Mood Disorders

Mood disorder can be broken down into Depression and Bipolar disorder. Since I have a section for Major Depressive Disorder, I will use this section to discuss Bipolar Disorder I and II as well as Cyclothymia. The criteria for Bipolar Disorder I include a manic episode that lasts a week or requires hospitalization. The mood elevation must be present nearly all day, most days. The mood is a distinct period of being persistently elevated or irritated.



There will be increased activity or energy. Symptoms such as inflated self-esteem, decreased need for sleep, more talkative than usual, flight of ideas or racing thoughts, distractibility, increased goal-oriented activity, excessive involvement in activities with high potential for painful consequences will be present. This episode must not be attributable to a substance or other medical condition, and it must be severe enough to cause marked impairment in social or occupational functioning or require hospitalization.

To be considered hypomania, the mood must last 4 consecutive days and be present most of the day almost every day. This mood will also be accompanied by grandiosity or inflated self-esteem, decreased need for sleep, racing thoughts, distractibility, increase in goal-oriented activity or psychomotor agitation, and engaging in activities that hold the potential for painful consequences (such as unrestrained buying sprees). The depressive side of Bipolar Disorder is characterized by a Major Depressive episode resulting in depressed mood or loss of interest or pleasure in life. They will experience symptoms such as depressed mood, loss of interest or anhedonia, weight loss and decreased appetite, engaging in purposeless movements such as pacing the floor, fatigue or decreased energy, feeling worthless and having guilt, decreased concentration, and recurrent thoughts of death.

We all experience good and bad days. Circumstances may abrupt our mood, but have you ever gone to bed with energy and joy and then woke up hopeless and feeling empty? There are differences between a mood swing which is usually tied to situational variables and mood changes (mania or depression) out of the blue for no apparent reason. Treatment options for Bipolar Disorder include the gold standard, Lithium. This medication is known for its mood stabilizing properties. Blood levels must be monitored, especially at the beginning of treatment to ensure a therapeutic dosing without elevated levels in your blood.

We also use antiseizure medications and antipsychotics for mood stabilization. A therapist can help you to create a crisis plan, establish a routine, establish ways to monitor your mood (they have apps that do this!) and participate in other therapeutic interventions to make life easier to manage when living with Bipolar Disorder. Cyclothymia is characterized by a chronic, fluctuating mood disturbances that involves alternating symptoms of depression and hypomania. These fluctuations must be present for two years (one year for children and teenagers).

People with Cyclothymia may be reactive to positive events with extreme joy, enthusiasm, and activity, and to negative events with disproportionate intense reactions. These reactions do not meet the full criteria for Bipolar Disorder. Treatment options for Cyclothymia include psychotherapy (Cognitive Behavioral Therapy) and medications such as mood stabilizers like Lithium and other antiseizure medications.

Medscape, DSM-5