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Mood Disorders

What are Mood Disorders?

A mood disorder is a mental health condition that impacts your thoughts, emotions, and behaviors. People who suffer with mood disorders often experience episodes of sadness or despair, and sometimes experience episodes of mania or elevated mood. The duration of the episodes depends on the specific condition and can vary between individuals. Mood disorders must be present for a longer period and cause significant enough distress that it impacts normal functioning at home, work, school, and in relationships.

Mood disorders affect children, adolescents, and adults. Women are twice as likely as males to be diagnosed with major depression. The most common mood disorders are major depression and bipolar disorder. 

Mood disorders include:

  • Major depressive disorder (MDD). Generally, symptoms of MDD are prolonged and persistent episodes of extreme sadness, a lack of interest in things, hopelessness, sleep disturbance, and difficulties with attention and focus.
  • Persistent depressive disorder (dysthymia). This is a chronic form of depression, less severe than MDD. Depression is present more days than not for at least two years. In children and adolescents, mood can be irritable, and duration needs to be at least one year.
  • Premenstrual dysphoric disorder. Symptoms are present the final week before the onset of menses and will start to improve a few days after the onset of menses. Symptoms will be minimal to none in the week after your period ends. Symptoms may present as mood swings, irritability, anger, increased interpersonal conflicts, depressed mood, anxiety or feeling on edge.
  • Postpartum depression (peripartum depression). This type of depression occurs during or right after pregnancy. Women may experience postpartum due to hormonal fluctuations during and after pregnancy, the major life transition of having a baby, financial stress, or emotional distress. 
  • Bipolar 1 and bipolar 2. In bipolar 1, people must experience mania to meet criteria for diagnosis. Although major depression can be part of bipolar 1, a person does not need to experience a major depressive episode to meet criteria for diagnosis. In bipolar 2, criteria must be met for at least one hypomanic (less severe mania) episode and at least one major depressive episode. Additionally, in bipolar 2, there has never been a manic episode. 
  • Cyclothymic disorder. For at least 2 years (1 year in children and adolescents), there have been multiple hypomanic and depressive symptoms that do not meet full criteria for hypomania or a depressive episode. 
  • Disruptive mood dysregulation disorder. This disorder exhibits severe and recurrent temper or anger outbursts through verbal or behavioral aggression that is significantly disproportionate to the situation or provocation. The outbursts are inconsistent with the developmental level and the outbursts occur 3 or more times a week.

    • Symptoms

    There are many symptoms consistent with mood disorders. The most common symptoms include:

    Depressive

    • Extreme sadness most days
    • Feelings of hopelessness, worthlessness, and emptiness
    • Loss of interest in activities that used to bring enjoyment
    • Fatigue or feeling sluggish
    • Poor concentration, focus, and attention
    • Sleep disturbance
    • Loss of appetite or overeating
    • Thoughts about harming yourself
    • Thoughts about death or suicide

    Manic or hypomanic
    • Elevated mood (feeling extremely energized or elated)
    • Rapid speech or movement
    • Racing thoughts
    • Agitation, irritability, or restlessness
    • Risk taking behavior (reckless spending, reckless driving, etc.)
    • Sleep disturbance

    Causes

    There is no singular cause of mood disorders; rather, mood disorders develop from a culmination of biological factors, genetic factors, and environmental factors. These factors include:

    • Biological factors. Specific areas of the brain are responsible for mood and emotional regulation. In brain imaging scans, people with mood disorders have been shown to have a larger amygdala (the brain’s “fire alarm” or emotional response center).
    • Genetic factors. There is a much greater risk of developing a mood disorder if there is a family history of mood disorders, indicating a genetic link.
    • Environmental factors. People with mood disorders often have a trauma history, indicating a history of sexual, physical, or emotional abuse, attachment trauma, or enduring a traumatic event. People who experience complex grief, a chronic illness, or chronic stress in childhood may also have an increased risk of developing a mood disorder.

    Diagnosis

    It is important to contact your healthcare provider if you are experiencing symptoms of a mood disorder. Your healthcare provider will take a thorough medical history, conduct a physical exam, and may order lab work to rule out any medical condition that may be contributing to symptoms.

    Additionally, your doctor may refer you to a mental health professional. Your mental health provider will conduct an intake session, gathering information on your medical history, family history of mental illness, and presenting symptoms. Typically, after a thorough evaluation (usually done in 1-3 sessions, sometimes more) your mental health provider will be able to make a diagnosis.

    Treatment

    Mood disorders can be treated successfully and are typically treated by a combination of psychotherapy and medication. The specific modalities used to treat mood disorders depend on the disorder and the presenting symptoms. The most common forms of treatment include:

    Medications

    • Antidepressants. Antidepressants, such as SSRI’s (serotonin reuptake inhibitors), have proven to be effective at treating symptoms of depression, including bipolar depression. Antidepressants usually take 4-6 weeks to take effect. 
    • Mood stabilizers. This type of medication works to reduce mood swings and help with emotional regulation. Often, mood stabilizers are prescribed along with antidepressants. 
    • Antipsychotics (neuroleptics). This type of medication is typically used to treat severe mania in bipolar or treatment resistant depression.

    Psychotherapy
    • Cognitive behavioral therapy (CBT). This type of therapy seeks to identify distorted thoughts, beliefs, and patterns of behavior, and replace them with more positive and adaptive ways of thinking and being.
    • Dialectical behavior therapy (DBT). This therapy is generally used with patients who have more severe symptoms and higher distress intolerance. DBT often pulls from CBT and mindfulness-based stress reduction therapies.  
    • Psychodynamic therapy. This type of therapy uses interpersonal and intrapersonal relationships to identify and heal childhood wounds and internal structures that have led to the development of a mood disorder. 

    Other treatments
    • Electroconvulsive therapy (ECT). This treatment sends a mild electric current through the brain and has proven effective at treating treatment-resistant depression and bipolar. Generally, 6-12 sessions are required for optimal benefit.
    • Transcranial magnetic stimulation (TMS). This type of brain stimulation therapy is used when medication has been ineffective. The treatment sends an electrical current underneath the skull and helps regulate emotion.
    • Light therapy. This is used to help treat seasonal depression in the fall and winter months when the sunlight is less visible. It uses artificial light to act as sunlight, and research has shown efficacy at reducing symptoms of depression that are caused by lack of sunlight. It is important to note that if you are diagnosed with bipolar disorder, it is recommended to not use a light therapy box, as it may trigger a manic episode.