Mood stabilizers are a class of medications designed to help regulate mood swings and maintain emotional balance in individuals with mood disorders.
They are most commonly used to treat conditions like bipolar disorder, where a person experiences alternating episodes of depression and mania or hypomania. By stabilizing the brain’s chemical signaling, these medications help prevent extreme highs and lows, reduce the risk of impulsive behaviors during manic episodes, and reduce the severity of depressive episodes [1].
While mood stabilizers do not cure mood disorders, they are an essential tool in managing symptoms and improving overall quality of life.
Understanding Mood Disorders
Mood disorders are mental health conditions that affect a person’s emotional state, often causing long periods of sadness, irritability, or elevated moods that interfere with daily life. These disorders go beyond the typical ups and downs of life, impacting relationships, work, and overall health.
In the United States, approximately 21 million adults experience a major depressive episode each year, and bipolar disorder affects roughly 2.8% of adults [2]. Common types of mood disorders include:
- Major Depressive Disorder (MDD): Persistent sadness or loss of interest in daily activities, often accompanied by fatigue, sleep changes, and difficulty concentrating.
- Bipolar Disorder: Alternating episodes of depression and mania or hypomania, involving elevated mood, increased energy, and risky behaviors.
- Persistent Depressive Disorder (Dysthymia): Chronic, milder depression lasting at least two years.
- Seasonal Affective Disorder (SAD): Depression related to seasonal changes, commonly occurring in fall and winter due to reduced sunlight.
- Cyclothymic Disorder: A milder, chronic form of bipolar disorder with fluctuating mood swings that don’t meet full criteria for mania or major depression.
Types of Mood Stabilizers
There are three primary kinds of mood stabilizers, each with its own mechanisms of action [3].
| Mood Stabilizer | How They Work | Primary Uses |
| Lithium (Lithobid, Eskalith) | Regulates neurotransmitter activity and stabilizes neuron signaling to reduce mood swings | Bipolar disorder (mania and depression) |
| Anticonvulsants | Calms the overactive brain by signaling sodium, calcium, and GABA pathways in the brain | Bipolar disorder, seizure disorders |
| Atypical Antipsychotics (Seroquel, Abilify) | Regulated serotonin and dopamine activity to stabilize mood | Bipolar disorder, acute mania, bipolar depression |
How Do Mood Stabilizers Work?
Mood stabilizers help regulate abnormal brain activity that contributes to extreme emotional states, such as mania and depression. They act on neurotransmitters, the chemical messengers in the brain, to balance signaling in neural circuits that control mood, energy, and cognition.
For example, lithium is believed to strengthen neuronal connections and normalize the activity of neurotransmitters like serotonin, dopamine, and glutamate, helping prevent the intense highs and lows seen in bipolar disorder.
Anticonvulsant mood stabilizers, such as valproate, lamotrigine, and carbamazepine, work by calming overactive neural pathways that contribute to mood instability. Atypical antipsychotics, another class of mood stabilizers, regulate dopamine and serotonin activity in key brain regions, stabilizing mood while also helping with agitation or irritability that can accompany bipolar disorder [3].
How Are Mood Stabilizers Different Than Antidepressants?
Unlike standard antidepressants, which primarily increase serotonin (SSRIs) or both serotonin and norepinephrine (SNRIs) to elevate mood, mood stabilizers focus on overall regulation of brain activity rather than simply boosting one neurotransmitter.
Antidepressants are most effective for treating depressive episodes, but they can sometimes trigger mania in individuals with bipolar disorder if used alone. Mood stabilizers address both the highs and lows, making them essential for long-term management of bipolar disorder and other mood dysregulation conditions.
Common Side Effects of Mood Stabilizers
Mood stabilizers are essential for managing conditions like bipolar disorder, but like all medications, they can cause side effects. The type and severity of side effects often depend on the specific medication, dosage, and individual response.
Commonly reported side effects tend to go away after a week or two of taking mood stabilizers and may include:
Lithium:
- Dry mouth
- Hand tremors
- Weight gain
- Nausea or upset stomach
- Fatigue
- Increased thirst and urination
- Mild cognitive slowing or fatigue
Anticonvulsants:
- Drowsiness or dizziness
- Nausea or vomiting
- Tremors or unsteadiness
- Skin rashes
- Changes in liver function
Atypical Antipsychotics:
- Weight gain and increased appetite
- Sedation or drowsiness
- Restlessness, agitation
- Changes in blood sugar and cholesterol
Are Mood Stabilizers Addictive?
Mood stabilizers do not cause physical dependence and are not addictive in the traditional sense. But people who take them for long-term often experience uncomfortable side effects when stopping the drug due to the brain readjusting.
Symptoms also often come back. It’s always important to speak with your doctor before starting a new medication, stopping, or adjusting the dose of your mood stabilizer.
How Do I Know If I Need Mood Stabilizers?
Mood stabilizers should only be taken under the supervision of a medical professional. The decision to be put on a mood stabilizer is discussed between you and your provider, and depends on factors such as:
- Your diagnosis and the severity of your symptoms.
- What medications have you tried in the past
- Your medical history, including kidney, liver, or heart conditions
- Other medications or supplements you are on to assess for interactions
- Your age and overall physical health
- If you are pregnant, planning to get pregnant, or breastfeeding, mood stabilizers can affect fetal development and are typically avoided
Evidence-Based Mental Health Treatment for Mood Disorders in Utah
At Maple Mountain Mental Health and Wellness, our compassionate team of clinical psychiatrists and experienced therapists is committed to providing supervised psychiatric care and behavioral interventions to help adults recover from mood disorders and other mental health challenges.
Through a holistic, blended approach, we address each aspect of your health and recovery needs to support long-term healing. Contact our admissions team for trusted support.
Sources
[1] Cleveland Clinic. 2024. Mood Stabilizers.
[2] NAMI. 2020. Mental Health by The Numbers.
[3] Nath, M. et al. Mood Stabilizers.
