How to manage mood swings and impulsive behavior in an 18-year-old?

Question

Hello doctor,

I suffer from really intense mood swings, alternating between high moods and normal moods. I cannot remember what happens between them, it is like a fever dream I would say. I do not have stable relationships as they involve impulsive behaviors as well as anger towards loved ones. I am unable to control it but I keep getting angry with them and then immediately regret it. I have also been self-harming because I cannot control myself anymore. I am 18 years old and still in high school but it seems I cannot find a place there. I cannot trust people because I am afraid they will leave me someday, even in the late future maybe tomorrow or next week. I just tend to think not in the present but future as I am scared to be abandoned and always think of alternatives that should avoid to keep people around me but I do not always succeed. Lastly, not for a couple of months but for months, I have been struggling with self-esteem a lot, I tried multiple things to not overthink about it and just do something like trying to fix my self-esteem but I always hit rock bottom. My question is, is it really serious and I should see a psychiatrist in real life? I have visited some therapists but I just cannot help it, I think I do not trust people that easily, and I find it hard to talk about myself, my needs, and how I am feeling, just in general. Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

You may have a borderline personality disorder. It is a type of personality, nature. You may have a chronic feeling of emptiness, emotional outbursts, overwhelming behavior, and self-harming behavior. You mostly feel that no one understands you in this world. You may have difficulty keeping the relationship for a long time. You may have frequent job-related issues. You may have anger outbursts. There is non-pharmacological management for it. You should try to follow the below guidelines-

You should do exercises daily for 30 to 45 minutes like at least going for a walk.
You should do meditation for 20 minutes daily, just sit in one place in a comfortable position, and try to concentrate on your normal breathing, do not stop or force yourself to stop your thoughts, just let it be. This will help you to relax.
You should eat healthy home-cooked foods, and avoid junk foods.
You should spend quality time with friends and family daily or do video calls if you are living away from your family.
You should spend time on creative hobbies like reading good books, writing journals, painting, drawing, and learning new skills, languages, or musical instruments.
You should take seven to eight hours of sleep daily.
You must avoid tobacco alcohol or any substance abuse.
Live your life, do not just spend it.
Be bold and confident.
You can start capsule Fluoxetine 20mg daily in the morning after breakfast.

I hope that this will help you.

Thank you.