Mood Disorders

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Mood Disorders

• By Ceilidh Poole, Ashley Callaghan, Tiffany
  McNeil and Emily Matter

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Overview

• Mood Disorders
• Depression
• Seasonal Affected Disorder
• Bi-polar Disorder
• References

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What are Mood Disorders?

• People experience a wide range of moods
• The sense of control is lost and people
  experience distress
• People with an elevated mood (mania) can show
  expansiveness, flight of ideas, decreased sleep,
  heightened self-esteem and grandiose ideas.
• People with depressed mood (depression) can have
  a loss of energy and interest, feelings of guilt,
  difficulty in concentrating, loss of appetite and
  thoughts of death or suicide.

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Mood Disorders

• Also called affective disorder
• The central feature is a disturbance in mood
• Mood is broadly defined as a feeling or emotion
  (ex. Sadness, happiness, anger)
• Children suffer from extreme, persistent, or
  poorly regulated emotional states, such as
  unhappiness or swings in mood from deep sadness
  to high elation.

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Depression
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What is Depression?

• The most common mood disorder
• A clinical term used by psychiatrists to describe
  a long period when a person feels very sad to the
  point of feeling worthless, hopeless and
  helpless.

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Causes

• Stress
• A loss, or a major disappointment.
• Sometimes, it seems to happen for no particular
  reason at all.
• Can be the result of a chemical imbalance in a
  person's body
• Some people are born with a built-in tendency to
  become depressed

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Signs Of Depression

• Feeling worthless, helpless or hopeless,
• Sleeping more or less than usual,
• Eating more or less than usual,
• Having difficulty concentrating or making
  decisions,
• Loss of interest in taking part in activities,
• Avoiding other people,
• Overwhelming feelings of sadness or grief,
• Feeling unreasonably guilty,
• Loss of energy, feeling very tired,
• Thoughts of death or suicide.

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Signs Specific to Children

• Unlikely to talk about it
• Changes in Feelings
• Physical Changes
• Changes in Thinking
• Changes in Behaviour

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DSM-IV Criteria for Diagnosis

• At least five symptoms must be present for two
  weeks
• (1) You are depressed, sad, blue, tearful. (2)
  You have lost interest or pleasure in things you
  previously liked to do. (3) Your appetite is
  much less or much greater than usual and you have
  lost or gained weight. (4) You have a lot of
  trouble sleeping or sleep too much. (5) You are
  so agitated, restless, or slowed down that others
  have begun to notice. (6) You are tired and have
  no energy. (7) You feel worthless or excessively
  guilty about things you have done or not
  done. (8) You have trouble concentrating,
  thinking clearly, or making decisions. (9) You
  feel you would be better off dead or have
  thoughts about killing yourself.

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Types of Depression

• Major Depressive Disorder (MDD)
• Sadness, loss of interest or pleasure in nearly
  all activities, irritability, plus a number of
  additional specific symptoms that are present for
  at least 2 weeks
• Dysthymic Disorder (DD)
• Display depressed mood for most of the day, on
  most days for at least 1 year
• Psychotic Depression
• Begin to hear and see imaginary things that do
  not exist which are frightening and negative.
• Atypical Depression
• Sufferers can experience moments of happiness and
  believe that outside events control their moods.
  It can last for months or may live with it
  forever.

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Treatment

• Medications
• Monoamine Oxidase Inhibitors
• Tricyclics
• Selective Serotonin Reuptake Inhibitors
• Newer medication

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Treatment Contd

• Electroconvulsive Therapy
• Psychotherapy
• Cognitive Therapy
• Behaviour Therapy
• Cognitive-Behaviour Therapy
• Dialectical Behaviour Therapy
• Psychodynamic Therapy
• Interpersonal Therapy

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Prevalence

• 2- 8 of children (between 4- 18) experience
  Major Depressive Disorder
• Rare among preschool and school-age children
• 3 of adolescents experience depression at a
  given point in time
• 8 experience it over a 1-year span
• Lifetime prevalence in adolescents is as high as
  20

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How to Help a Child

• Talk to Child
• Professional help is there for parents child
• Check with family doctor to see if there is a
  physical cause
• Talk to school and childs teacher

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How to Help the Family

• Recognize your feelings about your childs
  depression
• Learn how to help the depressed child
• Consider getting counselling for yourself as well
  as for the child
• Be honest with others about your childs needs

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Seasonal Affected Disorder(SAD)
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Definition

• Those with SAD typically experience symptoms that
  come and go with seasons.
• These symptoms usually develop gradually,
  beginning in the fall, and worsen during the
  winter.
• However, a rare type of SAD called Summer
  Depression can occur during the beginning of
  Spring, and worsen during the Summer months.

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Symptoms

• Sense of hopelessness
• Anxiety
• Decreased energy
• Social withdrawal
• Fatigue/ oversleeping
• Change in appetite
• gt (w/ sweet and starchy food cravings)
• Weight gain
• Decreased cognitive function
• Difficulty concentrating
• Irritability

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Causes

• Definite cause is unknown, however clinicians
  link SAD to the following factors
• Circadian Rhythm
• Decreased sunlight can alter your internal
  clock.
• Hormone Imbalances
• Melatonin (sleep-related hormone) decreases with
  limited sunlight.
• Serotonin (mood-related hormone) also decreases
  with limited sunlight.

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Who is Likely to Suffer from SAD?

