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Presentation comparison
EmergencyCovers mania, hypomania, mixed states, induced activation, and organic causes.
1 of 7 diagnoses compared
| CriteriaComparison detail | Substance-induced maniaEmergency |
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Sustained episodic activation plus decreased need for sleep are the key separators.
Clinical reference — not validated decision support. Review before use.
| HypomaniaEmergencyNot selected |
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| Mixed stateEmergencyNot selected |
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| Antidepressant-induced switchingEmergencyNot selected |
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| Borderline affective instabilityEmergencyNot selected |
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| Organic late-onset "mania"EmergencyNot selected |
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| Why it fits | Stimulants, cocaine, methamphetamine, steroids, cannabis | Elevated/irritable mood, reduced need for sleep, overactivity, grandiosity, pressured speech | Less severe, no psychosis, but still clearly episodic | Depression with agitation, irritability, racing thoughts, insomnia | Activation after antidepressant initiation, especially in latent bipolarity | Rapid reactive mood shifts, anger, emptiness | First manic-like presentation in later life, neurological signs, frontal disinhibition |
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| What argues against | Applies to the whole presentationReview locally. | ||||||
| Must-not-miss | Hyperthermia, chest pain, prolonged psychosis, violent agitation | Psychosis, dangerous disinhibition, financial ruin, violence, exhaustion | Escalation to mania, mixed features, impulsive harm | Very high suicide risk, abrupt escalation | |||
| Bedside question | Applies to the whole presentationSustained episodic activation plus decreased need for sleep are the key separators. | ||||||
| Immediate action | Applies to the whole presentationSleep change is one of the highest-yield discriminators Hypomania is commonly found only on careful retrospective history | ||||||
| Investigations | Applies to the whole presentationGuided by presentation. | ||||||
| Mimics / overlap | Applies to the whole presentationReview overlap locally. | ||||||
Scroll horizontally to review more candidate differentials. Clinical reference — not validated decision support. Review before use.
Review locally.
Sustained episodic activation plus decreased need for sleep are the key separators.
Sleep change is one of the highest-yield discriminators Hypomania is commonly found only on careful retrospective history
Guided by presentation.
Review overlap locally.
Stimulants, cocaine, methamphetamine, steroids, cannabis
Hyperthermia, chest pain, prolonged psychosis, violent agitation
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Last updated: Pending review
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Create a concise comparison summary for documentation or handoff.
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Last updated: Pending review
| Escalating agitation, suicidality, psychosis |
| Self-harm, substance misuse, aggression |
| Stroke, brain tumour, dementia, thyrotoxicosis, corticosteroid exposure |