Lesson on mood disorder . This is prepare for Tamil speaking counseling students.

4. Mood Chart

5. Mood Chart, Manic Episode

6. Classification of Mood Disorders
International Classification of Diseases (ICD-10) came
into use in WHO Member States as from 1994
F30 Manic episode
F31 Bipolar affective disorder
F32 Depressive episode
F33 Recurrent depressive disorder
F34 Persistent mood (affective) disorders
F38 Other mood (affective) disorders
F39 Unspecified mood (affective) disorder

7. DSM-IV lists 10 mood disorders
• Major depressive disorder
• Dysthymic disorder
• Bipolar I
• Bipolar II
• Cyclothymic disorder
• Rapid cycling depression/mania
• Seasonal affective disorder
• Mood disorder with postpartum onset
• Mood disorder due to general medical condition
• Substance-induced mood disorder
Classification of Mood Disorders

8. F30 Manic Episode
F30 Manic episode
F30.0 Hypomania
F30.1 Mania without psychotic symptoms
F30.2 Mania with psychotic symptoms
F30.8 Other manic episodes
F30.9 Manic episode, unspecified

9. F30.0 Hypomania
 Hypomania is characterized by
 persistent mild elevation of mood for at least several
days
 increased energy and activity
 usually marked feelings of well-being and both physical
and mental efficiency
 Increased sociability, talkativeness, overfamiliarity,
increased sexual energy, and a decreased need for
sleep are often present but not to the extent that
they lead to severe disruption of work or result in
social rejection. There are no hallucinations or
delusions

10. F31 Bipolar Affective Disorder
 Bipolar affective disorder is characterized by repeated, at least
two episodes in which the patient’s mood and activity levels are
significantly disturbed (manic or depressive syndromes, patients
who suffer only from repeated episodes of mania are
comparatively rare).
 The first episode may occur at any age from childhood to old age.
 The frequency of episodes and the pattern of remissions and
relapses are both very variable.
 The lifetime prevalence is between 0,5 an 1 %. Sociality – about
19%. Comorbidity with alcohol and drug abuse
 The rapid-cycling specified identifies those patients who have
had at least four episodes of a major depressive, manic, or mixed
episode during the past 12 months.

11. Risk facts of Bipolar disorder

12. 12
Sylvia Plath (2000)
The Unabridged Journals of Sylvia Plath, 1950-1962
New York: Anchor Books

13. F31 Bipolar Affective Disorder
F31 Bipolar affective disorder
F31.0 Bipolar affective disorder, current episode hypomanic
F31.1 Bipolar affective disorder, current episode manic without psychotic
symptoms
F31.2 Bipolar affective disorder, current episode manic with psychotic
symptoms
F31.3 Bipolar affective disorder, current episode mild or moderate
depression
F31.4 Bipolar affective disorder, current episode severe depression without
psychotic symptoms
F31.5 Bipolar affective disorder, current episode severe depression with
psychotic symptoms
F31.6 Bipolar affective disorder, current episode mixed
F31.7 Bipolar affective disorder, currently in remission
F31.8 Other bipolar affective disorders
F31.9 Bipolar affective disorder, unspecified

14. Mood Episodes
 Building blocks of mood
disorders
 Not diagnosable
 Helps in understanding
mood disorders
 Manic episode
 Mood is persistently
elevated, irritable, and
expansive.
 Leads to impaired
functioning.
At least 3 of the following
 Pressured speech,
psychomotor
agitation, flight of
ideas, decreased
need for sleep,
increased
involvement in
goal orientated
activities,
distractibility,
inflated self-
esteem,
grandiosity.
High risk activities
Lasting at least 1 week.

15. Mood Episodes
 Hypomanic episode
 Similar to manic
 symptoms are less severe
but still interfere with
functioning.
 distinct period of
persistently expansive,
irritable, elevated mood
 Lasting at least 4 days but
less than 1 week.
 At least 3 of the following
 Pressured speech
Increased goal-
oriented activities
Psychomotor agitation
Distractibility
Decreased need for
sleep
Grandiosity
Risk taking

16. Bipolar Disorders
AKA manic depression.
bipolar affective disorder
severe recurrent
mood switches from
depression to mania
Prevalence
3-5% of U.S. Population
suicide rate 60 times
higher than general
population
High hospitalization,
comorbidity, disability,
morbidity
Risk taking
Majority are unable to
maintain long term
remission.
 with good med
maintenance 75%
will relapse within
5 years

17. Bipolar disorders
include
Bipolar I
Bipolar II
Cyclothymia
Bipolar disorder
not otherwise
specified

18. Bipolar Disorders
Bipolar I Disorder, Single Manic Episode
A) Presence of only one Manic Episode and no past
Major Depressive Episodes. Note: Recurrence is
defined as either a change in polarity from
depression or an interval of at least 2 months
without manic symptoms
Bipolar II Disorder (Recurrent Major Depressive
Episodes With Hypomanic Episodes)
A) Presence/ history of one or more Major
Depressive Episodes
B) Presence/ history of at least one Hypomanic
Episode.
C)There has never been a Manic or Mixed.

19. Bipolar Disorder –I

20. Overview of Mood Disorder

21. Symptoms
Elevated ( high),Expensive or Irritable Mood
a) Euphoria ( Mild elevation of mood).
b) Elation (Moderate elevation).
c) Exaltation ( severe elevation of mood).
d) Ecstasy (very severe elevation of mood).
Increased psycho motors activity
a) Over activeness.
b) Restlessness.
c) Activity usually goal oriented.
Speech and thoughts
a) More talkative than usual.
b) Develop pressure of speech.
c) Playful language and rhyming .
d) Joking and teasing.
e) Speaks loudly.

22. Symptoms cont …
Thoughts
a) Flight of ideas.
b) Delusions (Grandiosity).
Goal directed activity
The person is usually alert, trying to do many things at one
time.
Other features
a) Reduced with a decreased need for appetite.
b) Sleep behavioral changes

24. Etiology
 Genetic factors
 Neurochemical factors
 Environmental factors

25. Treatment
 Medication, ECT, Bright light therapy, Manipulation of sleep/wake
cycle, Exercise, Therapy, Compliance Strategies, Psycho educational
Approaches
 ECT, Li, Antipsychotics
 Psycho education
 Supportive therapies
a) Psycho analytical psycho therapy
b) Behaviour Therapy
c) Group Therapy
d) Family and marital therapy

26. Mrs. Thahir Noorul Isra (M.Phil PSW-R) Dip: Coun, HR.
Rehabilitation Counsellor (Rehabilitation Authority)
Psychiatric Social Worker
Palliative Care Activist
Email: israanas@gmail.com