Mood swing

Source: Wikipedia, the free encyclopedia.
"Mood swings" redirects here. For other uses of Mood swing or Mood swings, see Mood swing (disambiguation).
"Mood changes" redirects here. For the album, see Mood Changes (album).

Graphical comparison of mood swings, compared with bipolar disorder and cyclothymia

A mood swing is an extreme or sudden change of mood. Such changes can play a positive part in promoting problem solving and in producing flexible forward planning,[1] or be disruptive. When mood swings are severe, they may be categorized as part of a mental illness, such as bipolar disorder, where erratic and disruptive mood swings are a defining feature.[2]

To determine mental health problem, people usually use charting with papers, interviews, or smartphone to track their mood/affect/emotion.[3][4] Furthermore, mood swings not just fluctuate between mania and depression, but in some conditions, involve anxiety.[5][6]

Terminology

Definitions of the terms mood swings, mood instability, affective lability, or emotional lability are commonly similar, which describe fluctuating or oscillating of mood and emotions. But each has unique characteristics that are used to describe specific phenomena or patterns of oscillation.[7][8] Different from emotions or affect,[9] mood associated with emotional responses without knowing the reason (unaware).[10][11]

The dynamics of mood, mood patterns for long times are commonly erratic,[12] labile[13] or instable, also known as euthymic.[14] Although the term of mood swing is unspecific, it may be used to describe a pattern where mood goes down from positive to negative valency immediately (without delay in baseline) at specific periods.[15] And also generally have aperiodic patterns.[16][17] This is because mood dynamics are influenced by various factors which can magnify or lessen fluctuations,[18] such as when expectations become reality or not.[19] Other terms for describing patterns are episodic, periodic, cyclothymia, rapid cycling, mixed states, short episodes, soft spectrum,[20] diurnal variation, etc., although the definition of each term may be unclear.[21]

Overview

Speed and extent

Mood swings can happen any time at any place, varying from the microscopic to the wild oscillations of bipolar disorder,[22] so that a continuum can be traced from normal struggles around self-esteem, through cyclothymia, up to a depressive disease.[23] However most people's mood swings remain in the mild to moderate range of emotional ups and downs.[24] The duration of bipolar mood swings also varies. They may last a few hours – ultrarapid – or extend over days – ultradian: clinicians maintain that only when four continuous days of hypomania, or seven days of mania, occur, is a diagnosis of bipolar disorder justified.[25] In such cases, mood swings can extend over several days, even weeks: these episodes may consist of rapid alternation between feelings of depression and euphoria.[26]

Characteristics

Man running a marathon
People with high energy levels
Man sleep on the desk
Person with low spirited mood
  • Changing mood up and down without knowing the reason or external stimuli,[27] in various degrees, duration and frequent, from high mood (happy, elevated, irritated) to low mood (sad, depressed).[5][28]
  • Sometimes it's mixed,[29] a combination between manic and depression symptoms[30] or similar with bittersweet experiences that last for a day.[31][32]
  • Mood swings in normal people appear like "climate changing" at mild to moderate degree.[9][33] Thus, unless it happens at a moderate degree or more, some people need more high emotional intelligence[34] to recognize their mood change.[35]
  • Mood swings in mental illness simply can be described by generalized complexity[36] based on mood dynamics (patterns that characterize the oscillation) like intensity (mild, moderate, severe), duration (days, weeks, years), average mood and other features, such as:[37][38]
  1. Mood swings in cyclothymia: Mood swings occur episodically and aperiodic within 2 years or more at a moderate degree and frequently.[39] Characterized by coexisting with anxiety, persistence, rapid shift, intense, impulsive,[40] heightened by sensitivity and reactivity to external stimuli.[41]
  2. Mood swings in bipolar II: Episodic,[42] hypomanic (severe degree) episodes occur continuously for 4 days,[30] depression episodes for weeks,[43] and sometimes erratic episodes at moderate degree in between episodes.[44]
  3. Mood swings in bipolar I: Episodic,[42] manic episodes (severe degree) occur continuously for 7 days,[30] depressive episodes for weeks,[45][46] and sometimes erratic episodes at moderate degree in between episodes.[30] Alterations in bipolar I and II can be rapid cyclic, which means changes of mood happen 4 times or more within a year.[47] Symptoms of manic and hypomanic episodes are similar between bipolar I and bipolar II, just different in degree of intensity.[48]
  4. Mood swings in Premenstrual symptoms (PMS): Episodically at mild to severe degree in the menses period, occur gradually or rapidly,[49] start 7 days before and decrease at the onset of menses.[50] Characterized by angry outbursts, depression, anxiety, confusion, irritability or social withdrawal.[51]
  5. Mood swings in borderline personality disorder (BPD): Mood changes erratically with episodic mood swings.[52] Mood swings fluctuate in rapid shifts for hours or days, not persistent, sensitive and heightened negative mood (e.g. irritability) by external stimuli.[53][54] Mood appears in the form of high intensity of irritability,[55][56] anxiety,[57] and moderate degree depression (characterized by hostility, anger towards self, loneliness, isolation, related with relationships, emptiness or boredom).[58][59]
  6. Mood swings in attention deficit hyperactivity disorder (ADHD) : Mood changes erratically and mood swings occur episodically, sometimes several times a day in rapid shifts.[60][61] Characterized by a mild to moderate degree of irritability,[62] related to the environment, impulsiveness (impatience to get rewards).[63] In adult ADHD, high mood appears as excitement and low mood appears as boredom.[60]
  7. Mood swings in schizophrenia: Although schizophrenia has flat emotions,
    blunt affect),[67] and heightened by external stimuli.[68]
  8. Mood swings in major depressive disorder (MDD): Various mood patterns,
    diurnal variation mood (bad mood in the morning, good mood in the evening),[73] sensitivity to negative stimulation and mixed symptoms in some people, etc.[74][75]
  9. Mood swings in post-traumatic stress disorder (PTSD): Mood changes erratically[76] with episodic mood swings rising in the period of recovery process.[77][78] Characterized by temporary fluctuations in negative affect (anxiety, irritability, shame, guilt) and self-esteem, reactive to environmental reminders,[79] difficulty to control emotions,[80] hyperarousal symptoms, etc.[81][82]

Causes

There can be many different causes for mood swings. Some mood swings can be classified as normal/healthy reactions, such as grief processing, adverse effects of substances/drugs, or a result of sleep deprivation. Mood swings can also be a sign of psychiatric illnesses in the absence of external triggers or stressors.

