The Continuum of Mania
and Depression
As Defined In
The NIMH-LCM
4. Severe Mania: much insistence by others that patient get medical
attention, patient unable to function in any goal directed activity.
Symptoms: little or no
sleep, delusional, invincible, explosive, hallucinatory, catatonic.
Functional Impairment:
needs close supervision, has no judgement, puts self and others in
danger, should be hospitalized.
3. High Moderate Mania: very significant difficulty with behavior and
goal directed activities, can’t focus, non-productive.
Symptoms: grandiose,
very disruptive, little or no sleep, reckless, increases in energy and
activities.
Functional Impairment:
little or no judgement, not directable, outlandish behaviors, can’t
function at work.
2. Low Moderate Mania: noticeable impairment; others feedback about
behavior; less productive, unfocused.
Symptoms:
irritable/euphoric, intrusive, grandiose, increases in energy, decrease
in sleep, increase in spending and phone calls.
Functional Impairment:
poor judgement, sometimes disruptive at work and home, difficulty with
goal-oriented activity.
1. Mild Mania: no impairment or mild impairment, functioning
possibly enhanced.
Symptoms: decrease in
sleep, ebullient, energetic, more social, mildly pressured.
Functional
Impairment: little or no impairment can be focused and
productive.
0.
The Normal Range of Emotions
1. Mild Depression:
no impairment to mild impairment.
Symptoms: subjective distress, low mood, sleep and appetite
O.K.
Functional Impairment:
functions well at work and at home, little or no impairment in social
relationships.
2. Low Moderate Depression:
noticeable impairment; some extra effort needed to function in usual
social and occupational roles.
Symptoms:
decrease/increase in sleep and appetite, decreased energy and
concentration, anxious, loss of normal pleasures, sucidal.
Functional Impairment:
some impairment at work and home, misses days from work, has to push
self.
3. High Moderate Depression:
very significant impairment; great effort needed to function in any
role; barely scrapes by.
Symptoms:
retarded/agitated, very low energy, suicidal, withdrawn, poor hygiene,
much difficulty reading or concentrating.
Functional
Impairment: great difficulty functioning, rarely goes to
work, has to push self very hard.
4. Severe Depression: essentially incapacitated because of
depression.
Symptoms: immobilized, can’t read or concentrate, mute or
extremely agitated.
Functional Impairment:
Isolated, or in bed, may be hospitalized
