Mood disorders are characterized by depression and/or mania. While "mood" is extremely subjective and often used interchangeably with "feeling" or "emotion," the psychiatric profession classifies mood disorders as a group of defined mental disorders.
Most mood disorders fall under the broad categories of depressive disorders and bipolar disorders (formerly known as "manic depressive" disorders).
Though much progress has been made regarding diagnosis and treatment, mood disorders are still the subject of much controversy. For the general public, mood disorders are often regarded as the result of of personal failing and/or lack of self control ("You're just feeling sorry for yourself," for example).
Psychiatrists and other clinicians face additional challenges - they must make specific diagnoses based a wide range of often fluctuating psychological and physical mood disorders symptoms, and must determine the proper balance of pharmaceutical and therapy-based treatments.
Determining the truth about a person's inner feelings is never easy, and the potential conflict between moods and affects compounds this problem. Affects are transient states communicated through body language and vocal cues (joy, sadness, fear, etc.). Moods are felt over a longer period of time and may not always be conveyed through affective expression.
Dr. Hagop S. Akiskal frames the problem nicely:
Moods are also manifested in subtle ways, and their accurate assessment often requires empathic understanding by the interviewer. The words that subjects use to describe their inner emotions may or may not coincide with the technical terms used by researchers or clinicians and often vary from one culture to another. Furthermore, the inward emotion and the prevailing affective tone may be discordant. This conflict could be due to deliberate simulation (i.e., the subject does not wish to reveal his or her inner emotion) or it could result from a pathological lesion or process that has altered the emotions and their neural substrates. Thus, evaluating moods and affective expression requires considerable clinical experience.1
In short, the question often arises whether someone is just a "little down" or if they are clinically depressed.
According to the National Institute of Health, 20% of the U.S. adult population will suffer a mood disorder during their lifetime. During any given 12 month period, 9.5% of the adult population has a mood disorder, 5% of them classfied as severe. Unfortunately, only 20% of those with mood disorders receive adequate treatment.2
Mood disorders are among the top 10 causes of disability worldwide (Murray & Lopez, 1996), with unipolar major depression being the most widely experienced. Women are 50% more likely than men to experience a mood disorder.1
Mood disorders are treatable. Whether or not they can be cured is highly variable and dependent on the severity of a patient's disorder and their ability to comply with the demands of treatment.
A larger issue is getting people into treatment in the first place. There are numerous barriers to treatment. Lack of access to medical care is a major issue. The mood disorder itself can be another. Someone who is depressed, for example, may not feel worthy of treatment. And despite the progress that has been made in understanding mood disorders, there is significant stigma attached to being recognized as bipolar or depressed.
Once someone enters treatment, they often face a long road. Mood disorder treatment has three stages: acute, continuation and maintenance. If someone can make it through all three stages they will usually return to full functioning. The stages apply to both pharmacological and psychological aspects of treatment.
The acute phase leads up to the point when a patient begins to respond to treatment. Once a response is detected, the patient enters the continuation phase during which therapy is designed to prevent a relapse. If stability is acheived, and if the diagnosis is severe enough the patient continues with the maintenance phase which aims to prevent a recurrence.
Medication is usually a component of treatment for mood disorders but finding the right medication can take months because everyone responds differently to different drugs. Cycling through different medications can be frustrating for patients and may even exacerbate symptoms of their disorder.3
Some examples of mood disorders follow. Click on the individual names to learn more.
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