What should you know about mania and depression?

Mania may involve unusually high or irritable mood, rapid thoughts, increased activity, reduced need for sleep and decisions that feel out of character. Depression may bring persistent sadness or emptiness, loss of interest, low energy, sleep changes, difficulty concentrating and feelings of hopelessness. These states can occur for different reasons, and symptoms alone do not establish a diagnosis. A clinician considers the pattern over time, its effect on life, medicines, substances, physical health and family history. A period of unusually elevated energy can be clinically significant even when it initially feels productive. Sleep disruption can also intensify mood changes; related concerns include Insomnia and Difficulty Sleeping.

Write down changes in mood, sleep, energy, speech, spending, activity and concentration, including when they began and how long they lasted. Keep a steady sleep routine, reduce alcohol and avoid recreational drugs, especially when mood or judgement is changing. Ask a trusted person to tell you if they notice behaviour that seems unsafe or markedly different. Arrange a medical assessment if symptoms persist, recur or interfere with work, relationships or self-care. Do not start, stop or alter psychiatric medicine without the prescriber’s advice. A clinician may also ask about Fatigue, Feeling Anxious and Irritability.

Seek urgent help if there are thoughts of suicide or self-harm, inability to stay safe, severe confusion, hallucinations, aggression, or several nights with very little sleep and escalating activity. Urgent assessment is also needed when spending, driving, sexual behaviour or other actions place you or someone else at serious risk. If immediate danger is present, contact local emergency services and stay with the person if it is safe to do so.

Ask: Could my mood and sleep changes fit a mood disorder or another health problem? What information should I track before an appointment? Which warning signs mean I need urgent help? How can family support me while respecting my privacy? Could any medicine, substance or medical condition be affecting my mood?