Affective disorders, also known as mood disorders, are conditions that primarily affect a person’s emotional state. The two major affective disorders are depression and bipolar disorder. These conditions can significantly impact daily functioning, relationships, and overall quality of life. Early recognition and proper treatment can help patients manage symptoms effectively.
1. Types of Affective Disorders
A. Major Depressive Disorder (MDD)
A persistent feeling of sadness, loss of interest, and low energy lasting for at least two weeks.
B. Bipolar Disorder
Characterized by mood swings between depressive episodes and periods of elevated mood (mania or hypomania).
C. Dysthymia (Persistent Depressive Disorder)
Chronic depression lasting two years or more, with milder symptoms compared to major depression.
2. Causes and Risk Factors
Affective disorders result from a combination of biological, psychological, and environmental factors.
Biological Causes
- Imbalance of neurotransmitters (serotonin, norepinephrine, dopamine)
- Hormonal disturbances
- Genetic predisposition
Risk Factors
- Family history of mood disorders
- Stressful life events
- Chronic illnesses
- Substance abuse
- Lack of social support
3. Symptoms of Affective Disorders
A. Symptoms of Depression
- Persistent sadness or emptiness
- Loss of interest in activities
- Sleep disturbances (insomnia or excessive sleep)
- Fatigue or low energy
- Feelings of guilt or worthlessness
- Decreased concentration
- Appetite changes
- Suicidal thoughts
B. Symptoms of Mania (Bipolar Disorder)
- Elevated or irritable mood
- Increased energy and activity
- Decreased need for sleep
- Racing thoughts
- Impulsive or risky behavior
- Rapid speech
4. Diagnosis
- Clinical interview and psychiatric evaluation
- Assessment using standardized tools (PHQ-9, HAM-D, YMRS)
- Rule out medical causes such as thyroid disorders or anemia
- Review medication and substance use history
5. Treatment of Affective Disorders
Treatment depends on the specific disorder and severity of symptoms. It may include medications, psychotherapy, or a combination of both.
A. Treatment of Depression
1. Antidepressants
- SSRIs: Fluoxetine, Sertraline, Escitalopram
- SNRIs: Venlafaxine, Duloxetine
- TCAs: Amitriptyline, Imipramine
- MAOIs: Phenelzine (rarely used due to interactions)
SSRIs are the first-line therapy due to better safety and tolerability.
2. Psychotherapy
- Cognitive behavioral therapy (CBT)
- Interpersonal therapy (IPT)
3. Other Treatments
- Electroconvulsive therapy (ECT) for severe or resistant cases
- Light therapy for seasonal affective disorder
B. Treatment of Bipolar Disorder
1. Mood Stabilizers
- Lithium (gold standard treatment)
- Valproic acid
- Carbamazepine
- Lamotrigine
2. Atypical Antipsychotics
- Olanzapine
- Risperidone
- Quetiapine
- Aripiprazole
3. Antidepressants (with caution)
Used only in combination with a mood stabilizer to avoid triggering mania.
6. Non-Pharmacological Management
- Stress management techniques
- Regular sleep schedule
- Healthy diet and exercise
- Avoiding alcohol and recreational drugs
- Support groups and counseling
7. Complications
- Suicide risk
- Substance abuse
- Relationship conflicts
- Poor work or academic performance
- Social withdrawal
8. Prevention and Early Management
- Identify early warning signs (mood swings, sleep changes)
- Avoid triggers like stress and substance use
- Maintain routine follow-ups with mental health professionals
- Ensure adherence to prescribed medications
9. Role of the Pharmacist
- Provide medication counseling
- Monitor for side effects and interactions
- Encourage adherence to therapy
- Educate families about symptoms and relapse prevention
- Assist in managing medication-related problems
Detailed Notes:
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