Understanding Mood Disorders with DSM-5 and ICD-11

Mood disorders are a class of mental health conditions characterized by significant disturbances in a person's emotional state. These disturbances can range from prolonged periods of sadness and hopelessness to extreme mood swings between elation and depression. This article delves into the world of mood disorders, exploring their various types and symptoms as defined by the two major diagnostic manuals - the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, Eleventh Revision (ICD-11).

Types of Mood Disorders:

Both DSM-5 and ICD-11 classify mood disorders into two broad categories:

  • Bipolar and Related Disorders: Characterized by episodes of abnormally elevated mood (mania or hypomania) alternating with episodes of depressed mood.
  • Depressive Disorders: Characterized by a predominant mood of sadness or loss of interest in activities once enjoyed, along with other associated symptoms.

Within these categories lie specific diagnoses with distinct criteria. Here's a closer look:

Bipolar and Related Disorders:

  • Bipolar I Disorder: Characterized by dramatic mood swings. Episodes of mania (or a milder form called hypomania) involve abnormally elevated mood, racing thoughts, increased energy levels, and decreased need for sleep. These episodes can last for a week or more and can be so severe that they require hospitalization. Depressive episodes are also a defining feature, characterized by feelings of sadness, hopelessness, and a loss of interest in activities once enjoyed.

  • Bipolar II Disorder: This disorder involves a pattern of hypomanic episodes and major depressive episodes. Hypomanic episodes are milder than manic episodes but still cause significant disruptions in daily life. People with bipolar II disorder never experience a full-blown manic episode.

  • Cyclothymic Disorder: This is a milder form of bipolar disorder characterized by numerous periods of hypomanic symptoms and depressive symptoms that don't quite meet the full criteria for a manic or depressive episode. These mood swings can be disruptive to daily life, but they are not as severe as the mood swings experienced in bipolar I or II disorder.

Depressive Disorders:

  • Major Depressive Disorder: This is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. People with major depressive disorder experience a period (at least two weeks) of depressed mood or loss of interest in activities most of the day, nearly every day. Along with these core symptoms, they experience several other symptoms like significant changes in weight or appetite, sleep disturbances, psychomotor agitation or retardation, feelings of worthlessness or guilt, difficulty concentrating, recurrent thoughts of death or suicide.

  • Persistent Depressive Disorder (Dysthymia): Similar to major depressive disorder but with a less severe and more chronic course. Symptoms last for at least two years in adults (one year for children and adolescents) and can significantly impair a person's ability to function in everyday life. People with dysthymia may experience periods of major depressive episodes, but more often they experience a low-grade, chronic form of depression.

  • Disruptive Mood Dysregulation Disorder (DMDD): Primarily diagnosed in children and adolescents, DMDD is characterized by frequent and severe temper outbursts that are significantly out of proportion to the situation and inconsistent with developmental level. These outbursts occur at least three times a week for at least a year and can be directed towards people or objects. In addition to temper outbursts, children with DMDD may also experience chronic irritability and difficulty recovering from emotional upset.

Additional Notes:

  • Bipolar Spectrum Disorder: This term is sometimes used to encompass all of the bipolar and related disorders.
  • Postpartum Depression: A type of major depressive disorder that can occur after childbirth. While some degree of baby blues is common after giving birth, postpartum depression is more severe and long-lasting.
  • Seasonal Affective Disorder (SAD): A type of depressive disorder that occurs seasonally, typically during the winter months when there is less sunlight exposure.

Symptoms of Mood Disorders:

While specific symptoms can vary depending on the type of mood disorder, some common ones include:

  • Depressed mood: Feeling sad, hopeless, or numb most of the day.
  • Loss of interest or pleasure in activities once enjoyed.
  • Changes in appetite or weight (significant weight loss or gain).
  • Sleep disturbances (insomnia or excessive sleep).
  • Psychomotor agitation or retardation (feeling restless or slowed down).
  • Fatigue or decreased energy.
  • Difficulty concentrating or making decisions.
  • Feelings of worthlessness or guilt.
  • Recurrent thoughts of death or suicide.
  • Mania/Hypomania: Abnormally elevated mood, racing thoughts, increased energy, decreased need for sleep, irritability, grandiose sense of self-importance, excessive talking and social engagement, poor judgment leading to risky behaviors.

Seeking Help for Mood Disorders

If you suspect you or someone you know might have a mood disorder, seeking professional help is crucial. Mood disorders are highly treatable with various approaches, including psychotherapy (cognitive behavioral therapy is particularly effective for depression), medication, and lifestyle changes. Early intervention can significantly improve quality of life and prevent complications.

