Probably everyone has heard about mood disorders - after all, one of the problems among them is depression. However, affective diseases may be associated not only with sadness and depressed mood, but also with the opposite situation, i.e. states of excessive euphoria and exceptionally elevated mood. The problem of mood disorders is important because, although they affect more and more patients, still too often they are not recognized at all. What ailments in ourselves or in our loved ones should arouse anxiety and when should we seek help?

No person's mood is constant all the time. It is subject to fluctuations depending on the experienced events or appearing, quite naturally, reflections about the world and one's own life. Feeling sad or extremely strong joy is therefore completely normal - the problem arises only when the state of low or elevated mood persists for a long time (the exact time criteria differ depending on the type of a given disease) and then we can talk about the existence of a patient mood disorders . Affective disorders are common in people of all ages: they can occur in a working 30-year-old, as well as in a middle school student or pensioner.

Mood assessment is one of the foundations of any mental he alth test. A mood is defined as a long-lasting emotional state related to perceiving the world and analyzing it. There are basically three types of mood:

  • aligned (euthymic),
  • lowered,
  • increased.

A term narrower than mood is affect, that is, an emotional state experienced by the patient at a specific moment. Affect can be adapted or maladjusted, but also weakened, labile or rigid.

Causes of mood disorders

Although mood disorders are a common problem (according to the assumptions of the World He alth Organization, depression may become the second most common cause of death in the world in 2022), it is still not possible to clearly establish their pathogenesis.

Nowadays, as factors involved in the development of affective disorders, aspects related toneurotransmitters ,burdensfamily problemsandpsychological problems .

Neurotransmitters are molecules thanks to which the transmission of information between cells of the nervous system takes place. Examples of such substances include serotonin, dopamine and noradrenaline. Conditions in which neurotransmitter levels are disturbed in the nervous system can lead to mood disorders. Generally speaking, an excess of neurotransmitters is associated with the presence of elevated mood, while their deficiency may result in episodes of depressed mood.

There is a noticeable relationship between the occurrence of affective disorders and family burdens. It turns out that in people whose close relatives suffered from depression or bipolar disorder, the risk of developing the disease is higher than in the general population. Therefore, inherited genes are suspected to play a role in the development of mood disorders. This hypothesis can be confirmed by the observations on monozygotic (monozygotic) twins, in which it is noticed that when one of them suffers from bipolar disorder, the risk of developing this condition in the other is up to 80%.

The occurrence of affective disorders is also preceded by various events that are a source of strong stress. Examples include the death of a loved one, loss of job or change of residence, but also breaking up with a spouse or becoming a victim of an assault.

Patients suffering from somatic chronic diseases (e.g. diabetes, heart failure or rheumatoid arthritis) are in the group of increased risk of affective disorders.

Mood disorders are a consequence of medication use (this is the case with glucocorticoid treatment, which can induce both a depression and an elevated mood).

Hormonal disturbances can sometimes be the cause of mood problems - for example, low mood may be the result of an underactive thyroid gland.

An increased frequency of mood disorders is also observed in the group of people using psychoactive substances.

A contributing factor to any of the above-mentioned problems can be excessive consumption of alcohol, drugs or drug use, as well as sudden discontinuation of the above-mentioned substances.

Mood (affective) disorders: depressed mood

In the course of affective disorders, it is precisely the depressed mood that is encountered most often. According to statistics, the risk of developing depression in life is up to 25% for women and up to 12% for men. The most common conditionincluded in this group are depressive disorders. There are different types of "pure" depression, such as a single depressive episode or a recurrent depressive disorder.

The classification of states associated with depressed mood, however, is much more extensive and also stands out in it:

  • atypical depression,
  • postpartum depression,
  • old age depression,
  • depression of children and adolescents,
  • psychotic depression,
  • masked depression,
  • seasonal depression,
  • dysthymia.

Symptoms related to the individual, above-mentioned units slightly differ from each other. In general, however, the following are observed during depressive disorders:

  • significantly depressed mood,
  • sleep disorders (which may take the form of insomnia and increase the amount of sleep),
  • appetite disorders (its increase, but also decrease),
  • anhedonia (loss of happiness),
  • the patient has a feeling that the world and life do not make sense,
  • the patient's conviction that it has no value,
  • suicidal thoughts (their presence may be connected with both acts of self-harm and suicide attempts).

Important!Symptoms must last 2 weeks to be able to diagnose a depressive episode.

Check the symptoms of masked depression

Mood (affective) disorders: elevated mood

The group of mood disorders also includes those states in which the mood is elevated. In this situation, patients can:

  • have a reduced need for sleep,
  • be significantly more active,
  • engage in risky behavior (e.g. have intercourse with complete strangers or gamble),
  • feel a rush of thoughts and an increased need to speak,
  • be characterized by size figures (e.g. a belief in your extraordinary role in the world).

These symptoms may appear in the course of hypomania and mania. These disorders are distinguished by the intensity of the symptoms presented by the patient (they are much less pronounced in hypomania). An additional differentiating factor is the duration of symptoms: hypomania can be diagnosed when symptoms persist for more than four days, and mania only after one week of its symptoms.

Mood (affective) disorders: mood swings

The last group of mood disorders is associated with the presence of both depressive and manic states in the patient. In this casethere is a diagnosis of bipolar disorder, which is divided into two types:

  • type I with depressive and manic episodes,
  • type II, associated with the emergence of depressive states and hypomania.

A mood disorder somewhat similar to bipolar disorder, but associated with a lower intensity of the ailments experienced, is cyclothymia.

Worth knowing

Treatment of mood disorders: drug therapy

Treatment of mood disorders is mainly based on pharmacotherapy. The choice of drugs depends both on the general he alth of the patient and the type of affective disease present. In the case of depressive disorders, various types of antidepressants are used, examples include serotonin reuptake inhibitors (so-called SSRIs, one of the most popular antidepressants today) or tricyclic antidepressants. Their use is aimed at increasing the amount of neurotransmitters within the structures of the central nervous system.

A different therapeutic approach applies to patients with mood disorders in the form of increased mood. In bipolar disorder, mood-stabilizing preparations (mood stabilizers), such as lithium s alts, carbamazepine or valproic acid, are primarily used. In patients with this disease, atypical antipsychotics (second generation neuroleptics) are also used.

Treatment of mood disorders: electroconvulsive therapy

Therapy of affective disorders is based not only on pharmacotherapy - psychotherapy can also help patients. There are many different techniques for its management, the selection of a specific one depends both on the type of disease present in the patient and his personal preferences. In special cases of mood disorders, electroconvulsive therapy is also used.

In depression, electroconvulsive therapy is sometimes recommended, for example, when, due to the patient's general he alth condition, it is not possible to use antidepressants. Other situations in which electroconvulsive shock may be useful are depressive stupor associated with food refusal or persistent, recurrent depressive states that cannot be reduced with pharmacological treatment.

Electroconvulsive therapy may evoke unpleasant associations, but it is worth emphasizing that it is sometimes used even in pregnant women. It turns out that some of the antidepressants can be exertedadverse effects on the fetus, while electroshock therapy does not have such negative effects, they are safe for the developing baby.

Mood disorders are treated both in outpatient and inpatient settings. Regular visits to a psychiatric clinic may be recommended to those patients whose condition is at least fairly stable, while hospitalization is used in patients with more severe course of the described disorders. Sometimes there may be a need for compulsory treatment in a psychiatric hospital, the reason for using therapy in such conditions may be a significantly increased risk of a patient committing suicide or an exceptionally expressed manic episode during which the patient threatens his or her own life or that of other people.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Psychiatry