Major Depressive Disorder (Depression)
Description: Persistent sadness, loss of interest in activities, fatigue, sleep or appetite changes, and feelings of worthlessness.
Duration: Symptoms last most of the day, nearly every day, for at least two weeks.
Possible causes: Genetic factors, chemical imbalances (like serotonin or dopamine), trauma, or stress.
Major Depressive Disorder (MDD) — often simply called depression — is one of the most common and serious mood disorders. It affects how a person feels, thinks, and handles daily activities such as sleeping, eating, or working. It’s more than just feeling sad — it’s a persistent state of low mood and loss of interest that lasts for at least two weeks or longer.
🌧 Key Symptoms of Major Depressive Disorder
To be diagnosed, a person typically has five or more of the following symptoms during the same two-week period, and at least one must be depressed mood or loss of interest or pleasure:
Persistent sadness or emptiness
Loss of interest or pleasure in most activities (anhedonia)
Changes in appetite or weight (eating too much or too little)
Sleep disturbances (insomnia or sleeping too much)
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Difficulty thinking, concentrating, or making decisions
Psychomotor changes (moving or speaking very slowly, or being unusually restless)
Recurrent thoughts of death or suicide
These symptoms must cause significant distress or impairment in social, occupational, or other areas of functioning.
⚙️ Causes and Risk Factors
Depression usually arises from a combination of factors rather than a single cause:
Biological: Imbalance in brain chemicals (like serotonin, norepinephrine, and dopamine)
Genetic: Family history of depression or other mood disorders
Psychological: Negative thinking patterns, low self-esteem, unresolved trauma
Environmental: Stressful life events (loss, illness, isolation, abuse)
Medical conditions: Chronic pain, thyroid problems, or certain medications
💊 Treatment Options
Treatment is highly effective for most people, especially when started early.
1. Psychotherapy
Cognitive Behavioral Therapy (CBT): Helps challenge negative thought patterns.
Interpersonal Therapy (IPT): Focuses on relationships and life events that may trigger depression.
Psychodynamic Therapy: Explores underlying emotional conflicts.
2. Medication
Antidepressants such as SSRIs (e.g., sertraline, fluoxetine), SNRIs, or atypical antidepressants.
Usually prescribed by a psychiatrist and may take 4–6 weeks to show full effect.
3. Lifestyle and Self-Care
Regular exercise (increases endorphins and serotonin)
Healthy diet and consistent sleep
Reducing alcohol or drug use
Social support and structured routines
4. Other Therapies (for severe or resistant cases)
Electroconvulsive Therapy (ECT)
Transcranial Magnetic Stimulation (TMS)
Ketamine or Esketamine treatments (under medical supervision)
❤️ Prognosis
With proper treatment, 70–80% of people with major depression improve significantly. However, some may experience recurrent episodes, making maintenance therapy and ongoing self-awareness important.
Bipolar Disorder
Description: Alternating periods of mania (high energy, impulsivity, euphoria) and depression (sadness, fatigue, hopelessness).
Types:
Bipolar I: Severe mania and often major depression.
Bipolar II: Hypomania (less intense mania) and major depression.
Cyclothymic Disorder: Chronic, milder mood swings for at least two years.
Bipolar Disorder is a mood disorder characterized by extreme changes in mood, energy, and activity levels. These mood swings range from episodes of mania or hypomania (elevated mood, high energy) to depression (low mood, fatigue, hopelessness). The shifts are more severe and disruptive than normal ups and downs, affecting daily functioning, relationships, and judgment.
⚖️ Main Types of Bipolar Disorder
1. Bipolar I Disorder
Involves at least one manic episode that lasts 7 days or more, or is severe enough to require hospitalization.
Depressive episodes usually occur as well, often lasting 2 weeks or longer.
Example: A person might feel euphoric and unstoppable for a week, then crash into a deep depression.
2. Bipolar II Disorder
Involves hypomanic episodes (less intense than full mania) alternating with major depressive episodes.
The person doesn’t experience full-blown mania, but depressive episodes can be severe.
Example: Periods of high energy and productivity followed by long bouts of sadness and exhaustion.
