Mood disorders are mental disorders characterized by periods of
depression, sometimes alternating with periods of elevated mood.
While many people go through sad or elated moods from time to time, people
with mood disorders suffer from severe or prolonged mood states that
disrupt their daily functioning. Among the general mood disorders are
major depressive disorder,
, and dysthymia. In classifying and diagnosing mood disorders, doctors
determine if the mood disorder is unipolar or bipolar. When only one
extreme in mood (the depressed state) is experienced, this condition is
called unipolar. Major depression refers to a single severe period of
depression, marked by negative or hopeless thoughts and physical symptoms
like fatigue. In major depressive disorder, some patients have isolated
episodes of depression. In between these episodes, the patient does not
feel depressed or have other symptoms associated with depression. Other
patients have more frequent episodes.
Bipolar depression or bipolar disorder (sometimes called manic depression)
refers to a condition in which people experience two extremes in mood.
They alternate between depression (the low mood) and mania or hypomania
(the high mood). These patients go from depression to a frenzied, abnormal
elevation in mood. Mania and hypomania are similar, but mania is usually
more severe and debilitating to the patient. Dysthymia is a recurrent or
lengthy depression that may last a lifetime. It is similar to major
depressive disorder, but dysthymia is chronic, long-lasting, persistent,
and mild. Patients may have symptoms that are not as severe as major
depression, but the symptoms last for many years. It seems that a mild
form of the depression is always present. In some cases, people may also
experience a major depressive episode on top of their dysthymia, a
condition sometimes referred to as double depression.
Psychologists have identified the teenage years as one of the most
difficult phases of human life. Although they are often seen as a time for
enjoying friendship and engaging in activities that adults would not
usually do, the teenage period can be difficult. Many changes in the human
mind take place during
. Apart from the onset of sexual maturity, teenagers must also make key
decisions about their future, develop their identities, change schools and
meet a new sets of friends, find out about their family's past, and
cope with a wide range of other issues. Many young people have difficulty
coping with these stresses.
Four out of five teenagers who commit
are male, but the average female teenager is prone to attempt suicide
four more times during her teen years than the average male. White teenage
males are more likely to commit suicide than any other ethnic group, but
teenage suicide among blacks was as of 2004 increasing. Teenagers who have
unsuccessfully tried to commit suicide in the past are more likely to
attempt suicide in the future. The odds increase after each failed
attempt. There are two groups of teens that are at the highest risk for
committing suicide: Native Americans and teens who are gay, lesbian,
bisexual, and transgendered.
Gay and bisexual male teens, which represent about 10 percent of the male
teen population, are six to seven times more at risk for attempting
suicide than their heterosexual peers. Several surveys show gay and
lesbian youth account for 30 percent of all suicides among teens,
according to the U.S. Department of Health and Human Services. Yet most
studies of teen suicide have not been concerned with identifying sexual
As many as 14 percent of children will experience at least one episode of
major depression by age 15. Girls are significantly more likely to
experience depression than boys after the age of 16. Out of 100,000
adolescents, two to three thousand will have mood disorders out of which 8
to 10 will commit suicide. In the early 2000s, suicide, attempted suicide,
and thoughts of committing suicide are growing problems among adolescents
in the United States and much of the world. It is the third leading cause
of death among 15 to 19 year olds in the United States and the sixth
leading cause of death among 10 to 14 year olds. About 2 percent of
adolescent girls and 1 percent of adolescent boys attempt suicide each
year in the United States. Another 5 to 10 percent of children and teens
each year come up with a plan to commit suicide.
Causes and symptoms
Mood disorders tend to run in families. These disorders are associated
with imbalances in certain chemicals that carry signals between brain
cells (neurotransmitters). These chemicals include serotonin,
norepinephrine, and dopamine. Women are more vulnerable to unipolar
depression than are men. In adults, major life stressors (like
, serious financial problems, death of a
member, etc.) will often provoke the symptoms of depression in
susceptible people. Children's versions of these stressors
contribute to their vulnerability to depression.
