This pattern is affiliated with bipolar disorder, alternating between manic (crazy laughter, over confidence, shouting) and depression (dullness, confusion, muttering to oneself). The initial stage is wild behaviour or over excitement that eventually develops into mental symptoms. This pattern is caused by severe emotional problems and depression that harms both heart and spleen. This pattern is a combination of heart and spleen dysfunction.
Mental restlessness, palpitations, bitter taste in the mouth, insomnia, dream disturbed sleep, propensity to be startled, incoherent speech, mental confusion, rash behaviour, tendency to hit or scold people, uncontrolled laughter or crying, agitation, shouting, muttering to oneself, mental depression and dullness.

Jost Sauer Spiritual attunement acupuncture

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