Changes in a person's energy level,

sleep patterns, self-esteem, sexual function, concentration, drug or alcohol use can be signs of an oncoming mood disorder.[83]

Other major causes of mood swings (besides

ADHD), epilepsy,[84] and autism spectrum are three such examples.[85][86]

The hyperactivity sometimes accompanied by inattentiveness, impulsiveness, and forgetfulness are cardinal symptoms associated with

autism, and the associated changes in neurochemistry, are also known to cause autistic fits (autistic mood swings).[87] The seizures associated with epilepsy involve changes in the brain's electrical firing, and thus may also bring about striking and dramatic mood swings.[84]
If the mood swing is not associated with a mood disorder, treatments are harder to assign. Most commonly, however, mood swings are the result of dealing with stressful and/or unexpected situations in daily life.

Degenerative diseases of the human

Celiac disease can also affect the nervous system and mood swings can appear.[89]

Not eating on time can contribute, or eating too much sugar, can cause fluctuations in blood sugar, which can cause mood swings.[90][91]

Brain chemistry

If a person has an abnormal level of one or several of certain neurotransmitters (NTs) in their brain, it may result in having mood swings or a mood disorder.[92] Serotonin is one such neurotransmitter that is involved with sleep, moods, and emotional states. A slight imbalance of this NT could result in depression. Norepinephrine is a neurotransmitter that is involved with learning, memory, and physical arousal. Like serotonin, an imbalance of norepinephrine may also result in depression.[93]

List of conditions known to cause mood swings

  • Bipolar disorder[94][95] or cyclothymia: Bipolar disorder is a mood disorder with characteristics of mood swings from hypomania or mania to depression. While cyclothymia is a lower degree of bipolar disorder.[96] In 2022, ENIGMA Bipolar Disorder Working Group found that people with bipolar disorder have smaller subcortical volumes, lower cortical thickness and altered white matter integrity,[97][98] which one of the functions is for emotion processing.[99]
  • Anabolic steroid abuse:[100] Anabolic steroids are synthetic derivatives of testosterone. Used for treatment of male hypogonadism or delayed puberty,[101] stimulates muscle growth,[102] impotence, and AIDS.[103] Studies found that overly using anabolic-androgenic steroids can cause mood swings, impulsive, and aggressive behavior.[104] This behavior is associated with decreased emotion regulation systems such as the frontal cortex, temporal, parietal, and occipital.[105] Studies found too, that using anabolic-androgenic steroids can cause neuronal changes and death in the hypothalamic-pituitary-gonadal axis, thus symptoms of sleep and mood disorder occur.[106]
  • Mood dysregulation may be caused by distraction when absorbed in pleasurable tasks.[109][110] Another contribution to mood swings is lower brain activity in the prefrontal cortex (PFC),[111] orbitofrontal cortex (OFC),[112] increased size of the hippocampus and decreasing size of the amygdala in some people.[113] Abnormalities in these parts of the brain can cause disturbance in attention, motivation, mood, and behavioral inhibition.[114]
  • Autism or other pervasive developmental disorder: Autism is a neurological and development disorder with symptoms such as lack of social, restricted repetitive behaviors, hyper- or hyporeactivity to sensory input, etc.[115] Abnormal sensory processing is one of the reasons for mood swings in autism.[116] Studies in 2015 found that in autism, the brain becomes overactivated in limbic areas, primary sensory cortices, and orbitofrontal cortex (OFC), which functions for emotional and sensory processing. Studies found too, that the brain in autism has decreased connectivity between the amygdala and ventrolateral prefrontal cortex, increased amygdala reactivity, and reduced prefrontal response which contribute to emotion dysregulation.[117][118]
  • Borderline personality disorder: It has been theorized that borderline personality disorder comes from lack of ability to endure, learn[119] and overcome negative events.[120] People with BPD commonly have difficulty in relationships,[121] which is associated with a tendency to anger-outbursts, judgment[122] or expecting how others behave.[123] Emotion dysregulation may be as a result of lack of interpersonal skills such as knowledge about emotions and how to control them, especially with intense emotions.[124] Mostly, people with BPD use maladaptive emotion regulations like self-criticism, thought suppression, avoidance, and alcohol, which may trigger more mood disruption.[125][126][127]
  • Dementia, including Alzheimer's disease, Parkinson's disease and Huntington's disease: Dementia is known as a decreasing brain function disease that affects older people.[128] In Alzheimer's disease, mood dysregulation can be caused by decreasing function of emotional regulation, salience, cholinergic, GABAergic, and dopaminergic function.[128] Parkinson's disease can generate mood swings and mood dysregulation such as depression, low self worth, shame and worry about the future caused by cognitive and physical problems.[129] And in Huntington's disease, common mood swings occur as a result of psychosocial, cognitive deficits, neuropsychiatric and biological factors.[130]
  • Dopamine dysregulation syndrome: Dopamine dysregulation syndrome is an effect of abusing Parkinson's disease drugs to decrease motor and non-motor syndromes, which result in mania, violent behavior, and depression when withdrawal.[131] Mood dysregulation from dopamine dysregulation syndrome occurs as a result of changes in the neurotransmitter systems such as disturbance in the dopaminergic reward system.[132][131]
  • Epilepsy: Epilepsy is an abnormal brain activity disease marked with seizures. Seizures occur because hypersynchronous and hyperexcitability of neurons, in other words, too much neural activity and excitability at the same time.[133] Mood swings commonly appear before, during, after a seizure and during treatment.[134] Studies found that seizures contribute to decreased function of emotions and mood processing as a consequence of abnormal neurogenesis and damaged neuron connections in the hippocampus and amygdala.[133] Experiencing a seizure can cause mood swings caused by depression, anxiety, or worry about life being threatened. Another source of mood change comes from anticonvulsant drugs for epilepsy, like phenobarbital for increasing brain inhibitors or antiglutamatergic for decreasing brain activity which generates depression, cognitive dysfunction, sedation or mood lability.[135]
  • Hypothyroidism or hyperthyroidism: Hypo- and hyperthyroidism is an endocrine disease caused by low or excessive production of thyroid hormone. Abnormal thyroid hormone can affect mood,[136] although the correlation between thyroid hormone and mood disorder is still not known.[137]
  • Intermittent explosive disorder: Intermittent explosive disorder is frequent rage that occurs spontaneous, uncontrolled, unproportioned and not persistent.[138][139] This short duration of alternate mood occurs in the form of aggression verbally or physically towards people or property, sometimes followed by regret, shame and guilt after an act which might generate depression symptoms.[140] Impulsive behavior in IED can be associated with hyperactivity in brain regions for regulating and emotional expression, such as the amygdala, insula, and orbitofrontal area.[141]
  • Menopause:[142] Menopause in women commonly happens at age 52. One factor that causes mood disturbance is fluctuation of milieu hormones[143] including sex steroids, growth hormones, stress hormones, etc.[144][145]
  • Major depression: Major depression is a disorder with symptoms such as feelings of sadness, loss of interest, emptiness[146] and, for some people, mixed with irritability, mental overactivity, and behavioral overactivity.[147] Development of irritability or anger may result from personality traits like narcissistic or coping strategies to avoid looking sad, worthless, or frustrated.[148]
  • Obsessive Compulsive Disorder: Obsessive compulsive disorder is marked with obsessions and compulsions about something that causes life distress and dysfunction.[149] Alteration of mood and feeling discomfort such as shame, guilt or anxiety may occur caused by intrusive thoughts, fear, urge,[150] and fantasy.[151]
  • Pathological demand avoidance
  • Post traumatic stress disorder: Post-traumatic stress disorder is a disorder which is associated with frequently being disturbed by flashback memories and being haunted by feelings of fear and horror in the past. This contributes to the alteration of mood that occurs after a traumatic event happens, such as depression, outbursts of anger, self-destructive behaviors, and feelings of shame.[152][153]
  • Pregnancy: Women commonly experience mood swings during the pregnancy and the postpartum period. Hormone changes, stress and worry may be the reasons for changes of mood.[154]
  • Premenstrual syndrome:[155] Women experience premenstrual syndrome like physical pains, mood swings, irritability or depression[156] in a few days until 2 weeks of their period with different intensity.[157] Furthermore, 4% to 14% of women experience severe PMS or premenstrual dysphoric disorder (PMDD), which can decrease life quality.[158] Despite the reason mood dysregulation in PMS is still unclear, Studies found that mood dysregulation is related with drop in progesterone concentrations, disruption of serotonergic transmission, GABAergic, stress, body-mass index, and traumatic events.[157]
  • Schizoaffective disorder: Mood swings in schizoaffective disorder are caused by mixed symptoms between schizophrenia and mood disorder.[159]
  • Schizophrenia: Schizophrenia is a disorder with symptoms of delusions, hallucinations, mood dysregulation, etc.[160] Mood changes may be generated from hallucinations and delusions[161] which cause anger,[162][163] paranoia,[164] and shame.[165]
  • Seasonal affective disorder: Seasonal affective disorder is depression which occurs during some seasons (commonly in winter), then manic or hypomanic episodes in the other season and that happens every year.[166] These fluctuating moods appear in the form of anger attacks with depression[167] and occur from season to season, also known as seasonal mood swings.[168]
  • neurodevelopment and psychiatric diseases which can cause mood disorders.[169][170]

