this is a brief video on mood disorders we're going to be talking about psychiatric mood disorders across the entire Spectrum from low mood to high mood and everything in between we're going to start with this axis that you see here toward the bottom of the screen and we're going to label this axis with low mood on the left neutral mood which is where you want to be in the middle and high mood on the right side this axis is also color coded which will correlate with some of the some of the psychiatric conditions that we're going to talk about and you'll be able to see where they mostly fit in on the axis let's begin with the low mood side of the axis depression largely makes up this left side of the axis and we're going to be talking about the criteria for the condition major depressive disorder major depressive disorder requires five or more of the following symptoms and one of those symptoms must be either depressed mood or anhedonia the symptoms are listed as follows depressed mood sleep changes interest lost also called anhedonia guilt or worthlessness energy lock reduced concentration appetite changes psychomotor changes that could be psychomotor agitation or psychomotor retardation which is essentially a manifestation of somebody's mood in their physical movements and suicidal ideation or thoughts now this mnemonic Sig e caps can help you remember these criteria and you need at least five of these symptoms and one of the symptoms must be depressed mood or anhedonia in order to be categorized as major depressive disorder these symptoms must last for at least two weeks and they also cannot be attributed to any substances like drugs or any medical conditions there are several medical conditions that can lead to depressive episodes like copper overload and Wilson's disease and hypothyroidism and there are several substances that can make you depressed as well like alcoholism or opioid abuse but major depressive disorder is an organic brain disorder treatment for mood disorder includes Psychotherapy and medications and some classes of medications used for depressive disorder are ssris snris MAO inhibitors and tcas that's selective serotonin reuptake Inhibitors serotonin norepinephrine reuptake Inhibitors monoamine oxidase Inhibitors and tricyclic antidepressants we'll talk about more about those drugs in another video ECT or electroconvulsive therapy is also used in refractory cases for major depressive disorder now let's go to the other side of the spectrum where we have Mania in green Mania is a very high mood somebody's talking all the time they're jumping around much quicker people are all over the place sleep a lot less Mania requires three or more of the following symptoms symptoms are distractibility irresponsibility irritability or impulsiveness grandiosity flight of ideas an increase in activity a decrease in sleep and talkativeness the mnemonic dig fast can be used to help you remember these patient must have these symptoms for at least one week for it to be a manic episode and the manic episode must cause significant impairment in their social lives whether it's distracting them from school from work from their family from their kids or whatever other responsibilities they have it must be significantly impacted and impaired by the Mania again the Mania cannot be attributed to other substances or medical conditions for it to categorize as bipolar and we'll talk about that in a second a little less than Mania a little less High than Mania is hypomania which also requires three of the Dig Fast criteria that we see in Romania but this time the time is reduced for a hypomanic episode you only have to express those symptoms for four days and what makes it different from a manic episode is that there isn't significant impairment so a person might sleep a lot less and have a lot more activity and be very talkative but they're still able to function they're still able to go to work and get their work done and pick up their kids after work they're still able to to have their normal lives they are not significantly impaired so that's kind of the difference between a manic episode and a hypomanic episode and these two fit into the bipolar diseases which we're going to talk about next there's bipolar one and there's bipolar two bipolar 1 requires one episode of mania does not require anything else although it often includes several episodes of hypomania and as and episodes of depression as well bipolar 2 on the other hand requires at least one episode of hypomania and at least one episode of major depression so you can kind of see how bipolar 2 really bounces across the Spectrum going from hypomania to depression whereas bipolar one oftentimes bounces around the Spectrum but it really only requires one manic episode to be categorized as bipolar one so bipolar 2 really does have two poles bipolar one can have two poles but it really only requires that manic episode I think a better name for bipolar one would be Mania disorder or just an episode of mania or recurrent media either way the treatments for bipolar disorder include mood stabilizers that's like lithium and valproic acid or valproate you can also consider Lamotrigine and ketiapine as mood stabilizers and you also want to add an antipsychotic if a person is acutely manic somebody comes into the ER and they have flight of ideas and they're running all over the place and they're very talkative they can't sleep they're not really able to calm down you can add in atypical antipsychotic for acute Mania there are a couple disorders that kind of fall in between in that orange area between depression and hypomania we're going to be talking about those next one of them is cyclothymic disorder this is a person who alternates between periods of hypomania and depression that don't actually meet criteria for hypomania and depression they have some of the symptoms of Dig Fast but not exactly three of them for four days they have some of the symptoms of Sig ecaps but not exactly five of them for two weeks so they kind of Bounce Around they have symptoms from both sides and they don't actually meet criteria for full hypomania and full major depressive disorder this has to last for about two years before it's called cyclothymic disorder a little lower on the Spectrum oh sorry cyclothymic disorder is usually treated with cognitive behavioral therapy and lithium as well as antipsychotics a little lower on the Spectrum a little more left on the spectrum is persistent depressive disorder this was previously called dysthymic disorder this is kind of like a mild depressive episode it requires depressed mood and some of the Ziggy caps symptoms without meeting the full five criteria so you have some of the Siggy caps but you don't have five or more of them for two weeks a person with the persistent depressive disorder has these criteria for over two years and they often are described as Baseline sad they often have just described themselves as having a sad personality or say they're always depressed without actually meeting the criteria for major depressive disorder one key way to differentiate between persistent depressive disorder and major depression is that people with persistent depressive disorder can still enjoy some things they still have interest in some of their activities and they're still things they like to do or people they like to see or places they like to go they can still smile occasionally throughout the day whereas somebody with major depressive disorder is unhappy all the time one and you treat persistent depressive disorder with cognitive behavioral therapies less often you would consider ssris and other antidepressants one more disorder to talk about is adjustment disorder this is when you have symptoms of depression and anxiety for three months for within three months of a stress in your life or another major event in your life these symptoms must start within three months of that stressor and they typically resolve within six months of that stress again an adjustment disorder you don't meet the full criteria for major depressive disorder and you don't meet the full criteria for generalized anxiety or any other anxiety disorder you treat adjustment disorder with supportive therapy you can go see a psychiatrist or a counselor someone to talk to you can also consider medication for some of the symptoms associated with adjustment disorder like insomnia if somebody's unable to sleep or nausea if somebody gets anxious or irritable and start having stomach pains this has been a brief video on mood disorders including major depressive disorder the bipolar disorders cyclothymic disorder persistent depressive disorder and adjustment disorder I hope it was helpful and thank you for listening