Mood disorders are a group of mental health issues that affect your emotional state. After anxiety, they are among the most common forms of mental health disorders in the United States. The most common mood disorder is major depressive disorder, which affects more than 16 million people each year. Mood disorders often occur alongside substance use disorders. When the two are mixed, it could lead to serious consequences that affect your health, relationships, and other aspects of your life. Below, we’ll cover mood disorders and how they can be treated alongside substance use disorders.
What Is a Mood Disorder?
A mood disorder is a mental health condition that involves a distorted emotional state that doesn’t seem to match your current circumstances and interferes with functioning in your daily life. In most cases, this involves a depressed mood, which is when you have a very low mood, whether your circumstances are negative, neutral, or even positive. However, mood disorders can also involve an abnormally high mood, which is called mania. Mania can involve excessive happiness, energy levels, and hypervigilance.
Several types of mood disorders can have overlapping symptoms. Mood disorders can make daily life challenging. A very low mood can sap you of emotional and even physical energy. Challenges in your daily life will seem more overwhelming, and your motivation to meet them will plummet. Mania sounds like a positive, but it can lead to unrealistic expectations of yourself, hasty decision-making, and embarrassing mistakes.
People with mood disorders often see the consequences in their career, relationships, school, and health. If you have a mood disorder, you may feel more isolated as symptoms get in the way of occupational and social functioning. Mood disorders can also affect your physical health. Stress can impact sleep, affect weight, and lead to the development of chronic diseases.
Mood disorders are frequently comorbid with other mental and behavioral health issues, including anxiety disorders and substance use disorders (SUDs). Although depression and mania can come with chronic mood disorders, they can be treated effectively. Treatment can alleviate and help you better manage symptoms, leading to higher occupational and social functioning and improved quality of life.
What Is Thought Disorder?
Thought disorder is a phenomenon commonly associated with various kinds of mental health problems and neurodevelopmental disorders. When it comes to mental health, thought disorders are usually associated with schizophrenia and other disorders that cause delusional thinking. In some cases, the thought disorder can occur with mood problems, especially bipolar disorder.
There are several types of thought disorders, including:
- Alogia. This is also called poverty of content. This involves speech that conveys very little information. For instance, a person may give one- or two-word answers that don’t adequately answer the questions that someone is asking them.
- Thought blocking. This involves a person losing their train of thought, causing frequent interruptions in their speech.
- Loosening of association. This is when a person’s thoughts seem disconnected. It is evidenced by speech that involves many disconnected ideas in close succession.
- Tangentiality. Tangentiality is similar to loose association. It may involve deviating from your initial point and never returning to your first thought.
- Clanging. This is speech that involves diversions linked by rhyming or phonetics.
- Word salad. Word salad is when clear words are spoken in no logical order.
- Perseveration. This is repeating words or ideas that may no longer have relevance to the current conversation.
Thought disorders can be associated with mood disorders, especially bipolar disorder. Bipolar disorder can cause several symptoms similar to schizophrenia and other psychotic disorders. Bipolar disorder can cause delusional thinking during extreme moods, particularly during manic episodes. Mania can come with disorganized thinking, which can present itself through different thought disorders. Mania tends to cause rapid thoughts and the inability to focus on one thing at a time. This could cause tangential thoughts or even clanging.
How Do Mood Disorders Affect Substance Use Problems?
Mental health and addiction often occur at the same time. According to the National Institute on Drug Abuse (NIDA), around half of people that have mental health disorders also have substance use disorders and vice versa. There are several reasons why substance use problems and mental disorders might happen around the same time. One potential cause is that the two problems have some of the same risk factors.
Mental health problems like depression and addiction share many of the same common causes, including genetics. Plus, environmental factors can have a significant impact on your risk of depression and addiction. Stress and trauma can lead to either one or both of these different disorders.
Self-medication is a direct link between mental health problems and addiction. Someone who’s struggling with depressive symptoms may use drugs or alcohol to mask the way they feel. Self-medication may start as social or recreational substance use, but it could grow into drug abuse when you start using it to mask symptoms or cope with stressors. Using addictive substances like this increases your risk of developing a substance use disorder.
In some cases, substance use can worsen or trigger mood disorders. Someone predisposed to depression may begin to experience mood problems when they develop alcoholism, which is a central nervous system depressant. However, substance use problems can also add stressors to your life that worsen your mental health.
What Are the Different Kinds of Mood Disorders?
Several kinds of mood disorders are distinguished by symptoms, the severity of those symptoms, how long the symptoms last, and the circumstances that trigger the symptoms. While many of these disorders are treated with similar medications and therapies, the best treatment will come with the most accurate diagnosis.
