What Are Mood Disorders?
A mood disorder is a type of mental illness. When you have a mood disorder, your state of mind and how you feel is disconnected from what's happening in your everyday life. A mood disorder causes changes in your emotions that significantly affect your life.
Adults, teens, and children all can have mood disorders, though the symptoms can look different.
When you think of mood disorders, depression and bipolar disorder are likely the first ones that come to mind. That's because these are common, severe illnesses and leading causes of disability. Depression and bipolar disorder can make it difficult to live life to its fullest. Persistent depressive disorder is a newer diagnosis that combines chronic major depressive disorder and dysthymic disorder. In this condition, a person experiences depression for at least 2 years.
Mood Disorder Causes
The amygdala and orbitofrontal cortex are the parts of your brain that control emotions. When researchers look at brain images of people with mood disorders, they can see that the amygdala is different.
Many things can cause these changes in your brain. Or you might have a combination of factors.
Medical issues. Among the conditions that can cause mood disorders are brain tumors, syphilis, encephalitis, flu, multiple sclerosis, AIDS, thyroid problems, and cancer.
Genetics. Researchers have found that certain genes play a role in mood disorders. If someone in your family, especially a parent, has a mood disorder — that increases your risk.
Hormones. Your hypothalamic-pituitary-adrenal axis is a system in your body that manages how you react to stress. Studies show that a high level of activity in this system is linked to depression. Another hormone tied to mood disorders is thyroid stimulating hormone (TSH). High levels of TSH are linked to depression.
Life factors. Stressful things in your life can cause mood disorders. Examples include the death of someone close to you, a traumatic event, or a difficult childhood.
Immune system issues. Unusual changes in your immune system's response are linked to mood disorders.
How common are mood disorders?
About 21% of adults will have a mood disorder at some point in their lives. They are more common in women than in men. In any given year, about 10% of adults will deal with a mood disorder.
Types of Mood Disorders
There are several types of mood disorders, some more common than others.
Major depressive disorder (MDD)
Major depressive disorder is sometimes called depression, or clinical depression. It's not just a temporary low mood — it affects your everyday life.
An official diagnosis of MDD depends on a few things. Doctors use a checklist of symptoms. You must have one of the first two symptoms on the list (or both) that affects your daily life and at least five symptoms in total.
- Low mood
- Decreased interest in things you used to enjoy
- Feelings of guilt or worthlessness
- Low energy
- Poor concentration
- Changes in your appetite
- Restlessness or agitation
- Sleep problems
- Thoughts of suicide
Persistent depressive disorder (PDD)
This is a less severe form of depression. Although less extreme, PDD causes chronic or long-lasting moodiness that ranges in severity.
PDD can occur alone or with other psychiatric or mood disorders. PDD is more common in women than in men. A family history of mood disorders is not uncommon. This mood disorder tends to appear earlier than major depression, although it can begin anytime from childhood to later in life.
Up to 3% of the general population is affected by PDD. Its cause is not well understood. A combination of factors probably creates this mood disorder. These factors may include:
- Genetics
- Abnormalities in brain circuits involved in emotional processing
- Chronic stress or medical illness
- Isolation
- Poor coping strategies and difficulty adjusting to life stresses
These factors can feed off each other. For example, if you always see "the glass as half empty," you may reinforce the symptoms of depression. And a chronic mood disorder can sensitize you to stress, further feeding your risk for depression.
Bipolar disorder
Bipolar disorder causes big shifts in your mood and energy levels. The changes cause problems for you in your everyday life. It used to be called manic depression or manic depressive illness. When you have bipolar disorder, you'll have times when you are very "up" — engaged, energetic, and elated. (Though you might also be irritable.) This is known as a "manic" episode. Other times, you'll be "down" — sad, lacking energy, and apathetic. Those are depressive episodes.
