Mood Swings, Irritability, and Difficulty Controlling Emotions: How They Relate to Substance Use

Written by the medical team at Day One Rehabilitation Center, Nakhon Nayok, Thailand · Medically reviewed by Dr. Pichayut Kasemphakdeephong (Psychiatrist)

Being easily irritated, moods swinging up and down, anger more explosive than usual, frequent arguments with family, or trouble controlling one’s own words and behavior are symptoms families of people who use substances often encounter. Some people seem in a good mood for a while, but before long turn irritable, don’t want to talk, or react intensely to small things.

These changes may be directly related to the effects of a substance — such as yaba, ice, alcohol, or cannabis — may occur once the substance wears off or during withdrawal, or there may be a pre-existing mental health condition, such as depression, bipolar disorder, anxiety disorder, ADHD, PTSD, or a certain pattern of difficulty regulating emotions.

On the other hand, some people start using substances because they feel it helps them stay calm, forget stress, feel bolder about speaking up, or temporarily stop racing thoughts. But with repeated use, the substance can instead make sleep, mood, and self-control worse, until what was once used to “improve mood” becomes part of the problem itself.

Families therefore shouldn’t just see it as the person’s “personality changing” or being “unable to control themselves” — they should look at how the mood changes relate to periods of using the substance, periods without it, sleep, stress, and any psychiatric condition, because clearly identifying the cause is an important starting point for treatment and for preventing relapse into substance use.

What Do Mood Swings From Substance Use Look Like?

The term “mood swings” doesn’t refer to any one specific condition — it’s a symptom that can arise from many causes. Changes families may notice include:

Being more irritable or quick to anger than before
Mood changing quickly and unpredictably
Reacting to minor things more intensely than usual
Being impatient, making quick decisions, or having trouble controlling what they say
More frequent arguments with family or a partner
Restlessness and difficulty sitting still
Insomnia or an irregular sleep schedule
Unusually high energy at times, but exhausted and unmotivated at others
Withdrawing, not wanting to talk, or feeling low once the substance wears off
Using the substance immediately when angry, stressed, disappointed, or after an argument with someone
Needing to use the substance to feel calm or feel like they’ve “returned to themselves”
Problems with school, work, finances, or relationships stemming from emotional control and substance use

These symptoms don’t always confirm that they’re caused by the substance, and they don’t mean everyone with mood swings has a psychiatric condition. Assessment must look at the timing of symptoms, the pattern of substance use, sleep, and prior mental health history together.

Why Do Drugs Cause Irritability and Difficulty Controlling Emotions?

Each substance affects mood differently, and even the same person’s symptoms can change depending on whether the substance is actively working, wearing off, or being withdrawn from.

Yaba and ice may make the user alert, energetic, talkative, restless, and sleep-deprived. In some people, this can bring irritability, impatience, or greater difficulty controlling behavior. With continuous use and several nights of sleep deprivation, decision-making and emotional control can decline significantly, and paranoia or psychotic symptoms can also occur.

Once the stimulant’s effects wear off, some people enter a period of extreme exhaustion, lack of energy, low mood, irritability, or lack of motivation. Families may therefore see a clear swing between periods of high alertness and periods of complete exhaustion.

Alcohol can reduce inhibition, making it easier for some people to say or do things they would normally be able to control. Heavy drinking can lead to arguments, risky decisions, or difficulty controlling behavior.

For people who drink continuously to the point of dependence, the period when alcohol levels in the body drop can bring irritability, anxiety, hand tremors, sweating, and insomnia. If alcohol dependence is severe, stopping suddenly can cause severe withdrawal, which should be medically evaluated.

Cannabis may make some people feel relaxed at first, but the effect varies from person to person. Some may become anxious, paranoid, or experience mood changes, and with regular use, reducing or stopping can bring irritability, insomnia, restlessness, or cravings to use again.

In addition, using multiple substances together makes the symptom pattern more complex, so families should tell the treatment team all the substances being used, not just the one they think is the main problem.

Are Mood Swings Caused by Drugs, or Is There a Co-Occurring Psychiatric Condition?

