A disorder characterised by significant mood variations ranging from depressed mood to mania.

Common features include:

• Depression symptoms
• Mania symptoms
• Inflated self-esteem or grandiosity
• Decreased need for sleep
• Pressured speech
• Distractibility
• Excessive involvement in pleasurable activities

Tips for management:

• Communication during a manic episode may be difficult, due to distraction
• If conversation is one-sided due to pressured speech, be firm, clear and interrupt if needed
• If patient presents with psychomotor agitation and wants to pace, jiggle or tap legs, allow them as controlling them may increase agitation
• Encourage eye contact and breaths between bursts of speech
• Maintain clear professional boundaries, as highly sexualised behaviour may occur