Do you often have strange mood swings? (Mood Disorders) Let's talk about this!

It's normal for all of us to experience emotions like happiness, sadness, and anger. Some days we're very happy, and on other days we feel sad over even the smallest things. But, don't you think that sometimes these emotions can be so overwhelming that they last for days, weeks, or even months? Or do you suddenly feel so happy for no reason, and then feel so down that you don't want to do anything anymore? When that happens, it can be more than just a simple change in mood. We call these mood disorders `(Mood Disorders)` .

What is a mood disorder? Simply put...

Simply put, a mood disorder is a mental health condition that primarily affects our state of mind, that is, our mood. In this, you feel either excessively happy or unbearably sad for a long time. In some mood disorders, both of these feelings, that is, excessively happy and excessively sad, can alternate. Sometimes, feelings like anger and irritability can also be present.

Now you may be thinking, "Our moods change from time to time, that's normal." Yes, that's true. It's normal for our moods to change depending on the environment and other events around us. However, to be diagnosed with a mood disorder, these symptoms must persist for several weeks or even longer . These conditions can make it difficult for you to do your daily activities, work, or schoolwork properly.

The two most common types of mood disorders are depression and bipolar disorder.

What are these types of mood disorders?

There are several main types of mood disorders. Let's take a look at what they are:

• Depression and its subtypes.
• Bipolar Disorder and its subtypes.
• Premenstrual Dysphoric Disorder (PMDD).
• Disruptive Mood Dysregulation Disorder (DMDD).

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

What is Depression?

Depression, also known as ``Major Depression'' or ``Clinical Depression'', is a mental health condition that affects many people. It is characterized by feelings of sadness and hopelessness . It can also cause difficulty thinking, memory loss, changes in appetite, and sleep problems. To be diagnosed with ``Clinical Depression'', these symptoms must be present for at least two weeks .

There are also different subtypes of depression:

• Postpartum Depression / Peripartum Depression: This is a condition that often occurs in new mothers. This condition can occur during pregnancy or after the baby is born. Imagine, a new mother suddenly has a huge amount of responsibilities. Hormonal changes in the body, physical exertion, emotional stress, economic problems, and social changes can all contribute to this condition. Not only is it sad, some mothers may lose interest in their baby and may even fear harming the baby.
• Persistent Depressive Disorder: This is a chronic depressive disorder that lasts for at least two years . Sometimes the symptoms may wax and wane. Although it is not as severe as Major Depressive Disorder, it is persistent and has a significant impact on your life.
• Seasonal Affective Disorder (SAD): This is a very strange condition. This depression only appears at certain times of the year. For example, some people feel sad, depressed, and bored during the rainy and cold seasons. But when the sunny and spring seasons come, this condition improves. Most often, it starts in late autumn or early winter. However, it can also occur in the summer.
• Depression with Psychosis: This is a very serious condition. Along with depression, there are also hallucinations – seeing or hearing things that are not there – or delusions – believing things that are false and that are not true. People with this condition are more likely to have suicidal thoughts .

What is Bipolar Disorder?

Bipolar disorder is a lifelong mental health condition that causes severe changes in mood, energy levels, thought patterns, and behavior. It involves alternating periods of extreme mania (called manic or hypomanic episodes) and periods of extreme depression (called depressive episodes).

There are four basic types of bipolar disorder:

• Bipolar I Disorder: These people have experienced at least one ``Manic'' episode. Many people have both ``Manic'' and ``Depressive'' episodes. However, a ``Depressive'' episode is not required for a diagnosis. During a ``Manic'' episode, a person may experience overactivity, sleep less, lose control over their spending, have grandiose ideas, and talk rapidly.
• Bipolar II Disorder: This disorder also has depressive episodes, similar to Bipolar I. However, instead of a manic episode, a milder episode called a hypomanic episode occurs. Hypomanic episodes are not as severe or disruptive to daily life as manic episodes. A person with this disorder can usually carry out their daily activities.
• Cyclothymic Disorder / Cyclothymia: These people have unstable moods for a long period of time, at least two years. They alternate between hypomanic and mild depressive symptoms.
• Other specified and unspecified bipolar and related disorders: In this type, symptoms do not exactly fit the other types, but there are significant, unusual mood swings.

Other types of mood disorders

There are several other types of mood disorders:

• Premenstrual Dysphoric Disorder (PMDD): This is a condition that occurs 7 to 10 days before a woman's period and goes away a few days after her period starts. It is more severe than the common premenstrual syndrome (PMS). Researchers believe it is caused by hormonal changes associated with the menstrual cycle. Symptoms can include anger, irritability, anxiety, depression, and insomnia.
• Disruptive Mood Dysregulation Disorder (DMDD): This condition affects children and young adults. It is characterized by frequent, inappropriate outbursts of anger and rage. This anger and irritability last most of the day. Symptoms usually begin before the age of 10. It is more severe than Intermittent Explosive Disorder (IED).

