The words they use,
explained in plain language.

Also called concordance, compliance

Taking medication as agreed with your prescriber. The word is deliberately neutral now: the useful question is not whether someone is good at following orders, but whether the plan actually works for their life and side effects.

Restless, distressed overactivity driven by inner tension. It can be a feature of depression, anxiety, mania or mixed states, and in bipolar disorder it often signals a mixed picture.

An intense inner restlessness, as though you cannot sit still or settle. People pace, shift in the chair, or feel a crawling urge to move that does not ease with movement. It is a common side effect of antipsychotic medication, and it is often mistaken for worsening anxiety or agitation, so it is worth naming out loud.

Difficulty identifying and putting words to your own emotions, so feelings register as physical tension or as nothing at all. It is common in depression, autism and trauma, and it can be learned around.

The loss of pleasure in things that usually bring it: food, music, company, sex, hobbies. It is one of the core symptoms of depression and often the last thing to lift, which is why it deserves specific attention rather than being read as laziness.

Genuine difficulty recognising that you are unwell, common in psychosis and some forms of bipolar disorder. It is a symptom of the condition rather than stubbornness, which is why families often notice the illness before the person does.

Medication that treats depression and anxiety, most commonly by adjusting serotonin or noradrenaline. It usually takes two to four weeks to work, and it is stopped by tapering rather than abruptly.

Also called neuroleptic

A class of medication that reduces psychosis and mania, mainly by blocking dopamine. It is used in schizophrenia, bipolar disorder, severe depression and agitation. Side effects worth knowing about include akathisia, stiffness, weight gain and metabolic change.

Diminished interest, emotion and concern about things that used to matter. It can appear in depression, in long-term psychosis, and in some neurological conditions.

A reduced drive to start and sustain purposeful activity. The intention may still be there while the engine to begin is not, which is different from choosing not to bother.

A fast-acting anti-anxiety and sedative drug, such as diazepam or lorazepam. Useful in short bursts for crisis or severe agitation, but dependence develops quickly, so they are not a long-term answer.

Medication that slows the heart and eases the physical symptoms of anxiety, such as a pounding chest and shaking. Propranolol is also sometimes used to reduce the tremor of akathisia.

A marked disturbance of movement and responsiveness: stupor and immobility, or the opposite, restless purposeless movement. It is a serious state that needs urgent medical assessment, and it is treatable.

Also called cognitive behavioural therapy

A structured talking therapy that looks at how thoughts, feelings and behaviour feed each other, and tests small changes between sessions. Usually 6 to 20 sessions; well evidenced for depression and anxiety.

Over-inclusive speech that piles in detail and digressions but does eventually reach the point. It differs from tangentiality in that the destination is not lost.

Choosing words because they rhyme or sound alike rather than because of what they mean. It appears in some manic and psychotic states.

Also called CMHT

A multi-disciplinary team of nurses, psychiatrists, psychologists, social workers and support workers who provide ongoing care outside hospital, usually for people with more complex needs.

Also called co-occurring conditions

Two or more conditions present at the same time, such as bipolar disorder with anxiety, ADHD or a physical health condition. The norm rather than the exception, and it changes how treatment is sequenced.

A repetitive behaviour or mental act performed to reduce the distress of an obsession: checking, counting, washing, repeating words. It brings relief briefly, which is what keeps the cycle going.

Also called home treatment team

An intensive service that visits at home during an acute episode, as an alternative to hospital admission. Usually contacted through a GP, A&E, or the local crisis line.

Also called dialectical behaviour therapy

A skills-based therapy teaching distress tolerance, emotional regulation, interpersonal effectiveness and mindfulness. Designed originally for persistent self-harm and emotional instability, now used more widely.

A fixed belief that is firmly held despite clear evidence against it, and that is not explained by the person's background or culture. Common themes are being watched or persecuted, having special powers, or believing something catastrophic has happened.

Feeling unreal, as though you are observing yourself from a distance, or that your body or thoughts are not quite yours.

Also called long-acting injectable

An antipsychotic given as an injection every few weeks instead of daily tablets, so the dose stays steady and nothing has to be remembered each morning.

The world feeling unreal, flat, foggy or far away, as though viewed through glass. It commonly accompanies anxiety, panic and trauma.

Also called sectioned

Being kept in hospital for assessment or treatment without giving consent, when the risk to you or others is judged high enough. It comes with legal rights, an independent review, and the right to appeal.

The list of conditions that could explain the same symptoms, and the process of ruling them out. Bipolar disorder is frequently missed this way: years of treating each depression on its own without asking what came between them.

Also called withdrawal

Symptoms that appear when a medication is stopped or reduced quickly: dizziness, flu-like feelings, disturbed sleep, irritability, or a sense of electric shocks. It is the main reason medication is tapered gradually rather than stopped at once.

A sense of detachment from yourself, your body, your memories or your surroundings. It is often a protective response to overwhelming stress or trauma, and it can feel alarming even when it is not dangerous.

