There are two general classifications for mood disorders, also known as affective disorders. There are bipolar disorders, where the patient experiences swings from depression (extreme sadness) to mania (extreme happiness), and depressive disorders, where the person experiences extended, unexplainable periods of sadness.
In bipolar disorder, formerly known as manic-depression, there are swings in mood from elation to depression with no descernable external cause. During the manicky phase of this disorder, the patient may show excessive, unwarranted excitement or silliness, carrying jokes too far5. They may also show poor judgement and recklessness and may be argumentative. Manics may speak rapidly, have unrealistic ideas, and jump from subject to subject. They may not be able to sleep or sit still for very long. These symptoms are predominant for a specific period of time lasting for a few days or even a few months. Hospitalization can often be necessary to keep the person from harming themselves and others.
The other side of the bipolar coin is the depressive episode. Bipolar depressed patients often sleep more than usual and are lethargic. This contrasts with those with major depression, who usually have trouble sleeping and are agitated. During bipolar depressive episodes, a patient may also show irritability and withdrawl. Manic episodes can occur without depression, but this is very rare.4
Bipolar disorder is relatively uncommon, occurring in less than 1% of the population. Many researchers believe that it has an organic basis, as it is more common among identical than fraternal twins and may reflect an excess of norepinephrine (a neurotransmitter believed to play a part in depression).
Major Depressive Disorder
A person suffering from major depressive disorder is in a depressed mood for most of the day, nearly every day or has lost interest or pleasure in all, or almost all, activities, for a period of at least two weeks. 2h It is not necessary for the person to report feeling depressed to be diagnosed with major depression- the presence of depressed mood can be implied from observing the person's behavior. Similarly, they may not complain of a loss of interest or pleasure.
Other features include: significant weight change and appetite disturbance (especially loss of appetite), sleep disturbance, slowed movements and speech, restlessness, decreased feelings of energy, feelings of worthlessness, difficulty in thinking or concentrating, indecisiveness, excessive or inappropriate guilt, thoughts of death and suicide or suicide attempts.
Single episode depression is like major depression only it strikes in one dramatic episode.
Recurrent depression is an extended pattern of depressed episodes. Depressed episodes can include any of the features of major depressive disorder.
Mood disorders respond to two major forms of treatment, biogenic and psychotheraputic. The best approach is usually a combination of the two.1
Two major types of drugs, tricyclics and MAO inhibitors, are used in treatment of moderate to severe disorders. In unusually severe cases where drugs have been unsuccessful, electroconvulsive therapy may even be tried. The treatment of choice for bipolar disorders is lithium carbonate.
There are many types of psychotherapy that can be used to treat sufferers of depression. The National Institute of Mental Health studied interpersonal therapy as one of the most promising types of psychotherapy.7 It's a relatively short term therapy, usually lasting between 12 and 16 weeks with weekly seesions. It was specifically developed for the treatment of major depression and does not address unconscious phenomena, such as defense mechanisms or internal conflicts. Instead, it focuses primarily on the conscious factors that directly interfere with social relationships.
The National Institute of Mental Health studied cognitive behavioral therapy as the other most promising type of psychotherapy.7 This type of therapy focuses on changing the patient's negative thoughts and dyfunctional attitudes in order to over come their pessimism and hopelessness.
Psychoanalytically oriented therapy focuses on the opposite of cognitive behavioral therapy in that it concentrates on hypothesized unconscious phenomena, such as defense mechanisms or internal conflicts. It also differs from interpersonal therapy in that it looks toward's the patient's past rather than the "here and now." It has yet to be scientifically proven effective.
© 1999 Katrina Spoor