What does "low mood" actually mean?

January 10, 2022 2:32 PM

Please give me concrete examples of what the term "low mood" refers to.

This medical/psychological term has never made sense to me, maybe because I'm too literal-minded. "Mood" is not something that one can have less or more of, the way energy is ("low energy" makes sense to me; "low mood" does not). There is no corresponding "high mood" to contrast it to.

Is it sadness? Then why not just say sadness? Is it a lack of enthusiasm? Then why not just say a lack of enthusiasm? This seems to imply there's something more being pointed at by this term. What is it?

posted by heatherlogan to Health & Fitness (20 answers total)

Low mood is non-clinical depression and, yes, could be sadness, in combination with lack of enthusiasm, in combination with general disinterest, etc. Clinical depression is depression that has been diagnosed using specific criteria. "Low mood", I suggest, is depression that has not been "officially" or "properly" diagnosed.
posted by turbid dahlia at 2:38 PM on January 10, 2022 [1 favorite]

If you say depression, a lot of people think of a person who has a lot of problems with daily living, whereas low mood conveys a person who is functional but not necessarily at 100%. I think they use "low mood" as a catch-all that includes all the ways people experience that kind of thing-- not everyone is sad, but they just might not feel content, interested in life, fully awake, and so on. I can't really think of a better way to say it in two words.
posted by blnkfrnk at 2:38 PM on January 10, 2022 [5 favorites]

I don't think this usage of "low" is meant to be understood as "less of".

Think instead of low and high altitude.

When people are depressed or listless, they say they're feeling "down" or "low". When they're feeling good, they say they're "riding a high", "on top of the world", "upbeat", etc.

You might ask: why would low altitude correspond to a depressed mood, or high altitude to a positive mood?

And I can only answer: I dunno; because they do. Language is full of quirks like this, that don't make 100% literal sense once you start pulling at them.

Similarly, we say that smart people are "bright", and unsmart people are "dim". It has nothing to do with luminance. It's just a metaphor.

(Disclaimer: I have no background in psychology.)
posted by escape from the potato planet at 2:40 PM on January 10, 2022 [27 favorites]

This is generally a term adjacent to depression without using the word depression because "I'm not depressed/I have nothing to be depressed about" and depression manifests in dozens (hundreds) of ways, plus people don't use the same words necessarily. My depression rarely feels like sadness; it feels like anxiety, an inability to enjoy things, anger, joint pain/soft tissue damage, lack of concentration. Also, it's internally comparative: I have never enjoyed poker so my failure to enjoy poker today is not indicative of any change of state, but when I don't even WANT to cook (whether I have the time/energy or not, just the urge) I know I'm not okay. What I feel as "hopelessness" might feel like "dread" to the next person in line and "sadness" to the person behind them.

Low Mood can also be assessed in regards to other health concerns, as well. Nurses often chart mood (also affect, which is more about the tone of a person's outward/social behaviors) for patients in the hospital, because changes in mood can provide positive/negative feedback sometimes substantially in advance of testable measurable results. A person in significant pain might have an upswing on mood assessments because healing is progressing or pain management is becoming more effective or inflammation is reducing. In this case, the construct of "mood" is even more differentiated from clinical or sub-clinical depression. This is also the case in monitoring mood as a neurological metric, where things like hormone levels, oxygen saturation, nutritional absorption will have implications on mood. But again, it's not a single presentation of "mood" - one stroke patient might be combative and another hopeless and those both fall on the low mood scales,
posted by Lyn Never at 2:46 PM on January 10, 2022 [6 favorites]

For concrete examples of what it might feel like to have "low mood" or depression, I like the concrete statements in this depression scale (PDF). This scale is often used in community surveys to estimate the prevalence of depression in a population.