Tremor, muscle stiffness, a mask-like face and a shuffling walk caused by medication rather than Parkinson's disease. It looks similar but usually settles when the medication is reduced or changed.

A deep, unsettled sense of unease or distress, sharper and more agitated than plain sadness. Restlessness with despair is a mixed state rather than straightforward depression.

A sustained muscle contraction that pulls part of the body into an unusual posture, such as the neck twisting to one side or the eyes rolling upwards. When it follows antipsychotic medication it can come on within hours, and it needs medical attention the same day.

Also called electroconvulsive therapy

A treatment given under general anaesthetic, using a brief controlled electrical stimulus to produce a seizure. Reserved for severe depression, mania or catatonia that has not responded elsewhere. It is not what it looks like in films, and memory effects are monitored closely.

Also called eye movement desensitisation and reprocessing

A trauma therapy in which memories are revisited while doing a dual attention task such as following eye movements. Recommended for post-traumatic stress disorder.

A dulled range and intensity of emotion, often reported on antidepressants: less low, but also less joy. It is worth raising with a prescriber rather than accepting it as the price of treatment.

A heightened sense of wellbeing and elation. In a clinical context it is a mood state that becomes significant when it is out of proportion, sustained, and accompanied by the other features of mania.

A steady, even baseline mood between episodes. In bipolar disorder, staying euthymic for longer stretches is the practical goal of treatment.

Also called extrapyramidal side effects

The group of movement side effects caused by dopamine-blocking medication: tremor, stiffness, slowed movement, muscle spasms and restlessness. They are usually treatable, and often by adjusting the dose or adding a second medication rather than stopping treatment altogether.

Very little emotional expression in the face or voice, so that feelings are hard to read from outside. It does not mean the person feels nothing, and it can itself be a side effect of medication.

Speech that races and jumps between topics, with each new thought linked loosely or by sound, pun or rhyme. It is characteristic of mania and hypomania.

A shared explanation of why this is happening to you, now, built from your history, circumstances and patterns. It is more useful than a label because it points to what might actually change.

A seven-question anxiety questionnaire scored from 0 to 21, used in the same way as the PHQ-9: helpful for comparison, not conclusive on its own.

An inflated sense of importance, ability or specialness, out of keeping with reality. In mania it can range from unusual confidence to fixed belief in a unique mission.

Perceiving something that is not there: hearing voices, seeing things, or less often feeling, smelling or tasting something. Hearing voices is the most common form in mental illness, and it can happen to people who are not psychotic too.

Sleeping far more than usual, or feeling unrefreshed after long sleep. It appears in atypical depression and in bipolar depression, and it is easy to mistake for laziness.

A sustained period of elevated or irritable mood and increased energy that is noticeably different from usual but less severe than mania: less sleep needed, more talkative, ideas flowing, plans multiplying. It can feel genuinely good and productive, which is why it is often not reported. It is the defining feature of bipolar 2.

The sense that ordinary, unrelated events carry a personal message aimed at you: a song on the radio, a headline, a stranger's comment. Mild versions are common; when they become fixed and organising, they are part of psychosis.

A misreading of something that is really there, such as seeing a shape in a coat on a chair. It is different from a hallucination, where nothing is there at all.

Difficulty falling asleep, staying asleep, or waking far too early. Early waking is a particular hallmark of depression, and sleep change is often the first sign of mood shifting in either direction.

Also called emotional lability

Mood that changes quickly and unpredictably, often out of proportion to what triggered it. It can appear in bipolar disorder, brain injury, some medication effects and grief.

A heavy, slowed lack of energy, in body and mind. It is often described as walking through treacle rather than simply feeling tired.

A marked period of elevated or irritable mood and high energy with racing thoughts, very little need for sleep, pressured speech and impulsive or risky decisions, lasting at least a week or requiring hospital care. Psychosis can occur. Mania is not simply a good mood at volume.

Also called MSE

The structured assessment a clinician makes in an appointment: appearance, speech, mood, thought, perception, cognition and insight. It is what the letters in your notes are describing.

Also called metabolic syndrome

A cluster of physical changes linked with some antipsychotics and mood stabilisers: weight gain, higher blood sugar, and altered cholesterol or blood pressure. This is why physical checks such as weight and blood tests are part of good psychiatric care.

Also called mixed features

Depressive and manic symptoms at the same time: despair with agitation, worthlessness with racing thoughts, exhaustion with an inability to stop. Mixed states are particularly uncomfortable and carry a higher risk of suicidal thinking, so they are taken seriously.

Medication that reduces the swings of bipolar disorder: lithium, valproate, lamotrigine and others. Each has a different profile, and lithium in particular needs regular blood tests to stay in a safe range.

Also called NMS

A rare but life-threatening reaction to antipsychotic medication: severe muscle rigidity, high fever, confusion, sweating and an unstable heart rate or blood pressure. It is a medical emergency, so call 999 if it is suspected.

