Presentation comparison

Urgent

Mood instability and emotional dysregulation

Covers bipolar, trauma-related, personality, neurodevelopmental, substance-related, and neurological causes.

Mood Lability / Emotional Dysregulation

Safety snapshot

Urgent

Shifts are reactive, brief, and relationship-linked rather than sustained episodic elevation with reduced need for sleep.

Borderline personality disorder Bipolar disorder Cyclothymiasubthreshold bipolarityCLINICAL HINGE: Shifts are reactive, brief, and relationship-linked rather than sustained episodic elevation with reduced need for sleep.

1 of 8 diagnoses compared

Edit selection

CriteriaComparison detail	ADHDUrgent

1 of 8 comparedEdit

Safety snapshot

Urgent

Shifts are reactive, brief, and relationship-linked rather than sustained episodic elevation with reduced need for sleep.

Borderline personality disorder Bipolar disorder

Selected differentials (1 of 8)

+7 not selected

Open a selected differential to review its clinical record.

ADHD

Highest urgency

Based on current selection

Emergency

Safety first. Act early.

EmergencyNot selected

Substance intoxication or withdrawal

Clinical reference — not validated decision support. Review before use.

Why it fits	Chronic irritability, low frustration tolerance, impulsive outbursts, emotional reactivity since youth	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	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
What argues against	Applies to the whole presentationReview locally.
Must-not-miss	Substance misuse, accidents, educational/occupational collapse	Self-harm, dissociation, acute suicide risk, escalating interpersonal violence	Mixed state, psychosis, disinhibition, postpartum relapse	Escalation into bipolar I/II, antidepressant-induced switch
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.

Why it fits

Chronic irritability, low frustration tolerance, impulsive outbursts, emotional reactivity since youth

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

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

What argues against

Applies to the whole presentationReview locally.

Must-not-miss

Substance misuse, accidents, educational/occupational collapse

Self-harm, dissociation, acute suicide risk, escalating interpersonal violence

Mixed state, psychosis, disinhibition, postpartum relapse

Escalation into bipolar I/II, antidepressant-induced switch

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.

Mood instability and emotional dysregulation

Safety snapshot

Safety snapshot

Selected differentials (1 of 8)

Highest urgency

Applies to the whole presentation, not to one diagnosis

What argues against

Bedside question

Immediate action

Investigations

Mimics / overlap

Why it fits

Must-not-miss

Review & handoff

Copy after review

Source status

Selected differentials (1 of 8)

Highest urgency

Review & handoff

Copy after review

Source status