Mood Disorders

Mood disorders are a category of mental health conditions characterized by disturbances in a

person’s emotional state. In the DSM-5 (Diagnostic and Statistical Manual of Mental
Disorders, 5th Edition), mood disorders are primarily divided into two main categories:

1. Depressive Disorders
2. Bipolar and Related Disorders

Depressive Mood Disorder: Types, Clinical Picture, and Causes

Depressive mood disorders are characterized by persistent feelings of sadness, hopelessness,

and a lack of interest or pleasure in activities once enjoyed. These disorders significantly
affect an individual's emotional, mental, and physical functioning. The DSM-5 categorizes
depressive disorders into several types, each with unique features and diagnostic criteria.

Types of Depressive Mood Disorders

1. Major Depressive Disorder (MDD)

This is one of the most common types of depressive disorders, marked by severe and
persistent low mood, anhedonia (loss of interest in previously enjoyable activities), and a
range of physical and cognitive symptoms. It involves- Depressed mood or loss of
interest/pleasure for at least two weeks. Symptoms must represent a change from normal
functioning and cause significant impairment in daily activities.

Subtypes (based on symptoms or features):

 With anxious distress: Significant anxiety during depressive episodes.

 With melancholic features: Severe loss of interest in activities,
physical symptoms of depression (e.g., weight loss, insomnia), feelings
of excessive guilt.
 With psychotic features: Hallucinations or delusions occurring along
with depressive symptoms.
 With catatonia: Severe movement disturbances or immobility.
 With seasonal pattern: Depression occurring seasonally, typically in
winter (Seasonal Affective Disorder, or SAD).
2. Persistent Depressive Disorder (PDD)

Also known as dysthymia, this condition involves chronic low-grade depression that
lasts for at least two years (one year in children or adolescents). It involves-

Depressed mood lasting most of the day for more days than not, with
fewer severe symptoms than MDD.
 May have periods of full-blown depressive episodes (recurrent major
depression).
 Symptoms often include low self-esteem, poor appetite or overeating,
low energy, difficulty concentrating, and feelings of hopelessness.
3. Disruptive Mood Dysregulation Disorder (DMDD)
Diagnosed in children and adolescents, DMDD involves severe temper outbursts that are out
of proportion to the situation, alongside a consistently irritable or angry mood. It involves-

Severe temper outbursts (verbal or physical) occurring three times a


week or more.
 Chronic irritability or angry mood lasting at least 12 months.
 Symptoms must be present in two or more settings (e.g., at home,
school).
4. Premenstrual Dysphoric Disorder (PMDD)

A severe form of premenstrual syndrome (PMS), PMDD causes extreme mood changes,
irritability, and other depressive symptoms just before the menstrual cycle. It involves-

 Severe mood swings, irritability, anxiety, fatigue, sleep disturbances,

and physical symptoms like headaches and joint pain.
 Symptoms usually occur in the two weeks prior to menstruation and
improve once menstruation starts.

Clinical Picture of Depressive Mood Disorders

The clinical picture of depressive mood disorders involves a combination of emotional,

cognitive, physical, and behavioral symptoms. Below are the common symptoms and signs
that individuals with depressive disorders may experience:

1. Emotional Symptoms

 Sadness or hopelessness: Persistent feelings of despair or loss of joy in life.

 Irritability: Particularly in children and adolescents, depression may manifest more
as irritability than sadness.
 Feelings of worthlessness or guilt: Excessive guilt or self-blame over perceived
failures or mistakes.
 Loss of interest or pleasure (anhedonia): A marked disinterest in activities that were
once enjoyable, such as hobbies, socializing, or work.

2. Cognitive Symptoms

 Difficulty concentrating or making decisions: Depressed individuals often find it

hard to focus or make decisions, which can impair work and school performance.
 Negative thinking patterns: Thoughts may become overwhelmingly negative,
leading to feelings of hopelessness or helplessness about the future.
 Thoughts of death or suicide: In severe cases, depressive disorders can lead to
suicidal thoughts, plans, or attempts. These should always be taken seriously.

