Mood Swings: What They Are and How to Help Manage Them

We have all experienced our share of mood swings. Who hasn’t reacted – or overreacted – to everyday stresses like traffic problems, demanding bosses or long waits at the doctor’s office?

All of sudden our mood can change from good to irritated – and maybe even to angry.

During a presentation at the 2008 Women’s Health Matters Forum & Expo in Toronto, Women’s College Hospital psychiatrist, Dr. Anthony Levitt, said that ‘mood swings’ is such a commonly used term that probably 90 percent of the audience would say they have had a mood swing in the last 24 hours.

However, mood swings are a very different thing when they are associated with a mental illness, and they should not be ignored.

Mental illness and mood swings

When associated with a psychiatric condition, mood swings can be overwhelming. The two most common types of mood swings are mood changes (such as irritability), and anger attacks.

‘These changes can be devastating, for both the individual and for the people closest to them,’ Levitt said.

Mood changes can be a prompted by any number of situations, and refer to true changes in the person’s emotional state. Anger attacks are a sudden expression of negative emotion and are typically a response to something that has just happened.

When it comes to mental illness, the three most common causes of mood swings are:

  • Depression
  • bipolar disorder
  • premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD).
More than feeling a little blue

When someone is suffering from depression, irritability can be the sole mood change – but it can have a terrible impact, Levitt said.

Quite often, the depressive person’s irritability will be directed at those in closest contact, such as family and friends. The problem is that we all experience irritability and it can be hard for the recipient of the behaviour to step back and be objective. We really want to say, ‘Pull your socks up, we’ve all been irritated and we deal with it.’

But for the person who is depressed, irritability is like a ‘churning engine’ that is hard to stop, Levitt said.

‘It’s unfortunate. Irritability is terribly ignored as a symptom of depression.’

Anger attacks occur in two-thirds of people with depression but it is only in the last 10 years that they have been explored in the scientific literature. However, people who have anger attacks typically have the most severe from of depression, Levitt said.

Once again, though, it’s a symptom that can exacerbate depression by alienating loved ones, disrupting families and possibly leading to a higher risk of suicidal thoughts, partly as a result of the alienation.

Treatment includes cognitive behavioural therapy (connecting feelings to thoughts) and interpersonal psychotherapy (dealing with interpersonal relationships).

Medication can successfully treat depression and its related symptoms, but medication can also cause irritability. These effects should be carefully monitored by a physician and patients should be aware of their mood changes, Levitt said.

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