00:01
Let's take a look
at mood disorders.
00:03
We're going to be looking
at bipolar disorder,
as well as depressive disorder.
00:08
So what is a mood disorder
and what is affect?
Oftentimes, we're talking
about moods and affects,
as though they're
the same thing.
00:17
But they're not.
00:18
A mood is an emotional state.
00:21
It is one that a
patient experiences.
00:24
And we see it in an
emotional attitude.
00:30
We learn of it the
state of this mood
because the patient tells us.
00:36
They report on their feelings.
00:40
Now, the patient might say to
us, "I feel like there's no hope.
00:45
I haven't had any good feelings
or hope for a very long time."
And so we hear that
in the person's voice.
00:57
Now, an affect, on the other hand,
is how the patient is going to
show us what that mood is.
01:05
So for example,
if that patient is going to say,
"I feel like there is no hope."
The effect might be that
they are a little collapsed.
01:22
And their movement
might be slow.
01:26
And their eyes might
look quite sad.
01:29
It's more about how the patient
is responding in the environment
that conveys what
their mood is to us.
01:39
That's the affect.
01:42
So before we even look
at this next slide,
I want you to think
about mood and affect
and the word congruent,
meaning are they the same?
If a person comes into
you, and they say,
"I have no hope."
"I just don't see anything
good ever happening."
Well we're going to say their mood
and their affect is congruent.
02:12
As opposed to someone
going, "Hi, I have no hope."
There's like,
there's nothing to look forward to.
02:22
That's going to make
us a little bit worried
about this patient
because it's incongruent.
02:28
And we would write that down,
mood and affect incongruent.
02:33
What they are reporting, the sadness is
not being demonstrated by their behaviors.
02:40
So now let's look
at a client case.
02:42
So JJ Banter is coming
into our clinic.
02:47
And you notice that JJ
is walking really slowly.
02:51
And he's looking down at the ground,
almost speaking in a whisper.
02:59
"I'm not feeling like
myself these days."
You actually have to lean in,
in order to hear what JJ wants to say.
03:09
"Usually,
I'm so happy-go-lucky."
"But lately,
I've been feeling really down."
So what is JJ's mood?
Would you say it's elated?
Would you say it's sad?
It sounds like it's sad.
How do we know?
We know what his mood is
because JJ is reporting
that JJ feel sad, down.
03:43
But what about the affect?
Did you notice?
When I said what JJ was saying,
I had an affect.
03:55
There was a little collapse,
the little sad, a little heavy,
not getting eye contact,
my voice kind of fell down.
04:07
I started speaking more slowly.
04:11
So JJ's affect was also sad,
because we saw and heard...
04:20
how JJ was feeling.
04:24
Now if we have somebody who is
really, really sad,
who says they have no hope.
04:31
What do you think might be the
most important question to ask JJ?
If you are thinking that
maybe because he has no hope
that maybe there are
thoughts of self-harm,
or even thoughts
of killing oneself.
04:54
You are correct.
04:56
I hear what you're saying.
04:59
I hear you say you have no
hope, tell me JJ.
05:05
Are you thinking about
hurting yourself?
Are you thinking about
killing yourself?
So those would be the most
important things that you would ask.
05:16
Now, we're going to be talking a
little bit about mood episodes.
05:22
Mood episodes are
time sensitive.
05:25
It's really important to understand
that before we're going ahead
and saying someone
with a mood disorder,
they are probably
having episodes,
sort of showing
us some of a hint
of something that might
be coming in the future.
05:45
So we see them sort of as
building blocks of mood disorders.
05:52
We don't diagnose
a mood episode.
05:55
It is something that is
when we have people come in,
we say,
"Has this ever happened before?"
And quite frequently, they will
say, "Oh, when I was a teenager,
I'd go into a little sad period,
you know, a couple of weeks at a time,
but I always snapped out."
It's not something that gets
diagnosed by a clinician.
06:18
Also, it helps us to
understand what is going on,
and how sometimes you
have a mood episode,
you have a period of sadness
or a period of elation.
06:33
But it's self corrects
or you do something
that helps it go away
and get back into
a balanced life.