If you have what's known as bipolar I disorder, you'll have manic episodes that last at least 7 days, and depressive episodes that last at least 2 weeks. Your manic episodes might be so severe that you need medical care.
If you have what's called bipolar II, your manic episodes will be less extreme than those of someone with bipolar I disorder. Less severe manic episodes are called "hypomania."
Cyclothymic disorder
Cyclothymic disorder is often thought of as a mild form of bipolar disorder.
With cyclothymic disorder, you have low-grade high periods (hypomanias) as well as brief, fleeting periods of depression that don't last as long (less than 2 weeks at a time) as in a major depressive episode. The hypomanias in cyclothymic disorder are similar to those seen in bipolar II disorder and don't progress to full-blown manias. For example, you may feel an exaggerated sense of productivity or power, but you don't lose connection with reality. In fact, some people feel that the "highs" of cyclothymic disorder are even enjoyable. They tend to not be as disabling as they are with bipolar disorder.
Up to 1% of the U.S. population — equal numbers of men and women — have cyclothymia. Its cause is unknown, but genetics may play a role; cyclothymia is more common in people with relatives who have bipolar disorder. Symptoms usually appear in adolescence or young adulthood. But because symptoms are mild, it is often difficult to tell when cyclothymia begins.
Seasonal affective disorder (SAD)
When you have seasonal affective disorder, you have a low mood that usually appears when the days start getting shorter and improves when the days are longer and sunnier. It's more than just the winter blahs. These changes in your mood affect your ability to handle everyday life. Your thinking, emotions, and behavior will be different. For most people, the symptoms start in the fall or early winter. That's called winter-pattern SAD. But a few people will have the opposite pattern — they start to feel low in spring and summer, and their mood improves in fall.
Disruptive mood dysregulation disorder (DMDD)
This condition affects children and teens. If you have DMDD, you'll frequently be irritable and angry. You'll probably have outbursts when your temper flares. It's not just the occasional bad mood. Your symptoms are severe and affect your life and relationships with others.
Premenstrual dysphoric disorder (PMDD)
This is a more severe form of premenstrual syndrome. PMDD starts in the week before your period and goes away a day or two after your period starts. During that time, you may be depressed, anxious, irritable, extremely tired, and you may have a feeling of being out of control.
Postpartum depression (PPD)
This is a mood disorder that comes on when you have a new baby. Many people are anxious or sad in the first few weeks after giving birth — that's often called the "baby blues." If the feelings last longer than 2 weeks and make it hard for you to function and care for your child, you may have PPD. You might have trouble bonding with your baby.
Intermittent explosive disorder (IED)
This condition usually starts in your childhood or teen years. When you have IED, you have frequent outbursts that are out of proportion to the situation.
Mood Disorders Symptoms
Many mood disorders have common symptoms. Among them are:
- Feeling sad or anxious
- Feeling hopeless or helpless
- Low self-esteem
- Feeling worthless
- Feelings of guilt
- Lack of interest in things you used to enjoy, including sex
- Sleep troubles — insomnia or sleeping too much
- Lack of energy
- Trouble focusing
- Extreme sensitivity to failure and rejection
- Frequent physical issues — such as pain, headache, stomachache — that don't improve
- Threats of running away
- Trouble making decisions
- Irritability, hostility, aggression
- Thoughts of suicide or wishing to die
Persistent depressive disorder symptoms
When you have PDD, you'll have general symptoms of a mood disorder that come and go. Your symptoms might include:
- Feelings of hopelessness or helplessness
- Trouble sleeping or daytime sleepiness
- Poor appetite or eating too much
- Poor concentration
- Fatigue (or low energy)
- Low self-esteem
- Trouble concentrating or making decisions
A diagnosis of PDD in adults requires at least a 2-year history of depressed mood for most of the day on most days, along with at least two of the symptoms noted above.
Although some symptoms may overlap, you may be less likely to have weight or sleep changes with PDD than with depression. You may also tend to withdraw more and have stronger feelings of pessimism and inadequacy than with major depression. Children might be impatient, annoyed, and angry.
