In addition to interacting with our environment, we humans are chemical reactors, as well. The various moods we experience throughout the day are caused by a variety of factors such as the neurotransmitters and hormones circulating in our bodies (chemicals), our nature (genetics) and our nurture (upbringing, our environment and belief systems).
It not well understood what causes mood disorders to occur. However, chemical imbalance in the brain is thought by some to be a primary cause. Mood disorders are a known and specific set of mental health conditions, or mental disorders, that negatively affect a person’s emotional state. Suffering from a mood disorder can severely limit your ability to function effectively in normal activities of daily living, and make it generally more difficult to show up for every day life.
According to The American Psychiatric Association, depression can affect people at any stage of life:
Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can occur at any time, but on average, first appears during the late teens to mid-20s. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime. There is a high degree of heritability (approximately 40%) when first-degree relatives (parents/children/siblings) have depression.
Being honest with your health care provider about your medical history and day to day moods can be very helpful for early diagnosis of depression symptoms.
Symptoms of Mood Disorder
The occasional depressed mood in response to the ups and downs of everyday life is, of course to be expected. However, symptoms of mood disorders such as persistent depressive disorder, severe depression or bipolar disorder, should be addressed as soon as possible. Mood disorders are considered to be serious medical conditions and can impact all areas of a person’s life. If you feel that you or someone close to you is experiencing depression in any form, is imperative to seek the advice of a medical professional.
How are mood disorders diagnosed?
Physicians or mental health professionals are the only people who can formally diagnose a mood disorder. Only by getting a complete medical history and psychiatric evaluation can a doctor, or psychiatrist, diagnose whether or not a mood disorder is affecting your life. If you suffer from depression or anxiety, symptoms to be aware of are a persistent low mood, general fatigue, hopelessness, no motivation, and loss of interest in activities you previously enjoyed.
Depression and Bipolar Disorder
Along with anxiety, Major Depression and Bipolar Disorder are two of the most common mood disorders.
Major Depression and anxiety can co-occur for a variety of reasons. Experiencing a traumatic event or having suffered a major loss are two examples of events that can trigger depression. Occasionally, certain stressful life changes, such as divorce or moving to a new city, can contribute to changes in the brain’s biochemistry, which can result in depression. Substance abuse or poor sleep habits that persist can also cause these changes. Because there can be a combination of factors, it is important to seek advice from mental health professional in order to determine whether treatment is needed, and if so, the best course to take.
Bipolar disorder which used to be called manic depression, is primarily characterized by periods of depression alternating with periods of mania, both of which can last for weeks or months. The exact cause of bipolar disorder isn’t known. However, as in most mood disorders the cause is thought to be a combination of nature (genetics), and nurture or (environment) and chemical imbalance in the brain.
The manic episodes are a state of mind marked by an increased energy and intense excitement, combined with a euphoric type of exhilaration. This condition can persist over a period of time. This drastic shift in mood and perception can interfere with work, school, and relationships. Mania is the main feature of bipolar disorder. Episodes can also include symptoms such as a loss of touch with reality, and a substantially decreased need for sleep. In severe cases, hospitalization may be required.
Bipolar and Related Disorder
The hypomanic or depressed mood phase follows the manic phase. When this occurs the individual will exhibit very low motivation and fatigue combined with a loss of interest in hobbies or daily activities. The depressive or low state is also associated with self harm or suicidal thoughts. These hypomanic and manic episodes can last for days or weeks to months.
Symptoms of Mood Disorders
The symptoms one experiences from mood disorder can vary according to the actual diagnosis. However, there are symptoms that are common to most mood disorders. These include changes in sleep patterns- either sleeping too much, or suffering from insomnia; irritability, aggression, even outright hostility; persistent sad, and anxious mood; changes in weight or appetite and difficulty concentrating.
A diagnosis of mood disorder, which are also called mood affective disorders, obviously includes a range of conditions that can seriously impact an individual’s outlook and attitude toward life, and negatively affect physical health, as well as limit ability to function.
