Mood Disorders

What is a mood disorder?

A mood disorder is a mental health condition that primarily affects your emotional state. It’s a disorder in which you experience long periods of extreme happiness, extreme sadness or both. Certain mood disorders involve other persistent emotions, such as anger and irritability.

It’s normal for your mood to change, depending on the situation. However, for a mood disorder diagnosis, symptoms must be present for several weeks or longer. Mood disorders can cause changes in your behavior and can affect your ability to perform routine activities, such as work or school.

Two of the most common mood disorders are depression and bipolar disorder.

What are all the mood disorders?

Mood disorders include:

• Depression and its subtypes.
• Bipolar disorder and its subtypes.
• Premenstrual dysphoric disorder.
• Disruptive mood dysregulation disorder.

Depression

Depression (major or clinical depression) is a common mental health condition. Depressive symptoms include feeling sad or hopeless. The condition can also cause difficulty with thinking, memory, eating and sleeping. For a person to receive a diagnosis of clinical depression, symptoms must last for at least two weeks.

There are several different types of depression, including:

• Postpartum depression (peripartum depression): This type of depression occurs during pregnancy or after the end of a pregnancy in women and people assigned female at birth (AFAB). Women and people AFAB experience hormonal, physical, emotional, financial and social changes after having a baby. These changes can cause symptoms of postpartum depression.
• Persistent depressive disorder: This is a chronic form of depression that must last for at least two years. Symptoms may occasionally lessen in severity during this time. It’s less severe than major depressive disorder, but it’s ongoing.
• Seasonal affective disorder (SAD): This type of depression occurs during certain seasons of the year. It typically starts in the late autumn or early winter and lasts until spring or summer. Less commonly, SAD episodes may also begin during the late spring or summer. Symptoms of winter seasonal affective disorder may resemble those of major depression. They tend to disappear or lessen during spring and summer.
• Depression with psychosis: This is a type of severe depression combined with psychotic episodes, such as hallucinations (seeing or hearing things that others don’t) or delusions (having fixed but false beliefs). People who experience depression with psychosis have an increased risk of thinking about suicide.

Bipolar disorder

Bipolar disorder is a lifelong mood disorder and mental health condition that causes intense shifts in mood, energy levels, thinking patterns and behavior. There are a few types of bipolar disorder, which involve experiencing significant fluctuations in mood referred to as hypomanic/manic and depressive episodes.

There are four basic types of bipolar disorder, including:

• Bipolar I disorder: People with bipolar I disorder have experienced one or more episodes of mania. Most people with bipolar I will have episodes of both mania and depression, but an episode of depression isn’t necessary for a diagnosis.
• Bipolar II disorder: This disorder causes cycles of depression similar to those of bipolar I. A person with this illness also experiences hypomania, which is a less severe form of mania. Hypomanic periods aren’t as intense or disruptive as manic episodes. Someone with bipolar II disorder is usually able to handle daily responsibilities.
• Cyclothymia disorder (cyclothymia): People with cyclothymic disorder have a chronically unstable mood state. They experience hypomania and mild depression for at least two years.
• Other specified and unspecified bipolar and related disorders: Symptoms of this type of bipolar disorder don’t meet the criteria for one of the other types, but people still have significant, abnormal mood changes.

Other mood disorders

Other mood disorders include:

• Premenstrual dysphoric disorder (PMDD): This type of mood disorder occurs seven to 10 days before menstruation and goes away within a few days of the start of the menstrual period. It’s a more serious form of premenstrual syndrome (PMS). Researchers believe this condition is brought about by the hormonal changes related to the menstrual cycle. Symptoms may include anger, irritability, anxiety, depression and insomnia.
• Disruptive mood dysregulation disorder (DMDD): DMDD affects children and adolescents. It involves frequent anger outbursts and irritability out of proportion to the situation. DMDD is more severe than intermittent explosive disorder (IED), and anger is present most of the time, occurring before the age of 10.

Is anxiety a mood disorder?

Anxiety (generalized anxiety disorder) isn’t a mood disorder. It’s classified as one of many anxiety disorders, including panic disorder and phobias. However, anxiety often precedes or coexists with mood disorders.

