Mood Disorders

Mood disorders, also sometimes known as affective disorders, include all types of depression and bipolar disorder.

Clinicians and researchers believe that mood disorders in children and adolescents are one of the most underdiagnosed health problems. Mood disorders in adolescents can put them at risk for other conditions, such as anxiety disorder, disruptive behavior and substance abuse. These conditions may persist long after the initial episodes of depression are treated.

Mood disorder types

The following are the most common types of mood disorders experienced by children and adolescents:

• Major depression. A period of a depressed or irritable mood or a noticeable decrease in interest or pleasure in usual activities, along with other signs, lasting at least two weeks.

• Persistent depressive disorder (dysthymia). A chronic, low-grade, depressed or irritable mood for at least one year.

• Bipolar disorder. Manic episodes (period of persistently elevated mood), interspersed with depressed periods, or periods of flat or blunted emotional response. 

• Disruptive mood dysregulation disorder. A persistent irritability and extreme inability to control behavior exhibited in children under the age of 18. 

• Premenstrual dysmorphic disorder. This includes depressive symptoms, irritability and tension before menstruation. 

• Mood disorder due to a general medical condition. Many medical illnesses (including cancer, injuries, infections and chronic medical illnesses) can trigger symptoms of depression.

• Substance-induced mood disorder. Symptoms of depression that are due to the effects of medication or other forms of treatment, drug abuse or exposure to toxins.

Mood disorder causes

The causes of mood disorders in adolescents are not well known. Mood disorders may be caused by a chemical imbalance in the brain, or a chemical imbalance combined with environmental factors, such as chronic stress or unexpected life changes.

Mood disorders can run in families, though the factors that lead to the condition are often both environmental and genetic, involving a combination of genes from both parents.

If a mother passes a mood disorder trait to her children, a daughter is more likely to have the disorder. If a father passes a mood disorder trait to his children, a son is more likely to have the disorder. 

Females in the general population are 70 percent more likely to experience depression than males. Once a person in the family has this diagnosis, the chance for his or her siblings or children to have the same diagnosis is increased. In addition, relatives of people with depression are also at increased risk for bipolar disorder.

The chance for bipolar disorder in males and females in the general population is about 2.6 percent. Once a person in the family has this diagnosis, the chance for his or her siblings or children to have the same diagnosis is increased. In addition, relatives of people with bipolar disorder are also at increased risk for other forms of depression.

Mood disorder symptoms

Adolescents, depending on their age and the type of mood disorder present, may exhibit different symptoms of depression.

Although each adolescent may experience symptoms differently, symptoms may include:

• Persistent feelings of sadness

• Feeling hopeless or helpless

• Low self-esteem

• Feelings of inadequacy

• Excessive guilt

• Wanting to die

• Loss of interest in activities once enjoyed

• Difficulty with relationships

• Sleep disturbances (for example, insomnia or hypersomnia)

• Changes in appetite or weight

• Decreased energy

• Difficulty concentrating

• Inability to make decisions

• Suicidal thoughts or attempts

• Frequent physical complaints (for example, headache, stomachache, or fatigue)

• Running away or threats of running away from home

• Hypersensitivity to failure or rejection

• Irritability, hostility, aggression

• Constant anger

• Rebellious behaviors

• Trouble with family

• Difficulty with friends and peers

The symptoms of mood disorders may resemble other conditions or psychiatric problems. Always consult your adolescent's healthcare provider for a diagnosis.

Diagnosis and treatment

Mood disorders are real medical conditions. They are not something an adolescent will likely just "get over."

A child psychiatrist will usually diagnose a mood disorder following a comprehensive evaluation. The psychiatrist may also evaluate the adolescent's family and speak to teachers and care providers in order to make an accurate diagnosis.

Once diagnosed, mood disorders can often be effectively treated. Treatment should always be based on a comprehensive evaluation of the adolescent and family.

Treatment may include one or more of the following:

• Medication, which is often very effective, especially when combined with psychotherapy.

• Psychotherapy, most often cognitive-behavioral and/or interpersonal therapy.

• Family therapy

• Consultation with the adolescent's school

Parents play a vital supportive role in any treatment process.

Prevention of mood disorders

Preventive measures to reduce the incidence of mood disorders in adolescents are not known. Early detection and intervention can reduce the severity of symptoms, enhance the adolescent's normal growth and development, and improve the quality of life experienced by adolescents with mood disorders.