Mood states

Several studies have shown that caffeine can improve mood states, increasing the frequency of positive mood self-reports763 115 147 in both regular caffeine users and non-users.148 In fact, some evidence suggests that long-term use of the drug may improve overall mood.149 Caffeine has... 

While caffeine consumption has resulted in improved mood, abstinence has resulted in negative moods.147 Both acute withdrawal154 and overnight abstinence148 appear to cause dysphoric mood states. 

As we have seen, low doses of caffeine (75 to 300 mg) have been shown to increase positive mood states,153 with higher doses leading to more and more positive mood states, at least up to a point.155-265 At the very high levels of consumption (greater than 500 mg) seen in heavy caffeine users,157 the drug can elevate anxiety and depress affect.34 Our more general review of the mood state literature above leaves little doubt that caffeine is a psychoactive drug. 

Most findings for emotional functioning are also consistent with this theory. Mood states become more positive until arousal, including the caffeine component, crosses threshold, then deteriorate with further arousal increments. Happiness similarly increases, then decreases as arousal rises. Data on such arousal-relevant personality dimensions as extraversion and impulsivity clearly support the inverted-U hypothesis. What this suggests, then, is that many of the effects of caffeine are mediated by its effect on arousal and its interaction with other arousal agents. Such a finding... 

Parrott AC and Garnham NJ (1998). Comparative mood states and cognitive skills of cigarette smokers, deprived smokers, and non-smokers. Human Psychopharmacology, 13, 367-376. 

Parrott AC, Garnham NJ, Wesnes K and Pincock C (1996). Cigarette smoking and abstinence Comparative effects upon cognitive task performance and mood state over 24 hours. Human Psychopharmacology, 11, 391-400. 

There is ample support for the hypothesis of noradrenergic system dysfunction in depression however, the inconsistencies in findings rule out any simple model of increased or decreased noradrenergic activity. It is important to determine which noradrenergic system abnormalities relate specifically to the pathogenesis of mood disorders, and which are related to nonspecific effects of stress, homeostatic mechanisms, or comorbid psychopathology. More work is needed on the mood-state-depen-dence of noradrenergic function. 

In depressed patients, cortical-hypothalamic-pituitary-adrenal axis hyperactivity can be explained by the hypersecretion of CRF, and secondary pituitary and adrenal gland hypertrophy. Impaired negative feedback at various CNS sites, including the hippocampus and pituitary are also likely to contribute. Downregulation of hippocampal mineralocorticoid receptors and expression is reported in depressed suicides [50]. In bipolar disorder, hyperactivity of the cortical-hypothalamic-pituitary-adrenal axis has been observed [51]. This increase in cortical-hypothalamic-pituitary-adrenal axis activity has also been observed in mixed mood states, mania and in depression in rapidcycling patients. Partial reversal of HPA overactivity is associated with treatment and recovery from depression. 

Two or more major depressive episodes Manic episode major depressive or mixed episode Major depressive episode + hypomanic episode Chronic subsyndromal depressive episodes Chronic fluctuations between subsyndromal depressive and hypomanic episodes (2 years for adults and 1 year for children and adolescents) Mood states do not meet criteria for any specific bipolar disorder... 

For bipolar I disorder, 90% of individuals who experience a manic episode later have multiple recurrent major depressive, manic, hypomanic, or mixed episodes alternating with a normal mood state. 

Therapists and counselors also may wish to use one of several brief instruments that assess moods and emotions. These measures identify extreme emotional states that place the client at risk for drug use. A couple of the more well-known assessments include the Profile of Mood States (McNair, Lorr, Droppleman, 1992) and the Multiple Affect Adjective Check List (Herron, Bernstein, Rosen, 1968), which ask clients about various moods and emotions that they are experiencing at the moment. Furthermore, examining how the client socially interacts in therapy and treatment can identify strengths and weaknesses in the way a client is able to express emotions. If there are problems with identifying or expressing emotions, then the therapist or counselor can assess whether those problems are related to skill deficits. 

McNair, D. M., Lorr, M., Droppleman, L. F. (1992). POMS manual Profile of Mood States. San Diego Educational and Industrial Testing Services. 

Plutchik Geriatric Rating Scale (PLUT) 16. Profile of Mood States (POMS) X X... 

Profile of Mood States. Profile of Mood States (POMS) self-rating scale is used in both normals and psychiatric outpatients to evaluate feelings, affect, and mood. It has been widely used in medicine trials. The 65 adjectives included in this test may be used to rate the present and/or previous week. This test requires from 5 to 10... 

Emotions are subjective mood states that interact reciprocally with cognitive processes. Personality refers to traits of emotion and behavior that are more stable over time. Normal and pathological emotional states can be measured, to some degree, with objective tests to quantify changes in mood over time (or after drug treatment). Thus, several clinical scales have been developed for anxiety, depression, and mania. These measures are particularly useful for evaluating the effectiveness of psychotherapeutic herbs. 

The observation that certain regressive forms of psychotherapy may contribute to the emergence of personalities lends some credence to this argument. Some argue that DID is an iatrogenic ally created when the shifting mood states of a borderline patient are assigned personalities. This issue obviously needs further research, and its resolution is beyond the scope of our discussion. However, it reminds us that those with severe dissociative disorders should carefully be screened for BPD. 

Acetylcholine has been implicated in learning and memory in all mammals, and the gross deficits in memory found in patients suffering from Alzheimer s disease have been ascribed to a defect in central cholinergic transmission. This transmitter has also been implicated in the altered mood states found in mania and depression, while many different classes of psychotropic drugs are known to have potent anticholinergic properties which undoubtedly have adverse consequences for brain function. 

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