Treatment

It's part of human nature's mood going up and down caused by various factors.[171] Individual strength,[172] coping skill or adaptation ability,[173] social support[174] or another recovery model might determine whether mood swings will create disruption in life or not.[175][176]

Cognitive behavioral therapy recommends using emotional dampeners to break the self-reinforcing tendencies of either manic or depressive mood swings.[177] Exercise, treats, seeking out small (and easily attainable) triumphs, and using vicarious distractions like reading or watching TV, are among the techniques found to be regularly used by people in breaking depressive swings.[178]

Learning to bring oneself down from grandiose states of mind, or up from exaggerated shame states, is part of taking a proactive approach to managing one's own moods and varying sense of self-esteem.[179]

Behavioral activation is a component of CBT that can break the cycle (depression leads to inactivity, inactivity leads to depression).[180] This may rely on individual strengths to "cold start" the reward system.[181]

Dialectical behavior therapy (DBT): Another manifestation of mood swing is irritability, which can lead to elation, anger or aggression.[182] DBT has a lot of coping skills that can be used for emotion dysregulation, such as mindfulness with the "wise mind"[183] or emotion regulation with opposite action.[184][185]

Emotion regulation therapy (ERT) has a package of mindful emotion regulation skills (e.g., attention regulation skills, metacognitive regulation skills, etc.) that can be handy to have when mood swings happen.[186]

Interpersonal and social rhythm therapy can be used to regulate life rhythm when mood swings happen frequently and disrupt the rhythm of life.[187] Episodes of mood disorder often liberate people from daily routines by making a mess of sleep schedules, social interaction,[188][189] or work and causing irregular circadian rhythms.[190]

psychological flexibility by learning to assess present experience or be mindful, accept everything internally or externally, commit action to move toward personal recovery, etc.[191]

