Mood swings, or rapid changes in one's emotional state, may occur as a reaction to circumstances or environment, as a result of a physical or mental health condition, or for no apparent reason. General moodiness is likely to be a part of everyone's life, but in some circumstances, changes in mood may be severe and have an effect on health and daily function.

When rapid or frequent mood shifts seem to occur without a cause or when they affect one's behavior, well-being, or typical function, the support of a therapist or other mental health professional may be helpful. 

• What Causes Mood Swings?
• Managing Mood Swings
• Therapy for Mood Swings
• Mood Swings and Psychological Disorders
• Case Examples

What Causes Mood Swings?

Exactly what causes mood swings is not known. It is believed a person's moods might result from chemical reactions in the brain. Thus, rapid mood shifts may be the result of chemical imbalances. Mood might also be affected by sleep, diet, medication, and other lifestyle factors, and shifts in these may affect the stability of a person's mood.

Individuals facing changes or difficulties in life may be more likely to experience sudden, unexplained changes in mood. For example, many teenagers may find themselves experiencing frequent and varied mood swings. Issues regarding identity, self-image, and acceptance may contribute to these emotional changes. A person who is under a significant amount of stress might also have a greater chance of experiencing mood swings. When a person experiences high levels of stress, even a small negative occurrence might lead to abrupt shifts in mood.

A number of medical and psychiatric conditions may lead to mood swings:

• Mental health conditions such as bipolar, borderline personality, depression, schizophrenia, attention deficit hyperactivity, and addiction
• Hormonal changes and related conditions [fat_widget_right]
• Dementia, brain tumors, meningitis, or other conditions that affect the central nervous system
• Thyroid conditions 
• Conditions that affect the flow of nutrients and oxygen to the brain, such as lung or cardiovascular diseases
• Stress, emotional overwhelm, and other types of emotional distress

Mood swings can often be treated. When they are not treated, they may contribute to suicidal ideation, thoughts of self-harm, risky behavior, or have other negative effects on health and well-being.

Managing Mood Swings

Mood swings can sometimes be managed with the following strategies:

• Tracking moods can help facilitate a greater understanding of shifts and changes in emotions. Keeping written track of and journaling about moods may help some individuals notice patterns in mood shifts as well as potential triggers that might affect mood.
• Exercise produces endorphins, which are hormones that help control stress and improve mood. Even moderate exercise can help relieve frequent or abrupt changes in mood.
• Maintaining a schedule can be helpful. Doing things at the same time every day can help regulate emotional highs and lows.
• Sleep can help improve mood. Sleep deprivation, which can affect appetite and energy level, can also contribute to sadness, irritability, and general lowness of mood.
• Nutrition is considered to be a vital component to mood management. Getting enough nutrients and avoiding the consumption of large amounts of sugar, alcohol, and caffeine may help reduce the frequency of mood swings.

Because mood swings may have a significant impact on health and well-being, especially when the cause goes untreated, the support of a mental health professional may be recommended.

Therapy for Mood Swings

Conditions associated with mood disturbances, such as bipolar and depression, can have a debilitating effect, and therapy can often help individuals who are coping with mood swings. Because mood swings occur as a symptom of an underlying condition and are not a diagnosable condition, a mental health professional will help the person in therapy explore any potential causes. In therapy, an individual can also develop methods to gain control over sudden shifts in mood. Once this is accomplished—often through techniques such as journaling, meditation, mindfulness, or breathing exercises—it may be easier to address the underlying issues.

A therapist can often help a person identify whether mood swings occur as the result of a mental health condition or as a symptom of some other type of concern. Whether mood swings occur as a result of some type of mental or emotional distress or are particular to a certain situation, therapy can often assist in the process of identifying the causes of highs and lows as well as situations that may cause one’s mood to fluctuate. Therapy can also help people develop coping strategies to deal with stressors as they arise. In therapy, one might also be able to learn to become better able to focus on the present moment with a general goal of learning how to constructively manage moods and maintain a healthy emotional balance.

