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Mood disorders, also known as affective disorders, are characterized by their extremes in both intensity and duration. Even
at their most intense, however, symptoms of affective disorders are often misinterpreted as merely mood swings. Worse,
affective disorders are sometimes considered personality flaws rather than real medical conditions. Mood disorders are
treatable medical illnesses caused by a complex interaction of genetic, biochemical and environmental factors.
There are several types of mood disorders:
Major Depression:
Depression is extremely common affecting up to twenty percent of the population at some point during their life span. It is
relatively easily treatable with up to eighty percent of those treated reporting significant improvement. Unfortunately, many
people who are depressed do not present themselves for treatment. Depression can range from mild to moderate to severe. It can
be brief or long lasting. The criteria for major depression include:
- Depressed Mood such as feeling sad, empty, or tearful.
- Lack of interest in or deriving pleasure from most activities.
- Weight loss or gain of over 5% of body weight.
- Insomnia or hypersomnia.
- Agitation or psychomotor retardation.
- Lack of energy.
- Feelings of worthlessness or guilt.
- Difficulty in concentration and/or decision making.
- Thoughts, plans or attempts of suicide or preoccupation with death.
Bipolar Disorder (Manic Depression):
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person's mood,
energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar
disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. Bipolar
disorder can be treated, and people with this illness can lead full and productive lives. Bipolar disorder typically develops
in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them
late in life. It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and
treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a
person's life.
Bipolar disorder causes dramatic mood swings—from overly "high" and/or irritable to sad and hopeless, and then back again,
often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The
periods of highs and lows are called episodes of mania and depression. A manic episode is diagnosed if elevated mood occurs with
3 or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, 4 additional
symptoms must be present.
Signs and symptoms of mania (or a manic episode) include:
- Increased energy, activity, and restlessness
- Excessively "high," overly good, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one idea to another
- Distractibility, can't concentrate well
- Little sleep needed
- Unrealistic beliefs in one's abilities and powers
- Poor judgment
- Spending sprees
- A lasting period of behavior that is different from usual
- Increased sexual drive
- Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
Signs and symptoms of depression (or a depressive episode) include:
- Lasting sad, anxious, or empty mood
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in activities once enjoyed, including sex
- Decreased energy, a feeling of fatigue or of being "slowed down"
- Difficulty concentrating, remembering, making decisions
- Restlessness or irritability
- Sleeping too much, or can't sleep
- Change in appetite and/or unintended weight loss or gain
- Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
- Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if 5 or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks
or longer. A mild to moderate level of mania is called hypomania. Hypomania may feel good to the person who experiences
it and may even be associated with good functioning and enhanced productivity. Thus even when family and friends learn to
recognize the mood swings as possible bipolar disorder, the person may deny that anything is wrong. Without proper treatment,
however, hypomania can become severe mania in some people or can switch into depression. Sometimes, severe episodes of mania or
depression include symptoms of psychosis (or psychotic symptoms). Common psychotic symptoms are hallucinations (hearing, seeing,
or otherwise sensing the presence of things not actually there) and delusions (false, strongly held beliefs not influenced by
logical reasoning or explained by a person's usual cultural concepts). Psychotic symptoms in bipolar disorder tend to reflect
the extreme mood state at the time. For example, delusions of grandiosity, such as believing one is the President or has special
powers or wealth, may occur during mania; delusions of guilt or worthlessness, such as believing that one is ruined and
penniless or has committed some terrible crime, may appear during depression. People with bipolar disorder who have these
symptoms are sometimes incorrectly diagnosed as having schizophrenia, another severe mental illness.
Both children and adolescents can develop bipolar disorder. It is more likely to affect the children of parents who have the
illness. Unlike many adults with bipolar disorder, whose episodes tend to be more clearly defined, children and young
adolescents with the illness often experience very fast mood swings between depression and mania many times within a day.
Children with mania are more likely to be irritable and prone to destructive tantrums than to be overly happy and elated. Mixed
symptoms also are common in youths with bipolar disorder. Older adolescents who develop the illness may have more classic,
adult-type episodes and symptoms. Bipolar disorder in children and adolescents can be hard to tell apart from other problems
that may occur in these age groups. For example, while irritability and aggressiveness can indicate bipolar disorder, they also
can be symptoms of attention deficit hyperactivity disorder, conduct disorder, oppositional defiant disorder, or other types of
mental disorders more common among adults such as major depression or schizophrenia. Drug abuse also may lead to such symptoms.
Dysthymia:
Dysthymia, also known as dysthymic disorder, is classified as a type of affective disorder or mood disorder that often resembles
a less severe, yet more chronic form of major (clinical) depression. However, persons with dysthymia may also experience major
depressive episodes at times. Dysthymia affects women twice as often than men. Symptoms may include:
- persistent sad, anxious, or empty mood
- loss of interest in activities once previously enjoyed
- excessive crying
- increased restlessness and irritability
- decreased ability to concentrate and make decisions
- decreased energy
- thoughts of death or suicide, or suicide attempts
- increased feelings of guilt, helplessness, and/or hopelessness
- weight and/or appetite changes due to over- or under-eating
- changes in sleep patterns
- social withdrawal
- physical symptoms unrealized by standard treatment (i.e., chronic pain, headaches)
For a diagnosis of dysthymia to be made, an adult must exhibit a depressed mood for at least two years (one year in children and
adolescents), accompanied by at least two other depressive symptoms (noted above). The symptoms of dysthymia may resemble other
psychiatric conditions.
Cyclothymia:
Cyclothymia is characterized by pronounced but not debilitating shifts of moods often lasting approximately two to nine weeks.
Cyclothymia is similar to bipolar disorder since it is characterized by mood swings from mania to depression. However, there are
several important differences between the two. A person with cyclothymia experiences symptoms of hypomania but never a full
blown hypomanic episode. Likewise, while depression is a facet of cyclothymia, the symptoms are never severe enough to be
classified as a major depressive episode. While a person with cyclothymia is not likely to end up in the hospital, the intense
mood swings may seriously disrupt one's life. Imagine feeling on top of the world, ready to take on any project one day, just to
wake up the next morning feeling down, depressed and blue. This is what it's like living with cyclothymia. Symptoms include:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or pressured speech
- Flight of ideas or racing thoughts
- Distractibility
- Increase in goal-directed activity or agitation
- Reckless involvement in pleasurable activities
- Absence of evidence that these hypomanic periods caused marked occupational or social impairment
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