Mood disorders

Overview

Mood disorders, such as depression and bipolar disorder, affect people emotionally. If you have depression, you may constantly feel sad. You also may be anxious. If you have bipolar disorder, you'll likely have extreme mood swings. Your feelings may range from being very sad, empty or cranky to being very happy — going back and forth between each mood. Mood disorders are more common in women.

Having a mood disorder may raise your risk of suicide. This risk is higher if the mood disorder is serious and you also have problems with alcohol or drugs.

If you're thinking about suicide, contact a hotline for help. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline. It's available 24 hours a day, every day. Or use the Lifeline Chat. Services are free and private. The Suicide & Crisis Lifeline in the U.S. has a Spanish-language phone line at 1-888-628-9454 (toll-free).

Types of mood disorders

Mood disorders are divided into two major groups: depressive disorders and bipolar disorders. Each group includes several different types.

Depressive disorders

Depressive disorders cause loss of pleasure in most or all activities and ultimately affect your quality of life. You could have less energy, trouble sleeping, trouble concentrating, changes in appetite and lack interest. You also could have feelings of worthlessness or guilt and be in pain and tired.

Types of depressive disorders include:

• Major depression — typically lasts for at least two weeks and often longer than four weeks.
• Seasonal affective disorder — occurs at certain times of the year, typically with a change of season.
• Persistent depressive disorder — a long-term form of depression that causes feelings of sadness, emptiness and often hopelessness.
• Disruptive mood dysregulation disorder — a diagnosis used for children and teenagers. It features constant, serious and lasting testiness with frequent temper outbursts that are not consistent with the age of the child.
• Premenstrual dysphoric disorder — features mood changes, hopelessness and feelings of being overwhelmed or out of control. These symptoms occur in the 10 days before a menstrual period and go away within a few days after a period begins.
• Depression related to a medical condition — features a great loss of pleasure in most or all activities due to the physical effects of another medical health problem.
• Depression related to substance or medicine use — features depression symptoms that start during or soon after using a street drug or medicine, or after withdrawal from these substances.

Bipolar disorders

Bipolar disorders feature mood swings that include emotional highs called manic or hypomanic episodes, and lows, called depressive episodes. These highs and lows are usually continuous. But they also can change from high to low or low to high — or shift into a normal mood. Sometimes both the highs and lows might occur together. This is called a mixed episode. You could be easily distracted and have racing thoughts. Your sleep also could be affected.

Types include:

• Bipolar I disorder — features a constantly elevated mood that lasts for at least one week. This is called a manic episode. It affects your overall ability to function and makes it more likely that you'll take part in risky behavior.
• Bipolar II disorder — features constantly elevated moods — called hypomanias — that last at least four days and less than one week. There may be risky behaviors, but usually hypomania does not greatly affect your ability to function. But other people should be able to notice that something is different about you.
• Cyclothymia — features shifts from emotional highs to emotional lows that can affect your ability to function. The emotional ups and downs are not as extreme as those in bipolar I or II disorder.
• Bipolar related to a medical condition — features symptoms that are the same as bipolar disorder, but they can be due to a medical condition. For example, Cushing's disease, multiple sclerosis, stroke and traumatic brain injury can cause bipolar mania or hypomania.
• Bipolar related to the use of certain substances — features symptoms that are the same as bipolar disorder, but they can be due to alcohol, street drugs or medicine.

Symptoms

Symptoms depend on the type of mood disorder.

Depressive disorders

Depressive disorders are common and often long-lasting. They can:

• Cause you to feel sad, empty, anxious and cranky.
• Affect your ability to focus and function.
• Cause loss of pleasure in most or all activities.
• Affect your energy level and quality of life.
• Make you feel worthless or guilty.
• Affect how much you eat and sleep.
• Raise thoughts about suicide.

Bipolar disorders

Bipolar disorders may feature:

• Moods that go back and forth between emotional highs, called mania or hypomania, and lows, called depression.
• Feeling on top of the world, superior to others, or that you're so strong that nothing can harm or change you.
• Racing thoughts.
• Increased energy.
• Disrupted sleep, usually a decreased need for sleep, but a continued high energy level.
• Impulsive behaviors.

You also could be easily distracted and more likely to think about suicide or plan for suicide, depending on the seriousness of symptoms.

Other types of mood disorders may include other symptoms.

When to see a doctor

If you're concerned that you may have a mood disorder, see your doctor or a mental health professional as soon as you can. If you're not sure you want to seek treatment, talk to a friend or loved one, a faith leader, or someone else you trust.

Talk to a health care professional if you:

• Feel like your emotions are getting in the way of work, how you get along with others or other areas of your life, or you're not taking part in social activities.
• Have trouble with alcohol or drugs.
• Are thinking about taking your own life. If this is the case, seek emergency treatment at once.

Your mood disorder is not likely to go away on its own. And it may get worse over time. Get professional help before your mood disorder becomes serious. It may be easier to treat early on.

Causes

Mood disorders are caused by traits passed down to you, as well as environmental factors and life events. Environmental factors can include, for example, childhood experiences and stressful life events. Some prescription drugs, such as corticosteroids and medicines for Parkinson's disease, and street drugs also can cause mood disorders.

Risk factors

Risk factors include life experiences and stressful life events that increase the risk of certain types of mood disorders.

Mood disorders may occur along with neurological disorders. These are conditions that affect the brain and the nervous system. For example, depression is common among people with multiple sclerosis, dementia, traumatic brain injury, stroke and epilepsy. Depression also often occurs in people who have movements disorders like Parkinson's disease and those who have other long-term health conditions.

Diagnosis

To find out whether you have a mood disorder, such as depression or bipolar disorder, your doctor or other primary care professional may do a physical exam. This exam will look for other signs of illness. Your doctor will review your symptoms, medical and family histories, and history of alcohol or drug use.

Your doctor will want to know about your past episodes of a mood disorder. Questions may include:

• How long were past episodes?
• How long did you go in between episodes?
• How strong were these episodes?
• Were any of these episodes affected by the use of street drugs or medicines?

Your doctor also will ask about other current or past mental health issues. If needed, you may be referred to a mental health professional.

Treatment

For most people, mood disorders can be treated with talk therapy, medicines, or both. Talk therapy also is known as psychotherapy. It's a general term for treating a mood disorder by talking about your condition and related issues with a mental health professional.

Medicines can be used to treat depression and bipolar disorder. What drug works best for you will depend on how well it controls your symptoms, how well you tolerate it and your preferences. Medicines should be used along with talk therapy to improve results.

Cognitive behavior therapy (CBT), family-focused therapy or other types of therapy can be an important part of treatment for managing symptoms or stopping them from coming back.

For some people with depression, other procedures, sometimes called brain stimulation therapies, may be suggested. These include transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). These are typically considered secondary treatments, and they are used when other treatments do not work.