I've realized that I've been having "mood swings." I'm extremely confident for a week or two, then I'm emotional, then I'm paranoid and lack confidence and the cycle goes on. My emotions actually go through this pattern every year. What could be the cause of this? Is there something that could be done to reduce or control these swings? They are very difficult on my personal relationships.

Karen

I can't say for sure what might be going on with you without talking with you personally and obtaining more information. But I'll mention some possibilities you might explore, either on your own or with a therapist.

One thing you might consider is charting your moods over a few months, and perhaps retrospectively over the past few years if your memory suffices or you have journals or other records from which you can glean pertinent information. Then look for any patterns. Is there any seasonal relationship to your mood swings? Any relationship to your menstrual cycle?

Some people experience mood changes related to the seasons of the year -- usually winter-related depression that lifts in the spring. Such "seasonal affective disorders" ("affect" means "emotions") are thought to be triggered by decreasing exposure to the full spectrum of natural sunlight associated with the shorter days of winter. Some people may be more sensitive to a dearth of full-spectrum light than others. Treatment for seasonal affective disorder usually involves light therapy ("phototherapy") and sometimes the use of antidepressants. Some people are able to combat such conditions on their own by increasing their exposure to natural light in the winter, such as by taking daily walks outside in the daytime, or adding full-spectrum lighting to their homes or offices. (Warning: sun lamps are not the same thing as full-spectrum lighting; lengthy exposure to sun lamps, tanning beds, etc. can cause burns and skin damage.)

Some women report mood changes associated with their menstrual cycles. If your mood swings follow a monthly pattern, you might consider seeing your gynecologist for an evaluation and treatment recommendations. It might not be a bad idea to get a full physical examination anyway, to rule out other possible physiological causes of mood swings, such as endocrine disorders.

You can also examine your life and your mood swings for possible emotional or psychological stresses or triggers. Do they coincide with any kind of work or school problems, or relationship conflicts? Some people have a tendency to overinterpret or misinterpret events, taking things personally or globally when that isn't really the case. People who have an "all-or-nothing" way of viewing things, for instance, can feel good about themselves or other people until they make a mistake or hit a bumpy stretch, and then their feelings about themselves (or others) plummet. If you think your mood swings might have a psychological element (which can be the case even when physiological conditions are present), consider exploring them further with a psychologist or other therapist.