It could be either one or it could be both. I think 1200mgs of Trileptal is a therapeutic dosage. Obviously I'm screwed up because I'm up to 1800 and other stuff! If you noticed these mood shifts as a result of a change in your life, i.e., work or relationship issues, then it's not a med issue. If it seems out of the blue, then it may be time for a med adjustment. Only you would have an answer to that, but one can affect the other. I hope you and your pdoc are able to figure it out. Please take care.