What's the difference between moody and a mood disorder?
The question that I am often asked, especially about teen girls, is what is the difference between moody and a serious problem and is this normal? In order to answer questions like these I have to ask a lot of questions first. We want to be careful when diagnosing our children or patients with a mood disorder. Raising moody tweens and teens is a typical and normal part of development to be expected. Knowing the signs and symptoms of something more serious is helpful, so here goes my attempt to educate you (just enough) in a five minute read!
What are the signs of a Mood Disorder?
Last week, when I saw the parents of a teen I have been treating for a few months they seemed particularly concerned. When I inquired about what was going on they said that they just wondered if something other than typical teen angst was going on for their child. They described slamming doors, little communication outside of yelling a change in appetite, increased social media use and failing grades. In order to better assess what was going on, I needed to ask a lot of questions and get the parents educated around this topic.
I started with understanding the family history. It is important to be honest about the mental health history of parents, grandparents and other extended family members on both sides of the family. Issues such as history of depression, anxiety, attempted or completed suicides, hospitalizations and even unexplained issues are important to know.
The most common mood disorders in children and adolescents are:
Major Depression - depressed and/or irritable mood lasting at least two weeks
Persistent Depressive Disorder / Dysthymia - a chronic or low grade persistent, depressive mood lasting at least one year
Disruptive Mood Dysregulation Mood Disorder - this is a new and popular diagnosis to hit the world of psychology and indicates persistent irritability and an extreme inability to control one's behaviors
Bipolar Disorder - periods of elevated moods followed by periods of flat or unemotional response
It is not up a parent to figure out which of the mood disorders their child may or may not have but rather a general understanding gives a parent enough information to thoughtfully move forward with help. In any of these mood disorders, a serious change in mood significantly affects your child' emotional state. The thoughts and feelings are intense, difficult to control and are persistent. An actual mood disorder cannot be bribed, it will remain despite your best efforts to cheer your child up or even give in to their demands.
Mood disorders need to be understood because if they go untreated for extended periods of time they can lead to other high risk conditions such as conduct problems and or substance abuse issues.
Common signs of symptoms of mood disorders in children and adolescents:
- Sadness, irritability, anger and outbursts that are more intense than normal and last for longer periods of time
- Difficulty getting along or engaging with others such as friends or family
- Reduced interest in activities, sports or hobbies that they were once interested in
- Increase or decrease in sleep, appetite and possible weight fluctuation
- Physical complaints such stomach aches, headaches
- Low energy, complaint of fatigue
- Poor or failing grades
- Uncontrollable anger, possibly a feeling of walking on eggshells around the child
- Low self esteem
- High risk behaviors and or not acting like oneself for prolonged periods of time
- Talks about, or posts about dark thoughts, suicide and or death
As you can hopefully see, the difference between a moody teen and a teen with a mood disorder has to do with the duration, intensity, frequency around anger, sadness and irritability. If you suspect that your child may be struggling to manage their moods as a result of a specific stress, their menstrual cycle or even for no apparent reason seek out an evaluation with a mental health specialist. Many parents will start with a conversation with their pediatrician, which depending on your doctor may or may not be appropriate, as this is an area where many doctors receive little to no training. Pediatricians are helpful with referring their patients to mental health providers who they work with and trust.
Trust your gut, be honest about your family history and seek help if needed.