What is Affective Mood Disorders?
The separation of affect and mood is due to the fact that by affect is meant a vivid expression of emotions, which is reflected in behavior, by mood is understood as the sum of emotions for a certain period of time, which often, but not always, manifests itself in behavior and can successfully hide. Along with mania and depression, recurrent, bipolar and chronic affective disorders, such as seasonal weight changes, evening cravings for carbohydrates, premenstrual syndromes, part of adolescent aggression, and “northern depression” that occur in migrants to the north latitude during the polar winter. These syndromes are not yet included in the classification.
Prevalence
Exposure to affective disorders is 1%, the ratio of men and women is about the same. In children, they are rare and reach a maximum by the age of 30-40 years.
Causes of Affective Mood Disorders
Emotion is manifested in behavior, for example, in facial expression, posture, gesture, features of social communication, thinking, and is subjectively described in the structure of experience. When control is lost over it, it reaches a degree of affect and can lead to self-destruction (suicide, self-harm) or destruction (aggression). Affective disorders (bipolar, recurrent, dysthymic) have several links of etiology and pathogenesis:
- Genetic causes of diseases can be an abnormal gene in chromosome 11, although there are theories of genetic diversity of affective disorders. The existence of dominant, recessive and polygenic forms of disorders is assumed.
- The biochemical cause is a disruption in the activity of the metabolism of neurotransmitters, their number decreases in depressions (serotonin) and increases in mania, as well as catecholamines, the deficiency of which is noted in depressions.
- Neuroendocrine causes are expressed in impaired rhythms of the functioning of the hypothalamic-pituitary, limbic system and pineal gland, which is reflected in the rhythm of release of releasing hormones and melatonin. These processes are associated with photons of daylight. This indirectly affects the overall rhythm of the body, in particular, the rhythm of sleep / wakefulness, sexual activity, and food. These rhythms are systematically violated in affective disorders.
- Theories of the loss of social contacts include cognitive, psychoanalytic interpretations. The cognitive interpretation is based on the study of the fixation of depressogenic schemes of the type: bad mood — I can’t do anything — my energy is falling — I’m useless — my mood is declining. This scheme is reflected on the personal and social level. The style of depressive thinking suggests the absence of a plan for the future. Psychoanalytic concepts explain depression by regression on narcissism and the formation of self-hatred, narcissistic elements are found in self-presentation and exhibitionism, also in mania.
- The cause of affective disorders can be negative (distress) and positive (eustress) stress. A series of stresses lead to overstrain, and then exhaustion as the last phase of the main adaptation syndrome and the development of depression in constitutionally predisposed individuals. The most significant stressors are the death of a spouse, child, quarrel, and loss of economic status.
- The basis of psychobiology of affective disorders is a violation of the regulation in the spectrum of aggressive – auto-aggressive behavior. The selective advantage of depression is the stimulation of altruism in the group and family, the obvious advantage in group and individual selection is different and hypomania. This explains the steady number of susceptibility to affective disorders in the population.
Symptoms of Affective Mood Disorders
The main violation is a change in affect or mood, level of motor activity, activity of social functioning. Other symptoms, such as a change in the pace of thinking, psychosensory disorders, self-incrimination or overestimation, are secondary to these changes. The clinic appears as episodes (manic, depressive) of bipolar (two-phase) and recurrent disorders, as well as in the form of chronic mood disorders. Between psychosis intermissions are noted without psychopathological symptoms. Affective disorders are almost always reflected in the somatic sphere (physiological functions, weight, skin turgor, etc.).
The range of affective disorders includes seasonal weight changes (usually the increase in weight in winter and its decrease in summer within 10%), evening craving for carbohydrates, in particular for sweets at bedtime, premenstrual syndromes, expressed in a decrease in mood and anxiety before menstruation, as well as ” North Depression ”, which migrants to the northern latitudes are exposed to, is observed more often during the polar night and is due to a lack of photons.
Diagnosis of Affective Mood Disorders
The main signs are changes in affect or mood, the remaining symptoms are deducible from these changes and are secondary.
Differential diagnostics
Affective disorders are observed in many endocrine diseases (thyrotoxicosis and hypothyroidism), Parkinson’s disease, and vascular pathology of the brain. In organic affective disorders, symptoms of cognitive deficit or disorders of consciousness are present, which is not characteristic of endogenous affective disorders. They should also be differentiated in schizophrenia, but with this disease there are other characteristic productive or negative symptoms, in addition, manic and depressive states are usually atypical and closer to manic-hebephrenic or apathetic depressions. The greatest difficulties and disputes arise in the differential diagnosis with schizoaffective disorder, if the structure of affective disorders arise secondary ideas of revaluation or self-incrimination. However, with true affective disorders, they disappear as soon as it is possible to normalize the affect, and do not define the clinical picture.
Treatment of Affective Mood Disorders
It consists of the treatment of depression and mania itself, as well as preventive therapy. Depression therapy includes, depending on the depth, a wide range of drugs from fluoxetine, lerivon, zoloft, mianserin to tricyclic antidepressants and ECT. Sleep deprivation therapy and photon therapy are also used.
Mania therapy consists of therapy with increasing doses of lithium while controlling them in the blood, using neuroleptics or carbamazepine, sometimes beta-blockers. Maintenance treatment is carried out with lithium carbonate, carbamazepine or sodium valprat.