Occasional anxiety is a fairly common experience for most people. A 24 hour news cycle, for instance, can always give us something to worry about. Money, a job situation, or trouble in a relationship are other stress factors that can affect mood.
Although, anxiety disorder is the most common mental health diagnoses, it is not considered to be a mood disorder. However, it is common for anxiety to co-occur along with a mood disorder diagnoses. Persistent anxiety combined with chronic stress can actually cause changes to the brain’s structure, which can in turn affect brain chemistry. If the root cause of the anxiety and stress is not identified and treated, major depression can be the result.
Generalized anxiety disorder, and related disorders like obsessive compulsive disorder (OCD), and panic disorder include a variety of symptoms that are similar to other mood disorders. This is another reason that formal diagnosis by a mental health professional is so important.
Personality disorders are not usually considered to be mood disorders because they are generally identified by an individual’s persistent, abnormal and troublesome behaviors, perceptions and ways of interacting with others. Personality disorders are maladaptive behaviors that deviate from those that are generally accepted or customary in work and social situations.
However, Bipolar Disorder and Borderline Personality Disorder (BPD) can both exhibit the same symptoms. Just as individuals suffering from bipolar disorder, people with BPD have extreme mood swings, unstable relationships and trouble controlling their emotions. They have a higher risk of suicide and self-destructive behavior, as well.
Diagnostic and Statistical Manual
The Diagnostic and Statistical Manual, published by the American Psychiatric Association is used primarily for the classification of mental disorders. The DSM-5 is the most current edition, and the manual’s purpose has always been to bring common language and empirical evidence to the diagnoses of mood disorders and other mental health problems in order to allow communication of diagnostic information across various disciplines. In other words, the DSM enables everyone speak a common language..
The current edition of the DSM categorizes all mood disorders under the classifications of either Bipolar Disorders or Depressive Disorders. Accurate psychiatric evaluation of certain mood disorders and mood symptoms, which can stem from psychotic disorders or other mental health problems, is important in order to determine the best course of treatment.
People With Mood Disorders
Many people that develop mood disorders respond well to drugs called serotonin reuptake inhibitors (SSRI) and a relatively newer medication known as serotonin norepinephrine reuptake inhibitors (SNRI’s). Although not the complete solution, these medications can help restore some balance to the neurotransmitters like dopamine and serotonin, in the brain.
It should be apparent that any and all of these mood disorders can have a devastating effect on all areas of an individual’s life, such as personal relationships, school or performance at work. Additionally and most seriously, if no help is sought for these conditions, there is a very serious and real risk of self harm or suicide.
Major Depressive Disorder
Major Depressive Disorder (MDD) is also known as clinical depression or major depression. If you have periods of deep sadness and hopelessness which last long after a trauma or stressful event is over or these severe symptoms are present for no discernable reason, your doctor may diagnose you with MDD. Symptoms must be present for at least two weeks to meet diagnostic criteria.
According to the Cleveland Clinic, the following symptoms are indications of MDD:
- Feeling sad most of the time or nearly every day
- Lack of energy or feeling sluggish
- Feeling worthless or hopeless
- Loss of appetite or overeating
- Gaining weight or losing weight
- Loss of interest in activities that formerly brought enjoyment
- Sleeping too much or not enough
- Frequent thoughts about death or suicide
- Difficulty concentrating or focusing
Persistent depressive disorder
The two major categories of chronic depression are persistent depressive disorder (dysthymic disorder) and chronic major depressive disorder (MDD). Both persistent depressive disorder and major depressive disorders are serious mood disorders that can negatively impact many areas of daily living.
Persistent depressive disorder, is a chronic, or long term, form of depression and is characterized by a low mood that can last for years. Like other depressive disorders, dysthymic disorder can also be linked to suffering from a lifetime anxiety disorder as well.
Chronic Major Depressive Disorder
The main signs of chronic major depressive disorder can be the the same as other depressive symptoms; loss of interest in hobbies or activities that were previously enjoyable, irritable mood, feeling hopeless, change in sleep patters, low self esteem, fatigue or low energy, changes in appetite, and feelings of hopelessness.
