DIG FAST · Manic Episode Mnemonic

Published: Feb 04, 2025

Author: Lahav Constantini, MD•

Editor: Alyssa Haag, MD•

Editor: Ian Mannarino, MD, MBA•

Editor: Kelsey LaFayette, DNP, ARNP, FNP-C

Illustrator: Jessica Reynolds, MS•

Copyeditor: David G. Walker

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What is the DIG FAST mnemonic?

The DIG FAST mnemonic is a memory device used to remember the symptoms of mania, which may occur in the setting of bipolar disorder. Bipolar disorder is a mental health disorder characterized by periods of low moods that are similar to those in a major depressive disorder as well as periods of high moods, which are characterized as manic episodes or hypomanic episodes, depending on the level of severity.

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What is mania?

Mania is a state involving drastic changes in mood, energy, activity, behavior, sleep, and cognition. One of the core symptoms of mania is an atypically good, euphoric, or irritable mood, which may be accompanied by persistently increased energy and activity as well as decreased need for sleep. When an individual is experiencing a full manic episode, these symptoms can reach a dangerous extreme, often requiring hospitalization to prevent harm. Mania is diagnosed when individuals meet the criteria described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition, or DSM-5. According to the DSM-5, a manic episode lasts for at least a week but may often last longer, and these symptoms need to be severe enough to cause significant impairment at school, work, or social life. Alternatively, symptoms may be accompanied by psychotic features.

On the other hand, hypomania is similar to mania but lasts for a shorter amount of time, less than 4 consecutive days, and doesn’t have an equivalent impact on the individual’s functioning. This criteria is summarized in the DIG FAST mnemonic.

What does the “D” in DIG FAST mean?

The "D" stands for distractibility. While most individuals lose their attention from time to time, with mania, individuals may feel more easily distracted by minor stimuli, have difficulty distinguishing between relevant and irrelevant thoughts, and feel unable to concentrate.

What does the “I” in DIG FAST mean?

The "I" stands for indiscretion and excessive involvement in impulsive and reckless behaviors. These include sexual indiscretions, substance abuse, gambling, unrestrained shopping sprees, or bad financial investments without any regard for consequences.

What does the “G” in DIG FAST mean?

The “G” stands for grandiosity, which refers to having excessive self-esteem or self-image. This may progress into delusions of grandeur, when an individual believes they have special powers or abilities, they’re famous, or that they’ve been granted a special mission.

What does the “F” in DIG FAST mean?

The "F" stands for flight of ideas, which is characterized by a rapid flow of thoughts that are disconnected, illogical, or loosely connected. Flight of ideas typically causes individuals to speak rapidly and quickly jump from one topic to another.

What does the “A” in DIG FAST mean?

The “A” stands for activity increase. More specifically, individuals may feel the need to achieve certain things and engage in many goal-directed activities, such as spending all night and day working on a complex manuscript or starting a business on a whim. Activity increase is often associated with psychomotor agitation, which is when an individual feels restless and performs movements with no purpose, such as tapping their toes or pacing around the room.

What does the “S” in DIG FAST mean?

The “S” stands for sleep deficit or decreased need for sleep, meaning that individuals might feel “wired” as if they don’t require sleep. In fact, during a manic episode, individuals may function on very little or no sleep at all for days at a time. This is different from insomnia, which involves the inability to sleep despite feeling tired.

What does the “T” in DIG FAST mean?

The “T” stands for talkativeness. Individuals may act more talkative than usual or have pressured speech, meaning that they feel the need to keep talking constantly, at a rapid pace. The excessive talkativeness can last hours and be very difficult to interrupt. The individual may seem very energetic and talk swiftly, loudly, and often comically with the content and tone ranging from fun and amusing to heated and hostile.

What are the most important facts to know about the DIG FAST mnemonic?

DIG FAST is a mnemonic device that can be used to remember the main symptoms of a manic episode. The D refers to distractibility; I refers to indiscretion and excessive involvement in impulsive and reckless behaviors; G refers to grandiosity and inflated self-esteem; F refers to flight of ideas and racing thoughts; A refers to goal-oriented activity increase; S refers to sleep deficit; and T refers to talkativeness. In order to diagnose mania, these symptoms must last for at least a week and need to be severe enough to cause significant impairment at school, work, or social life, and they often require hospitalization to prevent harm.

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. 5th ed. American Psychiatric Association Publishing; 2022.

Goldberg JF, Ernst CL. What to do when your depressed patient develops mania. Fed Pract. 2016;33(Suppl 2):26S-33S.

Kadiyala, P.K. (2020). Mnemonics for diagnostic criteria of DSM V mental disorders: a scoping review. General Psychiatry, 33(3): e100109. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232614/

Soraggi-Frez, C., Santos, F. H., Albuquerque, P. B., & Malloy-Diniz, L. F. (2017). Disentangling working memory functioning in mood states of bipolar disorder: A systematic review. Frontiers in Psychology, 8, 574. DOI: 10.3389/fpsyg.2017.00574