Irritability or quickly changing moods alone aren’t enough to say someone has bipolar disorder, depression, or another psychiatric condition, because similar symptoms can arise from substances, withdrawal, stress, and sleep deprivation.

The treatment team will look at when the symptoms began, whether they occurred before starting to use the substance, whether they occur only during use or withdrawal, and whether they still occur during periods when the person has been able to stop using the substance for a long time.

For example, if there’s a period of unusually good mood or irritability together with very high energy, sleeping very little without feeling tired, talking fast, racing thoughts, unusually high confidence, spending money, or engaging in risky behavior, bipolar disorder may need to be further assessed — it shouldn’t be concluded that this is simply “a bad mood from the drug.”

If there’s low mood, loss of interest in things once enjoyed, lack of energy, feelings of hopelessness, withdrawal, or thoughts and behaviors of self-harm, depression and safety must be assessed alongside this.

People with ADHD may have impulsivity and difficulty controlling their emotions, while people with PTSD may be irritable, easily startled, and feel as though they must be constantly on guard.

Some people have had problems with emotional control and relationships since adolescence or early adulthood, which may require further assessment of personality patterns.

It’s therefore possible that mood changes come directly from the substance, that a pre-existing psychiatric condition exists and the substance is being used to cope with its symptoms, or that both problems are occurring together. Monitoring symptoms after stopping the substance is therefore important for diagnosis.

Why Do Some People Use Substances to Control Their Emotions, and Why Does Using More Make It Harder to Stop?

For some people, substance use doesn’t start from wanting fun — it may start from trying to manage emotions that feel hard to bear.

Some drink when angry or stressed because they feel alcohol helps them stop overthinking. Some use cannabis when feeling overwhelmed because they want to calm their mind, while others use stimulants when feeling low or exhausted because they want to feel energetic again.

When a substance changes mood quickly, the person may start to learn that every time they feel bad, they can use the substance to change how they feel.

Someone might argue with their partner and feel angry and empty, so they go out to use a substance to stop thinking. When the feeling temporarily lightens, they start to believe the substance is a way to get through these situations. The next time conflict arises, it becomes easier to go back to the same method.

As use becomes more frequent, the effects of the substance, sleep deprivation, financial problems, and the conflict that follows can make mood even less stable than before. What started as using the substance because of a bad mood becomes both a mood that triggers substance use and substance use that makes mood harder to control.

Treatment must therefore help the person develop a range of ways to cope with emotions, not simply tell them to “calm down” or “stop overthinking.”

How Are Mood Swings and Substance Addiction Treated?

Treatment must start by identifying what the mood changes are related to, because the approach for substance-induced symptoms may differ from that for a co-occurring mood disorder.

Assess Periods of Use, Withdrawal, and Sleep

The treatment team will ask what substance was used, how often, when it was last used, and what mood was like before use, during use, and after the substance wears off, as well as the sleep pattern.

This information helps show whether the person uses the substance when their mood changes, whether the substance is what changes their mood, or whether both are happening at the same time.

If alcohol, sedatives, or a substance with a risk of severe withdrawal is involved, a medical evaluation should be sought — don’t stop on your own without assessing the risk.

Build Emotional-Regulation Skills

Controlling emotions doesn’t mean never being angry, sad, or stressed — it means being able to recognize those emotions and choose a response that doesn’t create additional problems.

Therapy can help the person notice warning signs before emotions become intense — such as starting to speak quickly, a racing heart, tensing up, ruminating, or wanting to walk away immediately — and then practice creating space for themselves before deciding how to act.

People in treatment can also learn which thought patterns intensify their emotions — such as interpreting that someone else meant to insult or abandon them — and practice checking the situation before responding.

Treat the Substance Use Problem at the Same Time

If a substance has become the main way of managing emotions, treatment must help identify the events or feelings that typically occur before use.

Triggers may include work stress, family conflict, loneliness, boredom, guilt, rejection, insufficient sleep, or returning to the same group of friends.

Once triggers are known, a plan can be made to cope before cravings become intense — such as temporarily leaving the situation, contacting someone trustworthy, doing an activity that reduces tension, or using skills practiced in therapy.

