Presenting Complaints

• Patients may have a period of depression, mania or excitement with the pattern described below.

Diagnostic Features

• Periods of mania with:
  • increased energy and activity
  • rapid speech
  • decreased need for sleep
  • elevated mood or irritability
  • loss of inhibitions
  • increased importance of self
    
• The patient may be easily distracted
  
• The patient may also have periods of depression with:
  
  • low or sad mood
  • loss of interest of pleasure
    
• The following associated symptoms are frequently present:
  • Disturbed sleep
  • Poor concentration
  • Guilt or low self-worth
  • Disturbed appetite
  • Fatigue or loss of energy
  • Suicidal thoughts or acts
• Either type of episode may predominate
• Episodes may be frequent or may be separated by periods of normal mood.
• In severe cases, patients my have hallucinations (hearing voices, seeing visions) or delusions (strange of illogical beliefs) during periods of mania or depression.
  

Differential Diagnosis

• Alcohol or drug use may cause similar symptoms. If heavy alcohol or drug use if present, see Alcohol Use Disorders and Drug use disorders.