A person with dysthymia may not be actively suicidal or have trouble getting out of bed in the morning, but he or she is plagued by a nagging sense of despair and worthlessness that sap the joy out of life. The other major category of mood disorder is that of bipolar disorder and cyclothymia. Bipolarity manifests itself in rapid, extreme mood shifts from mania to depression. Manic periods are often preceded by a hypomanic phase, in which the person is extremely productive, needs little sleep, and may feel extremely confident and creative. However, the risk-taking behavior grows more marked as the patient enters the fully manic phase, and the sufferer becomes increasingly distracted, grandiose, and unpredictable in his or her behavioral patterns. At its most extreme, mania may be misdiagnosed for schizophrenia because of the patient's delusions of grandeur. Depression amongst the bipolar is often more extreme and results in complete catatonia and suicidal despair.

With cyclothymia, the patient exhibits hypomanic symptoms and less extreme depressive episodes. "The risk of bipolar disorder developing in patients with cyclothymia is about 33%; although 33 times greater than that for the general population, this rate of risk still is too low to justify viewing cyclothymia as merely an early manifestation of bipolar type I disorder" (Mood disorders, 2011, Mental Health: A report of the Office of the Surgeon General). Like dysthymia, the symptoms of cyclothymia must cause significant social or personal impairment to be classified as a disorder.

Treatment

Both mood and anxiety disorders are commonly treated with a combination of therapy and psychopharmacology. Cognitive-behavioral therapy (CBT) is generally considered to be the most effective treatment for anxiety disorders. CBT challenges patient's maladaptive responses (such as excessive worrying, checking, and obsessing) with confrontational, rationally-based questions and replaces current habits with new patterns of thinking and coping mechanisms to deal with stress. Clients are encouraged to monitor themselves, and when they note "patterns of worrisome thinking, catastrophic imagery, physiological activity, behavioral avoidance, and the external cues that may trigger these responses," they replace them with the "newly learned coping responses" (Newman & Borkovec 1995). Anxiety disorders are also treated with medications, including selective serotonin reuptake...

However, a randomized placebo-controlled study of antidepressants approved by the Food and Drug Administration study published in the Journal of American Medicine found no difference between a placebo and the antidepressants for patients suffering dysthymia. Cognitive behavioral therapy has also been found to be effective in treating dysthymia, by challenging ingrained thinking patterns such as 'I am not a good person' and 'things always turn out horribly for me' (Fournier, 2010). Medication can be helpful for majorly depressed patients return to a state of functionality so they can benefit from talk therapy. However, for both bipolar and cyclothymic disorder, medication is nearly always indicated to stabilize the patient's mood, usually through the use of lithium to treat manic phases and antidepressants to treat the depressive phases. Anti-psychotics are also frequently used to subdue a severely manic phase and anti-anxiety medications to treat less florid forms of mania (Bipolar, 2008, Gale).