Have you or a loved one been experiencing disturbances in your mood and behaviour? While the occasional bad mood is not out of the ordinary, extreme disturbances in emotions that cause issues in your day-to-day life may be a sign of a mood disorder that may warrant a visit to a clinical psychologist. These conditions can be varied when it comes to symptoms.
Mood disorders, also known as affective disorders, are a series of psychological conditions that cause a disruption in the way a person experiences emotions. It may lead to sudden “ups” (mania) or “downs” (depressive episodes) and may vary in intensity. These are generally caused by imbalances of hormones in the body.
The world of mood disorders is quite vast, and it is easy to get lost in the varied diagnoses and condition names. The umbrella of mood disorders is quite vast. Read on to get an insight on what all of them are, the risk factors and what you can do to avoid and manage them.
Overview
Mood disorders, as the name suggests, are long-term and marked disruptions in emotions.1 This class of psychological disorders encompass depressive disorders and variations of bipolar disorders. The exact causes of mood disorders, like other psychological conditions, are not fully understood, but the role of various neurotransmitters (chemical “transmitters” that help the neurons to communicate throughout the body) has been well documented.
Two important terms related to mood disorders are:
Mania/Hypomania
It is an “elevated period” or a “high” time where a person under mania (said to be “manic”) engages in irritated, stimulatory or goal-directed behaviour for over a week as defined by the DSM-V (Diagnostic and Statistical Manual of Mental Disorders). DSM-V is a handbook used to diagnose mental disorders in many parts of the world.
In simple terms, the person may appear hyperactive to the point of irrationality, very active, and constantly trying to engage themselves in various activities. Hypomania is a milder form of mania. Manic episodes may also lead to psychosis or a detachment from reality.2
Depression
Depression, in general, should not be confused with Major Depressive disorder, which is a specific clinical condition. Depression is described as persistent low mood, reduced drive and productivity, and the person may not respond very well to any conditions around them.3
Common examples of mood disorders
There are many types of mood disorders. Our knowledge of the human psyche is constantly evolving as research grows, and the classifications of mood disorders may change, too. However, according to our current knowledge, listed below are some of the most common mood disorders.
Bipolar disorder
Bipolar disorder, also known as manic-depression or bipolar affective disorder, consists of emotional disturbances showing distinct episodes of mania or hypomania alternating with depression.4 Bipolar is said to have many types, the most prominent of which are Bipolar I and II. Patients suffering from Bipolar I usually experience 2 weeks of depressive episodes followed by mania, while patients with bipolar type II show depressive episodes followed by hypomania.
Cyclothymia or cyclothymic disorder
A milder form of bipolar disorder, where alternating episodes of manic and depression are experienced, similar to bipolar disorder, but of less severe intensity. These may or may not be separated by periods where the mood is relatively “normal”.5
Major depressive disorder
Commonly referred to as depression, it is a persistent feeling of sadness and “feeling down”. Diagnosis of a depressive disorder is different from the occasional occurrence of “feeling depressed.6 Major depressive disorder is a chronic condition that often requires treatment. Depression is a marked, long-term loss of pleasure, fatigue and occasionally suicidal thoughts over an extended period.7
Persistent depressive disorder or dysthymia
This disorder is a persistent and long-term form of depression. There are no “episodes” and the loss of self-esteem, loss of motivation and other hallmarks of depression last longer for at least two years.8
Premenstrual dysphoric disorder
Some women may experience premenstrual dysphoric disorder (PMDD), a similar but extreme form of premenstrual syndrome (PMS) during or before menstruation. You may experience a range of physical and emotional symptoms such as insomnia, irritability, anxiety, confusion, spells of crying and moodiness along with poor self-image. It may also lead to gastrointestinal symptoms like nausea and vomiting.9
Disruptive mood dysregulation disorder
This is a condition where small children or adolescents (12-18 years old) experience frequent outbursts of anger and irritability and experience subsequent trouble at school. They may also face issues with concentration and start tantrums. These symptoms should persist for 12 months in order to receive a diagnosis.10
Causes of mood disorders
The exact cause of psychological disorders is difficult to determine due to different individual experiences and the different ways in which each person responds to the condition. However, a few causes have been linked to various disorders relating to mood.
Age and hormonal imbalances
Most mood disorders are associated with hormonal imbalances, which can happen during menstruation, pregnancy, menopause and ageing. Many mood disorders like disruptive mood dysregulation disorder are diagnosed in teenagers going through puberty as hormone levels are elevated and have been shown to influence mood.
Neurotransmitters
Neurotransmitters are signalling molecules that help parts of the body communicate with neurons and the nervous system. Most mood disorders are caused by disrupted levels of neurotransmitters in the body. Serotonin imbalance is most prominently linked to depression, but the exact mechanisms of depression are not fully understood, and it is likely that multiple factors contribute to the development of depressive disorders. Dopamine is a neurotransmitter that affects motivation, energy levels, and feelings of elation linked to mania.11
Genetic predispositions
Certain disorders like depression and bipolar disorder are likely to be inherited if their family has a history of mental health conditions. Bipolar disorder shows a particularly strong genetic risk factor, as there is a 10% chance of a child developing it at some point in their lives if one of their parents is suffering from the condition.12
Signs and symptoms of mood disorders
Mood disorders encompass an array of slightly differing disorders with no generalised symptoms. Each of us experiences the world differently and may respond differently to the environment. However, there are certain warning signs you can look for in yourself or in a loved one if you think they may be suffering from a mood disorder:
- Prolonged (more than two weeks) periods of “feeling low”, lack of motivation, and suicidal thoughts and feelings
- Alternating bouts of depressive symptoms followed by periods of hyperactivity and psychosis in some cases
- Extreme irritability accompanied by abnormally severe physiological symptoms in women before or during the menstrual cycle
- Extreme and irrational anger in adolescents accompanied by tantrums uncharacteristic of the person
- Significant deviation from one's typical behaviour.
