Are My Moods Normal?

Everyone gets the blues, feels afraid or experiences anxiety. When do you need help?

By:
Stacey Colino

Life can be rocky—and so can your feelings. Sometimes you may feel downbeat, anxious or fearful. In most cases, you probably endure these emotions, knowing they’ll soon pass. But how can you tell if your mood shifts are a normal response to what’s going on in your life, like financial or job stress, or signs of a clinical condition that warrants treatment? After all, it’s no secret that women are at least two times more likely to experience depression or anxiety than men.

“It’s normal to have some mood variation during the day,” says psychologist Carol Landau, Ph.D., a clinical professor of psychiatry and medicine at the Alpert Medical School at Brown University and author of The New Truth About Menopause. “Most people have good moods and bad moods and good days and bad days. While it’s one thing to feel sad or anxious for hours, maybe days, and connect it to a loss or stress in your life, it’s another to feel like you can’t pull yourself out of this.” .

The best way to think of mood and anxiety issues is on a continuum, looking at the frequency, severity and duration of your symptoms, says Landau. Part of making the judgment call between what’s normal and what’s not involves determining whether your emotional symptoms are interfering with your ability to function at work, at home or in life. Just as important, are your feelings impeding your ability to enjoy yourself? .

You owe it to yourself to ask these questions, because if you do have a mood or anxiety disorder, the sooner you get treatment, the better you’ll feel and fare. Until you get help, these conditions can have potentially serious consequences for your physical and emotional health. Read on to get a pulse on what’s normal—and what’s not—in the way of emotional ups and downs.

NEXT: A bad mood or a “suitcase of sadness”?

 

Feeling Down in the Dumps
Everybody gets the blues. It’s natural to feel sad when you’ve experienced a loss—a friendship ends, a family member gets sick, a pet dies or you lose your job. Usually, these feelings are nothing to be concerned about. They’ll pass naturally. .

But if you feel sad or down for most of the day, nearly every day, or you stop getting pleasure from activities that are normally enjoyable for you, and it’s been going on for at least two weeks, you may be depressed, according to psychologist Landau. Other symptoms of depression may include:

• enduring changes in eating or sleeping habits
• lack of energy
• feelings of worthlessness or guilt
• hopelessness or helplessness
• agitation
• trouble concentrating or making decisions
• feeling empty or irritable
• thinking about your own death or suicide (If you have suicidal thoughts or feelings, especially any plans, see a mental health professional immediately.)

Even clinical depression can lie along a spectrum from mild to major. “Mild depression can be like the common cold—energy-draining and annoying—but not life-threatening,” says psychologist Ellen McGrath, Ph.D., founder of the Bridge Coaching Institute in New York City and chair of the American Psychological Association Task Force on Women and Depression. “But major depression is like a mood cancer: It can go into spontaneous remission, but it can come back, and it’s often a progressive illness for many people.” .

There’s an even trickier form of depression: dysthymia, which literally means “bad state of mind” or “ill humor.” It’s a chronic, but less severe, form of depression that’s been ongoing for at least two years. Because it’s so long-lasting, some people think this state of mind simply reflects the way they are (irritable or low in energy) or that it’s part of their personality (somewhat gloomy or pessimistic), rather than recognizing it as a mood disorder. “Dysthymia is so internalized that it almost approaches a personality issue,” Landau says. “Some women run around for years with a suitcase of sadness, always feeling negative or down.” Besides raising the risk of getting major depression on top of it—a phenomenon called “double depression”—dysthymia can increase your chances of developing substance abuse, heart disease and other health problems. .

You can seek professional help. There is talk therapy, in the form of cognitive behavioral therapy, which focuses on changing your thoughts and behavior, or you can try interpersonal therapy, which focuses on improving your relationships. Antidepressant medications also are used to treat both major depression and dysthymia. “In neither of these situations is medication the only answer, but that’s what most people get,” Landau says. With the right combination of medication, therapy and lifestyle measures (like regular exercise), many people with major depression or dysthymia will feel better, so it pays to be persistent until you find the right mix for you.

NEXT: Rational anxiety or 24/7 dread?

