Mood swings

Although lithium is not a true antipsychotic drug, it is considered with the antipsychotics because of its use in regulating the severe fluctuations of the manic phase of bipolar disorder (a psychiatric disorder characterized by severe mood swings of extreme hyperactivity to depression). During the manic phase, the person experiences altered thought processes, which can lead to bizarre delusions. The drug diminishes the frequency and intensity of hyperactive (manic) episodes. 

Central nervous system—mental depression, mood swings, insomnia, psychosis, euphoria, nervousness, and headaches ... 

The mood stabilizers were so called because they prevent recurrences of mood swings in people with bipolar disorder. The evidence for this is best with lithium, but is based on smdies carried out more than 20 years ago. However, recent naturalistic surveys tend to find that lithium is far less useful in general clinical practice than in research settings. Many patients discontinue lithium... 

Depression and mania are both affective disorders but their symptoms and treatments are quite distinct. Mania is expressed as heightened mood, exaggerated sense of self-worth, irritability, aggression, delusions and hallucinations. In stark contrast, the most obvious disturbance in depression is melancholia that often co-exists with behavioural and somatic changes (Table 20.1). Some individuals experience dramatic mood swings between depression and mania. This is known as "bipolar disorder which, like mania itself, is treated with lithium salts or neuroleptics. 

Short-term use of corticosteroids is not associated with most of the adverse effects of chronic steroid use. The most common adverse effects encountered are gastrointestinal upset, insomnia, and mood swings.28... 

Changes in mood or behavior rapid mood swings with no apparent reason why... 

O Patients presenting with depressive or elevated mood features and a history of abnormal or unusual mood swings should be assessed for bipolar disorder. 

Cyclothymic disorder is a chronic mood disturbance generally lasting at least 2 years (1 year in children and adolescents) and characterized by mood swings including periods of hypomania... 

First trimester Menstrual spotting, missed menses, fatigue, breast tenderness, increased urination, mood swings, nau-sea/vomiting, headache, heartburn, constipation Second trimester Frequent urination, heartburn, constipation, dry skin, edema, linea nigra, melasma Third trimester Backache, edema, shortness of breath Routine Pregnancy Visits... 

O Common symptoms of menopause include hot flashes, night sweats, vulvovaginal atrophy, and vaginal dryness. Women less commonly may experience mood swings, depression, insomnia, arthralgia, myalgia, and urinary frequency. 

Bruce Bower. Pushing the Mood Swings Social and Psychological Forces Sway the Course of Manic Depression. Science News. 157 (Apr. 8, 2000) 232-233. 

Adverse effects of progestogens are irritability, depression, headache, mood swings, fluid retention, and sleep disturbance. 

Bipolar Affective Disorder. A class of disorders that features mood swings from great highs (mania) to great lows (depression). 

I particularly recalled my clinical work in 1958 and early 1959, when my assignment was to care for hospitalized soldiers and their dependents. We had few drugs to work with in those days. We relied mainly on Thorazine in the treatment of psychotic patients. It was the first major tranquilizer and preceded by decades the wonder drugs used today. For less severely disturbed patients we used meprobamate (Equanil) which has all but disappeared from today s pharmacies. In fact, the value of lithium, for mood swings, was just beginning to be accepted. 

In the bipolar affective disorders (BPADs), periods of normal mood are interspersed with episodes of mania, hypomania, mixed states, or depression. BPAD differs from MDD in that there is a bidirectional natnre to the mood swings and, for many patients, the rate of cycling is more rapid in BPAD than MDD. The phases of BPAD inclnde mania, hypomania, and depression, though mixed states, the simultaneous presentation of symptoms of both mania and depression, are common. 

Shown by an obvious slant variation from left to right in the same sentence. This person has trouble making decisions because the head and heart are in conflict. He withdraws into the introverted personality when he feels insecure. Unpredictable mood swings. 

Manic-depressive illness connotes a psychotic disorder of affect that occurs episodically without external cause. In endogenous depression (melancholia), mood is persistently low. Mania refers to the opposite condition (p. 234). Patients may oscillate between these two extremes with interludes of normal mood. Depending on the type of disorder, mood swings may alternate between the two directions (bipolar depression, cyclothymia) or occur in only one direction (unipolar depression). 

Steroid psychosis Steroid psychosis is characterized by a delirious or toxic psychosis with clouded sensorium. Other symptoms may include euphoria, insomnia, mood swings, personality changes, and severe depression. The onset of symptoms usually occurs within 15 to 30 days. Predisposing factors include doses greater than prednisone 40 mg equivalent, female predominance, and, possibly, a family history of psychiatric illness. 

These are usually treated with sedative neuroleptics (as for schizophrenia, above). Treatment must also aim to support the patient socially including for instance advising on legal protection from the financial or other consequences of mania. One of the risks of treatment is the sudden mood swing at the end of the manic episode, with acute depression possibly triggered by the neuroleptics. Because of the concern for the manic episode and symptoms, return to normal is viewed with relief, and the downswing may go un-noticed, with the concomitant suicidal risk. 

Bipolar disease, or recurrent unipolar disease may be manic-depressive illness. This disease can manifest as typical bipolar disease, with alternating depressive and manic episodes, or as recurrent depression (or more rarely recurrent mania). The age of onset and frequency of recurrence may be highly variable, with at best a single episode, where the disease may be suspected from family history. The intensity of individual episodes may vary from the maximal intensities of depression, also called melancholia, or mania justifying rapid hospitalisation to barely pathological mood swings, where it is an alternation and... 

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