Mood related difficulties are amongst the most common diagnoses in psychiatry. Mood is a persistent emotional state as opposed to affect which is the manifestation of feelings. Mood related difficulties are diagnosed along 3 broad categories: depressive mood disorders, bipolar mood disorders and mood disorders having a known cause such as in substance abuse or the effects of medication.

Mood related difficulties lie on the same continuum as typical mood states. Although depressive disorders are thought to be at opposite ends of the continuum with manic disorder, that is not always the case. There are individuals who experience both episodes of depressive and manic symptoms, giving rise to mixed mood states.

Within the depressive mood disorders, there are sub-types of difficulties:

Major depressive disorder (MDD) – this is commonly known as clinical depression, and individuals affected are at risk of suicide or self-harm. It can affect anyone at any time regardless of age, gender, ethnicity or socio-economic background. It is estimated that about 10% of the population suffers from MDD. For more information on depression, click here.

Atypical depression – this is characterised by mood reactivity (people with this type of depression are able to experience positive feelings when things go well for them), substantial weight gain and increased appetite, excessive sleep, sensation of heaviness in limbs and significant deficits in social interactions due to fear of rejection.

Melancholic depression – this is a loss of pleasure in most or all activities, lack of reactions to pleasurable activities, intense depressed mood, deterioration of symptoms in the morning, or after waking up, psycho-motor retardation, excessive weight loss or excessive guilt.

Psychotic major depression – these are the characteristics of a major depressive episode where symptoms of psychosis are also experienced such as delusions or hallucinations.

Post-partum depression – it refers to the depression experienced by women after giving birth. It sets within three months of labour and usually lasts for three months. It can cause significant impaired functioning at home or work and can cause difficulty in relationships with friends and family.

Seasonal affective disorder (SAD) – the depressive episodes are usually triggered in autumn or winter and it is usually caused by changes in daylight. The diagnosis is made if the 2 or more depressive episodes have occurred in the colder months of the year but not at any other time.

Dysthymia – it is a chronic type of depression where the individual reports low mood almost every day over a span of at least two years. The symptoms are not as severe as MDD but individuals affected are vulnerable to episodes of major depression.

Subtypes of bipolar disorder, a disorder which includes alternating episodes of mania and depression are:

Bipolar I – is characterised by the presence of one or more manic episodes with or without major depressive episodes. Depressive episodes are often part of the manifestation of the disorder.

Bipolar II – is characterised by recurring episodes of depression and mania.

Cyclothymia – is characterised by recurring episodes of hypomania and dysthymia without a full blown manic or major depressive episode.

Mood disorders can also be induced by substance abuse such as alcohol, amphetamines, methamphetamines and cocaine. They can cause manic, hypomanic and depressive episodes. Some medication such as benzodiazepines used in the treatment of heart conditions can induce depressive episodes if used in the long term.

Cognitive behavioural therapy is the most effective treatment for mood related difficulties. Because they are thought to be caused by a negative and irrational outlook on life, CBT can help to tackle those negative thoughts, improving mood and the individual’s quality of life.

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