Mood Disorders can be divided into three parts: Mood Episodes (Major Depressive Episode, Manic Episodes, Mixed Episode, and Hypomanic Episode), Mood Disorders (Major Depressive Disorder, Dysthymic Disorder, Bipolar Disorder) and the third part includes specifics that describe either the most recent episode or the course of most recent episodes.
Major Depressive Episode symptoms include five or more of the following criteria and last longer than two-weeks at a time: depressed mood most of the day, nearly every day; diminished interest or pleasure in all, or almost all, activities; significant weight loss when not dieting, weight gain, or decrease/increase in appetite; insomnia or hypersomnia; inability to sit still, pacing, pulling or rubbing of the skin, slowed speech, thinking, and body movement; fatigue or loss of energy; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate; and recurrent thoughts of death, including thoughts of suicide, with or without a specific plan for committing suicide, or an actual attempt at suicide. These symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning, and are not due to the effects of substance abuse.
A Manic Episode is defined by a specific period of time (more than one week), when there is an abnormal and persistent elevation in irritable mood and lack of restraint in expressing ones feelings. During the period of mood disturbance, three or more of the following symptoms have to be present to a significant degree: inflated self-esteem; decreased need for sleep; being more talkative than usual or feeling pressure to keep talking; thoughts that race; being easily distracted; an increase in goal-oriented activity; and excessive involvement in pleasurable activities that may have a high potential for negative consequences. These mood disturbances are severe enough to impair functioning in normal social activities or relationships, and are not caused by substance abuse.
A Mixed Episode is a period of time (one week or more) where both Major Depressive Episode and Manic Episode symptoms are present.
A Hypomanic Episode is a distinct period (at least four days) of elevated, expansive, or irritable mood that is clearly different from the usual, non-depressed state. Symptoms can include inflated self-esteem; decreased need for sleep; being more talkative than usual or feeling pressure to keep talking; racing thoughts; being easily distracted; an increase in goal-oriented activity; and excessive involvement in pleasurable activities that may have a high potential for negative consequences. These episodes, which are easily observed by others, are a definite change in one’s behavior and are uncharacteristic of the person, though they are not severe enough to cause social impairment or interfere with daily routines.
Major Depressive Disorder
Major Depressive Disorder can be characterized by one or more Major Depressive Episodes (see above) without a history of Manic, Mixed, or Hypomanic Episodes. If Manic, Hypomanic, or Mixed Episodes develop, then the diagnosis is changed to Bipolar Disorder, unless the symptoms of the Episodes are brought on by medications or substance use.
Individuals with Dysthymic Disorder describe their mood as sad or “down in the dumps,” and they experience this feeling more days than not for at least two years. They also show additional symptoms that can include poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.
Bipolar I Disorder
Bipolar I Disorder is present when Major Depressive Episodes are accompanied by one or more Manic or Mixed Episodes. Polarity is the shift from Major Depressive Episodes to either Manic or Mixed Episodes.
Bipolar II Disorder
Bipolar II Disorder is present when Major Depressive Episodes are accompanied by Hypomanic Episodes. Individuals with Bipolar II Disorder often don’t see their Hypomanic Episodes as pathological, and often remember such episodes without reminders by others about their erratic behavior
Cyclothymic Disorder is characterized by Hypomanic symptoms that turn on and off for at least two years but do not meet the criteria for a Manic Episode, as well as Depressive symptoms that do not meet the criteria for a Major Depressive Episode.
Substance-Induced Mood Disorder
Substance-Induced Mood Disorder symptoms often resemble those of Manic, Mixed, or Hypomanic Episodes, but the disturbance in mood is brought on by the psychological effects of an outside substance (drugs, alcohol, medications, or toxin exposure). The disturbance may involve depressed mood, lack of interest or pleasure, or elevated, expansive, or irritable mood depending on the nature of the substance and whether it occurs during intoxication or withdrawal.