CATEGORIES OF MOOD DISORDERS
The primary mood disorders are major depressive disorder and
bipolar disorder (formerly called manic-depressive illness). A major depressive
episode lasts at least 2 weeks, during which the person experiences a depressed
mood or loss of pleasure in nearly all activities. In addition, four of the
following symptoms are present: changes in appetite or weight, sleep, or
psychomotor activity; decreased energy; feelings of worthlessness or guilt;
difficulty think-ing, concentrating, or making decisions; or recurrent thoughts
of death or suicidal ideation, plans, or attempts. These symptoms must be
present every day for 2 weeks and result in significant distress or impair
social, occupa-tional, or other important areas of functioning (American
Psychiatric Association [APA], 2000). Some people also have delusions and
hallucinations; the combination is referred to as psychotic depression.
Bipolar disorder is diagnosed when a person’s mood cycles between
extremes of mania and depression (as described previously). Mania is a distinct period during which
mood is abnormally and persistently elevated, expansive, or irritable.
Typically, this period lasts about 1 week (unless the person is hospitalized
and treated sooner), but it may be longer for some individuals. At least three
of the following symptoms accompany the manic episode: inflated self-esteem or
grandiosity; decreased need for sleep; pressured
speech (unrelenting, rapid, often loud talking without pauses); flight of ideas (racing, often
unconnected, thoughts); distractibility; increased involvement in goal-directed
activity or psy-chomotor agitation; and excessive involvement in
plea-sure-seeking activities with a high potential for painful consequences
(APA, 2000). Some people also exhibit delusions and hallucinations during a
manic episode.
Hypomania is a period of abnormally and
persistently elevated, expansive, or
irritable mood lasting 4 days and including three or four of the additional
symptoms described earlier. The difference is that hypomanic epi-sodes do not
impair the person’s ability to function (in fact, he or she may be quite
productive), and there are no psychotic features (delusions and
hallucinations). A mixed episode is diagnosed when the person experiences both
mania and depression nearly every day for at least 1 week. These mixed episodes
often are called rapid cycling. For the purpose of medical diagnosis, bipolar
disorders are described as follows:
·
Bipolar I disorder—one or more manic or mixed episodes usually
accompanied by major depressive episodes.
·
Bipolar II disorder—one or more major depressive episodes
accompanied by at least one hypomanic episode.
People with bipolar disorder may experience a euthy-mic or normal
mood and affect between extreme episodes, or they may have a depressed mood
swing after a manic episode before returning to a euthymic mood. For some,
euthymic periods between extremes are quite short. For others, euthymia lasts
months or even years.
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