MOOD DISORDERS

Mood disorders (also called as Affective disorders) are a set of psychiatric diseases, also
called affective disorders. The main types of affective disorders are depression, bipolar
disorder, and anxiety disorder. Symptoms vary by individual, but they typically affect mood.
They can range from mild to severe.
Individuals with mood disorders suffer significant distress or impairment in social,
occupational, educational or other important areas of functioning.
Neurobiological Theory

Psychoanalytical Theory

Cognitive-Behavioral
Theory
With high familial and genetic Disturbance in interpersonal Depression associated with
patterns
relations in early childhood
significant loss of important
sources of positive
Dysregulation of
Arouse from withdrawal of
reinforcements or high rate
norepinephrine and
maternal love and support
of aversive experience
serotonin (biogenic mine
during oral phase and later
(reinforcement theory)
hypothesis)
experiences of loss
Low levels od tryptophan
Predisposed by ambivalence Learned helplessness
Cognitive triad: negative view
(precursor of serotonin)
in love relationships
of the self; of the world; and
of the future
Types of Mood Disorders
The three main types of affective disorders are: depression, bipolar disorder, and anxiety
disorder. Each includes subtypes and variations in severity.
Depression
Depression, or major depressive disorder, is characterized by feelings of extreme
sadness and hopelessness. It is more than simply feeling down for a day or two. If you have
depression, you may experience episodes that last for several days or even weeks. A milder
form of depression is called dysthymia.
2 Basic Theories of Depression
A. RESULT OF LOSS (REAL OR SYMBOLIC)
B. HOSTILITY TURNED TOWARD HIMSELF
MAIN CONCERN BY THE NURSE in DEPRESSED CLIENTS: SAFETY
Types of Depression:
1. INVOLUTIONAL: severe type with loss of weight, somatic complaints, severe guilt feelings
(ECT, ANTI-DEPRESSANTS, and HYDRATION)
2. REACTIVE DEPRESSION: less severe, secondary to uncontrolled or unresolved loss, with
poor sleep and appetite, withdrawal (PSYCHOTHERAPY, ANTI-DEPRESSANTS, HYDRATION
AND NUTRITION)
3. MAJOR DEPRESSION: severe type, lasting for 2 weeks
4. DYSTHYMIC: less severe but lasts up to 2 years
5. NON SPECIFIC: less severe, lasting for 2 days to 2 weeks.
PRECIPITATING FACTORS
1. Loss of love ones
2. Major life events
3. Role strain
4. Decreased coping resources
5. Physiological changes

Bipolar Disorder
Bipolar disorder means having periods of depression, and periods of mania. Mania is
when you feel extremely positive and active. This may sound good, but mania is the feeling of
irritable, aggressive, impulsive, and even delusional. There are different types of bipolar,
classified by the severity of depression and mania, as well as by how often mood swings occur.
Anxiety Disorders
There are several different types of anxiety disorders. All are characterized by feelings of
nervousness, anxiety, and even fear. They are:

social anxiety: anxiety caused by social situations

post-traumatic stress disorder: anxiety, fear, and flashbacks caused by a traumatic
event
generalized anxiety disorder: anxiousness and fear in general, with no particular
cause
panic disorder: anxiety that causes panic attacks
obsessive-compulsive disorder: obsessive thoughts that cause anxiety and
compulsive actions
Symptoms of Mood Disorders

Depression:
prolonged sadness
irritability or anxiety
lethargy and lack of energy
lack of interest in normal activities
major changes in eating and sleeping habits
difficulty concentrating
feelings of guilt
aches and pains that have no physical explanation
suicidal thoughts
Bipolar Disorder:
unusual and chronic mood swings
during depression, symptoms similar to those for major depressive disorder
during mania, less sleep and feelings of exaggerated self-confidence, irritability,
aggression, self-importance, impulsiveness, recklessness, or in severe cases delusions
or hallucinations
Anxiety Disorders:
constant worry
obsessive thoughts
restlessness
trouble concentrating
trembling
irritability
difficulty sleeping
sweating
shortness of breath and rapid heart rate
nausea
Diagnosis of Mood Disorders
There are no medical tests to diagnose mood disorders. To make a diagnosis, a
psychiatrist or other trained mental health professional can give a psychiatric evaluation.
Treatment of Mood Disorders
Cognitive-Behavioral Therapy
A FORM OF PSYCHOTHERAPY THAT EMPHASIZES THE IMPORTANT ROLE OF THINKING ,
FEELING ,AND BEHAVING

A GENERAL TERM FOR CLASSIFICATION OF THERAPIES WITH SIMILARITIES IN

APPROACH:

BEHAVIORAL THERAPY
COGNITIVE THERAPY

BEHAVIORAL THERAPY

IT SEEKS TO INCREASE FREQUENCY OF CLIENTS POSITIVELY REINFORCING

INTERACTIONS WITH ENVIRONMENT AND DECREASE (-) NEGATIVE INTERACTIONS
FOCUS:
MODIFY BEHAVIOR INCLUDING EMOTION & VERBALIZATION
VARIOUS BEHAVIOR ARE SUBJECTED TO REWARD AND PUNISHMENT
CERTAIN BEHAVIORS CAN BE CHANGED IF ENVIRONMENT IS CHANGED

COGNITIVE THERAPY

HELPING THE INDIVIDUAL CHALLENGE AND INVALIDATE DISTORTED THOUGHTS THRU

SERIES OF MENTAL EXERCISE AND ULTIMATELY REPLACE THEM WITH APPROPRIATE
REALISTIC THOUGHTS

Medications

ANTI-DEPRESSANTS / mood elevator ( for Depression)

INDICATIONS: Treatment of endogenous depression
1. MAO ( Monoamine Oxidase Inhibitors) (PaNaMa )
A. PARNATE ( Tranylcypromine)
B. NARDIL ( Phenelzine)
C. MARPLAN ( Isocarboxazid )
( Avoid Thyramine Rich foods)
* Aged Cheeze
* Liver
* Beer
* Sausage
* Chocolates
REMEMBER: HYPERTENSIVE CRISIS s/s--RESULTS FROM TAKING TYRAMINE
CONTAINING FOOD WHEN UNDER MAO INHIBITORS:
1. HEADACHE
2. CHEST PAIN
3. PALPITATION
4. DIAPHORESIS
2. TRI-CYCLICS (Tofel)
A. TOFRANIL
B. FLUOXETINE ( Prozac)
C. ELAVIL
Action: Block the reuptake of norepinephrine & serotonin
Adverse Effects:
a. Anti-cholinergic Effects- dry mouth/ constipation
b. Cardiovascular Effects Arrhythmias / Palpitation
General considerations:
1. Antidepressants effect may not occur until up to 3 weeks after the initial
dose !
2. Drugs must be discontinued gradually
3. Common side effects:
a. Constipation
b. Dry mouth
c. Blurred vision
d. Sedation

e. Restlessness & Irritability