What are the two key moods involved in mood disorders?

A mood disorder is a condition that severely impacts mood and its related functions. Mood disorder is a broad term that refers to the different types of depressive and bipolar disorders, all of which affect mood. If you have symptoms of a mood disorder, your moods may range from extremely low (depressed) to extremely high or irritable (manic).

Types of Mood Disorders

With the update of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013, mood disorders were separated into two groups: bipolar and related disorders and depressive disorders. Types of mood disorders include:

• Major depressive disorder (MDD): This is what we often hear referred to as major depression or clinical depression. It involves periods of extreme sadness, hopelessness, or emptiness accompanied by a variety of physical, cognitive, and emotional symptoms.
• Bipolar I disorder: This disorder was formerly called manic depression. Mania is characterized by euphoric and/or irritable moods and increased energy or activity. During manic episodes, people with bipolar I also regularly engage in risky activities that can result in negative consequences for themselves and/or others.
• Bipolar II disorder: To be diagnosed with bipolar II, a person must have had at least one episode of current or past hypomania (a less severe form of mania), and at least one episode of current or past major depression, but no history of any manic episodes.
• Cyclothymic disorder:Diagnosis requires a minimum two-year history of many episodes that resemble hypomania and resemble major depression, but none of which actually meet the criteria for these conditions.
• Bipolar and related disorder due to another medical condition: Some medical conditions can actually cause symptoms of bipolar disorder. This is diagnosed when there is evidence that the mood disturbance is the direct physiological result of another medical (not mental) condition.
• Depressive disorder due to another medical condition: Similar to bipolar disorder related to another medical condition, this diagnosis is used for people who have the symptoms of depression; however, the symptoms are directly caused by an underlying medical condition such as hypothyroidism.
• Substance/medication-induced bipolar disorder: This describes a person who is experiencing symptoms of bipolar disorder as a result of alcohol, drugs, or medication.
• Substance/medication-induced depressive disorder: This diagnosis is used when a person experiences a depressive disorder as a result of alcohol, drugs, or medication.
  
• Other specified or unspecified bipolar: These diagnoses may be used when a person doesn't meet the criteria for any other type of bipolar disorder, but they do experience bipolar symptoms (such as a hypomanic episode lasting only two days).
• Other specified or unspecified depressive disorder: These diagnoses may be used when a person experiences a depressive disorder, but they don't technically meet the full criteria for any other depressive disorder. This allows communication around the specific reasonings the presentation does not meet criteria for any specific depressive disorder.

New Mood Disorders

The DSM-5 added three new mood disorders. These include:

• Disruptive mood dysregulation disorder:This depressive disorder was added to the DSM-5 for children 6 to 18 years of age who exhibit persistent irritability and anger and frequent episodes of extreme temper outbursts without any significant provocation.
• Persistent depressive disorder: This diagnosis is meant to include both chronic major depressive disorder (that has lasted for two or more years) and what was previously known as dysthymic disorder or dysthymia, a lower grade form of depression.
• Premenstrual dysphoric disorder: This diagnosis is based on the presence of one or more specific symptoms in the week before the onset of menstruation, followed by the resolution of these symptoms after onset. The symptoms include mood swings, irritability or anger, depressed mood or hopelessness, and anxiety or tension, as well as one or more of an additional seven other mood symptoms, for a total of at least five symptoms.

The DSM-5, text revision (DSM-5-TR) added a new category within the depressive disorders and bipolar disorders chapters—it's called unspecified mood disorder.

With an unspecified mood disorder, a person displays symptoms characteristic of a mood disorder, but they don't meet the criteria for a doctor to diagnose them with a depressive or bipolar disorder (including unspecified bipolar disorder or unspecified depressive disorder). It is applied to presentations where it is difficult to choose between an unspecified depressive or unspecified bipolar disorder.

Symptoms of Mood Disorders

Mood disorders can lead to difficulty in keeping up with the daily tasks and demands of life. Some people, especially children, may have physical symptoms of depression, like unexplained headaches or stomachaches. Because there are various types of mood disorders, they can have very different effects on quality of life. In general, symptoms may include:

• Loss of interest in activities one once enjoyed
• Eating more or less than usual
• Difficulty sleeping or sleeping more than usual
• Fatigue
• Crying
• Anxiety
• Feeling "flat," having no energy to care
• Feeling isolated, sad, hopeless, and worthless
• Difficulty concentrating
• Problems making decisions
• Feelings of guilt
• Irritability
• Thoughts of dying and/or suicide

With mood disorders, these symptoms are ongoing and eventually start to affect daily life in a negative way. They're not the sporadic thoughts and feelings that everyone has on occasion.

Causes

No one knows the exact cause of mood disorders, but a variety of factors seem to contribute to them and they tend to run in families. Chemical imbalances in the brain are the most likely cause. Stressful life events like death, divorce, or trauma can also trigger depression, especially if someone has already had it before or there's a genetic component.

Diagnosis

Mood disorders should be properly evaluated and treated by a mental health professional, such as a psychiatrist. If any of your symptoms have been interfering with your life, particularly if you are having suicidal thoughts, you should seek help immediately.

A doctor will be able to diagnose you by performing a physical exam and lab tests to rule out any physical reasons for your symptoms along with a psychiatric evaluation.

Treatment

Millions of people experience mood disorders and are successfully treated, helping them live a better quality of life. Treatments for mood disorders can include psychotherapy, also known as talk therapy, as well as medications to help regulate chemical imbalances in the brain. A combination of therapy and medication is often the best course of action.

Therapy

Cognitive behavioral therapy (CBT) is a common form of therapy used to treat many types of mental health conditions, including depression and bipolar disorder. With CBT, a therapist teaches you to reframe negative thought patterns and redirect potentially harmful behavior by using healthy coping mechanisms instead.

Another type of therapy that may be recommended for those with mood disorders is family therapy. Family therapy can help your loved ones learn more about your condition, which can help them become better able to support you during treatment.

Medication

A doctor may prescribe antidepressants for someone with a mood disorder. Antidepressants are used to treat both depression and certain types of bipolar disorder.

Depakote (sodium valproate), Lamictal (lamotrigine), and Tegretol (carbamazepine) are anticonvulsants that are sometimes used to treat symptoms of bipolar disorder. Anticonvulsants are used to treat seizures in people with epilepsy but have been found to be effective in treating the symptoms of bipolar disorder as well.

A Word From Verywell

It can be intimidating if you or a loved one receives a diagnosis of a mood disorder. But remember, there are many resources that can help you cope, including therapy. If you are concerned you may have symptoms of a mood disorder, be sure to talk to a doctor who can diagnose you if necessary. The more honestly you communicate with a doctor, the better they will be able to help you by coming up with a treatment plan.

By Lauren DiMaria
Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert. 

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