Questionnaire/history: Mania (manic episode for at least 7 days with usually abrupt begin)? - Abnormally elevated mood? - Extreme irritability? - Sometimes aggression? - Increased energy or activity, restlessness and a decreased need for sleep (eg - feeling rested after only 3 hours of sleep)? - Pressure of speech? - Incomprehensible speech? - Flight of ideas or racing thoughts? - Distractibility, poor concentration? - Increased libido, disinhibition, sexual indiscretions? - Extravagant or impractical plans? - Delusions (usually grandiose)? - Hallucinations (usually voices)? Hypomania (symptoms not severe enough to cause marked impairment in social or occupational functioning and the absence of psychotic features, hypomanic episode for at least 4 days)? - Mild elevation of mood or irritability? - Increased energy and activity, which may lead to increased performance at work or socially? - Feelings of well-being, physical and mental efficiency? - Increased sociability, talkativeness, over-familiarity? Mixed episode? - Mixture or rapid alternation (usually within a few hours) of manic/hypomanic and depressive symptoms? Depression? - Feelings of persistent sadness or low mood? - Loss of interested or pleasure? - Low energy? Do you currently (or have you in the past) experienced mood that is higher than normal, or do you feel much more irritable than usual, and have others noticed?

At the same time, do you have increased energy levels so that you are much more active or do not need as much sleep? Past medical history? Family history? Current medication? Drug allergies? Management: Referred to mental health team Resources: NICE CKS: Bipolar disorder