Affect lability is characterized by severe and rapid fluctuations in basic mood. Even the slightest stimuli trigger significant mood swings. In this context, the mood changes can be an expression of normal hormonal changes as well as pathological organic processes.
What is affect lability?
Affect lability is characterized by a rapid change in basic mood that often occurs without any noticeable external cause. This mental state is also referred to as mood lability. The affected person is aware of the mood swing, but does not perceive it as pathological or embarrassing. In affect lability, there is a rapid change of emotions (affects), although the duration of the emotions is usually very short. Thus, anger can quickly turn into sadness or sadness can quickly turn into joy. In this case, the affect-labile reacts excessively to external offered affects. He can no longer differentiate the emotions arriving from the outside and is not able to control his reactions to them. For example, the emotions quickly change from “sky-high” to “saddened to death.” These mood swings can be completely normal in certain developmental phases or hormonal changes. This applies, among other things, to childhood, puberty, menopause or hormonal changes during menstruation. A rapid change in mood can also occur during pregnancy. However, there are also many pathological processes associated with affect lability.
Causes
There can be many causes of affect lability. Often, they are normal reactions that occur during hormonal changes. Women are particularly affected before menstruation or during pregnancy. Rapidly changing affects are also normal in children. Particularly strong mood swings can be observed during puberty. The same applies to menopause in women. During hormonal changes or growth processes, there are often physical discomforts that manifest themselves externally as mood swings. However, there are also a number of physical and psychological disorders that are associated with severe affect lability.
Symptoms, complaints, and signs
Affect lability is particularly extreme in bipolar affective disorder, also formerly known as manic-depressive illness. In this disorder, phases of depressed mood constantly alternate with highly euphoric phases. Between these phases, the patient’s condition may temporarily return to normal until the next episode of illness occurs. In the depressive phases, the affected person is sometimes even suicidal, while in the manic state he develops feelings of omnipotence, among other things. In this clinical picture, phases of increased drive alternate with phases without drive. Depression without mania is also characterized by mood swings in some patients. Especially in the morning after getting up, the mood is at its lowest point. In the course of the day, however, there is often a brightening of mood. Mood swings are also common in borderline personality disorder. Here, even the smallest occasions are enough to cause mood swings. Furthermore, affective instability often occurs in the early phases of schizophrenia. Many forms of personality disorders are also associated with affective lability. Of course, severe psychological stress or conflict can also lead to significant mood swings. Another cause of affective lability can be the onset of dementia, such as Alzheimer’s disease. With addictive diseases such as alcoholism or drug addiction, there is always affect lability. Other causes of severe mood swings include brain tumors or hormonal disorders such as hyperthyroidism.
Diagnosis and course
In the case of severe and persistent mood swings, a doctor should definitely be consulted. The physician can then clarify whether the affect lability occurs as part of a normal hormonal change or is nevertheless an expression of a pathological process. For this purpose, a comprehensive anamnesis is very important. Among other things, the doctor will ask how often and how severe the mood swings are, whether there are any particular triggers and what other symptoms occur.In addition, certain cognitive tests can be performed to determine whether there is an incipient dementia, depression or other mental disorder. Neurological examinations are also carried out to rule out physical causes of affect lability, and hormone levels or vitamin status are determined. It also depends on the accompanying symptoms whether certain imaging procedures such as MRI, CT or even an EEG as well as an ECG are still necessary.
Complications
In itself, it is difficult to impossible to name “complications” that can occur in the context of affect lability. It should be pointed out here that affect lability can occur in the context of various mental illnesses, but also as a normal circumstance of a certain stage of development. Thus, affect lability is merely a symptom and not a disease in its own right and, moreover, does not indicate a disease in every case. However, based on the assumption that affect lability occurs in the context of a mental illness, it can be said that some quite dangerous behaviors arise from it, which can be understood as “complications” in the broadest sense. One example is excessive aggressiveness, which can result from uncontrollable rage. Such uncontrollable anger can occur relatively easily in the context of affect lability and may lead the affected person to behave in unusual ways. The lack of control of affect or mood is the hallmark of affect lability and therefore cannot be seen as a complication of it. Complications arise only from these uncontrollable moods and emotions. Self-injurious or suicidal behavior may also occur along with affect lability. However, many behaviors are seen as further symptoms rather than complications or consequences. Ultimately, it can be stated that various “undesirable” and sometimes dangerous behaviors can result from affect lability.
When should you see a doctor?
