Labile Mood

When Emotions Shift Drastically and Suddenly

A labile mood is characterized by emotions that shift quickly, drastically, and uncontrollably. Labile mood is typically associated with an underlying health condition. It can be a symptom of a mental health condition, or it can occur with conditions that affect the brain.

This article discusses mood lability—what it is, what causes it, how it is diagnosed, and how it is treated.

Woman covers face in hands

Photoboyko / Getty Images

Symptoms of Labile Mood

It's normal to experience various emotions throughout the day, but these shifts in mood are typically related to things that happen or thoughts that are occurring.

People with labile mood often experience extreme emotional reactions that may not relate to their current situation. These emotions are very strong and can seem to come out of nowhere. Oftentimes, these severe mood changes can interfere with daily activities.

Other Names for Labile Mood

Other names for labile mood include emotional lability, labile affect, emotional incontinence, pathological laughing and crying, pseudobulbar affect, and involuntary emotional expression disorder (IEED).


Strong emotional reactions that shift rapidly are the main symptom of labile mood. These can include:

  • Uncontrollable laughter
  • Crying (without a specific cause)
  • Inappropriate behavior for the situation (such as laughing at a funeral)
  • Low tolerance for frustration
  • Overreaction to situations

Causes of Labile Mood

People with certain neurological conditions and those with brain injuries can develop a specific type of mood lability called pseudobulbar affect. These medical conditions affect the way the brain controls emotion, which leads to unpredictable outbursts of laughing or crying. These conditions include:

Mood lability can also occur with certain mental health and medical conditions, though the mood changes are not as sudden or inappropriate to the situation (like laughing uncontrollably in a serious setting). Mental health causes of labile moods include:

What Medications Can Cause Labile Mood?

Medications that may have mood lability as a side effect include oral corticosteroids, such as prednisone, and some antidepressants.

How to Treat Labile Mood

Mood lability that is not severe might not require treatment. However, for many people, symptoms significantly interfere with daily life. Treatment for labile mood can include medications and therapy.

Medications

Medications are generally targeted to any underlying condition that might be contributing to the mood lability. Mood stabilizers are used for mood lability related to bipolar disorders. Antidepressants are one type of medication used to treat mood lability related to depressive and anxiety disorders. These medications change levels of chemicals in the brain called neurotransmitters that help manage emotions. Commonly prescribed medications include Remeron (mirtazapine), Wellbutrin (bupropion), and Luvox (fluvoxamine).

Pseudobulbar affect (PBA) is treated with a medication called Nuedexta (dextromethorphan-quinidine), which reduces symptoms of mood lability.

Therapy

Psychotherapy is very beneficial for people who live with mood lability related to a mental illness. Two types of therapy that are used include:

  • Cognitive behavioral therapy (CBT) focuses on helping a person change their negative thought patterns and behaviors that can contribute to mood shifts.
  • Dialectical behavior therapy (DBT) is a specific type of therapy that uses a combination of mindfulness, distress tolerance, and emotional regulation skills to help manage certain conditions that contribute to mood lability—particularly certain personality disorders.

Coping Techniques

Several coping techniques can improve quality of life for a person with mood lability. These include:

  • Talking about it: Discussing your condition with the people around you can reduce the element of surprise that can occur with sudden mood changes.
  • Ignoring it: Focusing on your uncontrollable symptoms can make them worse. Distracting yourself with another activity can help.
  • Identifying and avoiding triggers (when possible): Certain situations can make emotional swings more likely when you have labile mood. These can include: fatigue, feeling stressed or anxious, funny or sad movies/books/situations, public speaking, and talking about stressful events.
  • Walking away: A change in environment can help you regain control of your emotions during a mood shift.

Complications and Risk Factors Associated With Labile Mood

People whose mood changes are caused by mental health issues such as bipolar disorder and borderline personality disorder are at risk for suicide.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.


Are There Tests to Diagnose the Cause of Labile Mood?

Mental health conditions that cause labile mood are diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This clinical handbook gives mental health professionals specific criteria for determining whether or not a mental health condition is present.

Pseudobulbular affect (PBA) is diagnosed using history, mental status examinations, and neurological testing. Sometimes standardized questionnaires and scales are used. Certain criteria that might support the diagnosis of PBA include:

  • Emotional outbursts that are unrelated to the current situation
  • Emotions being expressed do not reflect how the person is actually feeling
  • Emotional episodes follow a pattern of ramping up, then slowly decreasing
  • Episodes cause significant distress and interfere with daily functioning

Summary

Labile mood refers to unpredictable, uncontrollable, and rapid shifts in emotions. This is most commonly caused by mental health conditions, such as bipolar and personality disorders, and medical conditions that affect the parts of the brain that control emotions. Labile mood causes uncontrollable laughter, crying, irritability, and other emotional overreactions. Treatment includes medication and therapy.

A Word From Verywell

Living with mood lability can make a person feel shame or embarrassment. If someone you care about is living with this condition, understand that the behavior is out of their control. When mood shifts occur, provide support without making a big deal over the outburst.

If you are personally living with mood lability, know that you are not alone. Being open with family and friends about your condition can help draw less attention to your mood shifts when they do occur. Talk to a therapist about ways to cope with your symptoms and improve your quality of life. For additional support and resources, consider joining a support group.

Frequently Asked Questions

  • What causes labile mood?

    Mood lability can be caused by certain mental health disorders, such as bipolar disorder, or neurological conditions like multiple sclerosis or the effects of a traumatic brain injury.

  • What are the symptoms of labile mood?

    Labile mood describes sometimes dramatic shifts in mood over a short period of time. It can also cause behavior that is inappropriate to the situation (such as laughing at a funeral).

  • How can labile mood be treated?

    Depending on the underlying cause, treatments can include antidepressants, psychotherapy, or a medication called Nuedexta that is specifically for labile mood caused by neurological disorders.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cruz MP. Nuedexta for the treatment of pseudobulbar affectP T. 2013;38(6):325-328.

  2. Engelman W, Hammond FM, Malec JF. Diagnosing pseudobulbar affect in traumatic brain injuryNeuropsychiatr Dis Treat. 2014;10:1903-1910. doi:10.2147%2FNDT.S63304

  3. Lauterbach EC, Cummings JL, Kuppuswamy PS. Toward a more precise, clinically--informed pathophysiology of pathological laughing and crying. Neurosci Biobehav Rev. 2013 Sep;37(8):1893-916. doi:10.1016/j.neubiorev.2013.03.002

  4. PBA Info. What is pseudobulbular affect?

  5. Genetic and Rare Diseases Information Center. Pseudobulbar affect.

  6. Kapugi M, Cunningham K. Corticosteroids. Orthopaedic Nursing: September/October 2019 - Volume 38 - Issue 5 - p 336-339 doi:10.1097/NOR.0000000000000595

  7. Johns Hopkins Medicine. Mood disorders.

  8. Matusiewicz AK, Hopwood CJ, Banducci AN, Lejuez CW. The effectiveness of cognitive behavioral therapy for personality disordersPsychiatr Clin North Am. 2010;33(3):657-685. doi:10.1016%2Fj.psc.2010.04.007

  9. May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorderMent Health Clin. 2016;6(2):62-67. doi:10.9740%2Fmhc.2016.03.62

  10. Queensland Health Acquired Brain Injury Outreach Service. Understanding emotional lability.

  11. Brådvik L. Suicide risk and mental disorders. Int J Environ Res Public Health. 2018 Sep 17;15(9):2028. doi: 10.3390/ijerph15092028