Mood Disorders

Mood Episodes

                Major Depressive Episode – 5 or more of the following for the same 2 week period (and not due to bereavement):

-                      Depressed mood most of the day, almost every day, by report of client or others

-                      Diminished interest or pleasure in all or nearly all activities most of the day, almost every day

-                      Significant weight loss when not dieting or weight gain

-                      Insomnia or hypersomnia almost every day

-                      Psychomotor agitation or retardation nearly every day

-                      Fatigue or loss of energy nearly every day

-                      Feelings of worthlessness or excessive or inappropriate guilt nearly every day

-                      Diminished ability to think or concentrate or indecisiveness nearly every day

-                      Recurrent thoughts of death, recurrent suicidal ideation w/o a specific plan or suicide attempt or plan for committing suicide

Manic Episode -  abnormally and consistent elevated, expansive, or irritable mood for at least 1 week with 3+ (or 4+ if mood is irritable) of the following

-                      Inflated self-esteem/grandiosity

-                      Decreased need for sleep

-                      More talkative than usual

-                      Flight of ideas/subjective experience that thoughts are racing

-                      Distractibility

-                      Increase in goal-directed activity

-                      Excessive involvement in pleasurable activities that have painful consequences

Mixed Episode – period of at least 1 week with criteria met for both manic episode and major depressive episode every day resulting in reapidly alternating moods

Hypomanic Episode – similar to manic episode except it last for at least 4 days and there cannot be any hallucinations.

Depressive Disorders:

                Characterized by sadness, irritability, lack of energy or interest in life, slowed movements, pessimism, feelings of worthlessness, guilt, morbid thinking, and changes in patterns of eating and sleeping. Can result in suicide ideations, attempts, or completion.  Typical feelings of sadness will disappear over time but depression has a more prolonged experience (unless Major Depressive Episode).

MDD has 5 or more of the following without a mix of mania (bipolar) or due to bereavement/grief:

-          Depressed mood most of the day, almost every day, by report of client or others

-          Diminished interest or pleasure in all or nearly all activities most of the day, almost every day

-          Significant weight loss when not dieting or weight gain

-          Insomnia or hypersomnia almost every day

-          Psychomotor agitation or retardation nearly every day

-          Fatigue or loss of energy nearly every day

-          Feelings of worthlessness or excessive or inappropriate guilt nearly every day

-          Diminished ability to think or concentrate or indecisiveness nearly every day

-          Recurrent thoughts of death, recurrent suicidal ideation w/o a specific plan or suicide attempt or plan for committing suicide

MDD can be single episode or recurrent (multiple episode but W/O mania in between). MDD can also exist with psychotic symptoms and if there are psychotic symptoms present, one must complete a differential diagnosis to make sure that one of the psychotic disorders does not better fit client’s symptoms.

Dysthymic Disorder – chronically depressed mood that occurs for most of the day and most days within at least 2 years with 2 of following: poor appetite/overeating, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hopelessness

Depressive d/o NOS – doesn’t meet full criteria for Major Depressive d/o such as premenstrual dysphoric d/c or minor depressive d/o

Bipolar D/o’s:

Bipolar I D/o –

Single manic episode – only one manic episode and no hx of Major Depressive Episodes

                Specifiers:           Mild, Moderate, Severe

With/Without psychotic features

With Catatonic Features

with Postpartum Onset

Most Recent Episode Hypomanic – currently or just came out of a hypomanic episode and there has previously been at least one manic or mixed episode

                Specifiers:          

Longitudinal course Specifiers (with and w/o Interepisode Recovery)

With Seasonal Pattern (applies to pattern of Major Depressive Episode)

With Rapid Cycling

Most Recent Episode Manic – currently or just came out of a manic episode and there has been at least one Major Depressive Episode or Mixed Episode

                Specifiers:           Mild, Moderate, Severe

                                with/without Psychotic Features

                                with Catatonic Features

                                With Postpartum onset

Longitudinal course Specifiers (with and w/o Interepisode Recovery)

With Seasonal Pattern (applies to pattern of Major Depressive Episode)

With Rapid Cycling

                                Most Recent Episode Mixed – must previously have had at least one Major Depressive, or Manic, or Mixed Episode. Specifiers same as Most Recent Episode Manic

                                Most Recent Episode Depressed – must have previous Manic or Mixed Episode.

                Specifiers:           Mild, Moderate, Severe

                                                                with/without Psychotic Features

                                                                Chronic

                                with Catatonic Features

                                With Melancholic Features

                                With Atypical Features

                                With Postpartum onset

Longitudinal course Specifiers (with and w/o Interepisode Recovery)

With Seasonal Pattern (applies to pattern of Major Depressive Episode)

With Rapid Cycling

                                Most Recent Episode Unspecified – criteria met but not duration

Bipolar II d/o – the biggest difference is that one experiences no manic episodes but has one or more Major Depressive Episodes and at least one Hypomanic Episode (do not confuse with nondepressed state)

Cyclothymic Disorder – cycling of hypomanic symptoms (but not full criteria for Hypomanic Episode) and depressive symptoms (but not full criteria for Major Depressive Episode) for 2 years

Bipolar d/o NOS – can included very rapid alternation that meet symptoms for a Mood Episode but not duration; etc

Mood d/o due to gen med condition

Substance-Induced Mood d/o

Mood d/o NOS