When it comes to the issue of mood disorders, most people associate this kind of diagnosis with adolescents and women of reproductive age; however, that is a common stereotype. Mood disorders can affect everyone, including children. The term mood disorder is a mental health condition used by health care providers to describe all types of depression and bipolar disorders blanketly. The article will use the psych info database to lookup publications that will help shed more light on the issue of mood disorders, that is, the prevalence, the causes, treatment options that exist for each disorder, and provide a conclusion based on the findings.
Lack & Green (2009) describe the causes of mood disorders as biological, cognitive, behavioral, interpersonal, family, and life stresses. The authors suggest that models have been proposed and hypothesized as to why mood disorders are expressed in either children or adolescents. While the models are particularly useful in describing mood disorders, none of the models can thoroughly explain each aspect. The biological model involves the complex interaction of the brain, genetic influence, and neurochemistry. Lack & Green (2009) argue that having a parent, more so, a mother, with depression is a strong predictor of the child developing a mood disorder. Compounding Lack & Green’s study, Silberg et al. (2001) conducted a study on twins assessing the impact of genetics on the development of mental disorders. The study used a large-scale population of twins, and the authors found out that genetic influence played a significant role in the development of depression. It is, however, unclear on what is inherited, but the authors acknowledge the possibility of neurochemical differences, temperament, reactivity to stress, and brain structure being passed on with the parent genetic composition. Additionally, the biological model also introduces the aspect of alterations in the brain neurotransmitters, i.e., norepinephrine, serotonin, and dopamine, which has been associated with the development of depression and other mood disorders.
Delegate your assignment to our experts and they will do the rest.
The next model is the cognitive model. In this model, much emphasis is placed on the adaptive ways of thinking, which impact a child’s behavior and emotions. Lack & Green (2009) discuss three types of maladaptive cognitive functions that encompass a person with a mood disorder. For starters, people with mood disorders engage in automatic negative thoughts, which lead to negative interpretations of events. Secondly, they have excess self-critical views of themselves. Lastly, they tend to have elevated negative views of themselves, the world, and the future. This phenomenon is referred to as a negative cognitive triad. Other than this model, other models have come out explaining the importance of attributions in mood disorders. These attributions barely change in different situations and adversely affect the person (Goodyer et al., 2007).
The behavioral model focusses on mood disorders caused by social deficits, i.e., a lack of social skills causes high levels of negative feedback rather than positive from the environment. This negative feedback is eventually internalized hence leading to negative self-perceptions and thoughts. These thoughts consequently predispose the child to mood disorder symptoms, which can, in turn, lead to maladaptive behavior, creating a loop of continuous negative feedback. Lastly, the interpersonal model was developed by Coyne and proposes that people with mood disorders have interpersonal behaviors such as always seeking reassurance from others that they are loved. Even when the reassurance is provided, they still question and seek further reassurance. This causes a negative pattern of interactions, and the final nail on the coffin is when the person receives rejection rather than reassurance. The most prevalent types of mood disorders include major depression, which is associated with disinterest in usual activities coupled with other symptoms lasting for at least two weeks. Next is dysthymia, a type of chronic depression that lasts for at least two years. Bipolar disorder is the most commonly known disorder in which a person has periods of depression alternating with periods of elevated mood. Generally, bipolar disorder is sometimes associated with the person having two distinct personalities.
To better understand the magnitude of mood disorders, Merikangas et al. (2009) provide a breakdown of significant studies across the world. The studies used by the authors implement a quantitative longitudinal approach, hence are useful in providing estimates of the phenomenon under study. However, some of the studies are somewhat localized to specific global regions; thus, they cannot be used to create a clear picture of the real situation on the ground. Despite this limitation, the authors note major depressive disorders as the leading mood disorder in children accounting between 0.6% in Great Britain to 3.0% in Puerto Rico. When it comes to adolescents, the situation is far much dire, with prevalence rates of between 23.2% in New Zealand and 43.3% in Oregon. Prevalence estimates of dysthymia among children and adolescents are usually lower than those of major depression. Merikangas et al. (2009) further note that depression rates among children exist in both genders; however, during adolescence, females experience more episodes when compared to males of similar age. Despite the vital insights into the phenomenon under discussion, Merikangas et al. study has significant limitations that hinder proper generalization of the data they reported. For instance, the above statistics relied on studies from two regions, which make it hard to report that as the real situation on the ground. Additionally, the authors failed to segregate the information based on race in the regions they reported on.
McLaughlin et al. (2007) compliment Merikangas et al. study by segregating mood disorder prevalence based on racial and ethnic differences. The authors conducted the study in the United States among sixth, seventh, and eighth graders, paying attention to the three major ethnic groups, i.e., White, Black, and Hispanic/Latino. The authors reported that mood disorders were more pronounced among the Latino group, more so, the Hispanic females who exhibited higher levels of aggression than the other groups. When it came to the males, Black males reported the highest levels of physiologic anxiety. These findings point out to a new dimension of looking at mood disorders. Race plays a significant part in the development of mood disorders. This can probably be as a result of genetic factors that have been inherited or psychosocial interactions. Kessler et al. (2005) note that the average age of onset of major depressive disorder is between 11 and 14 years. In adults, depression is often associated with lower social class and reduced economic capacities; however, this is not particularly true when it comes to adolescents and children, with only a few cases reporting the association (Kessler et al., 2003).