See also

References

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    . The literature spans psychiatry, psychology and neuroscience, and multiple terms are used to describe the same, or related phenomena, including affective instability, emotional dysregulation, mood swings, emotional impulsiveness and affective lability. Collating the main overlapping dimensions, definitions, and their measurement scales, a recent systematic review proposed that mood instability is 'rapid oscillations of intense affect, with a difficulty in regulating these oscillations or their behavioural consequences'.
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    . We typically have little control over fluctuations between episodes of good and bad mood. In most cases, we also have little understanding of the causal factors driving our mood fluctuations, contrary to emotional reactions that are circumscribed to a specific trigger and limited to a short duration.
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    . As expected, episodes of depressions were much longer than manias, but episode-duration did not differ among BD diagnostic types: I, II, with mainly mixed-episodes (BD-Mx), or with psychotic features (BD-P)...A total of 56.8% of subjects could be characterized for major course-patterns as either DMI or MDI, which occurred in similar proportions for each type. As expected, depressive episodes averaged 5.2 months
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    . These studies indicate that mood in patients with bipolar disorder is not truly cyclic for extended periods. Nonetheless, self-rated mood in bipolar disorder is significantly more organized than self-rated mood in normal subjects and can be characterized as a low-dimensional chaotic process. This characterization of the dynamics of bipolar disorder provides a unitary theoretical framework that can accommodate neurobiologic and psychosocial data and can reconcile existing models for the pathogenesis of the disorder. Furthermore, consideration of the dynamical structure of bipolar disorder may lead to new methods for predicting and controlling pathologic mood.
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    . The median duration of major depressive episodes was 14 weeks, and over 70% recovered within 12 months of onset of the episode. The median duration of minor depressive episodes was 8 weeks, and approximately 90% recovered within 6 months of onset of the episode...An early report from this study examined 66 participants with bipolar I followed for up to 5 years, and found that the median time to recovery from the first two prospectively observed episodes of major depression was 20 weeks and 24 weeks.16 A subsequent report described 82 participants with bipolar I followed for 10 years; the median duration of major and minor depressive episodes were 12 and 5 weeks, respectively.17
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    . (graph PMS pattern)...Key characteristics of PMS include a lack of symptoms during the follicular phase, a peak of symptoms during the late luteal or premenstrual phase, and a sudden decrease of symptoms with the onset of menses.
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    . The ACOG definition involves the presence of at least one of the six affective symptoms (angry outbursts, depression, anxiety, confusion, irritability and social withdrawal) and one of the four somatic…
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  53. PMID 23250816
    . It consists of a heightened emotional reactivity to environmental stimuli, including emotions of others. Emotion sensitivity in BPD has primarily been associated with negative mood states (e.g., anger, fear, sadness) and not positive emotions (although see [9, 10]).
  54. PMID 15939918
    . ...but in BPD, symptoms are usually associated with mood instability rather than with the extended and continuous periods of lower mood seen in classic mood disorders.19 Also, because of characteristic mood swings, BPD is often mistaken for bipolar disorder.30 However, patients with BPD do not show continuously elevated mood but instead exhibit a pattern of rapid shifts in affect related to environmental events, with "high" periods that last for hours rather than for days or weeks.
  55. PMID 34122197
    . Individuals with BPD report more negative emotions and a greater intensity of negative emotions than healthy individuals throughout the day (9). However, recent data suggest a particular relevance of anger, a negative emotion that is closely related to reactive aggression, in BPD. Using e-diaries, Kockler et al. (10) found that individuals with BPD exhibit anger more frequently in their daily life than healthy as well as clinical control groups and feelings of anger accounted for more distress than pure emotional intensity.
  56. ^ Reich Brad.(2012).Affective Instability in Borderline Personality Disorder.McLean Hospital."Graph"
  57. PMID 11986132
    . The results of this study suggest that the presence of greater lability in terms of anger, anxiety, and depression/anxiety oscillation characterizes borderline personality disorder, while suggesting that the subjective sense of high affective intensity is present in this population but does not explain these other affective phenomena.
  58. S2CID 22836499
    . Depressive symptoms that occur as part of BPD are usually transient and related to interpersonal stress (eg, after an event arousing feelings of rejection). Such "depression" usually lifts dramatically when the relationship is restored. Depressive symptoms in BPD may also serve to express feelings (eg, anger, frustration, hatred, helplessness, powerlessness, disappointment) that the patient is not able to express in more adaptive ways.
  59. PMID 25723972
    . Moderator analyses revealed lower depression severity in BPD patients without comorbid DeDs, but higher severity in BPD patients with comorbid DeDs compared to depressed controls...some authors labeled the depression experienced in BPD "borderline-depression", characterized by distinct feelings of loneliness and isolation (Adler and Buie, 1979, Grinker et al., 1968), emptiness or boredom (Gunderson, 1996), high dependency and fears of abandonment (Masterson, 1976), as well as intense anger and hate toward the self and others (Hartocollis, 1977, Kernberg, 1975, Kernberg, 1992).
  60. ^ a b FW, Reimherr & Marchant, Barrie & Olsen, John & C, Halls & Kondo, Douglas & ED, Lyon & Robison, Reid. (2010). Emotional dysregulation as a core feature of adult ADHD: Its relationship with clinical variables and treatment response in two methylphenidate trials. Journal of ADHD and Related Disorders. 1. 53-64. "Graph"
  61. PMID 23218897
    . This study replicates research showing that adults with ADHD report heighted emotional lability (EL), which contributes to impairments in their daily life.
  62. ^ J. Rosen, Paul; N. Epstein, Jeffery (2010). "A pilot study of ecological momentary assessment of emotion dysregulation in children" (PDF). Journal of ADHD & Related Disorder. 1 (4): 49 – via semantic scholar. This pattern is consistent with the pattern of dysregulation demonstrated by the ADHD-EDr child in the present study, as he demonstrated generally low positive affect along with 10 single time-point ratings of mild to moderate irritability over the 4 weeks.
  63. PMID 16504359
    . However, common themes include decreased inhibitory control, intolerance of delay to rewards and quick decision-making due to lack of consideration, as well as more universal deficits such as poor attentional ability.
  64. PMID 25481397
    . Kraepelin1 and Bleuler2 had already mainly focused on "flat" or "inappropriate" emotions as core features of the illness.
  65. PMID 34734342
