Four Mood Disorders that may co-occur with the high sensitivity trait are:
1. Persistent Depressive Disorder
2. Major Depressive Disorder
3. Bipolar Disorder 2
Persistent Depressive Disorder (PDD):
An Highly Sensitive Person may feel that it is impossible to come out of their powerful unpleasant emotional experience and this can lead them into a persistent depressive state. In that state they may feel constantly overwhelmed by their sadness and feelings of hopelessness, worthlessness, pessimism and sometimes a strong sense of guilt or failure. This depression can lead to difficulties with sleeping, appetite, motivation, social connection and some find it difficult to work or attend school. A person with persistent depression may report an absence of joy or good mood and this may have been their experience for 2 years or for so long they can't recall not feeling this way. HSP without PDD can have intense down days, weeks or seasons, however they are also able to enjoy positive times. A highly sensitive person can develop PDD when they lack the resources to deal with this powerful emotions and thoughts effectively.
Major Depressive Disorder (MDD):
An Highly Sensitive Person may have a stronger emotional reaction to the world and events, process more deeply, ruminate or show extensive concern about things, experience more frequent down moods, cry easily, experience low self-esteem and may have a pessimistic view of things. It is Major depressive disorder when there is persistent, significant emotional distress with a marked impairment in functioning. Features of depression may include constant sadness, extreme fatigue, hopelessness or worthlessness, thoughts of suicide, difficult childhood, impacted appetite, loss of motivation and energy, no enjoyment of things they used to enjoy etc.
Bipolar Disorder 2:
Most HSP's feel both enjoyable and unpleasant moods intensely, this does not mean they have Bipolar Disorder. Bipolar Disorder 2 includes episodes of major depression as above, and one or more episodes of hypomania. Hypomania is an opposite mood to depression, a very high and energetic mood that does not impair work or daily functioning. Hypomania could describe any person on a really up day as it describes a day of intense creativity, achieving a lot, having fast free-flowing ideas, and very high self-esteem. It is Bipolar Disorder 2 when both depression and hypomania occur with a distinct, identifiable change between them.
It is important to note that Mania, prevalent in Bipolar Disorder 1, extends beyond this to include highly irrational delusions of grandiosity/paranoia, special giftedness and abilities, high risk behaviours, flight of ideas, rapid speech, not sleeping etc.
Cyclothymia Is a chronic milder depression than major depressive disorder and includes periods of hypomania. Although the emotional lows and highs of Cyclothymia are less extreme than Bipolar Disorder or Major Depression, there are mood swings occurring over a two year period with not less than two months of no mood swings. This description could match the description of an HSP’s experience. It will take a trained Therapists eye to be able to identify this compared with increased emotionality of an HSP that is struggling.
Dr Elaine Aron has distinguished the difference between high sensitivity and mood disorders in a book she has written for Psychotherapists. This page offers a very brief comparison based on her distinctions to assist your understanding. Please note that this information is not intended to substitute professional medical treatment and is not adequate for a diagnosis of an Mood Disorder.