Q:  Dramatic Mood Changes - Is It a Sign of Bipolar?

I have dramatic mood changes i can be happy one minute then the slightest  thing will piss me off and my whole body reacts my heart races my arms and legs tingle and my head feels heavy and i feel nausea and like I'm going to black out and completely this doesn't happen all the time just out of the blue but the mood changes are daily and is affecting my relationship do you think its a sign of bipolar.

 
Dear Stacey --
Yipes, that sounds awful, to be going through that every day. I hope you’re in a position to try to get some help dealing with that (e.g. you have medical insurance, without which dealing with this is going to be tricky).

Here are some thoughts to keep in mind as you try to find some help.  It sounds as though you are describing as many as three different things.  #1, you describe "dramatic mood changes" that can happen suddenly, within a minute.  That is not typical for bipolar disorder, but it is not impossible for bipolar disorder to do that.  This would be called "mood instability", rather than "mood shifts".  In someone with bipolar disorder, this can be brought on, in some cases, by an antidepressant medication, which makes people "emotionally labile", reacting to everything in a large way (sometimes even to humor, with too much laughter).

#2, you described physical sensations, particularly feeling nauseous, and as though you are going to black out.  That would be very unlikely to be caused by "bipolar disorder" alone. The fact that these happen "out of the blue" also (combined with the nature of the symptoms you describe) raises the possibility that there is something more like a seizure-type-thing happening.  Usually that would be evaluated with a medical test called an EEG (electroencephalogram).  This is painless but fairly elaborate and expensive, more than you can probably handle on your own (including paying a neurologist to review the results and offer an interpretation).  I do not mean to imply that you are going to have a "seizure" in the usual sense of a “grand mal” event.  I'm just describing how we might think about symptoms that you describe, and what we would do to explore the relevant possibilities.

#3, you described "mood changes daily".  You may be referring to the first problem I mentioned here, "mood instability".  But if there is actually a sense that on some days you feel one way, and on other days you feel quite differently -- independent of any kind of provoking event -- then you might have "cyclic changes in mood and energy", which is the very definition of bipolar disorder.  Now technically, mood shifts are supposed to last 3-4 days at minimum.  But cycling more rapidly than that is so well recognized it even has a name: ultradian cycling.

I wrote an essay which is a bit technical, but you might find the graphs fairly clear, which describes one way of thinking about the relationship between mood instability and mood changes: Rapid Cycling and Mixed States As Waves (this is actually an attempt to translate into plain English an even more technical article). I think you might find that interesting.  It is kind of way of synthesizing #1 and #3 here.

Good luck with your attempts to get this figured out.  I hope you are able to take some steps in that direction soon.

Dr. Phelps

 

Published February, 2009