1. Manic episode.

Often begins with a pleasurable sense of heightened energy, creativity, and social ease. Can quickly escalate out of control into a full-blown manic episode. People with mania typically lack insight, deny anything is wrong, and angrily blame anyone who points out a problem. Symptoms are present for at least one week, to the point where the person has trouble functioning in a normal way:

Plus at least four (and often almost all) of the following:

In severe cases, there may be psychotic symptoms such as hallucinations or delusions.

2. Hypomanic episode. Hypomania is a milder form with similar, but less severe symptoms and less impairment. You may have an elevated mood, feel better than usual, and be more productive. These episodes often feel good to the extent people stop their medication to get a “high”. However, there is a severe price to pay - either escalating to mania or crashing to depression.

3. Major depressive episode. Symptoms are present for at least two weeks and make it difficult to function:

Plus at least four of the following:

Severe depressions may also include hallucinations or delusions.

4. Mixed Episode. Perhaps the most disabling are those episodes with symptoms of both mania and depression at the same time or swinging frequently during the day. You are excitable or agitated as in mania, but also feel irritable and depressed, rather than on top of the world.

[For more information visit SADAG’s website at or contact them on 011 783-1474 011 783-1474 . LLEWELLYN KRIEL can be reached on This email address is being protected from spambots. You need JavaScript enabled to view it.]