Baum et al. (2014) conducted a study on mood and emotion regulations among adolescents subjected to severe sleep restrictions. This study encompasses a mix of both the biological and cognitive models in that sleep restriction interferes with healthy brain development, hence leads to adverse changes in the neurological functioning of an individual. The subject of sleep and psychological interference raises many questions on whether there is adequate evidence that supports the notion. Despite the concerns mentioned above, the authors noted mood disorders and decreased ability to regulate negative emotions among sleep-deprived adolescents, i.e., sleep time lasting six and a half hours or less each night. This form of sleep pattern affects about 50% of American adolescents, especially during the school week, and as noted by Baum et al. (2014), this has the potential for adverse psychological outcomes. When it comes to bipolar disorder, there is a lot of significant issues surrounding the condition in terms of symptoms and epidemiology among children and adolescents. The situation is further worse among adolescents due to the diagnostic obstacles present. When diagnosing children, they do not exhibit similar signs as those in adults, such as the acute onset of the symptoms. This makes it difficult to make a bipolar diagnosis among this population group, and many cases may be mismanaged due to a misdiagnosis. Additionally, Lack & Green (2009) note that many bipolar disorder cases initially exhibit the symptoms of depression, and a diagnosis can only be made from multiple follow-ups.
Bipolar disorder global statistics are rather low, with a prevalence of 0.9% between the ages of 14 to 18 years (Lewinsohn et al., 2002). As initially discussed, these low figures can be attributed to misdiagnoses as diagnostic obstacles surround the condition. Additionally, Lewinsohn et al. (2002) further report that bipolar disorder peaks at age 14 in both genders and decreases gradually after that. When it comes to the causes of bipolar disorder, Furnham & Anthony (2010) categorize the causes as biological and psychosocial. They note that bipolar disorder is one of the most inheritable mental disorder, with up to 80% concordance rates. When it comes to psychosocial causes, the authors attribute stressful life events as the main culprit, which leads to dysfunctional attempts to avoid depression; hence bipolar ensues.
Treatment of mood disorders is mainly pharmacological. The use of antidepressants to treat depressive symptoms among children and adolescents is a common practice among health care practitioners. However, guidelines from the American Academy of Child and Adolescent Psychiatry suggest that unless depression is severe or recurrent, the use of medication is generally not advisable (Cheung et al., 2008). Conventional medication involves the use of selective serotonin reuptake inhibitors, which serve to balance the neurotransmitters and alleviate the symptoms of mood disorders. March et al. (2004) note that the use of SSRIs coupled with cognitive behavioral therapy yields about 71% improvement rates as compared to the use of SSRIs alone, which yield a 43% improvement.
Conclusion
In conclusion, the issue of mood disorder among children and adolescents is a relatively understated phenomenon as many people associated with such mental health conditions with adulthood. However, from the statistics noted, the issue is essentially rampant, thus requiring appropriate interventions. While the major depressive disorder is widely understood and appropriately diagnosed, bipolar syndrome faces several diagnostic limitations which have significantly impacted its management. While the issue of management is uniform, expert opinions contradict standard procedures creating room for mismanagement errors hence poor treatment outcomes.
For future research, some of the studies used in this article were narrow and only focused on particular regions in the world. It is, therefore, essential to implement more extensive studies which will enable a more generalized approach of the results, thus aid in the management of mood disorders. Additionally, most of the studies available were mainly cross-sectional, and the few longitudinal studies were conducted for a short period. It is vital to understand the long-term effects mood disorders can have on a child or adolescent when they age into adulthood. All in all, mood disorders have adverse effects on the life and wellbeing of a person, and interventions are needed to alleviate this issue.
References
Baum, K. T., Desai, A., Field, J., Miller, L. E., Rausch, J., & Beebe, D. W. (2014). Sleep restriction worsens mood and emotion regulation in adolescents. Journal of Child Psychology and Psychiatry , 55 (2), 180-190.
Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S., Stein, R. E., & Laraque, D. (2008). Expert survey for the management of adolescent depression in primary care. Pediatrics , 121 (1), e101-e107.
Furnham, A., & Anthony, E. (2010). Lay theories of bipolar disorder: The causes, manifestations and cures for perceived bipolar disorder. International Journal of Social Psychiatry , 56 (3), 255-269.
Goodyer, I., Dubicka, B., Wilkinson, P., Kelvin, R., Roberts, C., Byford, S., ... & Rothwell, J. (2007). Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: randomized controlled trial. BMJ , 335 (7611), 142.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., ... & Wang, P. S. (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Jama , 289 (23), 3095-3105.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry , 62 (6), 593-602.
Lack, C. W., & Green, A. L. (2009). Mood disorders in children and adolescents. Journal of Pediatric Nursing , 24 (1), 13-25.
Lewinsohn, P. M., Seeley, J. R., Buckley, M. E., & Klein, D. N. (2002). Bipolar disorder in adolescence and young adulthood. Child and adolescent psychiatric clinics of North America , 11 (3), 461-75.
March, J., Silva, S., Petrycki, S., Curry, J., Wells, K., Fairbank, J., ... & Severe, J. (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. Jama , 292 (7), 807-820.
McLaughlin, K. A., Hilt, L. M., & Nolen-Hoeksema, S. (2007). Racial/ethnic differences in internalizing and externalizing symptoms in adolescents. Journal of Abnormal Child Psychology , 35 (5), 801-816.
Merikangas, K. R., Nakamura, E. F., & Kessler, R. C. (2009). Epidemiology of mental disorders in children and adolescents. Dialogues in Clinical Neuroscience , 11 (1), 7.
Silberg, J. L., Rutter, M., & Eaves, L. (2001). Genetic and environmental influences on the temporal association between earlier anxiety and later depression in girls. Biological Psychiatry , 49 (12), 1040-1049.
