December 7th, 2010
09:12 AM ET

Are mood swings, extreme sleeping signs of depression?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Question asked by Jeffery T. Johnson , San Diego, California

I would like to know what you recommend for a person that believes he or she is suffering from depression. There are mood swings, and extreme sleeping, and just thoughts of being lonely, and that no one cares. Is this depression?

Expert answer:

Dear Jeffery,

I get so many questions that I am unable to answer definitively that it is a great pleasure to get a question that I can answer unequivocally.

If you believe you are suffering from depression my recommendation is simple: You should make an appointment with a mental health professional for an evaluation. Nothing takes the place of this type of face-to-face interaction in terms of determining whether you have a condition that requires treatment and what that treatment should be. I know from your email that you are fortunate to live in a large city with tremendous psychiatric resources, so you should have no problem seeing someone with the expertise to help assess your situation.

So that's the easy part. Your question of whether your symptoms qualify as depression is a bit more complicated. Your description of mood swings and extreme sleeping suggests to me that your issues might transcend a simple major depression diagnosis. I don't know your age, but I am going to make the assumption that you are under the age of 40 because of the symptoms you describe.

Sleeping too much and rapid mood swings make me worry that you may be suffering from a bipolar condition. I say this because both mood swings and hypersomnia (i.e. too much sleep) are classic descriptors of the types of mood disturbances that characterize bipolar disorder. In fact, whenever I hear of a man who is feeling depressed and sleeping too much - especially a young man - the first thing that crosses my mind is to wonder if he has a bipolar disorder that is being missed.

Men are only half as likely as women to get depressed before their 50s. Men have other ways of manifesting their misery, mostly in drugs/alcohol and behavioral disturbances. Whenever a man has really significant depressive problems before middle age, a clinician usually finds one of two explanations. The first is that he has some type of bipolar condition. The second is that that patient has experienced some type of early life abuse or trauma. Often people will have both situations operating at once, i.e. a bipolar condition that is being fueled by early trauma.

If any of this rings true to your personal story, I hope it provides further encouragement to seek professional help. To sum up my concerns: You may indeed be suffering from depression, but your very short description of symptoms makes me worry that your depression may be occurring within the context of larger issues such as bipolar disorder or significant childhood adversity. Again, whatever your particular truth is, the best course of action is to see a professional, and sooner rather than later.

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soundoff (33 Responses)
  1. Karen

    Hi Jeffrey, in connection with above subject, we just wrote two posts about how to avoid and conquer depression. We’ve looked more at the biology of depression. Depression is often linked to a deficit or an excess of certain neurotransmitters in the brain. Here, http://bit.ly/anke42 you can read part one with a link to part two. Hopefully you can benefit from it.

    December 7, 2010 at 09:57 | Report abuse | Reply
  2. razzlea

    Check out my health and fitness blog http://razzlea.blogspot.com/

    December 7, 2010 at 15:59 | Report abuse | Reply
  3. Trav202

    This is good, keep going while I grab some popcorn.

    December 7, 2010 at 16:14 | Report abuse | Reply
  4. Jean

    The chances are you are NOT bipolar. This is a mental condition that is rare, but it is being diagnosed these days with great frequency. Go see a mental health professional, but make sure it's a GOOD one. Not like the quack who wrote the answer to your email.

    December 7, 2010 at 18:24 | Report abuse | Reply
  5. brandon s

    Meditation is the key to overcoming the depressive tendencies of a dominant left hemisphere

    December 7, 2010 at 18:28 | Report abuse | Reply
  6. recovered

    I seriously agree with Jean here. This is a crime that this has been published on CNN. Bipolar is a RARE and serious condition that should not even be mentioned in the context of a few line email. Ridiculous!

    December 7, 2010 at 19:20 | Report abuse | Reply
    • KeithTexas

      I don't find that Bipolar is either rare or always serious. I have been Manic – Depressive most of my life (Bipolar) and I dealt with it many different ways, most of them destructive, until I was diagnosed. Since then with a little behavioral therapy and very light anti depressants I have been able to live with my condition. I really enjoy the manic phases so I wouldn't want to control my moods completely. It did take some time to find the right anti depressant for my condition that wouldn't take the normal ups and downs of life away from me.

      December 7, 2010 at 20:06 | Report abuse |
  7. KeithTexas


    December 7, 2010 at 19:56 | Report abuse | Reply
  8. hsr0601

    In my view : TAKING A BATH day-to day
    1. As we are all aware , TAKING A BATH day-to day is best for improving resistance to depression as "our body is also taking a breath".

