Diagnostic Evaluation: Mood Disorders

What is a Mood Disorder?

A mood disorder is characterized by emotional disturbances that consist of overly intense and persistent periods of sadness, elation, or both. These periods of intense mood significantly impair a child’s ability to function in everyday life and cause disruption. 

Mood vs Emotion

The difference between mood and emotion is outward expression. A child’s mood is a temporary, internal state of mind that induces an overall positive or negative feel that does not always have a specific cause. A child’s emotion is a specific short-lived feeling that has a known cause (happy, sad, frustrated, etc.).

Causes of Mood Disorders

There is no known single cause of mood disorders. There are many factors that play into mood disorders including genetics, chemical imbalance in the brain, traumatic life events, chronic stress, illness, and environmental factors.

Categories of Mood Disorders

There are two categories of mood disorders: Depressive Disorders and Bipolar Disorders.

Depressive Disorders

Depressive disorders are characterized by severe sadness or irritability that impairs a child’s ability to function or cause considerable distress. Common types of depressive disorders include:

  • Major depressive disorder
  • Persistent depressive disorder (dysthymia)
  • Disruptive mood dysregulation disorder

Signs and Symptoms of Depressive Disorders

Depressive disorders in children are similar to those in adults but are related to areas of life specific to children such as school and play. Children may not be able to express their feelings so they may take part in risky behaviors, withdraw from social situations, or perform poorly in school. Other signs and symptoms of depressive disorders include:

  • Feeling sad most of the day
  • Feeling sluggish
  • Feeling hopeless or worthless
  • Low self-esteem
  • Over or under eating
  • Over or under sleeping
  • Fatigue 
  • Difficulty focusing or concentrating
  • Difficulty making decisions
  • Gaining or losing weight
  • Performing poorly in school
  • Withdrawal
  • Acting out
  • Thoughts of death or suicide
  • Loss of interest or pleasure in activities

Bipolar Disorders

Bipolar disorders are characterized by alternating periods of mania, depression, and normal mood each lasting for weeks to months at a time. Certain children may have a predominance of one over the other. Common types of bipolar disorders include:

  • Bipolar I disorder: one full-fledged manic episode and depressive episodes
  • Bipolar II disorder: major depressive episodes with at least one hypomanic episode
  • Unspecified bipolar disorder: clear bipolar features but does not fit into the specific criteria

Signs and Symptoms of Bipolar Disorder

Signs and symptoms of bipolar disorder include depression and mania. 

What is a Manic Episode?

A manic episode is a period of abnormally elevated mood often accompanied by intense energy, racing thoughts, unusual talkativeness, distractibility, agitation, restlessness, and extreme or risk-taking behavior.  

What is a Hypomanic Episode?

A hypomanic episode involves the same signs and symptoms of a manic episode but is less severe and lasts for a shorter period of time.

Testing and Diagnosis of Mood Disorders

In order to diagnose a mood disorder, a comprehensive psychiatric evaluation must be performed. This comprehensive evaluation includes:

  • Child’s medical history
  • Child’s current symptoms, behaviors, and functioning
  • Expectations for the condition
  • Family dynamic
  • Environmental stressors
  • Family medical history
  • Family psychiatric history
  • Information from teachers and other care providers who have concerns about the child

Treatment of Mood Disorders

There is a wide variety of treatments for mood disorders. Each child is unique so there is no universal treatment plan for mood disorders. Different approaches to treatment include individual therapy, family therapy, and medication.

What is Individual Therapy?

Individual therapy is evidence-based therapy that includes cognitive-behavioral therapy and interpersonal therapy. 

  • Cognitive-behavioral therapy: This approach to therapy helps a child to decrease their depressive symptoms by changing their views of the world and themself and learn strategies and coping skills to promote positive moods.
  • Interpersonal therapy: This approach to therapy helps a child to decrease their depressive symptoms by having them cope with and work through stressors by learning communication skills, problem solving skills, and social skills.

Why is Family Therapy Important?

Family therapy is important because parents help to manage a child’s life. Parents play an important role in addressing family dynamics or other stressors contributing to a child’s mood disorder. They are a child’s primary guidance to working towards therapy goals at home.

Why is Medication Important?

Medication can be effective in treating mood disorder symptoms when combined with a therapy approach that best fits a child.