3. Cyclothymic Disorder (Cyclothymia)
A chronic, milder form of bipolar disorder.
Numerous periods of hypomanic and depressive symptoms over 2 years or more, but not meeting full criteria for either.
People often describe it as feeling like they’re “always on a bit of a rollercoaster.”
🔄 Mood Episode Types
Manic Episode
A distinct period (at least one week) of abnormally elevated, expansive, or irritable mood, plus increased activity or energy.
Symptoms include:
Inflated self-esteem or grandiosity
Decreased need for sleep (feeling rested after only a few hours)
Rapid or pressured speech
Racing thoughts
Distractibility
Increased goal-directed activity (starting many projects)
Impulsive or risky behaviors (spending sprees, reckless driving, sexual indiscretions)
Manic episodes can lead to hospitalization or psychosis (loss of touch with reality).
Hypomanic Episode
Similar to mania but less severe and lasting at least 4 consecutive days.
Doesn’t cause major impairment in social or work life.
Others may notice the mood change, but the person may still function well.
Depressive Episode
Same features as Major Depressive Disorder: sadness, hopelessness, fatigue, loss of interest, changes in sleep or appetite, poor concentration, and thoughts of death or suicide.
⚙️ Causes and Risk Factors
Bipolar disorder doesn’t have a single cause — it usually results from a combination of biological, psychological, and environmental factors:
Genetic: Often runs in families; risk increases if a parent or sibling has bipolar disorder.
Brain chemistry: Imbalances in neurotransmitters (dopamine, serotonin, norepinephrine).
Stress and trauma: Major life changes or early life adversity can trigger episodes.
Sleep disruption: Irregular sleep patterns can precipitate mood shifts.
💊 Treatment Options
1. Medication
Mood stabilizers: Lithium (most established treatment), valproate, carbamazepine.
Atypical antipsychotics: Quetiapine, olanzapine, lurasidone, etc.
Antidepressants: Used cautiously (may trigger mania if not paired with a mood stabilizer).
2. Psychotherapy
Cognitive Behavioral Therapy (CBT): Helps manage distorted thinking and mood triggers.
Psychoeducation: Teaches individuals and families about symptoms, triggers, and relapse prevention.
Interpersonal and Social Rhythm Therapy (IPSRT): Focuses on stabilizing daily routines and sleep schedules.
3. Lifestyle Management
Maintain a regular sleep schedule
Avoid drugs and excessive alcohol
Reduce stress and create structure
Keep a mood journal to identify patterns and early warning signs
❤️ Prognosis
Bipolar disorder is a lifelong condition, but with proper treatment, many people live stable, fulfilling lives.
Early diagnosis and consistent treatment greatly reduce the frequency and severity of episodes.
Support systems (family, therapy, peer groups) play a crucial role in long-term stability.
Persistent Depressive Disorder (Dysthymia)
Description: A chronic form of depression with less severe but longer-lasting symptoms — often for two years or more.
Symptoms: Low mood, low energy, poor self-esteem, and difficulty feeling joy.
Persistent Depressive Disorder (PDD) — formerly known as Dysthymia — is a chronic form of depression in which a person experiences a low mood for most of the day, more days than not, for at least two years (one year in children or adolescents).
It’s often described as a kind of “background sadness” that never completely lifts. While symptoms may not be as intense as in major depression, their chronic nature can seriously affect daily functioning, motivation, and quality of life.
🌧 Key Symptoms of Persistent Depressive Disorder
A person with PDD experiences two or more of the following symptoms — in addition to a depressed mood:
Poor appetite or overeating
Insomnia or sleeping too much
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
These symptoms persist most of the time for at least two years (or one year in children/teens).
During that period, the individual does not go more than two months without symptoms.
⚙️ How It Differs from Major Depressive Disorder
FeaturePersistent Depressive DisorderMajor Depressive DisorderDurationAt least 2 yearsAt least 2 weeksSeverityChronic but milder symptomsMore intense and acuteCourseOngoing low mood, can fluctuate but never fully goes awayDistinct episodes that may resolve completelyOnsetOften gradual, may start in childhood or adolescenceCan begin suddenly, often triggered by an event
People with PDD can also experience episodes of major depression — this is called “double depression.”
