Extreme Mood Swings

Mood changes, or swings, refer to abrupt shifts in your mood or emotional state, and may be a normal response to stress or hormonal shifts. However, they can also signify a mental health disorder like borderline personality disorder or bipolar disorder, which is characterized by extremely high and low moods. Rapid or extreme mood swings may interfere with your daily life and relationships.

This article explains how to recognize the symptoms of mood swings, what may be causing them, and how they can be managed.

Symptoms of Mood Swings

When you experience mood swings, you may feel very happy one moment for no reason and very sad the next without knowing why. These mood changes may also be accompanied by changes in sleep patterns, activity levels, and behavior.

Mood changes are a normal part of life, especially when you are going through a lot of stress. Sometimes, however, they can be a sign of a mental health disorder. For example, bipolar disorder, a type of mood disorder, causes manic (abnormally happy or irritable) and depressive (excessively sad) episodes. Unlike regular mood shifts, these episodes can last for several days or weeks.

When someone experiences a depressive episode, they may have the following symptoms:

• Talking more slowly than usual
• Feeling sad, hopeless, and worthless
• Having trouble sleeping, waking early, or sleeping too much
• Experiencing an increased appetite and weight gain
• Having trouble concentrating
• Feeling fatigued
• Having little interest in activities they usually enjoy
• Having thoughts of suicide or self-harm

When someone experiences a manic episode, their symptoms may include:

• Talking more or more quickly than usual
• Engaging in risky behaviors
• Appearing irritable or euphoric
• Doing more goal-oriented activities with more energy and intensity
• Sleeping less than they normally would
• Feeling like their thoughts are racing
• Feeling like they are unusually powerful or important

Causes of Mood Swings

The causes of mood swings vary. Some of the most common causes include:

• Stressful life changes
• Hormonal shifts
• Substance use disorders
• Mental health disorders

Stressful life changes like relationship breakups; school or job changes; and moving can sometimes cause enough stress to trigger mood swings, or trigger episodes of mood swings in those with certain mental illnesses.

Hormonal shifts during puberty, menopause, and during a woman's menstrual cycle can cause mood swings as well. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), which affect some women, can cause more significant mood swings and irritability. Symptoms of PMS and PMDD usually go away two to three days after your period starts.

Significant mood swings can also happen while consuming psychoactive drugs and alcohol. Substance use disorders are often associated with mental illnesses that cause mood swings.

Mental Health Disorders

When mood swings are extreme, rapid, and long-lasting, they may be a sign of a mental health disorder. Three mental health disorders that are strongly associated with mood swings include:

• Borderline personality disorder (BPD): BPD is a personality disorder characterized by difficulties regulating emotions, as well as extreme mood swings. These mood episodes are easily triggered and can last from minutes to hours.
• Bipolar disorder: Extreme episodes of either depression and mania or hypomania (a less severe form of mania) are a hallmark feature of bipolar disorders I and II. Changes in mood can last for several days to several months. People can also experience long periods (months to years) without any mood symptoms.
• Cyclothymic disorder: Cyclothymic disorder is related to bipolar disorder. With this disorder, an unstable mood state in which people experience hypomania and mild depression may last for two years or longer. Periods of stable moods typically last less than eight weeks.

What Medications Can Cause Mood Swings?

Steroid drugs in particular are commonly associated with changes in mood and mood swings. There are two classes of steroids:

• Corticosteroids: These are anti-inflammatory drugs like prednisone, cortisone, and methylprednisolone. They are used to treat myriad conditions such as arthritis, lupus, asthma, allergies, inflammatory bowel disease, and multiple sclerosis. In high doses, steroids can cause mood swings, personality changes, depression, mania, and even psychosis.
• Anabolic-androgenic steroids: These are synthetic substances similar to testosterone. They are often used as performance-enhancing drugs, but they can also treat delayed puberty and other conditions. Anabolic steroids can cause increased irritability, aggression, anxiety, mania, or depression.

Other medications that are known to cause mood swings include Accutane (isotrentoin) and selective serotonin reuptake inhibitors (SSRIs) such as Effexor and Zoloft.

How to Treat Mood Swings

Treatment for mood swings depends on what is causing them. If they are transient—for example caused by a period of extreme stress—they will likely pass once the stress subsides.

For more serious causes of mood swings, treatment may include:

• Medications: Mood stabilizers (e.g., lithium), atypical antipsychotics (e.g.,Abilify) and antidepressants (e.g., Zoloft) can be used to treat underlying conditions such as bipolar disorder that trigger mood swings.
• Psychotherapy: Various types of psychotherapies have been found to be useful for people with mood disorders, often in conjunction with medications. Cognitive behavioral therapy (CBT) is a type of psychotherapy that can help you learn to recognize triggers and warning signs of oncoming mood swings before they happen. It can also challenge and change your thinking so that coping becomes easier. Dialectical behavioral therapy (DBT) helps patients learn how to control intense emotions and develop coping skills.
• Lifestyle measures: Using a journal to record your mood symptoms and mood swing triggers can help you get a handle on them. Healthy lifestyle habits including getting regular exercise and enough sleep can help ward off depression.

Are There Tests to Diagnose the Cause of Mood Swings?

There is no definitive test that can diagnose the cause of mood swings. A healthcare provider or mental health professional will take a detailed medical and family history and ask you about your symptoms, triggers, and how long they last. If a mental health disorder is suspected, they may consult with other providers you've seen and/or ask for input from friends or family.

When to See a Healthcare Provider

If your mood swings are severe and frequent, or are having an impact on your job, family life, or other relationships, it is important to contact your healthcare provider, who may refer you to a mental health professional.

Specific symptoms that warrant a consultation with a provider include:

• Feeling unusually "revved up," and unable to control the urge to spend a lot of money, be sexually promiscuous, or engage in other risky behaviors
• Feel depressed to the point where you are unable to get out of bed or engage in your usual daily activities
• Feel like you want to harm yourself or end your life
  

Summary

It's normal to experience mood swings, especially during times of extreme stress. Hormonal changes, life changes, addiction, and high doses of some drugs like steroids can all cause changes in your emotional state. However, some mental health disorders can also cause mood swings and require treatment from a mental health professional.

A Word From Verywell

There’s nothing wrong or unhealthy about feeling overwhelmed, worked up, or even angry in certain situations. It’s also understandable if you’re experiencing mood swings caused by mental illness, even if you’ve been trying to control or treat them. A mental health professional can offer resources to help you manage your mood swings and offer advice on talking to your loved ones so they can better understand and support you.