Tears may linger for the night,
but with dawn come cries of joy.
Psalm 30:5 (CJB )
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One classification of mental illness is the mood, or affective, disorder. Moods affect the way we feel about ourselves and others, think about the world around us, think about ourselves and others, and the way we respond to situations. They can impact our internal dialog (the way we talk to ourselves) as well. Left untreated, they can lead to extremely disrupted lives (relationships, work, etc), and even lead to thoughts of or actions based on
substance abuse or
Types of Mood Disorders
There are two basic types of mood disorders and one subcategory:
So let's unpack these one at a time.
- Unipolar -- a mood disorder that stays at one pole (either "highs" (mania) or lows (depression).
- bipolar -- a mood disorder in which a person cycles between mania and depression (this used to be called manic depressive disorder).
- Mixed episode -- sometimes a person with bipolar disorder can have aspects of both manic and depressive tendencies in the same episode.
Note that the Diagnostic and Statistical Manual (DSM-V) doesn't classify unipolar mania as a specific mental health disorder, but I have for clarification purposes only. Unipolar mania is rare as compared to bipolar disorder, which is why it has been removed from the DSM-V. The DSM helps clinicians diagnose mental illness and allows insurance companies to pay/reimburse for treatment. People who have four or more manic episodes without depressive episodes are considered to have unipolar mania. What are the signs and symptoms?
See this article for a description of a manic episode.
- elevated mood
- inflated self-esteem
- decreased need for sleep
- racing thoughts
- difficulty paying attention
- increase in goal-directed activity
appetite--eating too little or too much
- excessive involvement in pleasureable activities
Everyone feels sad sometimes, but when it's long-lasting (more than two weeks), there may be a problem. There are several different types of depression:
Depression symptoms, no matter what the type, can include:
- Major depressive disorder (MDD) -- This is a severe form of the mental disorder, with episodes lasting a few weeks to several months.
- Dysthymia -- Chronic, but milder form of the disorder.
- Double Depression -- comorbid (occurring together) MDD and dysthymia
- Post-partum Depression -- a disorder that occurs shortly after the birth of a baby
- changes in appetite -- eating too little or too much
- hypo/hypersomnia--getting too little or too much sleep
- Apathy--lack of emotion or feeling numb
- Lack of interest in previously enjoyed activities
- Isolating and withdrawing from social situations
- thoughts of
self-injury and or
Mood is affected by chemicals in the brain called neurotransmitters--specifically seratonin, norepinephrine and dopamine. When they are out of balance, mood disorders and personality can be affected. That's why my traumatic brain injury that I mentioned in the
this part of the video
really messed with my pre-existing
What can be done to treat mood disorders? Or do people just have to deal with wrecked, uncontrollable lives? Sometimes it truly does feel like life is out of control when the mood disorder or my PTSD seem to take over. There are effective treatments, though.
There are many different types of medications, and all of them act on the neurotransmitters I mentioned above. The most common types of antidepressants in use are called selective seratonin reuptake inhibitors (SSRIs). They increase levels of seratonin in the brain. SSRIs approved to treat depression are:
I'm currently taking an SSRI as part of my mental health medication regimen; I'm on Viibryd, and it works extremely well.
seratonin and norepinephrine uptake inhibitors make more seratonin and norepinephrine available to the brain. Some of these medications include:
Norepinephrine and dopamine reuptake inhibitors (NDRIs) make more of these two neurotransmitters available to the brain. One of these medications is Wellbutrin.
atypical antidepressants don't fit into any other categories and include:
Tricyclic antidepressants are an older class and are associated with more side effects than newer antidepressants. Some of these medications are:
Monoamine oxidase inhibitors (MAOIs) are also an older class of antidepressants and are tried after other antidepressants haven't been effective. People on these medications must follow a strict diet to avoid serious, and even deadly interactions. Some of these medications include:
Here is an article
that explains antidepressants in greater detail.
Sometimes, you have to try a number of medications before you can find the right medicine and dose for you. It took years, but when I found the right medications and dosage adjustments, things worked well. Here's my current mental health medication regimen--I'm on other medications for other health problems; these are just the ones for mental health:
It's extremely important to stick with your medication regimen, even if you start to feel better. Your medicines help you remain stabalized and stay mentally well. It's no different than taking medication for diabetes or a heart condition. Mental health disorders are very real and deserve the same respect, care and consideration as physical conditions.
