Mood changes may be a constitutive feature of several psychiatric disorders and a broad classification based on the nature of the disorder (sadness or elation) can be made into depressive and manic mood changes, each presenting with distinct clinical features [1] [2]:

• Depressive disorders - Numerous subtypes have been described in literature - major depressive disorder, persistent depressive disorder, substance or medication induced, depression occurring as a result of another disease, premenstrual dysphoric disorder and unspecified forms [3] [4]. The presence of irritable or sad mood that substantially influences everyday life of affected individuals due to somatic and cognitive disturbances is a common finding in all of them, but their distinction can be made according to the duration, onset or the underlying etiology [2]. For example, major depressive disorder is diagnosed when mood changes last for at least two weeks, while persistent depression is suspected if symptoms last for two years in adults and one year in children [2]. Moreover, patients may suffer from psychotic, melancholic or catatonic episodes that can mislead the physician from depression as the underlying disorder.
• Mania and hypomania - Abnormally irritable and expansive mood present for one week accompanied by symptoms such as elevated self-esteem, decreased need for sleep, psychomotor agitation, racing thoughts, increased goal-directed activity and a propensity for distraction by irrelevant or unimportant stimuli are hallmarks of a manic episode [2] [5]. A fast rate of speech, verbosity, accelerated mental and physical activity, and personal belief that he/she is at an excellent mental state is often encountered, which can be dangerous or even life-threatening. A hypomanic state is described as a milder form of mania, lasting at least four days and presenting with less severe clinical symptoms than that observed in manic patients [5].
• Bipolar disorders - When manic episodes, depression, and/or hypomania are all seen in one individual, the diagnosis of a bipolar disorder should be suspected. Like in depressive disorders, several clinical types are recognized - type I, type II, drug-induced, etc. [1], while cyclothymia denotes a less severe form.

• Fatigue

  Depressed symptoms of cyclothymia include: Hopelessness, sadness, or emptiness Irritability, particularly in children or teens Loss of interest in enjoyable activities or hobbies Sleeping too much Difficulty concentrating Feeling rundown or fatigued [sunrisehouse.com]

  […] unrelated disorders, such as schizophrenia, bipolar disease, dementia, Alzheimer’s disease, epilepsy, migraine headaches, strokes, neuropathic pain, Parkinson’s disease, ataxia, transient ischemic attack, cardiomyopathy, coronary artery disease, chronic fatigue [bipolarnutrition.wordpress.com]

  Bipolar Disorder can manifest in many ways, including: difficulty falling or staying asleep, difficulty waking up in the morning, chronic fatigue, anxiety, low self-esteem, high irritability and risky or destructive behaviors. [newmarkeducation.com]

  Forty-seven percent of patients were reported to have at least one side effect, most commonly vomiting (13%), tremor (10%), fatigue (10%), irritability (7%), and enuresis (7%). [ncbi.nlm.nih.gov]

• Weakness

  The patient was brought to our emergency department because of general weakness and fever. Low plasma glucose concentration and low blood pressure were noted at arrival. She expressed mood change and persecutive thoughts. [ncbi.nlm.nih.gov]

  Anxiety symptoms include: Nervousness Fearfulness Restlessness Tenseness Racing heart Shortness of breath Significant sweating Trembling for no reason Weakness Trouble sleeping and fatigue Stomach issues Ohrt says treatment for anxiety disorder is different [unitypoint.org]

  14 22 M Yes 7.0 5.0 33 2 0 2 1.00 3.0 Depression, faintness, weakness 15 39 M Yes 8.0 5.0 47 2 4 6 3.00 0 None 16 42 F No 3.0 1.5 13 2 0 1 0.50 4.0 Headaches, sedation, confusion, weakness, sweating 17 30 M No 8.5 2.5 12 4 0 e 3 7.80 2.2 Rash, dry mouth [benzo.org.uk]

• Family History of Depression

  […] with minor depression from one another on the basis of past history of major depression or family history of depression. [doi.org]

  It is not clear whether people who have had depression before, or have a family history of depression, are more prone to this complication, and its causes are not understood. [benzo.org.uk]

  However, it can also occur in people who have no family history of depression. [0005] Major depressive disorder is prevalent in a large number of elderly patients, resulting in a significant increase in the number of suicides in this population. [faqs.org]

• Fever

  The patient was brought to our emergency department because of general weakness and fever. Low plasma glucose concentration and low blood pressure were noted at arrival. She expressed mood change and persecutive thoughts. [ncbi.nlm.nih.gov]

