Mood disorders include (1) depressive disorders and (2) bipolar disorders. Bipolar disorders are further divided into (a) manic, (b) depressed, (c) mixed, or (d) cyclothymia. The mood disturbance may occur in a number of patterns of severity and duration, alone or in combination, where client feels extreme sadness and guilt, withdraws socially, expresses self-deprecatory thoughts (major depression), or experiences an elevated, expansive mood with hyperactivity, pressured speech, inflated self-esteem, and decreased need for sleep (manic episode or disorder).
Another specific mood disorder is dysthymic disorder (depressive neuroses), in which there is a chronic mood disturbance involving a depressed mood or loss of interest and pleasure in all usual activities, but not of sufficient severity or duration to be classified as a major depressive episode. Table 10-12. Comparison of the Two Different Types of Depressive Disorders summarizes the main points of difference between the two types of depression.
These affective disorders should be distinguished from grief. Grief is realistic and proportionate to what has been specifically lost and involves no loss of self-esteem. There is a constant feeling of sadness over a period of 3 to 12 months or longer, with good reality contact (no delusions) (see Figure 10-3. Grief Versus Depressioncomparing normal grief reaction and symptoms of clinical depression).