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POBRERO, Mary Greyzel BSN136

TAYSON, Leah Marie

A mood disorder is the term given for a group of diagnoses in the Diagnostic and
Statistical Manual of Mental Disorders (DSM IV TR) classification system where a
disturbance in the person's mood is hypothesized to be the main underlying feature.
The classification is known as mood (affective) disorders. Mood disorder is a group
of disorders characterized by a decrease or entire loss of control over mood.
The mood disturbance may occur in different patterns of severity, duration, alone or
in combination.

English psychiatrist Henry Maudsley proposed an overarching category of affective


disorder.[2] The term was then replaced by mood disorder, as the latter term refers
to the underlying or longitudinal emotional state whereas the former refers to the
external expression observed by others.

Common Etiologic Theories

• Genetic theory - if one parent has bipolar disorder. 25% chance of


transmission to the child
• Aggression turned inward theory - over-devel0ped superego leads to
depression
• Object loss theory - loss of parent before age 11 increase risk of
depression
• Personality Organization Theory - obsessive-compulsive, oral dependent,
hysterical personalities have higher predisposition to mood disorders
• Cognitive theory - mood disorder results from (-) view of self, (-)
interpretation of experience
• Learned Helplessness theory - mood disorder is caused by a belief that
one has no control over his environment
• Psychoanalytic theory - mania is a defense against an underlying
depression (due to rigid superego)
• Biologic factor - mania is related to increased norepinephrine
whiledepression is related to low norepinephrine

Common Precipitating Factors

• loss of loved one


• major life events
• roles strain
• decreased coping resources
• physiologic changes

Types of Mood disorders

1. Depressive Disorders
2. Bipolar Disorders
3. Substance-induced mood Disorders

a. Alcohol-induced mood disorders


b. Benzodiazepine-induced mood disorders

Substance-induced mood disorders

A mood disorder can be classified as substance-induced if its etiology can be traced


to the direct physiologic effects of a psychoactive drug or other chemical substance,
or if the development of the mood disorder occurred contemporaneously with
substance intoxication or withdrawal. Alternately, an individual may have a mood
disorder coexisting with a substance abuse disorder. Substance-induced mood
disorders can have features of a manic, hypomanic, mixed, or depressive episode.
Most substances can induce a variety of mood disorders. For example, stimulants
such as amphetamine (Adderall, Dexedrine; "Speed"), methamphetamine (Desoxyn;
"Meth", "Crank", "Crystal", etc.), and cocaine ("Coke", "Crack", etc.) can cause
manic, hypomanic, mixed, and depressive episodes.

Medications and drugs which can cause substance induced mood disorder include
the following...

• antihypertensives such as reserpine, methyldopa, clonidine, guanethidine,


hydralazine, and prazosin hydrodhloride
• gastrointestinal medications such as cimetidine
• anticonvulsant medications such as clonazepam
• steroids
• oral contraceptives such as progesterone
• anti-inflammatory medications such as indomethacin
• L-dopa
• antipsychotic medications
• all sedatives including barbiturates such as phenobarbital, benzodiazepines
such as diazepam, meprobamate, methaqualone, gultethimide,
elhchlorvynol, chloral hydrate, and ethanol
• amphetamines (stimulates)
• methadone
• heroin
• cocaine

A. Alcohol-induced mood disorders

High rates of major depressive disorder occur in heavy drinkers and those with
alcoholism. Controversy has previously surrounded whether those who abused
alcohol and developed depression were self-medicating their pre-existing
depression, but recent research has concluded that, while this may be true in some
cases, alcohol misuse directly causes the development of depression in a significant
number of heavy drinkers. High rates of suicide also occur in those who have
alcohol-related problems. It is usually possible to differentiate between alcohol-
related depression and depression which is not related to alcohol intake by taking a
careful history of the patient. Depression and other mental health problems
associated with alcohol misuse may be due to distortion of brain chemistry, as they
tend to improve on their own after a period of abstinence.

B. Benzodiazepine-induced mood disorders

Long term use of benzodiazepines which have a similar effect on the brain as
alcohol and are also associated with depression. Major depressive disorder can also
develop as a result of chronic use of benzodiazepines or as part of a protracted
withdrawal syndrome. Benzodiazepines are a class of medication which are
commonly used to treat insomnia, anxiety and muscular spasms. As with alcohol,
the effects of benzodiazepine on neurochemistry, such as decreased levels of
serotonin and norepinephrine, are believed to be responsible for the increased
depression. Major depressive disorder may also occur as part of the benzodiazepine
withdrawal syndrome. A year after a gradual withdrawal program, no patients had
taken any further overdoses. Depression resulting from withdrawal from
benzodiazepines usually subsides after a few months but in some cases may persist
for 6–12 months.

Symptoms of Substance induced mood disorder

• Sadness • Restlessness
• Emptiness • Slow movement and thinking
• Loss of interest and pleasure • Fatigue
• Irritability and anger • Worthlessness and guilt
• Changes in appetite • Poor concentration
• Sleep problems • Thoughts about death and
suicide

Manic Symptoms of Substance induced mood disorder


• Elation • increased sexual behavior
• Confidence • over spending
• delusional thinking • fast reckless driving
• high level of energy • wild business schemes
• increased activity • overeating
• productivity • drinking too much
• loud and rapid speech • irritability
• racing thoughts • anger
• risky behavior • aggitation
• impulsive behavior

Diagnosis of Substance-Induced Mood Disorder

A. A person has significant disturbance in mood that includes either (or both):
1. Depressed mood or significantly reduced level of interest or pleasure in most
or all activities.
2. Mood that is euphoric, heightened, or irritable.

B. The person's symptoms develop during (or within four weeks of) intoxication or
withdrawal, or are caused by medication use.

C. Another disorder does not better explain the mood disturbance.

D. The mood condition is not present only when a person is delerious.

E. The symptoms are a cause of great distress or difficulty in functioning at home,


work, or other important areas.

Treatment for substance induced mood disorder

• Should begin with a medical evaluation and medically supervised


detoxification (if indicated) from the substance.
• psychotherapy should be used to help the individual establish recovery from
any addiction which may be present. Psychological treatment must help the
person’s development of adequate coping skills as well.