Mood swings

and Sabine Schrör, medical journalist

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.

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Everyone has experienced mood swings before: Sometimes you're down and sad, sometimes happy and full of joie de vivre - depending on your life situation. In addition to “normal” mood swings, there are also pathological forms, for example due to depression or a bipolar disorder. Read everything you need to know about the causes, diagnosis and treatment of mood swings and find out what you can do about harmless mood swings yourself.

Brief overview

What are mood swings? Rapidly changing moods from joy or euphoria to sadness or aggressiveness and vice versa. Are can be "normal" (physiological) or diseased (pathological).
Causes: e.g. hormonal contraception using the pill, puberty, premenstrual syndrome (PMS), menopause, lack of magnesium or sodium, hypoglycaemia, migraines, bipolar disorder, borderline disorder, dementia, multiple sclerosis, Parkinson's disease, liver cirrhosis, drug addiction, pregnancy, " Baby Blues ", postpartum depression, postpartum psychosis
When to the doctor In the case of severe, long-lasting or recurring mood swings with no apparent cause. If other psychological or physical symptoms occur at the same time. For mood swings during puberty, when additional symptoms such as persistent sadness, aggressiveness or eating disorders appear.
Examinations: initial consultation (anamnesis), physical examination, neurological examination to check the functionality and conductivity of the nerves, computed tomography (CT), magnetic resonance tomography (magnetic resonance tomography, MRT), ultrasound (sonography)
Treatment: Appropriate medical treatment for disease-related causes. Otherwise, self-therapy helps with slight mood swings, e.g. with medicinal plants (such as valerian, St. John's wort, black cohosh, monk's pepper, red clover during menopause), omega-3 fatty acids, vitamin B6 preparations, L-tryptophan (for PMS), homeopathy.

Mood swings: causes

Mood swings are quickly changing emotional states - from joy or euphoria to sadness or aggressiveness and vice versa. A distinction is made between physiological ("normal") and pathological (pathological) mood swings.

The most important causes of changing moods include:

Puberty: Due to the physical and emotional changes during puberty, many adolescents suffer from irritability and severe mood swings.

Premenstrual Syndrome (PMS): This complex of symptoms in the days leading up to the menstrual period can include, for example, mood swings, depression, restlessness, anxiety, food cravings, sleep problems, gas, abdominal cramps and chest pain.
Menopause (climacteric): The characteristic symptoms include hot flashes, dizziness, nausea, libido disorders (libido = sexual desire) and mood swings.
Magnesium deficiency: A persistent magnesium deficiency can cause mood swings, depression, reduced stress tolerance, anxiety, nervousness, headaches, calf cramps, smooth muscle cramps (e.g. in the stomach, intestines, bladder and uterus), palpitations and a feeling of pressure behind the sternum trigger.
Sodium deficiency: If the body does not have enough sodium in the long term, this can lead to circulatory disorders, low blood pressure and mood swings.
Hypoglycemia: Exhaustion, headaches, concentration and behavior disorders, irritability, awakening at night, cravings for sweets and mood swings can accompany hypoglycaemia.
Migraine: In the so-called prodomal phase (hours or days before the headache attack), various complaints can occur such as mood swings, inner restlessness, poor concentration, desire to eat, excessive thirst, shivering, water retention in the tissue (edema), sleep and digestive disorders.
Bipolar affective disorder (formerly: manic-depressive illness): Extreme mood swings shape the clinical picture of a bipolar affective disorder. Those affected oscillate between euphoria (mania) and extreme dejection (depression).
Borderline Disorder: People with borderline syndrome find it difficult to regulate their highly fluctuating emotions. Among other things, they suffer from violent, unpredictable mood swings.
Dementia: With the onset of dementia, for example, the short-term memory no longer works reliably. In addition, patients can no longer correctly assess complex situations and facts. In addition, there are orientation problems in a strange environment, word-finding disorders and mood swings.
Multiple sclerosis (MS): accompanying symptoms of this chronic inflammatory disease of the nervous system are, for example, mental disorders with mood swings and reactive depression.
Parkinson's disease (paralysis): In this neurological disease, nerve cells in the brain are gradually destroyed. In addition to the main symptoms of lack of movement through to immobility, tremors at rest and muscle stiffness, mood swings and / or sleep disorders can occur.
Liver cirrhosis: The progressive decline of liver tissue triggers symptoms such as fatigue, weight loss, pressure and fullness in the upper abdomen and skin abnormalities as well as dementia-like symptoms, including memory loss, disorientation and mood swings.
Drug addiction: Addicts very often suffer from emotional disorders such as symptoms of depression and mood swings. This also applies to drug addiction.

Mood swings from the pill

Women using birth control pills are also prone to mood changes. Combined preparations with estrogen and progestin can trigger depressive moods as a side effect. However, this does not apply to the so-called mini pill, which only contains progestin.

You can find out more about mood swings and other undesirable effects of the contraceptive pill in the article Side effects - pill.

Mood swings in pregnant women

Mood swings during pregnancy are not uncommon - the hormonal changes and the psychological challenge are behind the rapid change between feelings of happiness and sadness. The mood swings usually go away on their own from the second trimester of pregnancy.

