As you spend more time discussing goals and challenges with your Talkspace therapist, you may have questions or are interested in learning more about specific mental health topics and conditions. The Talkspace Bookshelf offers up-to-date mental health information directly from our behavioral health team to provide a better understanding of condition origins, diagnoses, various forms a condition may take, and different treatment options. Feel free to use this resource as a starting point to open up a dialogue and pose questions for your Talkspace therapist.
Depressive and Related Disorders and Bipolar and Related Disorders
Mood disorders are a cluster of mental health conditions that primarily impact a person’s mood or their day-to-day emotional experience. Those living with mood disorders most often experience disruptive negative moods, such as those common in depressive conditions. They may also experience periods of elevated mood experienced periodically with depression, such as in bipolar disorder. As such, mood disorders may include a variety of conditions as defined by the Diagnostic and Statistical Manual of Mental Health Disorders 5 (DSM 5).
Major Depressive Disorder
Major Depressive Disorder is a condition by which one of the most prevailing features is low mood, or depressive feelings. In addition, those living with Major Depressive Disorder may experience symptoms such as: changes in activity level, loss of interest or pleasure in previously enjoyed activities, difficulty concentrating, unintended loss of weight, insomnia or hypersomnia (sleeping more than usual), loss of energy, feelings of guilt or unworthiness, and thoughts of death and/or suicide.
Due to the individual nature of depression, symptoms can be experienced on a continuum. Some may experience mild depression, while others may live with more severe symptoms.
Bipolar Disorder
There are two types of Bipolar Disorders, often referred to by their types as Type I or Type II. Bipolar I Disorder can have serious detrimental effects on one’s life, as it includes periods of depressive episodes, which alternate with periods of extreme euphoria and exuberance known as mania (or manic episodes).
During depressive episodes, individuals may experience the typical signs of depression as listed previously. They may be at risk for changes in mental ability, focus, and daily self-care regimens (such as failing to take regular baths, doing laundry, brushing teeth, eating poorly, etc.). By contrast, when experiencing manic episodes those with Bipolar I Disorder will experience periods of extreme euphoria, happiness, and productivity. While the person living with condition will appear brighter and more excited about life, this time is often quite dangerous as it can lead to very risky behaviors such as poor business or financial decisions, excessive shopping, reckless driving, sexual indiscretions, etc.
By contrast, those with Bipolar II Disorder don’t experience the “high highs” that those with Bipolar I may experience. Instead, living with Bipolar II often looks like intense regular periods of depression with interspersed periods of slightly elevated mood (hypomania). These hypomanic episodes, by definition, do not reach the same level of full blown manic episodes, which can make them hard to categorize or distinguish.
With both Bipolar Disorders, and Major Depressive Disorder, accessing treatment is often very difficult. Those in depressive episodes may not easily find the ability to seek out support or follow up on recommended resources, while those in manic episodes often believe that they don’t need professional support and go on with their lives without treatment.
Seasonal Depression
Seasonal Affective Disorder, also known by the acronym SAD, is an old name for a condition that was consumed under the umbrella of Depressive Disorders in 5th edition of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM 5). Despite it now being referred to as simply a specifier to a diagnosis of a depressive condition — rather than a stand-alone diagnosis — the understanding behind seasonal depression remains intact.
Typically, those who live with seasonal depression will experience episodes of Major Depression that correlate to fall and winter months. By contrast they will also experience a noticeable lifting of mood and symptoms during spring and summer months. While those who live with seasonal depression may experience depression at other periods sporadically, in order to maintain the diagnosis of seasonal depression, individuals must experience most depressive episodes during those darker, and colder months of the year. The symptoms experienced by those with seasonal depression are similar to the ones experienced in Major Depressive Disorder such as: changes in sleep patterns (insomnia or sleeping too much), feelings of worthlessness or guilt, difficulty concentrating, indecisiveness, loss of energy, feeling slowed down, or recurrent thoughts of death.
Premenstrual Dysphoric Disorder
As the name suggests, premenstrual dysphoric disorder is a condition in which, prior to the onset of menstruation, a person may experience disruptive psychological symptoms such as mood swings, irritability, anger and frustration, as well as increased anxiety or depressed mood.