    . There were no statistically significant differences between individuals with BD-I and SZ for any ALS-SF dimension and these two groups had very similar score patterns throughout. This suggests that despite the overlap in core affective symptom profiles of BD-I and BD-II, the BD-I group is more similar to SZ than it is to BD-II concerning levels of affective lability.
  66. PMID 19793794
    . Evidence from multiple domains indicates that affective dysregulation is strongly associated with reality distortion.1,2 Genetic epidemiological studies have demonstrated that the liabilities for bipolar disorder and schizophrenia are correlated.
  67. PMID 26035179
    . Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions [1], characterized by diminished facial expression, expressive gestures and vocal expressions in reaction to emotion provoking stimuli [1–3]. However, patients' reduced outward emotional expression may not mirror subjective internal emotional experiences [4] suggesting a disconnect in what patients experience, perceive and express when interpreting emotional stimuli [5] due to problems associated with emotional processing [6–7].
  68. PMID 18245057
    . There is evidence that the occurrence of stressful life events3,6–8 or the presence of social relationship stressors such as high levels of familial "expressed emotion9–11" are associated with subsequent exacerbation of psychotic symptoms in patients as a group.
  69. PMID 22708886
    . Whether depressed individuals and healthy controls will differ in their instability of PA is less clear. As we noted above, depressed individuals have been found to have blunted emotional responses to valenced stimuli in the laboratory (Bylsma, et al., 2008) and decreased responsivity to reward (e.g., Pizzagalli, Iosifescu, Hallett, Ratner, & Fava, 2009)...
  70. PMID 28446884
    . He noted that people with melancholia could become over-talkative and manic but did not adequately explain why this is so." & "On the VAS ratings, the depressed group experienced more severe low moods and less severe high moods than the non-depressed group, as would be expected given the selection criteria. This is consistent with reports of more severe negative emotions and variable positive emotions in ecological momentary assessment studies of patients with major depression (12, 33, 53).
  71. PMID 35379283
    . Emotional effects of depression and treatment vary, but may include, for example, feeling emotionally "numbed" or "blunted" in some way; lacking positive emotions or negative emotions; feeling detached from the world around you...
  72. S2CID 242802425
    . Retrieved 25 August 2023. Major depressive disorder is characterized by high mean NA and low mean PA (e.g., Watson et al., 1988).... Note that major depressive disorder generally is unassociated with instability of NA or PA (Köhling et al., 2016; Koval et al., 2013).
  73. PMID 17239958
    . Diurnal variation in mood is a prominent symptom of depression, and is typically experienced as positive mood variation (PMV — mood being worse upon waking and better in the evening).
  74. PMID 7995029
    . The depressives are more sensitive to displeasure and more anhedonic than controls.
  75. PMID 25687279
    . The mixed depressive syndrome is not a transitory state but a state of long duration, which may last weeks or several months. The clinical picture is characterized by dysphoric mood, emotional lability, psychic and/or motor agitation, talkativeness, crowded and/or racing thoughts, rumination, initial or middle insomnia.
  76. PMID 17345648
    . Emotional abuse was associated with average daily mood and mood lability.
  77. S2CID 33989429
    . The results showed that less than 50% of PTSD cases presented with anxiety as the primary emotion, with the remainder showing primary emotions of sadness, anger, or disgust rather than anxiety
  78. PMID 31730736
    . Taken together, these results indicate that PTSD development is a dynamic process in which symptoms interact over time (Gelkopf et al., 2017). As hypothesized, intrusions and AAR symptoms may be more important early on and lead to other symptoms in the disorder.
  79. PMID 19716997
    . Chronic PTSD most often co-occurs with mood, anxiety and substance use disorders. It is highly reactive to environmental reminders of the traumatic event and to renewed life-stressors, and thus may have a fluctuating course (23).
  80. S2CID 144129832
    . Posttraumatic stress symptom severity was uniquely correlated with greater intensity and variability, but not occurrence, of certain negative emotions, and with less frequent occurrence but greater variability of joy/happiness. Intrusive reexperiencing was uniquely associated with greater variability of both anxiety and joy/happiness. Results suggest that women with more severe posttraumatic stress symptoms do not experience more episodes of negative emotion but, once emotion occurs, they have difficulty modulating its intensity.
  81. S2CID 25239428
    . Reexperiencing symptoms describe spontaneous, often insuppressible intrusions of the traumatic memory in the form of images or nightmares that are accompanied by intense physiological distress...Hyperarousal symptoms reflect more overt physiological manifestations, such as insomnia, irritability, impaired concentration, hypervigilance, and increased startle responses.
  82. PMID 29197703
    . Kleim, Graham, Bryant, and Ehlers (2013) asked a sample of trauma-exposed individuals to report state levels of various unpleasant emotions (i.e., fear, helplessness, anger, guilt, and shame) following naturally occurring intrusive memories over the course of a week.
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    , retrieved 5 August 2023, Currently, the etiology of BD is unknown but appears to be due to an interaction of genetic, epigenetic, neurochemical, and environmental factors. Heritability is well established.[3][4][5] Numerous genetic loci have been implicated as increasing the risk of BD; the first was noted in 1987 with "DNA markers" on the short arm of chromosome 11. Since then, an association has been made between at least 30 genes and an increased risk of the condition.[6]
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    , retrieved 29 July 2023, mesial limbic system (nucleus accumbens, amygdala, and hippocampus) and the entire prefrontal cortex. They play a determining role in emotional expression and motivation. For example, a reduction in the activity of the mesocortical pathway will result in a paucity of affect and loss of motivation and planning
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  101. S2CID 6016824
    . Anabolic steroids are used to accelerate the growth of normal boys with constitutional, delay of growth and puberty
  102. PMID 10932810
    . The anabolic effects are considered to be those promoting protein synthesis, muscle growth and crythopoiesis
  103. S2CID 6055905
    . Anabolic steroids and other agents are fast becoming part of the standard of care for HIV disease, gaining acceptance in reversing loss of lean body mass...
  104. PMID 26074746
    . High doses of AASs can lead to serious physical and psychological complications, such as hypertension, atherosclerosis, myocardial hypertrophy and infarction, abnormal blood clotting, hepatotoxicity and hepatic tumors, tendon damage, reduced libido, and psychiatric/behavioral symptoms like aggressiveness and irritability
  105. PMID 30955206
    . AAS users who fulfilled the criteria for AAS‐dependence had significantly thinner cortex in frontal, temporal, parietal, occipital and pre‐frontal regions compared to non‐dependent users
  106. eISSN 2317-4404
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  107. PMID 36704731
    . ADHD is a neurodevelopmental disorder defined by impairing levels of inattention, disorganization, and/or hyperactivity-impulsivity. Inattention and disorganization entail inability to stay on task, seeming not to listen, and losing materials necessary for tasks, at levels that are inconsistent with age or developmental level.
  108. PMID 31541305
