Affective disorders: mania and depression

By Cristiano Antonino Last updated Nov 18, 2022

Affective disorders are characterised by an alteration in mood, the sense of euphoria (manic states), or that of sadness (depressive states)

Sometimes the two psychopathological pictures (mania and depression) are associated, in a continuous alternation of manic and depressive episodes interspersed with more or less long periods of normality, as in the case of bipolar disorder and cyclothymic disorder.

They can be distinguished into: primary, when the affectivity disorder turns out to be, if not the only one, the main problem; and secondary, i.e. related to other conditions such as organic illnesses, other psychiatric disorders, drug intake, substance use or abuse.

Moreover, one cannot overlook the fact that some mood alterations exist as ‘normal’, as a consequence of, for example, stressful situations, frustrations, losses, disappointments or common fluctuations, even daily, in mood. Primary disorders include so-called unipolar and bipolar disorders.

Affective disorders: in the former the mood alteration takes a single direction, either towards exaltation or towards despondency

This subdivision includes mania and major, chronic and reactive depression. Bipolar disorders are those pictures in which the affectivity oscillates between the two poles of euphoria and depression.

Cyclothymia and bipolar disorder types I and II fall into this category.

Causes of affective disorders

Various psychological theories have developed different conceptions to explain the onset of affectivity disorders, emphasising psychological, physiological and hereditary factors.

The current trend is to consider a multifactorial etiopathogenetic scheme, in which multiple aspects are involved:

heredo-genetic: the studies conducted, taken as a whole, suggest that there is a hereditary predisposition to major depression, having found a greater likelihood of developing this disorder in families with one or more depressed relatives;
constitutional: understood as personality predisposition. These include character traits such as difficulty asserting oneself, lack of confidence in one’s own abilities, emotional instability, asociality, concern for one’s state of health, feeling haunted by an adverse fate;
biological-metabolic: e.g. hormonal dysfunctions, alterations in the functioning of neurotransmitters, in particular noradrenaline and serotonin, organic or metabolic alterations
psychological: these include predisposing personality traits and characteristics, family factors (upbringing, culture, ways of relating and interacting) and traumas resulting from events with a strong emotional charge or particular affective significance that can act as a trigger for the disease or as a precipitant (of an already precarious situation) or emergent (of a latent pre-existing situation). The main traumatising factors include the loss of significant persons (death or abandonment), or of status or role (retirement, dismissal,…), or even major disappointments, frustrations, failures;
socio-environmental: in addition to traumatic events and the role of the family, the support and assistance the individual receives from society in overcoming or mitigating the consequences of ‘stress’ is important;

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