Managing Mood Swings in Older Adults

Have you noticed your elderly loved one go on a tangent or burst out in tears seemingly out of nowhere? And later on, they return to a cheerful mood as if nothing had happened? As their caregiver or child, it can be difficult to understand what’s going on. Without understanding, it can be easy to dismiss mood swings as part of “normal aging,” but that’s entirely false. Severe emotional shifts can be a sign of an underlying health issue that needs to be addressed.

Key takeaways

• Mood swings in the elderly can be a sign of underlying medical, emotional, or cognitive problems that require attention.
• Sudden or persistent mood changes—particularly those that affect daily functioning—should prompt a conversation with a healthcare provider.
• Compassionate support, environmental adjustments, and professional mental healthcare can make a meaningful difference for both seniors and their caregivers.

What causes mood swings in the elderly?

Mood swings in older adults can occur for several reasons, ranging from medical conditions to grief.

Biological and physical factors

Underlying chronic health problems may contribute to sudden mood swings in the elderly, including issues like:

• Urinary tract infections (UTIs): UTIs may trigger or worsen delirium in older adults, leading to sudden changes in mood. Delirium is a sudden mental state of confusion, hallucinations, memory problems, and mood changes in the elderly.
• Diabetes: If your loved one frequently has unstable blood sugar levels, their diabetes can cause mood swings. Research also shows that older people with diabetes have significantly higher rates of depression, which can cause rapid mood changes.
• Thyroid problems: A thyroid imbalance can contribute to sudden mood swings in the elderly. Unbalanced hormone levels can affect brain function in older adults, leading to anxiety, depression, and irritability.
• Chronic pain: Seniors frequently report chronic pain from various medical conditions. Research shows that persistent pain can be a risk factor for anxiety and depression. 

Medications

Many older adults are taking multiple medications to manage their health. Polypharmacy—regular use of five or more medications simultaneously—may cause side effects like anxiety or excitability. Certain prescription drugs may also cause sudden mood swings in the elderly, including:

• Anesthetics
• Anticholinergics 
• Amphetamines 
• Barbiturates 
• Corticosteroids
• Digoxin 
• Levodopa 
• Metronidazole 
• Opioids 
• Thiazide diuretics 

Cognitive decline

One of the primary symptoms of dementia is mood swings. According to research, mood disturbances, such as weeping, explosive outbursts, and elevated mood, are common among older adults with dementia.

In some cases, sudden mood changes in seniors can be an early sign of Alzheimer’s. Your loved one may experience mood swings before more prominent signs of the disease, such as memory loss or confusion. Research suggests that this type of mild behavioral impairment (MBI), can be a crucial early indicator of Alzheimer’s.

Emotional factors

Loss of independence can contribute to extreme mood swings in the elderly. No longer being able to take care of themselves can leave some seniors feeling frustrated and ashamed. 

Microgrief may also lead to mood swings in later life. Microgriefs are the small, often unnoticed losses that accumulate over time, but have a large emotional impact on seniors. The ongoing loss of friends, neighbors, or life partners, the gradual decline of physical function, and loss of identity or role are all manifestations of microgrief. Over time, these losses can lead to extreme mood swings. 

Gender differences

Gender may also play a role in how sudden mood changes manifest in older adults. Mood swings in older females often stem from hormonal shifts that occur during perimenopause and menopause. The risk of depression and anxiety also increases during this transition, which can contribute to elderly mood swings.

Hormonal shifts can also be the cause of mood swings in older men. Research shows testosterone levels may cause sudden changes in mood, such as feelings of hopelessness, anxiety, and even suicidal thoughts. Older men may also feel frustrated about their declining physicality and their inability to be the family's provider.

What mood swings can look like in seniors, and when to worry

Mood changes in the elderly aren’t always a sign of an underlying mental health problem. Maybe your loved one is just having a bad day and is experiencing a mix of emotions. It’s when the mood swings are persistent and abrupt that there’s a cause for concern.

Here’s how you can distinguish between a typical bad day and extreme mood swings.

Having a bad day:

• Feels off, low-energy, or emotionally flat for a day or two
• More sensitive, quiet, withdrawn, or easily overwhelmed
• Mood linked to a clear reason (poor sleep, pain flare, stress, illness, bad news)
• Mood improves with rest, routine, or support
• Daily tasks may feel more challenging but still manageable
• Person is aware they’re “just having a rough day”
  
  

Concerning mood changes

• Emotional changes last days or weeks
• Noticeable shifts in personality or behavior
• Mood changes seem unrelated to current circumstances
• Little or no improvement despite rest or support
• Daily functioning, self-care, or routine decline
• Limited insight or confusion about emotional changes

Sundowning and mood swings in the elderly

Some children and caregivers notice that the mood swings are more intense at certain times of the day. This experience is likely a sign of sundowning or sundowner’s syndrome. Sundowning is increased confusion, disorientation, agitation, and aggressiveness in the late afternoon, evening, or at night. It’s very common among older adults with dementia, and likely caused by cognitive impairment, circadian rhythm disruption, and social and environmental factors.

Gradual vs. rapid mood changes in seniors

Loved ones of older adults need to know the differences between gradual and rapid mood swings in the elderly. Gradual shifts in mood can be a regular part of aging, while sudden or ongoing mood changes may signal something else is going on.