Here are some of the different types of mood disorders and how they differ:
Major Depressive Disorder
Major depression is among the most common types of mood disorders. It involves a major depressive episode, which is a period of low mood that lasts for at least two weeks. The most common symptoms are low mood — which involves feelings of sadness, emptiness, and worthlessness — and loss of interest in most activities. Major depressive disorder will recurring periods of major depressive episodes, followed by a return to a normal mood. In some cases, major depressive symptoms can be severe, leading to thoughts of suicide or suicidal actions.
Bipolar disorder was once called manic depressive disorder or bipolar affective disorder. It involves alternating periods of high, low, and normal moods. It’s a common misconception that people with bipolar disorder can have sudden extreme mood shifts. Instead, high and low moods can last for a week or two before returning to normal or shifting to the other extreme. Low moods involve major depressive episodes. High moods involve manic episodes, which are characterized by extreme happiness, excitement, self-worth, energy levels, and confidence. In some cases, mania can cause hasty investments, risk-taking, or overspending, which can lead to financial or relationship problems.
There are two major types of bipolar disorder. Bipolar I involves at least one manic episode, regardless of whether a major depressive episode has also occurred. Bipolar II involves a major depressive episode and a hypomanic episode, which involves a high mood that has fewer or less intense symptoms than it would take to be considered a manic episode.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder (SAD) is a mood disorder involving depressive symptoms that center around certain times of the year. It’s mostly associated with winter periods when daylight hours are shorter, and people in calendar climates spend more time indoors. SAD symptoms occur for at least two years in a row around the same time each year. SAD is thought to have to do with melatonin and changes in your circadian rhythm that seasonal changes cause. Symptoms usually go away during the spring and return in the fall or early winter.
Persistent Depressive Disorder (PDD)
Persistent depressive disorder (PDD) is also called dysthymia. It involves depressive symptoms that last for years at a time. In most cases, depressive symptoms are milder than the ones you might experience with major depressive disorder, but periods of low mood last much longer. To be diagnosed with persistent depressive disorder, you will need to have experienced low mood symptoms for at least two years.
Cyclothymic disorder, or cyclothymia, is similar to bipolar disorder and involves shifts between high, low, and normal moods. However, moods are typically less extreme than they would be with bipolar disorder. You may experience depression that doesn’t meet the qualifications of a major depressive episode, and you may also experience hypomanic episodes.
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder involves mood changes associated with the premenstrual phase of a woman’s menstrual cycle. Symptoms usually go away when menses begins. Premenstrual dysphoric disorder involves more severe symptoms than routine mood changes before or during menstruation. It may involve irritability, hopelessness, fatigue, anxiety, aggression, and other symptoms of severely low mood.
Peripartum depression involves low mood during pregnancy or in the four weeks after birth. Peripartum depression includes postpartum depression, a term more commonly associated with birth-related depression. This mood disorder is thought to be caused by hormone and body changes during and after pregnancy. This mood disorder is distinct from what is commonly referred to as “baby blues,” which affects many women after pregnancy. Baby blues usually don’t significantly hinder function or require medical attention, but peripartum depression causes clinically significant depressive symptoms.
Disruptive Mood Dysregulation Disorder
This mood disorder is specifically seen in some children. It involves severe irritability that could include frequent tantrums that may be inconsistent with the child’s level of development. The symptoms are persistent and go beyond a bad mood.
Depression Related to Medical Illness
This is a consistently depressed mood that comes with a negative diagnosis or the symptoms of physical disease. It often follows the loss of physical function, chronic pain issues, or the diagnosis of a serious illness. Symptoms may include low mood, loss of interest in most activities, and other major depressive symptoms. The symptoms go beyond a natural reaction to bad news and may involve symptoms that hinder your quality of life or functioning.
Medications or illicit substances can sometimes affect your mood and lead to depressive symptoms. Drugs, like stimulants, can also cause severe depression during the withdrawal phase. The symptoms can be consistent with major depressive disorder and usually get better after the drug is discontinued or the withdrawal phase ends.
Is Anxiety a Mood Disorder?
Anxiety is often associated with depression, and there are many mood disorders that may lead to anxiety symptoms. However, anxiety is technically a separate category of mental health problems that covers a range of anxiety disorders like generalized anxiety disorder (GAD), panic disorder, and obsessive-compulsive disorder (OCD). In many cases, anxiety and depression go together. For instance, panic disorders often cause depressive symptoms, especially when the disorder causes people to isolate themselves from people and places that may cause a panic attack.
Bipolar disorder can also involve anxiety symptoms, especially with elevated mood and manic episodes. Mania usually involves positive moods, happiness, and elation. However, very high moods can also cause hypervigilance, anxiety, and paranoia.
Signs and Symptoms of Mood Disorders
Since there are many different kinds of mood disorders, there are different sets of symptoms you might experience depending on the mood disorder you have. However, there are some common overlapping symptoms to look out for. Knowing the symptoms of a major depressive episode can help identify a mood problem. Not every mood disorder will involve episodes that meet the criteria of major depression, but you may experience a few of the same symptoms as major depression.