Cyclothymic disorder symptoms
Your symptoms will switch between highs and lows when you have cyclothymic disorder. This pattern of episodes must be present for at least 2 years. You won't go more than 2 months in a row without symptoms.
Episodes of cyclothymic disorder are often unpredictable. Either depression (lows) or hypomania (highs) can last for days or weeks, interspersed with a month or two of normal moods. Or, you may have no "normal" periods in between. In some cases, cyclothymic disorder progresses to full-blown bipolar disease.
When you're in the high phase, called hypomania, you may feel:
- Extremely happy (euphoria)
- Optimistic
- High self-esteem
- Very talkative
- As if your thoughts are racing
- Strong drive to get things done
- Little need for sleep
- Easily distracted
- As though you can't concentrate
Hypomania can affect your judgment, leading you to risky decisions or behaviors.
During your low period, you may feel:
- Sad, hopeless, or empty
- Teary
- Irritable (this is especially true of children and teens)
- No interest in activities you usually enjoy
- Worthless or guilty
- Restless
- Tired
- Unable to concentrate
You might also have thoughts of death or suicide. If you're thinking of harming yourself or taking your own life, seek help at once. This is a medical emergency. In the U.S., you can reach a crisis hotline 24 hours a day by calling or texting 988.
Mood Disorders Diagnosis
There's no specific test to find out whether you have a mood disorder.
Your doctor will do a physical exam to make sure a different illness isn't causing your symptoms. They'll also ask about your family history, whether you've had these symptoms in the past, and about your drug and alcohol use. If your doctor thinks substance abuse is a factor, you may be given a urine test.
Mood disorder questionnaire
Doctors use questionnaires and rating scales to help diagnose mood disorders.
Hamilton Rating Scale for Depression (HAM-D). This system involves 17 criteria and is used to diagnose depression. Your doctor will ask about depressed mood, sleep difficulties, the ability to concentrate, guilt, thoughts of suicide, and anxiety. Your answers are rated on a 3-point or 5-point scale. If your total score is higher than 20, your doctor will recommend treatment.
Montgomery-Asberg Depression Rating Scale (MADRS). This is another tool to diagnose depression. It assesses sadness, tension, sleep, appetite, and thoughts of self-harm or suicide. It uses a scale of 0 to 60. If you score between 0 and 6 points, your mood is normal. Depression is diagnosed this way: 7 to 19 is mild depression; 20 to 34 is moderate depression; and a score more than 34 is severe depression.
Young Mania Rating Scale (YMRS). This is used to diagnose mania. Four things are rated on a scale of 0 to 8: irritability, manner of speech, content of thoughts, and disruptive behavior. Seven things are rated on a scale of 0 to 4: elevated mood, increased physical activity or energy, sex drive, sleep, appearance, insight into your own condition, and how easily distracted you are. Scores of 13 to 25 are considered signs of moderate mania, while scores of 38 to 60 indicate severe mania.
Mood Disorders Treatment
Your health care provider will probably suggest a combination of things to treat your mood disorder. Those might include:
- Medication
- Talk therapy
- Brain stimulation
- Lifestyle changes focusing on a healthy diet, exercise, and not smoking
Persistent depressive disorder treatment
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or tricyclic antidepressants, are often used to treat PDD. Because you may need to continue treatment for a lengthy period, it's important to consider which medications work well and have few side effects. You may need to try more than one medication to find the one that works best. It may take several weeks or longer to take effect. Successful treatment for chronic depression often takes longer than for acute (non-chronic) depression.
Take your medications as prescribed. If they're causing side effects or still not working after several weeks, discuss this with your doctor. Don't suddenly stop taking your medications.
Doctors believe treatment for PDD is effective with a combination of antidepressants and psychotherapy.