🧠 Causes and Risk Factors
Persistent Depressive Disorder develops from a combination of biological, psychological, and social factors:
Genetics: Family history of depression or other mood disorders
Brain chemistry: Imbalances in serotonin and norepinephrine
Early life experiences: Trauma, neglect, or chronic stress
Personality factors: Tendency toward pessimism or low self-confidence
Chronic stressors: Ongoing illness, loneliness, or difficult life circumstances
💊 Treatment Options
1. Psychotherapy
Cognitive Behavioral Therapy (CBT): Helps challenge and reframe persistent negative thoughts.
Interpersonal Therapy (IPT): Focuses on improving relationships and communication.
Mindfulness-Based Cognitive Therapy (MBCT): Teaches awareness of thought patterns and reduces relapse risk.
Supportive Therapy: Offers emotional support and coping strategies for long-term struggles.
2. Medication
Antidepressants: SSRIs (like sertraline, fluoxetine), SNRIs (like venlafaxine), or atypical antidepressants (like bupropion).
Sometimes combined with psychotherapy for better results.
Medication may take several weeks to work, and finding the right one can take time.
3. Lifestyle Strategies
Regular physical activity and exposure to sunlight
Consistent sleep and meal routines
Avoiding alcohol or drugs
Setting small, realistic goals to maintain motivation
Building supportive relationships and engaging in meaningful activities
❤️ Prognosis
PDD tends to be long-lasting but highly treatable.
Many people experience gradual improvement with ongoing treatment and support.
Even small positive changes — consistent therapy, medication, structure, or social connection — can significantly improve quality of life.
Seasonal Affective Disorder (SAD)
Description: Depression that occurs seasonally, usually in winter when sunlight is reduced.
Treatment: Light therapy, vitamin D, and psychotherapy.🌧 Key Symptoms of Persistent Depressive Disorder
Seasonal Affective Disorder (SAD) is a type of depression that occurs at a specific time of year, most often during the fall and winter months, when daylight hours are shorter. It’s sometimes called “winter depression.”
People with SAD experience mood changes and symptoms similar to major depressive disorder, but the symptoms follow a seasonal pattern, typically improving in spring and summer when sunlight returns.
🌧 Key Features of Seasonal Affective Disorder
Symptoms appear around the same time each year (usually starting in late fall or early winter).
Symptoms improve or disappear during spring and summer.
Less commonly, some people experience summer-onset SAD, with depression occurring in warmer months.
⚙️ Symptoms of Winter-Pattern SAD
To meet diagnostic criteria, symptoms must last for at least two consecutive years in the same season and include several of the following:
Persistent low mood or sadness
Loss of interest or pleasure in usual activities
Low energy and fatigue
Increased sleep (often oversleeping)
Changes in appetite — especially craving carbohydrates and weight gain
Difficulty concentrating
Feelings of hopelessness or worthlessness
Social withdrawal (“hibernating” or isolating from others)
☀️ Symptoms of Summer-Pattern SAD (Less Common)
Trouble sleeping (insomnia)
Loss of appetite or weight loss
Anxiety, irritability, or restlessness
Increased agitation
🧠 Causes and Contributing Factors
SAD is linked to changes in daylight exposure, which can disrupt the body’s internal clock and brain chemistry.
Reduced sunlight → affects serotonin (mood regulation) and melatonin (sleep and circadian rhythm).
Circadian rhythm disruption → body’s “biological clock” becomes misaligned.
Vitamin D deficiency → sunlight helps produce vitamin D, which supports serotonin levels.
Genetics: Family history of depression or SAD increases risk.
💡 Treatment Options
1. Light Therapy (Phototherapy)
The most common and effective treatment for SAD.
Involves sitting near a special light box that mimics natural sunlight (10,000 lux) for 20–30 minutes each morning.
Typically improves symptoms within 1–2 weeks.
Should be used consistently during darker months under medical guidance.
2. Psychotherapy
Cognitive Behavioral Therapy (CBT): Helps identify negative thoughts and establish healthier behaviors during winter months.
