For someone with daily rapid mood swings, what conditions might be the underlying cause and when should I consider seeing a doctor?

Doctor's Answers (1)

Dr Beng Yeong Ng

"Psychiatrist with over 20 years of experience"

Thank you for highlighting this topic that is commonly encountered at the psychiatric clinic. ‘Mood swings’ pertains to rapid and intensely fluctuating emotions. People with mood swings oftentimes experience a roller coaster of feelings ranging from happiness and contentment to anger, irritability, frustration, depression and despair.

For ease of explanation, may I classify the common causes for mood swings into the following categories? These categories are not mutually exclusive and may have overlaps.

  1. Psychiatric conditions
  2. Other medical causes
  3. Hormones and illicit substances
  4. Others

For psychiatric conditions, persons with the following psychiatric disorders may present with mood swings:

  • Depressive disorder
  • Bipolar disorder
  • Cyclothymic disorder (a mild form of bipolar disorder)
  • Insomnia disorder (a contributing factor could be sleep deprivation leading to irritability)
  • Dysthymia (also called persistent depressive disorder)
  • Personality disorders (e.g., borderline personality disorder)
  • Disruptive mood dysregulation disorder (seen in children where outbursts are not on target with their developmental stage)
  • ADHD
  • Schizophrenia
  • Schizoaffective disorder, and others.

Mood swings are a hallmark symptom of bipolar disorder. There are two main types of bipolar disorder: Bipolar I and Bipolar II. Both are characterized by periods of mania or hypomania that alternate with depression. Some people experience both sets of symptoms at the same time (mixed episodes). The swings mood for people with bipolar disorder may contain some or all of the symptoms of a depressive or manic/hypomanic episode.

For medical causes, these would include conditions that affect the brain and hormones found in the body. Thyroid disorders commonly present with mood swings. Conditions like traumatic brain injuries, stroke, Parkinson’s disease, dementia may also report mood disturbances. For patients with diabetes, they may experience mood changes when their blood sugar level is too low or too high.

For hormones and substances. Women who experience hormonal fluctuations during menses, pregnancy and menopause may report mood swings. The female hormones are indeed important in regulating a person’s mood. People who take steroids are also prone to mood swings. They could be taking them for health reasons or for recreational purposes. Caffeine withdrawal can also cause moodiness, lack of energy and irritability.

Under other causes, I would include causes like too much stress, overwork, and other nonspecific causes. Common triggers for mood swings include stress, significant changes in one’s life situations, diet, sleep habits and medications.

Mood swings are indeed a commonly reported symptom at the mental health clinic. If your mood swings affect your functioning (e.g., cause you to be absent from school or work, spend excessively, withdraw from social interactions) or your relationships with others, it will be important to seek consultation with a mental health professional.  

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