Is anxiety also a mood disorder?

A question that many people ask is whether Generalized Anxiety Disorder is also a mood disorder. No. Anxiety is a separate category of anxiety disorders. Conditions like Panic Disorder and Phobias also fall into this category. However, the important thing is that anxiety often precedes or coexists with a mood disorder.

Who can develop mood disorders?

These mood disorders can affect anyone . They can affect children, young people, adults, anyone. However, the condition called ``Major Depression`` is twice as common among women.

How common are these?

Mood disorders are relatively common among adults. Depression and bipolar disorder are the most common. These conditions are also common among children and young people. Although exact statistics in Sri Lanka are difficult to obtain, a significant number of people worldwide suffer from these conditions.

What are the symptoms of mood disorders?

Each mood disorder has its own set of symptoms, and the pattern of symptoms can vary.

Typically, mood disorders affect your mood, sleep, eating habits, energy levels, and thinking skills (for example, feeling like your thoughts are racing, having trouble concentrating).

Depressive symptoms are usually like this:

• Being sad most of the day, or almost all the time.
• Feeling of lifelessness and boredom in the body.
• Feeling worthless and hopeless .
• Losing interest in things that used to be enjoyable.
• Having thoughts about death or suicide .
• Difficulty concentrating and concentrating .
• Sleeping too much or not sleeping enough .
• Loss of appetite or overeating .

Symptoms of hypomanic or manic episodes are usually:

• Feeling overly strong and excited .
• Talking very fast, moving around quickly .
• Restlessness, constant worry, irritability .
• Engaging in risky behaviors (e.g., spending more money than usual, driving recklessly ).
• Racing thoughts are a feeling of thoughts running rapidly through your mind .
• Insomnia or difficulty sleeping .

What are the causes of mood disorders?

Researchers believe that mood disorders are caused by several factors. These include:

• Biological factors: The main centers of our brain that control emotions are the amygdala and the orbitofrontal cortex. When examining the brains of people with mood disorders, it has been found that this part of the amygdala is enlarged. Also, an imbalance in the chemicals called neurotransmitters in the brain may be a reason for this.
• Genetic factors: If someone in your family has a mood disorder, you are more likely to develop it too. This means that these conditions can be inherited to some extent through genes.
• Environmental factors: Severe, stressful life events (e.g., the death of a loved one), prolonged stress, traumatic events, and childhood abuse are major risk factors for later developing a mood disorder, especially depression. Depression has also been linked to chronic conditions such as diabetes mellitus, Parkinson's disease, and heart disease.

How to recognize mood disorders?

If you or your child is experiencing symptoms of a mood disorder, a doctor will first do a physical exam to rule out other physical causes for the symptoms. For example, thyroid disease, other medical conditions, or vitamin deficiencies can also cause these symptoms.

The doctor will then ask you about your medical history, the medications you take, and whether anyone in your family has mood disorders. You may then be referred to a mental health professional, such as a psychiatrist or psychologist.

A mental health counselor will talk to you, perhaps have you fill out a questionnaire, and gather information about your symptoms, sleep and eating patterns, and other behaviors. They diagnose mood disorders using the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).

Typically, someone's sadness, extreme happiness, anger, or other emotion:

• If it is too intense and continues ,
• If there are also other mood disorder symptoms, such as sleep changes and changes in activity level,
• Also, if the condition significantly interferes with daily activities ,

That's when it's diagnosed as a mood disorder.

How are mood disorders treated?

Treatment for mood disorders depends on the underlying condition and symptoms. Typically, treatment involves a combination of medication and psychotherapy (talk therapy). Sometimes, other treatments, such as brain stimulation therapy, are also used.

Medications for Mood Disorders

There are several types of medications that doctors prescribe to treat mood disorders:

• Antidepressants: The most commonly prescribed class of medications for depression and bipolar disorder are the Selective Serotonin Reuptake Inhibitors (SSRIs). Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are also commonly prescribed and work in a similar way to the SSRIs. Although studies have shown that different types of antidepressants work in the same way, some medications may be more effective for some people. It usually takes four to six weeks for an antidepressant to work. The most important thing is to take the medication exactly as your doctor prescribes and to keep taking it even if you feel better.
• Mood Stabilizers: These medications help control mood swings that occur in bipolar disorder or other disorders. They reduce abnormal brain activity. Sometimes, doctors may prescribe these medications along with antidepressants. The most commonly used mood stabilizers are lithium and anticonvulsant drugs.
• Antipsychotics / Neuroleptics: People with bipolar disorder who are experiencing mania or mixed episodes may be treated with an atypical antipsychotic, such as Aripiprazole (Abilify®). Doctors sometimes prescribe these drugs for depression if antidepressants alone do not control symptoms.

