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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4486
Experience:  MD Psychiatry
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My mood swings are overwhelming at present. Going from grand

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My mood swings are overwhelming at present. Going from grand ideas and confidence i can achieve all my goals to complete self doubt and loathing. Swinging from being unable to sleep to sleeping for upto 20 hours. I have a history of post traumatic stress and subsequently anxiety, depression and insomnia. I'm currently being treated for depression (40mg citalipram daily) yet my moods are still dipping really low. I'm unsure of what I should do about this. I feel mentally exhausted from trying to balance my mood and it is dramatically affecting my attendance and concentration at university. Is there any recommendations on how I can cope with this? Also I have had panic attacks in recent months because I'm so overwhelmed at trying to live a normal everyday life. I have had flashbacks of trauma from my childhood recently too, I'm assuming this is all connected to my mood swings but is it a reaction or a cause? I'm confused at what I should be seeking help with. Also is there a better medication I could be on? I just want to feel normal and be able to function on a normal level. I have been achieving 1st's in all my modules at university but was recently asked if I wanted to take a leave of abscess (which I do not!) as my attendance has been poor this semester.

Hi there,


Welcome to Just answer !


I am sorry to learn about your situation and I empathize with you.


Well from your narration of your mood fluctuating from a phase where you are overly confident and grandiose in thinking with inflated self esteem and lack of sleep but still highly energetic to a phase which is completely in contrast to the former where in you are low in confidence , self esteem , lethargic , low mood and poor concentration and lack energy and have excessive sleepiness.


Well if the above description is what you are going through then I must inform you that you may perhaps be suffering from Bipolar disorder with the high phase being best defined as manic or hypomanic episode which then shifts abruptly to depressive phase ( low phase). This needs to be thoroughly evaluated preferably by a psychiatrist and once this is confirmed you will need to get your drug regime revised which will entail addition of a mood stabilizer drug like valproate at dose of 300-500 mg twice a day or Depakote at dose of 750 mg / day in divided doses.


Other than this you may also be required to get one anti psychotic drug to be added to your drug regime such as zyprexa at dose of 10-20 mg / day or abilify ( aripiprazole ) at dose of 10-30 mg / day.


So I will summarize this ..


-- Please get yourself evaluated by Bipolar disorder preferably by a psychiatrist. You shall request the psychiatrist to use Young mania scale for your diagnosis which shall help in getting a more Accurate diagnosis.


-- If Bipolar disorder is confirmed then citalopram alone cannot be able to control your mood swings so your psychiatrist will more likely add two drugs -- 1 mood stabilizer like valproate or Depakote and 1 anti psychotic drug like abilify or zyprexa.

You shall discuss these drug names to provide him more options to choose from. With this 3 drug regime comprising of citalopram + 1 mood stabilizer + 1 antipsychotic drug your all complaints of mood swings/ bipolar disorder , depression , anxiety will be taken care of.


-- If Bipolar disorder is ruled out , so in that case you ask your doctor to add klonopin ( clonazepam ) at dose of 0.5 mg twice a day to get your anxiety and other complaints under control.


Kindly do the needful.


I hope this helps.


Wish you all the best and I pray for faster and effective control of your symptoms.


Please kindly leave a Positive rating if you are satisfied with the answer as only then will I be credited for my service.


If there is any further assistance needed please feel free to ask using the reply button.



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