Individuals may also experience other symptoms such as: difficulty concentrating, decreased pleasure in previously enjoyed activities, notable changes in appetite, drastic changes in sleeping patterns, feeling “out of control,” stomach cramps, bloating, breast tenderness, etc. Typically, these symptoms arrive about one week prior to menstruation and dissipate within one week following menstruation.
In addition to these conditions mentioned above, there are also less common mood disorders such as Disruptive Mood Dysregulation Disorder, Substance-induced mood disorders
Cyclothymic Disorder, and Persistent Depressive Disorder (formerly known as dysthymia).
Treatments
Evidence-based therapies, such as psychotherapy (talk therapy) and pharmacotherapy (medication) are well-established treatments for mood disorders. A combination of the two has been well-documented as the best course of action for treating this class of conditions.
Pharmacotherapy or Medication
For Major Depressive Disorder and some of the other conditions listed here, antidepressants are most often recommended for effective management of symptoms. Selective serotonin reuptake inhibitors (SSRI), norepinephrine-dopamine reuptake inhibitors (NDRI), and antipsychotics. Some commonly prescribed medications include bupropion, sertraline, citalopram, mirtazapine, and fluoxetine.
For Bipolar I and II Disorders, often prescribed medications include antipsychotics, mood stabilizers, and lithium. Lithium has been well-established to help regulate mood and promote “evenness,” disrupting the often drastic elevation and drop of mood experienced in Bipolar Disorders. It can help reduce suicidal and other disruptive thoughts and behaviors, increasing overall stability and health for those who take it. If prescribed, it requires regular medical visits to avoid toxicity and monitor lithium levels in the body (approximately every 3 to 6 months).
Cognitive Behavior Therapy (CBT)
CBT focused therapy for mood disorders may include working through problematic thinking patterns or automatic thoughts that may negatively impact a person’s daily well-being. This may include thoughts about self and others, including self-critical thoughts and the internalization of the negative stigma associated with living with a mental health condition. Tools and strategies to help build self-esteem may also be indicated throughout treatment.
In addition, a therapist will help educate you on coping strategies that may be healthier and more adaptive. Skills training and practice may be conducted in session with your therapist, outside of session, and may also be accompanied by homework assignments such as reading handouts, completing worksheets, and tracking behavioral changes.
Interpersonal (or Relational) Therapy
Mood disorders can be incredibly disruptive to a person’s life. Due to feelings of fatigue or ongoing frustration, depression and agitation, maintaining relationships can be difficult. Interpersonal or relationally focused therapy will center on helping you establish better social connections and how to maintain those relationships. This may include interpersonal feedback from your therapist in session, as well as encouraging you to try out social engagement in your daily life until you reach your goal of building or re-establishing a social network.
Support Groups
Support groups, or mutual assistance groups, may also be a helpful addition to individual talk therapy. In group settings, you will be able to share your experience with others and learn from group members in different stages of the recovery process how they best cope with their symptoms. Additionally, as mood disorders can often be isolating, group settings free of stigma can be incredibly healing spaces for those living with this category of conditions.
Therapeutic Note
Remember your therapist is here to help you figure out the best way to address your concerns. Therapy works best when it is a collaboration between you and your therapist. It is important to be open, honest, and an active participant in this process. Talk to your therapist about your goals for therapy so that together you can come up with the best plan to achieve your goals.
Questions You Might Have For Your Talkspace Therapist
- How can I find a support group? Is there one for me at Talkspace?
- What if I have anxiety, is that a mood disorder?
- Will I get better if I don’t take medication?
Sources
American Psychiatric Association. "Bipolar and Related Disorders." Desk Reference to the Diagnostic Criteria From DSM-5®. Washington: American Psychiatric Publishing, 2014. 65-92.
American Psychiatric Association. "Depressive Disorders." Desk Reference to the Diagnostic Criteria From DSM-5®. Washington: American Psychiatric Publishing, 2014. 93-114.
PsyGuides.com. Mood Disorder Symptoms, Causes and Effect. (n.d.). Retrieved May 17, 2017