Rapidly changing mood, otherwise known as rapid cycling
Agitation, or physical restlessness
Insomnia
Anxiety
Hopelessness, guilt, or seeing few reasons for living
Psychotic features: hearing voices or seeing things that are not there
Atypical features of depression (as defined in the preceding section)
Substance use and abuse
Serious medical illness
Lack of medical treatment
Lack of family or social support
Personality disorders, or long-standing patterns of behavior that interfere with relationships and functioning