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What is diurnal mood variation?

beyondblue’s Clinical Advisor Assoc/Prof Michael Baigent explains:
Diurnal mood variation is a symptom of depression defined by feeling worse in the morning and better as the day goes on. It’s a symptom usually associated with more severe or melancholic depression and is accompanied by a range of other depression symptoms. These can include loss of appetite, sleep disturbance with early morning wakening, weight loss, low energy and low sex-drive.

Diurnal mood variation shouldn’t be confused with “not being a morning person”. If you wake up and don’t want to go to work, but you don’t have any other symptoms of depression – there might be other causes for why you feel unhappy. With diurnal mood variation, we’re usually talking about more severe depression. It’s not as though you wake up feeling terrible then feel great by tea time, you’re quite depressed all day, but you feel absolutely dreadful when you wake up.

We don’t know a great deal about what causes it, but it’s likely to have something to do with our biological circadian rhythms (a person’s natural body clock).

For a clinician, it is usually an indication to consider antidepressants for treatment. That is not to say that you don’t get diurnal mood variation with the milder forms of depression, because you can, but it’s not as common.

Based on my clinical experience, I probably see the diurnal mood variation symptom in around a quarter to a third of people with more severe forms of depression.

Diurnal mood variation is not treated as an isolated symptom. The approach to treatment of clinical depression involves first excluding medical causes, then deciding on appropriate treatment. That might include an antidepressant medication and psychosocial treatments as well (i.e. talking therapies and lifestyle changes). In cases of severe depression, the person may benefit by being referred to a psychiatrist for assessment of the best treatment options.

It can take a bit of time to get better from it and generally the longer you leave treatment, the harder it can be to get on top of.

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