 

Feeling Tense or Anxious
In these topsy-turvy times, you’d be crazy not to feel a certain amount of anxiety. It’s natural and normal, even helpful. “Anxiety is critical for survival: It warns us when there’s impending danger, it motivates and energizes us to prepare for challenges, and it tells us when we need to get something like a strange growth on our skin checked out,” says Washington, D.C.-based psychotherapist Jerilyn Ross, M.A., president and CEO of the Anxiety Disorders Association of America and author of One Less Thing to Worry About: Uncommon Wisdom for Coping With Common Anxieties. “In and of itself, anxiety is not bad. The problem comes when anxiety is overwhelming, chronic, paralyzing and saps your energy.” .

Is your anxiety normal? It depends on the degree of anxiety and whether it’s rational in relation to what’s triggering it, Ross says. Anxious about whether you’ll be able to keep your job while pink slips are being handed out at work? That’s rational. Feel tense and worried while your husband waits to get the results of a biopsy? Rational and perfectly understandable. .

But if you have free-floating anxiety 24/7, your anxiety leads to an excessive dread of everyday situations, or it’s “persistent, chronic and irrational, you may have an anxiety disorder,” Ross says. When your anxiety level hits overload, you may begin to suffer consequences: flare-ups of asthma or irritable bowel syndrome, heart palpitations or panic attacks, insomnia, depression, substance abuse and the like. “When anxiety interferes in your life, creating problems in your relationships or at work or causing you to do things in a manipulative way, such as going two hours out of your way to avoid driving over a bridge or through a tunnel,” Ross says, it’s time to seek help. .

The 40 million adults with anxiety disorders in the U.S. are usually treated with cognitive behavioral therapy and/or medication. Short-acting drugs like alprazolam (Xanax) or diazepam (Valium) may be prescribed on an as-needed basis to calm an extreme bout of anxiety. “There are numerous ways to deal with milder anxiety that doesn’t require professional therapy or medication. For example, exercise is a terrific anxiety-buster,” Ross says. Finding the right mix of therapies for you may be a matter of trial and error. .

Feeling Fearful or Phobic
Like anxiety, fear can be normal and rational. But when fear is irrational and out of proportion to any real threat of danger, it may be a phobia, Ross says. Fearful of walking down dark streets alone at night? Pretty rational, because there is a potential for danger. But if you practically start hyperventilating at the thought of having to drive over a suspension bridge and you go out of your way to avoid having to do so, that’s a phobia. “A person with a phobia knows their fear is excessive and irrational but they just can’t help it,” Ross says. A phobia is “really a fear of the fear itself. People worry about panicking or losing control in the situation they’re afraid of.” Even phobias can fall along a spectrum from mild (the person can live with it) to major (it’s debilitating). .

When it comes to treating phobias, cognitive behavioral therapy typically involves exposing the person to what they’re afraid of. Through gradual, repeated exposure and the help of relaxation techniques, such as deep breathing, the goal is to help people change their response to the object or situation they fear so intensely. “The ideal therapy is actual real-life exposure. In a typical cognitive behavioral therapy session, the person is gradually exposed to the object or situation that triggers their anxiety--elevators, crowds, spiders or whatever the phobia is,” Ross explains. “Eventually the person becomes desensitized to the frightening feelings.” In some instances, medications can be helpful, too.

NEXT: Cleaning up your “mental hygiene”

 

Finding Ways to Feel Better
Now that you understand the differences between normal mood swings and mood and anxiety disorders, you’ll be less likely to get alarmed by your own reasonable shifts in mood. You can take comfort in knowing, for example, that it’s perfectly understandable if you feel down or cry for several days after breaking up with your boyfriend, or if you find yourself worrying every night about paying your mortgage after your spouse has lost his job. “If there’s a trigger, and if the change doesn’t seem to be outside of what’s normal for you, and at times you can step out of that feeling, then you’re probably okay,” Landau says. .

If you suspect your mood changes have spiraled into a worrisome condition, however, it may be time to seek help. There are a variety of effective therapies for these common conditions, and thanks to the recent passage of full mental health parity legislation, they’ll now be equally covered by health insurance as physical conditions are. Life is short, so you owe it to yourself to be proactive and persistent until you get the relief you need. .

As you try to manage your emotional ups and downs, be patient with yourself. These are tough times we’re living in, and “especially now, it’s normal to feel upset and anxious because so much is out of our control in this economy,” Landau says. So take good care of yourself emotionally by practicing what Ross calls “stress hygiene”: exercising regularly, eating healthy foods, getting enough sleep and practicing relaxation techniques such as deep breathing or yoga. Each of these measures can help protect your body, mind and mood.