Mood Disorders And How They Affect Quality Of Life

Mood disorders are mental health challenges that can happen to you reading this. They can affect your emotional state and you experience distorted feelings of extreme sadness or happiness.

You can normally have mood changes from time to time depending on events and situations in your life.

But mood disorder lingers for several weeks and is a deviation from how you know yourself and becomes a concern.

Your behaviour changes and your ability to run your day-to-day routine is hampered. You pick up feelings that are either hyper or super low, and can alternate.

Depression is the commonest exhibition of mood disorder and there are many types and sub-types of it. Read on!

Depression

Depressions are common symptoms of mood disorders and can be confirmed after it has been present for many weeks.

Episodes of depression cause persistent feelings of sadness and loss of interest in activities that were otherwise pleasurable. Rips off a person’s confidence and replaces that with a feeling of worthlessness.

In its general sense, depression as a mood disorder occurs on a continuum in its progression in severity.

This means it continues to be severe and from one stage to another in the depression spectrum.

ALSO REEAD: Are Nurses Indispensable? Why do we Need them?

According to WHO depression is a worldwide common illness and affects an estimated 3.8% of the world’s population.

It also affects 5% of adults, slightly above 5% of the elderly older than 60 years. It is estimated that above 280 million people worldwide have depression in different stages and types.

In Nigeria where the most basic provision for livelihood is lacking and mental healthcare is scarce, the situation is even worse.

Mood disorders versus mood fluctuations

Mood disorders are not to be confused with the normal mood fluctuations of everyday life that are short-lived and do not come in the way of an individual’s functioning.

It can affect men and women, teenagers and children. Mental health issue in teenagers is called teenage or teen depression.

Characteristics of depression as a mood disorder

It also cannot be confused with grief which is an emotional response to the loss of a loved one or any life event that is capable of causing an unhappy feeling.

Depression always has to do with self-hate and the absence of self-esteem while such cannot be said of grief.

It also seems to be constant or come and go in close bouts which increase in intensity or gradually progresses to become a serious health situation that can interfere with work and negatively influence relationships with accompanying low emotional intelligence and can also aggravate other health conditions.

Some conditions that depression can aggravate are – arthritis, heart diseases, asthma, cancer, diabetes, etc.

It is believed that about 800,000 people die yearly as a result of depression-related situations like suicide and it is the fourth leading cause of death in adolescents and youths.

It is worth mentioning that it is part of life to feel down or upset when events trigger those feelings, but feeling down and having feelings of worthlessness regularly could be a betrayal to depression and will get worse without treatment or management.

Quick facts about depression

• It’s a common mental disorder that affects about 5% of people globally
• It affects more women than men
• It is a leading cause of worldwide disability
• It can lead to suicide
• Treatment is available for all the stages of depression

Causes of depression

Various factors can cause depression, they include the following:

Brain chemistry

Abnormalities in interaction of brain chemicals can lead to depression. Depression though, does not come simply by having too much or little of a particular brain chemical. It is more complex than that.

There are millions of interactions of brain chemicals called neurotransmitters that make up the dynamic system that conducts the mood and emotions. Any mishaps in this reaction could lead to depression.

Antidepressants help to restore the balance or correct the mishaps in the brain chemical interactions.

Genetics

Genes plays a big role in determining who has depression. If a father or mother had depression, it is likely that some of the offspring would have depression.

About 50% of depressions are genetic, and around 50% are not related to genes, either psychological or physical. However, in some cases, the tendency to experience depression is completely genetic.

Life events

As humans, we are faced sometimes with unplanned tragedies that hit us suddenly like the death of a loved one, accident, loss of job or any life event that has a huge impression on the psyche.

Such events of course cause grief which can morph into depression and cause serious disruption to the way we individual functions.

Medical conditions

Some medical conditions can have a bad impression on the psyche of the sufferer by way of stopping such person from attending to their daily activities or work.

The thought of being bedridden or incapacitated can usher in bouts of depression which if not treated or managed professionally can worsen.

Also, there are ongoing conditions that can happen together with depression. People who have diabetes, cancer or Parkinson’s disease can also have depression.

Medication

There are medications whose side effect is depression. Such depression usually goes away when the medication is discontinued. Medication usually cause depression on a long-term use.

Personality

There are people who have soft minds and are easily affected by events. Any little shift in the moods affects them negatively. This group of people are prone to having depression.

Such people also find it hard to cope with tragedies or unfavourable events. It is said that resilience is a good bulwark to depression.

Symptoms of depression

Depression symptoms vary from person to person, male to female and differ in severity, duration, and how intermittently they occur.

Before the symptoms could be certified as depression, they have to occur nearly every other day for not less than 2 weeks.

During bouts of depression, the individual has very low moods that can be described as sadness, irritability, and emptiness.