Treatment for these disorders can include SSRI and SNRI medications combined with CBT – cognitive behavioral talk therapy. Persistent depressive disorder and major depressive disorder are not insignificant diagnoses. Seek help from a mental health professional if you feel you may be suffering from symptoms of depression, anxiety, or both.
Other depressive mood disorders include:
- Seasonal affective disorder (SAD), which is depression related to the lack of daylight during certain seasons of the year. The disorder is especially prevalent in northern and southern latitudes from late fall to early spring. Depression that happens only during certain times of the year for at least two consecutive years meets diagnostic criteria for SAD.
- Depression related to withdrawal from drugs or alcohol or from certain medications.
- Depression related to a medical condition, including postpartum depression.
- Psychotic depression is severe depression combined with psychotic episodes which may include hallucinations or delusions.
- Premenstrual dysphoric disorder is a cyclical, hormone-based disorder that triggers mood swings, depression, irritability, anger, hopelessness, and more. It occurs during the premenstrual phase of a woman’s cycle and is an unspecified depressive disorder.
- Disruptive mood dysregulation disorder is a childhood disorder characterized by frequent, severe angry outbursts that are not consistent with the child’s developmental age. This depressive disorder is a relatively new diagnosis.
- Intermittent explosive disorder is a less common mood disorder, marked by repeated, sudden explosions of anger or rage which are out of proportion to the situation. Depression and anxiety often co-occur with this disorder.
Bipolar Disorder (BD)
If you have bipolar or manic-depressive disorder, your moods may swing between extreme highs and extreme lows. When you are in a low mood, your symptoms are similar to those common in clinical depression. During high mood swings, known as periods of mania, you may engage in a frenzy of activity, feel elated, and may be unusually irritable.
The Cleveland Clinic describes four basic types of bipolar disorder:
This is the most severe form of bipolar disorder and includes at least one manic episode lasting at least seven days which may include required hospitalization. You may also experience related depressive episodes, many of which often last for at least two weeks.
Bipolar II disorder
Less severe than bipolar I, this disorder causes depressive cycles similar to bipolar I but a less severe form of mania. If you have bipolar II disorder, you may have longer lasting bouts of depression.
Cyclothymia is a mild form of bipolar disorder. With this disorder, you may experience mild to moderate, rather than severe, mood swings. Your doctor may diagnose cyclothymia if your symptoms have persisted for at least two years. For children or adolescents, symptoms must last at least one year to meet diagnostic criteria.
Other Types of Bipolar Disorder
If you are experiencing significant mood changes that do not meet the criteria of the bipolar disorders described above, your doctor may diagnose you with “unspecified” bipolar disorder.
How are Mood Disorders Treated?
Obviously, methods of treating mood disorders will vary according to the specific diagnosis and symptoms. However, most methods incorporate a combination of psychotherapy and medication.
Medications used to treat depression or depressive episodes and bipolar disorder include:
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa, Lexapro, Zoloft, Prozac, and Paxil. These drugs work by blocking the reabsorption of the neurotransmitter serotonin in the brain. Serotonin plays a major role in many physical and mental functions, such as muscle movement and of course mood.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) like Cymbalta, Effexor, Pristiq, and Fetzima. These drugs work by blocking the reabsorption of serotonin and norepinephrine. Also called noradrenaline, norepinephrine is a hormone and neurotransmitter that regulates communication between brain cells and affects mood as well as other physical functions.
- Psychotropic medications are substances that can affect cognition, behavior, and perceptions. Abilify or Seroquel are examples of this type of drug, and are also considered to be neuroleptic drugs, because they work to block dopamine receptors in the central nervous system. This action will then reduce the chaotic stream of messages in the brain that contribute to psychosis and bipolar episodes.
- Antipsychotic medications are also a group of psychotropic drugs. These medications alter functions of the central nervous system which result in changes to perception, mood, consciousness, cognition, and behavior. These substances are primarily used to manage psychosis associated with schizophrenia, and are also used in a range of other psychotic disorders. However, together with mood stabilizers, these drugs are also the basis of treatment for bipolar disorder.