    . Ozel-Kizil et al. (2013; also see Ozel-Kizil et al., 2014) defined hyperfocusing as being "characterized by intensive concentration on interesting and non-routine activities accompanied by temporarily diminished perception of the environment".
  109. ^ "Can ADHD Cause Mood Swings?". Psych Central. 12 August 2022. Retrieved 27 July 2023. ADHD-induced mood shifts may be a result of being distracted, comorbid conditions like depression or bipolar disorder, or a side effect of certain medications.
  110. S2CID 149490018
    . Shifting attention was more significantly associated with trait anger and anger out than response inhibition, which was significantly related to anger control
  111. PMID 20596295
    . Studies have found that ADHD is associated with weaker function and structure of prefrontal cortex (PFC) circuits, especially in the right hemisphere.
  112. S2CID 23189353
    . ADHD subjects indeed showed a performance deficit in the tasks, supporting OFC dysfunction in ADHD. Furthermore, a discriminat analysis using the task performance variables correctly classified 89.7% of the participants among ADHD patients and normal controls.
  113. PMID 18982173
    . We conclude that the findings of interest (i.e., hippocampus enlargement and amygdala volume loss) are not very stable across different samples of patients with ADHD and that the different and contradictory findings may be related to the different locations of alterations along the complex circuits responsible for the different symptoms of ADHD.
  114. PMID 20596295
    . The prefrontal association cortex plays a crucial role in regulating attention, behavior, and emotion, with the right hemisphere specialized for behavioral inhibition.
  115. PMID 32206584
    . Table 1 :Changes in ASD criteria from the DSM-IV to DSM-5
  116. PMID 34255236
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  117. PMID 26061819
    . The authors found that youth with ASDs had overactivation in limbic areas, primary sensory cortices, and orbitofrontal cortex (OFC) compared with typically developing (TD) control subjects in response to mildly aversive visual and auditory stimuli." & "Finally, Green et al10 found that SOR symptoms correlated with hyperactivity in the amygdala and OFC.
  118. PMID 30979647
    . Children with ASD and disruptive behavior showed reduced amygdala–vlPFC connectivity compared with children with ASD without disruptive behavior.
  119. PMID 28413687
    . In BPD, the appraisal mechanisms are at fault, in large part because of mentalizing difficulties (e.g. in the mistaken appraisal of threat at the moment of its presentation) or a breakdown in epistemic trust, which damages the capacity to relearn different ways of mentalizing – or appraising – situations (i.e. the inability to change our understanding of the threat after the event).
  120. PMID 28613633
    , retrieved 7 August 2023, There are many theories about the development of borderline personality disorder. In the mentalizing model of Peter Fonagy and Anthony Bateman, borderline personality disorder is the result of a lack of resilience against psychological stressors. In this framework, Fonagy and Bateman define resilience as the ability to generate adaptive re-appraisal of negative events or stressors;...
  121. PMID 31240430
    . Core symptoms that comprise the disorder are often explicitly interpersonal in nature (e.g., tumultuous romantic relationships and frantic efforts to avoid abandonment) or are expressed in reaction to interpersonal stressors (e.g., affective instability, paranoid ideation, suicidal behavior
  122. PMID 24223110
    . Individuals with a diagnosis of BPD have difficulty making appropriate social judgements about others from their faces. Judging more faces as unapproachable and untrustworthy indicates that this group may have a heightened sensitivity to perceiving potential threat, and this should be considered in clinical management and treatment
  123. PMID 28857585
    . Individuals with BPD features often have distorted cognitions. Specifically, they often make simplified judgments about people and situations.
  124. PMID 23250816
    . Following Linehan's biosocial model, we conceptualize emotion dysregulation in borderline personality disorder (BPD) as consisting of four components: emotion sensitivity, heightened and labile negative affect, a deficit of appropriate regulation strategies, and a surplus of maladaptive regulation strategies.
  125. PMID 33730065
    . In comparison to a healthy control group, BPD patients show deficits in the following areas: mindfulness, self-compassion and adaptive emotion-regulation strategies.
  126. PMID 29527105
    . BPD features are also associated with self-criticism, thought suppression, avoidance, and alcohol use as strategies for regulating emotions (Aldao & Dixon-Gordon, 2014).
  127. PMID 33444358
    . Studies of the general population indicate that attempts to suppress thoughts typically result in a heightened accessibility of suppressed thoughts (e.g., a rebound effect) together with increases in emotional and physiological arousal [27].
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    PMID 29067350
    . ...NPSs based on neurobiological dimensions and behaviors rather than clinical syndromes, grouping them into five domains: (1) negative valence; (2) positive valence; (3) cognitive systems; (4) processes for social systems; and (5) arousal or regulatory systems [13]. Yet here, too, there is tremendous overlap. For example, impairment of cognitive systems may manifest in delusions, hallucinations, agitation, aggression, depression or dysphoria, anxiety, elation or euphoria, apathy, disinhibition, irritability, motor disturbance, sleep disorder, appetite disorder, aberrant vocalization, and ruminative, repetitive, and somatoform behaviors.
  129. ^ Sjödahl Hammarlund, C., Westergren, A., Åström, I., Edberg, A. K., & Hagell, P. (2018). The Impact of Living with Parkinson's Disease: Balancing within a Web of Needs and Demands. Parkinson's disease, 2018, 4598651. https://doi.org/10.1155/2018/4598651.PMCID: PMC6087577.PMID: 30151098."Psychological symptoms and mood swings were intertwined with cognitive and physical problems, adding to the struggle of managing the demands of everyday life. The participants felt depressed, low-spirited, and were worried about the future. Some held dark and destructive thoughts and considered intentionally ending their lives. In a previous study, suicidal and death ideation was present among one-third of persons with PD [25]. "
  130. ^ Jauhar, S., & Ritchie, S. (2010). Psychiatric and behavioural manifestations of Huntington's disease. Advances in Psychiatric Treatment, 16(3), 168-175. doi:10.1192/apt.bp.107.005371."Cognitive deficits combined with neuropsychiatric symptoms often cause the greatest difficulties in behaviour, for example anergia, lack of initiative, blunted affect, egocentricity, constant demands, irritation and threatening behaviour."
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    . (d) impairment in social or occupational functioning: fights, violent behaviour, loss of friends, absence from work, loss of job, legal difficulties, arguments or difficulties with family; (e) development of hypomaniac, maniac, or cyclothymic affective syndrome in relation to DRT; (f) development of a withdrawal state characterized by dysphoria, depression, irritability, and anxiety on reducing the level of DRT; (g) duration of disturbance of at least 6 months." & "Patients with DDS develop an addictive pattern of DRT use, self-administering doses of dopaminergic drugs in excess of those required to control their motor symptoms.
  132. PMID 32761061
    . However, the findings argue against a simple relationship between dopamine level and reward sensitivity. Many PD+ICD patients were also found to experience behavioural apathy and impulsivity comorbidly, suggesting that aberrant reward sensitivity is just one component of a dysfunctional system which may incorporate functional changes in other neurotransmitter systems.
