Emotional Symptoms: What They Are and What Causes Them

Emotional symptoms: definition

In medicine, symptoms are often grouped into four kinds:

• Emotional: how you feel (sad, anxious, angry, empty)
• Cognitive: how you think (poor concentration, memory problems, negative or racing thoughts)
• Physical: what happens in your body (tiredness, sleep change, appetite change, aches)
• Behavioral: what you do (withdrawing, crying, drinking more, snapping at people)

An emotional symptom is a feeling state that is out of proportion to the situation, persists, or gets in the way of daily life. Feelings themselves are not symptoms. Grief after a death, nerves before an exam and anger at an injustice are healthy responses. They become symptoms when their intensity, duration or effect on functioning crosses a line.

Examples of emotional symptoms

What causes emotional symptoms

Stress and life events

Job loss, money worries, relationship breakdown, caring for someone, bullying or a major illness commonly cause anxiety, low mood and irritability. When symptoms start within 3 months of a stressor and are more intense than expected, doctors may diagnose an adjustment disorder. Symptoms usually ease within 6 months as the situation resolves.

Grief

Bereavement brings sadness, yearning, guilt, anger and numbness in waves. Normal grief does not need treatment. Grief that stays intense and disabling beyond about a year may be prolonged grief disorder. See our page on grief reaction.

Mental health conditions

• Depression: low mood or loss of interest on most days for at least 2 weeks, with sleep and appetite change, tiredness, poor concentration and guilt.
• Anxiety disorders: excessive worry (generalized anxiety disorder), panic attacks, social fear or phobias.
• Bipolar disorder: periods of depression alternating with highs (mania or hypomania).
• PTSD: fear, numbness, irritability and flashbacks after a traumatic event.
• Personality disorders: long-standing patterns of intense, unstable emotions.

Hormonal causes

• Premenstrual syndrome and PMDD: irritability, low mood and anxiety in the 1 to 2 weeks before a period that lift within a few days of bleeding.
• Pregnancy and after birth: baby blues in the first 2 weeks; postpartum depression or anxiety afterward.
• Perimenopause: mood swings, anxiety and low mood alongside hot flashes and irregular periods.
• Thyroid disease: an underactive thyroid (hypothyroidism) causes low mood and sluggishness; an overactive thyroid causes anxiety and irritability.

Other physical causes

• Long-term illness and pain, including heart disease, diabetes, cancer and multiple sclerosis
• Vitamin B12 or folate deficiency, anemia
• Neurological conditions: stroke, Parkinson's disease, dementia, head injury
• Sleep deprivation and sleep apnea

Alcohol, drugs and medicines

Alcohol is a depressant, and hangovers cause anxiety ("hangxiety"). Cannabis, stimulants and withdrawal from many substances cause mood swings. Medicines that can affect mood include corticosteroids, isotretinoin, some blood pressure medicines, hormonal contraceptives in some people, and interferon.

Physical and emotional symptoms of stress

Stress rarely stays in the mind. Common physical companions of emotional symptoms are:

• tiredness and poor sleep
• headaches and muscle tension
• stomach upset, nausea and bowel changes
• a racing heart, chest tightness and sweating
• appetite and weight changes
• reduced sex drive

When physical symptoms dominate, people often see a doctor about their body before anyone asks about mood.

When emotional symptoms need help

Seek help if:

• symptoms last most days for 2 weeks or more
• they affect work, study, relationships or self-care
• you are using alcohol or drugs to cope
• friends or family are worried about you
• you have any thoughts of self-harm or suicide

How doctors assess emotional symptoms

A primary care doctor or mental health professional will ask what you are feeling, how long it has lasted, what is happening in your life, and about sleep, appetite, energy, alcohol and drugs, medicines and family history. Short questionnaires such as the PHQ-9 (depression) and GAD-7 (anxiety) measure severity and track progress. Blood tests may check thyroid function, blood count, B12 and blood sugar when a physical cause is possible.

Treatment and self-help

• Talking therapies: cognitive behavioral therapy (CBT) is effective for depression and anxiety. Other options include interpersonal therapy, behavioral activation and trauma-focused therapy.
• Medicines: antidepressants such as SSRIs help moderate to severe depression and anxiety disorders. Mood stabilizers treat bipolar disorder.
• Treating physical causes: correcting thyroid problems, deficiencies or medicine side effects can resolve symptoms.
• Self-help that has evidence: regular physical activity, consistent sleep times, limiting alcohol, staying connected with people, and structured problem-solving for practical stressors.

Frequently asked questions

What is the definition of emotional symptoms?

Emotional symptoms are changes in feelings and mood, such as persistent sadness, anxiety, irritability, guilt, numbness or loss of pleasure, that are stronger or longer-lasting than expected and interfere with daily life. They are distinct from physical, cognitive and behavioral symptoms, though they often occur together.

What are examples of emotional symptoms?

Common examples include feeling sad or empty, constant worry, irritability, anger outbursts, guilt, hopelessness, mood swings, feeling numb and losing interest in things you used to enjoy. Panic attacks and feeling overwhelmed are also emotional symptoms.

Can a physical illness cause emotional symptoms?

Yes. Thyroid disease, anemia, vitamin B12 deficiency, chronic pain, heart disease, stroke, Parkinson's disease and hormonal changes can all cause low mood or anxiety. Some medicines, such as steroids, can too. A doctor may order blood tests to look for a physical cause.

How long is too long to feel low?

If low mood, loss of interest or anxiety is present most of the day, nearly every day, for 2 weeks or more, it is worth seeing a doctor. Seek help sooner if symptoms are severe, affect your daily life, or you have thoughts of harming yourself.

Where can I get help right now?

If you are thinking about suicide or are in crisis, call or text 988 in the US to reach the Suicide and Crisis Lifeline, or call 911 or your local emergency number if you are in immediate danger. For ongoing symptoms, your primary care doctor is a good first contact.