Mood disorders: Major Depressive Disorder, Bipolar Disorder, and Seasonal Affective Disorder

Mood Disorders

INTENSE, PERSISTENT, RECURRING

Definition of Mood Disorders

Causes

Risk Groups

Symptoms

Diagnosis and Treatment

Prevention

Proposed Dimensions for DSM5

In a single year, approximately 7% of Americans suffer from mood disorders, seen as depression or mania, likely to turn worse or cause death (Satcher, 2011). It is one of the top 10 causes of disability throughout the world. Mood disorder subjects spouses, children, parents, siblings and friends to frustration, guilt, anger, financial burden and even physical abuse in coping with the person who suffers from it. Depression has damaging effects on the economy in the form of decreased productivity and increased use of healthcare resources. Depression leads to absenteeism or reduces productivity. Depression accounts for the large part of healthcare expenditure. Depressed persons go through expensive diagnostic procedures in search for the cause of their pain. In many cases, they are treated for other complaints while the mood disorder escapes diagnosis and treatment (Satcher).

Mood Disorders

Mood disorders represent pathological extremes of normal moods, specifically sadness and elation (Boeree, 2003). The mood is said to be disordered when normal sadness or elation remains too long or becomes too strong. It may even lead to death through suicide or some reckless behavior (Boeree). These comprise all types of depression and bipolar disorder (OSUMC, 2011). They are also called affective disorders. Their distinguishing characteristic is a subjective experience of mood unusual for a particular circumstance (McGuigan, 2011). Common mood disorders are bipolar disorder, depression, postpartum depression, cyclothymia, schizoaffective disorder and seasonal affective disorder. When a single mood is brought to extreme, it is called a unipolar disorder. Severe depression is an example of a unipolar disorder (McGuigan).

Causes

The causes of mood disorders are not yet known (OSUMC, 2011). Brains chemicals, called endorphins, bring on positive moods. Other chemicals, neurotransmitters, regulate endorphins. An imbalance between these chemicals is assumed by some experts to be a cause of depression in response to unwanted life changes. Others believe many factors predispose a person to a mood disorder. These factors are genetic and environmental and occur more often in women than in men (OSUMC).

Risk Groups

These are children, adolescents, and adults who have parents with a mood disorder (OUSMC, 2011). Their own stresses and misfortune can exaggerate the sadness or depression they have been habitually exposed to. These events include losing a job, divorce, losing a loved one, a death in the family and financial problem. The incidence of depression is twice as high in women as in men. The incidence of manic depression is both sexes in the general population is 2.6%. A diagnosis of the disorder in a family increases the risk among the siblings, children and relatives (OUSMC).

Types

The most common ones are major depression; dysthymia or dysthymic disorder; manic depression or bipolar disorder; mood disorder induced by medication; and mood disorder caused by a medical condition (UOSMC, 2011; Boeree, 2003, McGuigan, 2011). Major depression is a two-week irritable mood or noticeable decrease in interest or pleasure in usual activities. Dysthimia is a chronic, minor depressed or irritable mood for at least a year. Manic depression or bipolar disorder consists of at least one episode of depressed or irritable mood and at least one period of elevated mood. Certain illnesses, like cancer, infections and injuries can produce depression. It can also be a consequence of medication, drug abuse, exposure to poison, and other forms of treatment (UOSMC, Boeree, McGuigan).

Symptoms

Among the most common ones are a persistent feeling of sadness, a sense of hopelessness or helplessness, low self-esteem, excessive guilt, desire to die, sleep disturbances, appetite changes, decreased energy, physical complaints, hypersensitiveness to failure or rejection, and a desire to run away from home (OUSMC, 2011; McGuigan, 2011; Boeree, 2003). These feelings are more intense than those of a normal person and persist for a longer period (OUSMC, McGuigan, Boeree).

Complications and Associated Conditions

A major and most dreaded complication of these disorders is suicide (Satcher, 2010). Records say 10-15% of those hospitalized with depression commit suicide (Angst et al., 1999 as qtd in Satcher). The figure represents 20-35% of all recorded completed suicides. Completed suicide is most common among those with severe and/or psychotic symptoms, occurring in later years of life along with some form of addiction. It is also more common in those experiencing severe life events and suffering from some medical illness. Men are four times more prone to complete suicide than women, although women attempt suicide four times more often than men. The seriousness of this public health problem led to the issuance of the Call to Action on suicide in 1999 (Satcher).

Persons suffering from mood disorders are also at risk for coronary heart disease (Satcher, 2010). These disorders are also often simultaneous with other mental and bodily disorders, such as anxiety at about half of all cases. They co-occur so often that experts tend to categorize them together. Substance abuse is another condition often found with mood disorders at 24-40% in the U.S. If untreated, substance abuse makes mood disorders worse. Other conditions, which tend to occur with these disorders, include personality disorders and chronic medical conditions. Examples of these chronic medical conditions are hypertension and arthritis at 65-71%. Mood disorders also tend to hamper or damage normal personality development (Satcher).