  Call your health care provider or go to the nearest hospital emergency room right away if you have some or all of the following signs and symptoms of NMS: high fever, increased sweating, stiff muscles, confusion, or changes in your breathing, heart rate [latuda.com]

  […] interactions of SSRIs and St John's wort are associated with an increased risk of serotonin excess (e.g., serotonin syndrome, characterized by at least three of the following: confusion, agitation, hyper-reflexia, diaphoresis, lack of coordination, fever [doi.org]

  […] sufficient to prevent, and preferably reduce by at least about 25 percent, more preferably by at least 50 percent, most preferably by at least 90 percent, a clinically significant change in a feature of pathology such as for example, elevated blood pressure, fever [faqs.org]

• Unconsciousness

  It was specifically developed for the treatment of major depression and does not address unconscious phenomena, such as defense mechanisms or internal conflicts. [purgatory.net]

  «Pittsburgh Post-Gazette, जुलाई 15» Mental health patient left alone for 35 minutes in lead-up to his death Mr Campion, who suffered from bipolar affective disorder, was found unconscious in his room at 3.10am on October 1, 2013. He was taken to ... [educalingo.com]

  The Discovery of the Unconscious. Allen Lane : London. Errera, P. ( 1962 ). Some historical aspects of the concept of phobia. Psychiatric Quarterly 36, 325 – 336. Erwin, E. ( 1978 ). Behaviour Therapy. [doi.org]

  Pain in the jaw and teeth is probably due to involuntary jaw clenching, which often occurs unconsciously during sleep. [benzo.org.uk]

• Overeating

  METHODS: This retrospective, cross-sectional study included veterans evaluated in an epilepsy clinic over the course of 1.5years. Individuals completed standardized assessments for epilepsy and sleep complaints. [ncbi.nlm.nih.gov]

  "One of the things I do is think about something over and over and over again, and that's when I start writing," he said. Sensitivity to one's surroundings is also associated with both creativity and depression, according to some experts. [cnn.com]

  We describe 29 patients with SAD; most of them had a bipolar affective disorder, especially bipolar II, and their depressions were generally characterized by hypersomnia, overeating, and carbohydrate craving and seemed to respond to changes in climate [doi.org]

• Loss of Appetite

  […] of appetite, insomnia, and fatigue) associated with paresthesias affecting his toes. [ncbi.nlm.nih.gov]

  Having a mood disorder, particularly one that involves depression, increases the risk of other problems, such as inability to do daily activities and maintain relationships, loss of appetite, extreme anxiety, and alcoholism. [msdmanuals.com]

  Major depressive disorder can have a number of symptoms such as insomnia, loss of appetite, fatigue and overwhelming feelings of sadness or grief. There may also be thoughts of death or suicide. [questia.com]

  Other features include : significant weight change and appetite disturbance (especially loss of appetite), sleep disturbance, slowed movements and speech, restlessness, decreased feelings of energy, feelings of worthlessness, difficulty in thinking or [purgatory.net]

• Nausea

  […] treatment with LATUDA The most common side effects of LATUDA include: Adults with schizophrenia: sleepiness or drowsiness; restlessness or feeling like you need to move around (akathisia); difficulty moving, slow movements, or muscle stiffness; and nausea [latuda.com]

  […] sadness; still enjoy some things Treat with CBT first, then meds like SSRIs Adjustment disorder: mood and anxiety symptoms 3 months after a stressor, typically resolving within 6 months Treatment: supportive psychotherapy and meds for symptoms (insomnia, nausea [youtube.com]

  […] impulsiveness, recklessness, or in severe cases delusions or hallucinations Anxiety disorders constant worry obsessive thoughts restlessness trouble concentrating trembling irritability difficulty sleeping sweating shortness of breath and rapid heart rate nausea [healthline.com]

  Common side effects include drowsiness, blurred vision, constipation, dry mouth, agitation, drowsiness, nausea and headache. Some side effects of bipolar disorder medications often go away within the first few weeks. [psychguides.com]

• Alopecia

  Depression circumstantially related to the administration of finasteride for androgenetic alopecia. J Dermatol. 2002 Oct. 29(10):665-9. [Medline]. Rahimi-Ardabili B, Pourandarjani R, Habibollahi P, Mualeki A. [emedicine.medscape.com]

• Visual Impairment

  Various leucodystrophies may have different clinical presentations, ranging from subtle cognitive and psychiatric manifestations to gross motor disabilities, visual impairment and seizure. [ncbi.nlm.nih.gov]

• Mood Swings

  Mood Swings vs. Mood Disorders - Discovering Bipolar Disorder People use the term mood to describe the emotional tones that color their daily lives. Moods are everywhere and ubiquitous; everyone has them. [mentalhelp.net]

