What to do now
If they suddenly become confused, go to A&E or call 999. Do not assume this is caused by a mental-health condition. Sudden confusion needs immediate medical assessment.
- Write down what is different. Note when it began and changes in sleep, speech, movement, energy, eating, drinking, confusion, unusual beliefs and safety. Use examples rather than trying to name a condition.
- Check what changed beforehand, if you know. This could include recent illness, a hospital stay, medicine changes, alcohol or drug use, or a major lack of sleep. Tell the service if you do not have this information.
- You can ask for help as a friend. You do not need to find their GP first. For urgent mental-health advice in England, call NHS 111 and select the mental-health option. Say you are a friend and describe what has changed. If you already have their care team's number, you can use it. Routes elsewhere in the UK.
- Do not change their medicines yourself. Ask the prescriber, ward, GP, pharmacist or NHS 111 for advice if you are worried about a medicine or side effect.
If the change is not urgent, offer to help them contact their GP. Ask whether they want you to call together. An adult usually needs to agree to assessment and treatment; you can encourage them, but usually cannot make them accept help. What you can do if they refuse.[1]
Are you somewhere else? Read how to get urgent help from a distance, including what location to give. Support for a student away at university.
They seem unusually cheerful, energetic or talkative
A person does not need to look frightened or unhappy for a marked change to deserve attention. They might seem much happier, more sociable, more active or more talkative than usual. What matters here is that the change is pronounced and out of character, not what diagnosis might explain it.
Notice whether they are also sleeping much less, speaking unusually quickly, becoming hard to interrupt, moving constantly, making uncharacteristic plans or seeming unable to slow down. Report what you can actually see and hear. Do not tell services that the person “must be manic” unless that is already part of an established diagnosis and care plan.
What to say when you call
You could start with:
Say whether you are with them and where they are, if you know. Mention a recent hospital stay, medicine changes or sleep changes if you know about them; be clear when you do not. You do not need their medical history to explain what you have seen.
If they say they feel fine
Do not argue about whether they are unwell. Keep the conversation about the change you have noticed: “You seem much more active and you have hardly slept. That's very different for you, and I'd feel better if we got some advice.”
If you know their GP or care team, you can pass on factual concerns even if they do not want you involved. Being a friend does not stop you sharing what you have observed. Confidentiality may limit what staff can tell you back, but it does not prevent them listening. They may need to tell the person what you have shared.
Confidentiality: what you can tell the care team and what they may share.[2]
Why this page does not suggest a diagnosis
Changes in behaviour can have mental-health, physical-health, medication, substance-related and other causes. Similar outward behaviour can arise for very different reasons. A website cannot safely decide the cause.
This guide is designed to help you notice a significant change, describe it clearly and reach an appropriate service. Condition guides are for understanding a diagnosis the person already has, not for matching someone to one.
While you are waiting for advice
Keep things calm and reduce avoidable stimulation. Avoid a heated confrontation or trying to prove that their behaviour is abnormal. If it is safe, stay in contact and encourage food and fluids. Have any information they have shared with you ready for the clinician.
If they suddenly become confused, go to A&E or call 999. If other changes are escalating or cannot safely wait, use the urgent-help route rather than waiting for a routine appointment.
And you?
Seeing someone change suddenly can be frightening. Tell another trusted person what is happening if you can, and visit Support for you if you need help carrying it.
Sources and how this guide was written
What to do now
NHS: where to get urgent help for mental health
NHS: sudden confusion needs immediate medical help
NHS: you can call 111 about someone else
NHS England: urgent mental-health advice for someone worried about a loved one
If they say they feel fine
GMC confidentiality guidance, paragraphs 39 and 40: listening to people close to a patient.
Last full source check: 29 August 2026
Consent and seeking advice wording checked: 7 October 2026. Sources and explanation.
Later checks: Calling as a friend and confidentiality guidance checked: 27 September 2026. Editorial changes and help-route wording checked against the linked guidance: 1 October 2026.
Independent information, not a medical or crisis service. This guidance has not been clinically reviewed. How we use sources.
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