Management and treatment for mood disorders
Treatment of each patient for a mood disorder is different and depends on individual factors such as age, family history, and co-existing health conditions.
There are two main avenues for the treatment of these disorders:
Medication
Medications typically help with the management of symptoms of mood disorders and can be helpful in disorders with extreme mood swings like depression and bipolar. However, medication must be prescribed by a qualified psychiatrist as they may lead to severe side effects if wrongly prescribed. There is a class of drugs called antidepressants dedicated to treating depressive and suicidal symptoms.
Therapy
Various types of therapy are helpful for the long-term management of disorders. They can offer coping strategies and advise individuals dealing with persistent depression on managing troubling thoughts. Therapy can also help one deal with the possible psychological origin of the disorders a person is experiencing and provide ways of dealing with it. The various forms of therapy that help manage mood disorders include cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT) and mindfulness-based approaches.13
All therapy should only be carried out with a licensed therapist or counsellor.
Diagnosis
Mood disorders are diagnosed by a qualified clinical psychologist or a psychiatrist. Each mood disorder has different diagnostic criteria, which usually depend on the period of persistence of symptoms/mood changes and the extent to which it affects a patient’s life. Some manuals that provide the diagnostic criteria for mental disorders, including mood disorders, are the ICD (International Classification of Diseases) provided by the World Health Organisation and the DSM (Diagnostic and Statistical Manual of Mental Disorders) provided by the American Psychiatric Association. They provide specific durations and descriptions for symptoms to diagnose each mental disorder.
FAQs
How can I prevent mood disorders?
There are no concrete ways to prevent mood disorders, especially if there is a genetic predisposition. Practising preventative practices like maintaining a healthy lifestyle, familiarising yourself with the warning signs, and discussing coping strategies with a qualified counsellor are effective ways of managing your symptoms.
How common are mood disorders?
The incidence of any psychological disorder varies across cultures, and it is difficult to determine what portion of the population may be suffering from one as many cases go undiagnosed. According to a recent study, 9.7% of the US adult population suffers from a mood disorder in a year.15
Who is at risk of mood disorders?
People with a family history of mood disorders, teenagers, and individuals with previous mental trauma are at risk of these disorders.
When should I see a doctor?
If you feel that you are facing mania/depression or any of the symptoms discussed above for a week or more, visit a clinical psychologist for an evaluation.
Summary
Mood disorders, also known as affective disorders, are a category of psychological conditions that cause long-term disturbances in emotions and motivation levels. The two main symptoms are mania and depression. The intensity and recurrence of this lead to different subclasses of disorders like major depressive disorder, Bipolar 1, and Bipolar 2 to name a few. These are diagnosed by fixed criteria from the ICM or the DSM. These conditions can be treated using a combination of medication and therapy alongside lifestyle changes. Due to the sensitive nature of mood disorders and psychological conditions in general, in case of doubt, it is best to refer to a clinical psychologist.
References
- Sekhon S, Gupta V. Mood disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jun 30]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK558911/
- Administration SA and MHS. Table 11, dsm-iv to dsm-5 manic episode criteria comparison [Internet]. 2016 [cited 2023 Jun 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t7/
- ICD-10 Version:2016 [Internet]. [cited 2023 Jun 30]. Available from: https://icd.who.int/browse10/2016/en#/F30-F39
- Cleveland Clinic [Internet]. 2023 [cited 2023 Jun 30]. Do you know the different types of bipolar disorder? Available from: https://health.clevelandclinic.org/bipolar-1-vs-2/
- 2023 icd-10-cm diagnosis code f34. 0: cyclothymic disorder [Internet]. [cited 2023 Jun 30]. Available from: https://www.icd10data.com/ICD10CM/Codes/F01-F99/F30-F39/F34-/F34.0
- ICD-10 depression diagnostic criteria - General Practice notebook [Internet]. [cited 2023 Jun 30]. Available from: https://gpnotebook.com/simplepage.cfm?ID=x20091123152205182440
- Mayo Clinic [Internet]. [cited 2023 Jun 30]. Depression (Major depressive disorder) - Symptoms and causes. Available from: https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- Mayo Clinic [Internet]. [cited 2023 Jun 30]. Persistent depressive disorder - Symptoms and causes. Available from: https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929
- Premenstrual dysphoric disorder(Pmdd) [Internet]. 2019 [cited 2023 Jun 30]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd
- National Institute of Mental Health (NIMH) [Internet]. [cited 2023 Jun 30]. Disruptive mood dysregulation disorder: the basics. Available from: https://www.nimh.nih.gov/health/publications/disruptive-mood-dysregulation-disorder
- Can a neurotransmitter imbalance be causing your mood problems? : Beverly hills optometry: advanced dry eye centre: optometrists [Internet]. [cited 2023 Jun 30]. Available from: https://www.bheyeguy.com/blog/can-a-neurotransmitter-imbalance-be-causing-your-mood-problems
- Black Dog Institute [Internet]. [cited 2023 Jun 30]. Causes of bipolar disorder. Available from: https://www.blackdoginstitute.org.au/resources-support/bipolar-disorder/causes/
- Child Mind Institute [Internet]. [cited 2023 Jun 30]. Mood disorders treatment. Available from: https://childmind.org/care/areas-of-expertise/mood-disorders-center/mood-disorders-treatment/
- National Institute of Mental Health (NIMH) [Internet]. [cited 2023 Jun 30]. Any mood disorder. Available from: https://www.nimh.nih.gov/health/statistics/any-mood-disorder