Depressed More than Happy: Charting Mood Swings

Reader’s Question

Sometimes I feel happy and good but sometimes I feel very down and depressed. Deep down I know that I’m smart and that I can accomplish things, but when I’m in a bad mood, I start doubting all that.

Last year I was depressed more than I was happy. People around think I’m a disappointment. They can’t rely on me and they never ask me to do anything. I feel not needed. I am a shy person and I don’t like pushing myself out there, but I am also very outgoing around my close acquaintances. That’s why people who don’t know me think I’m arrogant. I feel like they lie when they compliment me.

I have no friends whom I can talk to honestly and openly because I don’t trust anyone, and I don’t like discussing my problems. I recently stopped being friends with a girl who had been a bad influence on me, and now she gossips about me, but still pretends to be nice. I can’t avoid meeting this girl every day. This brings me down even more, and I don’t feel like going outside anymore.

I would only like to know: how can I overcome my bad moods and stay positive? I feel that if I knew how, it would be easier for me to deal with all the other problems I have.

Psychologist’s Reply

I agree with you that the presenting problem is the mood swings you’ve described. If that was overcome or at least managed, then the other problems might be manageable too.

Mood swings can be caused by any number of things. Assuming your mood is not dependent on your situation — that is, you are not responding to something that is happening in your situation that makes you feel sad or mad or glad — then we should rule out a physical/biological cause. I do not know whether you are a man or a woman, but if you are a woman, from the frequency of the mood shifts, it does not sound like it’s related to your menstrual cycle. However, you should start by consulting your primary care doctor. We want to rule out anything from his perspective that could cause this before assuming a psychiatric cause.

It would be helpful if we knew your family medical history, as mood disorders such as Bipolar Disorder are largely inherited. For example, if you have Bipolar Disorder on either your mother’s or father’s side of the family, then it might be useful to start charting your moods in order to establish a baseline.

Try Online Counseling: Get Personally Matched
(Please read our important explanation below.)

Regardless of the specialist who ultimately provides treatment — psychologist, psychiatrist, etc. — it will be very useful if you chart your moods. Here is a simple way to accomplish that. On a wall calendar, mark a +, -, or 0 on each day. Use the ‘+’ when you feel unusually upbeat, grand, and happy. Use a ‘0’ when your mood is ‘normal’ and matches the situations that you’re in. Use a ‘-‘ when you are feeling down and depressed. Over a number of weeks, you may start to notice a cycle in the mood swings. That is, the swings may have some regularity, some pattern. You can then show the chart to the doctor and say that your mood is cycling every two weeks, or whatever you notice.

When patients do this bit of homework, it greatly helps the doctor make a differential diagnosis. Getting a proper diagnosis is crucial, as it will determine the course of treatment you begin.