Your lifestyle choices, including your sleeping, eating, and exercise patterns, have a significant impact on your moods. There are many things you can do in your daily life to get your symptoms under control and to keep depression and mania at bay.
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Learn how to relax. Relaxation techniques such as deep breathing, meditation, yoga, and guided imagery can be very effective at reducing stress and keeping you on an even keel. A daily relaxation practice can improve your mood and keep depression at bay.
Hormone changes that happen after birth may cause the baby blues. After delivery, the amount of the hormones estrogen and progesterone suddenly decreases, causing mood swings. For some people, the hormones made by the thyroid gland may drop sharply, which can make them feel tired and depressed. Not getting enough sleep and not eating well can add to these feelings.
Other influential writers in psychiatry and psychology have endorsed similar notions. Bowlby compared negative emotions in adults to those that occur during separation from the attachment figure in infants (6). Beck attributed depression to dysfunctional negative thoughts of defeat, failure, and rejection (7). He dismissed mood-swings as a normal phenomenon (7). Although Watson paid more attention to mood instability (MI), he also dismissed negative mood variability as mundane and of little importance (8).
In the non-depressed group, the overall means of low mood and high mood were uncorrelated. This supports the observation that in normal people low and high moods are not strongly related and easily distinguished (8). In the depressed group, however, mean low mood and mean high mood were moderately positively correlated. This indicates that the depressed group experienced high moods concurrent with low moods (54, 55). This is contrary to the common-sense view that low mood should not be associated with high moods.
Rapid cycling is not a type of bipolar disorder, but a term used to describe the course of illness in people with bipolar I or II disorder. It applies when mood episodes occur four or more times over a 1-year period. Women are more likely to have this type of illness course than men, and it can come and go at any time in the course of bipolar disorder. Rapid cycling is driven largely by depression and carries an increased risk for suicidal thoughts or behaviors.
You may think diabetes just affects your pancreas, but living with this condition often affects your mood and mental health too. For one, you may experience mood swings when your blood glucose levels are too high or low. Stress, depression, and anxiety can also crop up.
Feeling a range of highs and lows is not uncommon if you have diabetes. Your blood sugar impacts how you feel and can contribute to mood swings. Poor management of blood glucose can lead to negative moods and a lower quality of life.
Pre-teens and teenagers can feel down for minutes, hours, days or much longer. If your child seems down, flat, irritable or sad for more than 2 weeks, or if you notice moods are stopping your child from getting on with their usual daily activities, this could be a sign of a more serious mental health problem.
Medication is not always needed, but consultation with your GP or a psychiatrist is always advised. CBT can be effective in the treatment of depression and anxiety. In other cases, you and your therapist may decide that medication, together with CBT, would produce the best results. For example, people with bipolar disorder usually benefit from medication that helps control their mood swings.
Everyone has mood changes. However, a very low emotional state (depression) and extremely elevated mood swings (as occurs in bipolar disorder) affect how you think, behave, and function. Depression and sudden mood changes can disrupt travel or cause a relapse in persons with mood disorders. Managing travel stress, recognizing the warning signs of depression and mood changes, and knowing where to get help are key to a safe trip.
As part of the ongoing getting-to-know-you process, your psychologist may want to do some assessment. Psychologists are trained to administer and interpret tests that can help to determine the depth of your depression, identify important personality characteristics, uncover unhealthy coping strategies such as drinking problems, or identify learning disabilities.
Risperidone is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age and older. It is also used to treat episodes of mania (frenzied, abnormally excited, or irritated mood) or mixed episodes (symptoms of mania and depression that happen together) in adults and in teenagers and children 10 years of age and older with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Risperidone is also used to treat behavior problems such as aggression, self-injury, and sudden mood changes in teenagers and children 5 to 16 years of age who have autism (a condition that causes repetitive behavior, difficulty interacting with others, and problems with communication). Risperidone is in a class of medications called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain.
One meta-analysis and one systematic review fulfilled inclusion criteria (see Table 1). Data from studies involving volunteers mostly showed no effect, including a meta-analysis of parallel group studies [50]. In a small meta-analysis of within-subject studies involving 75 people with a positive family history, a minor effect was found, with people given the active depletion showing a larger decrease in mood than those who had a sham procedure [50]. Across both reviews, studies involving people diagnosed with depression showed slightly greater mood reduction following tryptophan depletion than sham treatment overall, but most participants had taken or were taking antidepressants and participant numbers were small [50, 51].
Since these research syntheses were conducted more than 10 years ago, we searched for a systematic sample of ten recently published studies (Table 2). Eight studies conducted with healthy volunteers showed no effects of tryptophan depletion on mood, including the only two parallel group studies. One study presented effects in people with and without a family history of depression, and no differences were apparent in either group [52]. Two cross-over studies involving people with depression and current or recent use of antidepressants showed no convincing effects of a depletion drink [53, 54], although one study is reported as positive mainly due to finding an improvement in mood in the group given the sham drink [54].
Our comprehensive review of the major strands of research on serotonin shows there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity. Most studies found no evidence of reduced serotonin activity in people with depression compared to people without, and methods to reduce serotonin availability using tryptophan depletion do not consistently lower mood in volunteers. High quality, well-powered genetic studies effectively exclude an association between genotypes related to the serotonin system and depression, including a proposed interaction with stress. Weak evidence from some studies of serotonin 5-HT1A receptors and levels of SERT points towards a possible association between increased serotonin activity and depression. However, these results are likely to be influenced by prior use of antidepressants and its effects on the serotonin system [30, 31]. The effects of tryptophan depletion in some cross-over studies involving people with depression may also be mediated by antidepressants, although these are not consistently found [63].
The chemical imbalance theory of depression is still put forward by professionals [17], and the serotonin theory, in particular, has formed the basis of a considerable research effort over the last few decades [14]. The general public widely believes that depression has been convincingly demonstrated to be the result of serotonin or other chemical abnormalities [15, 16], and this belief shapes how people understand their moods, leading to a pessimistic outlook on the outcome of depression and negative expectancies about the possibility of self-regulation of mood [64,65,66]. The idea that depression is the result of a chemical imbalance also influences decisions about whether to take or continue antidepressant medication and may discourage people from discontinuing treatment, potentially leading to lifelong dependence on these drugs [67, 68].
As with all research synthesis, the findings of this umbrella review are dependent on the quality of the included studies, and susceptible to their limitations. Most of the included studies were rated as low quality on the AMSTAR-2, but the GRADE approach suggested some findings were reasonably robust. Most of the non-genetic studies did not reliably exclude the potential effects of previous antidepressant use and were based on relatively small numbers of participants. The genetic studies, in particular, illustrate the importance of methodological rigour and sample size. Whereas some earlier, lower quality, mostly smaller studies produced marginally positive findings, these were not confirmed in better-conducted, larger and more recent studies [27, 32]. The identification of depression and assessment of confounders and interaction effects were limited by the data available in the original studies on which the included reviews and meta-analyses were based. Common methods such as the categorisation of continuous measures and application of linear models to non-linear data may have led to over-estimation or under-estimation of effects [69, 70], including the interaction between stress and the SERT gene. The latest systematic review of tryptophan depletion studies was conducted in 2007, and there has been considerable research produced since then. Hence, we provided a snapshot of the most recent evidence at the time of writing, but this area requires an up to date, comprehensive data synthesis. However, the recent studies were consistent with the earlier meta-analysis with little evidence for an effect of tryptophan depletion on mood.
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