I am diagnosed as Bi-polar with low grade OCD and acquired PTSD later on. There are a ton of things that affect my mood but only fewI can control myself. One of the things is my diet, there is scientific proof that blood sugar levels influence mental illness and that fluctuating levels can trigger episodes. Sleep is a factor that can influence as well but it not always something one can control . It is imperative to keep blood levels consistent and avoid spikes this means that you need to make sure you know what you are eating and how it reacts with your body. You need to eat several small meals a day consistently and avoid over eating or not eating enough. For me my episodes slashed them self in half when I went from vegetarian to vegan. And I have heard from other vegans that going vegan helped them substantially as well (but there is no scientific data to back this part). Not sleeping does not help either. As for not knowing what is real, it all is. You just are more sensitive at times so it hits harder but it does not make those emotions fake they are just amplified.