Sudden Mood Swings and Self-Harm: When to Seek Help

Emotional issues

Hello, doctor.
Recently, I've been experiencing sudden mood swings where I start hitting my own head and slapping my face, even though there's nothing specific making me unhappy.
When others see this, they just laugh, which makes me feel even worse.
I want to ask the doctor if I might be sick...

Chen Ziyu, 20~29 year old female. Ask Date: 2023/12/10

Dr. Li Guanying reply Psychiatry

Dear Sir/Madam,
From your letter, it is evident that you are experiencing discomfort and distress.
If these symptoms have appeared suddenly, it is important to consider whether they are related to a COVID-19 infection.
The Centers for Disease Control and Prevention (CDC) defines the symptoms that persist after an acute COVID-19 infection as "Post-COVID Conditions," also known as "Long COVID." Recently, daily confirmed cases of COVID-19 have exceeded ten thousand, but current public health policies are leaning towards achieving a balance and coexistence with the virus.
This includes monitoring for "Long COVID" symptoms in asymptomatic individuals, as the resulting physical and mental stress can easily lead to the recurrence of anxiety, depression, and other mental health disorders, which should not be underestimated.
Clinical findings indicate that, in addition to moderate to severe cases, individuals with mild or asymptomatic infections may also experience Long COVID, with symptoms sometimes lasting up to four months.
According to outpatient statistics, the most common Long COVID symptoms include respiratory issues, followed by fatigue, and cognitive dysfunction, often referred to as "brain fog," which ranks third.
This can lead to memory impairment and difficulty concentrating, subsequently affecting work and daily life.
Sometimes, individuals are unaware that they have Long COVID, and the impact of cognitive dysfunction can lead to a decline in work performance, increasing mental and physical stress, which may trigger the recurrence of mental health disorders.
Some individuals who contracted COVID-19 may only experience mild respiratory symptoms such as a cough.
After a telehealth consultation and adhering to medication, they may recover within a week, only to later experience difficulties in clearly expressing their thoughts and a decline in physical stamina.
Athletes often feel fatigued and worry about missing competitions, leading to insomnia.
Individuals who have recovered from COVID-19 may still face mental and physical stress between family life and work arrangements, losing balance and continuing to experience symptoms such as insomnia, fatigue, restlessness, anxiety, depression, and cognitive dysfunction, which should prompt consideration of Long COVID.
Moreover, among patients experiencing Long COVID symptoms, women are more likely to encounter complications related to mental health, emotions, endocrine issues, and fatigue.
Maintaining a regular exercise routine, normal sleep patterns, adequate rest, and practicing self-relaxation can help mitigate concerns about how long Long COVID may affect them.
If related symptoms persist for more than a month without improvement, it is advisable to seek professional medical assistance to prevent the emergence of more complex issues, especially for those with pre-existing mental health conditions, who may be more susceptible to relapse.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, anesthesia-free, highly safe treatment option that does not require hospitalization.
It can improve anxiety and depressive symptoms, showing significant improvement in patients with treatment-resistant depression or those unable to tolerate medication side effects after rTMS treatment.
Our clinic offers outpatient services from Monday to Friday, both in the morning and afternoon.
We recommend that you consider visiting our facility for a personal evaluation of your symptoms by a physician, to collaboratively discuss the best course of action for you.
Wishing you good physical and mental health.

Reply Date: 2023/12/10

More Info

It sounds like you're going through a very challenging time, and I want to acknowledge the pain and confusion you're experiencing. Sudden mood swings and self-harm behaviors, such as hitting yourself or slapping your face, can be distressing and are often signs that something deeper may be going on emotionally or psychologically. It's important to understand that these behaviors are not just a phase or something to dismiss lightly; they can indicate underlying mental health issues that deserve attention and care.

Self-harm is often a coping mechanism for emotional pain, frustration, or overwhelming feelings. It can provide a temporary sense of relief or release, but it does not address the root causes of your distress. Instead, it may lead to a cycle of negative emotions and further self-harm, which can be harmful both physically and mentally. The fact that you feel worse when others laugh at your actions suggests that you may be struggling with feelings of isolation or misunderstanding, which can exacerbate your emotional turmoil.

It's crucial to consider seeking professional help. A mental health professional, such as a psychologist or psychiatrist, can provide you with a safe space to explore your feelings and behaviors without judgment. They can help you understand the triggers for your mood swings and self-harm, and work with you to develop healthier coping strategies. Therapy can also help you build self-esteem and improve your relationship with yourself, which is essential for emotional well-being.

In addition to therapy, there are several strategies you can implement to help manage your emotions and reduce self-harm urges. Here are a few suggestions:
1. Identify Triggers: Keep a journal to track your mood changes and any events or thoughts that precede your self-harm behaviors. Understanding what triggers your emotional responses can help you anticipate and manage them better.

2. Develop Healthy Coping Mechanisms: Instead of resorting to self-harm, try finding alternative ways to cope with your feelings. This could include physical activities like exercise, creative outlets like drawing or writing, or relaxation techniques such as deep breathing or meditation.

3. Reach Out for Support: Talk to someone you trust about what you're going through. This could be a friend, family member, or a mental health professional. Sharing your feelings can help alleviate some of the burdens you're carrying.

4. Practice Self-Compassion: Be gentle with yourself. Recognize that it's okay to feel sad or overwhelmed, and that seeking help is a sign of strength, not weakness. Treat yourself with the same kindness you would offer to a friend in a similar situation.

5. Establish a Routine: Having a daily routine can provide structure and stability, which may help reduce feelings of chaos and unpredictability in your emotions.

6. Limit Exposure to Negative Influences: If certain environments or people contribute to your feelings of sadness or self-harm, consider setting boundaries to protect your mental health.

In conclusion, your feelings and behaviors are valid, and it's essential to seek help when you're struggling. You deserve support and understanding as you navigate these challenges. Remember, reaching out for help is a courageous step towards healing and finding healthier ways to cope with your emotions. If you feel overwhelmed, please consider contacting a mental health professional or a crisis hotline for immediate support. You are not alone in this, and there are people who want to help you.

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