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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 is affected by a behavioral disorder, contact a qualified behavioral healthcare professional


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