Why Your Mood and Energy Levels Fluctuate—and How to Find Stability

Do you ever feel like you are on an emotional rollercoaster while everyone else seems steady? One week, you are unstoppable—bursting with energy, juggling work, family, and everything else. The next, you are exhausted, unfocused, and struggling to enjoy things you normally love. If this sounds familiar, you are not alone—and it is not “just depression” or “just anxiety.”

What if there was a name for this? I call it Mood Variability Disorder (MVD)—a pattern I have seen in many patients that does not fit any single diagnosis.

What Exactly is Mood Variability Disorder (MVD)?

Many people with MVD also have Attention Deficit Hyperactivity Disorder (ADHD). As an ADHD specialist, I often see the emotional ups and downs that can come with ADHD—like struggling to manage strong emotions or experiencing sudden mood shifts. But MVD goes beyond ADHD or “poor coping skills.” It is a unique pattern that does not fit neatly into any mental health category.

Living with MVD is like playing a game where the rules keep changing. One week, you are full of energy and focus; the next, you are drained and struggling. It does not quite match ADHD, depression, generalized anxiety, OCD, or bipolar disorder. Instead, MVD has its own cycle—like April weather: bright and sunny one week, stormy and low-energy the next. This constant shifting makes MVD unique, with moods and energy that never quite settle for long.

Why Mood Variability Disorder (MVD) Needs a Name

After years of seeing patients with symptoms that do not fit standard mental health categories, I coined “Mood Variability Disorder.” MVD is common but often overlooked and misunderstood. In my work with adult ADHD, I’ve found that ADHD alone does not explain the intense mood swings, fluctuating energy, waves of anxiety, and obsessive thoughts that many people experience. MVD often appears alongside ADHD but brings unique challenges that require a different approach.

When I suggest mood stabilizers like low-dose lithium or Lamictal, patients often ask, “But do I have bipolar disorder?” Others may not ask but leave worried about the stigma around bipolar disorder. Bipolar is often misunderstood as “crazy” or “untreatable,” when in reality, many people with bipolar disorder live stable, successful lives. These misconceptions make patients hesitant to try mood stabilizers that could help.

This is why MVD needs a name. Recognizing MVD helps people understand their symptoms, validates their experience, and leads to more effective, targeted treatment. While antidepressants like Zoloft, Prozac, or Effexor may help briefly, they often stop working, leaving patients less anxious or depressed but feeling flat, disconnected, and unable to find joy. Key risk factors like early mood or anxiety symptoms, a family history of mood or substance-use disorders, suicide attempts, or hormonal changes can also indicate a higher likelihood of MVD. It’s time to bring MVD into the light and support those who live with it daily.

Key Signs of Mood Variability Disorder (MVD)

Are you wondering if MVD might apply to you or someone you know? Here are some key signs:

• Mood Phases: Do you feel clear-headed and motivated one week, only to feel down, disconnected, or irritable the next?

• Anxiety Swings: MVD brings anxiety in waves. One week, you’re calm; the next, you’re overwhelmed with worry or panic.

• Sleep and Energy Rollercoaster: During the “up” phases, insomnia might keep you up; in the “down” phases, you feel drained and need extra rest.

• Periods of Stability: Sometimes, you have “normal” weeks where everything feels balanced, tricking you (and others) into thinking everything is fine—until the cycle starts again.

How MVD, ADHD, and OCD Connect—and When They’re Separate

Many people with MVD experience symptoms similar to ADHD or even OCD. However, with MVD, these symptoms come and go in cycles rather than persisting. You might find yourself obsessing over details or needing everything “just right” during high-energy phases, only for these urges to fade as your mood shifts. In some cases, ADHD or OCD can exist as a separate diagnosis, but for those with MVD, these traits appear and disappear along with mood fluctuations.

Why “Just Take an SSRI” Isn’t the Answer

People with MVD are often prescribed SSRIs like Zoloft or SNRIs like Effexor, but these medications were designed for steady anxiety or depression, not MVD cycles. They frequently work briefly, only to lose their effect, leaving patients feeling flat or disconnected.

Why Mood Stabilizers Can Be a Better Fit

Mood stabilizers like low-dose lithium or lamotrigine (Lamictal) often work better for MVD, and no, it doesn’t mean you have bipolar disorder. When I suggest mood stabilizers, some people worry: “Am I going to end up like my father, who was in and out of hospitals?” The answer is no.

Mood stabilizers are simply tools for managing cyclical symptoms. Unlike antidepressants, which are designed to treat steady depression or anxiety, mood stabilizers help with MVD’s highs and lows without dulling emotions. Recognizing that mood stabilizers can help with MVD offers relief that doesn’t require years of trial and error.

What Works for MVD?

In my experience, mood stabilizers like lamotrigine (Lamictal) or low-dose lithium often provide better outcomes for MVD than traditional antidepressants or anti-anxiety medications.

Better Options for Mood Variability:

• Lamotrigine (Lamictal): Reduces depressive and anxiety symptoms without emotional blunting.

• Low-Dose Lithium: Known for neuroprotective effects, it stabilizes mood and energy without intense side effects.

• Emerging Options: Low-dose ketamine or psilocybin are being explored for those who don’t respond to traditional medications.

Mood Variability Disorder: A New Approach to Mental Health

Mood Variability Disorder (MVD) represents a more thoughtful, nuanced approach to mental health. It’s not about adding more medications but about seeing the big picture, challenging outdated assumptions, and helping people find relief without years of trial and error.

If you or someone you know recognizes these patterns, know that effective treatments and support are available. MVD is real, and stability is possible—you don’t have to navigate the ups and downs alone.