When do you go to your GP? When you consider there is something that you need for prevention, such as antihypertensives or asthma inhalers, or when you are ill. In psychiatry often the question is does this person have…

In severe disorders, involving psychosis, you do not need to ask, it is usually obvious, although the person themselves may not have insight into this. What about less severe or more subtle disorders, where is the line from helpful productivity to hyperactivity, or grass-hopper mind to inattention? When does productivity become pathological?

People all have mood variation. This is usual. Some people have mood variation that they do not want or find too much, or find it difficult to manage. Is this pathology? Does this require treatment?

There is also a significant variation in activity, some may liken themselves to a sloth and are not depressed and would not ask about being depressed either. Depressed mood is often something we all recognise, as long as we are not severely depressed.

What about elation? Is this normal, yes, imagine getting married or having a baby? Sadly, the elation wanes and these life changing circumstances become mundane and usual.

What if the elations lasts for weeks, there is less sleep, increased activity and poor concentration. This can lead to problems at work, with family and social settings. This may then be considered pathological.

If there is elation and high self-esteem, overoptimism and increased appreciation of say, colour, in that it is extremely vivid, most would recognise that may be this is pathological.

If there is elation and a grandiose delusion, well, that is pathological.

By reading this, you can begin to appreciate why psychiatric appointments are so long and why psychiatrists ask so many different questions. The treatment of a severe psychosis is not without adverse effects, so we have to be sure that it is warranted.

If you have elevated mood, what do you want to do and how do you get assistance if you want it or need it? An assessment will definitely help but how do you access it? Hopefully you understand why a doctor with less than ten minutes, cannot make a clinical diagnosis and an effective treatment plan, so may have to refer you to another doctor or the local mental health team. However, your GP, who has known you for many years and if you have any other conditions, will know if something additional is occurring in your health.

What if I have bipolar affective disorder is may be a question you should not have to ask but may be you have another pathology, that presents with elated mood or overactivity and you are seeking help. This is when a doctor, especially a psychiatrist can give you the definitive answer.