Mood disorders

We all experience changes in mood from time-to-time - it’s a normal part of life. But, when mood changes are intense, persistent, or frequent, they can impact our ability to function.

Mood disorders is a clinical term for a category of mental health conditions in the DSM 5, which is the manual therapists use for diagnosis. The mood disorder category includes the two subcategories of depressive and bipolar conditions, where the main area affected is a person’s emotional state.

If mood problems are impacting your daily life, it’s important to seek help from a qualified mental health professional. In most cases, mood disorders can be successfully managed with therapy and medication.

Types of mood disorders

There are two main categories of mood disorders in the DSM 5: bipolar disorder and depressive disorders.

Bipolar disorders: The category of bipolar disorders includes the following conditions:

• Bipolar I disorder: This involves dramatic mood shifts from one extreme to the other: between episodes of major depression and mania. During mania, people have lots of energy and a very high mood -- which could be experienced as happiness or irritability.
• Bipolar II disorder: This disorder is characterized by fluctuations in moods, between episodes of major depression and hypomania. Hypomania also involves periods of high mood and energy, but of a lesser severity than mania.
• Cyclothymic disorder: Often thought of as a milder form of bipolar disorder, the depressive and hypomanic symptoms of cyclothymic disorder do not meet the criteria for the above diagnoses.

Depressive disorders: Several different diagnoses fall under the depressive disorders category, including:

• Major depressive disorder: This is the most common of the mood disorders, characterized by episodes of low mood that impact daily functioning. As well as feeling sad, people also experience a combination of additional symptoms, such as low energy or appetite, poor sleep, feelings of worthlessness, or a loss of interest or pleasure. These symptoms are present for at least two weeks and affect how people think and behave.
• Persistent depressive disorder (also called dysthymic disorder): This is a chronic form of depression. Many of the same depressive symptoms impact daily functioning in persistent depressive disorder, but on a continuous basis, for at least two years.
• Premenstrual dysphoric disorder (PMDD): In PMDD, symptoms of depression are experienced in connection with the menstrual cycle.

Prevalence of mood disorders

Mood disorders are relatively common, with an estimated 21.4% of U.S. adults likely to experience a mood disorder at some point during their lives (1).

Within the broad category of mood disorders, some diagnoses are more common than others. Major depressive disorder is one of the most common mental health diagnoses in the U.S., with an estimated 16.9% of adults likely to have the experience at some point during their lives (2). On the other hand, bipolar disorders are less common; around 4.4% of U.S. adults experience this disorder during their lives (3).

Symptoms of mood disorders

Given the broad nature of the mood disorder category, symptoms for diagnosis can vary widely. See our depression and bipolar disorder explanations for additional, specific information about each of these diagnostic categories.

Some of the common symptoms characteristic of depressive and manic episodes are listed below. If you have been experiencing some of these, it’s important to seek an evaluation from a mental health professional:

Depressive episode

• Persistent sadness
• Feelings of hopelessness, helplessness, worthlessness, or guilt
• Loss of energy
• Irritability or restlessness
• Difficulty concentrating
• Loss of interest or pleasure in usual activities
• Changes to eating or sleeping patterns
• Thoughts of suicide

Manic episode

• Feelings of elation
• Heightened energy and activity
• Reduced sleep
• Very distractible
• Irritability or restlessness
• Rapid speech or having many fast thoughts or ideas
• Increased risky behaviors, such as substance use, sexual behavior, or spending behavior

These disorders can be experienced so differently from person-to-person, so you won’t necessarily experience all these symptoms; diagnosis also entails assessing the length and persistence of these symptoms over time, as well.

The important thing is to ask for help if any symptoms are impacting your daily life. This is especially important if the symptoms have been present for most of the day, and nearly every day, for two weeks or more.

