Emotional Instability: Signs, Symptoms, and Solutions

Q: Emotional Instability: Signs, Symptoms, and Solutions

Hello： Based on what you have described, it is indeed possible that your mother is unwell. <br>It is advisable to seek medical evaluation and treatment. <br>When encouraging her to see a doctor, approach her with concern and use reasons that she may find more acceptable, such as

Emotional instability

Hello doctor, my mother has often been preoccupied with finding things to do and cannot stop.
After finishing one task, she continues to look for other things or engages in meaningless activities (for example, washing the floor in the yard for several hours, or shaking freshly washed clothes, claiming she wants to get rid of the water stains).
I have seen her shake one piece of clothing for over 10 minutes without stopping.
Moreover, she cannot be made to stop; even if I finish tasks she would normally do, she still finds other things to keep herself busy.
There was an incident where she wiped the floor all night until dawn and then fainted, requiring hospitalization.
She appeared dazed, as if she were trying to grasp something, mumbling softly but I couldn't understand what she was saying.
Afterward, she claimed not to remember anything before or after fainting (all tests were normal).
When I suggest she take a break, she finds excuses to continue working and often hardly eats or drinks.
She did not smoke before, but started smoking heavily last year.
Previously, she enjoyed watching TV dramas, was cheerful, and often interacted with the cat.
However, about two months ago, I noticed a sudden change in her personality; she abruptly cut her hair short, rarely smiles, and almost never watches TV anymore.
She cannot stop moving, and there are times when she only sleeps one night out of two.
I cannot convince her to rest.
I have heard her say she doesn't know why she keeps touching things until dawn.
Sometimes, she talks to herself softly, saying: "crazy woman, shameless." At first, I didn't hear this often, but now it has become more frequent.
When I asked her why she keeps calling herself a crazy woman, she said it was because she feels she cannot finish her tasks and cannot stop.
However, I believe she is not just criticizing herself; it feels more like another person is scolding her.
Recently, her condition has worsened; I see her doing the same things every day, but she does not repeat the same task.
Instead, she finishes one task and moves on to the next.
Her daily routine is similar, and even while showering, I can hear her continuously scolding the "crazy woman." The volume has increased from a soft murmur to loud shouts.
Her personality has split into two states: 1.
Cheerful, playing with the cat, laughing while watching TV, everything seems normal (when not engaged in tasks).
2.
Expressionless, as if she has become another person, talking to herself and scolding the "crazy woman." Sometimes she also talks to herself about other things (when working).
When I try to chat with her, I often have to ask several times before she responds, and her mood swings can be abrupt.
For example, if I try to talk to her when she is in state 2, she may revert to state 1.
Recently, I have been trying to help her with tasks she might want to do and encouraging her to take breaks, but I cannot find any similar conditions.
I would like to ask the doctor what might be wrong with my mother.
I believe she may be unwilling to go to the hospital.
How can I approach this to encourage her to accept treatment? Thank you, doctor.

Nìmíng, 20~29 year old female. Ask Date: 2018/03/23

Dr. Liang Sunyuan reply Psychiatry

Hello: Based on what you have described, it is indeed possible that your mother is unwell.
It is advisable to seek medical evaluation and treatment.
When encouraging her to see a doctor, approach her with concern and use reasons that she may find more acceptable, such as insomnia, poor appetite, decreased energy, or worsening memory.
It would be best to accompany her to the appointment and inform the physician of her actual condition.

Reply Date: 2018/03/23

More Info

Understanding emotional instability, particularly in the context of your mother's behavior, can be complex and multifaceted. From your description, it appears that your mother is exhibiting signs of significant emotional and behavioral changes, which may indicate an underlying mental health condition.
The behaviors you described—such as her compulsive need to keep busy, engaging in repetitive and seemingly meaningless tasks, and her drastic personality changes—could be indicative of several potential issues. One possibility is that she may be experiencing symptoms of a mood disorder, such as bipolar disorder or major depressive disorder with psychotic features. In bipolar disorder, individuals can experience episodes of mania (or hypomania), characterized by increased energy, decreased need for sleep, and impulsive behaviors, followed by depressive episodes. The compulsive behaviors and the self-directed verbalizations you mentioned could be manifestations of this condition.

Another possibility is that she may be experiencing obsessive-compulsive disorder (OCD), where individuals feel compelled to perform certain behaviors repetitively to alleviate anxiety. The fact that she is engaging in these tasks to the point of physical exhaustion, as evidenced by her fainting episode, is concerning and suggests that her mental state is significantly impacting her physical health.

It's also important to consider the potential for a neurocognitive disorder, especially if there are signs of confusion or memory loss. The fact that she does not remember events surrounding her fainting could indicate a dissociative episode or other cognitive impairment.

Given the complexity of her symptoms, it is crucial to approach this situation with sensitivity and care. Here are some steps you can take to help your mother:
1. Open Communication: Start by having an open and non-judgmental conversation with her about your concerns. Express your observations and feelings without labeling her behavior. Use "I" statements, such as "I feel worried when I see you so overwhelmed," to avoid sounding accusatory.

2. Encourage Professional Help: Gently suggest that she see a mental health professional. You can frame it as a way to help her feel better and manage her stress. It may be helpful to accompany her to the appointment if she is open to it.

3. Educate Yourself: Learn more about mental health conditions that may relate to her symptoms. Understanding the signs and symptoms can help you communicate more effectively with her and with healthcare providers.

4. Create a Supportive Environment: Encourage a routine that includes regular meals, hydration, and sleep. Help her find activities that are calming and enjoyable, which can provide a break from her compulsive behaviors.

5. Seek Support for Yourself: Caring for someone with mental health issues can be challenging. Consider seeking support for yourself, whether through counseling or support groups, to help you cope with the stress and emotions involved.

6. Emergency Situations: If her behavior escalates to the point where she poses a danger to herself or others, it may be necessary to seek emergency medical help. This could involve contacting a mental health crisis line or taking her to the emergency room.

In conclusion, your mother's behavior is concerning and warrants professional evaluation. Mental health conditions can be complex, and early intervention is key to improving outcomes. By approaching the situation with empathy and support, you can help her take the necessary steps toward recovery.

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