Objective. To emphasize the clinical importance of mood instability (MI) in the treatment of patients with depression and anxiety, bipolar and substance abuse disorders.
Content. We summarize data to show that MI is common in patients with neurotic conditions; in fact, MI may be the central feature of neuroticism. We discuss the association of MI with irritability and suicidal thoughts. We also discuss the assessment of MI in family practice. MI and bipolarity are not well treated by antidepressants, which might actually aggravate the tendency to unstable moods and cycling. Suggestions are made about treatment but firm recommendations about medication are currently outside treatment guidelines.
Conclusion. MI is an important concern in the treatment of anxiety and mood disorders and more research is needed.
Keywords: mood instability, bipolar disorder, antidepressants, anxiety