A version called CBT-SAD combines CBT techniques with strategies to manage seasonal triggers.
3. Medication
Antidepressants, especially SSRIs (like sertraline or fluoxetine), may help balance serotonin levels.
Sometimes prescribed before the onset of symptoms each year (preventive approach).
4. Lifestyle and Self-Care
Maximize natural light: Open curtains, spend time outdoors, even on cloudy days.
Exercise regularly: Boosts serotonin and endorphins.
Maintain a routine: Consistent sleep and meal times help regulate mood.
Social engagement: Avoid isolation; connect with others for support.
Vitamin D supplements: Can help if levels are low.
🌅 Prognosis
SAD is highly treatable, especially with light therapy and lifestyle adjustments.
Many people experience full remission each spring and can prevent recurrence with early preparation.
Understanding your pattern helps you plan ahead — starting light therapy or antidepressants before symptoms return can be very effective.
Disruptive Mood Dysregulation Disorder (DMDD)
Typically seen in children and adolescents.
Symptoms: Frequent temper outbursts and persistent irritability.Seasonal Affective Disorder (SAD) is a type of depression that occurs at a specific time of year, most often during the fall and winter months, when daylight hours are shorter. It’s sometimes called “winter depression.”
Disruptive Mood Dysregulation Disorder (DMDD) is a childhood mood disorder characterized by severe, frequent temper outbursts and chronic irritability or anger between outbursts.
It was added to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) in 2013 to better describe children who display persistent irritability and behavioral dyscontrol — but who don’t fit well under bipolar disordercriteria.
🧠 Core Features of DMDD
To meet the diagnostic criteria, the following must be present:
Severe, recurrent temper outbursts (verbal or behavioral) — out of proportion to the situation.
Examples: yelling, hitting, destroying property, or extreme frustration.
Outbursts occur, on average, three or more times per week.
Persistent irritability or angry mood between outbursts — present most of the day, nearly every day.
Symptoms must:
Last for at least 12 months.
Be present in two or more settings (e.g., home, school, with peers).
Be severe in at least one setting.
Diagnosis is only made between ages 6 and 18, and symptom onset must occur before age 10.
😠 Examples of Behavior
A child with DMDD might:
Explode in anger over minor frustrations (like being told “no”).
Be irritable or angry most of the day, even when calm.
Struggle to make or keep friends due to frequent outbursts.
Have difficulty in school because of poor emotional control.
⚙️ Causes and Risk Factors
There isn’t one single cause. DMDD likely results from a combination of genetic, biological, and environmental influences:
Family history: Mood or anxiety disorders.
Brain differences: Irregular activity in areas related to emotion regulation (like the amygdala and prefrontal cortex).
Temperament: Children naturally prone to negative emotions or difficulty self-soothing.
Stressful environments: Family conflict, trauma, or inconsistent parenting.
🩺 Diagnosis
DMDD can be difficult to diagnose because its symptoms overlap with other conditions like ADHD, oppositional defiant disorder (ODD), and anxiety disorders.
A thorough evaluation by a child psychiatrist or psychologist includes:
Interviews with parents, teachers, and the child
Observation of mood and behavior
Review of medical, developmental, and family history
💊 Treatment Options
Treatment focuses on teaching emotional regulation, reducing irritability, and improving functioning at home and school.
1. Psychotherapy (First-line treatment)
Cognitive Behavioral Therapy (CBT): Helps children recognize triggers and learn coping strategies for frustration and anger.
Parent Management Training: Teaches parents consistent, calm responses to behavior and positive reinforcement.
Dialectical Behavior Therapy for Children (DBT-C): Focuses on emotional regulation, mindfulness, and distress tolerance.
Family therapy: Improves communication and understanding between child and caregivers.
2. Medication (if needed)
Used only when therapy alone isn’t enough or if symptoms are severe:
Stimulants (e.g., methylphenidate) — may help if ADHD symptoms are present.
Antidepressants (SSRIs) — reduce chronic irritability.
Atypical antipsychotics (e.g., risperidone, aripiprazole) — reserved for severe aggression or explosive behavior.
