Other Mood Disorders

disruptive mood dysregulation disorder

instability and emotional dysregulation

• without some of the other ODD or CD symptoms (ex. antisocial behaviors)

chronic, severe irritability → persistent outbursts and angry mood (tantrums, crying fits)

present for 1+ year in 2+ settings

onset prior to age 10

*cannot be comorbid w ODD or bipolar

treatment of DMDD

Dialectical Behavioral Therapy for children (DBT-C): for emotional dysregulation

Behavioral Parent Training (BPT): parents’ reactions to children → modeling emotioinal reactivity

SSRIs and CNS stimulants (depends on the causes)

atypical antipsychotics- Risperdal

pediatric bipolar disorder

unusually persistent elevated, expansive, or irritable mood alternating with major depressive episodes

common mania symptoms in children: pressured speech, racing thoughts, flight of ideas, restlessness, impulsiveness, energy surges

bipolar I vs. bipolar II vs. cyclothymia

BI: cycles of mania and major depression

BII: cycles of hypomania (less severe) and major depression

cyclothymia: cycles of hypomania and minor depression

hypomania vs. mania

hypomania: elevated or agitated mood, symptoms don’t typically require hospitalization, may bring happiness or joy since it does not cause harm

mania: abnormally elated mental state, euphoria, lack of inhibitions, risk taking, irritability, diminished need for sleep

• often requires hospitalization to control severe symptoms and delusional features

causes of bipolar disorder

genetics/family history

psychological trauma and/or abuse

neurotransmitter and hormonal imbalances

prevalence of bipolar disorder

BI: 1-1.8%

about 60% have their first episode prior to age 19

highest rates in 18-29year olds- 4.7%

BII and cyclothymic disorder are more common

• BI: worst prognosis

comorbidities: EDs, ADHD, heart/thyroid problems

treatment for bipolar disorders

multimodal plan:

• family and patient education- what to look for and how to address episodes

• monitoring symptoms closely

• administering medication- usually nonnegotiable

  • problem- adherence

• addressing related psychosocial impairments with therapy

psychopharmacological treatments

*mood stabilizers- lithium, Depakote

• limit both types of episodes

*antipsychotics- Risperdal, Abilify

• limit both types of episodes

antidepressants and anti-anxiety meds- benzodiazepenes

• not usually prescribed alone

psychosocial treatments for bipolar disorder

psychoeducation

developing emotion regulation strategies

improve verbal and non-verbal communication among family members

• reaching out for support

developing strategies to manage symptoms