Mood swings in young mothers

Many new mothers suffer from unstable mood in the early days after giving birth. The rapid change in feelings can usually be traced back to one of three possible causes:

Postpartum Blues ("Baby Blues")

A "baby blues" (also "baby blues") usually shows up between the third and tenth day after the birth. Signs are, for example, exaggerated worries about the baby and the future, tearfulness, dejection, difficulty concentrating, irritability, previously unknown aggressiveness, mood swings, feelings of confusion and mild sleep and appetite disorders. Numerous experts see the “baby blues” not as a psychological disorder, but as a normal reaction of the new mother to the numerous changes that birth and the role of motherhood bring with them. Most of the time the symptoms subside by themselves. The baby blues can also develop into postpartum depression.

Postpartum depression (postpartum depression)

Postpartum depression develops in the first few weeks, usually up to the third month after delivery, and is one of the most common complications in the puerperium. The main symptoms are persistent sadness, loss of zest for life and interest (especially in the baby) and a feeling of worthlessness.

Experts suspect that the interaction of several factors triggers postpartum depression. For example, lack of sleep, physical and mental exhaustion, babies who scream a lot (screaming children), and mental disorders in the medical history of the woman or her family all play a role.

Postpartum psychosis

This severe mental disorder after childbirth is very rare. It usually develops within the first hours or days after delivery. Experts differentiate between three forms of postpartum psychosis:

Typical of the manic form are, for example, hyperbole, megalomania, a low need for sleep as well as motor restlessness and delusions.
The depressive form, on the other hand, shows the typical characteristics of severe depression. In addition, those affected lose touch with reality.
The schizophrenic form is associated with extreme listlessness, hallucinations, delusions and unreality, among other things.

In addition to these three forms of postpartum psychosis, mixed forms can also occur.

Mood Swings: When Should You See a Doctor?

If you have any of the following symptoms, you should consult a doctor:

The rapid change between highs and lows lasts longer or keeps returning.
The mood swings are very strong.
You cannot explain your mood swings.
You notice other psychological and / or physical symptoms.
With mood swings during puberty, additional complaints such as persistent sadness, aggressiveness or eating disorders occur.

Mood swings: diagnosis

The doctor will first talk to you in detail about your medical history (anamnesis). Among other things, it is about how long the mood swings have existed, how severe they are, whether they were triggered by a certain event and whether other complaints occur.

In order to find the cause of the mood swings or to rule out certain diseases, various examinations are available to the doctor, for example:

Physical examination: The physical examination is routine for patients with unclear symptoms such as mood swings.
Blood tests: A magnesium or sodium deficiency as well as possible liver cirrhosis can be recognized by the blood count.
Neurological examinations: If there is a suspicion of a neurological disease such as migraine, multiple sclerosis, Parkinson's disease or dementia, the doctor will check the functionality and conductivity of the nerves. These neurological examinations include, for example, electroneurography (ENG).
Computed tomography (CT) and magnetic resonance tomography (MRT): These are very detailed imaging procedures that can be used to detect neurological diseases that trigger mood swings.
Ultrasound (sonography): If the doctor suspects cirrhosis of the liver, for example, behind the mood swings, an ultrasound examination of the liver can help.

Mood swings: treatment

If the mood swings are due to an illness that requires treatment, suitable therapy for the underlying illness often also helps against the changing mood.

You can also do something yourself against slight mood swings:

Medicinal plants: Medicinal plants with a calming effect (valerian, lemon balm, lavender etc.) can, for example, reduce mood swings in premenstrual syndrome (PMS). Herbal preparations with black cohosh and monk's pepper are then often recommended - as is the case with menopausal symptoms. The same applies to preparations containing red clover. In addition, St. John's wort is often used for mood swings, depressive moods, restlessness, nervous stomach and sleep disorders.
Vitamin B6: A vitamin B6 supplement can help with PMS symptoms such as unstable mood, tissue retention, breast tenderness, and abdominal pain. It is taken in the days leading up to your menstrual period. Sometimes it makes sense to also take vitamin B2 and magnesium. Talk to your doctor about this.
L-tryptophan: This protein component (amino acid) is also recommended for PMS. It can be found in milk, cheese, beef, poultry, potatoes and nuts, for example.
Omega-3 fatty acids: They also have a stabilizing effect on mood swings and are found, for example, in rapeseed, walnut, soy and linseed oil as well as in high-fat fish such as mackerel and herring. Omega-6 fatty acids (for example in sunflower, corn germ and evening primrose oil) can help against unstable moods.
Avoid sugar and other simple carbohydrates: Because they pass quickly into the blood, which triggers a sharp increase in the blood sugar-lowering hormone insulin. As a result, the blood sugar level can drop rapidly and sharply, up to hypoglycaemia. That can sway the mood. Complex carbohydrates are more suitable (for example in cereals, potatoes, vegetables).
Exchange with others: Especially pregnant women who suffer from mood swings should talk to their partner or close friends about their feelings and / or exchange ideas with other expectant mothers who feel the same way.
Homeopathy: Homeopaths recommend Cimicifuga D12, Ignatia C30 and Pulsatilla D12 for mood swings. However, the effectiveness of homeopathic medicines is controversial and has not been scientifically proven.

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