Diagnosis and Associated Issues Mood changes
The mood changes of depression and mania are discussed below. Psychosis can related to mood changes in various ways. For example, psychosis could be part of a major depression. Alternatively, people could become depressed as a reaction to knowing they have developed psychosis. Mood changes should be discussed with the treatment team so they can be addressed.
Most people have experienced a depressed mood at some time in their lives. It is a normal reaction to disappointment or loss and lasts for hours, or days but gradually disappears.
The line between a depressed mood and a diagnosis of Major Depression is crossed when the person suffers five or more symptoms of depression for more than two weeks; the symptoms are more severe, and they impair the person's ability to function.
Some of the symptoms of depression are:
- mood is "down", "depressed" or "blue"
- large decrease in pleasure or interest in things
- sleep problems (insomnia or sleeping too much)
- the person appears agitated or slowed down
- extreme fatigue or loss of energy
- rapid unintentional weight loss or weight gain
- feeling worthless or excessive inappropriate guilt
- problems concentrating or thinking, extreme indecisiveness
- thoughts of dying or committing suicide
The exact cause is not known and there is no laboratory test that can reliably diagnose Major Depression. The biological changes associated with Major Depression are still under investigation.
There are very effective and well researched treatments for depression. Both talking therapies and biological therapies such as medication have been shown to be effective. Social support from family and friends is also important.
Mania refers to a period when a person experiences an abnormally up or irritable mood and also has significantly increased energy or activity most of the day for at least a week and causes impairment.
Hypomania is considered a milder version that lasts four days but is not severe enough to impair the person or need hospitalization.
A person in a manic state can appear to be overly positive, excited about life and feeling euphoric.
People without this disorder often think that mania sounds like fun. It is true that mild mania may be fun, because it is so energizing and may lead to periods of highly productive activity, however, mania often includes agitation, anxiety, extreme irritability, or self-destructive feelings or actions.
Some of the symptoms of mania include:
- an inflated self-importance and self-confidence
- a decreased need for sleep
- more talkative or feels pressured inside to keep talking
- having racing thoughts or rapidly switching ideas
- easily distracted
- Increased goal directed activity (e.g. at work, sexually etc)
- Increased activity that could have negative consequences (buying sprees, sexual sprees)
- Psychosis – especially delusions, may accompany mania
The best way to help a person suffering from mania is to be aware of the signs and struggles involved with mania, and encourage the person to seek help. Lithium and other medications are very useful in ending a manic episode and preventing relapses. Research on social and psychological supports and therapies show they are also effective in helping a person maintain their life and prevent relapse and shorten episodes.