Mood Disorders

 

Meaning-cum-Definition  

          Mood is a state of feeling experienced internally that is likely to influences behavioral manifestations and awareness.   

          Mood disorders are also called as Affective disorders. Individual manifests extremes of ‘emotion or affect’ - Hyper elation (Mania) or Depression.

Affect - It is external expression of mood and is known by the facial expressions.

 

Components of Mood Disorder 

         

Mania – Characterized by intense and unrealistic feelings of excitement and

euphoria.

 

Depression – Excessive and intense feeling of dejection and sadness.

 

Introduction   

         

          Kraeplin in 1899 introduced the term Manic-depressive psychosis. He described it a series of attacks of elation and depression, with period of relative normality in between. Depressive disorders are more common than maniac. The individual when swings between the two extremes of continuum or remain fixated at one end for longer time (4+ days for Manic and 2 Weeks for depressive episode) is diagnosed as suffering from mood disorders.

 

Comparative Symptoms

 

	Maniac	Depressive
Emotional	Euphoric, Elated Mood, Sociability, Extreme Impatience	Gloomy outlook, hopeless, Helplessness, Social Withdrawal, Marked irritability
Cognitive	Short attention span, Racing of thoughts and flight of ideas, Impulsiveness, Excessive talkative, Positive self-image, Grandiose delusions, tendency to blame others.	Slowed thought process, Excessive and obsessive worry, exaggeration of problems, indecisiveness, negative self-image, tendency to blame self, Delusion of sin, guilt, disease, poverty
Motor	Hyperactivity, Decreased need of sleep, Variable appetite, increased sex drive	Hypoactivity, Fatigue, Insomnia, Loss of appetite, Decreased sex drive

 

Diagnostic Criterion

         

ICD 11 – Mood episodes (Affective Disorder). Symptoms (for maniac 1 week and for depressive 2 weeks)

(i)       Euphoria,

(ii)      Irritability,

(iii)     Increased activity, and

(iv)     Subjective experience of increased energy.

DSM V – Major depressive disorder 3 or more Symptoms

(i)       Increased talkativeness or pressured speech,

(ii)      Flight of ideas,

(iii)     Increased self-esteem or grandiosity,

(iv)     Decreased need of sleep,

(v)      Distractibility,

(vi)     Impulsive reckless behaviour, and

(vii)    Increased sexual drive, sociability or goal-directed activity.

 

Classification  

Mood disorders are classified into following categories:

 (i)     Bipolar affective disorder - Repeated episodes (minimum two) of either mania or hypomania only or episodes of both depression and hypomania/ mania.

(ii)     Depressive episode - One episode of mild or severe depression.

(iii)    Recurrent depressive disorder – Repeated (at least two) episodes of

depression.

(iv)    Persistent mood disorder – Persistent, longstanding fluctuating mood.

(Dysthymia is characterized by persistent, long standing low grade depressive symptoms and in Cyclothymia patients may have persistent, long standing frequent mood swings of mild depression and mild cheerfulness).

(v)     Other mood disorders - Mixed affective episode and recurrent brief depressive disorder.

(vi)     Unspecified mood disorder is diagnosed when diagnostic guidelines of any of the categories mentioned above are not met with.

Salient Features      

(i)       The client experiences predominant emotional outburst.

(ii)      Mood swings are common & intense and stays for longer time.

(iii)     Rapid shifts in mood over brief periods of time.

(iv)     In maniacs the increased activity levels may manifest at unusual hours of the day.

(v)      Inflated self-esteem, grandiosity and self-confidence to delusional proportions.

(vi)     In maniacs speech is likely to be rapid, pressured, loud, and difficult to interrupt.

(vii)    Thoughts race at a rate faster than they can be expressed through speech.

(viii) Impairment in social or occupational functioning.

(ix)     Do not perceive that they are ill and require treatment.

 

Behavioural Consequences

Maniac	Depressive
Spending sprees, Giving away possessions, Reckless driving, Foolish business investments, and Sexual promiscuity that is unusual for the individual	Minimized movements, Careless towards interpersonal relations, Confined to self, Digestive difficulties, Hallucinatory behavioural manifestations, Refuses to speak or eat, Vegetative state, Immobility

Causes    

Biological factors       

(i)       Genetics factors,

(ii)      Neurophysiological factors, and

(iii)     Biochemical factors.

Psychological factors

(i)       Predisposing family and personality factors,

(ii)      Stress,

(iii)     Feeling of helpless and loss of hope, and

(iv)     Extreme defenses.

Socio-cultural factors

For example – Sethi et al. (1973) suggested that in India the depression among urban and rural population was in the ratio of 4:1.

(i)       Modern technology,

(ii)      Changing social values, and

(iii)     Modern living (Increasing physical distances).

 

Treatment

(i)       Pharmacological treatment

(ii)      Psychotherapy

(iii)     Psycho-education

(iv)     Counselling

(v)      Interpersonal and Social Rhythm therapy for Bipolar Disorder

(vi)     Cognitive behaviour therapy (CBT) for Depression

(vii)    Physical Exercise for Depression

 

References:

1.       1.       Verma, L. P. (1965). Psychiatry in ayurveda. Indian J Psychiatry. 1965;7:292.

2.       पांडेय, जगदानंद. (1956). असामान्य मनोविज्ञान. पटना: ग्रंथमाला प्रकाशन कार्यालय।

3.       Coleman, J. C. (1981). Abnormal psychology and modern life.

 

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