My moods are up and down, what is that?

There is no one blanket reason for fluctuation in mood, and there are many different types of mood changes one can experience. Stress of course can aggravate mood changes, a difficult work situation, stormy or unfulfilling intimate relations, stress with ones family, etc., all may cause one to have mood changes. While these examples are all related to some outside stressors some people have mood fluctuations that are not related to outside events. These may be personality based, i.e., the person has trouble with self-esteem or other issues in their sense of self (they feel unloved or unwanted, etc), or biologically based, i.e., medical illness, use of drugs or alcohol (intoxication or coming off these substances), premenstrual mood changes, or a psychiatric mood disorder.

Psychiatric mood disorders may be relatively mild like Dysthymia (mild chronic depression), or more severe like Major Depression or Manic Depression (also called Bipolar Disorder). While current diagnostic systems classify anxious states under anxiety disorders, and states of depression under mood disorders, there is considerable controversy on this issue. Because anxiety and depression commonly coexist, Counseling Tokyo agrees with psychiatrists who think it makes sense to consider both anxiety and depression as a mood disorder (see this reference). Illness constructs such as Generalized Anxiety Disorder, Panic Disorder, and Social Anxiety Disorder then would also be subsumed under the general term of mood disorder for the purposes of this discussion.

Persons with these problems may find their moods fluctuate rapidly or widely even though the name of the disorder suggests the person is only depressed or anxious- the nature of the problem to be up and down somewhat is itself showing there is an abnormal instability. For Manic-Depression, especially, mood may change very intensely, and some persons even have both manic (rapid speech, racing thoughts, lack of need for sleep, etc) and depressed symptoms (lack of energy, tearfulness, hopelessness, etc.) at the same time (this is called a Mixed State). Persons with these problems will also be more sensitive to stress, and sometimes only blame stress for their mood states.

Treatments of the above problems necessarily differ depending on the problem. Outside stressors require coaching and advice to change one’s understanding and coping with their situation, if not change their situation concretely (like change jobs). Personality issues require intensive individual and group therapy and take a long time to make modest changes. Psychiatric disorders usually require counseling and education, and evaluation for medication therapy.