Mood Disorders

Depression (Major Depressive Disorder) :  Depression impacts all aspects of life. When we become depressed, our work and relationships suffer and we are at greater risk for physical health problems and self destructive behaviors. At any one time, up to 1% of the population may suffer from depression. All of us experience a sad mood when we feel down about ourselves or aspects of our lives. Fluctuations in our mood are normal. However, when depression is excessive, lasts more than a few days, and interferes with regular functioning it becomes a problem.

Symptoms of depression include:
•Depressed or sad mood 
•Diminished interest or pleasure in activities previously enjoyed 
•Significant weight loss (not due to diet) or gain or appetite change 
•Insomnia or sleeping too much 
•Restlessness or slowness 
•Fatigue or loss of energy 
•Worthlessness or guilt 
•Diminished ability to concentrate 
•Suicidal ideation 

Depressive disorders in childhood may look different than depression in adults. However, despite the differences, it is just as insidious. Untreated childhood depression can lead to other problems such as poor relationships, chronic low mood and pessimism, self harming behavior, drug and alcohol abuse and even suicide. A child who is depressed may be sad or angry and irritable. She may be socially withdrawn or exhibit behavioral problems where the number of social interactions is generally more telling than number of friends. Decreased social interactions often lead to a decrease in pleasurable activities which in turn contributes to further depressed mood. "Acting out" behavior is also common in depressed youth since these children may not be adept in conveying their feelings through verbal means.

Other symptoms of childhood depression include:

•difficulty getting along with others 
•restlessness or difficulty sitting still 
•lack of energy 
•recurrent somatic complaints 
•problems with eating or appetite increased or decreased weight or appetite 
•problems with sleeping trouble sleeping or sleeping too much 

Bipolar Disorders:  Bipolar disorders are characterized by alternating periods of depressive symptoms as noted above and symptoms of mania (noted below). Usually, mood changes fluctuate between severe highs (mania) and lows (depression). These mood changes generally occur in a cycling fashion; sometimes fluctuating in a rapid manner with mood shifts repeating often, and at other times there can be weeks, months or years between episodes. When experiencing a depressive episode, a person with bipolar disorder can have any or all of the symptoms of Major Depression including hopelessness and suicidal thoughts or behaviors. In the manic phase, the person may be very talkative, have an abundance of energy, and be full of big ideas and plans.

Symptoms of mania include:
•excessively elevated mood 
•irritability and agitation 
•decreased need for sleep 
•increased talking 
•poor judgment 
•increased sexual desire   
•increased risk taking 
•significantly increased energy 
•racing thoughts 
•grandiose ideas 
•inappropriate social behaviors 

Individuals with Bipolar disorder in a manic episode may behave impulsively and not think or care about the consequences of their actions. Explosiveness is common.  During a manic episode a person may find themselves spending a lot of money, driving recklessly, making risky business investments and staying up all night working or partying. Problematic thoughts may include, "I can do anything I want," "I'm going to strike it rich," "Everybody love me." Often individuals with bipolar disorder experience multiple episodes of depression and only one or an occasional manic episode. Many individuals have difficulty accepting their bipolar disorder since episodes of mania can be enjoyable and productive, but exhausting.  Bipolar disorders are distinguished by the types and durations of moods that a person experiences. In Bipolar I Disorder, the person experiences long episodes of mania and depression. In Bipolar II Disorder, the mania lasts less longer and can be of less intensity. In Cyclothymic Disorder, the person experiences episodes of sadness and extreme happiness that cannot be classified as either depressed or manic but have a negative effect on the persons quality of life. Rapid cycling an interesting clinical phenomenon, involves alternations between good and bad moods over hour long intervals. 

Dysthymic Disorder:  Also called Dysthymia, this is a disorder where an adult is significantly unhappy for at least two years or a child for at least one year, but the person never had enough symptoms to be considered clinically depressed or suffering from Major Depressive Disorder. People with Dysthymic Disorder suffer from symptoms that may include poor appetite or overeating, insomnia or too much sleeping, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness. Being chronically unhappy, people suffering from Dysthymic Disorder have difficulty keeping jobs, keeping friends, and keeping busy.

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