Autonomic Nervous System Disorders and Mood Swings in Young Adults

Q: Autonomic Nervous System Disorders and Mood Swings in Young Adults

Hello, netizen： <br>Q： I am 25 years old and currently a college student. <br>I have previously been diagnosed with ADHD and depression. <br>Recently, I have been experiencing chest tightness, insomnia, gastrointestinal dysfunction, and poor memory for the past six months. <br>I

Autonomic Nervous System Dysregulation and Bipolar Disorder?

I am 25 years old and currently a university student.
I have previously been diagnosed with ADHD and depression.
Over the past six months, I have been experiencing chest tightness, insomnia, gastrointestinal disturbances, and poor memory, which I suspect may be due to academic pressure.
However, my emotional fluctuations are not significant.
Is it possible that I am experiencing autonomic nervous system dysregulation, or are these physiological issues a result of anxiety and stress?
Additionally, with exams approaching, I recently fell victim to a scam, losing over a hundred thousand dollars.
My emotional and physiological state has fluctuated greatly in the past few days.
In the mornings, I feel mentally constrained and depressed, often fatigued and haggard due to insomnia.
My gastrointestinal function is poor, leading to nausea and a lack of appetite, and I find myself preoccupied with the money lost in the scam, feeling distressed.
Coupled with academic difficulties, I feel inadequate and downcast.
However, by evening, I suddenly feel like a different person—my mood lifts, I am energized, and my appetite returns.
I no longer care about the money lost and instead feel exhilarated about spending it freely.
Is this normal? Could there be tendencies toward bipolar disorder?
Moreover, I have experienced a recurring pattern of feeling both timid and fearless at different times.
Sometimes, when I see sharp objects or blood, I feel a rush of excitement and think about cutting my skin and bleeding, which gives me a thrill.
I often dream of intense scenes involving fighting and violence.
However, when I was threatened during the scam, I felt fear and concern for my safety.
Yet, a couple of days later, I find myself excited, thinking about the gruesome imagery described by the scammers, and I anticipate engaging in fights, getting hurt, and bleeding, which I find thrilling.

Sometimes, I am moved by emotional scenes in TV shows, but at other times, I derive enjoyment from watching others suffer, even feeling impulses to harm or kill them.
Is this normal, or could there be underlying mental health issues? I have previously discussed my concerns with a counselor and a guidance teacher, who suggested seeking professional help.
Given all these issues, do you think it is necessary for me to seek medical attention?

Liu, 20~29 year old female. Ask Date: 2021/06/16

Dr. Wu Enliang reply Psychiatry

Hello, netizen:
Q: I am 25 years old and currently a college student.
I have previously been diagnosed with ADHD and depression.
Recently, I have been experiencing chest tightness, insomnia, gastrointestinal dysfunction, and poor memory for the past six months.
I am unsure if this is due to academic pressure, but my mood has not fluctuated much.
Is there a possibility of autonomic nervous system dysregulation, or are these physiological issues caused by anxiety and stress?
A: It is possible that these physiological issues are caused by anxiety and stress.
Q: Additionally, with exams approaching, I experienced a scam a couple of days ago, resulting in a loss of over a hundred thousand.
My emotional and physiological state has changed significantly in the past two days.
In the mornings, I feel mentally constrained and depressed, and due to insomnia the previous night, I feel exhausted and haggard.
My gastrointestinal function is poor; I feel nauseous and have no appetite.
I am also very concerned about the money I lost in the scam, which weighs heavily on my mind.
Coupled with academic difficulties, I feel useless and downcast.
However, after most of the day passed (without any significant events occurring), by evening, I suddenly felt like a different person—my mood lifted, I felt energetic, and my appetite returned.
I suddenly became indifferent to the money I lost in the scam, feeling happy about spending it, and I felt exhilarated about the large sums of money I had spent.
Is this normal? Could there be a tendency towards bipolar disorder?
A: Has such significant mood fluctuation within a single day occurred frequently in the past? If so, it is indeed possible that you may have a rapid-cycling bipolar disorder.
However, a medical evaluation by a physician is necessary.
Q: I have also noticed a recurring pattern where I sometimes feel very timid and at other times feel completely fearless.
Occasionally, when I see sharp objects or blood, I feel particularly excited and think about the idea of cutting my skin and seeing blood, which gives me a sense of thrill and stimulation.
I often dream of intense scenes involving fighting and killing.
However, when I was threatened during the scam, I felt scared and afraid of being harmed.
Yet, a couple of days later, I feel excitement thinking about the bloody scenes described by the scammers, and I anticipate engaging in fights with others, imagining myself getting hurt and bleeding, which gives me a thrill.
Sometimes, I am moved by touching scenes in TV dramas, but at other times, I enjoy watching others in pain and even have impulses to harm or kill them.
Is this normal, or could there be some mental or psychological issues? I have previously discussed these issues with a counselor and a guidance teacher, and they suggested seeking medical attention.
Given all these concerns, do you think I should see a doctor?
A: If these issues are causing disruptions in your life, it is indeed possible that they stem from mental or psychological problems, and I recommend seeking medical attention.
Dr.
Wu Enliang

