Healthy Mood Management A Developmental Perspective

The development of effective mood management is an essential aspect of individual human growth. It is also a major factor in the health of a community. Among the major causes of death are several causes that appear to be influenced by mood problems. The top nine preventable causes of death, which account for about one half of all deaths in the United States, are tobacco, diet and exercise patterns, alcohol, microbial agents, toxic agents, firearms, sexual behavior, motor vehicles, and illicit use of drugs. Consider for a moment how many of these might be exacerbated by depressed mood.

The relationship between negative mood states and smoking and drinking has already been described. It is highly likely that illicit use of drugs follows a similar pattern. Diet and exercise certainly are affected by depressed mood. Deaths from firearms present an interesting illustration of how strong, and yet invisible to most of us, the impact of depression is on our society: few people are aware that for several decades over half the deaths from firearms in the United States have been suicides. Unprotected sexual behavior not only exposes individuals to sexually transmitted diseases, but also to unplanned pregnancies. And some proportion of motor vehicle accidents are related to alcohol and other substance abuse, or to reckless driving, which may be the result of desperate states of mind. The proportion of these factors that is attributable to depression is yet unknown, but is likely to be significant.

Many factors have been implicated in the development of deficits in emotion regulation. None appear to be necessary or sufficient to cause depression, nor are there known factors that offer complete protection from depression.

There appears to be a substantial genetic component in the more severe forms of depression, such as bipolar disorders and major depression. How this genetic influence is manifested physiologically is not yet known. Several biological abnormalities have been identified in subgroups of individuals exhibiting depression. However, most of them appear to occur during a depressed episode and to subside once a normal mood state is attained. None appear to be universally shared by clinically depressed individuals. Developmental influences also appear to be risk factors for depression, such as being born to a mother who is currently depressed, the loss of parents in childhood, and a high number of stressful life events. Social and environmental factors also have well-documented effects on depression. For example, poverty has been shown to account for approximately 10% of new cases of major depression.

The emotion regulation literature suggests that cer

Depression — Applied Aspects tain mechanisms can be used to affect whether a given emotion occurs or to modulate the intensity, duration, and tone of the emotion once it has been triggered. Factors that can come into play prior to the triggering of the emotion include changes in either the external or the internal environment, that is, either in the environment in which the individual is located (including the people in such an environment) or in the mind of the individual. Attention, memory, mental rehearsal, and the interpretation of the material brought into consciousness via these avenues, all can set the probabilities of certain emotions being triggered. Once an emotion is triggered, the responses of the individual to the emotion can maintain or diminish the intensity and duration of the emotion.

Developmental aspects of emotion regulation include the basic survival aspects of emotion expression in infants, including the instrumental functions of crying or smiling, cooing, and vocalizing; the development of language and its role in modulating emotional response when used by others and by the child; the differential reinforcement and punishment of specific emotions; acquiring expectations regarding which kinds of emotion regulation are possible by observing role models; and, as the individual moves into adolescence and adulthood, gaining greater ability to shape one's environment, choosing one's friends, activities, and school and work settings. Certain professional training includes fairly specific instructions regarding the types of emotional expression that are preferred, discouraged, or prohibited.

The development of healthy mood management or emotion regulation is a key prerequisite of mental health. As individuals develop, a large proportion attempt to modulate their mood by maladaptive methods, including the use of psychoactive substances. If these methods become part of the person's usual repertoire, they can have serious long-term consequences. The delineation of mood management strategies and their consequences deserves further study and dissemination.

Mood management skills are important in at least three broad contexts: work, relationships, and alone-ness. The ability to maintain a healthy mood state in each of these situations appears to be necessary to good mental health. The theoretical factors that have been important in the development of treatment modalities can be integrated into a concept of mood management. Each addresses a different level of anal ysis: biological approaches focus on the neurochemical bases of emotion regulation, cognitive - behavioral approaches focus on psychological mediators of emotion regulation, and interpersonal approaches emphasize the influences of interpersonal relations on emotion regulation and dysregulation.

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