NATIONAL UNIVERSITY OF ADVANCED LEGAL STUDIES

MOOD DISORDERS
- PSYCHOLOGY PROJECT

CONTENTS

NO.

TOPIC

PAGE NO.

1.

INTRODUCTION

2.

TYPES OF MOOD DISORDERS

3.

BIPOLAR DISORDER

5-7

4.

ANXIETY DISORDER

8-9

5.

AFFECTIVE DISORDER

10-11

6.

DYSTHYMIC DISORDER

12-13

7.

DEPRESSIVE DISORDER

14-15

7.

CONCLUSION

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INTRODUCTION

Mood disorders affect about 10% of the population. Everyone experiences highs and lows in life, but people with mood disorders experience them with greater intensity and for longer periods of time than most people.1 A mood disorder, also referred to as is a condition impacting mood and related functions. In a mood disorder, moods range from extremely low (depressed) to extremely high or irritable (manic).2 Mood disorders can lead to changes in sleeping and eating patterns. Some people, especially children, may have physical symptoms of depression, like unexplained headaches or stomach aches. People are more easily demoralized by depression and slower to recover if they are withdrawn and unreasonably self-critical or irritable, impulsive, and hypersensitive to loss. Most people with major depression also show some signs of anxiety, and 15-30% have panic attacks.3 As a biological mechanism for coping with danger, anxiety creates a need for help or protection that may give way to despair if it is disappointed. Chronically anxious people may also medicate themselves with alcohol or drugs that can cause depression. Mood disorders can increase a person's risk for heart disease, diabetes, and other diseases. Treatments include medication, psychotherapy, or a combination of both. With treatment, most people with mood disorders can lead productive lives. The most common mood disorders are depression and bipolar disorder.4 Another mood disorder is seasonal affective disorder (SAD), a form of depression most often associated with fewer hours of daylight in the far northern and southern latitudes from late fall to early spring. Each of these mood disorders are dealt with in succinct detail subsequently.

http://www.cmha.ca/mental-health/understanding-mental-illness/mood-disorders/ >> Last accessed at 19:34 on 23.03.2014 2 http://depression.about.com/od/glossarym/a/mood-disorder.htm>> last accessed at 19:55 on 23.03.2014 3 http://mentalhealthamerica.net/conditions/mood-disorders
4

Also called manic depression.

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TYPES OF MOOD DISORDERS

As explained earlier mood disorders can be primarily categorised into the following five broad heads:

BIPOLAR DISORDER ANXIETY DISORDER AFFECTIVE DISORDER DYSTHYMIC DISORDER DEPRESSIVE DISORDER

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BIPOLAR DISORDER
Bipolar disorder causes serious shifts in mood, energy, thinking, and behaviorfrom the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function.5 During a manic episode, a person might impulsively quit a job, charge up huge amounts on credit cards, or feel rested after sleeping two hours. During a depressive episode, the same person might be too tired to get out of bed, and full of self-loathing and hopelessness over being unemployed and in debt.

SIGNS & SYMPTOMS

Bipolar disorder can look very different in different people. The symptoms vary widely in their pattern, severity, and frequency. Some people are more prone to either mania or depression, while others alternate equally between the two types of episodes. Some have frequent mood disruptions, while others experience only a few over a lifetime. There are four types of mood episodes in bipolar disorder: mania, hypomania, depression, and mixed episodes. Each type of bipolar disorder mood episode has a unique set of symptoms. Common symptoms of bipolar depression include6:
1. 2. 3. 4. 5. 6. 7. 8. 9.

Feeling hopeless, sad or empty. Irritability Inability to experience pleasure Fatigue or loss of energy Physical or mental sluggishness Appetite or weight changes Sleep problems Concentration and memory problems Feelings of worthlessness or guilt

http://www.helpguide.org/mental/bipolar_disorder_symptoms_treatment.htm ibid

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CAUSES & TRIGGERS

Bipolar disorder has no single cause. It appears that certain people are genetically predisposed to bipolar disorder, yet not everyone with an inherited vulnerability develops the illness, indicating that genes are not the only cause. Some brain imaging studies show physical changes in the brains of people with bipolar disorder. Other research points to neurotransmitter imbalances, abnormal thyroid function, circadian rhythm disturbances, and high levels of the stress hormone cortisol. External environmental and psychological factors are also believed to be involved in the development of bipolar disorder. These external factors are called triggers. Triggers can set off new episodes of mania or depression or make existing symptoms worse. However, many bipolar disorder episodes occur without an obvious trigger.

