Mood Swings or Bipolar Disorder? How to Tell the Difference

What Does It Mean to Have Mood Swings?

Shifts in your emotions and mood are a normal, common, and healthy way to react to events that take place in our lives, says Robert McFerren, a licensed independent clinical social worker and clinical director at the Pathlight Mood & Anxiety Center in Seattle.

Emotions may change quickly in response to a specific situation, says Hayden Center Jr., PhD, a licensed professional counselor and contributing faculty member at Walden University. For example, say you start the day feeling happy but then find out your friend lost her job. You might rapidly go from feeling happy to concerned or even sad.

On the other hand, mood swings last longer — for hours or days — and are not necessarily specific to a situation. “Someone may be in a dysphoric mood for several days, meaning they feel very down and depressed,” Dr. Center says.

“And mood swings can be more intense and don’t always have an obvious trigger,” adds McFerren.

In addition, experiencing extreme stress, sleep deprivation, or low blood sugar, or taking certain medications, could lead to mood swings, Center says. Or they may be caused by hormones or traumatic experiences, McFerren notes. In other words, the causes for mood swings vary from person to person.

When Might a Mood Swing Be a Symptom of Bipolar Disorder?

A shift in mood that lasts no more than a few hours or even a day is normal. In contrast, mood episodes that last days, weeks, or even months are a defining feature of bipolar disorder, according to the American Psychiatric Association (APA).

Someone with bipolar disorder who is experiencing a mood episode may feel manic (extremely happy or extremely irritable) or depressive (extremely sad). Sometimes their shifts between moods happen abruptly, sometimes not. And it’s important to note that people with bipolar disorder can experience periods of neutral moods between mood episodes. They can even experience normal mood swings.

The nature and frequency of mood episodes vary by bipolar disorder type. There are three types of bipolar disorder:

• Bipolar 1 In this form of bipolar disorder, a person has such severe manic episodes that they cause noticeable problems in everyday life and ultimately may require hospitalization. People with bipolar 1 also have depressive episodes. In some cases, manic and depressive symptoms may occur simultaneously.
• Bipolar 2 A person with this type of bipolar disorder experiences depressive episodes, as well as hypomanic episodes, which are episodes involving milder symptoms of mania that, compared with full-blown manic episodes, typically impede their ability to function in subtler ways.
• Cyclothymia A milder form of bipolar disorder, cyclothymia involves emotional ups and downs that are less severe than those of bipolar 1 or 2.

In some cases, a person’s bipolar symptoms might not fit neatly into any of the categories described above. This may lead to a diagnosis called other specified and unspecified bipolar and related disorders.

What’s the Difference Between a Manic Mood and a Depressive One?

To be formally diagnosed, a manic episode must last at least one week or require hospitalization, while a less severe hypomanic episode must last at least four days in a row. According to the Mayo Clinic, manic or hypomanic episodes also must include at least three of these symptoms:

• Abnormally upbeat, jumpy, or wired
• Increased activity, energy, or agitation
• Decreased need for sleep
• Exaggerated sense of well-being and self-confidence (euphoria)
• Unusual talkativeness
• Racing thoughts
• Poor decision-making (for example, taking sexual risks, going on shopping sprees, or making unwise financial investments)

According to the APA, a depressive episode must last at least two weeks and involve at least five of the following symptoms, including at least one of the first two symptoms:

• Intense sadness or despair
• Loss of interest in activities one usually enjoys
• Fatigue
• Feelings of worthlessness or guilt
• Increased or decreased appetite
• Increased or decreased sleep
• Slowed speech or movement
• Restlessness (for example, pacing)
• Difficulty concentrating
• Frequent thoughts of death or suicide

RELATED: 7 Triggers That Can Cause a Bipolar Episode

How Can I Know if I Should Seek Treatment?

You don’t need to have a specific mental health condition to seek help. Whether you’re struggling with troublesome symptoms or would simply like to better manage your emotions and moods, talking to a medical professional could help you understand what you’re experiencing and let you know about potential treatments.

That said, if your significant mood swings are affecting your ability to function as usual and causing problems with your relationships, work, social activities, or other important parts of your life, it’s important to get a proper diagnosis from a mental health professional based on the symptoms you’re experiencing, as well as your overall health history.

Untreated bipolar disorder can have serious consequences. For example, someone experiencing a manic episode may impulsively spend more money than they intended, McFerren says. Afterward, they may feel so depressed that they can’t get out of bed and so miss work for several days.

The consequences of mood episodes can even be life-threatening. “Not attending to moods that are out of the ordinary for long periods of time can lead to dangerous consequences such as suicide or drug misuse,” explains Center.

Extreme mood swings could be caused by health conditions other than bipolar disorder, such as poor blood sugar regulation, reports the University of Michigan School of Public Health.

In addition, attention deficit hyperactivity disorder and anxiety can also lead to intense, shifting moods. For these reasons, Center suggests that you first get a physical exam from your primary care doctor, who can then refer you to a specialist for a mental health assessment.

Which Treatments Are Most Effective for Bipolar Disorder?

The most effective treatment for bipolar disorder is a combination of psychotherapy (also known as talk therapy) and medication, McFerren says.

The most effective psychotherapies for bipolar disorder, according to the National Alliance on Mental Illness, include:

• Cognitive Behavioral Therapy (CBT) This form of therapy helps people with bipolar disorder identify triggers that may cause a mood episode and enables them to develop healthy thinking and behavioral patterns to better manage their mood.
• Interpersonal Social Rhythm Therapy (IPRST) This therapeutic technique involves developing regular daily routines, such as going to bed and waking up at the same time each day, eating meals at regular times, and decreasing stressful triggers in one’s surroundings.
• Family-Focused Therapy This includes both the person with bipolar disorder and the people closest to them, such as spouses and parents, so that everyone is well-informed about the condition and develops skills for avoiding conflicts.

Several medicines can help alleviate the severity of symptoms for people with bipolar disorder:

If you are prescribed a medication to treat bipolar disorder, don’t stop taking it without consulting your doctor first. Taking medication as directed reduces the likelihood of future mood episodes, and stopping and restarting medication abruptly can be dangerous.

“The most important thing in managing bipolar disorder is to maintain a consistent medication regime,” McFerren says. “Often, people who are diagnosed with bipolar disorder hit a point where they are regulated on medication and either miss the euphoria that can come with a manic episode, or they feel great after being on the medication for a period of time and feel they don’t need them anymore.”

In addition to professional treatment, adopting new habits often helps people with — and without — bipolar disorder better manage their mood. The Substance Abuse and Mental Health Services Administration suggests:

• Keeping a consistent daily routine by taking your medicine, eating meals, and going to sleep at the same times each day
• Minimizing stress by simplifying your life where you can and trying activities like exercise, meditation, tai chi, and yoga
• Keeping a daily mood journal in which you briefly note changes in your mood to help you recognize triggers and give your doctor feedback on how well treatment is working
• Maintaining a healthy support system by helping certain family members and friends learn about bipolar disorder and how best to support you if you are experiencing a tough time

Also important: Steer clear of over-the-counter and illegal drugs that cause changes in your mood and thoughts, says Center. These include tobacco, alcohol, cannabis, amphetamines, ecstasy, cocaine, and heroin.