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Dr John B
Dr John B, Psychologist
Category: Mental Health
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Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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I am a male in my mid-40s. My entire life my emtions run wildy.

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I am a male in my mid-40s. My entire life my emtions run wildy. I have experienced within the last five days the same type of flow of emotions I always experience albeit sometimes more time goes by before the mood swing hits. The last five days were extreme happiness and content and very productive and clear. Then I went into a mode where I wanted to just lie down, do nothing, felt like sobbing and sometimes entertain ending it although those are fleeting thoughts since I have kids but scarry thoughts nonetheless. Then today, happy for awhile then as the day went on very angry and very irritiable and I want to hit and throw stuff. I feel frustrated and things are not clear and I feel lazy. Finally, I am sure in two more days, life will be wonderful, I will have incredible energy and I will be the life of the party again. All of this is tiring on me, is embarassing and ill fated. What now?

Hi,

Sorry to hear of the situation. Just a few questions first:

Is there any history of mental health problems within your family (Mum, Dad, grandparents, etc)?

Do you have a history of trauma (abuse, serious automobile accident, etc)?

Does your need for sleep change when your mood is high/good?

Do you recognize any kind of trigger to a mood switch? - it may be small like an disagreement with someone or something annoying at work?

For how long have you had trouble with mood instability?

Customer: replied 4 years ago.

No history of mental health problems but my great-grandmother did have alzhemiers back when young.

 

No abuse. No accidents. No trauma of any kind.

 

No sleep issues. Even when depressed I don't sleep any more that usual. I just darken the lights, get up under a blanket and veg out in front of tv or listen to radio. I am not happy around people and this point and do avoid personal contact if I can. I just sulk and I am not always sure why.

 

I wish I knew the triggers. Sometimes I am just mad and sometimes just said I am not sure why. My 14 year old daugther has said these things too. We just fall into a mood. I do know that I will get angry when very sad. I will also get very angry when I feel victimized. Whether it is at work or with my wife or if I am being sub par at things like sports or making money (commissions). I feel like a bad loser or I more feel like I just can not get a break. I am always the one that unluckiness happens to. You know, there is a black cloud over me. When I feel inferior or I am not achieving that will trigger some anger episodes I guess.

 

I am the same moody way now that I was when I was about 10 or so. I guess I simply never grew up or as I am afraid to admit I never matured. I act like a big baby sometimes cursing and being an ass and it is then when the anger fades, the emabarrassment of those actions creeps in then the depressed moments follow.

 

--Kevin

Hi Kevin,

Thanks for the extra information. How would you say your self-esteem is?

Customer: replied 4 years ago.
It is very mixed. Sometimes I feel very good about me and what I have done with myself. In fact, I feel great. Other times, especially in the downer mood, I feel that I am not worthy of things. I am not the smartest, I am not the wealthiest, not the best in sports..... in other words, I feel like a huge underachiever. Then, on an upswing, I feel that I am very good at my job, very good at sports - compared to some, a very good father. Then you guessed it.....then I feel like I am a horrible father. Again, very mixed as you can see depedning on the mood and my outlook I guess.

Ok.

So the key point I'm trying t get a sense of here is whether your mood is swinging due to a more biochemical cause (and then your thinking/perspective changes as a symptom) or whether there is some cognitive process that is triggering the swing (such as problematic low-self esteem).

You don't describe typical manic/hypomanic features so far but maybe it's best to just check these off.

So, we know your sleep doesn't change and aside from your thinking/perspective shifting are there any other differences you notice between a low state and a high/good state?

Just to check again, does the anger only occur when you are 'up'?

Customer: replied 4 years ago.
The anger can occur anytime. I guess what I am trying to point out is that my anger can snap, sometimes mildly and sometimes absolutely explosively when I am in a good mood even. I do, think, however, the irritabilty, frustration, anger and things happen more and more severe when I feel down or am starting to feel down. It is almost like I am feeling crappy so let's see how deep the crappiness can go. I feel helpless to stop it. In fact, if I were feeling really horrible right now. I would not be writing you. I know my gut would tell me, "he can't help, he does not know. Forget him! I will tell you that I only feel things like ending it (and again, that is very few times but just the thought entering my mind is confusing to me) and when I feel like throwing things or hitting walls or really beating myself up emotionally is when I am down. It is a roller coaster ride that is exhausting. I do understand what some people feel when the feel worthless or feel less than important. I go to those depths and it is scarry. I understand how someone could kill themselves. Luckily for me, I know I will bounce back. It is hard but I keep telling myself that and then I think of my wife and kids too. Geez, with no kids.....I don't even want to think about it.

