MOOD
DISORDERS

What are Mood Disorders?

Mental health problems ranging from depression to bipolar disorder are known as mood disorders, or affective disorders. In any of these disorders, a serious change in mood shapes your child’s emotional state. Unlike a normal bad mood a child feels occasionally, a mood disorder involves thoughts and feelings that are intense, difficult to manage, and persistent. A mood disorder is a real medical condition, not something a child will likely just "get over” on his own.

Today, clinicians and researchers believe that mood disorders in children remain one of the most underdiagnosed health problems. Mood disorders that go undiagnosed can put kids at risk for other conditions, like disruptive behavior and substance use disorders, that remain after the mood disorder is treated. Children and teens with a mood disorder don’t always show the same symptoms as adults. So it can be difficult for parents to recognize a problem in their child, especially since he or she may not easily express his or her thoughts or feelings.

The most common mood disorders in children and adolescents include:

  • Major depressionA depressed or irritable mood, lasting at least two weeks.
  • Persistent depressive disorder (dysthymia). A chronic, low-grade, depressed or irritable mood for at least 1 year.
  • Bipolar disorder. Periods of persistently elevated mood followed by periods of depressed or flat emotional response.
  • Disruptive mood dysregulation disorder. A persistent irritability and extreme inability to control behavior.
  • Premenstrual dysmorphic disorder. This includes depressive symptoms, irritability, and tension before menstruation.
  • Mood disorder due to a general medical condition. Many medical illnesses, including cancer, injuries, and chronic medical
    illnesses, can trigger symptoms of depression.
  • Substance-induced mood disorder. Symptoms of depression due to drug use, the effects of a medication, or exposure to toxins.

Girls are at least twice as likely as boys to develop depression. Boys and girls are equally likely to develop bipolar disorder and obsessive-compulsive disorder.

Suspected Causes

The causes of mood disorders are not well understood. Imbalances in brain chemicals play a role. Environmental factors, such as unexpected life events and/or chronic stress, can also contribute to a mood disorder.

Mood disorders often run in families, so there is a genetic component, too. Children who have relatives with depression are at increased risk for depression. In addition, a family history of bipolar disorder may predispose a child to have bipolar disorder or other mood disorder.

Sometimes, extreme stress or a life event can “turn on” a gene, causing the disorder to develop. This can happen especially with depression.

Signs and Symptoms

Children show symptoms differently, according to their age and biological makeup. Symptoms also vary according to the type of mood disorder. Overall signs of a mood disorder may include:

  • Sad, depressed, irritable, angry, or elevated mood that appears more intense than the child usually feels, lasts for a longer period of time, or occurs more frequently.
  • Trouble with family, including difficult behavior.
  • Lack of motivation or pleasure in previously enjoyed activities.
  • Changes in sleep or eating patterns or weight.
  • Frequent physical complaints, such as headaches, stomachaches, or fatigue.
  • Loss of energy or fatigue.
  • Difficulty achieving in school.
  • Worthlessness, guilt, or low self-esteem.
  • Severe recurrent temper outbursts.
  • Increased energy or bursts of energy with racing thoughts or fast speech.
  • Rebellious or high risk behavior.
  • Running away or threats of running away from home.
  • Difficulty with friends and peers.
  • Expressions of suicidal thoughts, which should be evaluated immediately.

Diagnosis

If you believe your child is struggling with a mood disorder, you can ask your pediatrician for a referral to a therapist or child psychiatrist. An accurate diagnosis of the mood disorder, as well as any other conditions, is a crucial first step in managing the disorder effectively. At The Children’s Hospital of Philadelphia, a specialist will perform a comprehensive evaluation. The evaluation may assess: 

  • Your child’s overall health and medical history.
  • Your child’s symptoms.
  • Your child’s behavior at home, at school, and with peers.
  • Environmental factors that might be stressors in your child’s life.
  • Input from teachers or guidance counselor about issues at school.
  • Your child's past experiences with specific medications or therapies.
  • Your opinion or preference for treatment options.

Treatment

Mood disorders can be treated with evidence-based treatments, especially with early recognition of the problem. Treatment can help manage the episode, reduce the severity of symptoms, and help to prevent future episodes. It can also enhance your child’s normal growth and development and improve his or her quality of life and relationships.

A CHOP specialist will design a personalized treatment plan based on your child’s symptoms and other factors unique to her situation. The plan may include:

Individual therapy

Family therapy

The specialist will identify key problems in your child's life and help your child learn how to manage these stressors. The specialist may also use a variety of techniques to help your child manage the symptoms of the mood disorder, including

  • Cognitive-behavioral. This approach involves changing problematic thoughts, feelings, and behaviors that your child may be experiencing.
  • Interpersonal therapy. This technique focuses on building social skills and helping children with difficult relationships in their lives.

Families play a vital supportive role in any mood disorder. Families, including parents or guardians, can learn methods to help their child manage mood and behavior problems. The specialist may also explore potential stressors in a child’s life and patterns of interaction within the family. A consultation with your child’s teachers or guidance counselor may also be advised.

  • Clinical Depression (Major Depressive Disorder)
  • Bereavement - Mourning the Loss of a Loved one, a way of life (such as after a divorce, or having to move schools, or the loss of pet.)
  • Disruptive Mood Dysregulation Disorder.
  • Self-Harm (Cutting) - Often a symptom of additional mood and/or anxiety disorders.
  • Bipolar Disorder - Extremely rare in children and adolescents

Behavioral Self-Regulation and Attention Disorders

  • ADD and ADHD
  • Attachment Disorder
  • Intermittent Explosive Disorder (Uncontrolled Anger)
  • Kleptomania
  • Oppositional Defiant Disorder (ODD)
  • Pyromania
  • Self Injury (Cutting)

Stress-Related/Reactive Disorders

  • General Adaptation Disorder (Adjustment Disorder)

  • Post Traumatic Stress Disorder (PTSD)

Sleep Disorders

  • Insomnia Disorder

  • Sleep Terror Disorder

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