Maybe you’re having a great day and your smile is as bright as the sunlight shining through the window, or maybe your day seems like one setback after another and there’s no way to mask the gloom and doom you feel. In either case, there’s no sudden emotional switch or inexplicable change in your feelings or outlook.
Unless, of course, you’re experiencing mood swings brought on by mood disorders, medical conditions, or other triggers. Understanding the causes of mood swings may help you and your loved ones see these jarring changes in your disposition not as problems with anger management, for example, but as possible signs of a mental or physical condition that needs attention.
“Normal mood changes happen to all of us and are not necessarily a reason for worry,” explains David Mischoulon, MD, PhD, with Massachusetts General Hospital. “They are typically brief and appropriate to the situation—for example, sadness after a conflict with a friend, or happiness after getting good news. Usually, people are aware of them and can control their reactions. In some cases, you may feel ‘off’ for a short time but then return to your normal baseline.”
What Are Mood Swings?
Conversely, mood swings often involve rapid and/or extreme shifts from one emotional state to another. For example, you may go from happiness to anger in minutes or hours. Dr. Mischoulon adds that a new mood is often out of proportion to the seriousness of the triggering event, if there is one.
“They can interfere with one’s life, relationships, work, and other responsibilities,” he explains. “They may occur suddenly and unexpectedly, or they may occur predictably, sometimes secondarily to a situational trigger, and sometimes not. They can be a sign or symptom of a psychiatric disorder, another medical condition, or a medication side effect.”
Making Sense of Mood Swings
Determining a mood swing’s meaning may require the evaluation of a medical professional. However, sometimes the causes of mood swings, especially if they are infrequent, can be traced to episodes of stress, grief, or other emotionally challenging periods.
But when there is no obvious trigger or circumstance and mood swings start interfering with everyday life, it may be time to talk with your primary care physician or see a mental health professional for answers. Certain mood disorders can bring on changes in mood that last for minutes or weeks at a time.
“If the mood swings are very frequent, intense and unpredictable, and/or impairing the person from the standpoint of their interpersonal relationships—with family, friends, or coworkers—this could suggest a more serious illness and should be assessed by a professional,” Dr. Mischoulon says. “This is especially true if you are also experiencing other symptoms like sleep disturbances, racing thoughts, impulsive behavior, feeling out of control, or having suicidal thoughts. If other people are worried about you, you probably should be worried as well.”
What Are the Causes of Mood Swings?
Getting to the bottom of mood swings’ meanings and origins usually requires an assessment of their frequency, duration, and severity, as well as an evaluation of any other symptoms or health concerns. Are there any underlying medical conditions? What medications are you taking? What is your medical history and that of your family?
Then, of course, it may be appropriate to undergo a mental health assessment to look for signs of mood disorders or other conditions. “Mood swings can be seen in practically any psychiatric condition, often in bipolar illness, which is characterized by changes between depression and mania or hypomania,” Dr. Mischoulon says. “Bipolar illness can also present with irritability and anger. Unipolar depression can also have anger attacks and mood swings as one of its presentations. Many other conditions, including psychotic disorders, personality disorders, attention-deficit disorders, post-traumatic stress disorder, and substance-use disorders, may be characterized by sudden and intense changes in mood.”
Other causes of mood swings may include side effects of medical treatments, he adds. For example, steroid treatments can precipitate mood symptoms, including agitation and anger. The difference between mood swings brought on by medications or other treatments and those reflecting mood disorders or other mental health concerns should be parsed out by a thorough psychiatric evaluation, Dr. Mischoulon says.
How Are Mood Swings Treated?
The causes of mood swings and their severity and frequency help determine what, if any, treatment is appropriate.
“Medication is often necessary when mood swings are part of a serious psychiatric disorder or sometimes for managing psychiatric symptoms secondary to medical conditions,” Dr. Mischoulon says. “In the case of mood swings due to a psychiatric condition, these can sometimes be managed with medications such as mood stabilizers, antidepressants, and/or sedatives.”
He adds that the same approach may apply for mood swings that are secondary to medical problems, but in those cases, every effort should be made to manage the underlying medical issue before resorting to medications for the mood symptoms themselves.
Many physical health conditions and diseases can affect mood. Neurological conditions, such as Parkinson’s disease and Alzheimer’s disease, can lead to sudden changes in mood. So can diabetes, sleep deprivation, and chronic stress, among others.
Dr. Mischoulon notes that some of the more common physical health issues that can be the causes of mood swings are those involving hormonal imbalances. For example, thyroid disease, because of the hormonal changes involved, can trigger mood swings. “Management of any thyroid imbalance can help to reverse these mood swings,” Dr. Mischoulon says.
Women may experience mood swings just before or during their menstrual periods, and during perimenopause or menopause. These conditions can also be managed with medications, such as antidepressants for PMS and hormone replacement therapy during menopause.
“As always, the risks and benefits must be weighed against each other before making a decision about optimal treatment.” Dr. Mischoulon says. “If medical management of the underlying condition is not enough, using psychotropic medications for managing mood swings may be appropriate.”
In some cases, psychotherapy may be considered before turning to medication. Some people may benefit from both. “Cognitive behavioral therapies can also be helpful, either alone or in conjunction with medications, to help people develop approaches for controlling their moods and not letting them get out of control when something triggers them,” Dr. Mischoulon says. “Dialectical behavior therapy, for example, is very helpful for people with borderline personality disorder who need to control their mood swings.”
Lifestyle changes can also help reduce the intensity or frequency of mood swings. Options include exercise, mindfulness or meditation, good sleep hygiene, healthy diet, avoidance of alcohol and drugs, and having strong social connections, Dr. Mischoulon says.
Mood Swings: Takeaway
Regardless of the causes of mood swings, these abrupt emotional shifts can be alarming for an individual and family members, friends, and co-workers. Rather than chalk them up to a person simply being excessively “moody,” consider looking further for the mood swings’ meanings or origins. It’s estimated that about one in five adults will experience a mood disorder at some point, so allow for the fact that someone’s mood swings may require attention, treatment, and patience.
