What is a Mood Disorder?

Depression and Moods

Mood disorder has become a bit of a generic term when discussing mental health. In reality, the term mood disorder refers to one of two specific conditions: depression or Bipolar Disorder.

Many people refer to feeling sad or disappointed as “being depressed”. This is a factually incorrect description. Depression is, in part, a chronic change in one’s mood, outlook, or behavior. Normal sadness and disappointment don’t linger on for weeks at a time.

Bipolar Disorder is a swing between feeling euphoric mania, and major depression. Bipolar Disorder can have a severe impact on the lives of people inflicted with it, as the euphoric mania stage sometimes results in excessive, irresponsible behavior — spending a great deal of money unwisely, for instance, or inappropriately interjecting oneself into certain situations — while the major depressive stage can leave a person almost completely incapacitated, and sometimes leads to a suicide attempt.
Having anxiety is quite a different scenario than having Bipolar Disorder. Anxiety is, generally speaking, feeling emotionally overwhelmed and/or extremely fearful, be it most of the time, or only in certain situations. The person with anxiety may feel as though they aren’t in control, but an anxious person typically isn’t going to engage in public displays of irrational or unreasonable behavior like someone with Bipolar Disorder may. Interestingly enough, this fear of becoming mentally ill is typically an indication that one is not mentally ill at all, as most people who are truly mentally ill consider themselves to be normal and healthy, and may even react hostilely to anyone suggesting otherwise.

While using the term mood disorder when one really means anxiety may just be a case of semantics, it is important to differentiate between various emotional and psychological conditions, if for no other reason than to ensure proper treatment.

Sleep and Mood Concerns

Sleep and Mood

Drugs, stressful situations, and even excessive noise can affect daily body rhythms and moods. An irregular living schedule can aggravate mood disorders. The old-fashioned sanitarium rest cure was effective with the “nervous” because it put the patient on a regular schedule of sleep, activity, and meals. Below are some kinds of sleep disturbances that can make mood disorder worse.

Insomnia

A person suffering from insomnia has difficulty initiating or maintaining normal sleep, which can result in non-restorative sleep and impairment of daytime functioning. Insomnia includes sleeping too little, difficulty falling asleep, awakening frequently during the night, or waking up early and being unable to get back to sleep. It is characteristic of many mental and physical disorders. Those with depression, for example, may experience overwhelming feelings of sadness, hopelessness, worthlessness, or guilt, all of which can interrupt sleep. Hypomanics, on the other hand, can be so aroused that getting quality sleep is virtually impossible without medication.

Delayed Sleep Phase Syndrome

This is the most common circadian-rhythm sleep disorder that results in insomnia and daytime sleepiness, or somnolence. A short circuit between a person’s biological clock and the 24-hour day causes this sleep disorder. It is commonly found in those with mild or major depression. In addition, certain medications used to treat bipolar disorder may disrupt the sleep-wake cycle.

REM Sleep Abnormalities

REM sleep abnormalities have been implicated by doctors in a variety of psychiatric disorders, including depression, posttraumatic stress disorder, some forms of schizophrenia, and other disorders in which psychosis occurs.

Irregular Sleep-Wake Schedule

This sleep disorder is yet another problem that many with Bipolar II experience and in large part results from a lack of lifestyle scheduling. Bipolar drug abusers and/or alcoholics who stay awake all night searching for similar addicts and engaging in drug-seeking behavior, which results in sleeping the next day, usually experience the reverse sleep-wake cycle.

Supporting children’s mental health is a good investment, says new report

3 February 2015

Investing in children’s mental health services is excellent value for money and will bring a lifetime of benefits to young people, their families, communities and the economy as a whole, according to a report published today by Centre for Mental Health for CentreForum’s Mental Health Commission.

Investing in children’s mental health examines the costs and the benefits of a range of interventions to prevent or treat some of the most common mental health conditions that affect children and young people.

It finds that there is a wide range of interventions for conduct disorder, anxiety, depression and ADHD that not only improve children’s mental health but also lead to substantial economic benefits including future savings in public spending. Group parenting programmes for conduct disorder in young children, for example, generate measurable benefits of at least £3 for every £1 invested, while group cognitive behavioural therapy for anxiety in adolescence produces benefits of £31 per £1.

The report concludes that under-investment in children’s mental health support is a false economy. But it also warns that to achieve the best value for money, children’s mental health services need to reach out to those who need them most and to be delivered to a high standard. And it finds that there are significant gaps in evidence in one or two areas of great need and growing concern, such as self-harm and eating disorders.