There is also a significant drop in warmth towards family, personal, social, educational, and other aspects of human functioning.

A depressive episode can be classified as mild, moderate, or severe. This is dependent on the severity of the observable symptoms and the capacity to impair human functioning.

The general symptoms of depression are as follows:

• Feeling of sadness
• Constant feeling of worthlessness laced with loss of hope
• Feeling of emptiness and nothing to live for
• Loss of interest in hobbies or favourite activities
• Lack of energy, frequent tiredness
• Irritability and short temper
• Memory loss and concentration problems
• Sleeping problems, waking in the middle of the night, and stays away
• Loss of appetite
• Unexplained headaches, aches, digestive issues
• Drift towards suicide

Types of depression

However, there are many types of depression categorized according to their severity and who they affect. Some of the types of depression are:

• Major depression
• Psychotic depression
• Bipolar disorder
• Postpartum depression
• Premenstrual Dysphoric Disorder (PMDD)
• Seasonal Affective Disorder (SAD)
• Dysthymia (Persistent Depressive Disorder)
• Situational Depression

Major depression

This is the type of depression people always refer to when they talk about depression. It is also known as unipolar depression or major depressive disorder (MDD).

It is also called clinical depression when the severity reaches the end of the depression spectrum and requires the attention of a professional.  

Major depression is different from the grief caused by the loss of a job, or the death of a loved one. It is distinguishable by a continuous feeling of sadness and disinterest in response to the outside stimuli.

In the US, 24% of women and 10% of men have depression. This is quite a good chunk of the population and its effect can have a significant disturbance on the output of the general economy.

The majority of these people do not seek treatment according to the Journal of the American Medical Association and so the condition can degenerate or worsen to serious forms that can portend danger to the individual and the people around them.

The median age for the appearance of major depression is around 31 and affects more women than men as reflected in the percentage difference above.

It is not clear why women are most affected by this type of depression but could be from the major depression’s tendency to co-affect an individual with other illnesses and mental conditions.

It can occur together with pregnancy, cancer, HIV, and heart diseases. But the most significant reason it occurs more in women is as a result of fluctuations in hormones, particularly at the times of puberty when major feminine hormones are hyperactive, pregnancy and menopause.

If untreated, major depression could pose danger for both genders. However, it is noted that about 81% of patients who accept treatment improve within a few weeks of medication and psychotherapy.

Symptoms of major depression

Below are some of the symptoms of major depression and they have to be present for at least 2 weeks for the diagnosis to be accurate.

• Disinterest in activities
• Worthlessness feelings
• Clouded and negative thoughts
• Restlessness and fidgety
• Lack of concentration
• Anger issues that were not previously known
• Withdrawal from close friends and family
• Changes in sleeping pattern
• Irritability
• Low energy
• Thoughts of suicide and self-harm

Diagnosis of major depression

To diagnose major depression, many doctors use the symptom criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association.

The patient has to be experiencing about five of the above symptoms including depressed mood or loss of disinterest in activities for a straight two-week period.

Treatment for major depression

Major depression can be ameliorated with a number of treatment options including anti-depressant drugs, psychotherapy, behavioural therapy, electroconvulsive therapy, etc.

Each person’s case peculiarity will determine the type of treatment that would be appropriate and could also be a combination of some of the treatment options above.

Psychotic depression

Psychotic depression is an offshoot of major depression but in its most severe form. It is major depression in the presence of psychosis.

Psychotic depression or depressive psychosis is when psychosis occurs in the presence of major depression.

It is estimated that nearly 45% of people who are confirmed to have depression also have psychotic depression.

Psychosis is a major mental situation that manifests with symptoms such as hallucinations – seeing things that are not there or hearing voices that are not real and delusions – feeling of unrealistic impressions eg. the feeling of being watched or followed which cannot be corroborated with reality.

There is a disruption in the process of thought and judgment which projects the individual as unhinged or weird to the normal person.

The victim is usually unable to agree or realize their perception is not agreeable with reality. They also do not know or believe they have an illness and think their distress and inability to distinguish their thought and feeling from the reality of the outside world is normal.

People who suffer from psychotic depression might believe that they are the culprit of a crime and that people are after them. Such people might also neglect their personal life entirely by not bathing or putting on neat clothes.

They also seem to be fidgety (psychomotor agitation) – not being able to be calm and relax for a moment. Or the opposite of that – moody and slow physical movements and thoughts. There is a high risk of suicide in this group.

Diagnosis of psychotic depression

Psychotic depression is not that easy to diagnose because it is somehow hidden in the other kind of depression.

And another reason is that some people with the illness seem to know that their thoughts may be embarrassing as they might not follow reality and so they prefer to keep it to themselves.

