Facts on Mental Health

Mood Disorders are characterised by disturbance in regulation of mood, behaviour and affect.
 

Mood Disorders are broadly classified into the following categories:

1. Manic Episode

2. Depressive Episode

3. Bipolar Mood Disorder

4. Recurrent Depressive Disorder

5. Persistent Mood Disorder

6. Other mood Disorders (including Mixed Affective Episode and Recurrent Brief Depresive Disorder)

Manic Episode : A manic episode is characterised by following features which should last for atleast one week and cause disruption in occupational and social activities:

Elevated, Expansive or Irritable Mood : Here the patient experiences increased sense of psychological wellbeing and happiness not in keeping with ongoing events. There is increased feeling of confidence of enjoyment along with increased psychomotor activity. The patient may also experience intense sense of rapture or blisfulness. At times elevated mood may not be apparent; instead irritable mood may be predominant, especially when the person is stopped from doing what he wants. there may be rapid, short lasting shifts from euphoria to depression or anger.

Psychomotor Activity : There is an increased psychomotor activity ranging from overactiveness and restlessness to manic excitement. The activity is usually goal-oriented and based on external environmental cues.

Speech and Thought : The person is more talkative than usual, describes thoughts racing in mind, develops pressure of speech, uses playful language and speaks loudly. There is also flight of ideas in his speech. There can be delusions with marked inflated self-esteem. Distractibility is common and results in rapid chnages in speech and activity, in response to even irrelevant stimuli.

Goal Directed Activity : The person is usually alert, trying to do many things at one time. The ability to function becomes much better and there is marked increase in productivity and creativity. There is marked increase in activity with excessive planning and at times execution of multiple activities. Because of involving in so many activities and distractions, there is decrease in funcioning ability in later stages. There is marked increase in socialibility even with previously unknown people. The person becomes impulsive, shows disinhibition, sexual indiscretion and usually becomes hypersexual and promiscuous. The manic person is involved in high risk activities like buying sprees, reckless driving, foolish business investments, distributing money or personal articles to unknown persons. Sleep is usually reduced with a decreased need for sleep.

Depressive Episode : The most important feature is the sadness of the mood or loss of interest or pleasure in almost all activities present throughout the day. The loss of interest in daily activities results in social withdrawl, decreased ability to function in occupational and interpersonal areas and decreased involvement in previously pleasurable activities. Sadness of mood usually is associated with pessimism like hopelessness, helplessness and worthlessness.

Other features are guilt feelings, difficulty in thinking, concentration, indecisiveness, slowed thinking, poor memory, anxiety, irritability, frustration, lack of initiative and energy. Thoughts of suicide may also be present.

These may result in insomnia (sometimes hypersomnia), loss of appetite and weight (sometimes, weight gain may also occur) and loss of sexual drive.

Bipolar Mood Disorder : This disorder, earlier known as manic depressive psychosis (MDP), is characterised by recurrent episodes of mania episode and depression episode in the same patient at different times. These episodes can occur in any sequence.

The current episode in bipolar mood disorder is specified as : hypomanic, manic without psychotic symptoms, manic with psychotic symptoms, mild or moderate depression, severe depression without psychotic symptoms, severe depression with psychotic symptoms, mixed or in remission. Bipolar Mood Disorder is further classified into Bipolar-I and Bipolar-II disorders.

Recurrent Depressive Disorder : This disorder is characterised by recurrent (at least two) depressive episodes (unipolar depression). The current episode in recurrent depressive disorder is specified as : mild, moderate, severe without psychotic symptoms, severe with psychotic symptoms, or in remission.

Persistent Mood Disorder : These disorders are characterised by persistent mood symptoms which last for more than 2 years but are not severe enough to be labeled as even hypomanic or mild depressive episode. If the symptoms consist of persistent mild depression, the disorder is called as dysthymia, and if symptoms consist of persistent instability of mood between mild depression and mild elation, the disorder is called as cyclothymia.

Other Mood Disorders : This category includes the diagnosis of mixed affective episode. This is a frequently missed diagnosis. In this type, full clinical picture of depression and mania is present either at the same time intermixed, or alternates rapidly with each other (rapid cycling) without a normal intervening period of euthymia.