Ok. Point taken about the anger.

Are you able to differentiate between a 'normal' period and an 'up' period? So, when you aren't experiencing a 'low' period is there two other distinct phases?

What would you say is the typical length of a low episode?

Please bare with me, I'm trying to discount possibilities.

In regards XXXXX XXXXX able to help, what I'm hoping to do here is get a sense of what it i you are describing and then provide recommendations on what to do about it. If I can't get a good idea I'll opt out of the question and open it up to other exerts for their opinion.

Customer: replied 4 years ago.

Yes. I know a normal period. I know an up period. I know those two are different because when I am up, I am extremely positive about everything, and I do better at everthying I think. I am also extremely productive. I can come home from work and clean the house non stop for six hours. I want to accomplish things.

 

When I am feeling down it is almost like I can feel it coming. I feel lazy. I feel like staying in bed and not working. When I do work I achieve only the lowest level I can without getting fired and I hate doing the work. Then, I can come home and just sit and do nothing. (When up, I love my work and I love chasing those commissions).

 

I know the three phases and I can identify them pretty easily although I guess there can be some shades of gray on occassion but I can normally feel the swing coming and I do not have an answer as to why these swings come to me. I wish I did. Heck, it might make things easier for you as well!

 

I am appreciating the help. Often, I just do not know where to turn. I feel kind of like a freak sometimes, you now, a walking time bomb. Sometimes, my wife is unsure how to act around me until she gauges my mood. How sad!

 

A low episode can be quick sometimes (like within the same day) but often it takes a good two to three days before I feel myself "bouncing back".

Just to clarify, you recognize a significant difference in energy levels between 'normal' an 'up'?

Would your wife recognize the difference between normal and up? If so, how would she describe you in each phase?

Customer: replied 4 years ago.

Yes, I do recognize the difference between up and normal.

 

I think so but I am not sure what degree she would see the difference. But I will try to answer.

 

When I am in a up mood, I think she would say that I am humorous, smiles a lot, lots of energy, and a whole lot of fun. I want to go out and party or have real creative and wild sex (if there is such a thing I guess).

 

When in a normal mood, I think she would say that I am more serious. Fun but not as flamboyant and funny. I am calmer not necessarily finding a multitude of projects in finish. Just doing things in small spurts. Wants to go out dinner and maybe make love or hang out. Again, just a calmer guy. Fun but calmer.

Ok.

The issue I've been trying to resolve is whether you are describing mod variation that is Bipolar in nature or otherwise. Initially I was thinking that it didn't sound Bipolar in nature but given the description of increased energy, increased libido and 'multitasking' I think that the possibility of Bipolar instability has to be considered. Bipolar Illness is a form of mod disorder where people experience significant shifts in mood from low/depressed up to elevated/high/manic. While some people experience full blown mania as part of Bipolar instability there are also many people who experience a milder form of elevation called 'hypo-mania' and it is starting to sound like this is what you are experiencing. Bipolar mood instability can have a very significant genetic component and your comment that your daughter experiences something similar also makes me query whether it is Bipolar in nature.

Obviously it is impossible to formally diagnose someone via Just Answer so what my formal statement here would be that in my opinion you describe enough elements of Bipolar Illness to warrant an assessment, at least to rule it out as a possibility. I note from your earlier post that you aren't much of a fan of Psychiatrists (completely understandable), so my suggestion would be that you work through this excellent Cognitive Behavior Therapy (CBT) based self help program for Bipolar Illness and if after working through the first several modules you feel that it is relevant to your situation then I would recommend you do return to a Psychiatrist (not the one you didn't like) and seek a formal assessment.

You can find the self help program here http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=38

If nothing else it will provide you with a range of strategies for manging strong mood swings.

I hope this has been of some help. Please let me know if you have further questions or would like me to clarify any part of my answer.

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