Centre for Mental Health chief executive Sean Duggan said: “Despite clear evidence that the financial benefits of supporting children’s mental health far outweigh the costs, only a minority of children with mental health problems get any form of treatment. And recent cuts to mental health services suggest that this gap could be getting wider rather than narrowing.

“Our analysis implies that failing to meet children’s mental health needs carries a heavy cost that can last a child’s lifetime. It is vital that health services, schools, local authorities and community bodies work together to offer young people effective interventions where they need them, when they need them in a way that they find helpful.”

Professor Stephen Lee, Chief Executive of CentreForum, said: “It is clear both from this report and from earlier work undertaken by the CentreForum Mental Commission that there remain significant gaps in children’s mental health treatment, with most young people missing out on much needed support. Intervening early in mental health helps to nip problems in the bud. That in turn saves money by eliminating the need for costlier treatments down the line. This is one of those areas where government would be better off spending more on services than cutting them.”

Rt Hon Paul Burstow MP, chair of the Commission, said: “Just one in four children and young people with a mental health problem receive any treatment. We have a once in a generation opportunity to put in place a much better service that offers children and young people timely care and support. This report provides the essential ingredients forcreating mental health services that are fit for purposes. Getting this right will have life long benefits, the case for investing is compelling.”

New report reviews ‘what works’ for people facing multiple and complex needs

29 January 2015

A report published today by Revolving Doors Agency and Centre for Mental Health shows that some of the most excluded and disadvantaged people in society can be effectively helped through better, more targeted support.

The report, Comprehensive Services for Complex Needs: A Summary of the Evidence assesses the evidence for three programmes designed to work directly with people facing multiple and complex needs: Multisystemic Therapy; wraparound; and the link worker model. It shows these programmes can address important issues such as crime and homelessness, while improving clients’ wellbeing.

The briefing outlines both the cost-benefit and the effectiveness of these service models. While highlighting the need for further robust research regarding some outcomes, our review found promising evidence that:

  • All three models can reduce reoffending rates. In a UK trial, Multisystemic Therapy reduced the percentage of young people reoffending by 26%.
  • All three models have potential to save public money in the long run, through reduced reoffending, reduced demand on costly emergency responses, and fewer young people going into care.
  • There is promising evidence that the link worker model helps the long-term homeless into stable homes and improves their mental health.

People facing multiple and complex needs experience a combination of problems at once, such as mental ill health, substance misuse, homelessness and offending. The report comes at a key time; it follows the 2014 Autumn Statement, in which the government committed to “look to develop and extend the principles of the Troubled Families programme to other groups of people with complex needs from the next Spending Review”.

Funding effective support has the potential to address important priorities for local leaders. The evidence review shows the models can reduce reoffending rates, improve access to mainstream healthcare, reduce homelessness and reduce the amount of children going into care.

Vicki Helyar-Cardwell, Director of Research and Development at Revolving Doors, said: “People facing multiple and complex needs exist in all our communities, but they are too often written off as ‘too difficult’ to help or simply overlooked as services focus on single issues. However, providing effective support for people with multiple needs should be a priority for local leaders in light of recent government commitments. In a time when local authorities need to make savings, programmes which can address key local priorities, such as reducing reoffending and preventing young people going into care, as well as potentially saving money should be seriously considered”.

Centre for Mental Health chief executive Sean Duggan said: “People with multiple and complex needs have been overlooked for too long. This briefing sets out three promising ways in which local services can get together to produce cost-effective solutions. If we are serious about achieving parity for mental health, engaging and effective support for people with complex needs should be a focus for sustained action in every local community.”

Julie Repper appointed as new Director of National Programme helping mental health services to support recovery

9 January 2015

Stephen Dalton, Mental Health Network Chief Executive, and Sean Duggan, Centre for Mental Health Chief Executive, are delighted to announce the appointment of Dr Julie Repper as the Implementing Recovery through Organisational Change (ImROC) Programme Director from 1 April 2015.

The appointment follows the retirement from the role of programme director of Professor Geoff Shepherd, who has led the programme since 2008 and will continue as a team member after 1 April.

Julie brings a wealth of experience to the team, both in facilitating service wide developments to support recovery and a rich academic history in researching recovery-focused innovation. Julie’s appointment will ensure the ImROC programme continues to grow from strength to strength in the following years working alongside its experienced team of consultants and associates.