Treatment options for mood disorders

Mood disorders are often best managed through a combination of medication and psychotherapy. If you’re concerned that you might have a mood disorder, consider a combination of the following treatment options:

• Therapy: Therapy is an important component of treatment for mood disorders. Look for a therapist who can help you understand your challenges and find strategies for managing your mood. You could consider therapy in individual or group contexts, or even a combination of both. See more tips below on types of therapy and selecting a therapist.
• Medication: Medication is a common component of treatment for mood disorders. Any medication should be taken as directed, in close consultation with a psychiatrist.
• Check-ups: It’s important to have a check-up with your doctor to ensure that no underlying medical factors are contributing to your symptoms.
• Self-care: Pay attention to your diet, try to maintain a regular sleep pattern, and exercise regularly. Find activities that you enjoy, and make time for them in your schedule. Such lifestyle factors can help to regulate our moods (4,5,6).
• Journal: Keep a record of your mood changes, thoughts, and events. This can help you to identify patterns, events affecting your mood, and the early signs of a mood change.
• Social support: People sometimes feel like withdrawing from family and friends when they are going through a challenging time. However, it’s important to stay connected. Reach out to friends and family for help or to talk things over.
• Hotlines: If you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255.

People experience mood disorders in such different ways, so it’s important to keep trying if you find that your first treatment attempt does not help. Many medications, therapy types and other options are available, so it might take a couple of tries before you find what works best for you.

Therapy for mood disorders

Psychological treatment is an important part of a mood management plan and there are many different types of therapy that can help. Consider the common approaches below and choose one that resonates with you. If you’re unsure, your prospective therapist is a great person to seek advice from.

• Cognitive Behavioral Therapy (CBT): CBT helps us to problem-solve, become aware of, and change unhelpful thinking patterns, behaviors, and beliefs. There is a particularly strong evidence base supporting the efficacy of CBT for treating mood disorders. For example, for individuals diagnosed with major depressive disorder who have trouble with daily functioning (like struggling to get out of bed or go to work), behavioral activation is a CBT technique that encourages more activity, setting goals, and engaging in positive behaviors.
• Psychodynamic Therapy: Psychodynamic therapy can help address mood through the exploration of how the past influences current patterns of thought, emotion and behavior. Compared to CBT, psychodynamic therapy focuses more on gaining insight into the root of the problem. This can be helpful when depression is linked to specific events or causes, even dating back to childhood.
• Mindfulness Practices: Mindfulness helps us to be aware of our thoughts and experiences without automatically reacting to them as problematic, which helps with the regulation of emotion.
• Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies to help us take an acceptance approach and respond differently.
• Family Systems Therapy: Family systems therapy approaches treatment from within the context of family dynamics. This could be a good match for individuals who find their relationships and family dynamics impact their mood.

What to look for in a therapist for mood disorders

There are several factors to keep in mind when selecting a therapist for help with mood disorders, including:

• Specialization: Look for a therapist who has experience and specialized training in mood disorders (specifically, look for “depression” or “bipolar disorder” depending on the symptoms you are experiencing) and the particular therapy type that resonates with you. Therapists often include this kind of information in their biographies so that it’s easy for you to find.
• Qualifications: With so many different provider types available, it can be difficult to decide which type of mental health professional to see. The most important thing is to look for a currently licensed therapist. That said, if you think medication might be needed, make sure you see a psychiatrist. This particular type of mental health professional is able to prescribe.
• Personal fit: The trusting relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also enables you to ask about their experience and what therapy with them will be like. Try to speak to a few different therapists before deciding on a provider.

Sources and references

• (1) National Institute of Mental Health, “Any mood disorder” based on National Comorbidity Survey (Data at https://www.hcp.med.harvard.edu/ncs/ftpdir/table_ncsr_LTprevgenderxage.pdf)
• (2) National Comorbidity Survey (Data at https://www.hcp.med.harvard.edu/ncs/ftpdir/table_ncsr_LTprevgenderxage.pdf)
• (3) National Institute of Mental Health, “Bipolar disorder” based on National Comorbidity Survey (Data at https://www.hcp.med.harvard.edu/ncs/ftpdir/table_ncsr_LTprevgenderxage.pdf)
• (4) Walsh, Roger, 2011," Lifestyle and Mental Health", American Psychologist, 66(7)
• (5) Hearing, C.M., et al., 2016, "Physical Exercise for Treatment of Mood Disorders: A Critical Review", Current Behavioral Neuroscience Reports, 3(4)
• (6) Reid, K.J., et al., 2006, "Sleep: A Marker of Physical and Mental Health in the Elderly", The American Journal of Geriatric Psychiatry, 14(10)
• American Psychiatric Association website, “What is depression?”
• National Institute of Mental Health website, “Depression”