There are nine major symptoms of major depressive disorder, but the first two are the most common. In fact, you need to experience at least one of them to be diagnosed with a major depressive episode. These symptoms are a depressed mood and a loss of interest in most activities.
Depressed mood can include sadness, a sense of worthlessness, and hopelessness. Children tend to exhibit a depressed mood through irritability. Loss of interest in activities refers to a general lack of motivation to engage in obligations and leisure activities that are a part of your life. Doing them may feel forced and like you are going through the motions.
The other seven symptoms include the following:
- Significant weight change. Unintentional weight loss or gain of more than 5% of your body weight is considered significant, and it could point to a mood disorder.
- Sleep disturbances. Mood disorders can disturb your sleep cycle and cause hypersomnia or insomnia. Hypersomnia is sleeping for long hours, while insomnia involves being unable to sleep enough.
- Psychomotor changes. This refers to jerky movements or slowed movements. Depression can make these movement changes severe enough that your friends and family members notice them.
- Fatigue. Fatigue and low energy are two physical symptoms of depression. You may feel like you don’t have the energy to get through your day or even to get out of bed.
- Worthlessness. A sense of worthlessness is common in depression. You may feel you are worthless, or you may have delusional guilt, which is guilt that is inappropriate for your situation.
- Impaired cognition. You may find it difficult to think, concentrate, or make decisions.
- Thoughts of death. You may think about death repeatedly, have suicidal ideations, or suicidal actions.
Different mood disorders may have different levels of severity. Major depressive disorder involves five or more of these symptoms. But other depressive disorders, including persistent depressive disorder or cyclothymia, may involve fewer symptoms.
Bipolar disorder and cyclothymia will also involve manic symptoms. Manic episodes will involve elevated mood symptoms and may even feel good while they are happening. However, many people feel shame, guilt, or embarrassment for actions or behaviors during the episode.
Manic episode symptoms include:
- Inflated self-importance
- A decreased need for sleep
- Pressure to keep talking
- Racing thoughts and ideas
- Increased distractibility
- Goal-oriented activity or psychomotor agitation
- Involvement in high-risk activities
To qualify as a manic episode, you will need to experience three or more of these activities for a week or more. However, if you have bipolar II or cyclothymia, you may experience manic symptoms that don’t meet those criteria.
How Are Mood Disorders Diagnosed?
If you suspect that you have a mood disorder, it’s important to seek help as soon as possible. An accurate diagnosis is the first step in getting effective treatment. But how can you get diagnosed with a mood disorder?
The first step is to speak to your doctor. Even though no medical test can definitively diagnose a mood disorder, it’s important to go through a physical exam and blood tests to check for other biomedical causes of your symptoms. In some cases, brain injuries, vitamin deficiency, and other medical issues can cause mental health-related symptoms.
In addition to medical exams, your doctor will give you a psychological evaluation. Your doctor is likely to use the Diagnostic and Statistical Manual of Mental Disorders (DSM), a major resource for identifying and diagnosing mental health disorders. The fifth edition (DSM-5) is the most recent and is more likely to be used by your doctor. The DSM-5 outlines the symptoms and criteria to help you and your doctor determine the best diagnosis for you.
In addition to many of the symptoms of major depression and mania listed above, the DSM will have other stipulations for specific mood disorders. For instance, major depressive disorder requires five symptoms for at least two weeks, persistent depressive disorder requires at least two years of depressive symptoms, and bipolar I requires at least one manic episode that lasts for a week or more.
Getting an accurate diagnosis is the first step in finding effective treatment options.
How Are Mood Disorders Treated?
Mood disorders are chronic mental health problems, but they can be treated effectively. Treatment for mood disorders can involve medication and psychotherapy. In many cases, the most effective treatment is a combination of the two. If you also have a substance use disorder, you will need to address both problems. Addressing one while ignoring the other can lead to limited treatment outcomes.
The first step in treatment is to speak to your doctor and talk about your options. If you have a severe mental health disorder or substance use disorder, you may need to go through an inpatient or outpatient treatment program.
Several medications can help treat a mood disorder. However, you will need to work with your doctor to find one that is effective for your needs and appropriate for your symptoms. Some options include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin–noradrenaline reuptake inhibitors (SNRIs)
- Anxiolytics (anti-anxiety)
SSRIs are first-line medications for depression, and there are several to choose from. If you have bipolar disorder with some psychotic features, you may need antipsychotic medication to address delusional thinking. If your depression comes with insomnia or anxiety and isn’t responding to antidepressant medications, anxiolytics may be used to calm anxiety or help you sleep.
Mood disorders can also be treated with psychotherapies, including cognitive-behavioral therapy (CBT). Behavioral therapies can help examine your thoughts and coping responses to stress and triggers. CBT involves learning better coping responses and increasing your self-efficacy.