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Diagnosis   

Mania and Hypomania

Diagnosis is established if the patient has the symptoms / features for 7 days with sustained dysfunction. By its nature mania often renders the patient distractible and irritable; they may be some of the harder patients to interview. Lack of insight is an early feature of mania.

Hypomania as the name suggests, is a less severe presentation of mania. Symptoms have to be present for 4 days with only mild/moderate dysfunction, insight tends to preserved.

Bipolar affective disorder is a disorder characterised by two or more episodes of significantly disturbed mood and activity. Changing between hypomania or mania and depression.

Mood symptoms

'How do you feel in you yourself? How is your emotional state?'
'Have you been getting cross or impatient more easily?'
'Does your mood change alot…?'

Psychological / Distractibility

'Does it ever feel like thoughts are racing through your head?'
'Do you have a lot of ideas in your head all the time?'
'Can you stick at one task without getting sidelined?'

Attention / Concentration

'Can you read a book or an article and remain focused?'
'Do you stay focused during a entire TV programme or DVD?'
'Can you cook a full meal from start to end?'

Increased energy

'Have you been doing a lot more recently?'
'Have you noticed a change in your energy levels?'

Grandiose ideas

'What’s been on your mind recently?
'Do you feel have any unique abilities?'
'Are you exceptionally special in any way?'
'Have you had any religious experiences?'
(Its likely the patient will tell you the above without you having to ask)

Sleep

'Have you been getting as much sleep as you normally do?'
'Have you found yourself staying up longer than normally?'

Disinhibition

'How have you been spending your time recently...?'
'Has your interest in sex changed?'
'Have you done anything that’s out of character for you recently?'
'What are you doing in your spare time nowadays?'
'Have you made any large purchases recently?'