Information Section: Conditions
Condition: Mood
Article: Other Types of Mood Disorder
Source: Leslie E. Packer, PhD   2001

Page 1 of 1  

Preface

In this section, we will briefly consider some other kinds of mood episodes or mood disorders: hypomania, mixed episodes, cycylothymia, and dysthymia.

HYPOMANIC EPISODE

The prefix "hypo" means "under," so "hypomania" actually translates into "under mania," or just below the level of (full) mania. An individual who is hypomanic will be sleeping less (or may not sleep at all), will have a burst of energy, feel heightened focus or creativity, a sense of increased confidence, and may be able to accomplish a lot and tackle a number of meaningful and organized projects. If the individual is able to control the hypomania, it is a state that may actually be very positive and pleasurable. Some of the impulsivity and increased energy may result in spending sprees or other activities that, while not bizarre, are not what the individual would normally do. While some aspects of hypomania are experienced as positive, the individual's impulsivity can pose genuine problems. Distractibility is often present, and as in mania, speech may be very rapid as the person responds to everything going on around them. All too often, hypomania progresses into full-blown mania.

MIXED EPISODE

Some individuals may experience both depression and mania at the same time, giving rise to the notion of a "mixed episode." Indeed, if the predominant symptom is irritability, it may be difficult to know whether it is from depression or mania. An individual in a mixed episode may exhibit signs of agitation, suffer from insomnia, experience changes in appetite, have some psychotic features, and experience suicidal thinking.

CYCLOTHYMIC DISORDER

As we saw elsewhere, some individuals have mood swings or cycles that meet the criteria for Bipolar Disorder. But what about people who seem to cycle but whose "lows" don't quite meet the criteria for Major Depressive Episodes and whose "highs" don't quite meet the criteria for Manic Episodes? They may have Cyclothymic Disorder, sometimes referred to as BP-III (Bipolar, subtype III).

DYSTHYMIC DISORDER

Some people just always seem to have the "blahs." These may be the colleagues or children that we think of as being depressed over the long term. Adults may always seen "down in the dumps" even if there's nothing particularly depressing going on in their lives, and when asked, may tell you that they've "always" been this way. Children may also seem to be always 'down,' although in some cases, children may seem to be always irritable. While symptoms in children may appear a bit different than in adults, the key features here are the duration of the depressed mood and the presence of at least two of the following symptoms we associate with the depressed mood:

  • change in appetite/eating habits,
  • change in sleeping habits,
  • low energy or fatigue,
  • poor self-esteem,
  • poor concentration or difficulty making decisions, and
  • feelings of hopelessness

If you've already read the on-site files on depression from the NIMH, you will probably recognize these signs of depression.

But what happens to individuals with dysthymia?  Do the symptoms progress into full-blown depression or do they remit? Hayden and Klein (2001) assessed 86 patients with early-onset dysthymia (i.e., prior to age 21) over a 5-year period. They found that a number of factors predicted outcome. Comorbid anxiety disorder, cluster C* and depressive personality features, and chronic stress were associated with a lower rate of recovery from dysthymic disorder, while family history of bipolar disorder was associated with a higher probability of recovery.

Dysthymia was more likely to evolve into depression in cases where there was a family history of dysthymia, a history of poor childhood relationship with parents, childhood sexual abuse, cluster C features, neuroticism, a history of anxiety and eating disorders, and/or chronic stress.

NOTE

* Cluster C personality disorders constitute the anxious/fearful set of personality disorders, and include Obsessive-Compulsive Personality Disorder, Avoidant Personality Disorder, and Dependent Personality Disorder.

Information Section: Conditions
Condition: Mood
Article: Other Types of Mood Disorder
Source: Leslie E. Packer, PhD    

Page 1 of 1  

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