Mood Disorders

Major Depression

Depression Facts

• Fewer than one in three people experiencing depression seek treatment.
• Major depression can develop at any age or stage of life.
• Depression has soared over the last two decades, especially among adults.
• Young children, teenagers, men, and women of every age and every social, age related, or ethnic group can develop depression.
• Women are 2-3 times more likely than men to develop a depressive disorder.
• Rates for men and women are highest between the ages 25-44 years. The average age at onset is the mid-twenties.
• Like many other illnesses, major depression can strike out of the blue without apparent reason.

Can be mild, moderate, or severe. Identified by three different forms, melancholic, atypical and psychotic. Individuals with melancholic depression feel sad in a way they describe as different from other experiences of depression. They typically wake before dawn and cannot return to sleep, their depression is most intense in the morning.

Individuals with atypical depression are capable of joy, however fleeting, and can feel temporarily happy in response to a pleasurable occurrence. Often they have a chronic and extreme sensitivity to rejection that interferes with their ability to work and socialize. Individuals with psychotic depression, which is uncommon, lose touch with reality and may develop hallucinations, or other more bizarre psychotic phenomenon.

Most cases of major depression can be treated successfully, usually with therapy, medication or both. Some individuals for whom standard psychotherapeutic approaches and a variety of medication trials does not work may consent to Electo convulsant therapy or ECT. This therapy is used still today with varying positive levels of success. The person is sedated during this therapy. Essentially no single approach works for all depressed people, but individuals who do not improve with one form of therapy may improve with a different one.

Seasonal Affective Disorder (SAD)

A recurrent mood disorder characterised by depressive episodes and related symptoms that develop at particular times of the year, most often in autumn or winter, and remit when the season ends. People with SAD, like those with other forms of major depression, often feel helpless, guilt-ridden, hopeless, have difficulty thinking and making decisions. Individuals tend to eat more, gain weight and spend many more hours asleep.

SAD often improves with a specialised treatment called phototherapy (exposure to bright light). The recommended light therapy system consists of a set of florescent bulbs installed in a metal box with a plastic diffusing screen. Light therapy should be monitored by a psychiatrist. For severe forms of seasonal depression, therapists may combine phototherapy with antidepressant medications.

Postpartum Depression

Also known as Postnatal Depression. Sadness and tearfulness are common for new mothers to experience during the first seven to ten days after child birth. These "baby blues" are not a mental disorder and do not require treatment. Postpartum depression usually develops within four weeks of delivery, although it can occur at any time in the baby's first year. Common symptoms include sadness, decreased concentration, physical complaints, feelings of guilt and unworthiness, agitation, anxiety, lack of energy, loss of interest and pleasure, and obsessive behaviours (checking on the baby constantly). A small percentage of women with postpartum depression develop psychotic symptoms, such as hallucinations and delusions.

The treatment is like other forms of major depression, except that women who are breast feeding may initially be treated with therapy because antidepressants, which are secreted in breast milk, may have harmful side effects on infants.

Dysthymia (chronic mild depression)

Although everyone feels discouraged, sad, or inadequate at times, people with dysthymia experience symptoms of depression most of the day, and more days than not, for a period of at least two years. These individuals may sleep and eat more or less than usual, have low self-esteem, lack energy, have problems making decisions or concentrating and may feel a sense of hopelessness. These symptoms, however, are less intense than those of major depression.

Psychotherapy, antidepressant medications, or a combination of both may be effective treatment for dysthymia. Aerobic exercise appears to be an especially helpful form of additional therapy. Treatment is very individualised and is a process that can take some time.

Bipolar Disorder (formerly called Manic Depression)

Characterised by mood swings that include episodes of depression and of mania or hypomania. Individuals describe themselves as having "higher highs" and "lower lows" than others. These moods swing from both poles, and although there may be long periods of normal mood, without treatment individuals with this disorder tend to cycle up and down for many years.

Professional therapy is essential in the treatment of bipolar disorders. Therapy plays a critical role in helping individuals to understand their illness and rebuild their lives. Medication is an important key to recovery for people with Bipolar Disorder and most people with Bipolar Disorder will need to stay on their medication for life to sustain a stable mood state. While the depressive aspect of Bipolar disorder may look like any other depression the preferred treatment is not usually an anti-depressant as these may increase the mood beyond normal and set off a maniac phase. Mood stabilisers are the medication of choice in the disorder. 

There are several types of bipolar and related disorders.

• Bipolar I disorder. You've has at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
• Bipolar II disorder. You've has at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode. Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment. 
• Cyclothymic disorder. You've had at least two years - or one year in children and teenagers - of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression). 
• Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as cushing's disease, multiple sclerosis, or stroke.