Psychotherapy for mood disorders

Psychotherapy, or talk therapy, is a collection of different treatment methods that help a person identify and change their unhealthy feelings, thoughts, and behaviors.

This treatment is provided by a trained, licensed psychiatrist, psychologist, or mental health counselor . It provides support, education, and guidance to you and your family, helping you to function better in your daily life and increasing your well-being.

Some of the most commonly used types of psychotherapy are:

• Cognitive Behavioral Therapy (CBT): This is a systematic, targeted form of psychotherapy. It is used to treat and manage mental health conditions and emotional problems. Simply put, it helps us identify and change our faulty thinking and behavior patterns.
• Dialectical Behavior Therapy (DBT): This is also a talk therapy based on CBT, but it is specifically designed for people who experience very intense emotions.
• Psychodynamic Therapy: This type of therapy is based on the idea that our behavior and mental well-being are influenced by childhood experiences and recurring problematic thoughts or feelings that we are unaware of (that is, unconsciously).

Other treatments for mood disorders

Other treatments include:

• Electroconvulsive Therapy (ECT): This is a medical procedure. It involves sending a very mild electric shock through your brain, causing a brief seizure-like state. This method has been shown to be very effective for severe, treatment-resistant mental health conditions, especially depression and bipolar disorder. These (ECT) sessions can be done on an outpatient basis. They usually take place two or three times a week, over a period of two weeks or more. A total of 6 to 12 sessions are usually needed.
• Transcranial Magnetic Stimulation (TMS): This is a treatment for people with severe depression who have not responded to at least one antidepressant. This is another type of brain stimulation. Transcranial Magnetic Stimulation (TMS) sends magnetic energy through your scalp, converting it into electrical currents, helping you control your emotions.
• Light Therapy: This method has long been used to treat seasonal affective disorder (SAD). It is based on the idea that bright artificial light can compensate for the lack of natural sunlight during the fall and winter seasons.

Can mood disorders be prevented?

There is currently no known way to prevent mood disorders. However, treatment can help reduce many of the problems associated with them. Seeking help as soon as symptoms appear can help reduce the disruption to your life.

What is the prognosis of mood disorders?

The outlook for a mood disorder, that is, the nature of recovery, depends on several factors:

• The type of medical condition and its severity.
• How quickly the disease was diagnosed.
• Whether or not they received proper treatment.

Depression and bipolar disorder can sometimes recur after initial treatment, or they can be persistent conditions. Therefore, long-term or lifelong treatment may be required.

The most important thing is to remember that mood disorders are treatable conditions. Even if it takes some time to find a treatment plan that works for you, stay determined to get better.

About one-third of people with a mood disorder develop psychotic disorders, and another third develop a lifelong anxiety disorder.

Children and adults with a mood disorder are at increased risk of suicidal behavior . If you are having thoughts of harming yourself or others, please seek medical advice immediately or talk to someone you trust. In Sri Lanka, you can get free help from organizations such as Sumithrayo (0112692909).

People with mood disorders are also at higher risk for the following:

• There are varying degrees of disability, from mild disability, to complete incapacity to care for oneself and maintain social relationships.
• Not being able to go to work or school.
• Severe anxiety.
• Alcohol Use Disorder.
• Substance Use Disorder.

When should I see a doctor about a mood disorder?

If you think you or your child may be experiencing symptoms of a mood disorder, be sure to talk to a doctor.

If you have been diagnosed with a mood disorder, you will need to see your doctor and/or mental health professional regularly to make sure your treatment plan is working properly.

Talk to your doctor about any questions you have about changing or stopping your medication. If the medication you are currently taking is not working or is causing side effects, ask them if you should try a different medication or change the dosage.

Remember, mood disorders are mental health conditions. As with all mental health conditions, seeking help as soon as symptoms appear can help reduce the disruption to your life. Mental health professionals can provide treatment plans to help you manage your symptoms.

So, what did we learn from this? (Take-Home Message)

Okay, so after this long talk, here are some of the most important things you need to remember:

• Mood disorders are more than just feelings of sadness or happiness. They are mental health conditions that affect your daily life and require treatment.
• These can happen to anyone. You are not alone.
• Depression and bipolar disorder are two of the most common types, but there are other types.
• It's important to recognize the symptoms. Be aware of things like persistent sadness, excessive happiness, changes in sleep, changes in appetite, and changes in energy.
• There are several possible causes. These include genes, brain chemical changes, and life events.
• There are effective treatments! These conditions can be managed with various treatments, such as medication and psychotherapy.
• It is very important to seek help early. If you have symptoms, don't delay in seeing a doctor or mental health counselor .
• You need support. The support of family, friends, and doctors will be a great strength for you on this journey.

Remember, mental health is just as important as physical health, so take care of your mental well-being as well.

` mood disorder, depression, bipolar disorder, mental health, depression, treatment, symptoms