Mood Disorders

Major depressive disorder

2+ weeks of depressed mood or loss of interest plus sleep changes, appetite changes, low energy, worthlessness, poor concentration, and possible suicidal thoughts.

OT focus: activity scheduling, graded tasks, routine, sleep hygiene, behavioral activation, success-oriented activities.

OT approach for depression

Start with short, structured, achievable tasks to build mastery. Avoid overly complex or competitive tasks early. Encourage routine and social participation.

Persistent depressive disorder (dysthymia)

Chronic low mood lasting 2+ years (1 year in adolescents). Less severe than major depression but long-lasting.

Bipolar I

At least one manic episode, usually lasting 1+ week. Depression is common but not required.

Bipolar II

At least one hypomanic episode plus at least one major depressive episode. No full mania.

Manic episode symptoms

Elevated or irritable mood, decreased need for sleep, grandiosity, pressured speech, racing thoughts, distractibility, risky behavior.

OT approach during mania

Low stimulation, structured, short tasks with clear limits. Avoid competitive or highly stimulating activities. Redirect gently and set firm, calm boundaries.

OT approach in the depressive phase of bipolar

Same as depression: graded, achievable tasks and routine building.

Lithium and OT

Mood stabilizer. Watch for tremor, dehydration, and toxicity signs. Hydration matters, especially in heat.