Counseling, otherwise known as talk therapy or psychotherapy, helps a person learn how to change thoughts and behaviors, coping skills, stress management, and mental illness-specific skill sets. For example, a therapist working with someone who has dissociative identity disorder will work differently with someone with depression. Sometimes, therapists specialize in certain areas or fields, such as post-traumatic stress disorder (exposure therapy) or cognitive behavioral therapy. Here is an
overview of psychotherapy. Click through the pages on this site to learn more about why it's done, the process and results.
I'll be honest here: Cognitive behavioral therapy hasn't worked well for me. Learning how to change my behaviors through first changing my thoughts is so hard, and I just keep thinking and thinking and thinking...even when my bmind is overwhelme. I can't let go. Sometimes that leads to a really bad spiral and a hospitalization. Note that CBT has been shown to work really well for many people with depression; it's worth a try! Just as with medications, you have to find the right therapist.
Bipolar disorder combines features of mania and depression. People with this mood disorder shift from one end of the mood spectrum to the other. Sometimes, people may have a mixed episode, in which they exhibit signs of both mania and depression at the same time. Bipolar disorder is categorized into two types:
Hypomania consists of the following, taken from the
Depression and Bipolar Alliance website:
- Bipolar I disorder is characterized by one or more extreme manic or mixed episodes, along with periods of depression.
- Bipolar II disorder consists of periods of hypomania (mania is not as extreme), with one or more major depressive episodes
The highs in bipolar II, called hypomanias, are not as high as those in bipolar I (manias). Bipolar II disorder is sometimes misdiagnosed as major depression if hypomanic episodes go unrecognized or unreported. If you have recurring depressions that go away periodically and then return, ask yourself if you have also:
Rapid cycling is when a person with bipolar disorder experiences four or more manic, hypomanic, depressive or mixed episodes in a twelve month period.
- Had periods (lasting four or more days) when your mood was especially or abnormally energetic or irritable? Were you:
- Feeling abnormally self-confident or social?
- Needing less sleep or more energetic?
- Unusually talkative or hyper?
- Irritable or quick to anger?
- Thinking faster than usual?
- More easily distracted/having trouble concentrating?
- More goal-directed or productive at work, school or home?
- More involved in pleasurable activities, such as spending or sex?
Treatmennt for bipolar disorder consists of medications such as mood stabalizers:
These medications may be prescribed in addition to mood stabalizers and or antidepressants.
Anxiolytics (antianxiety medications, antidepressants and the antidepressant-antipsychotic combination medication Symbyax may also be prescribed.
Counseling can also be an effective long-term treatment for bipolar disorder. several different types of
therapy are available. This page only mentions two types of therapy, but there are many different types.
People with treatment-resistent depression or bipolar disorder have other choices. Brain stimulation options, such as
neuro stimulation therapies are available. I have the
vagus nerve stimulator,
mentioned in the brain stimulation article. However, mine is to control my epilepsy, not the depression. It doesn't do a thing to control the depression, but it does help with the seizures. I have the surgery to replace my battery for the VNS next month, so website development will be on hold for a week at most. I'll be sure to let you all know when that will take place so I'm not suddenly off the grid.
Psychosis and Mood Disorders
Sometimes people who have bipolar disorder or who are severely depressed can experience psychosis (when they lose touch with reality). Sometimes, when my depression is extreme, I have some paranoia. That's one reason I'm taking Abilify--to control the paranoia. It's also a helper medication that boosts the effects of antidepressants. However, it does help with my psychotic features, so I no longer think there are cameras in my room and that people are listening to my phone conversations. I'm also not worried about people talking about me and leaving me out of the conversations. Thanks, Abilify! And thanks to my psychiaatrist, psychiatric nurse and case manager for taking my paranoia seriously! They adjusted my medication and are making sure that I'm a part of the conversations they have about me. Psychotic features include:
Here is an
that discusses psychotic depression, or major depression with psychotic features.
Though mood disorders can significantly disrupt life, there are effective treatments to control them. It takes a lot of courage to admit that you have a problem and that you need help, but that's the first and most important step in the process of taking control of your life. Sometimes it requires a
to become stabalized if you're
having trouble with psychosis,
or the desire to hurt yourself. Sometimes that's the first step, and that's okay. There is nothing to be ashamed of, and psychiatric hospital staff can help you plan the next steps. The job of the psychiatric staff is medication adjustments, finding a therapist/psychologist/psychiatrist, creating coping skills and a safety plan and designing goals. That way, you're ready to move forward when you're released, and you have the tools you need to progress. You and your support system can work together to get you back on track and move toward mental wellness.