Stephen Dalton said, “I am delighted that we attracted a strong field for this important role and that Julie has accepted the post. She has an outstanding record in this field and her appointment will be widely welcomed.”

Centre for Mental Health chief executive Sean Duggan said: “Under Geoff Shepherd’s leadership, the ImROC programme has helped mental health services across the UK to focus on personal recovery, to make big changes to the way they work and to transform the support they offer. Recovery Colleges and Peer Support Workers are now appearing in more and more mental health services and safety in inpatient wards is becoming a bigger priority.

“Julie Repper has been a key member of the team since the ImROC programme began and I am delighted that she will be taking up the role of Programme Director following Geoff’s retirement from the role at the end of March.”

Hear Julie set out her vision for supporting recovery in mental health care at the ImROC annual conference on Friday 13 February.

Service user experience key to changing Mental Health Act police powers and improving care in a crisis, says new report

18 December 2014

The use of police powers under the Mental Health Act is a major concern for service users, family carers and professionals alike, according to research published today by Centre for Mental Health.

Commissioned by the Department of Health and the Home Office as part of their review of police powers under Sections 135 and 136 of the Mental Health Act in England and Wales, the Centre’s report explores people’s experiences of these sections and their views about how they should be changed.

The report is based on meetings and interviews with health and social care professionals, police officers, commissioners, service users and carers who have had experience of the use of Sections 135 and 136. It is published today alongside the Government’s report of its findings based on evidence it received from the Centre and other research.

The Centre’s Review of Sections 135 and 136 of the Mental Health Act, by Dr Graham Durcan, finds that for many people being detained by the police was a frightening experience. The use of Section 135 powers in a person’s home was especially traumatic for those who had experienced it.

The report concludes that the use of police powers under the Mental Health Act has to change. In most cases, change could be achieved through better use of existing powers. In all cases, heeding the voices of people who have been detained under these sections is vital to ensure any changes to police powers or their application improve people’s experiences.

Dr Graham Durcan said: “Our research found a few areas of the country where the use of these sections was markedly better than in most places. This requires strong relationships between the police and health and social services, good commissioning and robust service provision. This can, for example, speed up the process of obtaining a warrant for the use of Section 135 and ensure that better places of safety are available when a person is detained.

“We found broad agreement among all those who worked with or had been subject to Sections 135 and 136 that police custody should seldom if ever be used as a ‘place of safety’ and that the duration of detention should be as short as possible. There was less agreement about the extension of police powers, which caused particular concern among service users.

“There was widespread agreement, however, that the use of these sections with children and young people was especially problematic. We also found consistently that Black people’s experiences of the police featured greater and earlier use of force.”

The Centre’s evidence review accompanies the Department of Health and Home Office report of their review of Sections 135 and 136. Their report includes proposals to change the law to outlaw the use of police custody as a place of safety for people under 18 who are detained under the Act, to extend the use of Section 136 to anywhere apart from a person’s home (such as a railway station), and to shorten the length of time a person can be detained under these sections. It also includes proposals for changing the use of the Act, including improved commissioning of places of safety and faster arrangements for the use of Section 135.

Responding to the Government report, Centre for Mental Health chief executive Sean Duggan said: “We welcome the Government’s approach to changing people’s experiences of Sections 135 and 136 of the Mental Health Act. The report clearly heeds the evidence gathered from professionals, service users and family members.

“The legislative changes proposed in the report are a proportionate response to the needs presented in our review and the wider evidence provided to government. They must be accompanied by robust action nationally and locally to improve crisis care for children and adults alike with mental health problems.

“This should include investment in age-appropriate places of safety in all areas; in the promising role of street triage to prevent the use of these sections wherever possible; and in the provision of liaison psychiatry services for people who attend A&E in a mental health emergency.

“It is vital that in all areas of the country local action plans to implement the Crisis Care Concordat are in place and that commissioners of health, social care and police services secure adequate levels of provision to meet the needs of the people they serve.”


Section 135 of the Act empowers police officers to enter private premises, after obtaining and warrant, to remove a person suspected of being in urgent need of a mental health assessment. Section 136 confers powers on the police to remove a person from a public place to a ‘place of safety’ where they can be detained for up to 72 hours pending a Mental Health Act assessment. In about a third of cases, the ‘place of safety’ is a police custody suite.

