Mood Disorders

• Bipolar Disorder
• Major Depressive Disorder
• Persistent Depressive Disorder (Dysthymia)

Bipolar Disorder is commonly known as “manic depression.”  The disorder is subdivided into Bipolar I, Bipolar II, and Cyclothymia. Individuals with bipolar disorder experience episodes of abnormally elevated mood called a manic episode. These episodes can consist of a decreased need for sleep, excessive energy, rapid speech, and feeling like one’s mind is racing. Individuals can be irritable, engage in confrontations with others or become aggressive, demonstrate poor judgment, and may engage in behaviors that appear out of character, such as spending sprees or risk taking behavior. Risk taking behaviors can include substance use or risky sexual behavior.  A milder version of a manic episode is referred to as “hypomania.”

During a depressive episode, an individual typically suffers from a change in mood (depressed, sad, anxious, empty), feelings of hopelessness, helplessness, guilt, pessimism, loss of interest in pleasurable activities, decreased energy; changes in sleep and appetite; difficulty concentrating and remembering, feeling restless or irritable, physical complaints, and thoughts of suicide or death.

To be diagnosed with Bipolar I, the individual must have experienced or currently be experiencing a manic episode. To be diagnosed with Bipolar II, the individual must have experienced or currently be experiencing hypomanic episode and a major depressive episode.

In contrast, Cyclothymic Disorder is characterized by symptoms of a hypomanic episode and a depressive episode. Individuals with this disorder do not meet the full criteria for a hypomanic or depressive episode, though they experience symptoms of them.

Major Depressive Disorder is a multifaceted disorder characterized by mood disturbance in combination with behavioral difficulties (social isolation, sleep and appetite disturbance) and cognitive dysfunction (poor concentration and memory). Clinical depression goes beyond the normal reaction to negative life circumstances, such as divorce, illness or loss of a significant other. A significant number of patients with major depressive disorder respond to a combination of antidepressant drugs and psychotherapy, with research indicating that the most effective psychotherapeutic approach is Cognitive Behavioral Therapy.

Persons of all ages can suffer from depression, including adults, children and the elderly. Studies estimate the prevalence rates of depression for adult women to be between 5-9% and for adult men 2-3%.

Estimates also suggest that 3-6 million children suffer from depression although the disorder may be vastly under identified and under treated, especially when symptoms overlap with other disorders, such as hyperactivity, school problems or somatic concerns. Depression in children may be indicated by symptoms similar to those seen in adults, such as hopelessness, and even suicidal thoughts. Some symptoms are more characteristic of childhood depression such as excessive dependency on adults, difficulties in school, behavioral problems, listlessness, bed-wetting, fatigue and bodily complaints.

Some data suggests that depression in older adults is also grossly underestimated. Symptoms of depression in the elderly are frequently incorrectly diagnosed as senility and other disorders associated with advanced age because of symptoms such as memory loss, confused thinking or apathy. Additionally, inconsistent sleeping patterns and reduced appetite, often occurring in this age group independent of depression, may in fact be signs of depression. Depression in the elderly may also manifest via multiple physical complaints, such as aches and pains.

Persistent Depressive Disorder (Dysthymia) is considered a more chronic but less severe depression than major depression.  Individuals with dysthymia experience many of the same symptoms as an individual in a major depressive episode but to a lesser degree.  In order to be diagnosed with dysthymia, an individual must suffer from the symptoms for at least 2 years.  During the 2 year period, the symptoms cannot be absent for more than 2 consecutive months.  Individuals with dysthymia can also experience a major depressive disorder, and this is commonly called a “double depression.”