Mood Disorders
Mood disorders,
also known as mood dysregulation,
are one of a group of neurobiological disorders that are poorly
understood. It is not completely understood why the number of
those diagnosed with a mood disorder has been on the increase since the
end of World War II. It is also not completely understood why
the
age of onset of these disorders has been lowering from early adulthood
to ages as young as 3 years. Terms such as "Manic-Depression"
and
"Bipolar Disorder" are rather scary expressions that may bring up
images of crazed individuals, as in the term "manic". Both of
these terms were conceived poorly and during a time when it was
in-vogue to paint a picture of individuals with "mental problems" as
somehow threatening. These individuals appeared threatening
and
scary only due to ignorance.
Connection
with Substance Abuse
What we now
know is that Mood Disorders belong to a
group of inherited conditions that tend to run in families and take
many different forms. For example, it is hypothesized that a
great many of those with the label of "alcoholic" are in fact
self-medicating individuals attempting to relieve the anxiety they
carry. Their mood swings are difficult to manage and alcohol
is
one attempt to deal with this. It is said that the
"inadvertent
addict" is one who inadvertently becomes addicted to alcohol or another
substance while in the process of self-medicating an unrecognized,
undiagnosed mood disorder.
Mood
Dysregulation
The term "mood
dysregulation" has been used more and
more as of late. What this attempts to describe is the
inability
to handle and control changes in mood. These are not subtle
changes, but rather large swings in mood. For example, if a
parent tells a child that does not have this problem to stop watching a
video game and take out the trash, there may be some mild grumbling,
but the trash is taken out. The child that cannot handle the
shift will become very angry, throwing things, crying, and having a
temper tantrum of "biblical proportions". This response is so
clearly outside the norm for the appropriate response as to raise the
red flag. The child's response to mood dysregulation is quite
different to those seen in adults. It must also be understood
that not all children that display these types of behaviors have
"Bipolar Disorder".
Manic-Depression
(Bipolar Disorder)
What
is more clearly understood by some is the
term Manic-Depression. This is understood as the inability to
control the swings of mood between feeling way too good and "high", to
the plunge into depression and feeling as if life is not worth
living. These swings are the result of what some have called
an
"angry brain". This is a brain that has way too much activity
taking place in areas that should be quieter.
Break
the Stigma
What all of
this signifies is that mood
dysregulation is not a condition of morality, character, upbringing, or
parenting. This is the result of a neurobiological, genetic,
inherited condition that can be treated. While some of the
medications may have side effects, the side effects of untreated
Bipolar Disorder can be disastrous. Recently, celebrities
such as
Patty Duke, Jane Pauley, Jonathan Winters, and others who have waged
battles with "mood dysregulation" or "Bipolar Disorder" have come out
publicly with stories of their illness and how treatment has allowed
them to continue with more normal lives. Their examples
should
encourage others to learn how to make sense of this illness, how to
treat it, and how to find help. Diablo Behavioral HealthCare
would like to recognize Dave Kahler, current president of NAMI of
Contra Costa County and Chet Watson, also of NAMI, who have worked
tirelessly to attempt to bring attention to the stigma that those in
recovery from these types of illnesses endure. Diablo
Behavioral
HealthCare also encourages anyone reading this website to contact and
join NAMI for further information. A link for this
organization
can be found under our Resources
Page.
Depression
in Adolescence
When is it
hormones, and when is it normal teenage
behavior? This is a question that arises over and over for us
as
parents and as healthcare professionals. A few basic
guidelines
may be helpful. Behavioral changes are a normal part of
growing
up. The pulling away from the family unit and the beginning
to
assert independence is a normal developmental milestone. However, when
the behavior is more extreme and the parents feel that all is not well,
it is a good time to think of a brief consult with a behavioral
specialist, if for nothing more than relieving your own
concerns.
Several signs can point to a possible onset of emotional difficulties:
when the teen shows dramatic changes in mood, shifts in friendship
groups, use of drugs or alcohol, and a significant move toward
isolating themselves from the family. Another example of those teens at
an increased risk are students that have done very well academically
but have begun to show a drastic lowering of grades. Another
known risk factor is the family history of any depression among blood
relatives. The overly perfectionistic teen is also seen at an
increased risk due to their lowered coping skills when events unfold
that challenge their preconceived notion of how things are supposed to
be. This is especially true of the first year or so of
college,
when a student that may have had nothing but a 4.0 grade point average
in high school is now faced with the rigors of college and the
realization that they are no longer the best at everything they
attempt. If you have a question about your child or teen,
contact
DBH for professional assistance.
Anti-Depressant
Warnings
Recently in the
news there has been a great deal of
press on the dangers of antidepressant medications. While
this
was primarily directed at the topic of their use in children and
adolescents, there is ample evidence to suggest that the same concerns
lie with adults as well. Often, due to a limited history and
when
an individual is experiencing depressive feelings, the first thought is
to prescribe an antidepressant. We have all heard their
names,
such as Prozac, Paxil, Zoloft, Effexor, and several others.
Now,
while they are all good medications when taken for the right reasons,
they can be very wrong if the individual taking them has a mood
disorder related to a family history of Bipolar disorder.
These
are the people that report feeling as they want to jump out of their
skin, feel very agitated and nervous, and have increased difficulty
sleeping and a number of other symptoms.
Activation
Phenomena
This response
is known as the "activation
phenomena".
What this is a clue to is, that instead of having a more common
depression, the person may be experiencing a type of bipolar
depression, even with no prior history of this disorder. This
is
when the clinician involved needs to be a detective. If the
patient with the adverse reaction to an antidepressant has any blood
relatives with a history of multiple marriages, alcoholism,
incarcerations, violence, and several other symptoms, the statistical
probability that they have a "mood
disorder" related to Bipolar is much
higher. This also means that the use of antidepressants as a
first line treatment is probably the wrong approach. More
often
than not, the use of a mood stabilizer will be used before dealing with
the depressive symptoms.
Thorough
Evaluation
A thorough
evaluation will almost always prevent the
unfortunate adverse response to typical antidepressants. This
is
the reason that at Diablo Behavioral HealthCare we begin with a two
hour initial evaluation, followed by a two hour initial medical
evaluation to thoroughly understand our patients before administering
any medications. We want to be as careful with our patients
as
you would want us to be with yourself or your family member.
Treatment
If you suspect that you or a loved one
are affected by a behavioral disorder, contact a qualified behavioral
healthcare professlonal.
