DISORDERS OF MOOD AND AFFECT

Affect is the feeling tone that accompanies ideation. It is synonymous with emotion. Mood refers to a sustained affective state. Affect may be shallow, inappropriate (does not relate to stimuli or situation), labile, or qualitatively changed as in depression, euphoria, anxiety or anger. Consequent behaviour changes such as aggression may be closely associated with disorders of affect.

Anxiety

An unpleasant emotional state characterised by feelings of apprehension, impending threat or danger that is associated with characteristic pattern of somatic and autonomic changes such as increased sweating, tremor, dry mouth, tachycardia and subjective feelings of tension. It may be either free floating, or phobic when it is focussed on specific objects or situations.

Depression

This varies from mild dejection to deep melancholia and despair. It is often closely associated with anxiety. When severe there may be secondary disorders of ideation (self blame and futility, hypochondriasis, or suicidal thoughts) and of behaviour (retardation, self neglect or agitation when anxiety is also marked).

Euphoria and elation

Euphoria is elevation of mood with feelings of emotional and physical well being combined with optimism concerning the life situation. When pathological it is usually quite clearly excessive and inappropriate, and may then be accompanied by over-confidence, increased motor activity and impaired judgement (Elation).

Ambivalence

The coexistence of opposite emotions and attitudes towards a given object or situation is a common cause of mood swings or oscillation between mild euphoria and depression/anxiety (cyclothymia).

Depersonalisition

It is a feeling of unreality and strangeness concerning one's own person. The person may feel outside the self, observing it objectively and feeling separate from it. The condition may occur in normal people especially with fatigue, or in epilepsy, psychosis (depressive or schizophrenic) or as a hysterical phenomenon.

Derealisation

It is loss of sense of reality concerning one's surroundings. This is closely associated with depersonalisation and they may occur together with severe anxiety in certain phobic states.