What to Know About Extreme Mood Swings

And what to do about the emotional ups and downs

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Mood changes refer to abrupt shifts in your mood or emotional state, and they are a normal part of life. However, they may be caused by a mental health disorder like borderline personality disorder or bipolar disorder, which is characterized by extremely high and low moods. Rapid or severe mood swings can feel disorienting, and they may interfere with your daily life and relationships.

mood swings

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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. However, sometimes they are a sign of a mental health disorder. For example, bipolar disorder, a type of mood disorder, causes manic (abnormally happy or irritable) and depressive (sad) episodes. Unlike regular mood shifts, these episodes can last for long periods, such as 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

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database.

Possible Causes

The causes of mood swings in children and in adults vary. Working with a mental health professional to uncover the causes requires being honest with yourself and others about what’s really going on in your life.

Life Changes

Change is a part of life, but some life changes like relationship breakups; school, job and career changes; moving; and getting divorced can cause enough stress to trigger mood swings.

For young children, mood swings can look like tantrums, meltdowns, and misbehavior. During puberty, when children reach sexual maturity, hormonal changes can also cause mood swings.

Alcohol and Drug Use

Significant mood swings can happen while consuming psychoactive drugs and alcohol. If people become addicted, they may reach for these mood enhancers even more to try to manage their emotions and energy levels, cravings, and withdrawal symptoms.  

Mood Swings in Women

Mood swings are normal in women experiencing natural hormonal fluctuations throughout their menstrual cycle. Estrogen and progesterone levels change dramatically throughout this time, dipping in the days preceding menstruation and causing mood swings. Mood swings are also expected during the years of natural estrogen decline leading up to menopause, which marks 12 months from the last period.

Mood Swings in Men

Mood swings due to hormonal fluctuations can also occur in males. Testosterone, the male sex hormone largely made in the testes, dips with age just like estrogen, and low levels can result in low mood.

According to the American Urological Association, about two out of 10 males over 60 years old and 50% of men over 80 have low testosterone levels.

Other potential causes of low testosterone in males include:

  • Opioid use
  • Injury to or loss of testicles
  • Diabetes
  • Obesity 

Steroids

Many physical ailments and medications can cause mood swings. One of the most common is steroids.

Anabolic-androgenic steroids (commonly referred to as anabolic steroids) 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.

Corticosteroids (commonly referred to as steroids) 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.

Mental Health 

Many mental health disorders can cause mood swings, including:

  • Stress: Problems with finances, relationships, work, and parenting can all contribute to mood swings.
  • Borderline personality disorder (BPD): BPD is a personality disorder characterized by extreme mood swings. These mood episodes are easily triggered and can last from minutes to hours.
  • Bipolar disorders: Extreme mood episodes of either depression and mania or hypomania are a hallmark feature of these mood disorders. Changes in mood can last for several days to several months and people can have long periods (months to years) without any mood symptoms.
  • Depression: People with depression (especially untreated depression) can experience dramatic mood shifts that affect energy levels, sleep, and appetite.
  • Anxiety: An anxiety disorder can also lead to negative mood shifts.
  • Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD): Everyone who menstruates experiences their monthly hormonal changes differently. For some, PMS can cause mood swings and irritability. PMDD is a more severe form of PMS. Symptoms of PMS and PMDD usually go away two to three days after your period starts.

Treatment

Treatment for mood swings may be necessary if you’re living with a mental health disorder or substance use disorder.

Treatment options include:

  • 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.
  • Mood stabilizers, second-generation antipsychotics, and antidepressants can be used to treat underlying conditions that trigger mood swings. 
  • Support groups may be helpful if you’re looking for someone safe you can talk to about your mood disorder and how it's affecting you.

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 legitimate mood swings caused by mental illness, even if you’ve been trying to control or treat them. Talk to your doctor or a mental health professional. They 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.

Frequently Asked Questions

Are mood swings normal?

Yes. Mild mood changes from time to time are normal, but when mood swings are severe and negatively interfere with your daily life and relationships, they are a problem and you should seek help from a mental health professional. 

Are rapid mood swings a sign of mental illness?

Sometimes. Rapid mood swings can be a sign of a mental health disorder like bipolar disorder, but this doesn’t mean all rapid mood swings are caused by mental illnesses. Other health conditions, addictions, and major life changes can also cause rapid mood swings.

How do you act around someone whose mood always changes?

When you love someone with mood swings, it can be frustrating. You may feel like you’re walking on eggshells or that you can’t ever be sure what to expect. Seek support for yourself and define your own personal boundaries regarding what you will and won't accept. 

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  1. National Institute of Mental Health. Bipolar disorder. Updated January 2020.

  2. American Urological Association. What is low testosterone?.

  3. Broome MR, Saunders KE, Harrison PJ, Marwaha S. Mood instability: significance, definition and measurementBr J Psychiatry. 2015 Oct;207(4):283-285. doi:10.1192/bjp.bp.114.158543