The Makers of Mood

From anxiety to borderline personality disorder, OCD, and PTSD, mood instability is a shared feature of psychiatric conditions and may even be the first sign of their onset. But sudden mood changes are scarcely the stuff of clinical settings. Many people find themselves jouncing about the jagged edges of their emotions in everyday life.

Characterized by mood swings, emotional impulsiveness, and rapid oscillation of intense affect, mood instability involves relentless reactivity to psychosocial cues. It is not only socially disruptive but precludes sustained
attention and impairs cognition, making daily life a roller coaster of unpredictability.

Affective instability may transform mundane events into a perpetual drama, but it does not bode well mentally or physically. It is related to neuroticism, depression, anger, and other signs of psychic disorder, as well as to low self-esteem. Physically, it may augur cardiovascular conditions, triggered via shared neural networks.

The underlying problem, researchers believe, is impaired or ineffective affect regulation, the inability to down-regulate overly intense experiences. People normally deploy an array of strategies to regulate their emotions, but the most common, and certainly the best-studied, are reappraisal and suppression.

Reappraisal requires cognitive re-evaluation of the emotion-eliciting situation and usually results in lower levels of negative emotions, higher levels of positive ones, and mood stability. Studies show it requires energizing the brain’s executive control center in the prefrontal cortex, which dampens the activity of the amygdala. Suppression consists of inhibiting behavioral expression of emotions.
Studies link a number of factors to mood instability.

Sleep—both getting a sufficient amount of high-quality sleep and getting it consistently—may be the most significant contributor to mood stability. Sleep directly affects mood and lack of it undermines the capacity for emotion control.
For one thing, irregular sleep disrupts circadian rhythms. Like every body process, all the neurochemicals and hormones that influence mood wax and wane on their own circadian schedules. Disrupting the actions of all those brain players leads to systemic irritability, susceptibility to stress, and, likely, low-grade inflammation, another path to mood instability.
Dampening executive control leaves the emotion-inflaming amygdala untamed, and studies show that not only is amygdala activity increased in people with insomnia but it particularly impedes the ability to control negative feelings and heightens sensitivity to negative experience.

Physical activity is another major player; lack of movement has been shown to correlate with mood instability. Activity lays the groundwork for neural plasticity, literally structurally beefing up regions of the executive cortex involved in reappraisal; it also contributes to high-quality sleep. Aerobic activity refreshes executive control, strengthening inhibitory capacity to down-regulate negative emotions.

Social life is an important everyday influence on mood, and in the absence of social connection, mental health suffers in myriad ways. Most emotion regulation takes place in social contexts to influence social functioning. Whether between couples, parents and children, or coworkers, it is interpersonal and dynamic by nature, engaging processes of empathy, attention, cognitive reappraisal, and modulation of response.

Heart rate, specifically heart rate variability— the capacity of the heart to adjust beat-to-beat to the ever-changing demands of everyday life—is another indicator of the capacity for emotion regulation. Heart rate variability reflects vagal tone, a marker of both physiological and behavioral adaptability—and of general health. Heart rate is related to emotion regulation capacity because the vagus nerve, responsible for calming the body, is connected to the same neural network involved in emotion regulation. Critically, heart rate variability reflects the inhibitory capacity of the prefrontal cortex, a sine qua non for emotional stability.

Diet Moment to moment, staying on an even keel requires the skills of emotion regulation. Longer term, a diet rich in omega-3 long-chain polyunsaturated fatty acids plays a significant role in assuring the stability of underlying brain processes.
Many psychiatric conditions—depression and bipolar disorders may be the most studied—are associated with a deficiency in omega-3 fats, which are most abundant in cold-water fish. These disorders are also associated with low-grade inflammation. Epidemiological studies report an inverse association between oily fish intake and seafood generally and the prevalence and incidence of major depression and bipolar disorders. Low levels of fatty acids have been found in the red blood cell membranes of patients with major depression.

Omega-3 fats are crucial for the structure, organization, and integ-rity of all cell membranes but especially in the brain. They modulate all neurobiological processes and gene expression and especially influence neural communication within and between cells. In addition, the two most prominent omega-3 fats in the brain—DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid)—are metabolized to major anti-inflammatory substances. Further, both are precursors for endocannabinoids, known to affect mood.

In animals, neuroplasticity—the generation of brain cells and connections—is positively associated with omega-3 fat intake. And in humans, omega-3 intake correlates with gray matter volume, notably in brain areas linked to memory, mood, and emotion regulation.

Researchers report that increasing intake of omega-3 fats by supplementation is helpful even when started at a late age. It not only counteracts cognitive decline and brain atrophy but also protects against emotional dysregulation.

Mood Facts

Mood instability is reported in 40 to 60 percent of those with depression, anxiety disorder, post-traumatic stress disorder, and obsessive-
compulsive disorder.

• Mood instability occurs in 14 percent of the general population.
• Several studies have independently reported inverse associations between membrane levels of omega-3 fats and suicide attempts.
• Omega-3 fats are involved in maintaining the brain’s balance of neurotransmitter systems.
• Although the human body can convert plant sources of omega-3 fats into DHA and EPA, the conversion is inefficient in people consuming a typical Western diet.
• A Western diet provides an average 150 mg a day of fish-derived omega-3 fats —equivalent to one fish meal every 10 days.
• The National Institutes of Health has established the adequate intake of omega-3 fats from all sources at 1.6 grams a day for males and 1.1 grams for females age 14 and above.