Handout 3: Mood Disorders Mood disorders are called affective (emotional) disorders. There are two categories of mood disorders: Depressive Disorders Bipolar Affective Disorders Depressive Disorders Minor Depression This is what we all experience from time to time: Normal ups and downs, the 'blues' Normal human response to bereavement, relationship break up, financial worries, loss or sadness or rejection or other situations Gets better with support, change of environment, time Major Depression Major depression is a regular or ongoing depression, called a depressive illness. Depressive illness is depression that doesn't go away for several weeks or months. Depression is a very common mental illness and is significantly different from unhappiness or sadness. It is a long lasting, often recurring illness as real and as debilitating as heart disease. There may be feelings of oppressive sadness, fatigue and guilt. The person who is depressed feels lonely and isolated, helpless, worthless and lost. There is usually a combination of physical and psychological symptoms involved in a depressive episode. Melancholia is the terrible sadness that never lifts. Common Symptoms of Depression The main two symptoms of depression are: Lack of energy, loss of interest in life's activities Depressed mood Other symptoms of depression include: Eating too much or too little, appetite loss leading to weight loss, or sometimes weight gain Sleep disturbances - Sleeping too much or too little, difficulty going to sleep (insomnia), waking up in the night, early morning wakening is common Handout 3 for Job 10 - Provide Support to People with Mental Health Issues Page 1 of 6
Changes in self-image - feelings of worthlessness or guilt Restlessness, agitation and irritability or physically slowed down Difficulty concentrating, remembering Slowed thinking, inability to make decisions Thoughts of death or suicide Inability to function at work or school Headaches, digestive disorders, nausea with no other cause Excessive crying Persistent feelings of sadness, anxiety and hopelessness Feelings of inappropriate guilt or worthlessness Types of Depression There are different types of depression. Major (Clinical) Depression Major depression is diagnosed if a person has experienced at least 2 weeks of depressed mood with at least 4 other symptoms of depression. Dysthymic Disorder This is diagnosed if a person has experienced at least 2 years of depressed mood more days than not and has additional symptoms of depression. Some common symptoms noticed with this disorder are feelings of inadequacy, loss of interest or pleasure, dwelling on the past, feelings of guilt and social withdrawal. It differs from Major Depression in that major depression consists of one or more episodes whereas dysthymic disorder may begin early in life, be less severe but is more or less continuous over the life span (unless treatment is sought). Adjustment Disorder with Depressed Mood Depression can be triggered by situations in life that are stressful; such as moving house, loss of a job or relationship break-up. Even "positive" changes can be difficult to adjust to such as marriage, new job, birth of a baby etc. Change at any level can cause stress levels to rise. Depression is more intense and lasts for much longer than the unhappiness experienced in daily life. Treatment is generally necessary and often very effective. Psychotic Depression Sometimes depression becomes so severe that the person is psychotically depressed - this means that the person has the symptoms of psychosis such as delusions and hallucinations and can become very withdrawn. Handout 3 for Job 10 - Provide Support to People with Mental Health Issues Page 2 of 6
What Causes Depression? Depression is almost always caused by a combination of factors - environmental, personality, genetics. Sometimes it is possible to point to a specific event that seems to have triggered a depression. At other times it comes on for no apparent reason even for individuals whose lives are going well. External Events Losses Loneliness resulting from relationship difficulties Financial Worries Retirement Other stresses Life Cycles Issues Depression is closely associated with stress and can occur at certain stages of life, such as puberty, middle age or retirement. Stress resulting from personal tragedies, family breakdown and unemployment, for example, can all contribute. Personality Some personality types are more prone to depression. People who set very high standards for themselves and others may be easily depressed if they are let down. Past Depressive Episodes Once a person has experienced an episode of major depression, they may be more likely to develop another depression in the future. Genetics People can inherit a predisposition to develop depression. Having close relatives who have had depression increases the risk of developing depression. The Body's Chemistry Current research suggests that an imbalance of brain chemicals called neurotransmitters, can be a factor in depression. Depression is thought to be a deficiency in a chemical called norepinephrine. An imbalance in the chemicals in the brain which regulate mood and activity, can alter someone's thoughts, emotions and behaviour. This can be corrected with the use of antidepressants. Other Causes Medical illnesses Some Medications Handout 3 for Job 10 - Provide Support to People with Mental Health Issues Page 3 of 6
Alcohol and other substances What are the Interventions for Depression? Counselling and therapy: Counselling and therapy involve a process of talking about concerns, working through possible solutions and learning problem solving, communication skills and coping strategies. Medication: Medication such as antidepressants can be effective in the treatment of depression. These medications are non habit forming and are helpful in reducing the severity, frequency and duration of depressive episodes. Electroconvulsive therapy (ECT) for severe depression. How Common is Depression? Estimates vary from 5% to 15% of Australians having experience of a major depressive illness at some point in their lives. What is the Outcome? Most people recover from depressive illness. Some people have numerous episodes of depression. People with depression have a high rate of suicide and suicide attempts. Bipolar Affective Disorder This is also a mood disorder but a person with bipolar disorder has both depression and mania. It is a disorder of mood and of energy level with swings from "high" to "low". It used to be called manic-depressive illness. What does Mania Mean? Mania means an increase in mental and physical activity. Hypomania is a mild form of mania where there is an 'upswing' in mood. A manic episode is when the mood change is more marked and severe and persistent. The person may no longer be connected with reality - they may be psychotic. What are the Common Symptoms of Mania? Feeling 'high' - everything seems wonderful to the person Irritability Not wanting to sleep Fast flow of ideas and speech, pressure of speech Increased sexual activity (out of character for the person) Feeling that one is great or significant or specially chosen Increased religious/spiritual feelings (out of character for the person) Handout 3 for Job 10 - Provide Support to People with Mental Health Issues Page 4 of 6
Reduced sense of danger Spending too much money (out of character for the person) How Common is Bipolar Disorder? About 1% of the population have bipolar disorder. When do people develop Bipolar Disorder? Between the ages of 18 and 25 is the most common time for people to have their first episode of bipolar disorder. What is the Outcome? Some people have only one episode of mania and one episode of depression. Other people have frequent swings between mania and depression. What does Bipolar Disorder feel like? "I went into a fantastic high, my mind was speeding with an unreal sense that all limits were off; I could set up grandiose schemes, be brilliantly creative, order people around because I was a genius, spend money with abandon. I didn't need to sleep or eat. I rode a motorbike the wrong way up a freeway. I plugged myself into a power point with a fork to hear messages from God - and mercifully survived both. From being a non-religious person, my psychotic delusions grew and I believed I was the Virgin Mary and talked incessantly about my special mission, and rang people in the middle of the night. Anyone who didn't agree with my brilliant ideas was treated with scorn." Meg Smith, Good Weekend. Handout 3 for Job 10 - Provide Support to People with Mental Health Issues Page 5 of 6