Misconceptions of Mood Disorders
It is normal to feel happy one day and then sad the next, as emotions are a part of life. The ups and downs of living can simply be a response to our internal and external circumstances. However, when these mood changes start to interfere with the way we live our lives, there may be something else at play.
Mood disorders are characterized by a chronic change in mood that disrupts our day-to day functioning. They are not uncommon: it is estimated that around 20.9 million Americans have one. Females are also more likely to be diagnosed than men, possibly due to specific hormones located within the female body.
Unfortunately, mood disorders are often stigmatized in the media for the “roller coaster” of emotions that are displayed as symptoms. People with mood disorders can often be stereotyped as violent, dangerous, or unpredictable which further prevents them from asking for help.
To combat this stigma, it’s time we educate ourselves on what mood disorders are exactly. According to the DSM-V, these are the main types of mood disorders:
Major Depressive Disorder
Bipolar Disorder 1 and 2
Cyclothymic Disorder
Disruptive Mood Dysregulation Disorder
Persistent Depressive Disorder
Premenstrual Dysphoric Disorder
Seasonal Affective Disorder
There are also mood disorders related to physical health conditions like chronic pain, and substance-use related mood disorders.
Major Depressive Disorder
This is more commonly referred to as clinical depression, or major depression.
Symptoms: It is characterized by persistent, and pervasive feelings of sadness.
According to the DSM-V, these symptoms have to occur for a period of two or more weeks, there has to be an interruption in daily life, and loss of interest in activities as well.
Misconceptions/Stigma:
People are always depressed for a specific reason. False, some individuals might have family, financial, or personal reasons to be depressed. Others may have no specific reason at all to be depressed. All of these are valid.
Depression is “something in your head” or just “being lazy.” False, oftentimes it is due to a chemical imbalance that is out of your control. Sometimes, you can’t face it on your own.
You can wait a depressive period out, you don’t need to go into treatment. False, without treatment depression can sometimes last years. It is important to get the right kind of help.
Treatment:
Medication, which can include anti-depressants and anti-anxiety medication. In addition, Electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS) may be used in more severe cases. Alternative medication can include activities like acupuncture, meditation, yoga, and exercise.
Bipolar Disorders
Formerly referred to as “manic-depressive” illness or “manic depression”, bipolar disorders cause a shift in “mood, energy levels, activity levels, concentration, and ability to carry out day-to-day tasks.” Most bipolar disorders can include manic and depressive periods. Manic refers to behaviors that are categorized as extreme “ups”, like irritability or feeling energized. They are severe and can sometimes require hospitalization. Depressive includes “down”, sad, hopeless-feeling periods. Hypomanic episodes are a milder form of mania, that include those same “ups”, just not interfering with life activities like jobs and holding relationships.
Bipolar Disorder 1
Symptoms: This is defined by manic episodes that last at least a week, or so severe that they are interrupting with day to day life. These can include depressive episodes that are typically two weeks long.
Bipolar Disorder 2
Symptoms: Bipolar type two is defined by a pattern of depressive and hypomanic episodes, instead of manic episodes. Sometimes it is misdiagnosed as depression due to its milder hypomanic episodes, and these become the focus of treatment.
Cyclothymic Disorder
Symptoms: Very similar to Bipolar 1 and 2, except for the rapid cycling of moods. The lows are not low enough to be diagnosed with depression, and the highs are hypomanic. These last a few days instead of months.
Misconceptions/Stigma:
If you have days where you are happy one second, and sad the next, it must mean you have bipolar disorder. False. Mood changes in bipolar disorders, even with cyclothymic, are extreme and require multiple days of repeated behaviors in order to diagnose correctly.
Mania isn’t so bad if you feel “up” all the time. False, people experiencing mania can seem happy at first, but untreated mania can quickly spiral into dangerous situations.
People who have bipolar disorders can’t hold down jobs. False, people with bipolar disorder can have normal, fulfilling lives and that includes work as well.
People who have bipolar disorders are “crazy” and can’t control their emotions: False. There are a wide variety of reasons why someone has bipolar disorder, ranging from chemical imbalances to genetics, and being “crazy” isn’t one of them.
Treatment:
General treatment involves a three step process: treatment of the manic or depressive episode, improvement, and then maintenance. Oftentimes, a mood stabilizer will be used with psychotherapy. In addition, cannabis and caffeine have been found to possibly worsen or contribute to manic episodes in patients, so it is recommended that you stop those. Avoiding alcohol, increasing sleep hygiene, and adding a regular exercise routine also help curb symptoms.
Disruptive Mood Dysregulation Disorder
This is a fairly new disorder, appearing for the first time in the DSM-V. This disorder is characterized by extreme outbursts and irritability that goes beyond the typical “moody” child.
Symptoms: Typically appear before the age of ten, and include being angry or irritated the majority of the day. It also includes trouble functioning, or having severe outbursts. This diagnosis is not given past the age of 18. It is often misdiagnosed as ADHD.
