Sarah Turner, Ph.D.

    Psychotherapy for Individuals, Couples, Families & Children

Mood Disorders


Everyone has moods. Moods are a normal part of everyday life. Daily life events, sleep, weather, physiological cycles, etc. can all alter one's moods. Mood disorders are distinct from normal moods in their depth and persistence, and in their interference in one's ability to function.


Adjustment Disorder with Depressed Mood

"I felt shattered when she broke up with me. I knew that things weren't going that well lately, but I felt like I was punched in the gut when she told me she had met someone else whom she was interested in. Since then I've felt really awful. I'm okay when I'm with friends, but when I'm alone, or when something reminds me of her, I feel really down. I've even thought of suicide at times. I haven't been able to concentrate well over the past while. I've been feeling quite worn out as well. Often I just can't seem to fall asleep. I just lie awake thinking about how alone I am."

One thing you can be sure of in life, is that at some point you will have an adjustment disorder with depressed mood. The symptoms may be relatively mild, and may go away simply with support from family and friends. At times the symptoms may be quite severe and professional help may be necessary. Usually the symptoms gradually get better with time. Overwhelming feelings of hopelessness and despair one week, may diminish to tolerable sadness the next week.

Dysthymic Disorder

"I've been feeling down for so long it feels like forever. I've been depressed for at least the past 3 years. It's gotten better and worse during that time. At times I feel just dreadful and hopeless. Other times I just feel low. Occasionally I feel okay. Most of the time I feel unhappy with everything in life. I'm doing okay in my courses, but I can't say I'm really enjoying them. Often I feel like I'm running on empty. I think I feel alone a lot of the time. I feel that no one really likes me. But then, I don't blame them. I wouldn't like me either."

Dysthymic disorder, or chronic depression, often starts in adolescence or young adulthood, and may continue for many years if untreated. The diagnosis is made when one has been feeling some level of depression almost continuously for at least 2 years. Common symptoms are low energy, decreased concentration or attention, loss of interest or motivation in activities, irritability, insomnia, and pronounced pessimism. Recurrent thoughts of death or suicide may occur, although people with dysthymia will usually not make serious suicide attempts. This condition is usually a result of unhappy or traumatic life events. It usually takes many years of repeated disappointments in life for one to develop dysthymia, and likewise may take several years of therapy for one to start to change the way they feel about themselves and about life. Certain people may be more prone to develop dysthymia than others under similar circumstances. This disorder usually begins early in adult life.

Treatment usually involves therapy aimed at helping the individual become more adaptive in his daily life, as well as uncovering the roots of the negative self perceptions which are often at the core of this disorder. Anti-depressant medication may provide some relief in about one third of people with dysthymia.

Major Depression

"I've been feeling so low for weeks that I just can't seem to do anything....It's hard for me to get out of bed even though I wake up early every morning...I just lie there feeling everything is pointless...I don't feel like eating... I can't concentrate on anything...I just want this to end...I don't care how."

The essential feature of this disorder is a persistent depressed mood which has been present for at least 2 weeks, with loss of interest or pleasure in almost all activities. Other symptoms include severe appetite disturbance, sleep disturbance, low energy, agitation, feelings of worthlessness or guilt, difficulty concentrating, and frequent thoughts of suicide or death. These symptoms are common in any kind of depression, and are also frequent in any kind of stressful situation. What distinguishes a Major Depression from other mood or stress related problems is the severity and the persistence of the symptoms. A person with a Major Depression will not feel much better under any circumstances, regardless of the amount of support one receives. Without proper treatment the depression may last for months or years. Some people may have only one episode of this type of depression in their lifetime. Other people may be prone to getting depressed repeatedly. It usually takes an extended evaluation for this diagnosis to be made. A person who appears extremely depressed at one point in time may seem quite different a week later or under different circumstances. An accurate diagnosis is important in order to arrive at the best treatment plan.

Manic-Depressive Disorder (Bipolar)

"Sometimes I feel like I have all the energy in the world or even the universe so I can do anything even if I never sleep 'cause I don't need to sleep when I have so much power to do whatever I want to, and no one can stop me anyway even though of course they're envious of me but who wouldn't be. I feel like I could fly sometimes and maybe I could and I felt that way last night when I went running in the middle of the night because who wants to sleep when I can do anything and its so great running at 3 A.M. even if it was minus 20 but I never feel the cold because of my special powers I can will myself to feel or do whatever I want."

Manic-Depressive Illness, known also as bipolar disorder, is the most distinct and dramatic of the affective disorders. It usually first occurs during young adulthood, and almost always appears before age 35. Nearly one in 100 people will suffer from this disorder at some time in their lives. The distinction between bipolar illness and other depressive disorders is that patients usually experience both periods of abnormally euphoric moods and severe depression. Manic-depression is not severe moodiness. People whose moods change between feeling good or somewhat euphoric to feeling down, distressed or suicidal within hours to a day or two, do not have manic-depressive illness. People with these kind of mood changes are usually individuals who are extremely sensitive to feelings of rejection or abandonment. In Manic-depressive illness the unnatural moods last days to months. Patients will often have periods of normal mood in between the manic and depressive phases. In the manic phase people will experience an excessively euphoric mood, usually will show very poor judgment about their abilities, and will often appear speedy or hyperactive. Their thoughts may be hard to follow, though often the individual themselves may interpret this as evidence of their creativity or genius. Their sleep is almost always disturbed, often with the person showing no need for sleep.

There is a strong genetic predisposition for this illness. Close relatives of people suffering from bipolar illness are 10 to 20 times more likely to develop either depression or manic- depressive illness than the general population. Many other physical and mental disorders can mimic manic-depressive illnesses. Certain drugs can induce symptoms similar to those of mania.


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