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Presentation comparison
UrgentCovers bipolar, trauma-related, personality, neurodevelopmental, substance-related, and neurological causes.
4 of 8 diagnoses compared
| CriteriaComparison detail | Borderline personality disorderUrgent |
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Shifts are reactive, brief, and relationship-linked rather than sustained episodic elevation with reduced need for sleep.
Clinical reference — not validated decision support. Review before use.
| Bipolar disorderUrgent |
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| CyclothymiaUrgent |
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| Complex PTSDUrgent |
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| ADHDUrgentNot selected |
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| Autism with overloadUrgentNot selected |
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| Substance intoxication or withdrawalEmergencyNot selected |
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| Frontal lobe syndromeUrgentNot selected |
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| Why it fits | Rapid affective shifts around perceived rejection, abandonment, invalidation | Distinct episodes of elevated/expansive/irritable mood with altered sleep, activity, confidence | Chronic oscillation between low and activated states falling short of major episodes | Affective storms linked to trauma reminders, shame, threat, attachment rupture | Chronic irritability, low frustration tolerance, impulsive outbursts, emotional reactivity since youth | Abrupt dysregulation from sensory overload, change, uncertainty, social demand | Mood swings around intoxication, rebound, or withdrawal periods | New lability, disinhibition, apathy, especially later in life |
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| What argues against | Applies to the whole presentationReview locally. | |||||||
| Must-not-miss | Self-harm, dissociation, acute suicide risk, escalating interpersonal violence | Mixed state, psychosis, disinhibition, postpartum relapse | Escalation into bipolar I/II, antidepressant-induced switch | Dissociation, self-harm, substance co-factors, | ||||
| Bedside question | Applies to the whole presentationShifts are reactive, brief, and relationship-linked rather than sustained episodic elevation with reduced need for sleep. | |||||||
| Immediate action | Applies to the whole presentationStabilise and reassess. | |||||||
| 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.
Shifts are reactive, brief, and relationship-linked rather than sustained episodic elevation with reduced need for sleep.
Stabilise and reassess.
Guided by presentation.
Review overlap locally.
Rapid affective shifts around perceived rejection, abandonment, invalidation
Self-harm, dissociation, acute suicide risk, escalating interpersonal violence
Distinct episodes of elevated/expansive/irritable mood with altered sleep, activity, confidence
Mixed state, psychosis,
Chronic oscillation between low and activated states falling short of major episodes
Escalation into bipolar I/II, antidepressant-induced switch
Affective storms linked to trauma reminders, shame, threat, attachment rupture
Dissociation, self-harm,
Based on current selection
Safety first. Act early.
Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
Open a selected differential to review its clinical record.
Based on current selection
Safety first. Act early.
Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
| Substance misuse, accidents, educational/occupational collapse |
| Catatonic regression, self-injury, exploitation risk |
| Alcohol/benzo withdrawal, stimulant crash suicidality, aggression, delirium |
| Rapid decline, seizure, focal neurology, tumour, delirium |