Mood Swings

What are Mood Swings?

Mood swings refer to sudden and rapid changes in a person’s mood from one extreme to another frequently that may impact normal functioning and relationships.

Mood swings may be caused by mental health disorders, hormonal changes, substance or other health issues. See and discuss with a doctor if you feel you are experiencing mood swings; they may be able to tell you why and help you out of the condition.

Brain and Mood – The Limbic System and Neurotransmitters

Mood is a transient state of mind that influences our thoughts and actions and how we view the world. It is affected by events in our lives, sleep, hormones, even the weather. So what is the role of the brain in determining our mood?

• Brain networks known to be fundamental to mood and mood changes are buried deep in those parts of the brain believed to be the earliest to evolve in the human species. This is probably because mood is considered to be evolutionarily important.
• Overall, the brain is wired to maintain a slightly positive state of mind or mood. Being in a good mood makes us creative, plan ahead, procreate and adapt to changing situations better and more open to trying out new stuff or seek new experiences.
• The limbic system is the major part of the brain associated with mood. It comprises a network of regions that function together to process events and respond to situations. It is made up of structures such as the amygdala, hypothalamus and hippocampus.
• The almond-shaped amygdala attaches emotional significance to memories and events. It was first noted in 1939 by scientists when monkeys whose amygdalae were excised (removed by cutting) showed bizarre behavioral patterns. They became fearless, unreasonably aggressive or emotionally flat and hypersexual.
• The hippocampus trains us to do stuff that match our mood. For instance, if we feel elated we may do a jig or decide to make a favorite dish for the family . On the other hand, if we feel blue, we may feel like listening to sad songs or just curl up in bed. It has been found to be diminished in size in persons with chronic depression .

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• Being evolutionally older, however, the limbic system is rather primitive, and in daily life, it is controlled by some newer and advanced brain networks. These areas better co-ordinate how we think and act, so that we control and check our emotions better keeping in mind longterm goals and benefits rather than react to every slight situation unnecessarily and in a foolhardy manner.
• Neurotransmitters, such as serotonin and dopamine, are chemical messengers involved in transmitting signals across the nerves. When brain regions receive these impulses, it results in recognizing objects and situations, assigning them an emotional value and accordingly influence our behavior. Any imbalance in the levels of these neurotransmitters could result in mood changes and depression.

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What Causes Mood Swings?

The exact reason for mood swings is not known. It is thought that alterations in the brain neurotransmitters may influence mood. Mood might also be influenced by diet, sleep pattern, medication, and other lifestyle factors. The following health conditions may be associated with mood swings

Mental Health Disorders

• Bipolar disorder – mood swings from elation to down in the dumps
• Cyclothymic disorder – similar to bipolar disorder but less severe mood swings
• Major depressive disorder (MDD) – prolonged periods of depression
• Dysthymia or persistent depressive disorder (PDD) – chronic state of depression
• Personality disorders – sudden mood changes over a short period
• Disruptive mood dysregulation disorder (DMDD) – usually seen in children; associated with emotional outbursts
• Schizophrenia
• Attention deficit and hyperactivity disorder (ADHD)

Hormonal Imbalances

• Adolescent children going through hormonal changes of puberty
• Pregnancy
• Premenstrual syndrome (PMS)
• Menopause

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Substance Abuse/Addiction

• Alcoholism
• Smoking
• Drug addiction

Miscellaneous Causes

• Dementia
• Thyroid disorders
• Brain tumor (tumors in certain locations)
• Medications such as hormone replacement therapy
• Neurotransmitter imbalance (serotonin, dopamine, GABA, norepinephrine) in the brain
• Head injury

Triggers/Risk Factors for Mood Swings

Irrespective of the presence of any of the above conditions or not, certain risk factors can trigger mood changes including

• Stressful life
• Life changing events (death of a loved one, shifting residence)
• Improper diet and
• Inadequate sleep

What are the Symptoms and Signs of Mood Swings?

It is normal and in fact considered healthy to go through a range of emotions every day. However when these are extreme, out of proportion to the situation and begin to disrupt one’s life and interpersonal relationships, it may be time to seek medical attention. Examples of such extreme mood swings include

• Feeling so low and depressed with thoughts of ending the life or inflicting self-harm
• Feeling so high and excited leading to uncontrolled spending, confronting others, being aggressive or indulging in potentially risky behavior
• Inability to go for work, perform daily routine activities or visit friends
• Disruption of sleep
• Disruption of eating pattern

How do you Diagnose Mood Swings?

Diagnosis of mood swings may not be easy. It involves

• Detailed patient history including medications, history of substance abuse, menstrual history, diet and sleep habits, lifestyle, recent life changing events and family history.
• Physical examination to rule out any obvious causes such as thyroid disease, possible brain disease etc
• Blood tests and imaging tests (CT scan or MRI) to rule out or confirm possible causes for mood swings

How do you Treat Mood Swings?

Mood swings is not a medical condition perse but is a symptom of an underlying disease condition. When they are severe enough to disrupt daily routine, detailed evaluation and investigations by a mental health professional is recommended and one or more of the following modalities of treatment may be given

• Medications – Medical treatment of the underlying mental health condition e.g. depression, bipolar disorder, schizophrenia
• Psychotherapy and cognitive behavioral therapy (CBT) – It is a form of intervention (counseling) intended to change negative thoughts and behavior and to develop coping strategies in situations. It was initially designed to treat anxiety and depression but is now widely employed in other mental and physical health problems
• Combination of medications and CBT
• Stopping any medications that may be causing mood swings
• Rehabilitation program in case of substance abuse and addiction

How do you Prevent Mood Swings?

When the mood swings are not severe or have been controlled by medications, the following measures may help in reducing or preventing further severe mood swings.

• Maintain a regular schedule with regards to diet and sleep
• Exercise regularly
• Get adequate rest and sleep
• Keep a diary of mood swings and look for triggers and avoid situations that affect the mood adversely
• Eat a healthy balanced diet containing plenty of fresh fruits and vegetables
• Limit consumption of sugar, alcohol and caffeine, salted food, baked and fried foods
• Practice relaxation techniques such as yoga and meditation
• Develop coping techniques for stress e.g. talking to a friend, taking a walk, reading a book
• Indulge in some favourite past time or become creative
• Find a therapist you can talk to and share your thoughts and feelings