Depressive Episodes

• Persistently low or empty mood A pervasive sadness or emotional numbness lasting at least two weeks that colors nearly every part of the day.Example: A person may wake up each morning with a heavy, hollow feeling and go through the entire day unable to shake the sadness, regardless of what happens around them.
• Loss of interest or pleasure Activities that were once enjoyable feel meaningless or require enormous effort to initiate.Example: Someone who used to love playing guitar may leave the instrument untouched for weeks, feeling no desire to pick it up even when they have free time.
• Fatigue and psychomotor changes Profound tiredness, slowed thinking, and either physical agitation or sluggishness that others can observe.Example: A coworker might notice that a person who normally moves and speaks at a brisk pace has begun speaking slowly, taking long pauses, and seeming physically drained despite sleeping more than usual.
• Cognitive difficulties Trouble concentrating, indecisiveness, and impaired memory are common during depressive episodes.Example: A student may read the same paragraph multiple times without absorbing any of it, or find themselves unable to decide what to eat for lunch because even small choices feel overwhelming.
• Thoughts of death or suicide Recurrent thoughts of dying, suicidal ideation, or suicide attempts may occur and require immediate professional attention.Example: A person might find themselves repeatedly thinking that their loved ones would be better off without them. If you or someone you know is experiencing these thoughts, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.

Manic Episodes

• Elevated or irritable mood An abnormally expansive, euphoric, or agitated emotional state lasting at least one week (or any duration if hospitalization is needed).Example: A person may feel on top of the world for days, telling everyone they meet about grand plans, or they may become intensely irritable and snap at family members over minor inconveniences.
• Decreased need for sleep Feeling rested after only a few hours of sleep, or going days without sleeping while maintaining high energy.Example: Someone may sleep only two or three hours a night for a week yet feel fully energized, staying up to start new projects or reorganize the entire house.
• Grandiosity and inflated self-esteem An exaggerated sense of confidence, special abilities, or importance that is out of proportion to reality.Example: A person with no musical training may become convinced they can write a hit album, or someone may believe they have been chosen for a special mission that only they can fulfill.
• Impulsive, high-risk behavior Reckless spending, risky sexual behavior, substance misuse, or impulsive major life decisions made without considering consequences.Example: Someone might max out several credit cards on luxury purchases in a single weekend or impulsively quit a stable job to pursue an unrealistic business idea.
• Racing thoughts and pressured speech Ideas come so fast they overlap; speech becomes rapid, loud, and difficult to interrupt.Example: A person may jump from topic to topic so quickly that listeners cannot follow the conversation, talking over others and struggling to stay on a single subject.

Treatment Approaches

Common Misconceptions