  Bipolar mood swings can damage relationships, affect job or school performance, and even result in suicide. Family and friends, as well as the affected person, often become frustrated and upset over how severe these mood swings can be. [gulfbend.org]

  In cyclothymic disorder, moods swing between short periods of mild depression and hypomania, an elevated mood. The low and high mood swings never reach the severity or duration of major depressive or full mania episodes. [uchealth.com]

  What distinguishes mood disorders from ordinary mood swings? Intensity: Mood swings that come with a mood disorder are usually more severe than ordinary mood swings. [careforyourmind.org]

  Managing Mood Swings Therapy for Mood Swings Mood Swings and Psychological Disorders Case Examples What Causes Mood Swings? Exactly what causes mood swings is not known. [goodtherapy.org]

• Feeling of Worthlessness

  Affective disorders may include manic (elevated, expansive, or irritable mood with hyperactivity, pressured speech, and inflated self-esteem) or depressive (dejected mood with disinterest in life, sleep disturbance, agitation, and feelings of worthlessness [britannica.com]

  Other symptoms of depression may include: changes in appetite, sleep disturbances, low energy, difficulty thinking or concentrating, feelings of worthlessness and guilt, anxiety and thoughts of suicide. [newmarkeducation.com]

  Symptoms, that are persistent and interfere with daily life, can include: Sadness or loss of interest or pleasure in activities the person used to enjoy Weight loss Difficulty sleeping or oversleeping Energy loss Feelings of worthlessness Thoughts of [wexnermedical.osu.edu]

  […] of worthlessness or guilt Difficulty concentrating Recurrent thoughts about suicide Major depressive disorder is much more common in women than in men. [sparknotes.com]

• Suicidal Ideation

  ideation and suicide. © 2014 John Wiley & Sons A/S. [ncbi.nlm.nih.gov]

  In severe cases depression can lead to suicidal ideation or psychosis. [youtube.com]

• Euphoria

  The presence of mania (p=0.033) or euphoria/elevated mood (p=0.041) were the pretreatment symptoms significantly associated with an "improved" rating. [ncbi.nlm.nih.gov]

  Depression is the more common symptom, and many patients never develop a genuine manic phase, although they may experience a brief period of overoptimism and mild euphoria while recovering from a depression. [britannica.com]

  Bipolar disorder also can cause elevated moods (mania) that are accompanied by feelings of euphoria, grandiosity, extreme energy and heightened arousal. [chihealth.com]

  […] worthless, guilty, or constant self-criticism Unable to concentrate or focus Irritable and easily frustrated Trouble sleeping or oversleeping Bipolar disorder Bipolar disorder causes extreme mood swings ranging from mania or extreme happiness, grandiosity, euphoria [bhevolution.org]

  During mania, notes The Harvard Mental Health Letter, bipolar patients “can be unbearably intrusive and domineering, and their reckless and restless euphoria may suddenly change into irritability or rage.” [wol.jw.org]

• Low Self-Esteem

  Bipolar Disorder can manifest in many ways, including: difficulty falling or staying asleep, difficulty waking up in the morning, chronic fatigue, anxiety, low self-esteem, high irritability and risky or destructive behaviors. [newmarkeducation.com]

  Dysthymic disorder can be characterized as a chronic low-grade depression, persistent irritability, and a state of demoralization, often with low self-esteem. [healthychildren.org]

  These mood disorders share some common symptoms: Slowness in motor behavior/speech Slowed thought processes Blunted emotions Poor grooming Social withdrawal Weight loss/gain Early morning awakening Excessive sleeping Low self-esteem Agitation In addition [bhevolution.org]

  Symptoms may include: Persistent feelings of sadness, hopeless or helpless Having low self-esteem Excessive guilt Feelings of wanting to die Suicidal thoughts or attempts Loss of interest in usual activities or activities once enjoyed Difficulty with [texaspanhandlecenters.org]

  Differences in brain structure may contribute to major depression Depression is associated with certain psychological traits: Low self-esteem General negative emotionality Tendency to blame self for bad things that happen It's also been associated with [study.com]

• Difficulty Concentrating

  A person experiencing major depression may have appetite changes or difficulty eating; be unable to concentrate on work, sleep, or hobbies; or experience persistent suicidal thoughts. [sunrisehouse.com]

  concentrating, trouble engaging in daily tasks and relationships and suicidal thoughts. [chihealth.com]

  concentrating Recurrent thoughts about suicide Major depressive disorder is much more common in women than in men. [sparknotes.com]

