Mood swings, sadness, low mood, etc. are integral to our nature as humans. These emotions are natural responses to life’s challenges and changes. However, when these feelings become overwhelming and persistent, they may indicate a mood disorder. Despite the significant impact these conditions can have on an individual’s life, many people choose to suffer in silence, often due to societal stigma and misconceptions about mental illness.

Recently, one of my friends, a high–achieving professional who has always been the life of the party, had been experiencing prolonged periods of sadness and a lack of interest in activities she once enjoyed. She felt exhausted all the time and struggled to focus at work. She realized that something was wrong, but she was hesitant to seek help. She worried about what her colleagues and friends might think if they knew she was struggling with her mental health.

Her fears are not unfounded. Even in today’s modern world, mental illness is still surrounded by stigma. People often dismiss the symptoms of mood disorders, attributing them to personal weakness or a lack of willpower. When individuals like her try to talk about their struggles, they are frequently met with disbelief or judgment. They are told that their feelings are “all in their head” or that they should “just snap out of it.” This invalidation can be incredibly damaging, leading to feelings of shame and isolation.

For my friend, the reluctance to address her mental health issues is compounded by the fear of being perceived as ungrateful or childish. She has a supportive family, a stable job, and many friends. How can she explain to them that, despite all this, she still feels a profound sense of emptiness and despair? The societal expectation to be happy and successful at all times leaves little room for acknowledging and addressing mental health issues.

WHAT IS A MOOD DISORDER?

Mood disorders are a category of mental health disorders that primarily affect a person’s emotional state. They can cause persistent feelings of sadness periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness.

These are some common types of mood disorders:

• Major Depressive Disorder (MDD):

MDD is a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. It is characterized by persistent feelings of sadness or a lack of interest in outside stimuli, which can last for at least two weeks. This disorder can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and home.

• Key symptoms of MDD:
• A continuous feeling of sadness or emptiness that doesn’t go away.
• Losing interest in most or all regular activities, such as hobbies, sports, or social interactions, that you once enjoyed.
• Insomnia (trouble sleeping) or hypersomnia (sleeping too much).
• Feeling tired all the time, even after a full night’s sleep, or experiencing a significant decrease in energy levels.
• Significant weight loss or gain unrelated to dieting. Some people may experience a decreased appetite, while others might overeat.
• Feeling worthless, guilty, or helpless. Often, these feelings are out of proportion to the situation.
• Trouble thinking, concentrating, making decisions, or remembering things.
• Physical symptoms like restlessness or slowed speech and movements.
• Recurrent thoughts of death, suicidal thoughts, or attempts. This is one of the most serious symptoms of depression.
• Impact on Daily Life:
• The symptoms of MDD can be severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities, and relationships with others.
• People with MDD may struggle to get out of bed, go to work, or complete simple daily tasks.
• The disorder can make it challenging to maintain relationships and the feelings of sadness and worthlessness can lead to social withdrawal and isolation.
• Bipolar Disorder:

Bipolar disorder is a mental health condition that causes extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). There are two main types: Bipolar I and Bipolar II.

• Bipolar I:
  Bipolar I Disorder is marked by severe manic episodes lasting at least seven days or requiring immediate hospital care. Depressive episodes also occur, typically lasting at least two weeks.
• Manic Episodes:
  These are intense periods of high energy and activity, with symptoms such as:
• Feeling extremely happy or overly confident
• Needing less sleep
• Talking more than usual
• Having racing thoughts
• Being easily distracted
• Taking on many tasks or activities
• Engaging in risky behaviours
• Depressive Episodes:
  These involve long periods of sadness or loss of interest, with symptoms like:
• Changes in appetite or weight
• Sleeping too much or too little
• Restlessness or moving slowly
• Fatigue or low-energy
• Feelings of worthlessness or guilt
• Trouble concentrating
• Thoughts of death or suicide
• Bipolar II Disorder:
  Bipolar II Disorder involves a pattern of depressive episodes and hypomanic episodes, which are less severe than full manic episodes.
• Hypomanic Episodes:
  These are milder than manic episodes and last at least four days. Symptoms include:
• Feeling unusually cheerful or irritable
• Increased energy or activity
• Being more talkative
• Having racing thoughts
• Being easily distracted
• Increased goal-directed activities
• Risky behaviour, but not as extreme as in manic episodes
• Depressive Episodes:
  These are similar to those in Bipolar I Disorder, involving prolonged periods of sadness or loss of interest and similar symptoms.
• Key Differences:
• Bipolar I includes severe manic episodes that can significantly impair daily life or require hospitalization. Depressive episodes are also present.
• Bipolar II involves severe hypomanic episodes and depressive episodes, without the full-blown manic episodes seen in Bipolar I.

Understanding these differences helps in accurately diagnosing and treating bipolar disorder.