Misconceptions/Stigma:
This is just a way of saying your kid is not disciplined, or “just being a kid.” False, this goes beyond the typical moodiness of a child. It is interfering with their growth and functioning.
DMDD is just bipolar disorder in children: False, in fact this disorder was created to distance itself from that label. These moods are persistent, not episodic.
Treatment:
Treatment includes DBT, Dialectical Behavior Therapy, that validates emotions and trains children how to react to their emotions. SSRIs are also used with psychotherapy, and antipsychotics will be prescribed if absolutely necessary as a last result.
Persistent Depressive Disorder
Also referred to as “dysthymia,” this depressive disorder has feelings that clinically last for years. It is more chronic and long-lasting than major depressive disorder, but often has milder symptoms.
Symptoms: Hopelessness, loss of interest in activities, and low self-esteem are some of the tell-tale signs of PDD. These feelings last two or more years to earn the diagnosis of PDD.
Misconceptions/Stigma:
Because it is mild, it’s nothing to worry about. False, treating symptoms regardless of their severity is important to overall well-being.
You never have a good day with PDD. False, you can still have good days with PDD, in fact it is often referred to as “high-functioning depression” for a reason.
Treatment:
Antidepressants as well as psychotherapy are typically the treatment regimens for PDD. Medication depends on severity, and adolescents specifically may be referred to psychotherapy before any medication.
Premenstrual Dysphoric Disorder
This is a condition that occurs a week or so before your menstrual cycle, but it causes much more severe symptoms than regular PMS. Due to the drop in hormones during ovulation, around 5% of women experience PMDD.
Symptoms: Extreme feelings of sadness or despair, thoughts of suicide, extreme irritability, food cravings, binge eating. You must have five or more symptoms from the DSM-V criteria to be diagnosed with PMDD.
Misconceptions/Stigma:
PMDD is just PMS. False, this disorder differs from regular symptoms because it interferes with the ability to live day-to-day life. People with PMDD can have hormone or chemical imbalances and experience these feelings chronically. In fact, it is a proven condition triggered by the steroid Allopregnanolone.
Because doctors can’t accurately diagnose it with a test, it’s not real. False, around 1 in 20 women have PMDD and it often takes multiple tests to diagnose. It doesn’t make it any less real.
It is a mental illness. False, it is actually a hormone condition but included underneath the umbrella of mood disorders due to its symptoms
Treatment:
SSRIs can be involved in the treatment of PMDD, as well as diet changes (less sugar, caffeine, and alcohol), adding exercises, and supplements like B6, Calcium, and magnesium. Birth control can alleviate some PMDD symptoms as well.
Seasonal Affective Disorder
Unfortunately, felt by those who live in northern areas (including Michigan), Seasonal Affective Disorder (SAD) is a type of depression that typically begins and ends when the seasons change. While it is not a separate disorder itself, it is important to note seeing as nearly 5% of all US adults experience SAD. In addition, around 75% of people who have the disorder are women. These episodes of depression must occur two years in a row, during specific seasons (though they don’t have to every year.)
Symptoms:
Symptoms mirroring major depression (see above)
Winter-based: oversleeping or eating (including carb cravings), withdrawal from activities (hibernation-like)
Summer-based: loss of appetite, insomnia, anxiety, behavior that can be violent
Misconceptions/Stigma:
It’s just the winter blues: False, SAD is much more than the “winter blues” and can affect those in the summer, too.
People who have SAD just have depression all the time: False, some who experience SAD only have depression during specific months, and not throughout the rest of the year.
Treatment:
Cognitive Behavioral Therapy (CBT), supplements of Vitamin D or light therapy lamps (phototherapy), and antidepressant medication can help alleviate symptoms. In addition, simply spending time outdoors in nature for sunlight exposure can do wonders.
Mood disorders can be incredibly difficult to live with, but the stigma around them can be even worse. What are some ways that we can combat this stigma, if you have a mood disorder or not?
Educate yourself
Take the knowledge you learned from this article and apply it to your life. Now you know a little more about these disorders and how they function.
Use person-first language:
People have bipolar disorder, they are not bipolar. It is important we focus on person-first language, where we emphasize the person rather than the disorder. Do not use mood disorders as an adjective. Making daily changes like that can help reduce the stigma.
Don’t be afraid to seek treatment
If you’re reading this and feel you or someone you know may fit some of this criteria, do not hesitate to seek help. Mood disorders can be difficult to deal with on your own, and with the right treatment plan you will live a happy, fulfilled life.
Emily Cervone earned her Bachelor’s Degree in Journalism and Professional Writing from Michigan State University, and is currently pursuing her Master’s in Clinical Psychology at the University of Detroit Mercy. She is passionate about all things mental health, and looks forward to conducting research and writing a book related to mental health. Emily currently works as a research assistant in public health, as a volunteer on an inpatient psychiatric unit and as a crisis text line counselor. In her off time, she is busy cooking her next Italian dish, trying a new coffee shop, spending time with family and friends, or out hiking in nature.