Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Depression and Mood Disorders

Conditions - Depression and Mood Disorders

Mood Disorders Statistics

Seven to 14 percent of children will experience an episode of major depression before the age of 15. And, while major depressive disorder can develop at any age, the average age at onset is the mid-20s.

20 to 30 percent of adult bipolar patients report having their first manic episode before the age of 20.

Out of 100,000 adolescents, 2,000 to 3,000 will have a mood disorder, of which eight to 10 will commit suicide. Dysthymic disorder, which often begins in childhood, adolescence, or early adulthood, affects nearly 10.9 million American adults each year.

The National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH) report the following:

  • Research indicates that depression onset is occurring earlier in life today than in past decades.
  • Early-onset depression often persists, recurs, and continues into adulthood. Depression in youth may also predict more severe illness in adulthood.

What are mood disorders?

The term "mood disorders" refers to a category of mental health problems that include all types of depression and bipolar disorder. Mood disorders are sometimes called affective disorders.

During the 1980s, mental health professionals began to recognize symptoms of mood disorders in children and adolescents, as well as adults. However, children and adolescents do not necessarily experience or exhibit the same symptoms as adults. It is more difficult to diagnose mood disorders in children, especially because children are not always able to express how they feel. Today, clinicians and researchers believe that mood disorders in children and adolescents remain one of the most under-diagnosed mental health problems. At any age, mood disorders put individuals at risk for other conditions that may persist long after the initial episodes of depression are resolved.

What causes mood disorders?

The cause of mood disorders is not well known. There are chemicals in the brain, called endorphins, that are responsible for positive moods. Other chemicals in the brain, called neurotransmitters, regulate endorphins. Most likely, depression (and other mood disorders) is caused by a chemical imbalance in the brain. Life events (such as unwanted changes in life) may also contribute to a depressed mood.

Affective disorders aggregate in families and are considered to be multifactorially inherited. Multifactorial inheritance means that "many factors" are involved. The factors are usually both genetic and environmental, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition. Often one gender (either males or females) is affected more frequently than the other in multifactorial traits. There appears to be a different threshold of expression, which means that one gender is more likely to show the problem, over the other gender.

Who is affected by mood disorders?

Anyone can feel sad or depressed at times. However, mood disorders are more intense and difficult to manage than normal feelings of sadness. Children, adolescents, or adults who have a parent with a mood disorder have a greater than 50 percent chance of also having a mood disorder. However, life events and stress can expose or exaggerate feelings of sadness or depression, making the feelings more difficult to manage.

Sometimes, life's problems can trigger depression. Being fired from a job, getting divorced, losing a loved one, death in the family, and financial trouble, to name a few, all can be difficult and coping with the pressure may be troublesome. These life events and stress can bring on feelings of sadness or depression or make a mood disorder harder to manage.

The chance for depression in females in the general population is five to nine percent and for males is three to four percent. Once a person in the family has this diagnosis, the chance for their siblings or children to have the same diagnosis is seven to 19 percent. In addition, relatives of persons with depression are also at increased risk for bipolar disorder (manic depression). The chance for siblings or children of a person with depression to have bipolar illness is 0.3 to two percent.

The chance for manic depression (or bipolar disorder) in males and females in the general population is 1 percent. Once a person in the family has this diagnosis, the chance for their siblings or children to have the same diagnosis is 4 to 18 percent. In addition, relatives of persons with manic depression are also at increased risk for depression. The chance for siblings or children of a person with manic depression to have depression is six to 28 percent.

What are the different types of mood disorders?

The following are the most common types of mood disorders:

  • major depression - a two-week period of a depressed or irritable mood or a noticeable decrease in interest or pleasure in usual activities, along with other signs of a mood disorder.
  • dysthymia (dysthymic disorder) - a chronic, low-grade, depressed or irritable mood for at least one year.
  • manic depression (bipolar disorder) - at least one episode of a depressed or irritable mood and at least one period of a manic (persistently elevated) mood.
  • mood disorder due to a general medical condition - many medical illnesses (including cancer, injuries, infections, and chronic medical illnesses) can trigger symptoms of depression.
  • substance induced mood disorder - symptoms of depression that are due to the effects of medication, drug abuse, exposure to toxins, or other forms of treatment.

What are the symptoms of mood disorders?