Who do mood disorders affect?

Mood disorders can affect anyone, including children, adolescents and adults.

Major depression is twice as likely to affect women and people AFAB than men and people assigned male at birth (AMAB).

How common are mood disorders?

Mood disorders are relatively common in adults, with depression and bipolar disorder being the most common. Approximately 7% of adults in the United States have depression, while about 2.8% have bipolar disorder.

Mood disorders are commonly seen in children and adolescents — approximately 15% have any mood disorder.

What are the symptoms of mood disorders?

Each mood disorder has different symptoms and/or different patterns of symptoms.

Mood disorders typically have symptoms that affect your mood, sleep, eating behaviors, energy level and thinking abilities (such as racing thoughts or loss of concentration).

In general, depressive symptoms include:

• Feeling sad most of the time or nearly every day.
• A lack of energy or feeling sluggish.
• Feeling worthless or hopeless.
• Loss of interest in activities that formerly brought enjoyment.
• Thoughts about death or suicide.
• Difficulty concentrating or focusing.
• Sleeping too much or not enough.
• Loss of appetite or overeating.

In general, symptoms of hypomanic or manic episodes include:

• Feeling extremely energized or elated.
• Rapid speech or movement.
• Agitation, restlessness or irritability.
• Risk-taking behavior, such as spending more money than usual or driving recklessly.
• Racing thoughts.
• Insomnia or trouble sleeping.

What causes mood disorders?

Researchers believe several factors contribute to the development of mood disorders, including:

• Biological factors: The brain areas responsible for controlling your feelings and emotions are the amygdala and orbitofrontal cortex. People with mood disorders have been shown to have an enlarged amygdala on brain imaging tests.
• Genetic factors: People who have a strong family history of a mood disorder are more likely to develop mood disorders, which shows that mood disorders are likely partly genetic/inherited.
• Environmental factors: Stressful life changes, such as the death of a loved one; chronic stress; traumatic events; and childhood abuse are major risk factors for the development of a mood disorder later on in life, especially depression. Depression has also been linked to chronic illnesses, such as diabetes, Parkinson’s disease and heart disease.

How are mood disorders diagnosed?

If you or your child are experiencing symptoms of a mood disorder, a healthcare provider may perform a physical examination to rule out physiological causes for symptoms, such as thyroid disease, other illnesses or a vitamin deficiency.

Your provider will ask about your medical history, any medications you’re taking and whether you or any family members have been diagnosed with a mood disorder. They may refer you to a mental health professional.

A mental health professional, such as a psychologist or psychiatrist, will conduct an interview or survey, asking questions about your symptoms, sleeping and eating habits and other behaviors. They use criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders to make diagnoses of mood disorders.

In general, a mood disorder is diagnosed when sadness, elation, anger or other emotion is:

• Overly intense and persistent.
• Accompanied by other mood disorder symptoms, such as sleep changes or activity level changes.
• Significantly impairs the person’s capacity to function.

How are mood disorders treated?

Treatment for mood disorders depends on the specific condition and symptoms. Usually, treatment involves a combination of medication and psychotherapy (also called talk therapy). There are also other types of treatment, such as brain stimulation therapy.

Medications for mood disorders

Medications that healthcare providers may prescribe to help treat mood disorders include:

• Antidepressants: Some of the most widely used drugs to treat depression and depressive episodes of bipolar disorder are selective serotonin reuptake inhibitors (SSRIs). Serotonin and norepinephrine reuptake inhibitors (SNRIs) are also commonly prescribed and are similar to SSRIs in their action. Although studies show that different types of antidepressants work equally well, some antidepressants may be more effective depending on the person. Usually, an antidepressant takes four to six weeks before it begins to work. It’s important to take the antidepressants as prescribed and continue taking them even if you feel better.
• Mood stabilizers: These medications help regulate the mood swings that occur with bipolar disorder or other disorders. They reduce abnormal brain activity. Providers may prescribe mood stabilizers along with antidepressants in some cases. Some of the most widely used mood stabilizers include lithium and anticonvulsant drugs.
• Antipsychotics (neuroleptics): People with bipolar disorder who experience mania or mixed episodes may be treated with an atypical antipsychotic (neuroleptic) drug, such as aripiprazole (Abilify®). Providers sometimes prescribe atypical antipsychotics to treat depression if symptoms aren’t controlled with an antidepressant alone.

