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Health condition · Clinically reviewed

Mood disorders, from persistent low mood to bipolar disorder.

Depression and bipolar disorder are common, treatable and often misunderstood. Safeguarding comes first, then a stepped plan matched to what you're actually experiencing.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, NHS Talking Therapies and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance including NICE NG222 for depression and specialist bipolar care pathways.

Key facts

Mood disorders at a glance.

The essentials, in plain English - what they are, the main types, and how they're treated in the UK today.

  • What it is

    A group of conditions affecting mood regulation - from persistent low mood to episodes of mania or hypomania.

  • Two broad families

    Depressive disorders (low mood only) and bipolar disorders (low mood alternating with elevated mood).

  • Depression severity

    Mild, moderate or severe - measured with tools like the PHQ-9 and matched to the right level of treatment.

  • Bipolar disorder

    Strongly genetic - collateral history from family is often essential, since insight into past manic episodes can be limited.

  • First-line depression

    Guided self-help and low-intensity therapy for mild disease; CBT and/or an SSRI for moderate-to-severe disease.

  • Bipolar cornerstone

    Mood stabilisers - lithium remains the best-evidenced option - under specialist psychiatric monitoring.

Why this guide matters

Safeguarding first, then a stepped plan.

Mood disorders are common, treatable and worth taking seriously from the first conversation. The three points below shape everything else on this page.

  • Risk assessment always comes first

    Suicide and self-harm risk is assessed at the very start of any presentation, before treatment options are even discussed.

  • Depression and bipolar need different plans

    An antidepressant given without first considering bipolar disorder can occasionally trigger mania - the diagnosis shapes the treatment.

  • Specialist input changes outcomes

    Bipolar disorder, treatment-resistant depression and any crisis presentation deserve early specialist psychiatric involvement.

How the diagnosis is made

From first assessment to a clear plan.

The steps a UK GP or mental health service will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Safeguarding and risk assessment

    Suicide and self-harm risk is assessed first, in every presentation, before anything else is explored.

  2. 02

    Assessing

    Detailed history

    Episode pattern, duration, functional impact, family history and substance use are all mapped out carefully.

  3. 03

    Assessing

    Validated screening tools

    PHQ-9 grades depression severity; the mood disorder questionnaire helps screen for possible bipolar disorder.

  4. 04

    Confirming

    Exclude medical causes

    Thyroid dysfunction and certain medications can mimic or worsen mood symptoms and are checked for routinely.

  5. 05

    Confirming

    Collateral history

    Particularly important in suspected bipolar disorder, where a person may not recognise past manic episodes as unusual.

  6. 06

    Planning

    Specialist psychiatric assessment

    For diagnostic clarification - especially bipolar disorder or treatment-resistant depression - via commissioned mental health services.

  7. 07

    Planning

    MDT care planning

    Psychiatry, psychology and primary care mental health work together on a plan matched to diagnosis and severity.

Typical timeline: a first assessment to a settled plan in weeks, sometimes sooner if risk is high.

Symptoms

What mood disorders actually look like.

The depressive picture, the manic and hypomanic picture - and the features that mean it's time to escalate.

  • Persistent low mood

    Depression - low mood and loss of interest or pleasure (anhedonia) lasting two weeks or more with real functional impact.

  • Sleep and appetite change

    Insomnia or hypersomnia, and appetite or weight change in either direction, are core depressive features.

  • Poor concentration and guilt

    Difficulty concentrating, feelings of worthlessness or excessive guilt, and slowed or agitated movement.

  • Suicidal ideation

    Thoughts of self-harm or suicide are critical to assess directly and honestly at every review.

  • Elevated or irritable mood

    Mania or hypomania - an unusually high, expansive or irritable mood with increased energy and activity.

  • Pressured speech, racing thoughts

    Fast, hard-to-interrupt speech and racing thoughts, often with a decreased need for sleep.

  • Impulsivity and grandiosity

    Risk-taking behaviour, overspending, grandiose beliefs about one’s abilities - hallmarks of a manic episode.

  • Red flag - psychotic features

    Severe mania can include psychotic symptoms - this needs urgent specialist psychiatric assessment.

Treatment

How mood disorders are treated in the UK.

A stepped approach for depression, and specialist mood-stabiliser led care for bipolar disorder - matched to severity and diagnosis.

  • Guided self-help

    Computerised CBT and behavioural activation - the first step for mild depression, alongside watchful waiting.

  • High-intensity psychological therapy

    CBT or interpersonal therapy for moderate-to-severe depression, accessed via NHS Talking Therapies.

  • Antidepressant medication

    SSRIs are typically first-line for moderate-to-severe depression, prescribed and monitored by GP or specialist.

  • Combination and augmentation

    For treatment-resistant depression - combining therapy and medication, with specialist psychiatric input.

