Mood disorders explained

Long-lasting low mood can feel like personality, and mild highs can feel like simply having a great week. Cyclothymia, for example, often goes undiagnosed.

Medical conditions such as thyroid problems can cause symptoms like depression or bipolar. A physical exam and tests help rule these out.

PMDD can cause severe depression, irritability and tension, and perinatal depression usually doesn’t get better without treatment. Both deserve care.

About 1 in 7 U.S. teens has had a mood disorder, and children with DMDD have severe, ongoing irritability that affects their lives.

SAD is a type of depression with a repeating seasonal pattern, lasting about four to five months a year. It can be treated.

Often

• Don’t stop you managing school, work or home
• Last hours or a few days
• Linked to something that happened
• Mixed with good moments

Often

• Changes sleep, energy, appetite or thinking, not just feelings
• Feels out of proportion, or comes with no clear reason
• Gets in the way of work, school, relationships or money
• Lasts for weeks or longer, most of the day, nearly every day
• Other people notice you seem “not yourself”

In this severe form, depression comes with delusions (strong false beliefs) or hallucinations (hearing or seeing things others don’t).

Major depression (also called clinical depression) causes symptoms most of the day, nearly every day, for at least two weeks. It affects how you feel, think and handle daily activities. Some people have one episode; for others it returns.

Persistent depressive disorder, once called dysthymia, means symptoms that are less severe than major depression but last much longer, usually at least two years. Because it goes on so long, people often think it’s just who they are.

Seasonal affective disorder (SAD) is a type of depression that follows a repeating seasonal pattern, most often starting in late fall or early winter and easing in spring and summer.

Bipolar I involves manic episodes that last at least seven days. Low (depressive) periods usually happen too.

Bipolar II involves a pattern of depressive episodes and hypomanic episodes. Hypomania is milder than mania, so it can be easy to miss.

Cyclothymia is a mild form of bipolar. Mood shifts between low periods and hypomanic highs that aren’t intense enough to count as full episodes. It’s often diagnosed after symptoms have lasted at least two years (one year in children and teens).

Because it’s mild, it often goes undiagnosed. People with cyclothymia are at risk of developing bipolar disorder, so it’s worth getting support early.

Perimenopausal depression is one of the hormone-linked kinds of depression NIMH describes.

Perinatal depression is a mood disorder that happens during pregnancy or after childbirth. The baby blues are mild, short-lived mood changes in the first two weeks after birth. Postpartum depression is stronger or lasts longer, and usually doesn’t get better without treatment. It can be treated.

Premenstrual dysphoric disorder (PMDD) is a more serious form of PMS. It can bring severe depression, irritability and tension in the one to two weeks before a period, easing within a few days after bleeding starts. It affects up to 5% of women of childbearing age.

All children have grumpy days and tantrums. Disruptive mood dysregulation disorder (DMDD) is a mood disorder in which children and teens have ongoing irritability and anger, with frequent, intense temper outbursts. The symptoms are severe, show up in more than one place (like home and school), and affect daily life.

DMDD was only recognised in 2013, so there is still limited research on it. Children with DMDD are more likely to have anxiety or depression later, which is one more reason early support matters. Help often includes therapy adapted for children and teaching parents ways to manage behaviour.

Brain imaging studies have found differences in emotion-related areas, such as the amygdala, in some people with mood disorders. Hormone changes and health conditions can also play a role.

A strong family history raises the risk, which suggests that genes play a part. But having a relative with a mood disorder does not mean you will have one.

Major life stress, long-term stress, trauma and childhood abuse are all linked to mood disorders. In some people, stress acts like the spark that sets off an episode.

Alcohol and drugs can trigger or worsen mood episodes, and health services advise avoiding them when living with a mood disorder.

Depression often occurs alongside long-term illnesses such as diabetes, cancer, heart disease and chronic pain, and each can make the other harder. Parkinson’s disease is also linked with depression.

The thyroid is a small gland in your neck. When it’s underactive (hypothyroidism), common symptoms include tiredness and depression. It can’t be diagnosed from symptoms alone; a blood test can help confirm it.

Light therapy means sitting in front of a very bright light box for about 30 to 45 minutes a day, usually in the morning, from fall to spring. People with certain eye conditions should check with a provider first.

There are also medical treatment options for mood disorders. These are personal decisions to make with your clinical provider, who knows your health history.

Peer support is linked with better quality of life, more engagement with services and fewer hospital stays.

The World Health Organization lists behavioural activation, cognitive behavioural therapy, interpersonal therapy and problem-solving therapy as effective psychological treatments for depression. Cleveland Clinic also lists DBT and psychodynamic therapy for mood disorders.

Avoiding alcohol, nicotine and drugs is part of NIMH’s self-care advice for depression and bipolar.

Try to keep a regular bedtime and wake-up time, eat regular meals, and structure your day with a steady routine for eating, sleeping and exercise.

Physical activity reduces symptoms of depression and anxiety. NIMH notes that just 30 minutes of walking a day can boost mood.

Keeping a mood journal or “life chart” can help you recognise mood swings and what sets them off. Over months, you may spot links with sleep, stress, seasons or your cycle.

Connect with people and tell someone you trust how you are feeling. Do what you can, as you can, and try to put off big life decisions until you feel steadier.

NIMH reminds supporters to take care of their own wellbeing too. Keep your own routines and connections, and consider a family support group or counselling for yourself.

NIMH suggests

• Help with practical needs, like rides to appointments
• Invite them for walks, outings and other activities
• Learn their triggers and watch for big mood changes
• Offer support, understanding, patience and encouragement
• Remind them that with time and treatment, things can get better

Try

• “I’ve noticed you seem different lately. How are you really doing?”
• “I’m here on the good days and the hard ones.”
• “Would it help if I came with you to an appointment?”
• “You’re not a burden. I want to help.”