Psychiatry and Mood Disorders

Psychiatry

• Psychiatry focuses on the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders.
• Psychiatrists hold either an MD or DO degree and specialize in psychiatry, encompassing substance use disorders.
• Psychiatrists are equipped to evaluate both the mental and physical dimensions of psychological disturbances.
• Psychiatric assessments generally include physical examinations, neurological and psychological evaluations, and patient discussions about experienced symptoms.
• Treatment options include medication, psychotherapy ("talk therapy"), brain stimulation therapies, or combinations thereof.
• Psychiatry covers a broad spectrum of mental health conditions like depression, anxiety disorders, schizophrenia, bipolar disorder, eating disorders, and addiction.
• Psychiatric subspecialties consist of child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry, addiction psychiatry, and neuropsychiatry.

Mood Disorders

• Mood disorders are defined by a primary disturbance in mood.
• Mood refers to a sustained emotional state impacting perception and behavior.
• Depressive disorders and bipolar disorders represent the two main categories of mood disorders.
• Depressive disorders entail continuous feelings of sadness, emptiness, or irritability, accompanied by somatic and cognitive changes impacting functioning.
• Bipolar disorders are characterized by periods of elevated mood (mania or hypomania) alternating with depressive episodes.
• Major depressive disorder (MDD) involves a minimum two-week period of depressed mood or loss of interest/pleasure in almost all activities.
• MDD symptoms include changes in appetite or weight, sleep issues, fatigue, feelings of worthlessness or guilt, concentration difficulties, and suicidal thoughts.
• Persistent depressive disorder (dysthymia) is a chronic, less severe form of depression lasting at least two years.
• Bipolar I disorder features episodes of full-blown mania lasting at least one week or requiring hospitalization.
• Bipolar II disorder includes periods of hypomania (a less severe form of mania) that alternate with major depressive episodes.
• Cyclothymic disorder is a milder bipolar form, marked by hypomanic and depressive symptoms not meeting full episode criteria.
• Disruptive mood dysregulation disorder (DMDD) affects children up to age 12, involving persistent irritability and frequent extreme behavioral dyscontrol.
• The causes of mood disorders are multifaceted, incorporating genetic, biological, environmental, and psychological elements.
• Neurotransmitters, including serotonin, norepinephrine, and dopamine, significantly affect mood regulation.
• Hormonal imbalances, such as with thyroid hormones or cortisol, can contribute to mood disorders.
• Stressful life events, trauma, and inadequate social support are environmental factors potentially triggering or worsening mood disorders.
• Cognitive and behavioral patterns, like negative thinking and maladaptive coping strategies, are contributors in the development and maintenance of mood disorders.
• Mood disorder treatment usually includes medication, psychotherapy, and lifestyle changes.
• Antidepressants like selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), are frequently used in treating depressive disorders.
• Mood stabilizers like lithium, valproate, and lamotrigine are employed to treat bipolar disorders and stabilize mood swings.
• Cognitive-behavioral therapy (CBT) assists people in identifying and altering negative thought patterns and behaviors that affect mood disorders.
• Interpersonal therapy (IPT) is centered on improving interpersonal relationships and social support to reduce mood disorder symptoms.
• Lifestyle adjustments, such as consistent exercise, a nutritious diet, sufficient sleep, and stress management methods, are important in managing mood disorders.

Stress

• Stress represents a physiological and psychological reaction to any demand or change.
• The body attempts to adapt to new/challenging situations during stress.
• Stressors manifest as physical, mental, emotional, or social.
• Acute stress is a short-term response to an immediate pressure or threat.
• Chronic stress results from prolonged exposure to stressful conditions, negatively impacting physical and mental well-being.
• The stress response involves activation of the hypothalamic-pituitary-adrenal (HPA) axis, and the sympathetic nervous system.
• Cortisol released by the HPA axis, is a stress hormone helping the body cope.
• Activation of the sympathetic nervous system causes the "fight or flight" response, elevating heart rate, blood pressure, and alertness.
• Prolonged stress response activation may cause cardiovascular disease, weakened immunity, digestive issues, anxiety, and depression.
• Psychological variables such as personality traits, coping mechanisms, and social support effect the stress response.
• Effective stress management strategies include exercise, relaxation methods (e.g., meditation, deep breathing), social support, time management, and cognitive restructuring.
• Mindfulness-based stress reduction (MBSR) uses mindfulness meditation to cultivate awareness and acceptance of present experiences.
• Cognitive-behavioral techniques aid in identifying and modifying negative thought patterns/behaviors that contribute to stress.
• Emotion-focused coping manages the emotional distress from stress, while problem-focused coping directly handles the stress source.
• Resilience involves adapting to stressful conditions, and the ability to recover from adversity.
• Cultivating positive relationships, developing problem-solving skills, maintaining a positive attitude, and ensuring physical health builds resilience.
• Stress contributes to the development and worsening of mental health disorders, including mood and anxiety disorders.
• Chronic stress disrupts neurotransmitter balance in the brain, causing mood changes and cognitive impairments.
• Stress management is an important element in treating many mental health disorders.