What are mood swings? Causes and how to manage

A mood swing is a sudden, sometimes intense change in emotions. In the midst of a mood swing, you can quickly go from feeling happy to sad, angry, or irritable. 

We all have mood swings––they’re an expected reaction to the stressors of daily life. However, if you experience mood swings that make you feel like you’re on a roller coaster (especially if it’s negatively affecting work or relationships), it can be a sign of an underlying health condition. 

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There are many reasons why your mood may change rapidly. Life events like a death in the family, marriage or divorce, a move, or job change often lead to dramatic changes. Lack of sleep, stress, dietary deficiencies, and even caffeine withdrawal can affect your mood (Firth, 2020; Sajadi-Ernazarova, 2021). 

Hormonal changes—such as fluctuations in estrogen or testosterone levels—can also lead to mood swings (Wharton, 2012; Johnson, 2013). Women may experience mood changes related to menstrual cycles, pregnancy, and menopause (Anokye, 2018; Soares, 2020).

Health conditions can also cause mood swings. Some conditions alter the levels of chemicals in your brain, while others cause symptoms like pain or fatigue, which can put anyone in a bad mood. Medical conditions linked to mood changes include (Cosci, 2015; Sekhon, 2021):

• Underactive or overactive thyroid (hypothyroidism and hyperthyroidism) 

• Anemia

• Concussion

• Brain tumors

• Neurological conditions like Alzheimer’s and Parkinson’s disease

• Stroke

• Heart disease

• Cancer  

• Multiple sclerosis

• Diabetes

• Autoimmune diseases

• Schizophrenia 

• ADHD (attention deficit hyperactivity disorder) 

• Substance use disorder or addiction

Medications can also affect your mood. Drugs commonly linked to mood swings include (Sekhon, 2021):

• Recreational substances like amphetamines and cocaine

• Steroids 

• Alcohol

• Antibiotics 

• Chemotherapy drugs

It may be surprising, but mood-elevating drugs like antidepressants can trigger mood swings and occasionally aggravate conditions like bipolar disorder.

Mood swings that are intense, long-lasting, and not related to a medical issue or life event may be caused by a mental health condition. 

In these cases, mood swings may be linked to changes in brain chemicals known as neurotransmitters. Dopamine, serotonin, oxytocin, and endorphins are all neurotransmitters that can affect your emotional state (Sekhon, 2021).

Up to 60% of people with depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) experience mood swings. This is significant because mood changes can lead to complications like alcohol use disorder or even thoughts of suicide (Marwaha, 2013). 

It’s also common for mood disorders to overlap with other mental health conditions like the ones below. 

Bipolar disorder

Bipolar disorder is characterized by extreme mood swings that oscillate between mania and depression. Mania is sometimes referred to as a “high” marked by inflated self-esteem, impulsivity, increased talkativeness and energy, and sometimes delusions (Howes, 2010). 

During a manic phase, you may not feel tired or sleep much. Depressive periods are marked by sadness, decreased concentration, guilt, lack of interest in activities you enjoy, and sometimes thoughts of self-harm or suicide. 

A mood disorder called cyclothymia is similar to bipolar disorder but milder and often goes undiagnosed. In cyclothymia, emotions rise and fall between periods of depressed mood and extra energy (Sekhon, 2021).  

Major depressive disorder

Commonly known as depression or clinical depression, major depressive disorder (MDD) leads to mood swings that range from extreme sadness to anger to thoughts of suicide. 

These mood swings often coincide with other symptoms of depression like trouble sleeping, eating more or less than usual, fatigue, difficulty concentrating, and feelings of worthlessness (Sekhon, 2021).

Borderline personality disorder

Intense mood swings often accompany borderline personality disorder (BPD) and can last for hours or days. People with BPD may experience extreme moods, including rage, sadness, restlessness, and a feeling of being outside one’s own body. This may lead to risky or dangerous behavior.  

A visit to a healthcare provider can help identify if you’re dealing with mood swings or a disorder. The diagnosis often involves a full medical and mental health history. Questionnaires are used to identify past or current stressors, trauma, mood changes, sleep, and eating patterns. 

A primary care physician may be able to identify some conditions, but it’s often beneficial to speak to a mental health professional like a psychiatrist to diagnose a mood disorder (Sekhon, 2021).

Evening out mood swings depends on the underlying cause. If you have mild mood swings that aren’t disruptive, they may not require treatment. For more serious mood swings, treatment may include psychotherapy, lifestyle changes, and medication if needed (Broome, 2015).

Medications used to treat mood disorders include mood stabilizers and antidepressants. A healthcare professional will prescribe medication based on the diagnosis.

Talk therapy 

There are many types of therapy that can help manage mood swings associated with depression and other mood disorders, including (Sekhon, 2021):

• Cognitive behavioral therapy (CBT): This type of treatment reframes negative thought patterns to help people respond to difficult situations in a more positive way.

• Behavioral activation: The basis of this therapy helps replace harmful moods with more positive behaviors like learning a new skill. 

• Couples and family therapy: This allows family members and loved ones to be part of a team to support people with mood swings and mood disorders.

Besides medication and therapy, lifestyle changes can help combat mood swings. Ways to improve your overall health and well-being include (Sekhon, 2021):

• Exercise: Inactivity is linked to an increased risk of developing depressive disorders. On the flip side, regular exercise and yoga may be protective against mood disorders. Workouts are known to boost brain chemicals that can elevate mood.

• Quit smoking: People often experience increased optimism and quality of life after they stop smoking. 

• Healthy diet: Following a nutritious, balanced diet decreases the risk of mood disorders. Nutrients like omega-3 fatty acids have a mood-boosting effect on brain chemicals like serotonin and dopamine. 

• Better sleep: Getting enough sleep makes a big difference in mood and brain function. Lack of sleep is known to trigger mood swings (Rumble, 2015). 

• Reduce stress: Stress relief techniques, such as mindfulness and meditation, can help reduce mood swings (Simon, 2021). 

• Avoid triggers: Understanding and avoiding situations that trigger mood swings can prevent them. For example, if you know drinking alcohol or skipping sleep will impact your mood, try avoiding alcohol or getting to bed early.

If mood swings are affecting your life in a negative way, speak to a healthcare provider. Changes in mood that are frequent and intense could be a sign of an underlying health condition. 

It may be helpful to keep a mood diary or journal to track changes in emotions. This helps identify patterns and triggers so your provider can make a more accurate diagnosis and suggest the right treatment. 

If you or someone else is in immediate danger, don’t wait for an appointment call 911.

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Current version

April 18, 2022

Written by

Kristin DeJohn

Fact checked by

Gina Allegretti, MD

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About the medical reviewer

Gina Allegretti, MD