Symptoms of psychotic depression

To be sure one has psychotic depression, there should be some of the general depression symptoms above and the following symptoms below:

• delusion
• hallucination,
• unrealistic guilt
• Feeling of personal inadequacy

It is however important to note that hallucinations are less common than delusions in psychotic depression patients.

Difference between psychotic depression and schizophrenia

Psychotic depression and schizophrenia can be mistaken for each other as they present almost the same symptoms. But there are sharp differences.

Psychotic depression can surface at any age while schizophrenia almost always surfaces at the teenage years.

If someone has pure psychosis and without depression or little depression, it could be schizophrenia.

Schizophrenia has little to do with depression but a lot to do with delusion and hallucinations that tend to persist with little or no thought and motivation. It is also more long-lasting and doesn’t come in bouts.

Also, the delusion in schizophrenia is more bizarre and is usually a spectacle to the normal person who observes.

Treatment for psychotic depression

There are two available procedures for treating psychotic depression. The use of antidepressants with an antipsychotic and the use of electroconvulsive therapy (ECT). However, it depends on the situation and the choice of the family.

ECT may be used in older patients to avoid the unpleasant side effects of medication. In some cases, ECT is prescribed concomitantly with antidepressants or antipsychotics.

Generally, a person who receives the right treatment for psychotic depression can get back to normal in a couple of months.

Bipolar mood disorder

Bipolar mood disorder was formerly known as manic depression. It is identified by extreme mood changes of high emotions and depressive lows. It makes the victim unstable and unpredictable with fluctuating moods.

Bipolar episodes are characterized by lows and are accompanied by sadness and feeling of hopelessness and loss of interest in activities. At the other end of the mood are euphoria and heightened energy.

These shifts have effects on sleep, judgment, behavior, and the overall personality of the victim.

ALSO READ: How to become a healthier woman in Nigeria

The Bipolar mood disorder could be a lifelong condition, but a victim can manage the mood shifts and other symptoms by having a treatment routine. In some cases, it is treated with medication and psychotherapy (counseling).

With bipolar mood depression, the low feeling can lead to suicidal thoughts that override the feeling of euphoria and heightened energy.

The conflicting extreme moods can swing more frequently and can show up in weeks or months.

There are two types of bipolar disorder – bipolar 1 and bipolar 2. However, the difference between the two is that in bipolar1, the elevated feeling called mania is severe while it is lower in bipolar 2. A feeling which appears weird to normal observers.

The symptoms of bipolar depression are bipolar mood swing episodes and the other general symptoms of depression described above.

Treatment of bipolar mood disorder

Bipolar mood disorder can be relieved by mood stabilizers, such as lithium. It can be used to control mood fluctuations. Also, antidepressants and antipsychotics are effective medications.

In the meantime, there is no permanent cure for bipolar disorder but can be controlled with the treatment above.

Postpartum depression

Postpartum depression accompanies childbirth and is slightly different from the ‘baby blues’ which is a common mood change that gives way within two weeks.

However postpartum depression is attributed to the hormonal changes before and after childbirth and tends to last longer.

About one in seven women will be a victim of postpartum depression which can persist through the year. It is a common depression and treatable but requires prompt attention.

Surprisingly, men are also victims of postpartum depression. Men’s testosterone level drops when they spend too much time with their baby which can alter the brain chemistry, reducing serotonin levels and so increasing the risk of depression.

More empathetic men are at greater risk of being depressed when the expected attachment with their baby is not strong enough to build a good bond.

Postpartum depression might not set off immediately after childbirth. However, symptoms always surface in the first two weeks following childbirth.

It sometimes it does not begin until months after birth and can emerge at any time during the baby’s first year.

It is not clear why postpartum depression occurs, but it is thought to be a result of a variety of factors including the physical changes accompanying pregnancy and childbirth, anxiety about becoming a parent, hormonal changes, mental health issues, difficult delivery, etc.

The symptoms of postpartum depression are the same with the general symptoms of depression.

Treatment for postpartum depression

Postpartum depression is treated with psychotherapy which involves talk sessions. Mental health counseling and medication can also help to alleviate symptoms.

Psychotherapy may help by talking through the problem with a professional psychiatrist. Sometimes a change of thoughts and behaviour would be the only therapy needed to feel better.

On the other hand, care should be taken to give a breastfeeding patient medication as the child would get a dangerous dose of the medication from the breast milk.

The doctor should be able to know what will be best after weighing the options. However, it is important to continue with medication when there is an improvement. A relapse may occur if the medication is stopped too early.

Premenstrual dysphoric disorder (PMDD)

As the name goes, some women have this kind of depression prior to seeing their monthly period. However, PMDD is different from the normal mild menstrual symptoms. PMDD is more intense and usually requires treatment.