Stress Stressful life events can trigger bipolar disorder in someone with a genetic vulnerability. These events tend to involve drastic or sudden changeseither good or badsuch as getting married, going away to college, losing a loved one, getting fired, or moving. Substance Abuse While substance abuse doesnt cause bipolar disorder, it can bring on an episode and worsen the course of the disease. Drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquilizers can trigger depression. Medication Certain medications, most notably antidepressant drugs, can trigger mania. Other drugs that can cause mania include over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids, and thyroid medication. Seasonal Changes Episodes of mania and depression often follow a seasonal pattern. Manic episodes are more common during the summer, and depressive episodes more common during the fall, winter, and spring. Sleep Deprivation Loss of sleepeven as little as skipping a few hours of restcan trigger an episode of mania.

TREATMENT
The best treatment for bipolar disorder is a combination of medication and counselling. Doctors often treat the mania symptoms associated with bipolar disorder with one set of drugs, and use other drugs to treat depression. Certain drugs are also used to maintain a steady mood over time. I. Bipolar Treatments Treatment for bipolar disorder most often includes a combination of a moodstabilizing drug and psychotherapy. Although drug treatment is primary, ongoing psychotherapy is important to help patients better cope with the condition. Mood Disorders
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II. Medications If you have bipolar disorder, you will probably need medication. In reality, you may need bipolar medication for the rest of your life. III. Therapy Along with medication, ongoing psychotherapy, or "talk" therapy, is an important part of treatment for bipolar disorder. During therapy, you can discuss feelings, thoughts, and behaviours that cause you problems. IV. Treating Bipolar Mania If you are suffering from mania, your doctor may initially treat you with an antipsychotic drug, benzodiazepine, and/or lithium to quickly control hyperactivity, sleeplessness, hostility, and irritability. Your doctor will also likely prescribe a mood stabilizer.7

http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-treatment-care >> Last accessed at 20:40 on 23.03.2014

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ANXIETY DISORDER
There are many types of anxiety disorders including panic disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, specific phobias, and generalized anxiety disorder. Anxiety is a normal human emotion that everyone experiences at times. Many people feel anxious, or nervous, when faced with a problem at work, before taking a test, or making an important decision. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person's ability to lead a normal life. An anxiety disorder is a serious mental illness. For people with anxiety disorders, worry and fear are constant and overwhelming, and can be crippling. There are several recognized types of anxiety disorders, including8:

Panic disorder: People with this condition have feelings of terror that strike suddenly and repeatedly with no warning. Other symptoms of a panic attack include sweating, chest pain, palpitations (unusually strong or irregular heartbeats), and a feeling of choking, which may make the person feel like he or she is having a heart attack or "going crazy." Obsessive-compulsive disorder (OCD): People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes his or her hands. Post-traumatic stress disorder (PTSD): PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event and tend to be emotionally numb. Social anxiety disorder: Also called social phobia, social anxiety disorder involves overwhelming worry and self-consciousness about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way that might cause embarrassment or lead to ridicule.

http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders >> Last accessed at 20:45 on 23.04.2014

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Specific phobias: A specific phobia is an intense fear of a specific object or situation, such as snakes, heights, or flying. The level of fear is usually inappropriate to the situation and may cause the person to avoid common, everyday situations. Generalized anxiety disorder: This disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety.

