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MOOD DISORDERS

NORMAL MOOD VARIATION

Fluctuation in mood or mood swings are normal. Our mood is influenced by a myriad of internal and external factors, and can change during the course of the day.  Simply speaking there are periods when we may feel especially happy, or not as happy, or even unhappy, or irritable.

Idiomatic Expressions are a figurative way of expressing ones self. The origin of such terms is based on shared experience. So the expression “woke up on the wrong side of the bed” figuratively means that the person is  going to be in a bad mood for the rest of the day. The fact that the expression exists in the first place and that people can relate to it simply illustrates that mood variability is normal part of our existence.

MAJOR DEPRESSIVE DISORDER

Introduction

It is normal for people to experience periods of unhappiness or sadness. Despite this, many people are unable to understand or relate to Major Depressive Disorder.  For most people their experience of depression is for a limited duration and they are generally of the perception that it can be controlled. This is not entirely incorrect but it is not quite as simple as that.


The intensity and the duration of the unhappiness and the degree to which it affects an individual’s normal day to day life will determine if one has Major Depressive Disorder.


Major Depressive Disorder

Major Depressive Disorder is defined by a low or irritable mood that occurs for prolonged duration of time (more than 2 weeks). Such individuals may not be able to experience pleasure or lose interest in things they normally enjoy doing. They may also feel hopeless, helpless or worthless and experience fatigue. Typically, difficulty sleeping and loss of appetite occurs. Although atypically the inverse may occur as well i.e. sleeping more than usual, eating more than usual (comfort feeding). 

It is not uncommon for one’s mental faculties to be affected. Impairment in memory and concentration are common experiences. Some individuals may forget where they leave things, experience difficulty finding words or forgetting important steps in  order to complete a task and in others it can be quite pronounced where they may  fail to recollect people’s names or how to go about performing a task .i.e. Pseudodementia (pseudo loosely translated as 'not actually'. This condition mimics a serious disorder i.e Dementia, whic is characterized by marked memory impairment among other symptoms. Some may experience difficulty in performing tasks e.g. it takes longer to complete a task.

Suicide is not essential to make a diagnosis of Major Depressive Disorder and can range from just a thought of dying to a plan to end one’s life, or even and attempt which could be serious such as an overdose and even more severe. It does however indicate severity. 

BIPOLAR DISORDER

Introduction

It is important to keep in mind that each person will have variability in their mood. Some individuals are more marked and others less so. A depressed individual or even a stressed or anxious person can present with irritability or an unstable mood. In order for the diagnosis to be made, there are more than just mood symptoms that need to be met.


Bipolar I Disorder (Mania)

Is characterized by a clear period of an abnormally elevated or irritable mood that persists for at least a week


Other symptoms include:

  • Goal directed behavior: engaging in a behavior to achieve a particular objective e.g. studying, working or even increased libido. In the case of manic individuals, it may be multiple activities that they engage in excessively which may not be sensible. Once again this is atypical of anxiety or depression which is generally associated with fatigue and poor motivation. An anxious or depressed individual however may experience insomnia and restlessness and for example may wake up at night to clean their homes in an attempt to avoid the distressing thoughts.

  • Self-esteem: typically enhanced. For example, a normally conservative individual will not have difficulty communicating and socializing. Sometimes they may feel a greater sense of self-importance. In contrast the opposite would be expected in a depressed or anxious individual

  • Talkative: they tend to talk a lot more than usual and perhaps even excessively or can’t stop talking.

  • Distractibility: easily losing focus or jumping from one thing to another. This may be reflected in their conversation and even in the actions.

  • Activities associated with potential harm: e.g. spending money they don’t have or sexual indiscretions. 


It is not uncommon for such individuals to experience psychotic symptoms. Psychosis is when a person is not in touch with reality. For e.g. believing that they are a messenger of god or they have inherited large sums of money. 


Bipolar II Disorder (Hypomania)

Is very much the same but the intensity and duration is much less. The duration is at least 4 day. Psychosis only occurs in individuals with Mania.

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