Mood swings: definition, traits and causes

Written in association with: Dr Richard Bowskill
Published:
Edited by: Aoife Maguire

How are mood swings defined?

There is no medical definition for mood swings, however, there are several things that doctors look out for.

 

Doctors will ask asking questions to try and elicit the nature of the mood swings. They ask for things such as the circumstances of the mood swings; whether they are triggered or whether they occur spontaneously.

 

In addition, they will ask about the nature of the mood swings; issues such as if they’re primarily anxiety related, or whether it’s depression. Irritability or frustration is another subjective experience of mood swings.

 

Another important aspect of mood swings is whether there’s any forms of elation or mania or hypomania because these aspects direct towards a diagnosis.

 

Furthermore, another other issue is if the mood swings are associated with triggers such as memories or previous experience, because these can identify some trauma related mood swings such as PTSD.

The doctor will ask about is how long the mood swings last; whether they last for minutes or brief periods, which is common with rage and anger, or if they last for hours, days, weeks or longer.

 

Some mood swings, including depression or mania, can last weeks or months, therefore the doctor will try and establish the pattern and ask the patient how long the mood swings have been lasting. They will ask what has been happening over the years as a way of establishing the pattern.

 

In terms of other associated aspects, the doctor will want to know whether there is any biological changes. For example, whether there are changes in sleeping patterns such as deterioration or changes in energy levels – whether you becomes very energised or slowed down and lethargic with the mood swings.

 

In addition, the doctor will ask whether the mood swings affect things like your speech and movement; whether it’s changed or sped up. This happens with hypomania.

 

Doctors will want to learn how much mood swings affect your daily functioning; whether it impacts on your work ability and the ability to interact with your family.

 

Mood swings,behaviour and physical symptoms

For some mood swings, such as those associated with bipolar disorder, mania or hypomania, sometimes people’s functioning alters. They become disinhibited or over-confident. Sometimes people can spend excessively, gamble or become involved in other reckless behaviour and that can be an important aspect to establish.

 

On the other hand, as opposed to the depressive side, if the mood swings are associated with suicidal thoughts or self-harm, it is crucial for doctors to know because it can indicate levels of risk. Different levels of treatment and support will be necessary, if the risk is thought to be high.

 

Doctors will also wish to learn if the patient is suffering from alcohol and substance abuse, due to their links to mood swings.

 

More rarely, mood swings can be associated with abnormal thoughts and psychosis. The doctor will probably ask if you’re having abnormal thoughts or hearing voices.

 

What causes mood swings?

There is a range of different conditions which can cause mood swings. One that most people are aware of is bipolar disorder.

 

Bipolar disorder is partly genetic meaning that some people are more predisposed to it due to their family history but there can be significant triggers related to life events.It is often seen as a more biochemical type of disorder and there is insignificant instability in different mood systems.

 

There is a range of different types of severity of bipolar disorder. One of the more severe types is bipolar 1 disorder, when phases of elevated mood are quite troublesome. People can become manic and sometimes become grandiose and deluded about when they are manic. This mania often disrupts functioning.

 

There is a less severe type called bipolar 2, which is when people have phases of depression but the elevated phases are less severe, known as hypomania which is less severe than a manic episode. Sometimes the hypomanic episodes don’t interfere greatly with functioning and it’s the depression which can cause the biggest problems.

 

Additionally, there is an even milder form called cyclothymia where the mood swings happen very frequently and more frequently than with bipolar 1 and bipolar 2.

 

Mood swings can often be linked to trauma related problems (different types of PTSD (post traumatic stress disorder)).

 

PTSD can be caused by one traumatic event or there can be a range of different traumas. Some traumas are prolonged and there can be association of mood swings with childhood traumas. If associated with childhood traumas, the diagnosis is more likely to be complex PTSD, which may provoke very significant mood swings.

 

Certain personality types are connected with mood swings. If people have difficulty in relationships with their parents, in childhood, that can cause attachment problems and in turn, can cause borderline or unstable personality. Primary treatment for these issues is psychological treatment.  

 

ADHD (Attention-Deficit Hyperactivity Disorder) is well known for causing problems with concentration and attention but mood instability is a key aspect of ADHD.

 

Additionally, Alcohol and substance misue can also cause significant mood swings.  It is important to find the correct diagnosis in order to guide treatment.

 

By Dr Richard Bowskill
Psychiatry

Dr Richard Bowskill is a leading consultant psychiatrist at Flint Healthcare in Brighton & Hove who specialises in the treatment of depression, anxiety, bipolar disorder, trauma, ADHD and obsessive compulsive disorder.

Dr Bowskill read medicine at Cambridge University where also obtained a Masters Degree in experimental psychology. He completed his training at Guy’s Hospital in London where his interests in psychiatry developed. Dr Bowskill then completed his membership of the Royal College of Physicians and the Royal College of Psychiatrists.

During his training, Dr Bowskill worked at the national unit for affective disorders at the Maudsley Hospital for two years. It was here where he developed an interest in the treatment of depression.

Dr Bowskill is an honorary clinical senior lecturer at Brighton and Sussex Medical School. He works part-time at the Sussex Partnership NHS trust. Previously, he was Deputy Head of the Post Graduate Medical School and led the development of the psychiatry curriculum at Brighton and Sussex Medical School for the school’s first ten years. 

From 2006 to 2017, Dr Bowskill was Medical Director at the Priory Hospital Brighton & Hove, which is now know as Elysium Healthcare. Between 2015 to 2016, he was also the National Clinical Director of Addictions at the Priory Group. 

Dr Bowskill lead the Clinical Academic Group for Bipolar Affective Disorders and is the Deputy Chair for the Mood and Anxiety Clinical Academic Group at the Sussex Partnership NHS Trust from 2015 to 2019 and is now the Acute Clinical Lead for Brighton and Hove. 

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