Mental disorder is a group of conditions where a disturbance in the person’s mood is the main underlying feature
Causes of Mood Disorders
– Genetic Factors have some role in bipolar disorder.
– Environmental factors like
- Loss of mother before age 11
- 3 or more children under 14 living at home
- Lack of confiding relationship
- Lack of employment etc are known to play a significant role in mood disorders.
– Physical Illness –
- A physical illness can be followed by depression, esp. those like cancer, AIDS, and heart diseases etc which carry serious implications. Also mood changes can occur after infectious mononucleosis or influenza and other viral illness.
- Depression or mania could be the presenting feature of cerbrovascular disease, neurological disorders such as multiple sclerosis, Parkinsonism and endocrine diseases such as Cushing’s syndrome, Addison’s Disease, and hypothyroidism.
- Mood changes can also be associated with drug therapy, for eg. corticosteroids, beta-adrenoceptor antagonists and other anti-hypertensive drugs. When mood disorder results directly from physical causes they are known as organc affective disorders.
– Personality – Some depressives have personality characteristics which are thought to predispose to the illness. this involves a negative attitude to oneself, the outside world and the future; the term ‘cognitive triad’ ha been applied to these attitudes.
Symptoms of mood disorders
- Depression of mood is the primary symptom. There may be a diurnal variation of mood, depression being most distressing early in the morning or at the end of the day.
- Loss of pleasure in life (anhedonia)
- Loss of interest in oneself and others
- Low self esteem
- Self blame
- Suicidal thinking
- Feeling of guilt and worthlessness
- Sleep disturbance (initial insomnia, early morning wakening or hypersomnia)
- Poor concentration
- Headache and other pains
- Anorexia (loss of appetite)
- Weight changes
- Reduced libido
- Sense of well being evident as elation or ecstasy
- Confidence and self-esteem are high
- Grandiose ideas without any substance.
- Thoughtless and risky behavior
- Delusion of being especially gifted or of being well-connected.
- Thoughts come rapidly
- Speech is fast
- Physical activity is increased
- Appetite is initially increased but may be decreased later.
- Sleep hours are reduced, but this does not cause fatigue.
- Promiscuity may occur.
All these symptoms may not be present in any single person and the level of intensity of symptoms vary from person to person.
Classification of Mood disorders
Mood disorders are classified as per the diagnostic criteria mentioned in DSM. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) explains standard criteria for the classification of mental disorders. The DSM is now in its fifth edition, the DSM-5, published on May 18, 2013. There are following types of mood disorders –
- Depressive disorders
- Bipolar disorders
- Substance-induced mood disorders
- mood disorders due to another medical condition
Commonly called major depression
Depressive disorders are further classified as –
- Atypical depression (AD) is characterized by mood reactivity (paradoxical anhedonia) and positivity, significant weight gain or increased appetite (“comfort eating”), excessive sleep or somnolence (hypersomnia), a sensation of heaviness in limbs known as leaden paralysis, and significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection.
- Melancholic depression is characterized by a loss of pleasure (anhedonia) in most or all activities, a failure of reactivity to pleasurable stimuli.
- Psychotic major depression (PMD- patient experiences psychotic symptoms such as delusions or, less commonly, hallucinations.
- Catatonic depression is a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. Here, the person is mute and almost stuporose, and either is immobile or exhibits purposeless or even bizarre movements.
- Postpartum depression (PPD)it refers to the intense, sustained and sometimes disabling depression experienced by women after giving birth. Postpartum depression, which affects 10–15% of women, typically sets in within three months of labor, and lasts as long as three months.
- Premenstrual dysphoric disorder (PMDD) is a severe and disabling form of premenstrual syndrome affecting 3–8% of menstruating women.
- Seasonal affective disorder (SAD), also known as “winter depression” or “winter blues”, is a specifier. Some people have a seasonal pattern, with depressive episodes coming on in the autumn or winter, and resolving in spring.
- Double depression can be defined as a fairly depressed mood (dysthymia) that lasts for at least two years and is punctuated by periods of major depression.
- Depressive personality disorder (DPD) is a controversial psychiatric diagnosis that denotes a personality disorder with depressive features.
- Recurrent brief depression (RBD), distinguished from major depressive disorder primarily by differences in duration. People with RBD have depressive episodes about once per month, with individual episodes lasting less than two weeks and typically less than 2–3 days.
- Minor depressive disorder, or simply minor depression, which refers to a depression that does not meet full criteria for major depression but in which at least two symptoms are present for two weeks
Bipolar disorder (BD) (also called Manic Depression or Manic-Depressive Disorder), an unstable emotional condition characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression)
- Bipolar I is distinguished by the presence or history of one or more manic episodes or mixed episodes with or without major depressive episodes. A depressive episode is not required for the diagnosis of Bipolar I Disorder, but depressive episodes are usually part of the course of the illness.
- Bipolar II consisting of recurrent intermittent hypomanic and depressive episodes or mixed episodes.
- Cyclothymia is a form of bipolar disorder, consisting of recurrent hypomanic and dysthymic episodes, but no full manic episodes or full major depressive episodes.
- Bipolar Disorder Not Otherwise Specified (BD-NOS), sometimes called “sub-threshold” bipolar, indicates that the patient has some symptoms in the bipolar spectrum (e.g., manic and depressive symptoms) but does not fully qualify for any of the three formal bipolar DSM-IV diagnoses mentioned above.