The statements include:

1. I was bothered by things that usually don’t bother me.
2. I had trouble keeping my mind on what I was doing.
3. I felt depressed.
4. I felt that everything I did was an effort.
5. I felt hopeful about the future [reverse coded]
6. I felt fearful.
7. My sleep was restless
8. I was happy [reverse coded]
9. I felt lonely
10. I could not “get going.”

posted by jb at 2:50 PM on January 10, 2022 [8 favorites]

Response by poster: Mood is not spatially positioned, so the analogy of altitude does nothing for me. Describing someone as "not 100%" leaves me wondering "not 100% of what?" and just loops back to my original complaint that mood is not something that one can have less or more of. "Low mood" is one of the descriptors/symptoms of depression, and if I don't understand what "low mood" means, then telling me that it's mild depression is not going to do me any good either, because what is depression? (Note again the upwards/downwards reference inherent in the word "depression", which also means a lower-altitude area of land.) Pretend that I'm a Vulcan and don't understand human emotions.

What criteria would a nurse charting mood use to determine the "mood level" of a patient? How would the nurse know that the outward signs they're going by correlate to an inward emotional state of the patient, and what emotional state are they looking for? (Is it just a crankiness scale?)
posted by heatherlogan at 2:53 PM on January 10, 2022 [1 favorite]

Best answer: You are absolutely right that human emotions are not unidimensional, but as scientists we have to try to get a handle on these terms, so we try for single dimensions as a first approximation.

I teach clinical psychology, and the way I explain this is that mood is on a continuum from very high to very low.

Think "very happy" to "very sad"

Therefore, the technical terms would be, from highest to lowest:

Mania
Hypomania
Euthymia
Dysthymia
Depression

To complicate things, Euthymia (literally "good mood") actualy means "normal everyday mood" for a clinician.

So, to answer your question, "Low Mood" would probably be most similar to "Dysthymia", or "a state of mood which is more sad than normal mood". You might ask, "does low mood" include "depression"? I bet you can find answers saying 'yes' and 'no', and since it's not really a clinical term, a doctor would probably try to use the technical terms of "dysthymia" or "depression".

Next part of your question:

How would the nurse know that the outward signs they're going by correlate to an inward emotional state of the patient, and what emotional state are they looking for? (Is it just a crankiness scale?)

They can't. The technical term for this is "affect", where "mood" is the subjective internal feeling state, and "affect" is the externally expressed behaviors that signify this internal mood state.

Mood and affect can therefore be congruent or incongruent, and in some disorders (such as schizophrenia) incongruent mood vs. affect may be a symptom of the disorder.

To make matters worse, there is not universal agreement about "mood" vs. "affect" and you will find clinicians using the terms differently sometimes. Sigh.


These 2 terms are small parts of something called the Mental Status Exam
posted by soylent00FF00 at 3:14 PM on January 10, 2022 [27 favorites]

"not 100% of what?"

Energy level, motivation, enthusiasm, resolve, resilience. Emotional bandwidth. Ability to keep up with daily tasks (without feeling like those tasks are impossible or pointless).

One can certainly have more or less of those things.
posted by escape from the potato planet at 3:14 PM on January 10, 2022 [2 favorites]

Mood is an interior state; it often does correlate with affect (externally visible signs, like crying/laughing/looking at the floor/restlessness). But the only way to know what someone's mood is, is to ask 'em.

For me, my depression manifests as inability to get out of bed, feeling depleted or exhausted with little effort, trouble engaging in small talk or otherwise connecting with others. I find the "highs and lows" metaphor really intuitive, so it's interesting to me that others do not!
posted by basalganglia at 3:14 PM on January 10, 2022 [3 favorites]

Oh, and I think the term "low mood" shows up as a way to get around the stigma of a term like "depression."
posted by basalganglia at 3:16 PM on January 10, 2022 [1 favorite]

A tool commonly used by clinicians to chart things like "mood level" is self-assessment. You ask the patient: on a scale of 1 to 10, where 1 is really bad and 10 is really good, how are you feeling right now? And you call that number "mood" and record it over time. While "good" and "bad" are wholly subjective terms, a given patient will usually be consistent enough in their self-assessment that this information can be used to detect overall trends in their mood. "Low mood" then simply means a low self-assessment number, perhaps consistently over a few days. Observations of external indicators of mood ("affect") can also be recorded and if these are consistently poor, then you might be able to infer the patient's mood is low.