Motivational conversations also help the person see both what they feel the substance helps with and its actual negative consequences, without starting from blame or force.

Use Medication When a Psychiatric Condition or Indicated Symptom Is Present

There is no single medication that treats “mood swings” in every case — the choice of medication depends on the cause.

If depression, bipolar disorder, anxiety disorder, psychotic symptoms, or another condition is found, a psychiatrist will consider medication based on the diagnosis and what’s appropriate for each individual.

For people with a history of substance addiction, the risk of the medication itself causing dependence or being misused must also be considered. Anti-anxiety medication, sleeping pills, or other psychiatric medication should never be bought and self-administered or self-adjusted.

How Should Families Cope When Someone Using Substances Is Irritable and Struggles to Control Their Emotions?

When arguments happen repeatedly, families may feel they need to make the person understand right away — but while the person is very angry, intoxicated, or in withdrawal, it may not be the right time for an important conversation.

It’s better to wait until the situation has calmed down, then talk about what you’ve observed rather than labeling them — for example: “Lately when you haven’t slept enough and you’ve used the drug, you get more irritable, and then we argue more often. We’re worried it’s affecting both your health and our relationship.”

Avoid words like “you have a bad character,” “you’re spoiled,” “you can never control yourself,” or using the name of a condition as an insult, because this often makes the person defensive and reduces the chance of talking about treatment.

Understanding the emotions doesn’t mean accepting every behavior. Families still need boundaries around substance use, money, destruction of property, and behavior that makes others unsafe.

If the situation starts to escalate, don’t gang up to argue or try to win — prioritize reducing tension and ensuring safety first.

If there is violent behavior that can’t be controlled, psychotic symptoms, extreme confusion, an inability to care for themselves, or thoughts or behaviors of harming themselves or others, an urgent evaluation should be sought.

With Mood Swings Alongside Substance Use, Where Should You Start Seeking Help?

If the main problem is mood-related — being easily irritable or having difficulty controlling emotions — and there is only occasional use of alcohol, cannabis, or another substance without a clear pattern of addiction, or if the patient isn’t ready for treatment yet and the family wants guidance first, you can start by consulting at Piti Clinic, our outpatient mental-health clinic in Bangkok (Pradiphat Road, Saphan Khwai), to assess emotional problems, sleep, any co-occurring psychiatric condition, and the relationship between the symptoms and substance use, as well as help the family plan how to talk with and encourage the patient into appropriate treatment.

But if there is repeated substance use that can’t be controlled, a need to use the substance every time they’re stressed, angry, sad, or unable to sleep, increasing amount or frequency, repeated relapse after stopping, withdrawal symptoms, or substance use that’s affecting work, finances, and relationships, addressing the substance addiction seriously should be the priority.

Especially for people whose intense emotions and impulsivity lead them straight back to using a substance whenever a problem arises, residential treatment can help create distance from the substance and its triggers in the early stage, while assessing whether, once the substance is stopped and sleep starts to stabilize, there are still emotional problems or a psychiatric condition that need continued treatment.

Treating Mood Swings and Substance Addiction at Day One Rehabilitation Center

For people with substance addiction alongside mood swings, irritability, or difficulty controlling emotions, Day One Rehabilitation Center focuses on identifying the relationship between mood, substance use, sleep, and each person’s individual life triggers.

Residential treatment helps reduce access to the substance and the previous environment in the early stage, making it possible to monitor how mood changes once the substance is stopped and the person begins to rest appropriately.

A psychiatrist can assess whether the mood instability is related to the effects of the substance or withdrawal, or whether depression, bipolar disorder, anxiety disorder, ADHD, PTSD, psychotic symptoms, or another psychiatric condition is present alongside it, and consider medication as indicated.

Individual therapy helps the person in treatment see their own patterns — for example, getting angry and wanting to use the substance every time they’re criticized, or going back to drinking every time they feel stressed from work in order to stop thinking. Once the pattern becomes clearer, they can practice new ways of responding before facing the same situation again.

Group therapy helps build skills in listening, communication, coping with differing opinions, and managing conflict without needing to leave the situation to use a substance.

