Mood disorders are common, affecting more than 1 in 5 individuals during their lifetime. While some experience a single episode, majority of the affected individuals  will have recurrent episodes, often triggered by stressful life situations.

Different varieties of mood disorders

Major Depressive disorder (or Depression)

generally makes individuals feel sadness while others might feel more irritable  or numb when they report having no feelings at all. When depressed people feel hopelessness and guilt. They lose interest in things and often isolate themselves from others. They have difficulty concentrating or remembering things, which often aggravates the problem at work or school. In addition, they have low energy, poor sleep and appetite. When depression becomes severe, suicidal thoughts may emerge.

Persistent Depressive disorder (or Dysthymia)

is similar to depression in many respects except that it requires a longer run of symptoms of over 2 years and the symptoms are less severe. It is not uncommon for people to experience dysthymia before onset of, or after partial recovery from, an episode of depression.

Bipolar disorder

is slightly different from above conditions in that the person, in addition to episodes of depression, also experiences episodes of mania or hypomania-the difference being in the degree of impairment between the two. When in manic/hypomanic phase individual typically feels unusually happy or, alternatively, irritable or angry. They may experience racing thoughts and rushed as if on a high. During these periods, they might become impulsive and do things they wouldn’t normally do such as getting into risky unprotected sex, drug binges, expensive shopping sprees, unplanned holidays, etc.

Many individuals with Bipolar disorder will experience Mixed episodes with symptoms of both mania and depression during the same episode. In addition, there are individuals who have frequent unexplained mood swings with symptoms which not severe enough to satisfy diagnosis of either hypomania or depression, and they are said to have Cyclothymic disorder.

Mood disorder impact different people differently depending on how frequent, how severe, how long-lasting the episodes are, and  how well they function during intervening periods between the episodes.

Can mood disorder be treated?

Mood disorders are very much treatable and with the right treatment, around 80% individuals no longer experience any symptoms. With mood disorder the problem is more of recurrence and in some cases residual symptoms. Some of the common treatments modalities are:

Self-management

There are some things you can do to manage your mood and improve coping with stress. This includes- regular exercise, eating well, getting enough sleep, keeping a consistent sleep schedule, managing stress, spending time with friends and family, spirituality, and moderating use of alcohol and other substances. These activities increase general well-being and may prevent episodes.

Medications

Depression is treated with medications called antidepressants while bipolar disorder is usually treated with mood stabilizers. Other medications  called antipsychotics are sometimes prescribed for psychotic symptoms which may accompany mood symptoms.

Counselling

A variety of counselling and psychotherapies are available for mood disorders and the main ones used in depression are Cognitive behavioural therapy (CBT) and Interpersonal therapy (IPT). They are considered as sole treatment only in milder cases, but sometimes they are advised when medications alone are not helping or to prevent recurrence of depression. For bipolar disorder, medications, not counselling, are the mainstay of treatment, but can be used once symptoms are resolved to maintain recovery.

Electroconvulsive therapy

may help people who have severe episodes of mood disorder when urgent intervention is required and sometimes in depression, when a number of medication trials have failed. This treatment requires general aesthesia and can only be offered in inpatient setting. Despite negative movie and media portrayals, modern electroconvulsive therapy is very safe, fast-acting, and effective, however often people require maintenance treatment after a course of electroconvulsive therapy to prevent recurrences.

Hospitalization

Hospitalization may be required in most severe cases which require urgent treatment due to emergence of suicidal, unpredictable or risky behaviour, or where ECT is being considered for treatment of symptoms. Generally the period of admission is short, which helps to restore the homeostasis balance enough to enable treatment in the community.

What if I’m not responding to my current treatment ?

Normally there is often a delay of few weeks after starting antidepressant and clinical relief in symptoms of depression. This is expected and it may be worthwhile to wait. However, not uncommonly there is often a lack of improvement or only partial improvement. In this situation, the doctor will usually try different medication or try a different approach, for example, adding medications or adding psychotherapy to ongoing medication. Unfortunately, the process can be quite challenging and time consuming and often a successful outcome is not guaranteed. This situation is called treatment resistant depression.

Fortunately, QEEG can assist in making the choice of most effective medication at the very onset of treatment, or anytime thereafter. This is done through Pharmaco-EEG, which can foretell which are most likely medication(s), among more commonly available medications, which will help. This can be very cost effective and practical in the long run when compared to quality-of-life  and financial dimension of untreated depression. Moreover, QEEG analysis can help predict if there a likelihood of poor response to antidepressants, for example when there is generalized slowing in EEG.

In cases where there is lack of clinical response to many antidepressant, alone or in combination, Neurofeedback may be more appropriate as it directly modulates brain activity where it may  be aberrant as determined by qEEG.

To know more about how we can help, contact our staff on 02 88815550 for more information.