Could intense mood swings indicate an underlying issue?

Almost everyone experiences the “emotional rollercoaster” at some point in life, but for those with bipolar disorder, the extreme emotional ups and downs do not end. Bipolar disorder, or manic depression, is one of the most common and severe mental illnesses diagnosed. About 5.7 million American adults, (age 18 and over) are affected every year. Both men and women are equally affected by the disorder, and it is found in all ages, races, ethnic groups, and social classes.

Figure 1. There are several subtypes of bipolar disorder.

Figure 1. There are several subtypes of bipolar disorder.

So, what is bipolar disorder? Bipolar disorder is a condition characterized by extreme mood swings from the lows of depression to the highs of mania. When people are depressed, they feel sad or hopeless and lose interest in activities they once enjoyed. When their mood shifts in the opposite direction, they may feel euphoric and full of energy.

There are several subtypes of bipolar disorder, each with its own symptom pattern.

  • Bipolar I disorder: At least one manic episode with periods of major depression, also known as “manic depression”
  • Bipolar II disorder: Less severe than Bipolar I disorder, experiences of high energy levels but not as severe as mania, alternates with depression
  • Cyclothymic disorder: Mild form of bipolar with less severe mood swings
  • Rapid cycling: More than four episodes per year

The pathophysiology is poorly understood and there has not been a definite biological marker found to correlate with bipolar disorder. However, genetics play a role. First-degree relatives of a person with bipolar are about seven times more likely to develop bipolar disorder.

Although there is not a concrete understanding of bipolar disorder, testing for neurotransmitter levels may be helpful. Elevations in glutamate can correlate with bipolar disorder. Studies have shown that abnormal amounts of serotonin and dopamine play a role in either the manic or depressive side.

A large amount of data confirms that neurotransmitter systems may be dysfunctional in bipolar disorder, explaining symptom relief from pharmacological interventions that target these imbalances. Continued research is needed to determine how neurotransmitter imbalances, abnormalities in signaling, and neuroplasticity of cells may cause bipolar disorder.

Guest author: Choua Lee is a member of the Clinical Support and Education Department at NeuroScience, Inc. and is the resident expert in psychiatry.

Manji, Husseini K., Jorge A. Quiroz, Jennifer L. Payne, Jaskaran Singh, Barbara P. Lopes, Jenilee S. Viegas, and Carlos A. Zarate. “The Underlying Neurobiology of Bipolar Disorder.” Pubmed. World Psychiatry, Oct. 2003. Web.
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1 Response to Could intense mood swings indicate an underlying issue?

  1. Great post. I have bipolar I (rapid cycling) with psychotic features, borderline personality disorder and PTSD. My biggest clues were intense and rapid shifts in my mood with no particular trigger at all. I would become angry and rage filled for no good reason at all and be crying on the couch the next minute. Thanks for sharing.

    Mental Parent

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