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Expert Q&A

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Are mood swings a signof depression?

Asked by Jeffery T. Johnson , San Diego, California

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I would like to know what you recommend for a person that believes he or she is suffering from depression. There are mood swings, and extreme sleeping, and just thoughts of being lonely, and that no one cares. Is this depression?

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Mental Health Expert Dr. Charles Raison Psychiatrist,
Emory University Medical School

Expert answer:

Dear Jeffery,

I get so many questions that I am unable to answer definitively that it is a great pleasure to get a question that I can answer unequivocally.

If you believe you are suffering from depression my recommendation is simple: You should make an appointment with a mental health professional for an evaluation.

Nothing takes the place of this type of face-to-face interaction in terms of determining whether you have a condition that requires treatment and what that treatment should be.

I know from your email that you are fortunate to live in a large city with tremendous psychiatric resources, so you should have no problem seeing someone with the expertise to help assess your situation.

So that's the easy part. Your question of whether your symptoms qualify as depression is a bit more complicated. Your description of mood swings and extreme sleeping suggests to me that your issues might transcend a simple major depression diagnosis.

I don't know your age, but I am going to make the assumption that you are under the age of 40 because of the symptoms you describe.

Sleeping too much and rapid mood swings make me worry that you may be suffering from a bipolar condition. I say this because both mood swings and hypersomnia (i.e. too much sleep) are classic descriptors of the types of mood disturbances that characterize bipolar disorder.

In fact, whenever I hear of a man who is feeling depressed and sleeping too much -- especially a young man -- the first thing that crosses my mind is to wonder if he has a bipolar disorder that is being missed.

Men are only half as likely as women to get depressed before their 50s. Men have other ways of manifesting their misery, mostly in drugs/alcohol and behavioral disturbances.

Whenever a man has really significant depressive problems before middle age, a clinician usually finds one of two explanations. The first is that he has some type of bipolar condition. The second is that that patient has experienced some type of early life abuse or trauma. Often people will have both situations operating at once, i.e. a bipolar condition that is being fueled by early trauma.

If any of this rings true to your personal story, I hope it provides further encouragement to seek professional help.

To sum up my concerns: You may indeed be suffering from depression, but your very short description of symptoms makes me worry that your depression may be occurring within the context of larger issues such as bipolar disorder or significant childhood adversity. Again, whatever your particular truth is, the best course of action is to see a professional, and sooner rather than later.

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