| Mania (Periods of Predominantly and Persistently Elevated, Expansive, or Irritable Mood) | Depression (Loss of Interest or Pleasure in Usual Activities) |
|---|---|
| Affect | |
| Lack of shame or guilt; inflated self-esteem; euphoria; intolerance of criticism | Anger, anxiety, apathy, denial, delusions of guilt, helplessness, feelings of doom, hopelessness, loneliness, low self-esteem (self-degradation) |
| Physiology | |
| Insomnia; inadequate nutrition, weight loss | Insomnia; anorexia, constipation, indigestion, nausea, vomiting → weight loss |
| Cognition | |
| Denial of realistic danger Thoughts: flight of ideas, loose associations; illusions, delusions of grandeur; lack of judgment; distractibility | Ambivalence, confusion, inability to concentrate, self-blame; loss of interest and motivation; self-destructive (preoccupied with suicide) |
| Behavior | |
| Hyperactivity (social, sexual, work) → irrationality, aggressiveness, sarcasm, exhibitionism, and acting out in behavior and dress Hostile, arrogant, argumentative, demanding, and controlling Speech: rapid, rhyming, punning, witty, pressured | Altered activity level, social isolation, substance abuse, overdependency, underachievement, inability to care for self, psychomotor retardation |