Substance-induced mood disorders
A mood disorder can be classified as substance-induced if its etiology can be traced to the direct physiologic effects of a psychoactive drug or other chemical substance, or if the development of the mood disorder occurred contemporaneously with substance intoxication or withdrawal. Also, an individual may have a mood disorder coexisting with a substance abuse disorder
- Alcohol-induced – High rates of major depressive disorder occur in heavy drinkers and those with alcoholism.
- Benzodiazepine-induced- Benzodiazepines, such as alprazolam, clonazepam, lorazepam and diazepam, can cause both depression and mania.
Mood disorders due to another medical condition
“Mood disorder due to a general medical condition” is used to describe manic or depressive episodes which occur secondary to a medical condition. There are many medical conditions that can trigger mood episodes, including neurological disorders (e.g. dementias), metabolic disorders (e.g. electrolyte disturbances), gastrointestinal diseases (e.g. cirrhosis), endocrine disease (e.g. thyroid abnormalities), cardiovascular disease (e.g. heart attack), pulmonary disease (e.g. chronic obstructive pulmonary disease), cancer, and autoimmune diseases .
Conventional treatment for Mood disorders
Treatment consist of two parts-
- Medicinal treatment
- Mood stabilizers
- Behaviour therapy
- Cognitive behaviour therapy
- Interpersonal therapy
Homeopathy Treatment & Homeopathic Remedies for Mood disorders
Homeopathy offers very good treatment possibilities for mood disorders with good results. There are large numbers of medicines which can be used and the selection of medicine depends not just on the symptoms but also on the cause. Mood disorders are manifestation of various disorder and to treat the manifestation it is necessary to find the cause. The success of treatment in such cases often depends on the ability of a homeopath to find the cause. The selection of medicine depends a lot on it. Like all psychological disorders, depressive illness also requires good case study and continuous monitoring by a competent homeopath. One should not try any form of self-medication. In qualified and experienced hands homeopathy offers good prognosis in this condition.
Some of the commonly indicated medicines are
- Kali brom
Fixed ideas. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Brain-fag. Impaired memory. Absent mindedness. Very easily offended. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious (Hyos). Clairaudient, hears voices far away or of the dead. Weak digestion, with fullness and distention. Empty feeling in stomach. Eructation, nausea, vomiting. Eating relieves the Anacardium dyspepsia. Apt to choke when eating or drinking. Swallows food and drinks hastily.
Feeling of self-condemnation and utter worthlessness. Profound despondency, with increased blood pressure, withSensation as if the heart stopped beating for two or three seconds, immediately followed by a tumultuous rebound, with sinking at the epigastrium. Palpitation. Pulse rapid, feeble, irregular thorough disgust of life, and thoughts of suicide. Talks of committing suicide. Great fear of death. Peevish and vehement at least contradiction. Anthropophobia. Mental derangements. Constant rapid questioning without waiting for reply. Cannot do things fast enough. Oversensitiveness; (Staph) to noise, excitement, confusion. Appetite and thirst increased, with qualmishness. Swelling of epigastrium. Burning at stomach and hot eructations.
Sensitiveness of feeling ; delicate conscientiousness. Fearfulness, timidity. Irresoluteness ; anxious ; to do now this, now that. The slightest contradiction irritates. Intolerance of noise. Taciturn, with continuous sad thoughts ; still, serious melancholy, with moaning. Anger, followed by quiet grief and sorrow. Inclination to grief, without saying anything about it ; keeping it to himself. Great tenderness. Changeable disposition ; jesting and laughing, changing to sadness, with shedding of tears.
Profound, melancholic delusion; feeling of moral deficiency; religious depression; delusions of conspiracies against him. Imagines he is singled out as an object of divine wrath. Loss of memory. Must do something-move about; gets fidgety. Fear of being poisoned. Amnesic aphasia; can pronounce any word told, but cannot speak otherwise. Night terrors. Horrid illusions. Active delirium. General failure of mental power, loss of memory, melancholia, anaesthesia of the mucous membranes, especially of eyes, throat, and skin; acne; loss of sexual desire, paralysis.
Psychic causes of disease; ill effects of grief, fright, anger, etc. Depressed, particularly in chronic diseases. Consolation aggravates. Irritable; gets into a passion about trifles. Awkward, hasty. Wants to be alone to cry. Apprehension for the future. Hypochondriacal, tired of life. Joyless, indifferent, taciturn. Hurriedness. Passionate vehemence ; gets angry at trifles. Difficulty of thinking ; absence of mind, weak memory.
WHAT ELSE CAN I DO? – ACCESSORY MANAGEMENT
- Visit a psychotherapist or join a support group where you can talk about your emotions freely.
- Be more open with your family and friends – do not hide your feelings, share them.
- Try to remain actively involved in some work/job.
- Exercise daily – it not only is good for your body, but also for your mind. Exercise is known to increase the level of many neuro-hormones, which bring a feeling of well-being and happiness.
- Eat a well balanced and nutritious diet with ample fluids.
- Learn some meditation, yoga, or stress relieving exercises. These help a lot in regaining your control over your emotions.
WHERE ELSE TO FIND MORE INFO? – INTERNET RESOURCES
- A short Textbook of Psychiatry, Niral Ahuja, 4th ed, 1999, Jaypee
- Harrison’s Principles of Internal Medicine, 14th ed, McGraw-Hill
- Davidson’s Principles and Practise of Medicine, 17th ed, 1996, Churchill Livingstone
- New Manual of Homeopathic Materia Medica & Repertory, William Boericke, 2nd revised ed., 2001, B. Jain
- A Concise Repertory of Homeopathic Medicines, S.R.Phatak, 3rd ed, B. Jain
- Practical Homeopathic Therapeutics, Dewey, reprint ed, 1993, B.Jain