Do your emotions fluctuate wildly? Let's talk about these mood disorders.

We all have happy and sad days in our lives, right? Some days we laugh at the smallest things, and other days we feel bored with the whole world. That's very normal. But don't you think that sometimes these emotions reach a point where you can't control them? That is, when there is extreme happiness, it goes beyond limits, and when there is sadness, it goes so deep that it is unbearable. If this affects your daily work, your relationships, all this, then we need to be a little concerned about this. Today we are talking about this condition, that is, 'Mood Disorders'.

Simply put, what is a mood disorder?

This is a mental health condition. What's happening here is that your emotional state, or 'mood', is being affected. Think of it like a switch that controls our emotions. Normally, we can turn the volume up or down. But in a mood disorder, this switch loses control, and either the volume goes all the way up (too happy/active) or all the way down (too sad/passive).

This condition doesn't develop overnight. For a doctor to diagnose it as a medical condition, these symptoms must persist for several weeks or longer. This can make it difficult for you to function properly in your daily activities, such as work, schoolwork, and family relationships.

Two of the most common mood disorders among us are depression and bipolar disorder .

What are the main types of mood disorders?

Several major medical conditions fall under this category. Let's take a brief look at each one.

• Depression and its subtypes
• Bipolar Disorder and its subtypes
• Premenstrual Dysphoric Disorder
• Disruptive Mood Dysregulation Disorder

Now let's talk about each of these types in a little more detail.

1. Depression - a heavy burden on the mind

Depression, or what we call ``Clinical Depression'', is a very common mental health condition. It is not just sadness. It is characterized by feelings of overwhelming sadness, hopelessness, and loss of interest in anything. It also affects things like thinking, remembering, eating, and sleeping. For a doctor to confirm that it is depression, symptoms must be present for at least two weeks in a row.

There are also different types of depression:

• Postpartum Depression: This is a condition that can occur in mothers either during or after the birth of a child. How many hormonal, physical, emotional, economic, and social changes occur in a mother's life after having a child? This condition can occur when the stress that comes with these changes cannot be tolerated.
• Persistent Depressive Disorder: This is a chronic depressive disorder that lasts for at least two years. The symptoms may wax and wane, but they are still there. Although it is not as severe as major depressive disorder, the problem here is that it lasts longer.
• Seasonal Affective Disorder (SAD): This is a depressive condition that occurs only at certain times of the year. It is common in countries with cold, rainy, and dark weather during the winter. Even in Sri Lanka, some people may feel lifeless and sad during the continuous rainy season. This feeling disappears when the sun shines and the weather improves.
• Depression with Psychosis: This is a severe depressive episode with psychotic symptoms . This means that you may see things that others cannot see (hallucinations) or believe things that are not true (delusions). People with this condition are at increased risk of suicidal thoughts.

2. Bipolar Disorder - The roller coaster of emotions

This is a lifelong mental state that causes dramatic changes in feelings, energy, thoughts, and behavior. Think of it like a clock hand swinging from one side to the other. What happens in this case is that the mind suddenly goes into a state of hyperactivity and happiness (Mania or Hypomania), and then suddenly goes into the opposite direction, which is deep depression (Depression).

There are several main types of this too:

• Bipolar I Disorder: These people have had at least one severe manic episode. During this time, they are hyperactive, sleepless, talkative, and make impulsive decisions. This manic episode is often followed by a severe depressive episode.
• Bipolar II Disorder: This is a less severe form of mania, called hypomania. During this time, people have a lot of energy and can function, but it is a bit erratic. However, it does not completely disrupt daily life like in Bipolar I. This hypomania is followed by a severe depressive episode.
• Cyclothymia Disorder: These people have persistent mood instability for at least two years. That is, they often alternate between mild hypomanic and mild depressive symptoms.

Other mood disorders

• Premenstrual Dysphoric Disorder (PMDD): This is a condition that occurs in women about 7-10 days before their period. It is much more severe than regular PMS. Symptoms include irritability, anxiety, depression, and insomnia, which usually subside within a few days of the start of menstruation.
• Disruptive Mood Dysregulation Disorder (DMDD): This is a condition that affects children and young adults. It is characterized by extreme irritability, frequent outbursts of anger, and irritability. The anger is often inappropriate for the situation. Symptoms usually begin before the age of 10.

What are the symptoms of these conditions?

Mood disorders can be divided into two main categories of symptoms: depressive symptoms and manic/hypomanic symptoms. Let's look at these two separately.

Why do situations like this occur?

There is no single cause for this. Researchers believe that a combination of factors may be responsible.

• Biological factors: The parts of the brain called the amygdala and the orbitofrontal cortex are primarily responsible for controlling our emotions. Brain scans of people with mood disorders have shown changes in these parts.
• Genetic factors: If someone in your family, such as your parents or siblings, has had this condition, you are at a higher risk of developing it. This means that it also has a hereditary influence .
• Environmental factors: Traumatic life events play a major role in the development of these conditions. For example, the death of a loved one, job loss, prolonged stress, and childhood abuse are major risk factors. People with chronic conditions such as diabetes, Parkinson's disease, and heart disease are also at higher risk of developing depression.

How is this condition diagnosed and treated?

The first thing to say is that if you have these symptoms, don't just assume that you have a mental disorder. You should definitely see a qualified doctor or psychiatrist.

Diagnosis

When you see a doctor, the first thing he or she will do is check to see if these symptoms are caused by other physical conditions, such as thyroid problems or vitamin deficiencies. If necessary, they may order some blood tests.

Then, they will talk to you about your symptoms, your sleeping and eating habits, and whether anyone in your family has had these kinds of mental health problems. This information is used to arrive at an accurate diagnosis.

Treatment methods

Typically, a combination of medication and psychotherapy (talk therapy) is used as treatment.

1. Medications

• Antidepressants: These are used to treat depression and depressive episodes of bipolar disorder. These medications work by balancing neurotransmitters like serotonin in the brain. They can take 4-6 weeks to work. Therefore, it is important to take the medication for the full duration as prescribed by your doctor.
• Mood Stabilizers: These are medications that are mainly prescribed to control the mood swings that occur in bipolar disorder.
• Antipsychotics: These drugs are used to control manic episodes of bipolar disorder and for severe depressive episodes.

2. Psychotherapy

We simply call this 'talk therapy'. This involves talking to a trained psychologist or psychiatrist to identify and help you change your problematic thoughts, feelings, and behaviors.

• Cognitive Behavioral Therapy (CBT): A targeted therapy that helps you identify your negative thought patterns and change them for the better.
• Dialectical Behavior Therapy (DBT): A specialized treatment method that helps people who experience very intense emotions manage their emotions.
• Psychodynamic Therapy: A form of therapy that focuses on how childhood experiences and unconscious issues influence current behavior.

3. Other treatments

• Electroconvulsive Therapy (ECT): The name may scare some people, but it is a very safe, effective treatment for severe, refractory depression and bipolar disorder.
• Light Therapy: A treatment method that involves exposing people to artificial light, especially for those with seasonal affective disorder (SAD).

What happens when you live with these conditions?

With early and accurate diagnosis and proper treatment, many of these conditions can be managed well and lead normal lives. Sometimes depression and bipolar disorder can recur, and lifelong treatment may be required.

If left untreated, it can lead to serious consequences such as inability to go to work/school, loss of social relationships, and addiction to drugs and alcohol.

So, if you have these symptoms, please see a doctor. It may take some time to find the right treatment plan, but be committed to getting better.

Mood Disorders, Depression, Bipolar Disorder, Mental Health, Anxiety, Sri Lanka, Sinhala