Reference
Guide | Reference

23  Affect and Mood Experiences

This chapter starts the Atlas: patient-near descriptions of experience before labeling. Most useful when clarifying phenomenology.

23.1 Summary

  • Shifts in emotional tone, intensity, or range that shape how a person feels, thinks, and functions.

23.2 Patient-Language Phrases

  • “I feel empty or numb.”
  • “Nothing feels enjoyable anymore.”
  • “My mood swings fast.”
  • “I feel unusually energized and wired.”

23.3 Core Features

  • Sadness, emptiness, or anhedonia.
  • Irritability or emotional lability.
  • Elevated or expansive mood with increased drive.
  • Emotional numbing or shutdown.

23.4 Boundary Markers

  • What it is: sustained or recurrent mood states that affect function.
  • What it is not: brief, proportional reactions to clear events.

23.5 Variants / Spectrum

  • Low mood with loss of interest.
  • Irritable or mixed mood states.
  • Elevated mood with increased energy and reduced sleep.
  • Emotional flattening or detachment.

23.6 Severity Anchors (0-4)

  • 0: Typical mood range and reactivity.
  • 1: Mild shifts, limited impact.
  • 2: Moderate, persistent, impacts function.
  • 3: Severe, marked impairment or risk.
  • 4: Extreme, disabling or unsafe.

23.7 Time-Course Patterns

  • Episodic mood changes.
  • Chronic low mood or blunted affect.
  • Cyclic or seasonal shifts.

23.8 Functional Impact

  • Work/school: reduced performance or overactivity.
  • Relationships: withdrawal, conflict, or instability.
  • Self-care: disrupted routine, sleep, or appetite.

23.9 Common Mimics / Differential

  • Trauma-related numbing or shutdown.
  • Substance or medication effects.
  • Medical contributors (endocrine, neurologic).

23.10 Medical / Substance Rule-Outs

  • Stimulants, sedatives, or withdrawal states.
  • Thyroid or sleep-related contributors.

23.11 Developmental Expression

  • Childhood: irritability or withdrawal.
  • Adolescence: mood lability, risk-taking, sleep shifts.
  • Late life: somatic focus, grief overlap.

23.12 Cultural / Context Notes

  • Mood expression varies by culture and context.
  • Grief and loss processes can mimic low mood.

23.13 Measurement Prompts

  • Brief mood measure.
  • Energy, sleep, and activity tracking.

23.15 Documentation Snippet (1-2 lines)

  • “Reports persistent low mood and anhedonia with reduced drive; Mood/Drive 3, Arousal 2; episodic course.”