In this blog, you’ll learn the symptoms to look out for—and how to seek help.

WHAT IS EMOTIONAL LABILITY?

What does emotional lability mean? The Encyclopedia of Personality and Individual Differences defines it as “a distinct emotional process characterized by frequent, excessively rapid, and intense changes in emotions resulting in an inability to maintain a consistent emotional state over time.” Alternate terms include:

• Affective instability
• Affective lability
• Emotional impulsivity
• Emotional instability
• Emotional variability
• Mood instability
• Mood lability

Emotional lability differs from typical mood changes because the moods are rapid, intense, and severe. While both may result from an outside stimulus (a “trigger”), typical mood changes are generally less extreme in nature.

In 2013, an article in the journal Psychological Medicine noted that affective instability remained poorly defined and thus attempted to define clearer parameters. The study outlined four general categories to help measure affective instability: oscillation, intensity, ability to regulate, and the change in mood triggered by environment.

Ultimately, the authors suggested that emotional lability be defined as “rapid oscillations of intense affect, with a difficulty in regulating these oscillations or their behavioral consequences.”

SIGNS AND SYMPTOMS OF EMOTIONAL LABILITY

Emotional lability may be confused with emotional dysregulation, a common feature of attention-deficit hyperactivity disorder (ADHD). According to The American Professional Society of ADHD and Related Disorders (APSARD), the term “affective lability” is typically used for those with mood disorders, while “emotional dysregulation” is often attached to ADHD.

Some common behaviors associated with emotional lability include:

• Uncontrollable crying or laughter
• Anger outbursts or temper tantrums
• Rapid shifts between moods
• Overreactions to events
• Irritability
• Inappropriate emotions (such as laughing at a sad event)

When moving through rapid emotional shifts, an individual may suddenly move from crying to laughter without any apparent cause. During the episode, each emotion is also exaggerated in intensity and severity.

CAUSES AND CONDITIONS ASSOCIATED WITH EMOTIONAL LABILITY

In 2015, an article in the British Journal of Psychiatry examined the significance, definition, and measurement of mood instability. It noted that mood instability is a common experience, affecting nearly 14% of the population. The issue is seen more frequently in women than men.

The authors stated that peak prevalence occurs in those ages 16-24, then gradually declines with age, affecting only 7% of those ages 65-74.

But they added that mood instability affects 40-60% of those with depression, anxiety disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). It is also a prevalent feature of bipolar disorder and ADHD and can result from trauma that contributes to borderline personality disorder, hallucinations, paranoia, and psychotic disorders.

Emotional lability increases risk of suicidal ideation, alcohol misuse, and other issues that reduce quality of life. In addition, mood instability can lead to poorer long-term outcomes in those with conditions like bipolar disorder.

According to the American Stroke Association (ASA), neurological conditions, such as stroke, amyotrophic lateral sclerosis (ALS), Parkinson’s, TBI, multiple sclerosis, and dementia, can also contribute to emotional lability.

These neurological conditions create what’s called the pseudobulbar affect (PBA), also called reflex crying and involuntary emotional expression disorder.

PBA occurs because parts of the brain that control emotions are compromised. The ASA points to a “neurological disconnect between the brain’s nerve connections or chemistry that interferes with accurate emotional expression” as a reason for these intense mood swings.

Finally, certain medications—such as amphetamines prescribed for ADHD—have been associated with risk of emotional lability, according to a 2018 meta-analysis published in Journal of Affective Disorders.

THE ROLE OF THE BRAIN IN EMOTIONAL REGULATION

Since brain function affects mood stability, mood swings and brain health are closely linked. Key regions of the brain contribute to these symptoms. For example, the limbic system, as the brain’s emotional center, plays a vital role in mood regulation.

Part of the limbic system, the brain’s thalamus is important in processing emotions. It acts as a relay station for sensory and motor information, carrying external stimuli from the outside world to the brain. The thalamus has been linked to numerous issues, from chronic pain and PTSD to clinical depression and low moods.

The temporal lobes are also involved in emotional stability. Dysfunction in these areas may lead to symptoms like angry outbursts, aggression, or emotional ups and downs.

The involvement of multiple brain regions, as well as numerous conditions that may contribute to emotional lability, makes brain imaging particularly useful to pinpoint its underlying root causes.

Because SPECT scans paint a picture of activity and blood flow in the brain, they are invaluable—alongside a comprehensive evaluation—to successfully diagnose and effectively treat the condition(s) in question.

DIAGNOSING AND TREATING EMOTIONAL LABILITY

Emotional lability can significantly impact many aspects of daily life, including relationships. It creates challenges in both personal and professional settings, taking a toll on loved ones and leading to outcomes like poor performance at work or school. Therefore, obtaining the correct diagnosis, treatment, and lifestyle recommendations is crucial.

Fortunately, various therapies and lifestyle tips can help individuals who are experiencing severe mood swings. Try these emotional lability treatment strategies to promote greater mood stability:

• Incorporate brain-boosting nutrients like omega-3 fatty acids, which help support the limbic system (and therefore emotional well-being)
• Avoid sugary foods
• Listen to calming music
• Try dancing or other forms of rhythmic movement
• Practice mindfulness-based cognitive therapy, hypnosis, meditation, and/or neurofeedback, which help support emotional regulation
• Boost serotonin with exercise, diet, and a 5-HTP nutritional supplement
• Reduce screen time
• Increase cerebral blood flow with deep breathing, yoga, and cardiovascular exercise

Meanwhile, the caregivers and family members of those who experience emotional lability should educate themselves on this topic to better offer support to their loved ones.

Understanding that it’s an issue of brain health helps prevent them from taking these extreme mood swings personally or viewing them as a moral failing.

WHEN TO SEEK PROFESSIONAL HELP FOR EMOTIONAL LABILITY

While moderate shifts in mood are normal, emotional lability raises certain red flags that indicate the need for intervention. When mood swings are especially severe and/or rapid, out of proportion to situations, and interfering with daily life tasks and relationships, it’s time to seek help.

If you suspect you or a loved one are experiencing emotional lability, it’s important to receive a comprehensive evaluation, including brain SPECT imaging if possible, to pinpoint the underlying causes. Starting on the road to recovery with a targeted brain-body treatment plan will help regulate moods to make life more stable, manageable, and enjoyable.