Specific kinds of talk therapy, such as cognitive behavioral therapy (CBT), psychodynamic psychotherapy, or interpersonal therapy (IPT), are known to be effective. CBD, a structured treatment lasting for a certain period, involves recognizing and restructuring thoughts. It can help you change your distorted thinking. IPT focuses is on addressing current problems and solving interpersonal conflicts. Psychodynamic psychotherapy involves exploring unhealthy or unsatisfying patterns of behavior and motivations that you may not be consciously aware of. These patterns can lead to depression, and negative expectations and life experiences.
Some studies also suggest that aerobic exercise can help with mood disorders. This is most effective when done four to six times a week. But some exercise is better than none at all. Other changes may also help, including seeking social support and finding an interesting occupation or hobby. Bright-light therapy, used for patients with major depressive disorder with seasonal pattern, also may help some people with PDD.
Cyclothymic disorder treatment
Some people with mild symptoms of cyclothymia are able to live successful, fulfilling lives. Others find their relationships troubled by depression, impulsive actions, and strong emotions. For these people, short-term medications may bring relief. However, cyclothymic disorder may not respond as well to medications as does bipolar disorder. A combination of mood stabilizers and psychotherapy is most effective. Mood stabilizers include anti-seizure drugs such as carbamazepine (Tegretol), divalproex (Depakote), lamotrigine (Lamictal), or lithium.
Living With Mood Disorders
You can take steps on your own to help manage your mood disorder. Broadly, experts suggest that you:
- Exercise regularly.
- Get a healthy amount of sleep.
- Build strong social connections.
- Focus on the mind-body connection, through meditation, yoga, or another practice.
- Eat a healthy diet, including foods rich in omega-3 fatty acids, which have an antidepressant effect.
One study looked specifically at things people with mood disorders say helped them manage their condition. Among those steps were:
- Surrounding yourself with supportive people
- Not isolating yourself
- Helping others, including family and friends
- Finding inspiration in others with mood disorders
- Setting aside negative thoughts
- Focusing on positive things in your life
- Recognizing your strengths and weaknesses
- Setting goals
- Establishing a daily routine
- Limiting tobacco, stimulants, drugs, and alcohol
- Being aware of your energy levels and adjusting your activities
- Learning more about your illness
- Keeping an eye out for changes in your moods or signs of relapse
Mood Disorder Complications
Mood disorders can cause trouble at work, in relationships with family and friends, and in everyday life. Research suggests that the longer it takes for you to get a diagnosis and treatment, the greater your risk of self-harm or suicide. People with poorly managed mood disorders are at higher risk for substance abuse.
Takeaways
Mood disorders are serious mental illnesses that affect your everyday life. Mood disorders can have many causes and many risk factors, including family history, stress, and brain chemistry. Treatment usually includes a combination of medication, talk therapy, and lifestyle changes. You can help manage your mood disorder by building strong social connections, exercising, eating a healthy diet, and getting the right amount of sleep.
Mood Disorders FAQs
What are the five mood disorders?
The most common types of mood disorders are:
- Depressive disorders
- Dysthymia, a low-grade, chronic low mood
- Bipolar disorder
- Mood disorders caused by other health conditions
- Mood disorders caused by substance abuse
Who is at risk for mood disorders?
You're more likely to have a mood disorder if you have a family member — especially a parent — with one. The risk of mood disorders for women is almost twice as high as it is for men. Stressful events in your life, such as divorce, job loss, a death in the family, or financial problems can increase your risk for a mood disorder or make an existing one harder to manage.
How do I identify my mood?
Take a moment and ask yourself, "How do I feel right now? And why?" Try putting those feelings into words. You can say them to another person, or just to yourself.
What is unspecified mood disorder?
Health care providers use this term when you have symptoms of a mood disorder but don't exactly meet the criteria for a specific disorder. They might choose this classification if they have trouble deciding whether you have a depressive disorder or bipolar disorder.