• Cyclothymic Disorder:
  Cyclothymic Disorder, also known as Cyclothymia, is a chronic mood disorder that causes emotional ups and downs, but they are not as extreme as those in Bipolar I or Bipolar II Disorder. People with Cyclothymic Disorder experience periods of hypomanic symptoms and periods of depressive symptoms that last for at least two years for adults or one year for children and adolescents.
• Symptoms of Cyclothymic Disorder:
  Chronic Condition: It is a long-term condition where mood swings continue for an extended period.
• Hypomanic Symptoms: These are milder versions of mania and include:
• Elevated or irritable mood
• Increased energy or activity
• Reduced need for sleep
• More talkative than usual
• Racing thoughts
• Being easily distracted
• Taking on many activities
• Engaging in risky behaviours, though not extreme
• Depressive Symptoms: These are less severe than major depression but include:
• Feeling sad or down
• Loss of interest in activities
• Changes in appetite or weight
• Trouble sleeping or sleeping too much
• Fatigue or low-energy
• Low self-esteem
• Difficulty concentrating
• Feelings of hopelessness
• Impact on Life:
  Functioning: While the symptoms of this disorder are less severe than those in Bipolar I and II, they can still significantly impact a person’s life. Individuals may find it challenging to maintain stable relationships or consistent job performance.
  Risk of Progression: Without treatment, the disorder can sometimes progress to a more severe form of Bipolar Disorder.
• Dysthymia (Persistent Depressive Disorder):

Dysthymia, also known as Persistent Depressive Disorder (PDD), is a chronic form of depression where individuals experience a generally low mood for an extended period. The symptoms are less severe than those of major depressive disorder but are longer-lasting.

• Symptoms:
• Feeling down, sad, or hopeless most of the time.
• Either poor appetite or overeating.
• Insomnia (difficulty sleeping) or hypersomnia (sleeping too much).
• Persistent tiredness and lack of energy.
• Feeling worthless or having low self-confidence.
• Difficulty focusing and making decisions.
• A pervasive sense of hopelessness about the future.
• Impact on Life:
• While the symptoms are not as disabling as those of major depression, they can still significantly impact daily life, relationships, and work.
• The chronic nature of dysthymia can lead to ongoing challenges in maintaining a positive outlook and achieving life goals.
• Seasonal Affective Disorder (SAD):

SAD is a type of depression that occurs at a specific time of year, usually in the fall and winter. It is related to changes in seasons and is sometimes referred to as “winter depression” or “seasonal depression”.

• Symptoms of SAD:
  The symptoms of SAD are similar to those of major depression but occur seasonally. They can vary from mild to severe and include:
• Feeling sad, down, or hopeless most of the day, nearly every day.
• Losing interest in activities once enjoyed, including hobbies and social interactions.
• Feeling tired and sluggish, even with adequate sleep.
• Typically oversleeping (hypersomnia) and difficulty waking up in the morning.
• Craving carbohydrates, overeating, and weight gain.
• Trouble focusing, making decisions, and remembering things.
• Feeling more irritable or anxious than usual.
• Negative thoughts about oneself, are often unwarranted.
• Causes of SAD:
  The exact cause of SAD is not fully understood, but several factors are believed to contribute:
  Reduced Sunlight: Decreased exposure to sunlight in fall and winter can disrupt the body’s internal clock (circadian rhythm), leading to feelings of depression. 
  Serotonin Levels: Reduced sunlight can cause a drop in serotonin, a brain chemical that affects mood, potentially triggering depression.
  Melatonin Levels: The change in season can affect the balance of melatonin which plays a role in sleep patterns and mood.
• Risk Factors for SAD:
• Gender: SAD is diagnosed more often in women than in men.
• Age: Younger adults have a higher risk of SAD than older adults.
• Family History: Having relatives with SAD or other forms of depression may increase risk.
• Geographical Location: Living where there is less sunlight during the winter months can increase the risk.
• Premenstrual Dysphoric Disorder (PMDD):

PMDD is a severe and chronic medical condition that is considered a more intense form of premenstrual syndrome (PMS). It involves significant mood disturbances and physical symptoms that occur in the luteal phase of the menstrual cycle, which is the period between ovulation and the start of menstruation.

• Symptoms of PMDD:
  PMDD includes a variety of emotional and physical symptoms that typically occur a week or two before menstruation:
• Sudden and severe changes in mood, such as feeling very sad or tearful.
• Increased irritability, frustration, and anger, often directed at others.
• Feelings of hopelessness, worthlessness, or severe depression.
• Heightened anxiety, nervousness, and feelings of being on edge.
• Loss of interest in daily activities, work, and social interactions.
• Problems focusing and thinking clearly.
• Extreme tiredness and lack of energy.
• Overeating or specific food cravings.
• Insomnia or sleeping too much.
• Breast tenderness, headaches, joint or muscle pain, bloating, and weight gain.
• Causes of PMDD:
  The exact cause of PMDD is unknown, but several factors may contribute:
• Fluctuations in estrogen and progesterone levels during the menstrual cycle are believed to play a key role.
• Changes in hormone levels can affect serotonin, a neurotransmitter that helps regulate mood, sleep, and appetite.
• A family history of PMS or PMDD may increase the risk.
• Women with a history of depression or anxiety are more likely to experience PMDD.
• Disruptive Mood Dysregulation Disorder (DMDD):

DMDD is a mental health condition that affects children and adolescents. It is characterized by severe temper outbursts that are disproportionate to the situation and a persistently irritable or angry mood.