  • Esketamine nasal spray

    A newer option for treatment-resistant depression, delivered only in specialist commissioned settings.

  • Mood stabilisers

    Lithium remains a key evidence-based treatment for bipolar disorder, alongside valproate and lamotrigine - requires careful monitoring.

  • Antipsychotics

    Used for acute mania or as mood-stabiliser adjuncts in bipolar disorder, under specialist prescribing.

  • Psychoeducation and family therapy

    Understanding relapse triggers and early warning signs, and CBT adapted for bipolar disorder alongside medication.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist college standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or mental health team knows your history and can tell you which parts apply to you. If you're at risk, get seen urgently.

  • NICE. Depression in adults: treatment and management (NG222).

  • NICE. Bipolar disorder: assessment and management (CG185, under review).

  • NHS Talking Therapies for anxiety and depression - access and referral standards.

  • Royal College of Psychiatrists. Guidance on mood disorders and lithium monitoring.

Red flags

When a mood disorder needs urgent attention.

Most mood symptoms are manageable in primary care. These are the situations that aren't - and where urgent or specialist help is needed.

  • Active suicidal ideation or plan

    Any expressed intent or plan needs urgent same-day assessment - contact crisis services or attend A&E.

  • Severe depression with psychotic features

    Delusions or hallucinations alongside depression need urgent specialist psychiatric assessment, sometimes as an inpatient.

  • Acute mania with risk

    Severe mania with reckless or dangerous behaviour, or psychotic features, often needs crisis team involvement or hospital admission.

  • Postnatal mood symptoms

    New or worsening low mood, anxiety or intrusive thoughts after birth need prompt assessment - postnatal depression is common and treatable.

  • Lithium toxicity

    Tremor, vomiting, confusion or drowsiness in someone on lithium is an emergency - check levels and seek urgent medical review.

  • Rapid mood cycling

    Frequent, fast swings between depression and elevated mood warrant specialist psychiatric reassessment of the diagnosis and plan.

  • Self-neglect

    Not eating, drinking or caring for basic needs during a severe episode is a safeguarding concern needing urgent support.

  • Substance misuse alongside mood symptoms

    Alcohol or drug use can mask, worsen or mimic mood disorder - it needs to be addressed as part of the overall plan.

  • Family history of bipolar disorder

    A strong family history, combined with new mood symptoms, should prompt closer specialist assessment before starting an antidepressant alone.

Living with it

A treatable condition, with a clear ladder.

Four things that make the biggest difference day to day - regular sleep, knowing your own triggers, healthy habits and using the support around you.

A quiet reminder

Asking for help early is a strength, not a failure.

Mood disorders respond well to treatment - the earlier a plan starts, the sooner things tend to settle.

  1. 01 Sleep

    Protect a regular sleep pattern

    Consistent sleep and wake times matter for everyone, and are particularly protective in bipolar disorder.

  2. 02 Triggers

    Know your early warning signs

    Psychoeducation helps you and those close to you spot the earliest signs of relapse, so support can start sooner.

  3. 03 Habits

    Exercise and reduce alcohol

    Regular activity, stress management and cutting back on alcohol or other substances all support mood stability.

  4. 04 Support

    Use the support around you

    Mind, Bipolar UK and your care team all offer practical, ongoing support beyond the prescription pad.

Frequently asked

Everything we get asked about mood disorders.

Quick answers on depression, bipolar disorder, seasonal patterns and when things become urgent.

  • What is the difference between depression and bipolar disorder?

    Depression involves persistent low mood and loss of interest without episodes of elevated mood. Bipolar disorder involves episodes of depression alternating with mania (bipolar I) or hypomania (bipolar II) - a less severe form of elevated mood.

  • What is persistent depressive disorder (dysthymia)?

    A chronic, lower-grade form of depression lasting two years or more. Symptoms are often less intense than major depressive disorder but their persistence can still cause significant functional impact over time.

  • What is seasonal affective disorder?

    Depression that follows a seasonal pattern, most commonly worsening over autumn and winter and improving in spring and summer. It is assessed and treated using the same principles as other depressive disorders.

  • How is bipolar disorder treated?

    Mood stabilisers are central - lithium remains a key evidence-based option, alongside valproate and lamotrigine. Antipsychotics may be added for acute mania, and psychological therapy and psychoeducation support long-term stability.

  • Why does bipolar disorder need collateral history?

    People experiencing mania or hypomania can lack insight into how unusual their behaviour was at the time. A account from family or close friends often reveals a pattern the person themselves would not otherwise report.

  • When is a mood disorder a mental health emergency?

    Active suicidal ideation with a plan, severe depression or mania with psychotic features, and acute mania with risky or dangerous behaviour all need urgent same-day assessment, via crisis services or A&E if necessary.

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