  […] relationships Sleep disturbances (i.e., insomnia, hypersomnia) Changes in appetite or weight Decreased energy and difficulty concentrating Frequent physical complaints (i.e., headache, stomach ache, fatigue) Running away or threats of running away from [texaspanhandlecenters.org]

• Seizure

  The clinical manifestations of primary hypoparathyroidism include tetany, seizures, paresthesias, dementia, and parkinsonism. [ncbi.nlm.nih.gov]

  While this link has been noticed for many years, the relationship between seizures and mood disorders has not been well understood until recently. [epilepsy.com]

  Abrupt benzodiazepine discontinuation can cause seizures (11, 12). Three cases of grand mal seizures on abrupt cessation of alprazolam have been reported (13, 14). Here we will describe tapered alprazolam discontinuation in panic disorder patients. [benzo.org.uk]

The diagnosis of a mood disorder can be quite challenging, having in mind the diverse clinical presentation and its variable appearance in patients. In addition, concomitant presence of anxiety disorders (social phobias, obsessive-compulsive disorders, or even panic attacks) may be noted, creating an even bigger issue to discern between the disorders [5]. For this reason, physicians must bear in mind that a long and carefully obtained patient history is the essential component during workup, as the majority of symptoms may not be evident during the hospital visit, but more importantly, because the diagnosis is made almost solely on clinical criteria [2] [5]. Not all patients will be able to describe typical changes seen in mood disorders, and some will not even admit that anything extraordinary is happening, which is why parents, close friends or even relatives can be interviewed as well. Apart from determining symptoms related to mood changes, physicians must inquire about recent use of drugs or substances that can induce such changes [3] [4], but also exclude some organic diseases that may mimic depression [5]. Thyroid hormone levels should be measured to exclude hypothyroidism, while folate, B12 and a complete blood count are recommended in the diagnostic workup as well [5].

BACKGROUND: There is suggestive evidence that prior illness history may have little association with response to long-term treatment in bipolar disorder (BD) or recurrent major depressive disorder (MDD), but relationships of illness-history to treatment-response [ncbi.nlm.nih.gov]

No specific treatment is required, other than support and reassurance. [emedicine.com]

This change is of concern because a large proportion of patients with mixed features are now unspecified, and this may influence treatment planning and prognosis. [ncbi.nlm.nih.gov]

Like cancer, "mood disorder" is a general term for a group of disorders that can vary widely in terms of symptoms, prognosis and treatment. [cnn.com]

Such differentiation might be important for establishing prognosis and optimal treatment. [ajp.psychiatryonline.org]

The etiology of the mental illness could be related to the processes contributing to the development of parkinsonism. [ncbi.nlm.nih.gov]

[…] irritable or sad mood that substantially influences everyday life of affected individuals due to somatic and cognitive disturbances is a common finding in all of them, but their distinction can be made according to the duration, onset or the underlying etiology [symptoma.com]

Centers for Disease Control and Prevention National Center for Health Statistics Office of Analysis, Epidemiology & Health Promotion, Room 6433 Hyattsville USA 2. National Institute of Mental Health Bethseda USA 3. [doi.org]

Keywords: age of onset, mood disorders, anxiety disorders, alcohol use disorders, comorbidity, NESARC, epidemiology 1. [ncbi.nlm.nih.gov]

This paper reviews the studies on the pathophysiology of SAD with emphasis on circadian, neurotransmitter, and genetic hypotheses. [ncbi.nlm.nih.gov]

These fund allow the American Foundation for Suicide Prevention to invest in new research, create educational programs, advocate for public policy, and support survivors of suicide loss. [dartmouth-hitchcock.org]

Depression Maintaining healthy lifestyle habits is the best way to prevent depression. [apps.carleton.edu]

It may be possible to detect symptoms of BD or other mood disorders early in adolescence and prevent the disorder from further interfering with someone's life. [clinicaltrials.gov]

[…] dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention [ncbi.nlm.nih.gov]

1. Marvel CL, Paradiso S. Cognitive and neurological impairment in mood disorders. Psychiatr Clin North Am. 2004;27(1):19-viii.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Fifth Edition. Arlington, VA: American Psychiatric Publishing; 2013.
3. Quello SB, Brady KT, Sonne SC. Mood Disorders and Substance Use Disorder: A Complex Comorbidity. Science & Practice Perspectives. 2005;3(1):13-21.
4. Tolliver BK, Anton RF. Assessment and treatment of mood disorders in the context of substance abuse. Dialogues Clin Neurosci. 2015;17(2):181-190.
5. Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.