Disabling Effects

Symptoms of anxiety and panic arising from the disorder would be unlikely to be prominent or cause any functional limitation. Limb function would be normal.

Mobility

People with mild functional restriction would, for example normally have no difficulty finding their way around outdoors, because they do not usually experience any confusion, inattention, memory loss, or impaired judgement.

Care

People with mild functional restriction would normally be able to care for themselves by maintaining personal hygiene, preparing meals etc. They would have little or no functional limitations on a day-to-day basis and their mood would be normal and they would be alert and orientated with no evidence of confusion, memory loss, poor concentration, disordered thinking, or impaired judgement. They would not require supervision or watching over to prevent abnormal behaviour.

Disabling Effects

People with moderate functional restriction who manifest hypomanic symptoms may become overactive, agitated, inattentive, noisy, have bizarre ideas, delusions and disordered thinking such that they are unable to initiate and complete the usual tasks of daily living. Sleep patterns may be disrupted with unacceptable or antisocial behaviour occurring at night. Aggressive, hostile and violent behaviour may develop. Insight into their medical condition may be limited and the need for treatment denied. Self - neglect, social isolation, and social withdrawal may occur in moderate bipolar disorder when depressive symptoms are predominant Confusion, incoherent speech, decreased memory, and impaired judgement may be present. Symptoms of anxiety and panic disorder may also occur as part of the illness. Limb function would be normal.

Mobility

People with moderate functional restriction would display inattention, confusion, poor concentration, incoherent speech, memory loss, impaired judgement and anxiety and panic disorder, which would indicate that they may need guidance or supervision outdoors. Bizarre and anti-social behaviour may be a problem out of doors.

Care

People with moderate functional restriction, if in the hypomanic phase, would need to be encouraged to get up at an appropriate time, wear suitable clothes, maintain personal hygiene, prepare and eat regular meals, go to bed and remain there at night.

If depressed they would need encouragement to initiate and complete tasks of daily living e.g. they may need to be told and encouraged to get up, wash, dress, and prepare meals in order to maintain a reasonable standard of hygiene and nutrition.

They might have to have support mechanisms in place to maintain a stable routine for the person to prevent relapse and exacerbations of symptoms or need to be reminded and encouraged to attend a day centre, hospital or psychiatric clinic appointments or attend for regular blood tests if taking lithium.

If depressed they may need to be encouraged to participate in social and leisure activities to reduce social withdrawal and isolation or need help with communication, correspondence, and financial matters including prevention of reckless spending.

Someone to supervise their medication and some supervision indoors due to inattention, decreased concentration, confusion, incoherent speech, memory loss, impaired judgement and bizarre/anti social behaviour. They may need protection from financial or sexual exploitation.

Disabling Effects

People with severe functional restriction who manifest severe symptoms of mania may become very overactive, very agitated, inattentive, noisy, have bizarre ideas, delusions, hallucinations and highly disordered thinking. Sleep patterns may be disrupted and unacceptable or antisocial behaviour occurs throughout the night as well as by day. They may fail to eat or drink at all and can potentially collapse with exhaustion. Aggressive, hostile and violent behaviour may develop. Insight into their medical condition may be limited and the need for treatment denied. Self - neglect, social isolation, and social withdrawal may occur in moderate bipolar disorder when depressive symptoms are predominant. Confusion, incoherent speech, decreased memory, and impaired judgement may be present. Symptoms of anxiety and panic disorder may also occur as part of the illness. Limb function would be normal.

Mobility

People with severe functional restriction would display inattention, confusion, incoherent speech, memory loss and impaired judgement, which is likely to indicate that they would need guidance or supervision outdoors. They may exhibit anti-social, bizarre or occasionally hostile or aggressive behaviour, which is also likely to require guidance or supervision outdoors.

Care

People with severe functional restriction, if in the manic phase would need to be encouraged to get up at an appropriate time, wear suitable clothes, maintain personal hygiene, prepare and eat regular meals, go to bed and remain there at night.

If depressed encouragement would be needed to initiate and complete tasks of daily living e.g. they may need to be told and encouraged to get up, wash, dress, and prepare meals in order to maintain a reasonable standard of hygiene and nutrition. Regular contact to prevent self - neglect and a decline into apathetic behaviour. If not encouraged, the person may lie in bed all day and do nothing, or engage in aimless, repetitive activities. They would need to be reminded and encouraged to attend a day centre, hospital or psychiatric clinic appointments and to attend for regular blood tests if taking lithium.

If depressed, encouragement to participate in social and leisure activities to reduce social withdrawal and isolation would be required and help with communication, correspondence, and financial matters including prevention of reckless spending. To have support mechanisms in place to maintain a stable routine for the person to prevent relapse and exacerbations of both manic and depressive symptoms.

Supervision from a carer to reduce risk of self - harm. Encouragement to eat or drink. Supervised medication including attendance for medication by injection in some cases. Supervision to deal with the consequences of bizarre, antisocial, hostile and aggressive behaviours. They may need protection from financial or sexual exploitation.