Interesting question, and a good one to think about. Thanks, Miguel'smom! I have to admit that mine leans more on the manic side than yours.

1. Hospitalization for depression (may or may not include psychosis)

2. Serious depression: Active medication adjustments/more appointments, possible conversation about hospitalization (or ECT, if depression long-lasting & med resistant.) Mostly paralyzed in bed unable to do any (or hardly any) IADLs and maybe some ADLs. Zero thinking or disturbingly negative thinking. If had a job, stopped going to work for the most part.

3. Moderate depression: Home in bed most of the day with anhedonia, slightly paralyzed, but doing a few IADLs and all ADLs (at least for the most part), either very negative thinking/anxiety, or few thoughts at all. If at a job, many "mental health days" taken, or sitting at desk doing almost nothing and going to my car to escape.

4. Low level depression.: Low motivation, slight malaise, negative thinking, often anxiety, but can function to get minimum tasks done, but with a struggle.

5. Baseline: Feeling euthymic, but not elevated. Normally productive, for me, but not particularly project-driven. My normal mostly glass half full self.

6. Slightly elevated (mild hypomania): Lively, quite motivated and project-driven, excellent attitude, (mild euphoric), or if mixed, a bit of irritability/anger/anxiety, too. Loud, loquacious, fast-moving. Noticeable by others, but they are not concerned. Or they are mildly entertained or annoyed by my behavior.

7. Low/Moderate elevated (hypomania): Acting a bit like Robin Williams on a talk show. Yapping up a storm and very high energy. Some mildly impulsive and disinhibited behavior that is clearly noticed, but not yet totally dysfunctional. More pronounced elation and/or irritability/anger.

8. Moderate/High elevated (high-level hypomania): Acting very much like Robin Williams on a talk show. Getting "out of hand", slightly shocking and concerning or significantly angering people. Impulsivity and disinhibition causing negative ramifications and warnings. Frequent psychiatrist appointments and medication modification.

9. High elevated (Mania): Extreme euphoria and/or tirades and ranting that start getting me in trouble and causing stares in public and great fear in my husband. Emergency psychiatrist appointments with major medication modifications. Possible paranoia, delusions, and hallucinations. Thoughts about IOP/PHP or even hospitalization.

10. Severely elevated (Severe Mania): Hospitalization, definite psychosis, major medication modifications, possible physical interactions with hospital staff, forced injections, and isolation room, possible talk about ECT. Often screaming/tirades/rants. Severe other symptoms. Very scary behavior, at times! Possible delirium. Cops have been called, at times.

NOTE: When I have mixed states, the severity and danger of the episode can skyrocket and I can sometimes become violent. I used to drink heavily. Generally, I only ever have self-harm issues or SI when in mixed states. I'm usually too paralyzed in pure depressions for that. I have been a danger to myself in euphoric mania, but they weren't intentional.
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