  133. ^
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    . Hyperexcitability of neurons and hypersynchrony of neural networks are the hallmarks of seizures." & "Seizures have been known to cause abnormal neurogenesis in the hippocampus and form faulty circuits that disrupt its function (11).
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    , retrieved 28 July 2023."Epilepsy is a disorder characterized by recurrent seizures. Epilepsy can alter mood and emotions. Treatments for epilepsy can also alter mood and emotions."
  135. PMID 31975826
    . Mood disorder may represent the most common, and likely the most worrisome, psychiatric manifestation associated with epilepsy. Depression is frequently associated, although anxiety and bipolar disorder may also co-occur with epilepsy
  136. PMID 22220285
    . Today, it is well recognized that disturbances in thyroid function may significantly affect mental status including emotion and cognition. Both excess and insufficient thyroid hormones can cause mood abnormalities including depression...
  137. PMID 33899528
    . Variations in normal-range TSH and FT4 levels have no effects on the risk of MDD and its subtypes, and neither on minor depressive symptoms. This indicates that depressive symptoms should not be attributed to minor variations in thyroid function
  138. S2CID 21679528
    . These data indicate that inter-outburst anger in those with IED is relatively brief and that such individuals do not generally display the kind of persistent anger that is a diagnostic feature of DMDD.
  139. PMID 32638683
    . A prominent bimodal conceptualisation of aggression classifies it as either: (i) spontaneous (referred to as reactive or impulsive aggression), or (ii) planned (referred to as proactive, premediated or instrumental aggression) (Babcock et al., 2014; Wrangham, 2018)." & "...DSM-5 is the occurrence of repeated episodes of impulsive aggression resulting in verbal or physical assaults or property destruction." & "DSM-IV criterion B for IED requires that the aggressiveness is 'grossly out of proportion to any precipitating psychosocial stressor'.
  140. PMID 25419043
    . Results suggest that shame and CSB converge into a common construct, significantly related to depressive symptoms and cognitions. Convergence of guilt and BSB, however, was limited to particular pairs of measures.
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    . We found hyperreactivity in brain regions involved in both, emotional expression, and regulation.
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  145. PMID 31581598
    . Sex steroids are able to modify several functions including behavior, cognition and memory, sleep, mood, pain and coordination, amongst others.
  146. PMID 33582959
    . Major depressive disorder (MDD) also referred to as depression, is one of the most severe and common psychiatric disorders across the world. It is characterized by persistent sadness, loss of interest or pleasure, low energy, worse appetite and sleep, and even suicide, disrupting daily activities and psychosocial functions.
  147. PMID 16889102
    . The most common DSM-IV-TR manic/hypomanic symptoms of mixed depression are irritability, mental overactivity (flight of ideas, racing thoughts, crowded thoughts), and behavioral overactivity (psychomotor agitation, overtalkativeness). Different frequencies of mixed depression have been reported, which may be related to treated versus untreated samples...
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    . Anger in people with depression often stems from narcissistic vulnerability, a sensitivity to perceived or actual loss or rejection. These angry reactions cause intrapsychic conflicts through the onset of guilt and the fear that angry feelings will disrupt relationships
  149. PMID 22305974
    . Obsessive compulsive disorder (OCD) involves obsessions, compulsions, or both, that are not caused by drugs or by a physical disorder, and which cause significant personal distress or social dysfunction.
  150. PMID 30692943
    . Recurring thoughts of death and suicide (27) and aggression (28, 29) are common features of OCD. The most prevalent obsession was the fear of harming oneself in the DSM-IV field trials of 431 patients diagnosed with OCD (30, 31).
  151. PMID 36061237
    . These thoughts can include horrific flashes of violence involving one's baby and frequently lead to shame and fear on the mother's part, but rarely result in real-world violence.
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    , retrieved 3 August 2023."The symptoms of PTSD include persistently re-experiencing the traumatic event, intrusive thoughts, nightmares, flashbacks, dissociation(detachment from oneself or reality), and intense negative emotional (sadness, guilt) and physiological reaction on being exposed to the traumatic reminder." & "Once people develop PTSD, the recurrent unbidden reliving of the trauma in visual images, emotional states, or nightmares produces a constant reexposure to the terror of the trauma" & "Negative alterations in mood and cognition that began or worsened after the traumatic event..."
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    . Psychological symptoms of PMS include irritability, depression, crying/tearfulness, and anxiety. Physical symptoms of PMS include abdominal bloating, breast tenderness, and headaches.
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    . The length of symptom expression varies between a few days and 2 weeks (figure 1). Symptoms often worsen substantially 6 days before, and peak at about 2 days before, menses start. " & "Such an enhanced tendency to have disphoria as a result of the effects of sex steroids on the brain might be heritable, as suggested by twin studies.56–58 Other possible risk factors for PMS are high body-mass index,59 stress,7 and traumatic events.60" " & "…various indices of serotonergic trans mission are reported to be aberrant in women with PMS.75,80–89" & "Another neurotransmitter that has been linked to PMS is the inhibitory aminoacid GABA. This theory gains support from an imaging study,90"
  158. PMID 23056116
    . Premenstrual syndrome (PMS) is characterized by a cluster of mild to severe physical or emotional symptoms that mainly begin during the luteal phase of the menstrual cycle. Symptoms should disappear within 4 days of the onset of menses and be severe enough to interfere with normal and daily function. The severe form of PMS is the Premenstrual Dysphoric Disorder (PMDD), which differs from PMS in respect to intensity of symptoms, predominance of mood symptoms, and the significant function impairment. (1, 2, 3). The most common symptoms are tension, irritability, hostility, depression, anxiety, mood swings, sleep changes, breast tenderness, and abdominal bloating (4).
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  161. PMID 27421793
    . ...phenomenology of depression in schizophrenia, however, has not often been interrogated in phenomenological terms. Some of our recent evidence suggests self-stigma, shame, difficulty in regaining trust in ones own thoughts after recovery from delusional beliefs, and poor motivation are core features rather than other more "biological" symptoms such as early morning wakening, diurnal variation in mood or loss of appetite.14
  162. PMID 34539522
    . Studying anger is important for schizophrenia because this disease is often associated with angry and hostile behavior (Volavka, 1999)
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  164. PMID 27990352
    . Paranoia is the most commonly reported delusion among individuals diagnosed with schizophrenia spectrum illnesses (Bentall et al., 2009)
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  169. PMID 36713919
