Mood disorders are characterized by disturbances in emotional and behavioral responses ranging from elation to depression. They include depressive disorders like major depression and dysthymia, as well as bipolar disorders characterized by episodes of mania and depression. Potential causes include genetic and biological factors. Management involves psychopharmacological treatment with mood stabilizers or antidepressants, as well as nursing care, psychotherapy, and electroconvulsive therapy.

1. By
Mr. Vincent Ejakait
MOOD
DISORDERS

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MOOD DISORDERS
•A group of psychiatric diagnoses characterized by
disturbances in emotional and behavioral response
patterns ranging from elation and agitation to
extreme depression and a serious potential for
suicide.
•Group of disorders characterized by a decreased or
entire loss of control over mood
•The mood disturbance may occur in different
patterns of severity, duration, alone or in
combination

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COMMON ETIOLOGICAL THEORIES OF MOOD
DISORDERS
1) Genetic Theory
• If one parent has a bipolar disorder, there is 25% chance of transmission to
the child
2) Aggression Turned Inward Theory
• Overdeveloped superego leads to depression
3) Psychoanalytic Theory
• Mania is a defense against an underlying depression
• Depression is due to a rigid superego
4) Biologic Factor
• Mania is related to increased norepinephrine while depression is related
to low norepinephrine

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COMMON PRECIPITATING FACTORS OF MOOD
DISORDERS
Loss of a loved one
Major life events
Roles strain
Decreased coping resources
Physiological changes

5. MOOD EPISODES
These are mood problems that occur over a short period of time and which
ultimately form the Mood disorders
Major Depressive
Episodes
Characterized by persistent
sadness often associated with
somatic symptoms e.g weight loss,
insomia
 Manic Episodes
Characterized by atleast 1 week of
abnormally and persistently
elevated, expansive or irritable
mood.
Hypomanic Episodes
Atleast 4 days of abnormally and
persistently elevated or irritable
mood. Less severe than mania
 Mixed Episodes
Patient meets criteria for both at
least one week of having rapidly
shifting moods

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Classification of Mood Disorders
•There are 3 main types of mood disorders:
Depressive disorders
Bipolar Disorders
Other Mood Disorders

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1. DEPRESSIVE DISORDERS
Depressive disorders are further divided into:
Major Depression
Dysthymic Depression
Depression Not Otherwise Specified

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MAJOR DEPRESSION
Severe depression which lasts for at least 2
weeks during which the person experiences a
depressed mood or loss of pleasure in nearly all
activities.
In addition, four of the following symptoms are
present:
Changes in appetite or weight
Changes in sleep
Changes in psychomotor activity
Decreased energy
Feelings of worthlessness or guilt
Difficulty thinking, concentrating or making decisions
Recurrent thoughts of death or suicidal ideation, plans, or attempts.

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DYSTHYMIC DEPRESSION
It is less severe than major depression
It is characterized by at least 2 years of depressed
mood for more days than not with some additional
less severe symptoms that do not meet the criteria
for a major depressive episode
OTHER DEPPRESION
Depression that lasts for 2 days to 2 weeks

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2. BIPOLAR DISORDERS
Bipolar mood disorders, earlier known as Manic
Depressive Psychosis (MDP), is characterized by
recurrent episodes of Mania and depression in the
same patient at different times.
These episodes can occur in any sequence. Bipolar
mood disorder is classified into:
Bipolar I
Bipolar II

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BIPOLAR I
Characterized by episodes of Severe Mania and
Severe Depression.
With history of mania
The patient exhibits:
Manic episodes
Periods of normal behavior
Periods of profound depression

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BIPOLAR II
Characterized by episodes of hypomania and sever
depression
No history of mania
The patient exhibits:
Depression
Normal behavior
At least one hypomanic episode, but NOT manic

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3. Other Mood Disorders
This category includes the diagnosis of mixed
affective episodes. In this type, depression and
mania is present either at the same time
intermixed or alternates rapidly with each
other.

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DIFFERENCE BETWEEN MANIA AND DEPRESSION
MANIA DEPRESSION
Appearance Colorful Sad
Behavior Highly driven,
Hyperactive
Passivity
Psychomotor
retardation
Communication Talkative (Flight
of Ideas)
Monotonous
speech
Nursing Diagnosis Risk for injury
directed at others
Risk for injury:
Self-directed
Nursing Care
Priority
Safety Safety

15. Management of Mania
•The management of Mania is collaborative and
no single management can fully manage the
manic patient:
Psychopharmacological management
Nursing management
Psychotherapy

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Psychopharmacological Management
•In manic patients MOOD STABILISERS are the
medication of choice:
Mood stabilizers ;
e.g Lithium Carbonate
Anticonvulsants;
used as mood stabilizers in this context
Mode of action
They act by blocking the excitatory neurotransmitters therefore reducing
the mania

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Nursing management
• Provide for client’s physical safety and safety of those around
the client
• Set limits on client’s behavior when needed and remind client to
respect distances between self and others.
• Use short simple sentences to communicate
• Keep channels of communication open with clients, regardless
of speech patterns (pressured, rapid, circumstantial, rhyming,
noisy or intrusive with flight of ideas)
• Frequently provide foods that are high in calories and protein
• Promote rest and sleep by decreasing environmental
stimulation
• Protect the client’s dignity when inappropriate behavior occurs

18. Psychotherapy management
Psychoanalysis
Behaviour therapy
Group therapy
Music therapy
Occupational therapy
Sport therapy
Family therapy
Spiritual therapy
etc

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REVIEW OF MAJOR SYMPTOMS OF DEPRESSIVE
DISORDER
Depressed mood
Anhedonism (decreased attention to and enjoyment
from previously pleasurable activities)
Unintentional weight change of 5% or more in a
month
Change in sleep pattern
Agitation or psychomotor retardation
Tiredness
Worthlessness or guilt inappropriate to the situation
(possibly delusional)

20. Management of Major Depression
•The management of depression is collaborative and
no single management can fully manage the
depressed patient:
Psychopharmacological management
Nursing management
Psychotherapy
Electroconvulsive therapy

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Psychopharmacological management
Here we use ANTIDEPRESSANT medication:
Antidepressants are classified into 3 main types:
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAO Inhibitors)
Selective serotonin reuptake inhibitors (SSRIs)
NB: You should be able to give an example of a drug in each
category

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Nursing management
Provide for safety of the client and others
Begin a therapeutic relationship by spending non-
demanding time with the client
Promote completion of activities of daily living by
assisting the client only as necessary
Establish adequate nutrition and hydration
Promote rest and sleep
Encourage the client to verbalize and describe
emotions

23. Psychotherapy management
Psychoanalysis
Behaviour therapy
Group therapy
Music therapy
Occupational therapy
Sport therapy
Family therapy
Spiritual therapy
etc

24. Electroconvulsive therapy
Involves application of electrodes to the head of the
client to deliver an electrical impulse to the brain; this
causes a seizure
It is believed that the shock stimulates brain chemistry
to correct the chemical imbalance of depression
Make sure you do the pre-ECT preparation to the patient
You should also be aware of the contraindications for
ECT