Psychotherapy for mood disorders

Psychotherapy, also called talk therapy, is a term for a variety of treatment techniques that aim to help a person identify and change unhealthy emotions, thoughts and behaviors.

Psychotherapy takes place with a trained, licensed mental health professional, such as a psychologist or psychiatrist. It can provide support, education and guidance to you and/or your family to help you function better and increase your well-being.

Some of the more common types of psychotherapy include:

• Cognitive behavioral therapy (CBT): This is a structured, goal-oriented type of psychotherapy. Mental health professionals use it to treat or manage mental health conditions and emotional concerns.
• Dialectical behavior therapy (DBT): DBT is a type of talk therapy that’s based on cognitive behavioral therapy (CBT), but it’s specially adapted for people who experience emotions very intensely.
• Psychodynamic therapy: This type of therapy is based on the idea that behavior and mental well-being are influenced by childhood experiences and problematic repetitive thoughts or feelings that are outside of your awareness (they’re unconscious).

Other treatments for mood disorders

Other treatments for mood disorders include:

• Electroconvulsive therapy (ECT): ECT is a medical procedure that involves passing a mild electric current through your brain, causing a short seizure. This procedure is proven to have strong positive effects on severe, treatment-resistant mental health conditions, including depression and bipolar disorder. The ECT sessions can be performed on an outpatient basis. Usually, two or three sessions per week are required, over a period of two weeks or more. Generally, six to 12 sessions are required.
• Transcranial magnetic stimulation (TMS): TMS is a treatment for people with severe depression that hasn’t been helped by at least one antidepressant medication. It’s a type of brain stimulation therapy. TMS elicits magnetic energy, which turns into an electrical current underneath your skull, to help regulate your emotions.
• Light therapy: This technique has long been used to treat seasonal affective disorder (SAD). It’s based on the idea of supplementing natural sunlight with bright artificial light during the fall and winter.

Can mood disorders be prevented?

At this time, there’s no known way to prevent mood disorders, but many of the related issues may be lessened with treatment. Seeking help as soon as symptoms appear can help decrease the disruption to your life.

What is the prognosis for mood disorders?

The prognosis (outlook) for mood disorders depends on several factors, including:

• The type of condition and its severity.
• How early it’s diagnosed.
• If it’s properly treated.

Depression and bipolar disorder may recur (come back after initial treatment) or be ongoing and, therefore, may require long-term or lifetime treatment.

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

Children and adults with a mood disorder have an increased risk of suicidal behavior. Seek help immediately if you have thoughts of harming yourself or others. If you live in the United States, you can call 988 for help. It’s the number for the Suicide & Crisis Lifeline. Someone will be available to talk to you at any time of the day.

People with mood disorders also have an increased risk of the following:

• Disability ranging from mild to complete inability to care for oneself and maintain social interactions.
• Missing work or school.
• Severe anxiety.
• Alcohol use disorder.
• Substance use disorder.

It’s important to remember that mood disorders are treatable. Even though it may take a while to find the right treatment plan for you, stay committed to feeling better.

When should I see my healthcare provider about a mood disorder?

If you or your child are experiencing symptoms of a mood disorder, talk to a healthcare provider.

If you’ve been diagnosed with a mood disorder, you’ll likely need to see your provider and/or mental health professional regularly to make sure your treatment plan is working.

Discuss any concerns you have about changing or stopping medications with your provider or another health professional. Ask them whether you might need to try a different medication or have the dosage adjusted if the one you’re taking isn’t working or causes unpleasant side effects.

A note from Cleveland Clinic

It’s important to remember that mood disorders are mental health conditions. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to your life. Mental health professionals can offer treatment plans that can help you manage your symptoms.