It is true that 82% of women experience mild premenstrual syndrome (PMS), and only about 8% of women are diagnosed with the premenstrual dysphoric disorder.

PMDD is a more debilitating condition than PMS which does not interfere with everyday function. PMDD comes along with severe depressive moods that can bring about thoughts of suicide.

The symptoms of dysphoric disorder

The symptoms of PMDD are similar to other depressions but present a week of two before the onset of the menses and go away in a few days. The following symptoms are present in PMDD:

• Irritability and quick anger
• Anxiety
• Panic attacks
• Suicidal thoughts
• Difficulty in concentrating
• Fatigue
• Binge eating
• Migraine
• Lack of proper sleep
• Mood swings

Diagnosis of the premenstrual dysphoric disorder

A woman must have experienced the above symptoms during most of her previous menstrual cycles and must have had a debilitating effect on her functioning.

The doctor has to take a medical inventory to evaluate the symptoms to find five or more PMDD symptoms including depression and mood-related to rule out other conditions that share similar symptoms.

Treatment of the premenstrual dysphoric disorder

To relieve mood and anxiety-related symptoms, antidepressants called selective serotonin reuptake inhibitors (SSRIs) can be taken to control the brain’s serotonin levels.

Dietary changes are also advised as reducing salt, fat, and sugar intake can be of help. Pain medications can also be prescribed to ease the cramps, headaches, and other pains. Regular exercise also improves mood and diminishes some symptoms of depression.

Seasonal affective disorder (SAD)/winter depression

Seasonal affective disorder (SAD) or winter depression is a depression that has to do with the change of seasons, especially at the onset of winter. The symptoms of SAD appear at the onset or tail-end around the same time each year.

SAD can also start in the fall and through the winter months, slowing energy and causing moodiness. The symptoms resolve during spring and summer. SAD sparingly causes depression during the spring or summer.

There are always symptoms like hopelessness, tiredness, disinterest in activities, and irritability, and these symptoms progress and become severe as the weeks come by.

This type of depression is prevalent in Europe and the Americas especially during winter when there is not sufficient sunlight. The lack of sunlight has been linked to low moods as a result of vitamin D deficiency.

Another factor is the lack of socialization during this period and people tend to spend more time at home because of the cold weather and shorter days.

Symptoms of seasonal affective disorder

Apart from the named symptoms above, these symptoms need to be looked out for in seasonal affective disorder:

• Weighty arms and legs
• Oversleeping
• Overeating and cravings for carbohydrates
• Irritability and relationship issues

Treatment of the seasonal affective disorder

Just like other depressions, treatment plans for the seasonal affective disorder (SAD) include medications, psychotherapy, light therapy, or a combination of these options to manage the depression symptoms.

Also, talk therapy can be very helpful. A psychotherapist can help discover patterns in negative thoughts which result in behaviours that aid depression.

Dysthymia (persistent depressive disorder)

Having bouts of depression that stretches into two years or more could spell dysthymia also known as persistent depressive disorder. People suffering from dysthymia find it difficult to be happy.

What makes it dangerous is the long-term duration as it can last for years while disrupting the functioning of an individual. They could appear irritable, gloomy, and always appear frowning.

They find fault with everything and complain all the way. The symptoms can come and go with varying intensity but the symptoms don’t go away for more than three months before they are back.

For the diagnosis of dysthymia to be accurate and separate it from another similar condition like major depression, the symptoms have to be present for two years.

Though not as intense as that of major depression, dysthymia can also have a negative effect on the victims while they appear fine to those around them.

A dysthymic person can also have major depression in what is regarded as double depression.

Over time more than 50% of people with dysthymia can have worsening experiences of symptoms that can lead to full-blown major depression.

The symptoms of dysthymia are the same as the general symptoms of depression.

Situational depression (reactive depression)/ adjustment disorder

According to Healthline situational depression is a short-term type of depression related to stress and can develop after a traumatic experience or a series of changes in everyday life is called situational or reactive depression.

It is also called adjustment disorder. Examples of situational depression triggers are changing a city, marital issues, loss of loved one, heartbreak, etc. It surfaces when a person tries to adjust or come to terms with a new situation.

Most people who are afflicted with this depression begin to see symptoms around three months after the event triggering the depression.

The symptoms of situational depression are similar to those of other depressions discussed above.

The key difference is a short-term response to an event in someone’s life and will resolve when the stress goes away or when the person comes to terms with the new situation.

Diagnosis of situational depression

To diagnose situational depression, the victim must be having psychological with behavioural signs around three months of observable stress which is beyond what can pass as an ordinary response; and which can also disappear with five months of adapting or removal of the stressor.

Situational depression always gets better or disappears with improved changes in a person’s situation and doesn’t usually require medication.