Here’s a closer look at how gradual and rapid mood changes can differ in older adults.

Gradual mood changes

• Develop slowly over weeks or months
• Feel like a steady shift over time
• Tend to persist or slowly worsen
• More often linked to ongoing issues (anxiety, depression, chronic illness, long-term stress)
• May be explained away as aging or life changes
  
  

Rapid mood changes

• Happen suddenly—within hours or a day
• Feel abrupt or out of character
• May come and go quickly
• Can be linked to short-term issues (medication, infection, sleep disruptions, sudden stress)
• Usually trigger a clear “something’s off” feeling

When to seek medical help for mood swings in older adults

Below are signs that your senior loved one’s sudden mood changes may need medical attention:

• Emotional shifts last more than a couple of weeks
• Withdrawal from activities, relationships, or routines they once enjoyed
• Increased confusion, disorientation, or memory issues
• Changes in sleep, appetite, or energy levels that don’t seem to improve
• Mood changes following a new medication, dosage change, illness, or hospitalization
• Heightened fearfulness, anxiety, or emotional distress
• Sudden aggression towards others
• Threats of self-harm or harm to others

How to help an older adult struggling with mood swings

If you’ve noticed extreme mood swings in your loved one and believe there’s an underlying problem causing them, the first step is to ask them what’s going on. Are they in pain? Are they hungry? Is their living environment too loud? Asking these questions can rule out other potential causes to help you get to the root of the problem.

If they’re in an active mood swing, here’s what you should (and shouldn’t) do in that moment:

Do:

• Stay calm and patient 
• Listen without trying to correct or minimize how they feel
• Acknowledge their emotions
• Offer suggestions, not demands, to support their independence
• Check in on how they’re feeling over time
• Make environmental changes, such as creating soft lighting or decluttering the living space
• Get a healthcare provider involved if changes persist or worsen

Don’t:

• Dismiss their feelings as part of “aging” or having a “bad attitude”
• Argue, correct, or pressure them to “snap out of it”
• Take mood changes personally
• Ignore sudden or severe changes
• Change medications or routines without medical guidance
• Wait too long to seek professional help if something feels off

Small and steady support strategies can make a world of difference—but it’s best to seek professional help for persistent or sudden mood changes.

Self-regulation tips for caregivers supporting an older adult with mood changes

As you take practical steps to support someone dealing with intense mood swings, it’s important that their behavior doesn’t negatively impact you, too.

Below are some self-regulation tips you can adopt to protect your mental health:

• Pause before responding: Take slow breaths to reset your nervous system.
• Lower your voice: A calm tone can help de-escalate their emotions.
• Remind yourself it’s not personal: Even though their behavior may feel directed at you, know they don’t mean any harm.
• Validate their feelings: You can acknowledge how they feel without agreeing with them.
• Seek support: Caregiver burnout can make self-regulation harder for yourself and your loved one—make sure you’re getting support, too.

The role of senior therapy in managing moods

Therapy can help seniors identify the underlying causes of their sudden mood changes and work with them to address them. If they’re living with untreated anxiety or depression, therapy can be an outlet for older adults to have an open conversation that they might not feel comfortable sharing with their children or caregiver.

Cognitive behavioral therapy (CBT) can help seniors identify their emotions and adopt coping strategies for better emotional regulation. CBT can be adapted to meet the needs of seniors, focusing on age-related issues such as life transitions, grief, and legacy. 

If your loved one has Medicare, mental health therapies like CBT should be covered by their plan. Medicare coverage for therapy can make getting support for mood swings much more accessible and affordable for seniors. 

Benefits of teletherapy

Mobility challenges and fears of being stigmatized can keep some older people from seeking mental health support. Virtual therapy can be an excellent option, as it can:

• Access care without travel, stairs, or transportation problems
• Receive support from the privacy and comfort of home
• Avoid discomfort or stigma from being seen entering a mental health office
• Attend appointments despite pain, fatigue, or limited mobility

If you’re seeking support for elderly mood swings, Sailor Health can help. We offer telehealth via computer, phone, or even landline. Plus, most of our Medicare patients have a $0 copay. We’re here to provide exceptional mental health care to seniors, including strategies and tools for managing mood swings. Get started today. 

Elderly mood swings FAQ

Here are answers to a few common questions families and caregivers have about mood swings in older adults.

Can mood swings in older adults be a sign of depression? 

Yes. Mood swings can be a significant indicator of depression in seniors.

Do mood swings get worse with age? 

Yes. Mood swings can become more frequent or worsen as people age due to a mix of biological changes, chronic health problems, medication side effects, and life stressors.

Can mood swings in older adults be temporary?

Yes. Some mood changes are short-term and tied to stress, illness, poor sleep, or changes in routine. If moods return to baseline within a few days and don’t interfere with daily functioning, they may resolve on their own. Ongoing or worsening mood swings are more likely to need medical or mental health support.

Should I talk to my loved one about their mood swings, or wait?

It’s usually better to talk sooner rather than later, especially if the changes feel out of character. Choose a calm moment, avoid blame, and focus on concern rather than behavior. Opening the conversation early can help identify issues like pain, fear, or emotional distress before they escalate.

References

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