Formula Medical Group
Apple Valley, CA

James Krider, MD

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Mood changes - emotional lability/instability

From time to time, everyone experiences a period of moodiness, in which the person may feel happy one moment, irritable the next, and then sad. Often there is an identifiable cause for these emotional ups and downs — a bad day at the office, worry over bills or a deadline, or perhaps not enough sleep the night before. But some people frequently feel they are on an emotional see-saw, and they can find no cause for their frequent mood changes. Since emotions are so closely linked with physical health, the cause of the mood changes may be organic, psychological, or a combination of the two.

Causes of mood changes

Alcohol abuse
Excessive alcohol use affects almost every organ, including the brain. Even a small amount of alcohol can dull the emotions and make a person forget his or her troubles. In some people, alcohol can produce excessive mood swings, ranging from rage to euphoria.

Occasionally, everyone experiences periods of sadness, but there's a big difference between "feeling depressed" and the psychiatric illness called depression.

Normal feelings of sadness, while they may temporarily be debilitating, do not prevent a person from going about his or her normal daily routine. In contrast, people with true depression are unable to function normally, and unless treated, they often sink lower and lower into their despair.

In some types of depression, the lows give way to unexplained periods of euphoria and hyperactivity. This is called bipolar depression or manic-depression. Women who have just had a baby often experience post­partum depression, which is believed to be caused by hormonal changes following childbirth.

Mood swings are a warning sign of an insulin imbalance in a person who has diabetes. Feelings of irritability and agitation may indicate low blood sugar, often due to an insulin overdose. High blood sugar, which is caused by inadequate insulin, also may cause mood changes.

Unexplained mood changes warrant medical investigation.

Drug abuse
Unexplained mood changes are a common sign of drug abuse. Most illicit drugs produce a "high," but the euphoria tends to be short lived and may be followed by an extreme low, or crash. Increased lassitude, inability to concentrate, agitation, and feelings of anxiety also are associated with drug abuse. Parents should be particularly alert to such symptoms in an adolescent.

Excessive caffeine
Caffeine is a mild stimulant that can help get a person started in the morning and act as a "pick-me-up" when energy begins to flag. But too much caffeine can produce feelings of irritability, anxiety, and mood changes.

Many medications can produce mood changes. Sometimes drugs given to treat anxiety, depression, and other emotional problems have an exaggerated or unintended effect on mood. Heart medications, such as beta blockers, can produce feelings of depression and lassitude; certain asthma drugs can produce nervous or jittery feelings. Diabetes medications and even mega-doses of certain vitamins can also affect emotions.

Many women experience mood swings in relation to menopause. Some of these emotional problems may be due to the woman's realization that she is reaching a turning point in life, but others are caused by hormonal changes.

Premenstrual syndrome
In the week or two before their menstrual periods, many women experience unexplained shifts in mood. Some experience feelings of anger forno apparent reason; others

swing from euphoria to crying jags; and still others feel anxious and on edge. The mood changes are believed to be due to hormonal changes, and with the onset of menstruation, the woman is again on an even keel. Keeping a diary of emotional and other symptoms can help determine whether the mood changes are related to the menstrual cycle.

People who are under a good deal of stress, or those who cope poorly with even ordinary levels of stress, often experience mood changes. Increased irritability, unexplained sadness, and emotional swings are common responses to stress.

Thyroid disorders
The thyroid gland secretes hormones that control metabolism and many other body functions. Both too much and too little thyroid hormone can result in emotional changes, ranging from agitation to lassitude. Mood changes accompanied by other symptoms, such as changes in bowel function, weight loss or gain, menstrual irregularity, and palpitations, among others, are an indication that the person should have his or her thyroid function checked.

Advice about mood changes

  • Keep a diary of mood changes. This may help pinpoint the likely cause or causes.
  • If you have recently started taking a new medication and are experiencing mood changes, ask your doctor if the drug can cause such a reaction.
  • Exercise regularly and make sure your daily routine includes some time simply to relax.
This article was last reviewed November 9 , 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.

Depression, post-partum
Diabetes, type 1
Diabetes, type 2

Drug abuse
Med's, asthma
Med's, diabetic
Med's, heart
Med's, seizure
Med's, steroid
Menopause, psychological
Thyroid, deficiency
Thyroid, overactive
Vitamins, mega-doses

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