MOOD

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Common ALPIMS-related mood presentations:

Major Depression (including atypical or treatment-resistant forms)
Bipolar Spectrum (especially in neurodivergent individuals)
Mood lability and emotional reactivity linked to pain, fatigue, inflammation, or trauma
PMDD (premenstrual dysphoric disorder)
Secondary mood changes from dysautonomia, MCAS, POTS, or nutrient deficiency

Zone	Mood Symptom	Management Strategies	ALPIMS Domains
Red	Shutdown, despair, suicidal ideation	Safety first: co-regulation, grounding, remove sensory triggers, professional support	Mood, Anxiety, Sensory
Yellow	Mood swings, irritability, emotional flooding	Vagal tone support, low sensory input, magnesium, saffron, remove inflammatory foods	Mood, Immune, Pain
Green	Persistent low mood, neuroinflammatory depression	Omega-3s, saffron, inositol, psychotherapy, structured pacing, CBT/ACT	Mood, Immune, Pain
Green	Bipolar spectrum regulation	Mood stabilizers (e.g. lamotrigine, lithium), sleep stabilization, avoid overstimulation	Mood, Sensory, Anxiety

Supplemental supports:

Omega-3s (EPA-dominant): anti-inflammatory, antidepressant properties
Saffron extract (15–30 mg/day): mood regulation and cognition
Inositol (500–2000 mg): useful for anxiety + mood regulation
Magnesium glycinate or threonate: calming, muscle relaxation
Vitamin D3 and B12 (if deficient): essential for neuroimmune mood support

Mood changes in ALPIMS are often biologically driven but exacerbated by social invalidation, misdiagnosis, or unsupported trauma. Stabilizing the immune, pain, and sensory domains often improves emotional regulation.

Mood symptoms such as depression, bipolar tendencies, mood swings, or emotional shutdown are rarely isolated—they are part of a neuroimmune feedback loop.

Here’s how the Mood domain interacts with each of the other ALPIMS domains:

Mood ↔ Anxiety

Connection	Explanation
Mood disorders like depression and bipolar often coexist with generalized anxiety or panic.	Anxiety amplifies emotional reactivity and leads to burnout, while depression can emerge from prolonged anxious overdrive.
Trauma, dysautonomia, and neuroinflammation can trigger both mood and anxiety dysregulation.	Emotional overwhelm may alternate between high anxiety (hyperarousal) and low mood (shutdown).

Mood ↔ Laxity

Connection	Explanation
Joint instability (from EDS/HSD) can lead to recurrent injuries, pain, and mobility limitations, impacting mental health.	Loss of function or fear of dislocation can fuel depression or mood lability.
Fatigue from inefficient movement and postural compensation contributes to mental and emotional exhaustion.	Physical vulnerability may erode confidence, feeding low mood or mood volatility.

Mood ↔ Pain

Connection	Explanation
Chronic pain directly affects neurotransmitters involved in mood regulation (e.g. serotonin, dopamine, endorphins).	Pain flares may trigger hopelessness or emotional shutdown.
Depression lowers pain tolerance; pain increases irritability and emotional reactivity.	The relationship is bidirectional and cyclical— called the “pain–mood loop.”

Mood ↔ Immune

Connection	Explanation
Immune dysfunction (e.g. cytokine inflammation, MCAS, autoimmune flares) alters brain chemistry and may cause neuroinflammatory depression.	Mast cell mediators and chronic inflammation affect mood via the gut–brain–immune axis.
Nutrient deficiencies (e.g. B12, iron, vitamin D) from immune conditions can worsen low mood and fatigue.	Anti-inflammatory supports (e.g. omega-3s, LDN, quercetin) often improve both immune and mood symptoms.

Mood ↔ Sensory

Connection	Explanation
Sensory overload (from light, sound, texture, or food) causes distress that can lead to irritability, shutdown, or meltdowns.	Chronic sensory stress dysregulates the nervous system, undermining emotional stability.
Mood swings and emotional flooding are more likely when sensory regulation tools are absent or ineffective.	Co-regulation and environmental adjustments can stabilize mood by reducing sensory threat.

Mood as an Integrating Domain

The Mood domain reflects the emotional cost of dysregulation in the other domains and often amplifies the overall symptom burden if left unsupported.

Stabilizing mood through DBT skills, pacing, nutritional support, and safe relational repair can help regulate the whole ALPIMS system.