Major depression is more serious than just feeling sad or
"blue." The symptoms of major depression may include the
Bipolar disorder includes mania or hypomania. Mania is an abnormal
elevation in mood. These individuals may be excessively cheerful, have
grandiose ideas, and may sleep less. They may talk nonstop for hours, have
unending enthusiasm, and demonstrate poor judgment. Sometimes the
elevation in mood is marked by irritability and hostility rather than
cheerfulness. While the person may at first seem normal with an increase
in energy, others who know the person well see a marked difference in
behavior. The patient may seem to be in a frenzy and will often make poor,
bizarre, or dangerous choices in his or her personal and professional
lives. Hypomania is not as severe as mania and does not cause the level of
impairment in work and social activities that mania can.
There are many methods for helping teenagers deal with mood disorders,
both medical and psychological. Most teenagers who have mood disorders
believe their problems are too hard or embarrassing to talk about, so it
is important for a helper to show they can be trusted and talked to.
Seeing a psychologist is widely recommended as well. Psychologists can
improve a teenager's vision of life by listening to them and making
them feel it will work out for the best.
If a child or teen is so depressed that he or she is talking about
suicide, doctors recommend that parents or other helpers do not ask the
adolescent what reason they have to think of such a thing to do; rather,
one should listen and wait for the child to gain trust enough so that he
or she finally can feel comfortable in talking about the problem. Helpers
should, however, show understanding of the teenager's situation.
Doctors also recommend that helpers do not mention any "reasons to
live" to the teenager,
as that might send the teenager back into depressing thoughts, e.g.
"What reason do I have to live?" Many doctors recommend that
teenagers be taken to a hospital immediately after they express the desire
to commit suicide.
Doctors diagnose mood disorders based on the patient's description
of the symptoms as well as the patient's family history. The length
of time the patient has had symptoms is also important. Generally patients
are diagnosed with dysthymia if they feel depressed more days than not for
at least two years. The depression is mild but long lasting. In major
depressive disorder, the patient is depressed almost all day nearly every
day of the week for at least two weeks. The depression is severe.
Sometimes laboratory tests are performed to rule out other causes for the
symptoms (like thyroid disease). The diagnosis may be confirmed when a
patient responds well to medication.
The most effective treatment for mood disorders is a combination of
medication and psychotherapy. The four different classes of drugs used in
mood disorders are as follows:
A number of psychotherapy approaches are useful as well. Interpersonal
psychotherapy helps the patient recognize the interaction between the mood
disorder and interpersonal relationships. Cognitive-behavioral therapy
explores how the patient's view of the world may be affecting his
or her mood and outlook.
When depression fails to respond to treatment or when there is a high risk
of suicide, electroconvulsive therapy (ECT) is sometimes used. ECT is
believed to affect neurotransmitters like the medications do. Patients are
anesthetized and given muscle relaxants to minimize discomfort. Then
low-level electric current is passed through the brain to cause a brief
convulsion. The most common side effect of ECT is mild, short-term memory
There are many alternative therapies that may help in the treatment of
mood disorders, including acupuncture, botanical medicine, homeopathy,
aromatherapy, constitutional hydrotherapy, and light therapy. The therapy
used is an individual choice. Short-term clinical studies have shown that
the herb St. John's wort (
) can effectively treat some types of depression. Though it appears very
safe, the herb may have some side effects and its long-term effectiveness
has not been proven. It has not been tested in patients with bipolar
disorder. St. John's wort and antidepressant drugs should not be
taken simultaneously, so patients should tell their doctor if they are
taking St. John's wort.
Most cases of mood disorders can be successfully managed if properly
diagnosed and treated.
People can take steps to improve mild depression and keep it from becoming
worse. They can learn stress management (like relaxation training or
regularly, and avoid drugs or alcohol.
—Psychological treatment aimed at changing a person's way
of thinking in order to change his or her behavior and emotional state.
Electroconvulsive therapy (ECT)
—A psychological treatment in which a series of controlled
electrical impulses are delivered to the brain in order to induce a
seizure within the brain. This type of therapy is used to treat major
depression and severe mental illness that does not respond to
—A chemical messenger that transmits an impulse from one nerve
cell to the next.
—A widely distributed neurotransmitter that is found in blood
platelets, the lining of the digestive tract, and the brain, and that
works in combination with norepinephrine. It causes very powerful
contractions of smooth muscle and is associated with mood, attention,
emotions, and sleep. Low levels of serotonin are associated with
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1000 Skokie Blvd., Suite 425, Wilmette, IL 60091. Web site:
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3615 Wisconsin Ave. NW, Washington, DC 20016. Web site:
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