SIGNS & SYMPTOMS

Symptoms vary depending on the type of anxiety disorder, but general symptoms include:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Feelings of panic, fear, and uneasiness Uncontrollable, obsessive thoughts Repeated thoughts or flashbacks of traumatic experiences Nightmares Ritualistic behaviors, such as repeated hand washing Problems sleeping Cold or sweaty hands and/or feet Shortness of breath Palpitations An inability to be still and calm Dry mouth Numbness or tingling in the hands or feet Nausea Muscle tension Dizziness

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AFFECTIVE DISORDER
Affective disorders are a set of psychiatric diseases. The main types of affective disorders are depression, bipolar disorder, anxiety disorder, seasonal affective disorder etc. All of the above but one has already been discussed. Symptoms vary by individual, but they typically affect mood. They can range from mild to severe. Seasonal affective disorder (also called SAD) is a type of depression that occurs at the same time every year. Mostly, the symptoms start in the fall and may continue into the winter months, sapping energy and making one feel moody. Less often, seasonal affective disorder causes depression in the spring or early summer.

SIGNS & SYMPTOMS

In most cases, seasonal affective disorder symptoms appear during late fall or early winter and go away during the sunnier days of spring and summer. However, some people with the opposite pattern have symptoms that begin in spring or summer. In either case, symptoms may start out mild and become more severe as the season progresses.
Winter-onset seasonal affective disorder symptoms include:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Depression Hopelessness Anxiety Loss of energy Heavy, "leaden" feeling in the arms or legs Social withdrawal Oversleeping Loss of interest in activities you once enjoyed Appetite changes, especially a craving for foods high in carbohydrates Weight gain Difficulty concentrating

TREATMENT
Treatment for seasonal affective disorder includes light therapy (phototherapy), psychotherapy and medications. Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year.

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I. Light therapy In light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you're exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood. II. Medications Some people with seasonal affective disorder benefit from antidepressant treatment, especially if symptoms are severe. Anti-depressants9 are commonly used to treat seasonal affective disorder. III. Psychotherapy Psychotherapy is another option to treat seasonal affective disorder. Although seasonal affective disorder is thought to be related to brain chemistry, your mood and behaviour also can add to symptoms. Psychotherapy can help you identify and change negative thoughts and behaviours that may be making you feel worse. You can also learn healthy ways to cope with seasonal affective disorder and manage stress.10

These include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).

10

http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/treatment/con20021047 >> Last accessed at 21:00 on 23.03.2013

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DYSTHYMIC DISORDER
This mood disorder is a less severe form of depression. Although less extreme, dysthymic disorder causes chronic or long-lasting moodiness. With dysthymic disorder, low, dark moods invade your life nearly every day for two years or more. Dysthymia is contrasted with a full major depressive episode that lasts two years or longer, which is called chronic major depression. Dysthymic disorder can occur alone or along with other psychiatric or mood disorders. As with depression, dysthymic disorder is more common in women than in men. A family history of mood disorders is not uncommon. This mood disorder tends to appear earlier than major depression, although it can begin anytime from childhood to later in life. Up to 5% of the general population is affected by dysthymic disorder. But its cause is not well understood. A combination of factors conspires to create this mood disorder. These factors may include11:

Genetics Abnormalities in the functioning of brain circuits involve in emotional processing Chronic stress or medical illness Isolation Poor coping strategies and problems adjusting to life stresses

These factors can feed off each other. For example, if you always see "the glass as half empty," you may reinforce the symptoms of depression. And a chronic mood disorder can sensitize you to stress, further feeding your risk for depression.

SIGNS & SYMPTOMS

In addition to chronic low moods, common symptoms of this mood disorder include:
1. 2. 3. 4. 5. 6.
11

Feelings of hopelessness or helplessness Trouble sleeping or daytime sleepiness Poor appetite or eating too much Fatigue or low energy Low self-esteem Trouble concentrating or making decisions

http://www.webmd.com/mental-health/mood-disorders >> Last accessed at 22:10 on 23.04.2014

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TREATMENT
A diagnosis of dysthymic disorder in adults requires at least a two-year history of depressed mood for most of the day on most days, along with at least two of the symptoms noted above. Although some symptoms may overlap, you may be less likely to have weight or sleep changes with dysthymic disorder than with depression. You may also tend to withdraw more and have stronger feelings of pessimism and inadequacy than with major depression. Staying in a constant state of moodiness is no way to live. That's one reason to seek treatment. Another is that dysthymic disorder can also increase your risk for physical diseases. If left untreated, this mood disorder can develop into more severe depression. It can also increase your risk for attempting suicide.