I'm largely with basalganglia on "low mood" being used to avoid saying "depression," but for a different reason: "low mood" is an observation, while "depression" is a diagnosis. A nurse (e.g.) isn't qualified to say that a patient has depression, but they can report that they have observed the patient's mood.
posted by kindall at 3:22 PM on January 10, 2022 [3 favorites]

Think of the spectrum of human emotions charted on a graph. Don't assign good or bad value to them, but rather intensity. Feeling very happy and enthusiastic? That's going to chart high. Sobbing so much you can't get out of bed? That is also going to chart high. That is a LOT of mood. As a human it is normal and healthy to have times throughout your day where you you have a LOT of mood. Maybe you get really pissed off at a coworker or you laugh more than expected at a joke on Twitter. These are all big amounts of mood. A person's tracking of mood intensity throughout the day looks like the 6mo DJIA--sometimes you're less exited, sometimes you're real excited, but the important thing is there's fluctuation.

Low mood is a flattening of this chart. Not only are you not feeling very happy, but you're not feeling very sad either, or mad, or surprised, or eager, or very strongly across any of the spectrum of emotion. Your chart has flattened. These mood values are low. You have "low mood."

It's normal and healthy to feel sad sometimes. It is not normal or healthy to never feel sad or happy or much of anything at all.
posted by phunniemee at 3:27 PM on January 10, 2022 [4 favorites]

Response by poster: phunniemee's answer, that "low mood" means feeling not much of anything (literally, a low amount of emotion) is conceptually different from most of the other answers. Is this a genuine ambiguity in the use of the term, or are some of these "right" and some "wrong" (as used by mental health professionals)? If it really is an ambiguity, that would seem to reveal a disturbing level of woolly thinking in that field...
posted by heatherlogan at 6:07 PM on January 10, 2022

Best answer: I don't think the concrete scale you want exists, or we'd have a lot more clarity into psychology and how it works and what treatments work and why. This is all subjective and for the most part self-reported because you can't take an X-ray to see state of mind. Most of academic psychology is people proposing, debating, and accepting or dismissing various people's theories about how all this works, which are largely only supported by asking people if they feel better or worse after X has occurred. Yes, it's pretty much wool all the way down! That's why there's so much barbarism and inhumanity in the history of psychological study and care, and why we're doing largely-accepted things today that will be considered barbaric and inhumane within years, especially by people with various agendas.

It is absolutely a challenge to make it meaningful, and for the most part with self-reporting you're asking someone to compare against their own personal history: Is this thing harder or easier for you today than yesterday/last month/before the treatment/before we changed the treatment? Are you having a hard time with things you used to not have a hard time with? Do you not take what you would consider your typical pleasure in X?

This is a challenge across medicine and education as well, though we do have access to some forms of (allegedly) objective testing. A physical therapist can measure the range of motion in my elbow, she can have me lift things and tell her how hard or easy each weight or movement is (pretty subjective but sort of assessable), but only I can tell her that this weight or that movement makes a funny nerve feeling over the bone. You might have the same injury as me and describe it as an ache in the joint.

Yes, it's absolutely a challenge in treatment. My elderly mother is pretty easily intimidated by authority figures and prone to telling doctors what she thinks they want to hear instead of what she's actually experiencing. She's also got the pain tolerance of a ketamined elephant so that I go running for a nurse if she actually has a look on her face like she's in pain. She's prone to saying she feels "tired" when actually she feels like absolute shit. I was unshocked to hear that one of her doctors prescribed her anxiety medication "so she sleeps better" (taking it morning and night, mhmm) and I suspect it's because she was saying she was just so "tired".

There are also people who either have a very chill energy or their trauma response is to batten down all hatches and show no emotion or weakness, and they get assessed as "low mood" and "low affect" because if you ask them how they are they'll shrug and say "fine" whether they're on fire or just won the lottery.

It's also very subject to every single kind of discrimination possible. I read as a fat middle-aged middle-class white woman, and the same nurse can talk to me for 5 minutes and assess my "mood" or "affect" as fatigued but responsive and cooperative and the Black woman in the next room giving the same answers as uncooperative and possibly under the influence.

But we don't have any other way to tell how someone's feeling except by asking.

