Diagnosing manic episodes is challenging due to reliance on subjective conversation rather than objective biomarkers and potential patient impairment in communication.

“this isn't a blood test, this isn't a measurement that you can take on a scale or with a biomarker, they have to use language, a conversation with somebody who, by all accounts, is pretty impaired at conversation to determine whether or not they're suffering from a manic episode that is the consequence of bipolar disorder.”