Mood Swings and Psychological Disorders

Although the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) contained a section on Mood Disorders, the fifth edition, DSM-5, has been updated to include separate sections on Bipolar Disorders and Depressive Disorders—conditions that are often indicated by mood swings. While clinical depression may often be indicated by a persistent low mood, in some cases, mood fluctuations may also indicate this condition. Euphoric moods, moods that bring about feelings of invincibility or grandiosity, and moods that lead to impulsive behavior or keep a person awake for days might all indicate a manic episode, such as those seen with bipolar. When one’s mood cycles rapidly from low to high and back again, bipolar may also be indicated.

The Mood Disorder section in the DSM-IV described major depression, dysthymia, postpartum depression, and bipolar, among others. In the current edition of the DSM, the section on Bipolar and Related Disorders includes bipolar I and II, cyclothymia, substance/medication-induced bipolar, bipolar related to another medical condition, and specified and unspecified bipolar or related disorder. The section on Depressive Disorders now includes disruptive mood dysregulation disorder, persistent depressive disorder, and premenstrual dysphoric disorder, in addition to the other types of depression previously included in the DSM-IV.

A primary goal of therapy is to treat and resolve mood issues without medication whenever possible. Some individuals, however, find that a combination of medication and therapy is most effective at preventing severe mood fluctuations from having a significant negative impact on daily life and function. Conditions such as bipolar, for example, may often be treated with a combination of medication and therapy.

Case Examples

• Therapy for severe mood swings: Sonya, 25, enters therapy, reporting extreme moodiness. Sometimes, she tells the therapist, she feels so tired and in such low spirits that she stays in bed for two to three days at a time. Other times, she feels so excited that she feels like she can do anything, but she cannot focus on any one thing and finds it so difficult to sleep that she cannot do so without drinking more alcohol than she would like to. She also tells the therapist that her moods change abruptly and that, although much of the time she "feels fine," at other times she feels as if she has no control over her emotions or mood. The therapist identifies the symptoms of bipolar and refers Sonya to a psychiatrist for a medication evaluation. Sonya is reluctant to take medication but agrees to try a small dosage at the psychiatrist's recommendation. Sonya continues in therapy to both address the feelings of lowness she has experienced and explore ways to track and manage her moods. Over the next several weeks, she finds her moods are fairly stable and her sleep schedule has normalized. She no longer resorts to alcohol to sleep, and her feelings of depression subside as she continues work in therapy with the goal of becoming able to completely manage the condition without medication. 
• Mild mood swings affecting self-image and relationships: Gregor, 49, enters therapy, reporting mood swings, trouble sleeping, and frequent irritability. He tells the therapist he is worried he might be bipolar. However, a review of his symptoms and discussion about his changes in mood indicate a more general, mild moodiness. The therapist and Gregor work together to uncover areas of life that may be affecting his mood, and in therapy he discusses his self-image, various life stresses, and the difficulty he has been experiencing in maintaining a romantic relationship. They also explore ways that Gregor might manage his changes in mood. He decides to try keeping track of when his mood shifts, and in what way, in order to identify possible triggers, and he also resolves to spend at least 20 minutes each day exercising. After a few weeks, Gregor finds his sleep is less troubled, his mood is overall improved, and he has a more positive outlook in general. He continues in therapy to achieve even greater improvement in these areas. 

References: 

1. 9 Biggest Triggers of Bipolar Mood Swings. (2015, March 20). Retrieved from http://www.everydayhealth.com/bipolar-disorder-pictures/biggest-triggers-of-bipolar-mood-swings.aspx 
2. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
3. Lloyd, W. (2014, June 4). Mood Swings - Symptoms, Causes, Treatments. Retrieved from http://www.healthgrades.com/symptoms/mood-swings 
4. Lyness, D. (2015, August 1). Why Am I in Such a Bad Mood? Retrieved from http://kidshealth.org/teen/your_mind/emotions/bad_mood.html# 
5. Parker, G. (2014). DSM-5 and Psychotic and Mood Disorders. The Journal of the American Academy of Psychiatry and the Law, 42, 182-190.