Mood Disorders Counseling
Mood disorders are characterized by vacillations between high and low mood states. Each mood state presents significant challenges and often, consequences. Counseling or therapy with individuals who have mood disorders involves integrating behaviors, techniques, and interventions to increase balance and mood stability--to turn the peaks and valleys to mere bumps in the road.
What are the 6 mood disorders and their characteristics?
The 6 mood disorders are the following:
Bipolar 1 Disorder
Bipolar 2 Disorder
Cyclothymic Disorder
Substance/Medication-Induced Bipolar and Related Disorder
Bipolar and Related Disorder Due to Another Medical Condition
Unspecified Bipolar and Related Disorder
“Bipolar Disorder can be a great teacher. It’s a challenge, but it can set you up to be able to do almost anything else in your life.”
What are the key features of each mood disorder?
Contrary to common belief, people with Bipolar Disorders do not typically feel amazing one second and terrible the next, nor do they tend to experience constant, dramatic mood swings from instant to instant. Rather, these disorders are most often characterized by distinct high and low mood cycles that occur independently from each other, often lasting weeks at a time.
Bipolar 1 Disorder:
Criteria for a manic episode must be met, including but not limited to the following:
A distinct period, lasting at least 1 week and present most of each day, of abnormal mood elevation, characterized by increased energy or activity.
Symptoms may include grandiosity, decreased need for sleep, increased verbal output, flight of ideas or racing thoughts, distractibility, increased goal-oriented activity, and involvement in high-risk activities.
The mood disturbance is severe enough to cause significant disturbance in social or occupational functioning or to require hospitalization to forestall self or other harm, or psychotic features are present.
The manic episode may be preceded or followed by a hypomanic or major depressive episode (DSM-5, 2013, American Psychiatric Association).
Bipolar 2 Disorder:
Criteria for a hypomanic episode must be met, including but not limited to the following:
A distinct period, lasting at least 4 consecutive and present most of each day, of abnormal mood elevation, characterized by increased energy or activity.
Symptoms may include grandiosity, decreased need for sleep, increased verbal output, flight of ideas of racing thoughts, distractibility, increased goal-oriented activity, and involvement in high-risk activities.
The episode is not severe enough to cause marked impairment in functioning or to require hospitalization. No psychotic features are present.
(DSM-5, 2013, American Psychiatric Association (2).
Cyclothymic Disorder:
At least 2 years of numerous periods of hypomanic symptoms that do not meet the full criteria for a hypomanic episode, as well as numerous periods of depressive symptoms that do not meet the full criteria for a major depressive episode.
Hypomanic and depressive symptoms are present at least half the time and the person has not symptom-free for more than 2 months at a time.
(DSM-5, 2013, American Psychiatric Association).
Substance/Medication-Induced Bipolar and Related Disorder:
A significant and persistent mood disturbance that features elevated, expansive, or irritable, with or without depressive symptoms or reduced interest or pleasure in activities.
The symptoms developed during or immediately following substance intoxication or withdrawal or following exposure to a medication.
(DSM-5, 2013, American Psychiatric Association).
Bipolar and Related Disorder Due to Another Medical Condition:
A significant and persistent mood disturbance that features elevated, expansive, or irritable, with or without depressive symptoms or reduced interest or pleasure in activities.
There is evidence that the mood disturbance is the direct consequence of another medical condition.
(DSM-5, 2013, American Psychiatric Association).
Unspecified Bipolar and Related Disorder:
Symptoms that are characteristic of mood disorders that do not meet the full diagnostic criteria for the aforementioned bipolar disorders. Symptoms may include the following:
Brief hypomanic episodes (2-3 days) and depressive episodes.
Hypomanic-like episodes that do not meet the full criteria and depressive episodes.
Hypomanic episodes without a major depressive episode.
Brief cyclothymia (less than 24 months).
(DSM-5, 2013, American Psychiatric Association).
What causes mood disorders, and how are mood disorders treated?
Multiple factors affect the incidence and activation of mood disorders, including biological, genetic, social, and stress-related variables. They are likely the result of an imbalance in brain chemicals and often run in families.
While not curable at this time, mood disorders are treatable through medication, therapy, and attending to healthy habits.
I apply, always with empathy and in collaboration with my clients, a four-pronged approach to the treatment of mood disorders:
Mood Maintenance: Because mood states are cyclical and can result in high highs and low lows, preventive care is very important. Attention to self-care can balance out mood states and limit their adverse impact. Attending to balanced diet, making time for adequate sleep, engaging in regular physical activity, balancing social time with alone time, balancing work and active time with down time, limiting or eliminating mood-altering substances such as alcohol and stimulants, and taking medication as prescribed (diet, exercise, sleep) are important self-care practices.
Mood and behavior monitoring: I encourage and assist clients with tracking their moods to gather data on what causes it to elevate or drop and which activities are helpful in maintaining mood stability. Prodromal symptoms are early indications of an upcoming mood cycle, such as increased anxiety, irritability, physical agitation, and difficulty focusing on one thought at a time. By being aware that moods are changing, efforts can be taken to mitigate mood swings.
Cognitive restructuring: Socratic dialogue during sessions and thought log worksheets completed at home help clients to identify and restructure maladaptive thoughts and utilize consequential thinking skills forestall impulsive urges, such as abruptly discontinuing medication.
Coordination with natural and professional supports. With collaboration and consent from the client, it is very helpful to coordinate with social and professional supports, including medication prescribers and those familiar with the safety plan that we establish at the outset of therapy. This facilitates regular communication with trusted adults to help the person reality test their thoughts, stay on track with their recovery plan, and get help in times of criss.
I welcome your call if you believe you would benefit from professional help and my approach is a good fit for your needs.