ZONE-BASED EMOTIONAL REGULATION KIT (ALPIMS)

Zone	Signs You’re Here	Emotional Regulation Tools	ALPIMS Domains
Red (Shutdown / Overwhelm)	Dissociation, panic, collapse, suicidal thoughts, emotional numbness	– Grounding: cold water, weighted item, 3-3-3 sensory scan – Co-regulation: safe person, hold hand, “I am safe enough” mantra – Remove stimuli: earplugs, dim lights, silence – Emergency support plan – DBT Distress Tolerance skills: STOP, TIP, self-soothe	Mood, Anxiety, Sensory
Yellow (Escalating / Flooded)	Irritability, spiraling thoughts, racing heart, tearful or angry	– Vagus activation: humming, deep exhale, chest tap – Lavender or chamomile scent cloth – Magnesium (glycinate/threonate) – Short rest in low-stimuli space – DBT Emotion Regulation: name the emotion, opposite action, check the facts	Mood, Immune, Pain
Green (Regulated / Resilient)	Stable mood, calm body, problem-solving available	– Joy microdoses: art, music, light social time – Movement: walk, yoga, tai chi – Supplements: omega-3s, saffron, inositol – Reflective tools: journaling, therapy, CBT or ACT – DBT Wise Mind practice, mindfulness, values clarification	Mood, Immune, Pain

Create your own kit items:

Comfort item: soft scarf, fidget, scented oil stick
Regulation item: cold pack, smooth stone, lip balm
Anchor phrases: “I’ve been here before and survived.” “Right now I’m safe.”
Mental cue card: Your 3 go-to strategies in red/yellow/green

This kit can be used at home, at school, or in care settings as a quick-access support tool.

Mood Medications – Pros, Cons, Suggested Doses, Alternatives & Zones (ALPIMS)

Medication Class	Examples	Typical Dose Range	Pros	Cons / ALPIMS Considerations	Alternatives	Best Zone
SSRIs	Sertraline, Escitalopram	12.5–100 mg (start low: 12.5–25 mg)	Helps anxiety, depression, OCD Often well-tolerated	May increase fatigue or nausea Can trigger MCAS or POTS flares	Saffron extract, inositol, therapy-based mood support	Green or Yellow
SNRIs	Duloxetine, Venlafaxine	20–60 mg (start at 20 mg)	Dual benefit for mood + pain Useful for fibromyalgia	Raises HR/BP Risk of withdrawal effects May worsen POTS or MCAS	Low-dose nortriptyline, SAMe, magnesium threonate	Green only
NDRIs	Bupropion (Wellbutrin)	75–150 mg (start at 75 mg SR)	Energizing Helps ADHD traits, brain fog	May worsen anxiety/insomnia Avoid in bipolar, seizure risk	Rhodiola, L-tyrosine, light therapy, omega-3s	Green only
TCAs	Amitriptyline, Nortriptyline	5–25 mg (low-dose bedtime)	Pain, migraine, IBS relief Sleep support	Anticholinergic effects May worsen POTS, cognition	Low-dose mirtazapine, doxepin (low dose), valerian	Yellow or Green
Mood Stabilizers	Lamotrigine, Lithium	Lamotrigine: 25–200 mg (start 12.5–25 mg); Lithium: 150–900 mg	Bipolar, mood swings, emotional instability Lamotrigine is non-sedating	Blood level monitoring Lithium may affect thyroid/kidney Valproate not ideal in ALPIMS	Inositol, taurine, magnesium glycinate (adjuncts)	Green or Yellow (with supervision)
Atypical Antipsychotics	Quetiapine, Aripiprazole	Quetiapine: 12.5–100 mg; Aripiprazole: 2–10 mg	Mood lability, agitation Sleep in low dose (quetiapine)	Weight gain, sedation Akathisia or movement issues	Omega-3s, low-dose melatonin + CBT for mood cycles	Yellow (low dose), Green
Sleep Adjuncts	Trazodone, Agomelatine	Trazodone: 12.5–50 mg; Agomelatine: 25–50 mg	Improve sleep and circadian rhythm May indirectly boost mood	Grogginess, vivid dreams Limited effect on daytime mood	Melatonin, magnesium, ashwagandha, glycine	Yellow or Red (with safety)
Tetracyclic (Avanza)	Mirtazapine (Avanza)	7.5–15 mg (low dose for sleep; 30–45 mg for depression)	Sedating Improves sleep and appetite Well tolerated in sensory-sensitive profiles	Weight gain Daytime sedation May activate MCAS in some	Low-dose doxepin, chamomile, saffron extract	Yellow (for sedation), Green