The exact causes of mood disorders are complex and not fully understood, but there are several factors that are believed to contribute to their development. Here's a breakdown of some potential reasons behind mood disorders:

Biological Factors:

  • Brain Chemistry: Imbalances in brain chemicals, particularly neurotransmitters like serotonin, norepinephrine, and dopamine, are thought to play a significant role in mood disorders. Depression is often linked to low levels of serotonin and norepinephrine, while bipolar disorder may involve fluctuations in these chemicals as well as dopamine.
  • Genetics: Mood disorders can run in families, suggesting a genetic predisposition. If a close relative has a mood disorder, you may be at an increased risk. However, having a genetic predisposition doesn't guarantee you will develop the disorder, and many people with mood disorders have no family history.

Psychological Factors:

  • Early Life Experiences: Negative childhood experiences like abuse, neglect, or trauma can increase the risk of developing a mood disorder later in life. These experiences can affect brain development and coping mechanisms.
  • Cognitive Patterns: Negative thinking patterns, such as rumination (focusing on negative thoughts) and catastrophizing (assuming the worst possible outcome), can contribute to depression and anxiety.

Environmental Factors:

  • Stress: Chronic stress can trigger or worsen mood disorders. Stress can lead to physical changes in the brain that can contribute to depression and anxiety.
  • Substance Abuse: Drug and alcohol abuse can be a cause or consequence of mood disorders. Substances can interfere with brain chemistry and worsen mood symptoms.
  • Medical Conditions: Certain medical conditions, such as thyroid problems, chronic pain, or neurological disorders, can increase the risk of mood disorders.

Social Factors:

  • Social Isolation: Lack of social support can increase the risk of mood disorders. Having strong social connections can provide a buffer against stress and can help people cope with difficult emotions.
  • Socioeconomic Disadvantage: Poverty, unemployment, and discrimination can contribute to stress and social isolation, which are risk factors for mood disorders.

It's important to remember that mood disorders are likely caused by a combination of these factors. For example, someone with a genetic predisposition for depression may be more likely to develop the disorder if they experience a stressful life event or have negative thinking patterns.

Here are some additional points to consider:

  • Mood disorders can affect people of all ages, races, and ethnicities.
  • There is no single "cure" for mood disorders, but there are effective treatments available, including psychotherapy, medication, and lifestyle changes.
  • With proper treatment, most people with mood disorders can live full and productive lives.

The most suitable approach often involves a combination of strategies tailored to the specific needs of the individual. Here's a breakdown of the main treatment categories:


  • Cognitive Behavioral Therapy (CBT): This is a highly effective form of therapy for mood disorders, particularly depression. CBT helps people identify and challenge negative thought patterns that contribute to their mood symptoms. By learning to think more realistically and develop coping skills, individuals can manage their emotions more effectively.
  • Interpersonal Therapy (IPT): This therapy focuses on how a person's relationships can affect their mood. IPT helps individuals improve communication skills and resolve interpersonal conflicts that may be contributing to their symptoms.
  • Family Therapy: Family therapy can be beneficial for individuals with mood disorders, especially children and adolescents. This type of therapy helps family members understand the disorder and learn how to support their loved one.


  • Antidepressants: These medications work by increasing the levels of certain neurotransmitters in the brain, such as serotonin and norepinephrine. Antidepressants can be very effective in treating depression and can also be helpful for some people with bipolar disorder.
  • Mood Stabilizers: These medications are used to treat bipolar disorder and help regulate mood swings. Lithium is the most common mood stabilizer, but other medications are also available.
  • Antipsychotics: In some cases, antipsychotic medications may be used in combination with other medications to treat mood disorders, particularly bipolar disorder with psychotic features.

Lifestyle Changes:

  • Regular Exercise: Physical activity has been shown to be just as effective as medication for mild to moderate depression. Exercise releases endorphins, which have mood-boosting effects, and can also help improve sleep and reduce stress.
  • Healthy Diet: Eating a balanced diet that is rich in fruits, vegetables, and whole grains can improve mood and overall well-being. Limiting processed foods, sugary drinks, and unhealthy fats is also important.
  • Sleep Hygiene: Getting enough sleep is essential for maintaining mental health. Developing good sleep habits, such as going to bed and waking up at consistent times each day, can help improve mood and energy levels.
  • Stress Management Techniques: Learning healthy ways to cope with stress can be helpful for preventing or managing mood disorders. Stress management techniques like relaxation training, yoga, and meditation can help reduce stress hormones and improve mood.
  • Social Support: Having strong social connections is important for mental health. Spending time with loved ones, joining a support group, or volunteering can help reduce feelings of isolation and loneliness.

Additional Considerations:

  • Treatment adherence: It's important to take medications as prescribed and attend therapy sessions regularly for optimal results.
  • Treatment duration: Mood disorders can be chronic conditions, and treatment may be needed for an extended period of time, even long after symptoms improve.
  • Complementary therapies: Some people with mood disorders may find complementary therapies, such as acupuncture or massage therapy, helpful in managing their symptoms. However, it's important to discuss these options with a healthcare professional before starting them.