(Medication should always be combined with therapy and closely monitored.)
🌱 Prognosis
DMDD symptoms often lessen as children grow older, especially with early intervention.
Some children later develop anxiety or depressive disorders in adolescence or adulthood.
With consistent therapy, family support, and structured routines, many children learn to manage their emotions effectively.
❤️ Key Takeaway
DMDD isn’t simply “bad behavior” — it’s a neurodevelopmental disorder that affects how a child experiences and expresses frustration.
Early recognition, emotional skills training, and supportive parenting are vital to helping these children thrive.
Cyclothymic Disorder
Description: Chronic mood fluctuations between mild depression and hypomania.
Duration: At least two years (one year in children/teens).Typically seen in children and adolescents.
Cyclothymic Disorder — also called Cyclothymia — is a chronic mood disorder involving frequent, mild mood swings that alternate between hypomanic (mildly elevated) and depressive (mildly low) states.
These mood shifts are less severe than those seen in bipolar I or II disorder, but they last a long time — at least two years in adults (or one year in children/adolescents).
People with cyclothymic disorder often describe feeling like they are on an emotional “rollercoaster” — never quite stable, but rarely reaching the extremes of full mania or major depression.
⚖️ Core Features
To be diagnosed with Cyclothymic Disorder, the following criteria must be met:
Numerous periods of hypomanic symptoms (elevated mood, high energy, confidence) and periods of depressive symptoms (low mood, fatigue, sadness).
Symptoms persist for at least 2 years (1 year in youth).
The person has not been symptom-free for more than 2 months at a time.
The symptoms don’t meet full criteria for hypomanic or major depressive episodes.
The mood changes cause significant distress or impairment in work, school, or relationships.
Symptoms are not due to substance use, medication, or another medical condition.
😌 Common Symptoms
During Hypomanic Periods:
Increased energy or activity
Reduced need for sleep
Talkativeness or racing thoughts
Heightened confidence or irritability
Taking on multiple projects or acting impulsively
Feeling unusually productive or creative
(These are milder than full mania and often go unnoticed or may even feel positive.)
During Depressive Periods:
Low energy or fatigue
Sadness or tearfulness
Difficulty concentrating
Sleep or appetite changes
Feelings of hopelessness or self-doubt
Withdrawal from social activities
🧠 Causes and Risk Factors
Cyclothymic disorder, like other mood disorders, is believed to result from a mix of genetic, biological, and environmental factors:
Genetic predisposition: Often runs in families with bipolar disorder or depression.
Brain chemistry: Irregular regulation of neurotransmitters (dopamine, serotonin, norepinephrine).
Stress or trauma: Early-life stress or loss can increase vulnerability.
Personality traits: Emotional sensitivity or high reactivity to stress.
💊 Treatment Options
1. Psychotherapy
The main form of treatment — helps individuals recognize mood patterns and maintain stability.
Cognitive Behavioral Therapy (CBT): Identifies and challenges unhelpful thoughts and behaviors tied to mood changes.
Interpersonal and Social Rhythm Therapy (IPSRT): Focuses on maintaining consistent daily routines (sleep, meals, activity).
Mindfulness-based therapy: Teaches emotional awareness and stress management.
Psychoeducation: Helps patients and families understand the disorder and learn early warning signs.
2. Medication
Used if psychotherapy alone isn’t sufficient.
Mood stabilizers: Lithium or valproate (to smooth out highs and lows).
Atypical antipsychotics: Sometimes used for mood regulation.
Antidepressants: Used cautiously, as they can trigger hypomanic symptoms if not combined with a mood stabilizer.
3. Lifestyle and Self-Care
Maintain a regular sleep schedule
Avoid alcohol or recreational drugs (can worsen mood swings)
Engage in regular physical activity
Track moods with a journal or app to spot early changes
Build a strong support system — therapy groups, family, or friends
❤️ Prognosis
Cyclothymia is a lifelong condition, but symptoms can be managed effectively with ongoing treatment and awareness.
Without treatment, it can progress to bipolar I or II disorder in some cases.
With therapy, medication, and self-monitoring, many people live stable, balanced lives despite mood fluctuations.
