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Mood disorders are a group of psychological disorders classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR) that involves the mood of the person as the main underlying cause of the disorder which affects the person's relationships, work or health causing distress to the person. The severity of the mood disorder can be seen through the damage it has done to the person's life such as job loss, loss of trust and unable to trust, loss of social support, loss of confidence, hopelessness and extreme behaviour.
Types of Mood Disorders
Major depressive disorderÂ (MDD), commonly called major depression, unipolar depression, or clinical depression, where a person has two or moreÂ major depressive episodes. Depression without periods of mania is sometimes referred to asÂ unipolar depressionÂ because the mood remains at one emotional state or "pole".Â Diagnosticians recognize several subtypes or course specifiers which are listed below.
Atypical DepressionÂ (AD)
Atypical depressionÂ (AD) is characterized by mood reactivity (paradoxical anhedonia) and positivity, significantÂ weight gainÂ or increased appetite ("comfort eating"), excessive sleep or somnolence(hypersomnia), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection.Â Difficulties in measuring this subtype have led to questions of its validity and prevalence.
Melancholic depressionÂ is characterized by a loss of pleasure (anhedonia) in most or all activities, a failure of reactivity to pleasurableÂ stimuli, a quality of depressed mood more pronounced than that ofÂ griefÂ or loss, a worsening of symptoms in the morning hours, early morning waking,Â psychomotor retardation, excessive weight loss (not to be confused with anorexia nervosa), or excessive guilt.
Psychotic major depressionÂ (PMD)
Psychotic major depressionÂ (PMD), or simply psychotic depression, is the term for a major depressive episode, particularly of melancholic nature, where the patient experiences psychotic symptoms such asÂ delusionsÂ or, less commonly,Â hallucinations. These are most commonly mood-congruent (content coincident with depressive themes).
Catatonic depressionÂ is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here the person is mute and almost stuporose, and either immobile or exhibits purposeless or even bizarre movements. Catatonic symptoms also occur inÂ schizophrenia, aÂ manic episode, or due toÂ neuroleptic malignant syndrome.
Postpartum DepressionÂ (PPD)
Postpartum depressionÂ (PPD) is listed as a course specifier in DSM-IV-TR; it refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which has incidence rate of 10 to 15%, typically sets in within three months ofÂ labour, and lasts as long as three months.
Seasonal Affective DisorderÂ (SAD)
Seasonal affective disorderÂ (SAD) also known as "winter depression" or "winter blues" is a specifier. Some people have a seasonal pattern, with depressive episodes coming on in the autumn or winter, and resolving in spring. The diagnosis is made if at least two episodes have occurred in colder months with none at other times over a two-year period or longer.
Dysthymia is a chronic, different mood disturbance where a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to asÂ double depression).
Depressive Disorder Not Otherwise SpecifiedÂ (DD-NOS)
Depressive Disorder Not Otherwise SpecifiedÂ (DD-NOS) is designated by theÂ codeÂ 311Â for depressive disorders that are impairing but do not fit any of the officially specified diagnoses. According to the DSM-IV, DD-NOS encompassÂ "any depressive disorder that does not meet the criteria for a specific disorder."Â It includes the research diagnoses of recurrent brief depression, andÂ minor depressive disorderÂ listed below.
Recurrent Brief DepressionÂ (RBD)
Recurrent brief depressionÂ (RBD), distinguished from major depressive disorder by differences in duration. People with RBD have depressive episodes about once per month, with individual episodes lasting less than two weeks and typically less than two to three days. Diagnosis of RBD requires that the episodes occur over the span of at least one year and, in female patients, independently of theÂ menstrual cycle.Â People with clinical depression can develop RBD, and vice versa, and both illnesses have similar risks.
Minor Depressive Disorder
Minor depressive disorder also known as minor depression refers to a depression that does not meet full criteria for major depression but in which at least two symptoms are present for two weeks.
Bipolar disorderÂ (BD), a mood disorder formerly known as "manic depression" and described by alternating periods ofÂ maniaÂ andÂ depressionÂ (and in some cases rapid cycling, mixed states, andÂ psychoticÂ symptoms).
Bipolar IÂ is distinguished by the presence or history of one or moreÂ manic episodesÂ orÂ mixed episodesÂ with or without major depressive episodes. A depressive episode is not required for the diagnosis of Bipolar I disorder, but depressive episodes are often part of the course of the illness.
Bipolar IIÂ consists of recurrent intermittentÂ hypomanicÂ and depressive episodes.
CyclothymiaÂ is a different form of bipolar disorder, consisting of recurrent hypomanic andÂ dysthymicÂ episodes, but no full manic episodes or full major depressive episodes.
Bipolar Disorder Not Otherwise SpecifiedÂ (BD-NOS)
Bipolar Disorder Not Otherwise SpecifiedÂ (BD-NOS), sometimes called "sub-threshold" bipolar, indicates that the patient suffers from some symptoms in the bipolar spectrum (manic and depressive symptoms) but does not fully qualify for any of the three formal bipolar DSM-IV diagnoses mentioned above.
Substance Induced Mood Disorders
Alcohol Induced Mood Disorders
Alcohol misuse directly causes the development of depression in a significant number of heavy drinkers.Â High rates of suicide also occur in those who have alcohol-related problems.Â It is usually possible to differentiate between alcohol-related depression and depression which is not related to alcohol intake by taking a careful history of the patient.Â Depression and other mental health problems associated with alcohol misuse may be due to distortion of brain chemistry, as they tend to improve on their own after a period of abstinence.
Benzodiazepine-induced mood disorders
Long term uses ofÂ benzodiazepines have a similar effect on the brain asÂ alcoholÂ and are also associated with depression.Â Major depressive disorder can also develop as a result of chronic use of benzodiazepines or as part of aÂ protracted withdrawal syndrome. Benzodiazepines are a class of medication which are commonly used to treat insomnia, anxiety and muscular spasms. As with alcohol, the effects of benzodiazepine on neurochemistry, such as decreased levels of serotonin and norepinephrine, are believed to be responsible for the increased depression. Major depressive disorder may also occur as part of theÂ benzodiazepine withdrawal syndrome.Â
Patients are given antipsychotic and mood stabilizers to consume and which can be done at one's own home unless the patient shows high risk of danger to self and others. The treatment is then followed by counselling. If the patient is no longer responding to the treatment or is heading towards suicide, the patient will be put through electroconvulsive therapy which it is a procedure of sending electric shocks through the brain while under short general anaesthetic. There is a high chance of patient having short or long term memory lost.
Mood disorders cannot be treated lightly. A long period of feeling sadness or short bouts of extreme euphoria cannot be just dismissed as a minor episode or ignored. The sufferer of mood disorder will hardly get help due to social stigma, self denial or unable to recognize the symptoms. It is up to the people the person hangs around with to take notice and give the person support or guidance and not to ostracise the person when help is sought for correcting the disorder.