Symptom Severity & Consequences

Severe Symptoms

• increased arousal, impulsivity and aggression towards others
• high levels of agitation or severe slowing down
• markedly reduced motivation and drive
• behaviour lacks direction, purpose or clear goals
• extreme fatigue and tiredness
• speech is fast, disjointed or unintelligible, or there is reduced communication
• relentless and severe feelings of being depressed and anxious, or persistently elated, angry, cynical and irritable mood
• excessive and repetitive preoccupation with seemingly unimportant or irrational issues
• markedly reduced appetite or sleep problems
• significantly reduced concentration, memory, or increased distractibility
• hopelessness about getting better or that anyone can help
• thoughts that life is not worth living or wishing to end one’s life
• lack of awareness that they are mentally unwell
• delusional beliefs (e.g. of persecution or reference)
• hallucinations (e.g. hearing voices) with aggressive or derogatory content, or instructing clients to act in certain ways

Consequences

• inability to perform daily tasks or structured activities, e.g. work, self-care, reading
• reduced levels of activity and taking to their beds
• non-cooperation to take medication or other advice to get better
• inability to cope with everyday demands and challenges
• self-soothing with drugs or alcohol
• self-neglect
• continuity of unhelpful behaviour believing it is normal or justified, or that others are to blame
• disregard for their roles, e.g. as carer, parent, employee, partner
• personality changes
• disengagement from family and friends
• social withdrawal and isolation at home
• inability to attend outpatient appointments
• low threshold for acting on mood and thoughts
• self-harm or harm to others
• relatives become worried, distressed or frustrated
• increased physical problems, e.g. infections, heart and vascular problems, poor management of existing conditions like diabetes