Reply Date: 2021/06/16

More Info

Based on your description, it seems that you are experiencing a complex interplay of symptoms that may be related to autonomic nervous system (ANS) dysfunction, anxiety, and possibly other psychological factors. Given your history of ADHD and depression, along with the recent stressors you mentioned, it is understandable that you are feeling overwhelmed and confused about your emotional and physical state.

The autonomic nervous system is responsible for regulating involuntary bodily functions, including heart rate, digestion, and respiratory rate. It consists of two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' activities. Dysregulation of this system can lead to various symptoms, including those you are experiencing, such as chest tightness, gastrointestinal disturbances, and sleep issues.

Your symptoms of feeling chest tightness, gastrointestinal upset, and sleep disturbances can indeed be manifestations of anxiety and stress, particularly given the academic pressures and the recent traumatic experience of being scammed. The fact that you experience significant mood swings, fluctuating between feeling low and then suddenly uplifted, could suggest a mood disorder, but it is essential to consider the context of these feelings. The rapid changes in your emotional state, especially in response to stressors, may indicate a heightened sensitivity to emotional stimuli, which can be common in individuals with anxiety or mood disorders.

Moreover, your fascination with sharp objects and blood, coupled with feelings of excitement and thrill, raises some concerns. While it is not uncommon for individuals to have fleeting thoughts about self-harm or aggression, the intensity and frequency of these thoughts, especially if they are accompanied by a sense of excitement, warrant further exploration. This could indicate underlying psychological issues that may benefit from professional evaluation.

Given the complexity of your symptoms and the potential for underlying psychological conditions, it is advisable to seek a comprehensive evaluation from a mental health professional. A psychiatrist or psychologist can provide a thorough assessment, including a review of your symptoms, history, and any potential risk factors. They can help determine whether you are experiencing an anxiety disorder, mood disorder, or another condition, and they can recommend appropriate treatment options.

In terms of treatment, a combination of psychotherapy and medication may be beneficial. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and mood disorders, as it helps individuals identify and change negative thought patterns and behaviors. Additionally, medication such as antidepressants or anti-anxiety medications may be prescribed to help manage your symptoms.

It is also important to develop healthy coping strategies to manage stress and anxiety. Regular physical activity, mindfulness practices, and maintaining a balanced diet can significantly impact your overall well-being. Engaging in activities that you enjoy and that promote relaxation can also help mitigate the effects of stress.

In conclusion, while your symptoms may be related to autonomic nervous system dysfunction and anxiety, it is crucial to seek professional help to gain a clearer understanding of your condition. A mental health professional can provide the necessary support and guidance to help you navigate these challenges and improve your quality of life. Remember, seeking help is a sign of strength, and taking this step can lead to significant improvements in your mental and emotional health.

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