• 2 - 3 of Ontarians have SAD
• Up to 15 have experienced winter blues
• Tends to begin in people over 20 yrs old
• Risk of SAD decreases with age
• More common in girls than boys
• More common in Northern areas
• People who live in urban areas

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SAD in Children

• 6 of Minnesota children reported extreme mood
  variations during the winter
• 1 reported depression during this time
• Percentage found to be higher in post-pubertal
  girls
• Between 1.7 - 5.5 of children between the ages
  of 9 and 19 have experienced SAD

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Diagnosis

• Considered a subtype of depression
• Proper diagnosis depends on honesty and accuracy
  of your answers to questions that relate to mood,
  seasonal changes in thoughts and behavior,
  lifestyle social changes, and sleeping eating
  patterns.
• This is because SAD can be mistaken for other
  mental disorders

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Treatment

• Light Therapy involves sitting near a light box
  which mimics sunlight.
• Medications Antidepressants are often
  prescribed.
• Psychotherapy
• Vacation People who vacation in southern areas
  during the winter generally find relief from
  their symptoms, although this is temporary

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Note

• If SAD is left untreated, it can lead to suicidal
  thoughts and substance abuse
• Sadly, many people suffering from Seasonal
  Affective Disorder are unaware that the disorder
  exists, and often go untreated.

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Bi-Polar Disorder(BP)
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What is Bi-Polar Disorder?

• Brain disorder and manic-depressive illness.
• Severe highs and lows which affect daily living.
• Feelings may not agree with every day life events.

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Mania Criteria

• Referred to as the high state.
• Three Symptoms must be present for at least one
  week, along with an elevated mood
• Increased energy
• Euphoric mood
• Extreme irritability
• Easily distracted and racing thoughts
• Inflated self-esteem
• Poor judgement
• Need of less sleep and an increased sex drive
• Frequent spending
• Aggressive

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Depression Criteria

• Referred to as the low state.
• As with clinical depression, 5 or more symptoms
  must be present for at least two weeks
• Prolonged sadness
• Feelings of loneliness and emptiness
• Feelings of helplessness and guilt
• Loss of interest
• Disruption of sleep
• Change in appetite and decreased energy
• Thoughts or attempts of suicide

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Other Important Terms

• Well State
• Normal functioning
• Hypomania
• Elevated moods, but not as severe
• Can turn into a manic episode
• According to DSM-IV symptoms must last for 4
  consecutive days and affect the persons daily
  functioning
• Mixed State
• Experience manic and depressive moods at the same
  time

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Comorbidity

• ADHD
• Learning Disorders
• Substance abuse
• Anxiety Disorders
• Binge Eating Disorder

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Types of BP

• Bi-Polar I
• Experiences 1 or more depressive episodes
  followed by 1 or more manic or mixed episodes
• Bi-Polar II
• Experiences 1 or more depressive episodes
  followed by 1 or more hypomanic episodes
• Cyclothymic Disorder
• Experiences symptoms of hypomania and depression
• Occurs for at least one year

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Who is Affected by BP?

• Rare in children
• More common among adults
• Rates increase after puberty
• 20 experience first symptoms after puberty
• Young people usually diagnosed with Type II or
  Cyclothymic BP
• Not based on gender
• Consistent across various cultures

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Prevalence

• About 0.4- 1.2 of young people
• 2.6 (5.7 million) Americans
• Average person with BP will suffer about 10
  episodes in their entire life
• Can go years without having an episode
• Cycling occurs in about 20 of patients
• Consists of having 4 episodes a year

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Causes of BP

• Highly heritable brain disorder
• Environmental factors
• Not present in just one gene
• Amygdala

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Treatment

• No FDA approved treatments exist for children
• Multi-method treatment
• Includes medicine, therapy and interventions
• Medicinal treatment
• Mood stabilizers
• Adjunct medications
• Therapies
• Electroconvulsive
• Psychotherapy

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References

• Canadian Mental Health Association(2008). Mood
  Disorders. Retrieved November 9 2008, from
  http//www.cmha.ca/bins/content_page.asp?cid3-8
  6
• Canadian Mental Health Association. Seasonal
  Affective Disorder. Retrieved November 13, 2008,
  from http//www.vanguard.edu/faculty/ddegelman/in
  dex.aspx?doc_id 796
• Centre for addiction and Mental Health (2008).
  Bipolar Disorder An Information Guide.
  Retrieved November 13, 2008, from
  http//www.camh.net/About_Addiction_Mental_Health
  /Mental_Health_ Information/Bipolar
  Disorder/index.html
• Depression. Retrieved November 13, 2008, from
  http//www.holisticonline.com/Remedies/Depression
  /dep_diag no1. htm
• Depression. Retrieved November 13, 2008 from
  http//depression.about.com/od/mooddisordertypes/
  p/depressiontypes .htm

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• Depression Help Basic Information and Treatment
  Options. Retrieved November 13, 2008 from
  http//www.depression-help- resource.com/types-of-
  depression.htm
• Mash, E.J Wolfe, D. A (2007). Abnormal Child
  Psychology (3rd Ed.) United States Thomson
  Learning, Inc.
• Mood Disorders Association of Ontario(2008). What
  is Mood Disorders? Retrieved November 9 2008,
  from http//www.mooddisorders.on.ca/md.html
• National Institute of Mental Health (2008).
  Bipolar Disorder. Retrieved November 13, 2008
  from, http//www.nimh.nih.gov/health/publications
  /bipolar-
• disorder/complete-publication.shtmlpub6
• One Healthy Lifestyle. Seasonal Affective
  Disorder. Retrieved November 13, 2008, from
  http//www.onehealthylifestyle.com/mental-health/m
  ental- disorders/seasonal-affective-disorder.aspx
• Seasonal Affective Disorder. Retrieved November
  13, 2008, from http//www.holisticonline.com/hol_
  sad.htmChildren