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Overview of Mood Disorders

By William Coryell, MD, George Winokur Professor of Psychiatry, Carver College of Medicine at University of Iowa

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(For mood disorders in children, see Depressive Disorders in Children and Adolescents.)

Mood disorders are emotional disturbances consisting of prolonged periods of excessive sadness, excessive joyousness, or both. Mood disorders are categorized as

Anxiety and related disorders also affect mood.

Sadness and joy (elation) are part of everyday life. Sadness is a universal response to defeat, disappointment, and other discouraging situations. Joy is a universal response to success, achievement, and other encouraging situations. Grief, a form of sadness, is considered a normal emotional response to a loss. Bereavement refers specifically to the emotional response to death of a loved one.

A mood disorder is diagnosed when sadness or elation is overly intense and persistent, is accompanied by a requisite number of other mood disorder symptoms, and significantly impairs the person's capacity to function. In such cases, intense sadness is termed depression, and intense elation is termed mania. Depressive disorders are characterized by depression; bipolar disorders are characterized by varying combinations of depression and mania.

Lifetime risk of suicide for people with a depressive disorder is 2 to 15%, depending on severity of the disorder. Risk is further increased in the following cases:

  • At the start of treatment, when psychomotor activity is returning to normal but mood is still dark

  • During mixed bipolar states

  • At personally significant anniversaries

  • By severe anxiety

  • By alcohol and substance use

Other complications of mood disorders include

  • Disability ranging from mild to complete inability to function, maintain social interaction, and participate in routine activities

  • Impaired food intake

  • Severe anxiety

  • Alcoholism

  • Other drug dependencies.