marsha M. Linehan Ph.D.,Henry Schmidt III M.A., Linda A. Dimeff Ph.D., J. Christopher Craft B.S., Jonathan Kanter M.A., and Katherine A. Comtois Ph.D. (October 1999). Subjects were assessed at 4, 8, and 12 months, and at a 16-month follow-up. Subjects assigned to DBT had significantly greater reductions in drug abuse than did subjects assigned to treatment as usual.

Other studies specifically studied DBT relative to abuse of methanphetamines and opioids. One summary stated that DBT and its adaptation may also be effective for substance abuse patients with multiple, complex problems rooted in emotional dyscontrol who have not responded to other evidence-based approaches. (Science and practice in action—Dialectical Behavior Therapy. DBT for Substance Abusers by Linda A. Dimeff, Ph.D., and Marsha M. Linehan, Ph.D. 2008)

DBT has been researched and proven effective to treat people with post traumatic stress disorder (PTSD). PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
- At least one re-experiencing sym
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms

Re-experiencing symptoms include:
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
- Bad dreams
- Frightening thought

Avoidance symptoms include:
- Staying away from places, events, or objects that are reminders of the traumatic experience
- Avoiding thoughts or feelings related to the traumatic event

Arousal and reactivity symptoms include:
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping
- Having angry outbursts

Cognition and mood symptoms include:
- Trouble remembering key features of the traumatic event
- Negative thoughts about oneself or the world
- Distorted feelings like guilt or blame
- Loss of interest in enjoyable activities

At Awake DBT, we offer DBT plus Prolonged Exposure for those with PTSD. For those who want to treat the trauma, we individualize the treatment plan and timing that is effective with the integration of DBT skills.

Borderline personality disorder (BPD) is a mental health disorder that impacts the way people think and feel about themselves and others, causing problems with functioning in everyday life. It includes a pattern of unstable intense relationships, distorted self-image, extreme emotions, and impulsiveness. It affects 1.6% of the adult population. (NIMH).

With borderline personality disorder, people have an intense fear of abandonment or instability and may have difficulty tolerating being alone. Inappropriate anger, impulsiveness and frequent mood swings may push others away, even though people with BPD may want to have loving and lasting relationships.

DBT was originally developed to help people who were emotionally dysregulated. These were people that were often suicidal and self harming, many with borderline personality disorder. Marsha Linehan, PhD, has researched DBT extensively. DBT has been proven more effective than treatment as usual for people with BPD.