Many manic patients have delusions or hallucinations, which can affect their actions while they are driving. Furthermore, concurrent use of alcohol and drugs, which commonly occur during a manic episode, may also affect driving ability. Similarly, severe depressive episode causes potential risks for driving, as reflexes and reaction time may be slowed and judgment may be impaired. Depressed patients may lack the drive and motivation necessary for task completion. Of even greater concern is the likelihood that a depressed driver may develop suicidal thoughts.
Reports indicate that persons with suicidal tendencies have greater vehicle accident rates.
Additionally, medication used to treat mood disorders may cause sedation or impair coordination, particularly as the medication is being initiated and doses are adjusted. Other psychiatric disorders frequently coexist with mood disorders. Persons with a history of mania or significant depressive symptomatology should be referred to a psychiatrist for further evaluation. Persons who suffer from mania or a severe depression, or who are suicidal at the time of the evaluation, should not be qualified to drive commercially. Persons who have experienced a severe depressive episode, a suicide attempt, or manic episode should be symptom free for one year before reevaluation.