    I firmly believe all disease are due to our broken immunity.
    2. After eating too much, we might feel so depressed.
    We are living in an age of Automation , naturally so the excess diet is more likely to work against wellness since the residues lingering in our body should act as a hot bed for all forms of germs, bacteria, virus and the likes, which I think spread to a variety of diseases including diabetes, depression & mental diseases & beyond.
    3. Sunlight & Fruits might make us positive and optimistic.
    4. Preventable depression might turn into dementia as we enter golden age.

    December 7, 2010 at 20:28 | Report abuse | Reply


    December 7, 2010 at 20:30 | Report abuse | Reply
  10. Brenda Reed

    I am a senior citizen, shall we say, and I have known for sure that I have unnatural depression since I was about 30 years old. Looking back, of course, I had it in childhood, also. It is not normal for a healthy, happy, intelligent elementary age kid to obsess about suicide. But, I did. And, I don't believe I had ever even known a person who committed suicide. Started taking anti-depressants in late 30's with little luck. Finally, at about age 56-7, found a new drug that has absolutely worked wonders for me. So, what do I do? As soon as I feel okay, I stop taking it. Crash and burn. Repeat the process X 10 or 12 times. Finally, a doctor told me that I was one of the few people who will never be free of the drug. Just that statement has led me to stop the see-sawing and take as prescribed. Today, I am healthy and happily retired. How do you know? The world is black (or sometimes, just blank); you cannot get out of bed; you cannot answer the phone; you cannot get the mail; you cannot even open the door and pick up the newspaper. And there are no apparent reasons - no life traumas or disappointments. No deaths or illnesses. Nothing. It just IS!

    December 7, 2010 at 22:03 | Report abuse | Reply
  11. Jessica

    The author states in the beginning that the first thing the person should do is see a mental health professional. That's probably where he should have stopped. With only 2 symptoms given, and no full evaluation & diagnosis, it's IMPOSSIBLE to get a proper diagnosis. Just throwing bipolar disorder out there is irresponsible. Bipolar disorder is not as rare as some people may like to think, and symptoms can overlap to great degrees. That is why it is so important to see a mental health professional for a complete evaluation. It could take several months of therapy and trials with different medications to pinpoint what the diagnosis is.

    Just meditation & exercise is not a viable solution. Mental disorders such as depression, bipolar disorder, anxiety disorder, etc... are often caused or aggrevated by chemical imbalances in the brain. Medication, along with therapy, healthier eating habits, and exercise, can be a huge benefit in stabilizing a mental disorder. Don't just disregard the benefits that medications can have. They aren't magic cures, but they can help.

    December 7, 2010 at 22:33 | Report abuse | Reply
    • JuneE

      I agree, after reading that first line, I almost automatically discounted the rest of the article.
      The first thing that should be recommended is self help measures and then if those aren't effective suggesting a mental health professional
      People go to therapy as a knee jerk reaction instead of taking responsibility for their own health!. This is part of the reason health care costs are spiraling out of control. And the professional is recommending therapy as the first lien of defense!

      December 8, 2010 at 15:00 | Report abuse |
  12. Sherri

    My son is 23. He doesn't have a job, so he sleeps a lot (but stays up pretty late at night) He's not depressed, just bored to tears.

    December 7, 2010 at 22:41 | Report abuse | Reply
  13. LS

    Not sure what happened to my post..... Basically I don't think he has Bipolar Disorder unless by "mood swings" he means alternating between euphora, feelings of invinciability, psychosis, delusions, or just extreme happiness and depression. Not sure why the psychiatrist often suggests Bipolar Disorder, when nothing in the question suggests that. Maybe he sees patients who's Bipolar Disorder was missed for some time a lot? Over diagnosis of Bipolar Disorder is almost as bad as under diagnosis, since the treatments for Bipolar disorder are often quite dangerous and all have serious side effects, like massive weight gain or organ failure as a relatively common side effect.

    All the symptoms he described are depression symptoms as well as could be do to another medical or mental health disorder (like addiction). Also, many young men have Major Depression, often their condition is missed because they develop addictions or substance abuse as a result which masks their symptoms, though. Also, in addition to traumatic early events, having anxiety problems and a strong family history of depression could lead to a depression in young men. Irritability and anger issues, which I think of as "mood swings" are particularly common in men with depression.

    A psychiatric evaluation is a good idea regardless.

    December 14, 2010 at 10:59 | Report abuse | Reply
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