    . 48,XXYY is one of the most under-studied and rare types of sex chromosome aneuploidies (SCAs). In male births, 48,XXYY incidence occurs with an estimated prevalence of 1 in 18,000–40,000 (1). The SCAs can influence the neurodevelopment of an individual and are associated with impairment in executive function, verbal skills, working memory, sustained attention, mental flexibility, and inhibition by altering the basic differentiation process of the neurons, encoding proteins, and synaptic transmission (2).
  170. PMID 18481271
    . Behavioral and psychiatric symptoms including hyperactivity, attention problems, impulsivity, aggression, mood instability, and "autistic-like" behaviors have also been described [Schlegel et al., 1965; Sorensen et al., 1978; Fryns et al., 1995; Hagerman, 1999].
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    , retrieved 13 August 2023, Neurotransmitters that play an important function in mood disorders are serotonin and...." & "Stressful life changes (death of significant other, parents, siblings, etc.) traumatic events and childhood abuse have been found to be major risk factors for the development of mood disorder later on in life....
  172. S2CID 143660204
    . A retrospective web-based study of 2087 adults found small but reliable associations between a history of physical illness and the character strengths of appreciation of beauty, bravery, curiosity, fairness, forgiveness, gratitude, humor, kindness, love of learning, and spirituality.
  173. PMID 28802085
    . Personal recovery involves developing the skills to live well and is a very individual process that the consumer can undertake on their own, with peers and family or through disorder-specific psychotherapies. Personal recovery can be contrasted with clinical and functional recovery and refers to the process of individual psychological adaptation to the disorder rather than the reduction of psychiatric symptoms, relapse prevention and addressing functional impairment (Tse et al., 2014)
  174. S2CID 257243921
    . Our findings indicate that people with mental illness who receive greater support from the family are better able to have self-caring attitudes...They may also have more positive experiences and perceptions of recovery and attain greater levels of life satisfaction and enjoyment.
  175. PMID 37373783
    . It encompasses various elements, such as spirituality, empowerment, embracing the illness actively, finding hope, restoring a positive identity, creating meaning in life, combating stigma, taking charge of one's own life, and cultivating supportive relationships [4]. PR concerns the individuals' perceived capacity to manage mental illness, their sense of purpose, and their confidence in their ability to lead a fulfilling life, irrespective of the disorder's severity [5]
  176. PMID 34143247
    . For many, recovery is their preferred term to describe the continuing experience of living with, managing, or overcoming mental health difficulties [5].
  177. ISBN 978-0-465-01508-5
    .
  178. ^ Goleman, pp. 73-4
  179. ISBN 978-0717127108. ASIN 0717127109
    .
  180. PMID 19555788
    . It is the unfortunate result of the bidirectional relationship between depression and inactivity: depression leads to a reduced activity level, and depressive symptoms then become more severe. Berlin, et al.
  181. PMID 20539837
    . By intentional activity, the authors meant discrete actions or practices that individuals must choose to engage in and that require some effort to enact. This might include adopting new behaviors such as an exercise program, changing one's cognitive attitudes or practices such as practicing forgiveness, or volitional activity such as pursuing personal goals.
  182. PMID 27343883
    . Irritability describes proneness to anger... Irritability is a mood in the sense that young people can remain in states of proneness to anger for very long times and sometimes for no apparent reason, as discussed below... irritability shares a negative valence with anxiety and depression but denotes approach and is therefore linked to elation in mania.
  183. PMID 28690851
    . The first session provided an overview of the training goals and an explanation of the differences between the three states of mind (i.e., emotional mind, rational mind and wise mind)...In DBT, ER skills training is oriented to encouraging behavioral activation (BA) by training patients in "opposite action" (OA) to depressive symptoms.
  184. ISSN 1359-1789
    . DBT was designed to treat emotional dysregulation (i.e., mood disturbance, affective liability, uncontrolled anger) and the behavioral difficulties..." & "Research has shown that there are potentially clinically significant results when using DBT to treat anger and aggression in various samples. Findings from this review suggest that treatments, even when modified show a positive impact on the reduction of anger and aggressive behaviors.
  185. PMID 36739574
    . While they also experienced more improvement in depressive symptoms and in their ability to control emotional states, the difference between the two groups did not reach statistical significance.
  186. PMID 32440604
    . ...first phase of treatment focusing on increasing momentary clarity of motivational responses during emotional episodes and the cultivation of mindful emotion regulation skills with the goal of promoting counteractive responding to intense emotional experiences. Skills are presented in a specific order focusing on less cognitively elaborative skills (e.g., attention regulation skills) followed by more cognitively elaborative skills (e.g., metacognitive regulation skills).
  187. S2CID 7926489
    . Interpersonal and social rhythm therapy is a manual-based psychotherapy (E. Frank et al, unpublished data, 1999) focusing on 1) the link between mood and life events, 2) the importance of maintaining regular daily rhythms as elucidated by the SRM, 3) the identification and management of potential precipitants of rhythm dysregulation with special attention to interpersonal triggers, 4).
  188. PMID 22381951
    . Shen, Alloy, Abramson, and Sylvia provided further evidence of social rhythm irregularities in bipolar spectrum disorder (2008). In a sample of 414 undergraduates, those diagnosed with either cyclothymia or bipolar II disorder reported significantly fewer regular activities than normal controls.
  189. PMID 21708409
    . As well as being strongly associated with the clinical manifestation of BD, reduced social rhythmicity has also been demonstrated in some populations with increased risk for BD.
  190. PMID 32909832
    . More than 30 years ago, it was observed that major life events associated with mood disorder (divorce, loss of job, life transitions) are not just psychologically challenging but also cause significant change to daily routines.10 Unemployment, for example, may be associated not just with challenges to self-esteem but also with less regular bed-, wake- and mealtimes. This instability of daily routines, in turn, may have circadian impact through weakened zeitgeber information.
  191. S2CID 203466750
    . ...To foster psychological flexibility, according to Grégoire et al. (2017), ACT relies on six interrelated and overlapping processes: acceptance (i.e., willingness to open fully to unwanted experiences such as difficult thoughts, memories, or emotions), contact with the present moment (i.e., being mindful and aware of one's experiences), self as context (i.e., maintaining perspective about oneself within one's experiences), cognitive defusion (i.e., being able to step back from unwanted experiences without getting stuck in them), committed action (i.e., engaging in actions that move toward important aspects of life), and values (i.e., staying connected to personal values or areas of life that are important).

Further reading

  • Ronald R. Fieve, Moodswing (1989)
  • Susanne P. Schad-Somers, On mood swings (1990)

External links

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