28th January 2024

Symptoms and diagnosis

A diagnosis of BPD can be suspected in primary care, but a specialist psychiatric assessment must be carried out in order to confirm diagnosis.

Use clinical judgement to determine the urgency of referral or admission.

Symptoms of mania may include:

• Increased energy and activity
• Marked feelings of wellbeing
• Feelings of physical and mental efficiency
• Increased sociability, talkativeness, over-familiarity
• Increased sexual energy
• Decreased need for sleep
• Irritability
• Conceit
• Impolite behaviour and loss of social inhibitions
• Inattention and distractibility
• Elation
• Pressured speech
• Inflated self-esteem and grandiose ideas
• Overconfidence

In episodes of mania with psychotic features, the following may be seen:

• Delusions
• Hallucinations
• Flight of ideas
• Manic stupor

Symptoms may be mood-congruent or mood-incongruent