Depending upon age and the type of mood disorder present, a person may exhibit different symptoms of depression. The following are the most common symptoms of a mood disorder. However, each individual may experience symptoms differently. Symptoms may include:

  • persistent feelings of sadness
  • feeling hopeless or helpless
  • having low self-esteem
  • feeling inadequate
  • excessive guilt
  • feelings of wanting to die
  • loss of interest in usual activities or activities once enjoyed
  • difficulty with relationships
  • sleep disturbances (i.e., insomnia, hypersomnia)
  • changes in appetite or weight
  • decreased energy
  • difficulty concentrating
  • a decrease in the ability to make decisions
  • suicidal thoughts or attempts
  • frequent physical complaints (i.e., headache, stomach ache, fatigue)
  • running away or threats of running away from home
  • hypersensitivity to failure or rejection
  • irritability, hostility, aggression

In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. It is also of concern if these feelings continue over a period of time, or interfere with an individual's interest in family, friends, community, or work. Any person who expresses thoughts of suicide should be evaluated immediately.

The symptoms of mood disorders may resemble other conditions or psychiatric problems. Always consult your physician for a diagnosis.

How are mood disorders diagnosed?

Mood disorders are a real medical disorder. A psychiatrist or other mental health professional usually diagnoses mood disorders following a comprehensive psychiatric evaluation.

Treatment for mood disorders:

Specific treatment for mood disorders will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the condition
  • type of mood disorder
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the condition
  • your opinion or preference
Mood disorders can often be effectively treated. Treatment should always be based on a comprehensive evaluation. Treatment may include one, or more, of the following:
  • antidepressant medications (especially when combined with psychotherapy has shown to be very effective in the treatment of depression)
  • psychotherapy (most often cognitive-behavioral and/or interpersonal therapy that is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stressors in the environment and how to avoid them)
  • family therapy - Families play a vital supportive role in any treatment process.

Prevention of mood disorders:

Preventive measures to reduce the incidence of mood disorders are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the individual's normal growth and development, and improve the quality of life experienced by persons with mood disorders.

Statistics related to suicide

According to the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), the highest suicide rates are among men over the age of 85.

Men are four times as likely to commit suicide than women. However, women attempt suicide two to three times more often than men.

According to the Centers for Disease Control and Prevention (CDC), suicide is the ninth leading cause of death for all Americans, and is the third leading cause of death for young people ages 15 to 24.

More than 90 percent of people who commit suicide have a diagnosable mental disorder - most commonly a depressive disorder or a substance abuse disorder.

Warning signs of suicidal feelings, thoughts, or behavior:

Many of the warning signs of possible suicidal feelings are also symptoms of depression. Observations of the following behaviors may be helpful in identifying persons who may be at risk of attempting suicide:
  • changes in eating and sleep habits
  • loss of interest in usual activities
  • withdrawal from friends and family members
  • acting out behaviors and running away
  • alcohol and drug use
  • neglect of personal appearance
  • unnecessary risk-taking
  • preoccupation with death and dying
  • increased physical complaints frequently associated with emotional distress such as stomach aches, headaches, and fatigue
  • loss of interest in work, school, community
  • feelings of boredom
  • difficulty concentrating
  • feelings of wanting to die
  • lack of response to praise
  • indicates plans or efforts toward plans to commit suicide, including the following:
    • verbalizes "I want to kill myself," or "I'm going to commit suicide."
    • gives verbal hints such as "I won't be a problem much longer," or "If anything happens to me, I want you to know ...."
    • gives away favorite possessions; throws away important belongings
    • becomes suddenly cheerful after a period of depression
    • may express bizarre thoughts
    • writes one or more suicide notes
Threats of suicide communicate desperation and a cry for help. Always take statements of suicidal feelings, thoughts, behaviors, or plans very seriously. Any person who expresses thoughts of suicide should be evaluated immediately.

The warning signs of suicidal feelings, thoughts, or behaviors may resemble other medical conditions or psychiatric problems. Always consult your physician for a diagnosis.

What immediate action should be taken to prevent a suicide?

According to the National Depressive and Manic-Depressive Association (NDMDA), the following steps should be immediately taken if someone is threatening suicide:
  • Take the person seriously.
  • Involve other people. Contact friends and family members.
  • Express concern.
  • Listen attentively.
  • Ask direct questions.
  • Acknowledge the person's feelings.
  • Offer reassurance.
  • Do not promise confidentiality.
  • If possible, do not leave the person alone.
  • Contact a mental health professional and/or call 911 immediately.
  • Keep potentially harmful objects hidden.
  • Prepare for possible hospitalization, if the physician advises.