• Symptoms of DMDD:
• Severe temper outbursts:
  Outbursts can be verbal, such as yelling or screaming, or physical such as hitting or kicking.
  These outbursts are extreme reactions to common stressors and are out of proportion to the situation.
• Persistent irritability:
  Children with DMDD are almost always irritable or angry.
  This mood is present most of the day, nearly every day, and is noticeable to others, such as parents, teachers, and peers.
• Causes of DMDD:
  The exact cause of DMDD is unknown, but several factors may contribute:
• A family history of mood disorders, such as depression or bipolar disorder, may increase the risk.
• Stressful life events, trauma, and family dynamics can contribute to the development of DMDD.
• Differences in brain regions that regulate emotions and behaviour may play a role.
• Impact on Life:
• Frequent temper outbursts and irritability can disrupt learning and lead to academic difficulties.
• Persistent irritability and anger can strain relationships with peers and lead to social isolation.
• The challenging behaviours associated with DMDD can create stress and tension within the family.
• Substance-Induced Mood Disorder:

It is a type of disorder characterized by significant mood disturbances, such as depression or mania, that are directly caused by the use of substances like drugs, alcohol, or medications.

• Symptoms of Substance-Induced Mood Disorder:
  The symptoms of a substance-induced mood disorder can resemble those of primary mood disorders, but they are specifically linked to substance use. The symptoms vary depending on whether the mood disturbance is depressive or manic. The symptoms of depression or mania are as mentioned before.
• Causes of Substance-Induced Mood Disorder:
  The primary cause of substance-induced mood disorder is the physiological impact of substances on the brain.
  
• Heavy drinking or withdrawal from alcohol can lead to depressive symptoms.
• Substances such as cocaine, amphetamines, and opioids can cause manic or depressive symptoms during use or withdrawal.
• Certain medications, including corticosteroids, antihypertensives, and some antibiotics, can cause mood disturbances as side effects.
• Some non-prescription drugs, such as cold medications and diet pills, can also impact mood.
• Impact on Life:
• Strained relationships with family, friends, and coworkers due to mood instability and behaviour changes.
• Difficulties maintaining job performance and attendance.
• Increased risk of physical health problems related to substance use and mood disturbances.
• Potential legal issues and financial difficulties resulting from substance use and associated behaviours.
• Mood Disorder Due to a General Medical Condition:

This mood disorder is characterized by significant mood disturbances, such as depression or mania, that are directly caused by an underlying physical health problem. This type of mood disorder arises when a medical condition affects the brain and subsequently alters mood and behaviour.

• Symptoms of a Mood Disorder due to a General Medical Condition:
  The symptoms of this mood disorder can resemble those of primary mood disorders but are specifically linked to the medical condition. Symptoms vary depending on whether the mood disturbance is depressive or manic.
• Causes of the Disorder:
  The primary cause of this type of mood disorder is the physiological impact of an underlying medical condition. Several types of medical conditions can lead to mood disturbances, including:
• Neurological conditions such as stroke, multiple sclerosis, Parkinson's disease, or traumatic brain injury (TBI) can result in mood swings, depression, or mania.
• Endocrine Disorders such as hypothyroidism and hyperthyroidism, High levels of cortisol in Cushing’s Syndrome, or poorly managed Diabetes can lead to mood disturbances.
• Chronic illnesses such as cancer and the psychological impact of its diagnosis and the physical effects of the disease and treatment, or chronic pain conditions such as fibromyalgia or chronic back pain can cause depressive symptoms.
• Infectious diseases such as HIV and Hepatitis C can cause mood changes due to the impact on the brain and the psychological stress of the illness.
• Impact on Life:
• Strained relationships with family, friends, and coworkers due to mood instability and behaviour changes.
• Difficulties maintaining job performance and attendance.
• Worsening of the underlying medical condition due to the impact of mood disturbances.
• Overall reduction in the quality of life due to the combined effects of the medical condition and mood disorder.

Awareness and understanding of mood disorders are crucial for creating a compassionate and supportive society. Making fun of or minimizing the experiences of those with these conditions only adds to their pain and reinforces harmful stereotypes. Instead, we should aim to build an environment where people feel safe seeking help and support. Educating ourselves and others about mood disorders, showing empathy and patience, avoiding hurtful language, and encouraging professional help are key steps. By promoting open conversations, supporting mental health policies, being role models of compassion, offering resources, and celebrating progress, we can break down stigma and create a community where everyone's mental well-being is valued. Together, we can make a positive difference in supporting individuals with mood disorders.

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