Relapse prevention must also plan for periods of low mood, because the goal isn’t to make the person in treatment never feel angry or stressed again — it’s to ensure that when those emotions arise, the person has options other than going back to using the substance.

Frequently Asked Questions About Mood Swings and Substance Use

Is it normal to become irritable after using drugs?

Some substances can cause irritability, restlessness, or mood changes both while active and after their effects wear off. But if the symptoms are severe, recurring, or affect safety and daily life, they should be evaluated — don’t dismiss them just because you think they’re only a drug effect.

Do mood swings mean someone has bipolar disorder?

Not always. Bipolar disorder doesn’t refer to ordinary ups and downs in mood. Diagnosis requires looking at a pattern of symptoms occurring in episodes, together with changes in energy, sleep, thinking, and behavior — and the effects of any substance must be ruled out first.

Can yaba or ice make someone angry easily?

Yes. Yaba and ice can cause alertness, restlessness, insomnia, irritability, and, in some people, greater difficulty controlling behavior — especially with continuous use or severe sleep deprivation.

Why do people feel low and irritable after stopping yaba?

After stopping a stimulant, some people may go through a period of exhaustion, lack of energy, reduced concentration, excessive sleep, low mood, or irritability. This should be monitored, especially if it’s severe or involves thoughts or behaviors of self-harm.

Can cannabis cause irritability?

Yes. This is especially seen in people who use it regularly and then reduce or stop — they may experience irritability, restlessness, and sleep problems. The effects of cannabis while using it also vary from person to person.

Does drinking alcohol when stressed help improve mood?

Some people may feel relaxed at first, but alcohol doesn’t address the cause of the stress, and when used as the main way of managing emotions, it can increase the risk of dependence, as well as create problems with sleep, behavioral control, and relationships.

Should you talk about treatment while the patient is angry?

If they are very angry, intoxicated, or have trouble controlling themselves, safety should come first. Talking about treatment is usually more productive once emotions have calmed down and both sides can listen to each other.

The patient says they use substances because the family stresses them out — how should I respond?

You can acknowledge that the conflict genuinely stresses them, without needing to accept that using the substance is the solution. You can address the two issues separately: the family is willing to adjust how it communicates, while at the same time the person needs help finding ways to manage stress that don’t create additional problems.

With mood swings and substance addiction together, which should be treated first?

They should be treated in a connected way, starting with safety, intoxication, withdrawal, and severe psychiatric symptoms first. Then, monitor mood after stopping the substance to assess whether there’s a psychiatric condition requiring ongoing treatment, while treating the substance addiction and building emotional-regulation skills together.

Do mood swings occurring alongside substance use always require going to a treatment center?

Not for everyone. If the mental health problem is the main issue and substance use is only occasional, without a clear pattern of addiction, starting with a mental health assessment may be enough. But if there is repeated use that can’t be controlled, needing to rely on the substance to manage emotions, relapse after stopping, withdrawal symptoms, or impulsivity that leads back to repeated substance use, residential treatment at Day One Rehabilitation Center is an option that should be seriously considered.

Controlling Emotions Isn’t About Forbidding Yourself From Feeling — It’s About Having Options Other Than Using a Substance

Anger, sadness, disappointment, stress, and irritability are emotions everyone experiences. The problem isn’t having these emotions — it’s how the person copes once they arise.

For some people, substances become the fastest way to change how they feel. But that temporary relief can come at the cost of worse sleep, reduced self-control, conflict, and greater reliance on the substance — until eventually the substance itself becomes another cause of emotional instability.

Treatment must therefore look at both sides at once. If mood changes stem from the substance, the body and brain need help recovering from its use. If a psychiatric condition lies behind it, that condition needs to be properly treated. And if the person has used the substance as a tool for managing emotions, they need help building new skills they can genuinely use the next time they face stress.

Families don’t need to wait until a serious incident occurs before seeking help. If you start to see that mood, sleep, and substance use are becoming connected, or that the person needs to rely on the substance every time they’re stressed, angry, or feel overwhelmed, assessment and treatment starting now can help stop the problem before the cycle of substance use and emotional control becomes more complicated.