Mood Disorders Health Article

Definition

Mood disorders are mental disorders characterized by periods of depression, sometimes alternating with periods of elevated mood.

Description

While many people go through sad or elated moods from time to time, people with mood disorders suffer from severe or prolonged mood states that disrupt their daily functioning. Among the general mood disorders classified in the fourth edition (1994) of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are major depressive disorder, bipolar disorder, and dysthymia.

In classifying and diagnosing mood disorders, doctors determine if the mood disorder is unipolar or bipolar. When only one extreme in mood (the depressed state) is experienced, this type of depression is called unipolar. Major depression refers to a single severe period of depression, marked by negative or hopeless thoughts and physical symptoms like fatigue. In major depressive disorder, some patients have isolated episodes of depression. In between these episodes, the patient does not feel depressed or have other symptoms associated with depression. Other patients have more frequent episodes.

Bipolar depression or bipolar disorder (sometimes called manic depression) refers to a condition in which people experience two extremes in mood. They alternate between depression (the "low" mood) and mania or hypomania (the "high" mood). These patients go from depression to a frenzied, abnormal elevation in mood. Mania and hypomania are similar, but mania is usually more severe and debilitating to the patient.

Dysthymia is a recurrent or lengthy depression that may last a lifetime. It is similar to major depressive disorder, but dysthymia is chronic, long-lasting, persistent, and mild. Patients may have symptoms that are not as severe as major depression, but the symptoms last for many years. It seems that a mild form of the depression is always present. In some cases, people may also experience a major depressive episode on top of their dysthymia, a condition sometimes referred to as a "double depression."

Causes and symptoms

Mood disorders tend to run in families. These disorders are associated with imbalances in certain chemicals that carry signals between brain cells (neurotransmitters). These chemicals include serotonin, norepinephrine, and dopamine. Women are more vulnerable to unipolar depression than are men. Major life stressors (like divorce, serious financial problems, death of a family member, etc.) will often provoke the symptoms of depression in susceptible people.

Major depression is more serious than just feeling "sad" or "blue." The symptoms of major depression may include:

• loss of appetite
• a change in the sleep pattern, like not sleeping (insomnia) or sleeping too much
• feelings of worthlessness, hopelessness, or inappropriate guilt
• fatigue
• difficulty in concentrating or making decisions
• overwhelming and intense feelings of sadness or grief
• disturbed thinking. The person may also have physical symptoms like stomachaches or headaches

Bipolar disorder includes mania or hypomania. Mania is an abnormal elevation in mood. The person may be excessively cheerful, have grandiose ideas, and may sleep less. They may talk nonstop for hours, have unending enthusiasm, and demonstrate poor judgement. Sometimes the elevation in mood is marked by irritability and hostility rather than cheerfulness. While the person may at first seem normal with an increase in energy, others who know the person well see a marked difference in behavior. The patient may seem to be in a frenzy and will often make poor, bizarre, or dangerous choices in his/her personal and professional lives. Hypomania is not as severe as mania and does not cause the level of impairment in work and social activities that mania can.

Diagnosis

Doctors diagnose mood disorders based on the patient's description of the symptoms as well as the patient's family history. The length of time the patient has had symptoms is also important. Generally patients are diagnosed with dysthymia if they feel depressed more days than not for at least two years. The depression is mild but long lasting. In major depressive disorder, the patient is depressed almost all day nearly every day of the week for at least two weeks. The depression is severe. Sometimes laboratory tests are performed to rule out other causes for the symptoms (like thyroid disease). The diagnosis may be confirmed when a patient responds well to medication.