In the case of affect lability, attention should be paid to how long it lasts and at what intervals it recurs. In principle, a doctor should always be consulted if the affect lability leads to distress for the affected person, which he or his environment perceives as problematic. Depending on the severity and cause, behavioral tips can be very helpful, especially at the beginning. In more severe cases, antidepressants are prescribed. The problem with affective lability is that those affected often have a very difficult time responding to a doctor’s advice. In most cases, there is a gradual process of social isolation that lasts for years. Vital tasks can then often no longer be managed from one day to the next. Once this point is reached, it is no longer possible for the patient to consult a doctor on his own. Therefore, timely help is needed in the case of affective lability. A delicate touch and good empathy are required in dealing with the affected person. Since affect lability is often very difficult to manage for relatives of a sufferer, it is advisable for them to consult a doctor. In a consultation, they receive valuable advice from an expert that can help them in their everyday lives to cope with the changing affects. Interrelationships are explained and stressful situations for those around them can be reduced.
Treatment and therapy
If affect lability occurs during pregnancy, puberty, or the premenstrual phase, therapy is not necessary. Mood swings often occur during these phases. However, if the affect lability is persistent and cannot be associated with a physical change phase, it must definitely be treated. Therapy is then based on the underlying disorder. Bipolar disorder is treated with antidepressants. These active substances intervene directly in the brain metabolism and help to lift the mood. In the case of many mental illnesses, the cause must also be investigated as part of psychotherapy. The trigger is often a traumatic experience in childhood. Only after its discovery is effective therapy often possible. In the case of organic causes, the affect lability disappears after the illness has healed.
Outlook and prognosis
In the case of affect lability, the prospect of improvement depends on the cause to which it is due. Affect lability that occurs as a symptom of physical diseases usually disappears with them or persists (in the case of permanent organic disorders) with them. In children, affect lability may be normal. It improves with age. Even in adults, affectability is not always a sign of illness or a deeper psychological problem. This is especially true if it occurs only in certain situations – for example, during an emotional movie. In the context of premenstrual syndrome (PMS) in women, affect lability may follow a cyclical course. In this context, it represents a recurring symptom that, however, rarely leads to permanent distress. There is a good prognosis for postpartum depression, especially if the social environment is stable. However, previous depression and other stressors may worsen the prospect for rapid recovery. The prognosis for personality disorders is more unfavorable. However, with appropriate treatment and sufficient motivation, significant improvements can be achieved in many cases. Almost always, the personality disorder weakens with age. A stable environment also has a positive effect on the course of personality disorders. Job, family and friends play a central role.
Prevention
No specific recommendations can be made for preventing affect lability because of the many possible causes. A healthy lifestyle with a balanced diet, plenty of exercise, and little stress reduces the likelihood of affective lability occurring.
Follow-up
In the case of affective lability, follow-up proves to be relatively difficult and cannot be easily accomplished. First and foremost, the condition itself must be treated to avoid further complications and discomfort. However, a complete cure of affect lability is not always possible. In most cases, the person affected by this disorder must seek psychological treatment. In this process, family and friends can also alert the patient to the symptoms of the disorder and recommend therapy to the affected person. This should also be carried out until the complaints of affect lability have completely disappeared. Furthermore, conversations with the friends and the own family can also be very useful to alleviate the complaints and to increase the quality of life of the affected person. Contact with other patients with affective lability can also have a positive effect on the further course of the disease, as this can often lead to an exchange of information. Since medication must also be taken, care should be taken to ensure that it is taken regularly. Possible interactions must also be taken into account. The intake should be as long as the disease has been cured.
What you can do yourself
Depending on the underlying disease, those affected can positively influence the course and severity of their affective instability at various levels. Everything that supports the balance between sympathetic and parasympathetic processes of the body is helpful. This includes: a healthy, balanced diet with a sufficient supply of vitamins and minerals, an appropriate way of dealing with stress, sporting activities and plenty of exercise in the fresh air. Consciously perceived experiences of nature, various relaxation methods and sufficient quality and quantity of sleep promote the ability to regenerate quickly as a basis for a more balanced everyday life. Basically helpful is the exchange with other affected persons, for example in self-help groups or online forums. Some patients benefit beyond conventional medical care from alternative and natural remedies and from nutritional supplements tailored to the underlying disease. However, these should not be taken without medical advice. An important contribution to the establishment of a balance between tension and relaxation in everyday life is also made by hobbies, pets and consciously used time out, in which the ability to enjoy is trained. A useful goal of supportive self-therapy can be to accept the uncontrollable moods as part of one’s life and to acknowledge them as such.The most effective approach is a combination of the above self-help building blocks according to individual standards in coordination with therapeutic requirements of the main underlying disease.
