A mood disorder is classified in the Diagnostic and Statistical Manual of Mental Disorders as a disorder in which a significant disturbance in the mood of the patient is the main underlying feature. Mood disorders typically fall into three main categories: elevated mood, depressed mood, and a combination of the two. The most common type of elevated mood disorder is mania or hypomania, the most common type of depressed mood disorder is major depressive disorder, and as far as a combination of mania and depression, bipolar disorder is by far the most prevalent. There are several subtypes of depressive disorder, and psychiatric syndromes which feature less intense psychological symptoms, such as dysthymic disorder (similar to major depressive disorder, but overall less severe), and cyclothymic disorder (similar to bipolar disorder, but again, less severe).
Mood disorders may occur in response to a pre-existing medical condition, or they may be substance-induced. For example, consuming excessive amounts of alcohol over a prolonged period of time may eventually result in nervous system depression, leading to chemical changes within the brain that cause a depressive disorder. Alcohol is a depressant, and repeated abuse can lead to lasting biochemical damage.
Types of Mood Disorder
Let us take a closer look at the three main types of mood disorder.
It is completely normal to suffer from bad days every once in a while. We may wake up on the wrong side of the bed, and feel gloomy and blue all day for no apparent reason. However, for many of us, these infrequent low periods will come and go quickly and naturally, and we will soon begin feelings like ourselves again. For those who are suffering from a depressive disorder, however, emotional low periods do not simply subside on their own. Clinical depression is a very serious mental disorder – one that can result in severe and lasting consequences for the afflicted individual and his or her loved ones.
There are numerous types of depressive disorder, ranging from seasonal affective disorder and post-partum depression to psychotic major depression and depressive personality disorder. Major depressive disorder is the most commonly occurring type of depression, especially amongst addicts and alcoholics. According to The Anxiety and Depression Association of America (ADAA), roughly 20 percent of individuals who are afflicted with a depressive disorder simultaneously suffer from a substance abuse or dependency disorder. Compared to members of the general population, individuals who are addicted to drugs or alcohol are more than twice as likely to suffer from a mood disorder such as depression, reported the National Institute on Drug Abuse (NIDA). When it comes to substance abuse and depression, it is often quite difficult to determine which came first. Many individuals who live with undiagnosed and untreated depressive disorders will eventually turn to chemical substance in order to help alleviate uncomfortable psychological symptoms, such as suicidal ideation and emotional detachment. Both conditions share certain triggers. Some of the potential connections between substance abuse and depression include:
- Early environment
- Developmental disorders
- Brain chemistry
It is important to note that environmental factors, such as recurring trauma or stress, are well-known in causing both addiction and depression. We at Next Chapter understand the importance of this link, and work to resolve underlying traumatic experiences in attempts to heal both mental disorders and substance abuse issues. Early in life, children undergo a constant process of discovery. They seek gratification, and develop effectively in a loving, nurturing, and supportive environment. When this process of discovery is interrupted, children may experience a clinical manifestation of depression. They begin believing that what they think and feel is wrong and bad, and when they grow up, they begin feeding this deeply rooted negativity with chemical substance (while initially attempting to self-medicate). For more information on the link between depression, trauma, and substance abuse, read our blog post HERE.
Mania (Elevated Mood)
Mania is a relatively uncommon mood disorder, and many individuals who experience mania remain relatively unaware of it. In most instances, manic episodes will pass undetected. The individual who is experienced mania will feel energized and motivated – usually relatively normal. Mania often goes unnoticed because it turns down the frontal lobes of our brains – the portion of our brains involved in self-awareness. Mania feels good to those who are experiencing it, because it allows them to be free from self-doubt and self-consciousness. Unfortunately, those who are in this state will often engage in self-destructive behavior, acting impulsively, failing to learn from mistakes, and constantly jumping in and out of relationships.
While most manic episodes will begin with lasting energy, high confidence, and increased creativity, the good feelings will typically only last for a few days. Eventually, the mania sufferer will be left feeling anxious, short-tempered, and agitated. Because of increased impulsivity coupled with uncomfortable psychological symptoms, drug and alcohol abuse is not uncommon amongst mania sufferers. Because mania is such common fuel for addiction, many sufferers will also begin engaging in behavioral addictions, such as compulsive gambling, sex, excessive spending, or overeating.
While mania, by itself, is relatively uncommon, a combination of mania and depression, known as bipolar disorder, is an extremely common diagnosis amongst addicts and alcoholics.
