To help you remember and nail that manic episode diagnosis, Dr. William Falk developed the DIG FAST mnemonic.
D: Distractibility – easily distracted and difficult to focus on the conversation at hand.
I: Indiscretion – showing poor judgment and a lack of the ability to see the consequences of actions.
G: Grandiosity – having a sense of being better and more meaningful than what is going on and inflated self-esteem.
F: Flight of Ideas – having racing thoughts from one idea to the next and the next and quickly changing ideas or thoughts, especially when talking.
A: Activity Increase – showing accelerated goal-directed activities without the ability to stick or complete one action at a time.
S: Sleep Deficit – the hyperactivity results in a lack of sleep, or in other cases, the patient is not even aware they have not slept.
T: Talkativeness – combining the above symptoms results in the patient being more talkative than usual.View Our Nursing Mnemonics Course
Deeper Insights into DIG FAST
Distractibility is the state of a person’s mind getting distracted easily by irrelevant and minute stimuli.
You and I can easily get distracted. Maybe an email or text message notification, a phone call, a passing ice cream truck that sells your favorite ice cream, or fantasizing about the position you will be in the next five years. This is normal since the human mind is naturally wired to get distracted. Some Harvard psychologists discovered we spend 47% of every hour mind wondering, or as they called it…stimuli-independent thoughts.
However, unlike our minds that wander off 47% of the time, the mind of a manic patient wonders constantly.
According to a Frontier in Psychology journal, such loss of focus and concentration can result in complications such as:
- Neurobiological changes
- Disruption of the working memory performance
- Disruption of the brain functioning
- Cognitive impairment
- Impaired learning
So, watch out for all these complications when taking care of a patient suffering from mania or when you encounter such a question in your exams.
Indiscretion is the lack of proper judgment while undertaking an immediate or unplanned action and failing to recognize the consequences of these actions.
A patient suffering from manic attacks is ready to take the immediate activity in response to stimuli. Such a patient has zero regards for the actions or repercussions of these actions to themselves or others. Some activities the patient could engage in include.
- Dubious financial deals
- Hypersexual escapades
- Out of control shopping sprees
- Starting and escalating confrontations
- Destruction of property
- Sudden change or canceling plans
- Physical violence
Oh, and by the way, do not confuse indiscretion with compulsion. With indiscretion, a patient suffering from a manic episode does not even notice the activities they are engaged in. On the other hand, compulsion is when a patient sees an abnormal behavior but is unable to stop it.
While indiscretion is a symptom of mania, little literature is available on what causes it…the human decision-making process is complicated that way. Some probable causes include:
- Psychological issues such as childhood PTSD
- Genetics – studies suggest a genetic anomaly on chromosome 9 can result in indiscretion by altering the neurotransmitters found on the brain’s frontal lobe that deal with mood and cognition.
- The sensation-seeking personality that causes a person to be indiscreet.
Grandiosity is inflated self-esteem, self-confidence, self-centeredness, and feeling more important than what is going on within the vicinity. The importance may be in power, intelligence, or identity that may progress to having delusions of grandeur.
I know; it sounds more like narcissism. However, grandiosity is more take-charge and assertive than narcissism.
You might notice your patient advising about a matter that they lack any experience or expertise in; tell you how they have a face-to-face and personal relationship with God, the president, a renowned community figure, or a celebrity. In addition, the patient might start planning for an unrealistic activity such as writing a novel or shooting a movie.
F: Flight of Ideas
Flight of ideas happens when a person suffering from a manic episode has racing thoughts.
Holding a conversation with the patient might be tricky since they make no logical sense while talking. They just throw words together in a non-logical succession. For instance, one minute, they are, “What is your favorite movie? The weather looks nice. I think I forgot to lock my house. What has this life come to? Oh boy, do I miss ice cream.”
Sadly, the patient has no control over the trail of thoughts, affecting their daily routines. These thoughts can also be manifested outwardly, with the patients uttering snippets of conversations, sentences from a book, or lines from a movie. There are instances when the person can wake up in the middle of the night and get confused by their rapid thoughts.