This process ought to be better developed to standardize but also normalize for cultural differences and make bias difficult to introduce into the assessment, but you'd first have to get somebody to care enough and see enough profit in doing that extensive and very difficult work.
posted by Lyn Never at 7:52 PM on January 10, 2022 [7 favorites]

Oh, and I think the term "low mood" shows up as a way to get around the stigma of a term like "depression."

When the term pops up in an ad for pharmaceuticals, I suspect this is true. However, my understanding from a variety of therapists over the years is that "low mood" is distinct from "depression" because the disease of depression encompasses different types of mood and also a series of other symptoms. Indeed a lot of depression goes misdiagnosed because instead of feeling "sad" or "muted" or "nothing at all," a person might in fact feel deeply angry, or experience their anxiety as a kind of productive busy-ness, but still be very depressed along other metrics.

I don't know that a "concrete example" of a mood exists though, that's...kind of the opposite of what moods are.
posted by We put our faith in Blast Hardcheese at 7:57 PM on January 10, 2022

Best answer: I remember learning it this way in psych classes

1) Mood includes both a) valence (negative or positive) and b) intensity (high or low, like turning the volume up or down on your radio or tv)

2) A mood is a *feeling*. It’s not quite a full emotion, which includes conscious attitudes and thoughts. It’s temporary, it’s not a persistent orientation. It’s less stable than that, more informed by stuff going on in your body and environment. Mood is like day to day emotional “weather”, vs the “climate” of your overall personality (or a more persisting and entrenched incursion on it like a mental illness eg depression).

So I could eg wake up feeling grumpy because I was short on sleep, have a little nap and feel better. Or the day could be extra sunny, and put a spring in my step. But I’ve got a kind of baseline way of feeling that I’m going to gravitate to outside of these blips. (The blips are moods.)

So there’s the content of the feeling and its intensity; its duration; and how sort of rooted it is in my personality vs awareness vs my physicality or environment.

~~~

Some people seem to be talking about dysthymia, which is having mild depression for a long time.
posted by cotton dress sock at 11:50 PM on January 10, 2022 [2 favorites]

phunniemee's answer, that "low mood" means feeling not much of anything (literally, a low amount of emotion) is conceptually different from most of the other answers. Is this a genuine ambiguity in the use of the term, or are some of these "right" and some "wrong" (as used by mental health professionals)? If it really is an ambiguity, that would seem to reveal a disturbing level of woolly thinking in that field...

From my POV (USA trained psychologist) this would be incorrect, although as discussed "low mood" is not really a clinical term so interpretations differ.

Phunniemee also uses the word "flattening" which would be more correct: A clinician might use terms such as "flat" or "blunted" affect to indicate someone who appears to be having a reduced intensity of emotional responses or behavior.
posted by soylent00FF00 at 7:53 AM on January 11, 2022

Additional complexity:
There is a disorder called "depression" (Technically Major Depressive Disorder sometimes abbreviated MDD) and there is also a feeling or emotion called "depression" (or "depressed mood").

A person can feel "depressed" without having "Depression" (MDD).

The difference between symptom vs. disorder is part of the confusion, and may be why "low mood" is used to describe the symptom to try to clarify? Though as we've seen here, "low mood" may not be any more clear to people than "depressed mood"...
posted by soylent00FF00 at 7:58 AM on January 11, 2022 [1 favorite]

Another relevant turn of phrase: “feeling down”
posted by misterbrandt at 7:45 PM on January 11, 2022

What criteria would a nurse charting mood use to determine the "mood level" of a patient? How would the nurse know that the outward signs they're going by correlate to an inward emotional state of the patient, and what emotional state are they looking for? (Is it just a crankiness scale?)

I mean, you say that you don't have an understanding of what is meant by "depression", but then you throw out terms like "crankiness" as though we can all agree on it. Is your query about psychology or is it about linguistics? Terms are used by the medical and psychiatric professions in order to approach, let's say, 80% consensus and understanding between professionals, so that something can be put down on a patient's chart and everyone can go home apart from the person who was institutionalised. 20% is missed because these sorts of things can only be rules of process that are applicable to most, but not all, cases.
posted by turbid dahlia at 7:53 PM on January 20, 2022