Mood Disorders Discussion
DSM-5 notes that issues related to genetics and symptoms locate bipolar disorders as a sort of bridge between mood disorders and schizophrenia. That’s why DSM-5 separated the deeply intertwined chapters on bipolar and depressive disorders. However, to explain mood disorders as clearly and concisely as possible, I’ve reunited them.
Quick Guide to the Mood Disorders
DSM-5 uses three groups of criteria sets to diagnose mental problems related to mood:
(1) mood episodes, (2) mood disorders, and (3) specifiers describing the most recent episode and recurrent course. I’ll cover each of them in this Quick Guide. As usual, the link refers to the point where a more detailed discussion begins.
Simply expressed, a mood episode refers to any period of time when a patient feels abnormally happy or sad. Mood episodes are the building blocks from which many of the codable mood disorders are constructed. Most patients with mood disorders (though not the majority of mood disorder types) will have one or more of these three episodes: major depressive, manic, and hypomanic. Without additional information, none of these mood episodes is a codable diagnosis.
Major depressive episode . For at least 2 weeks, the patient feels depressed (or cannot enjoy life) and has problems with eating and sleeping, guilt feelings, low energy, trouble concentrating, and thoughts about death.
Manic episode . For at least 1 week, the patient feels elated (or sometimes only irritable) and may be grandiose, talkative, hyperactive, and distractible. Bad judgment leads to marked social or work impairment; often patients must be hospitalized.
Hypomanic episode . This is much like a manic episode, but it is briefer and less severe. Hospitalization is not required.
A mood disorder is a pattern of illness due to an abnormal mood. Nearly every patient who has a mood disorder experiences depression at some time, but some also have highs of mood. Many, but not all, mood disorders are diagnosed on the basis of a mood episode. Most patients with mood disorders will fit into one of the codable categories listed below.
Major depressive disorder . These patients have had no manic or hypomanic episodes, but have had one or more major depressive episodes. Major depressive disorder will be either recurrent or single episode.
Persistent depressive disorder (dysthymia) . There are no high phases, and it lasts much longer than typical major depressive disorder. This type of depression is not usually
severe enough to be called an episode of major depression (though chronic major depression is now included here).
Disruptive mood dysregulation disorder . A child’s mood is persistently negative between frequent, severe explosions of temper.
Premenstrual dysphoric disorder . A few days before her menses, a woman experiences symptoms of depression and anxiety.
Depressive disorder due to another medical condition . A variety of medical and
neurological conditions can produce depressive symptoms; these need not meet criteria for any of the conditions above.
Substance/medication-induced depressive disorder . Alcohol or other substances (intoxication or withdrawal) can cause depressive symptoms; these need not meet criteria for any of the conditions above.
Other specified, or unspecified, depressive disorder . Use one of these categories when a patient has depressive symptoms that do not meet the criteria for the depressive diagnoses above or for any other diagnosis in which depression is a feature.