Affective Disorders

Affective disorders, or disorders of affectivity, are extreme and pathological mood disturbances that persist over time, do not go away on their own, and interfere with a person's ability to function, undermining self-esteem and impairing coherence and objectivity when interpreting reality.

Psychoaffective disorders in children and adolescents are very common, although they did not begin to be recognized and diagnosed at those ages until the 1980s. Despite being one of the leading mental health issues, they remain underdiagnosed because, in addition to the fact that minors may have greater difficulty expressing their emotions, the symptoms are often associated with typical developmental phases.

The most common types of affective disorders in children and adolescents include:

• Major depressive disorder: a persistently sad or irritable mood accompanied by a marked lack of interest or pleasure in usual activities. It lasts for a minimum of two weeks.
• Chronic depressive disorder (dysthymia): a depressive state that lasts for at least one year.
• Bipolar affective disorder: recurring episodes of extreme mood states. Euphoric, high-energy phases (manic episodes) alternate with periods of depression and sadness (depressive episodes).
• Disruptive mood dysregulation disorder: persistent irritability, severe anger, and extreme difficulty controlling behavior. Common from the age of 7.
• Premenstrual dysphoric disorder: a severe form of premenstrual syndrome that occurs in some adolescent girls.

Symptoms

Symptoms vary depending on the type of disorder, as well as the age and personality of the child or adolescent. In general, the most common signs include:

• Changes in appetite or weight
• Changes in sleep patterns
• Persistent extreme emotions: sadness, irritability, or anger
• Sudden mood swings
• General apathy
• Social withdrawal
• Difficulty relating to family and friends
• Low self-esteem
• Hypersensitivity
• Intense feelings of guilt, inadequacy, hopelessness, or helplessness
• Lack of energy
• Frequent physical complaints with no apparent cause
• Difficulty concentrating
• Abrupt decline in academic performance
• Frequent temper outbursts (tantrums)
• Suicidal thoughts

Causes

No single specific cause has been established for affective disorders, although they are believed to arise from a combination of various factors:

• Imbalances in brain neurotransmitters, such as serotonin and dopamine, which are involved in mood regulation
• Environmental factors: traumatic or stressful events that trigger the disorder
• Genetics: certain inherited genes may increase a person’s susceptibility to developing affective disorders

In some cases, however, affective disorders are secondary to another illness or triggered by the use or withdrawal of medications or drugs.

Risk Factors

Factors that increase the likelihood of developing an affective disorder include:

• Family history of affective disorders
• Unfavorable family environment: presence of conflict, abuse or neglect, and lack of emotional and affective support
• Lack of secure attachment in family relationships
• Authoritarian parenting style, characterized by excessive control, inflexibility, and poor communication
• Excessive parental overprotection, which prevents children from developing their own emotional regulation tools

Complications

Untreated affective disorders can have a very negative impact on a child’s or adolescent’s personal and social development and significantly worsen their quality of life. Furthermore, mood and behavioral disorders place minors at risk for engaging in dangerous behaviors such as alcohol and drug abuse, rebellious or violent conduct toward others or themselves, and suicide attempts. Affective disorders also disrupt the dynamics and stability of the family unit, often leading to ongoing conflict and turmoil.

Prevention

While it is not possible to completely prevent the development of an affective disorder, it is possible to reduce the risk by providing the child with a safe and healthy environment where they feel loved, supported, and understood. This setting also facilitates early detection of any symptoms and timely intervention, which can prevent potential complications in the child’s development.

What type of doctor treats affective disorders?

Affective disorders in children and adolescents are evaluated and treated by specialists in clinical psychology and child and adolescent psychiatry.