NHS England five year vision must support genuine parity between mental and physical health, says Centre

23 October 2014

“The NHS of the future must adapt to place mental health on a genuinely equal footing, with fairer funding, speedier access to care and integrated support for all of a person’s health needs,” Centre for Mental Health chief executive Sean Duggan said today.

Responding to NHS England’s five year forward view, published today, Sean Duggan said: “The paper sets out some bold new ideas about how health services can adapt to meet new challenges and offer a better service for people’s mental as well as physical health. Its proposal to enable new forms of integrated care is a welcome recognition that for too long the NHS has been organised around episodic, hospital-based care while most of what people need is ongoing support for a range of mental and physical health conditions.

“The paper restates the importance of achieving parity between mental and physical health and the plan to extend access standards to a wider range of mental health services. Combined with changes to the way services are paid for and fairer entitlements to effective care and support, this should help to rebalance the NHS and end the scandal of unmet need among people with mental health problems.

“The five year forward view makes little mention of children’s mental health despite clear evidence about the importance of early intervention and of the cuts taking place to child and adolescent mental health services across the country. From pregnancy to adolescence, the mental health of children and young people must be a priority for the NHS everywhere, working in tandem with local councils and schools and young people themselves to offer better, more engaging support.

“The five year forward view sets out the scale of the financial challenge facing the NHS. By investing in effective mental health interventions we can make much better use of scarce funding. The NHS spends £14 billion on untreated mental health problems among people with physical health conditions and among its own staff. Targeted reinvestment can help to cut that cost while enhancing people’s health and reducing inequalities. The NHS can no longer afford to overlook mental health.”

Places of safety must match levels of need across the country, says Centre chief executive

23 October 2014

The Care Quality Commission has reported this week that police custody was used as a place of safety in more than a third of Section 136 Mental Health Act detentions last year. Centre for Mental Health chief executive Sean Duggan said “We are very concerned that police cells continue to be used in mental health crises and that in some areas appropriate places of safety are still not available. We are particularly concerned about the lack of suitable places of safety for children and young people.

“The Crisis Care Concordat has prompted concerted action in many areas to improve urgent care for people with mental health problems. We need to see health services work closely with the police in every part of the country to put in place robust arrangements for responding to mental health crises. This should include proper care and support for under-18s and people who are intoxicated.

“Some very promising approaches are now emerging, such as the use of ‘street triage’ and locating mental health professionals in police control centres to reduce the number of people who are detained under Section 136. It is vital that the most effective approaches are extended across the country.

“We also need to invest in services that can prevent crises from happening, offering timely help when people seek it and support to recover when they are unwell. And we need to ensure that people who have experienced crisis care are involved in the design and development of better services.”

General Election 2015: Prioritising Mental Health Research

3 October 2014

As part of the Alliance of Mental Health Research Funders, we are today launching Prioritising Mental Health Research, our manifesto setting out what political parties can do to make mental health research a priority during the General Election 2015 and in government.

We believe there is a vital role for government leadership in championing mental health research and promoting mentally healthy communities.

General Election 2015: Prioritising Mental Health Research sets out three priorities:

  1. Championing mental health research funding in General Election manifestos. The next Government should redress the current imbalance in research funding.
  2. Removing blockages to mental health research. We cannot improve mental health and wellbeing without better quality data and information, improved coordination of data sharing between government departments and more mental health knowledge among the wider public service workforce.
  3. Giving priority to research that will make the biggest difference to people’s lives including research into children’s mental health, prevention and promotion of mental wellbeing and the links between mental and physical health. Setting research priorities should begin with the knowledge and experience of people with mental health problems

Why does research matter?

We asked Gill Grimshaw, a carer, who told us:

 

“I cannot make my son better but boosting mental health research would give us both some hope for the future. My son has had severe mental health problems for over ten years and spends several months in hospital most years. We can see that his disease impacts on his physical as well as his mental health. We can also see how much it costs to treat his disease. Since he became ill we have met so many people who have been pushed to the margins of society by mental ill health, trapped at home unable to be economically active, ending up in the criminal justice system or on the streets. Not only are the services my son uses under-resourced but precious little new knowledge and data is being developed to help us understand how money could be best spent on him. How soon can I expect priority to be given to mental health research?”

The Alliance of Mental Health Research Funders is a group of charities that fund research and use research to underpin initiatives to improve the mental health of our communities.

Read the manifesto here (download PDF).

England’s leading mental health organisations call on all political parties to make mental health a priority in run up to election

22 August 2014

Six of England’s leading mental health organisations have joined forces to produce a manifesto, laying out what the next Government must do to improve the lives of people with mental health problems.