3. Physical Symptoms

 Fatigue or loss of energy: Individuals with depression often feel exhausted, even
after adequate sleep.
  Changes in sleep patterns: Some people may experience insomnia (difficulty
sleeping), while others may sleep excessively (hypersomnia).
 Changes in appetite or weight: Some individuals may lose weight due to lack of
appetite, while others may gain weight from emotional overeating.
 Physical aches and pains: Unexplained physical symptoms such as headaches, back
pain, or digestive issues are common.

4. Behavioral Symptoms

 Withdrawal from social activities: Depression often leads to a reduced desire to

interact with others or engage in social activities.
 Reduced ability to function at work or school: Due to fatigue, lack of motivation,
or cognitive difficulties, individuals with depression may struggle to perform daily
tasks.
 Neglecting responsibilities: Difficulty maintaining personal hygiene, home upkeep,
and work responsibilities due to a lack of energy or interest.

Causes of Depressive Mood Disorders

The exact causes of depressive disorders are complex and multifactorial, involving a
combination of genetic, biological, psychological, and environmental factors.

1. Genetic Factors

 Family history: Depressive disorders tend to run in families, suggesting a genetic

predisposition. Individuals with a first-degree relative (e.g., parent or sibling) with
depression are at a higher risk of developing the disorder.
 Genetic mutations: While no single gene is responsible for depression, research
suggests that multiple genes related to neurotransmitter systems (serotonin, dopamine,
etc.) may play a role in susceptibility.

2. Biological Factors

 Neurotransmitter imbalances: Depression is associated with dysregulation in key

brain chemicals, particularly serotonin, norepinephrine, and dopamine, which
regulate mood, energy, and motivation.
 Brain structure and function: Research has shown that certain areas of the brain,
such as the prefrontal cortex (involved in decision-making and emotional regulation)
and the amygdala (involved in processing emotions), may be structurally or
functionally altered in individuals with depression.
 Hormonal changes: Hormonal imbalances, such as those related to thyroid
dysfunction or cortisol (stress hormone) dysregulation, may contribute to depressive
symptoms. This is particularly important in cases like postpartum depression.

3. Psychological Factors
  Cognitive patterns: Negative thought patterns, such as cognitive distortions (e.g.,
overgeneralizing or catastrophizing), are often present in individuals with depression.
These thought patterns can reinforce feelings of worthlessness or hopelessness.
 Stress and trauma: Exposure to chronic stress, abuse, or trauma (e.g., childhood
abuse, loss of a loved one) can increase vulnerability to depression. Early childhood
adversity can alter the way the brain reacts to stress and emotional regulation.
 Personality traits: Certain personality traits, such as neuroticism (a tendency to
experience negative emotions), may predispose individuals to depression.

4. Environmental Factors

 Life events: Major life changes such as the death of a loved one, divorce, financial
stress, or work-related challenges can trigger depressive episodes, especially in
individuals already vulnerable to mood disorders.
 Social isolation: Lack of social support, loneliness, or difficulty forming connections
can contribute to depression.
 Chronic illness or disability: Dealing with long-term illness or physical pain can
increase the risk of developing depression.

5. Medical Conditions

 Chronic medical conditions: Illnesses such as diabetes, heart disease, and cancer
are often associated with an increased risk of depression, either as a direct result of the
illness or the stress of coping with the condition.
 Substance abuse: Alcohol or drug abuse can contribute to or exacerbate depressive
symptoms, and withdrawal from substances may also induce depression.