An intrusive and unwanted thought, image or urge that repeats and causes real distress. The person does not want it, and trying to push it away tends to make it louder, which is why obsession is a technical term and not a synonym for enthusiasm.

A general sense of being watched, judged or threatened, often without evidence. It exists on a spectrum from understandable mistrust to fixed delusional belief.

Someone employed specifically because of their own lived experience of mental illness, to offer practical support and hope in a way that clinical staff cannot always provide.

A nine-question depression questionnaire scored from 0 to 27. Useful for tracking change over time, but it is a screening tool, not a diagnosis.

Also called pro re nata, as required

A medicine prescribed to be taken as needed rather than on a fixed schedule, often for agitation, anxiety or sleep. It usually comes with a maximum daily limit.

Also called prodromal phase

The early, subtle stage before a full episode: sleep shifting, mood drifting, sensory sensitivity or unusual thoughts. Learning your own prodrome is one of the most useful things you can do, because early action shortens episodes.

A doctor who has specialised in mental health, and the professional who can diagnose, prescribe and admit to hospital. Appointments are often shorter and more medication-focused than psychological therapy.

A professional trained in psychological assessment and therapy, usually to doctorate level. Clinical psychologists can assess, formulate and deliver therapy, but do not prescribe medication.

Thinking, speech and movement slowed together, visible to others as long pauses and heavy limbs. It is a recognised feature of severe depression, not rudeness or disinterest.

A state in which a person loses contact with shared reality, usually through hallucinations, delusions, or disorganised thinking. It is a symptom rather than a diagnosis, and it can occur in several conditions and with some drugs or physical illnesses.

An umbrella term for someone trained in a talking therapy, from counselling to psychoanalysis. Training and accreditation vary, so it is reasonable to ask about qualifications and approach.

Four or more distinct mood episodes within a year. It is a pattern that tends to need specific treatment attention rather than being read as an unstable personality.

In mental health, recovery does not always mean being symptom-free. It usually means building a life that is meaningful on your own terms, with the condition managed rather than erased.

The return of significant symptoms after a period of improvement. A relapse is not a failure of willpower, and it is usually a signal to revisit treatment rather than to give up on it.

Symptoms having largely resolved, even if the underlying condition has not gone away. Remission is the stage where relapse prevention does most of its work.

Circling the same thoughts and questions without moving toward an answer or a decision. It feels like problem solving but usually deepens low mood.

Also called drowsiness

Sleepiness or a flattened level of alertness caused by medication. Some drugs are deliberately used this way at night, but daytime sedation that interferes with work or driving is worth reporting.

A reaction to too much serotonin activity, usually from combining medicines that raise it. Signs include agitation, sweating, shivering, fast heart rate, muscle twitching or rigidity, and fever. It ranges from mild to dangerous, so it needs urgent advice.

Also called serotonin and noradrenaline reuptake inhibitor

An antidepressant group that acts on both serotonin and noradrenaline, such as venlafaxine and duloxetine. Sometimes used where depression is accompanied by pain or low energy.

Also called selective serotonin reuptake inhibitor

The most commonly prescribed group of antidepressants, including sertraline, fluoxetine and citalopram. Generally well tolerated; common early side effects include nausea, headache and sleep change.

Thoughts of ending your own life. Passive ideation is a wish not to be alive; active ideation involves planning or intent. Either is a reason to tell someone and seek help the same day.

Drifting away from the point of a question into loosely related territory and never coming back to answer it. It is common in mania and psychosis.

Reducing a medication in steps over weeks or months so the body can adjust. It applies to antidepressants, antipsychotics, benzodiazepines and mood stabilisers, and the pace should be agreed with a prescriber.

Also called TD

Involuntary, repetitive movements, most often of the tongue, lips, jaw or fingers, that develop after months or years of antipsychotic treatment. Tardive means late onset. It is one reason why long-term medication is reviewed regularly.

A thought stopping abruptly mid-sentence, leaving the person unable to continue or to recall what they were saying. It is described in psychosis and can be distressing to experience.

Disorganised thinking that shows up in speech: sentences that do not connect, topics that slide away, or words that stop meaning anything. It is a sign of how thought is flowing, not of intelligence.

Raising a dose gradually to reach the level that works while keeping side effects manageable. Slow titration is normal and is not a sign that treatment is being withheld.

Also called transcranial magnetic stimulation

A non-invasive treatment that uses magnetic pulses to stimulate specific brain areas, typically for depression that has not responded to other approaches. No anaesthetic or seizure is involved.

Rhythmic shaking, most often of the hands. It can come from medication such as lithium, from anxiety, from caffeine, or from a condition such as essential tremor, so the cause is worth checking rather than assuming.

Also called schizophasia

Words strung together without coherent grammar or meaning. It is an extreme form of disorganised speech and usually indicates significant psychosis.