Is It Stress Or A Mood Disorder?

Most of us are familiar with high and low mood swings. But if these extreme moods persist for longer periods of time, you may be suffering from a mood disorder.

Cody Nelson, PMHNP, a board-certified psychiatric mental health nurse practitioner with Franciscan Physician Network Outpatient Behavioral Health Center in Lafayette, discusses symptoms of mood disorders and how they're treated.

Key Takeaways: Stress Or Mood Disorder

• Stress can be a normal part of life, but a mood disorder is a persistent condition. While stress can cause temporary fatigue and irritability, a mood disorder is a severe disruption in emotion that impairs daily functioning for at least two weeks.
• Mood disorders are marked by extremes. They are characterized by severe and lasting lows (depression) or highs (mania).
• Symptoms of a mood disorder are more profound. Unlike stress, a mood disorder can cause a sustained sense of hopelessness, low self-esteem, a loss of interest in previously enjoyed activities, and significant changes in sleep and appetite.
• Seek professional help when symptoms persist. If you experience a depressed mood or other symptoms for two weeks or more, you should talk to a doctor to rule out any underlying medical conditions and discuss a treatment plan.

What Is A Mood Disorder?

A mood disorder described by marked disruptions in emotions (severe lows called depression or highs called hypomania or mania).

“A mood disorder can take a couple different forms, either an elevated mood, like an abnormally expansive or high mood or a depressed mood,” Nelson said.

Mood disorders are typically categorized as bipolar disorders and depressive disorders. They include:

• Bipolar disorder
• Cyclothymia
• Hypomania
• Major depressive disorder
• Disruptive mood dysregulation disorder
• Persistent depressive disorder
• Premenstrual dysphoric disorder. 

Is It Stress Or Mood Disorder?

The symptoms of stress and mood disorders can overlap, but there are differences are worth exploring.

“We all have times of highs and lows,” Nelson said. “The difference with a mood disorder is that it becomes problematic for somebody's functioning. It can start to impair them socially, occupationally, maybe within their family.”

Stress is a normal part of life, and we all experience it. When stress becomes chronic, it can have a negative impact on our mental and physical health and may lead to anxiety and depression. Work stressors, a marital change or a move are among the things that can lead to stress and a person feeling depressed.

Symptoms of stress

Some common symptoms of stress include:

• Feeling overwhelmed or anxious
• Fatigue or low energy
• Irritability or moodiness
• Headaches or body aches
• Difficulty sleeping

But these periods of lows or highs can lead to a mood disorder when external things are impacted by changes in a person’s mood.

When stress is a problem

“It becomes a disorder when there's not just a problem with the mood, but all kinds of other symptoms that kind of come together to create some significant problems,” said Nelson, adding that these problems occur for a period of two weeks or longer.

What Are Symptoms Of Mood Disorders?

Symptoms of mood disorders include many of the common signs of depression:

• Ongoing sad, anxious, or “empty” mood
• Feeling hopeless or helpless
• Having low self-esteem
• Feeling inadequate or worthless
• Excessive guilt
• Not interested in normal activities or activities that were once enjoyed. “In fact, you may not feel depressed and you may just feel like, ‘I don't want do these things anymore,’” Nelson said. “’I used to like to go play tennis with my friends,’ ‘I used to enjoy taking the kids to soccer,’ and you just don't seem to have that anymore.”
• Relationship problems
• Changes in sleep patterns. “We all hit snooze from time to time, but this is you hit snooze two and three times and you've gone to bed early and just you're tired all the time,” Nelson said. “You might come home from work and instead of getting at your garden, you want take a nap. The flip of that is some folks with depression can't sleep well at all. They'll go to bed and they'll lie and just can't fall asleep or they'll fall asleep really easily, but then they're up all night.”
• Changes in appetite or weight
• Decreased energy
• Trouble focusing
• Less able to make decisions
• Frequent physical complaints (for example, headache, stomachache, or tiredness) that don’t get better with treatment
• Running away or threats of running away from home
• Very sensitive to failure or rejection
• Irritability, hostility, or aggression
• Repeated thoughts of death or suicide, planning for death, or wishing to die

Symptoms of a mood disorder may occur over a period of two weeks or longer.

When to seek care

“When you have either a depressed mood or decreased interest for two weeks, and then at least four other of these symptoms with weight changes, sleep changes, energy changes, worthless feelings, concentration problems, or there can also be what we call psychomotor agitation or retardation, everything's kind of slowed down, people just can move along or people kind of feel antsy,” Nelson said. “The key is also that you're seeing this period of time and these symptoms kind of bleed into work, into family, into social functioning as well.”

If I Think I May Have A Mood Disorder, What Should I Do?

“The first step is to talk with your primary care physician,” Nelson said. “You make those appointments the same as you would if you called and said you've got a fever, ‘My ear hurts’ or ‘I've got a stomach problem,’ ‘I'm not sleeping well’ or ‘I think I'm depressed.’ And you talk with your doctor about that. And he or she would go through and weed things out a little bit and see if you need a treatment, which can take several forms and kind of get a treatment plan.”

It’s important to rule out any medical conditions, Nelson said.

“There's lots of medical illnesses that can masquerade, if you will, as depression or even mania,” he said. “Having physicals and some work done to rule out other causes for how you're feeling is important.”

These can include anemia, thyroid problems or diabetes or pre-diabetes.

If you are experiencing suicidal thoughts, don’t wait for an appointment with your primary care doctor. Call 988 or go to an emergency room.

How Are Mood Disorders Treated?

If medical conditions are ruled out as a cause of your symptoms, your doctor may recommend psychotherapy, counseling or medication as next steps for treatment for mood disorders.

“Often, you'll have a combination of medications along with therapy, which is really a beneficial combination to help treat these diseases,” Nelson said. “If it isn't getting better, you might get a referral to a psychiatrist and we specialize in treating these mood disorders.”

Talking To Your Doctor About Your Mental Health 

The journey toward improved mental health begins with a single step—a conversation with your doctor. Taking the initiative to talk with your doctor about your mental health helps you actively invest in a healthier, happier you. Your well-being is worth the conversation.

Listen Now: Mood Disorders

Franciscan Physician Network psychiatrist Besty Rosiek, MD, discusses mood disorders, their symptoms and treatment, in an episode of the Franciscan DocPod podcast.