Take note when a patient complains of having uncontrolled and racing thoughts.
A: Activity Increase
You will notice many objective-focused activities involving excessive planning and participation. There are no specific activities these patients favor. They range from social, sexual, political, or religious activities without any particular order, and in some cases, the patient will engage in these activities simultaneously.
You will encounter cases where a patient may have increased social interactions and norms. Unfortunately, the patient has no regard for the consequences, even when these interactions are awkward, intrusive, demanding, or domineering.
Do not be surprised when the patient strips in front of everyone and dresses back up!
Additionally, it is not uncommon for a patient to write tons of letters addressing multiple parties regarding various topics, such as religious leaders, the president, relatives, friends, or God.
Some noticeable features of increased activity include:
- Fast or repetitive motions
- Unintentional movements without any purpose
- Tapping fingers and feet
- Unable to sit or stay still for extended periods
- Stiff body movements
S: Sleep Deficit
Some patients wake up much earlier than usual and go for days without sleeping a wink and yet still function without feeling tired.
Now, for a nursing student or a nurse expected to pull a long shift, this can be a useful superpower. Don’t you think?
When you combine all the above symptoms, you will get an extremely talkative patient.
Throw in the burst of energy into the mix; you are left with a patient unable to keep quiet.
You will notice pressured speech in a patient suffering from mania. The patient may be loud, lively, and nonstop for hours, making it difficult, if not impossible, to stop or interrupt them.
In some cases, the patient can become irritable and start complaining or throwing abusive, angry, or hostile comments and tirades.
You might even think all is dandy when the patient starts to make jokes, amusements, or puns. They may even become theatrical and throw in their favorite song.
Nevertheless, listening closely, you will still notice the same faster than usual talking.
The Benefits of DIG FAST Mnemonic in Diagnosing Manic Attacks
The truth is identifying a manic episode can be difficult, especially when in nursing school. It takes you some time to learn, but you will get there eventually when you utilize the right tools. Combine all the information you must know, including the signs, symptoms, and the best way to handle a manic attack; your nursing school life can be stressful.
However, by utilizing DIG FAST in both mental health clinical and in the field, you are on your way to mastering the art of identifying a manic attack and better helping your patients.
Therefore, in school and the field, you should use and learn DIG FAST because:
- It is a memory aid. It will help you remember and recall lists of items, long answers, and any complex information relating to manic attacks both in nursing school, especially during your nursing exams, and in the field.
- It will help you save time and stress. You will slash the time required to study and identify manic signs and symptoms…bye bye stress. Such time is vital, especially in all exams.
- It will enable you to educate a manic patient and their family and help them navigate the health facility’s systems and processes.
- Mastering DIG FAST will help you become a better healthcare giver since you can nail a manic attack diagnosis within the shortest period.
- It will help you invent a fantastic nursing care plan after successfully identifying a manic episode, making you a better healthcare giver.
- Generally, mnemonics is an effective nursing educational tool.
- It promotes safety and success in nursing school and your healthcare facility since all the nurses follow a standard process of identifying and handling manic attacks.
I know the pressures of nursing school…I have been there, and how you are supposed to get everything right. However, you owe it to your future patients and yourself to ace your exams and nursing school. You have a duty to your prospective patients and yourself to learn and master the art and science of identifying and handling manic attacks.
It can be intimidating sometimes…or maybe most of the time. Luckily, the DIG FAST mnemonic is a reliable buddy to pass your exams and daily activities in the field.
Furthermore, you will be in charge of your manic patients’ wellbeing, including educating them and their families about manic attacks. We spend a lot of time taking care of patients, so it’s vital to master DIG FAST and learn how to apply it.
At Nursing.com, we are rooting for you. Whether you are a nurse or a nursing student, we have plenty of resources to help you master and handle manic attacks. So, head over…dig right in!
Fortunately, our Nursing Mnemonics course is all about helping you become a skilled nurse.