Bipolar disorder, also known as Manic-Depressive Disorder or Manic Depression, is described as an unstable mental condition characterized by cycles of abnormally elevated mood swings (mania) followed by very low mood swings (depression). A recent study concluded that 56 percent of individuals who had been professionally diagnosed with bipolar disorder suffered from some degree of substance abuse disorder at one point or another. Roughly 46 percent of this group of individuals had actively abused alcohol for a prolonged period of time, or was, at the time of the study, struggling to overcome an alcohol abuse disorder. 41 percent had abused drugs or were addicted to drugs. As with any dual diagnosis disorder, those afflicted with an addictive disorder as well as bipolar disorder may find entering into recovery to be significantly more challenging. However, comprehensive and long-term recovery is entirely possible, so long as both disorders are treated concurrently.
Individuals who are afflicted with bipolar disorder will experience radical changes in mood, behavior, and energy levels on a regular basis. Episodes may last for days, weeks, or months at a time. They may occur as frequently as every few weeks, or as seldom as only one or two times per year. There are many proposed causal factors for bipolar disorder. Chemical imbalances within the brain have been shown to contribute to this specific mental disorder, and genetic predisposition is highly common in sufferers. Growing up in a traumatic environment has also proven to be a significant risk factor for bipolar disorder. This disorder often leads to a slew of external consequences, such as financial hardship, strained interpersonal relationships, legal troubles, addiction, and suicide.
There are four main types of episode that an individual who is afflicted with bipolar disorder may undergo:
Manic episodes tend to last a week or more, and may require hospitalization depending on severity. Manic episodes may cause excessive cheerfulness or hostility. Energy levels will spike, and the afflicted individual may appear irrational, overzealous, and impulsive. He or she may be over-confident, extremely talkative, and remain fixated on a specific personal goal. The need for sleep may decrease significantly, and so might eating and personal care patterns.
Hypomanic episodes are shorter and less severe than manic episodes, usually lasting about 4 days to one week.
In order to meet the clinical definition of a major depressive episode, symptoms will need to last about 2 weeks. Often, they last for several months, and include a disinterest in previously enjoyed activities, an increased desire to sleep and isolate, and feelings of hopelessness, despondency, and self-loathing. It may become more difficult for the afflicted individual to take care of him or herself – more difficult to eat, practice self-care, or concentrate on achieving personal goals.
Mixed episodes include a combination of the symptoms characterized by the three aforementioned episodes – manic, hypomanic, and major depressive.
The DSM-V separates bipolar disorder into two distinctive categories – bipolar I and bipolar II. Individuals who suffer from bipolar I will experience more frequent manic and mixed episodes, followed by a major depressive episode. Those with bipolar II will have one or more major depressive episode, which will then be followed by a hypomanic episode. In most cases, bipolar I proves to be more severe, and will cause more long-term damage if left untreated for an extended period of time. It is extremely common for those with both classifications of bipolar disorder to begin abusing drugs and alcohol in attempts to alleviate uncomfortable psychological symptoms. Those who are experiencing a major depressive episode may be more inclined to abuse alcohol, and those who are manic or hypomanic episodes, and thus more prone to impulsivity and risk taking, are more likely to begin abusing drugs. At first, chemical substances seem to alleviate these symptoms – however, excessive and long-term use will only work to exacerbate and worsen the disorder.
Substance-Induced Mood Disorders
A mood disorder may be classified as substance-induced if persistent symptoms can be traced to the direct physiologic effects of a psychoactive drug or other chemical substance. Or, if the symptoms of the particular mood disorder began to occur during the withdrawal process, or during intoxication. Most substances can induce a variety of mood disorders, ranging from depression to mania and mixed episodes. Some chemical substances are more likely to induce manic episodes, however, while others are more likely to induce depressive episodes. For example, methamphetamine is known for causing users to enter into manic states. Alcohol, on the other hand, frequently causes depressed states in long-term users. In fact, extremely high rates of major depressive disorder occur in long-term alcohol abusers and in alcoholics. Several studies reveal that continuous alcohol misuse in fact results in depressive disorders, and that high rates of suicide and attempted suicide were prevalent amongst long-time alcoholics. Prolonged substance abuse has also been shown to lead to bipolar disorder in some cases.
It is important to remember that even if substance abuse does not result in a diagnosable mental disorder, continued abuse will inevitably lead to physical changes within the brain. The reward system is harshly altered, and seeking, obtaining, and using drugs and alcohol becomes compulsive and uncontrollable. Chemical substances also rewire certain parts of the brain that are directly linked to mood and behavior. Mood disorders, like all other psychological disorders, must be treated alongside chemical dependency in order for long-term recovery to be achieved – regardless of whether they originated in early childhood or were caused by excessive and continuous substance misuse. For more information on mood disorders and substance dependency, please feel free to contact us today.