Mood Disorder: Types, Symptoms and Treatment

A mood disorder is a mental health problem that mainly affects the emotional state of the individual. In this situation, the patient experiences long periods of immense happiness, immense sadness, or sometimes both. In some cases, the patient can feel other emotions like anger and irritability however situations can arise in which the patient can feel psychosis which can be fearful for the patient and the family. Mood disorders can severely affect the routine life and social life of the individual.

Types and Explanations Of Mood Disorders

Depression

It is a prevalent mental health disorder and requires a comprehensive understanding of the effective management and treatment of patients. According to NMHS depression is the most common psychiatric disorder in India. It is the most common cause of disability-adjusted life years (DALYs) among all psychiatric disorders.

Symptoms Of Depression (SIGECAPS)

• Sadness of mood/depressed mood
• Interest loss/loss of pleasure (anhedonia)
• Guilt/ Feeling of worthlessness
• Energy loss/ Fatigue
• Concentration loss
• Psychomotor agitation/Retardation
• Appetite loss with weight changes
• Suicidal thoughts
• Sleep disturbances

If these symptoms are present for more than two weeks, a diagnosis of depression is made. There are some specific symptoms of depression which can be categorized as follows:

Psychotic Features

If delusions and hallucinations are present along with depression then in management antipsychotics are added.

Atypical Features

• Mood reactivity is present (there is an improvement in mood with positive events). 
• Leaden Paralysis: subjective feeling of heaviness of limbs.
• Extreme sensitivity to interpersonal rejection. There will be immense disturbance if someone rejects or criticizes the person.
• The patient with atypical depression responds better to SSRIs and MAOIs than TCAs.

Melancholic Features

• There are significant biological symptoms like anorexia, weight loss, early morning awakening.
• Lack of mood reactivity and anhedonia.
• Depression worsens in the morning with a distinct quality of mood and there will be feelings of misery.

The pathophysiology of depression is neurotransmitter disturbances. There is a deficiency of serotonin norepinephrine and dopamine.

Treatment

• Antidepressants like SSRIs, SNRI, TCA, and atypical antidepressants.
• The first line of treatment for depression is SSRIs ( Escitalopram).

Dive deeper for a better understanding about Depression - Symptoms, Causes, and Treatment

Bipolar Disorder

Bipolar disorder is a mood disorder in which episodes of mania, depression, hypomania and mixed episodes can be seen.

Types of Bipolar Disorder

• Bipolar I Disorder- The patient has one episode of mania and one episode of depression.
• Bipolar II Disorder- The patient has one episode of hypomania plus one episode of depression.

Symptoms Of Bipolar Disorder

• Mood elation
• Energy (high)
• Distractibility
• Impulsivity (hypersexuality, overspending, over socialization)
• Grandiosity
• Flight of ideas
• Activity level (very high)
• Sleep(decreased need for sleep)
• Talkativeness

• Hypomania symptoms are similar to mania but they are not severe enough to cause marked impairment of social and occupational functioning, also the patient does not have any psychotic symptoms and the duration is only four days.

Diagnostic Criteria

• As per DSM 5, the first two symptoms that is mood elevation and increased energy along with three or more other symptoms for one week are required to diagnose a patient.
• Mania with psychotic symptoms
• Mania with delusion or hallucination

Treatment Of Bipolar Disorder

• The first line of drugs to treat bipolar disorder is lithium.
• Proper history should be taken and the patient should be asked to stop the antidepressant.
• In case the patient is showing signs of psychosis then antipsychotics like olanzapine and risperidone should be prescribed.
• The other mood stabilizers are valproate, carbamazepine, lamotrigine.
• In pregnancy, lamotrigine is safer.

Dive deeper for a better understanding about Bipolar Disorder: Types, Symptoms and Causes

Dysthymia

• Presence of mild depressive symptoms which are not enough to diagnose depressive episodes.
• The minimum duration for diagnosis in adults is 2 years and in children it is one year.
• Functional impairment is not severe
• The treatment is antidepressant and cognitive behavioral therapy.

Also Read: Schizoaffective Disorder: Causes, Symptoms, Diagnosis, Treatment and Complications

Cyclothymia

• It is a mild form of bipolar disorder in which mania and depressive symptoms occur, but the symptoms not severe enough to make a diagnosis of mania, hypomania or depressive episodes
• Functional impairment is not severe.
• Treatment is antipsychotics and mood stabilizers.

Also Read: All About Panic Disorder and Phobias

Premenstrual- Dysphoric disorder(PMDD)

• The onset is one week before menstruation and starts to improve after onset of menses and minimal to absent in weak post menses.
• The patient can feel some physical symptoms like breast tenderness and joint pain. The other mood symptoms are depressed mood and irritability along with insomnia and there will be changes in eating pattern.
• Treatment is SSRIs. 

Also Read: Obsessive Compulsive Disorder

Mood Disorders in Pregnancy

Postpartum Blues

• These are transient depressive symptoms like sadness, mood liability, tearfulness, irritability, and sleep disturbances and they may last for a few days to two weeks.
• There should not be any history of anhedonia, suicidal thoughts and thoughts of harming the baby.
• The treatment includes support to the mother only and no other treatment is required.

Postpartum Depression

• If the symptoms last for more than two weeks then patient should be evaluated for postpartum depression.
• It occurs within three months of delivery and increases the risk of depression in the future.
• These symptoms are depressed mood, insomnia, weight changes, tearfulness and anhedonia.
• There is a strong association with history of mood disorder and the treatment includes pharmacotherapy and psychotherapy.

Postpartum Psychosis

• It occurs within two to three weeks of delivery.
• The initial symptoms are insomnia, tearfulness, mood liability and fatigue but it can also lead to delusion or hallucination.
• There is still a risk of another episode of postpartum psychosis and there is a family history of mood disorder in the patient.
• The treatment includes psychiatric emergency treatment with antipsychotics and lithium in a combination of antidepressant.

Also Read: Sleep Disorder : Symptoms, Causes & Treatment

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