Mixed state

Insomnia plus despair, irritability, internal agitation, racing thoughts, suicidal risk

UrgentReview due

At a glance

Watch forHigh near-term suicide riskimpulsive self-harm

Sleep disturbance sits inside a broader syndrome. Reduced need for sleep is one of the most decisive bipolar bedside clues.

Separates the Sleep Disturbance / Insomnia / Reduced Need for Sleep group. It is not specific to Mixed state.

Rows marked “Whole group”: Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group — not specific to Mixed state

Insomnia plus despair, irritability, internal agitation, racing thoughts, suicidal risk

Key features

High near-term suicide risk, impulsive self-harm.

High-risk causes2 causes

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

Sleep disturbance sits inside a broader syndrome. Reduced need for sleep is one of the most decisive bipolar bedside clues.

Helpful clues

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

None listed

Priority steps

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

None listed

Core tests

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

None listed

Consider

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