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DEPRESSIVE DISORDER
Sadness or downswings in mood are normal reactions to lifes struggles, setbacks, and disappointments. Many people use the word depression to explain these kinds of feelings, but depression is much more than just sadness. Some people describe depression as living in a black hole or having a feeling of impending doom. However, some depressed people don't feel sad at allthey may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless. Whatever the symptoms, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief. The most commonly spoken and severe type of depressive disorder is Major Depressive disorder (MDD), also known as unipolar disorder, clinical depression among others. Major depressive disorder (MDD) is a debilitating disease that can seriously affect a person's health, well being, and life. People with major depression experience extended periods of sadness, emptiness, and despair, and they are often unable to enjoy activities that they once found pleasurable. MDD can cause problems with a persons diet, sleep, work life, and ability to connect with others.12 People with MDD are more likely to use alcohol or illegal substances than others, and are at an increased risk for other mental and physical health problems, and a much greater risk of suicide. The exact cause of major depressive disorder is not known, however many researchers believe it is linked to chemical changes in the brain, problems with a person's genes, or a combination of both. It tends to run in families, but can also occur in those with no family history of the disease. Alcohol and drug abuse may play a role in MDD, as can other medical conditions such as an under-active thyroid and certain types of cancer. Other conditions associated with the disease include sleep problems as well as some types of medications, including steroids.

12

http://www.healthline.com/health/depression/major-depressive-disorder>> Last accessed at 22:30 on 23.03.2014

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SIGNS AND SYMPTOMS

Signs and symptoms of depression include13:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Feelings of helplessness and hopelessness. A bleak outlooknothing will ever get better and theres nothing you can do to improve your situation. Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. Youve lost your ability to feel joy and pleasure. Appetite or weight changes. Significant weight loss or weight gaina change of more than 5% of body weight in a month. Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia). Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves. Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete. Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes. Reckless behaviour. You engage in escapist behaviour such as substance abuse, compulsive gambling, reckless driving, or dangerous sports. Concentration problems. Trouble focusing, making decisions, or remembering things. Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

TREATMENT
Depression can be treated. Treatment includes medicines, talk therapy, or both. I. Medicines Antidepressants are medicines used to treat depression. They work by bringing back the chemicals in the brain to the right levels. This helps relieve the symptoms. If one has delusions or hallucinations, the health care provider may prescribe additional medicines. Inform provider about any other medicines taken. Some medicines can change the way antidepressants work in ones body. Allow the medicine time to work. It may take a few weeks before it begins to show results. Do not stop taking it or change the amount (dosage without talking to the provider. Be informed about possible side effects, and what to do if you have any from the doctor.

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http://www.helpguide.org/mental/depression_signs_types_diagnosis_treatment.htm >> >> Last accessed at 22:30 on 23.03.2014

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CONCLUSION
Although there is no one cause of mood disorders and depression, research clearly reflects a genetic predisposition to develop a mood disorder. Studies have shown that mood disorders and depression are common among close relatives, and twin studies have also shown a strong genetic basis. Additionally, research has shown that people who tend to be more negative and have low self-esteem are more likely to develop a mood disorder. In addition to the genetic causes of mood disorders, studies have also shown that environmental and interpersonal stressors can trigger mood disorders and depression, especially in those who are already thought to be at risk. Events such as changes in relationships, academic struggles, financial difficulties, death of a loved one, divorce, and trauma can trigger a mood disorder. For children and adolescents, poor school performance, parental divorce, family relocation, and peer difficulties are common triggers for a mood disorder.

Left untreated, depression may remit on its own in about one year. However, during the depressive episode other events can occur as a result of the depression, leading to longer-term difficulties. For this reason, treatment is considered critical even though symptoms may remit. Further, for some forms of depression, symptoms will not remit and will last for years. Additionally, other mood disorders do not tend to remit spontaneously and may last for years without treatment.

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