- Anticonvulsant medications such as Lamictal or Neurontin are a group of drugs that have been used to treat epilepsy and epileptic seizures. However, because they have been found to be effective mood stabilizers. they are now increasingly being used in the treatment of bipolar disorder and borderline personality disorder, as well.
Psychotherapy also known as talk therapy, is a very effective approach for those with depression and other mood disorders. Psychotherapeutic approaches often incorporate several modalities, including cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy. These therapies give patients the tools they need to identify and solve problems, improve stress management and increase their quality of life.
Besides interpersonal therapy, the treatment plan may also include brain stimulation therapy, which is thought to target and change chemicals in the brain that are linked to symptoms of depression and bipolar disorders. Modalities include Electroconvulsive Therapy (ECT) and Repetitive Transcranial Magnetic Stimulation (rTMS), which is a non-invasive method of brain stimulation using a changing magnetic field to stimulate specific areas of the brain.
Light therapy is commonly used to treat SAD, by using a special lamp that provides cool-white fluorescent light to supplement natural sunlight in the morning, for about 30 minutes.
Other Methods to Treat Mood Disorders
In addition to these methods of treatment, there are other lifestyle changes that can assist in recovery from these sometimes disabling mental health concerns.
Exercise stimulates the brain to produce endorphins and dopamine, both of which contribute to a feeling of well-being. Cutting out fast food and limiting processed foods also have benefits to brain health. A regular habit of meditation as well as social connection are also extremely important.
If you have any of the symptoms described, or have suicidal thoughts, reach out for help immediately. If you are in crisis, contact the suicide prevention lifeline at 800-273-8255 or call 911.
Otherwise, reach out to a health care professional for help. If you feel that you or someone close to you has any of the major risk factors we have listed here, or believe you may be suffering from a mood disorder, please reach out to your healthcare provider. Additional information on mood disorder treatment options can also be obtained from the Substance Abuse and Mental Health Services Administration (SAMHSA) website.
Mood Disorders and Addiction
Many individuals who struggle with mood disorders including bipolar disorder, major depressive disorder, or general anxiety disorder may also struggle with addiction-related challenges that result from attempts to minimize their symptoms through substance abuse.
In cases of substance induced mood disorder, individuals may use drugs and alcohol as a coping mechanism to manage debilitating depression, anxiety, or mood swings which can actually be caused by the substance abuse itself. And, in some cases, drug and alcohol use can worsen an underlying mental health condition.
Whatever the case, individuals with mental health and addiction-related challenges should seek treatment that specifically focuses on co-occurring disorders. Dual diagnosis, according to the American Psychiatric Association (APA) is the identification of two distinct disorders that are present in the same person at the same time. For example, the coexistence of depression and a substance dependence disorder (e.g., alcohol or drug dependence). Effective treatment programs are those that are specially designed to treat mental health as well as addiction concerns simultaneously. This is generally considered to be a best practice that is also supported by research from the National Institute on Drug Abuse, among others.
About 45% of Americans seeking substance use disorder treatment have also been diagnosed as having a co-occurring mental disorder. Because both disorders may vary in severity and due to the complexity of symptoms, a dual diagnosis can be difficult to identify and treat. Occasionally, when the substance use disorder is treated and healthy lifestyle changes such as meditation and regular exercise have been incorporated, the mood disorder may resolve on it’s own,
Natasha is an award-winning speaker, author, certified professional life coach and a mental health advocate with over 20 years of lived experience. Natasha was born and raised on St. Thomas, U.S. Virgin Islands where she entered the world of professional speaking at age 14 and quickly became a sought-after keynote speaker at territory-wide forums addressing education, health, and economy. For the last five years, Natasha has devoted much of her time to mental health education and advocacy and was recently appointed as the Executive Director of the National Alliance on Mental Illness (NAMI)-Hillsborough affiliate, right here in Tampa, Florida.
Hear Natasha Pierre speak on Tackling the Stigma of Mental Illness w/ Natasha Pierre, CPLC, CWIC
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