A Manifesto for Better Mental Health‘ published today, has been written jointly by Rethink Mental Illness, Centre for Mental Health, Mental Health Foundation, Mental Health Network, Mind and the Royal College of Psychiatrists.

The manifesto sets out straightforward, practical changes that a future Government could make in order to ensure mental and physical health are valued equally.

Poor mental health carries an economic and social cost of £105 billion annually in England and business loses £26 billion due to mental ill health every year.

Just 25% of adults with depression and anxiety get any treatment and only 65% of people with psychotic disorder. Demand is also increasing. The number of people being referred to community mental health services went up by 13% in 2013.

Despite the fact that mental health accounts for 23% of the illness, it gets just 13% of the NHS budget and funding has been cut even further for the last three years. The organisations are calling on any future Government to rebalance this funding inequality, to ensure spending reflects demand.

The Manifesto sets out five key priorities for action:

  1. Fair funding for mental health – Commit to real terms increases in funding for mental health services for both adults and children in each year of the next Parliament.
  2. Give children a good start in life – Ensure all women have access to mental health support during and after pregnancy. Raise awareness of mental health by putting it on the national curriculum and training teachers and school nurses. Invest in parenting programmes across England.
  3. Improve physical health care for people with mental health problems – Ensure Government targets for smoking reduction apply equally to people with mental health problems. Create a national strategy to stop people with mental illness dying early, due to preventable physical health problems.
  4. Improve the lives of people with mental health problems – Continue to fund the Time to Change anti stigma campaign. Offer integrated health and employment support to people with mental health conditions who are out of work.
  5. Better access to mental health services – Introduce maximum waiting times for mental health care and support, including psychological therapies. Commit to continued improvements in mental health crisis care, including liaison psychiatry services in all hospitals. Continue to fund liaison and diversion mental health services, working with police and the courts.

Centre for Mental Health Chief Executive Sean Duggan said: “Mental health treatment has for too long been given a lower priority than physical healthcare. Three quarters of children and adults with mental health problems receive no treatment or support for them. We need to reinvest in effective early intervention services, in offering timely treatment when people seek help and in supporting people with mental health problems to recover their lives on their own terms. We know that offering the right help at the right time saves money; we now need to put the evidence into practice across the country.”

Mark Winstanley, CEO of the charity Rethink Mental Illness said: “Mental health must be a top priority for any new administration in 2015. It’s a scandal that people with mental illness still have no legal right to treatment and there are no maximum waiting times. People are waiting months, even years for the most basic care and many are getting no support at all. Successive Governments have failed to seriously tackle this issue, which impacts individual lives, the economy and society at large. We call upon parties across the political spectrum to commit to the simple, practical and affordable actions outlined on our manifesto and improve the lives of millions of people affected by mental illness in Britain.”

Jenny Edwards CBE, Chief Executive of the Mental Health Foundation said: “We know that half of all life time mental health problems begin by the age of 14 – therefore we must intervene early to protect and promote children’s mental health and well-being. We are asking the next Government to mandate all schools to put mental health and well-being on the school curriculum and for universal access to mental health support for the one in ten women who experience mental health difficulties during and after pregnancy. Supporting mental health and resilience from the very earliest days of life is critical if we’re going to address the mental health of the whole nation.”

Stephen Dalton, Chief Executive of the Mental Health Network, said: “This is a consensus of important voices, not partisan, but acting in the best interest of those who need mental health services now or may do one day. There can be few more important political issues than the mental health and well being of this and future generations.”

Paul Farmer, Chief Executive of Mind, said: “Staying mentally healthy is one of the biggest challenges we all face today. There have been welcome promises on mental health in recent years and the main parties say they value mental and physical health equally, but funding for mental health services has faced more severe cuts than other services. Whoever forms our next government must make mental health a priority and ensure that everyone experiencing a mental health problem gets the support they need and the respect they deserve.”

Dr Adrian James, Chair of the Royal Collage of Psychiatrists Parliamentary Committee said: “For far too long the treatment and care for people with mental health problems, and investment in mental health research, has been under-funded and under-valued. The stigma and discrimination experienced by people with mental health problems often prevents them from talking about them and seeking help. The NHS Mandate makes it clear that mental health should have parity of esteem with physical health, yet the majority of mental health services have endured a third year of real-terms reductions in funding. We hope that any future Government will take on board these five key priorities for action.”

ENDS