Conclusion

Depressive mood disorders are complex conditions that involve a combination of emotional,
cognitive, physical, and behavioral symptoms. The exact cause of these disorders can vary,
involving genetic, biological, psychological, and environmental factors. With proper
treatment, including psychotherapy (such as cognitive-behavioral therapy) and medications
(such as antidepressants), individuals with depressive disorders can manage their symptoms
and improve their quality of life. Early detection and intervention are crucial for effective
treatment and support.
Bipolar

https://www.medicalnewstoday.com/articles/37010#overview

https://www.nimh.nih.gov/health/publications/bipolar-disorder

Causes of Bipolar Disorder

The exact causes of bipolar disorder are not fully understood, but research suggests that a
combination of genetic, biological, and environmental factors contribute to the development
of the condition.

1. Genetic Factors

 Family history: Bipolar disorder tends to run in families. Individuals with a first-
degree relative (such as a parent or sibling) who has bipolar disorder are more likely
to develop it.
 Genetic predisposition: Although no single gene causes bipolar disorder, research
suggests that several genes may increase susceptibility to the condition.

2. Biological Factors

 Neurochemical imbalances: Imbalances in neurotransmitters (such as serotonin,

dopamine, and norepinephrine) are thought to play a role in bipolar disorder. These
chemicals are involved in regulating mood, and abnormalities may contribute to mood
swings.
 Brain structure and function: Studies have found differences in the brain structures
of individuals with bipolar disorder, including abnormalities in the prefrontal cortex
and amygdala, which are involved in emotional regulation.

3. Environmental Factors

 Stress: Major life changes or chronic stress, such as trauma, abuse, or the death of a
loved one, can trigger the onset of bipolar disorder or contribute to mood swings in
people already diagnosed.
 Substance abuse: Substance abuse or withdrawal can worsen bipolar disorder and
trigger episodes of mania or depression.
 Sleep disturbances: Disruptions in sleep patterns, such as poor sleep or jet lag, may
trigger manic or depressive episodes in individuals with bipolar disorder.

Diagnostic Criteria for Bipolar Disorder (DSM-5)

According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th
Edition), the diagnosis of bipolar disorder requires specific criteria for both manic and
depressive episodes.
1. Manic Episode Criteria

To be diagnosed with a manic episode, a person must exhibit three or more of the following
symptoms for a period of at least one week (or less if hospitalization is required):

 Inflated self-esteem or grandiosity

 Decreased need for sleep (e.g., feeling rested after only 3 hours)
 More talkative than usual or pressure to keep talking
 Flight of ideas or racing thoughts
 Easily distracted
 Increased goal-directed activities (either socially, at work or school, or sexually) or
physical restlessness
 Engagement in risky activities (e.g., excessive spending, sexual indiscretions, or
reckless driving)

These symptoms must cause significant impairment in social, occupational, or other

important areas of functioning or require hospitalization to prevent harm.

2. Hypomanic Episode Criteria

A hypomanic episode includes symptoms similar to those of a manic episode but to a lesser
degree, and the episode must last at least 4 consecutive days. The symptoms must cause
noticeable changes in functioning but do not cause marked impairment in social or
occupational functioning or require hospitalization.

3. Depressive Episode Criteria

A major depressive episode is characterized by at least five or more symptoms occurring

over a two-week period, with at least one of the symptoms being depressed mood or loss of
interest or pleasure in most activities. These symptoms must also cause significant distress
or impairment in functioning.

Bipolar I vs. Bipolar II Disorder

 Bipolar I Disorder: Characterized by at least one manic episode, with or without

major depressive episodes. The manic episodes tend to be more severe and may
require hospitalization.
 Bipolar II Disorder: Characterized by at least one hypomanic episode and at least
one major depressive episode. Hypomanic episodes are less severe and do not cause
significant problems in day-to-day functioning.

Conclusion

Bipolar disorder is a complex mental health condition that involves dramatic shifts in mood,
from periods of elevated, manic states to deeply depressive states. While the exact cause is
not entirely understood, genetic, biological, and environmental factors play a significant role.
Early diagnosis and appropriate treatment, including medication and therapy, can help
individuals manage their symptoms and lead productive, stable lives.