Your patient is a 32-year-old male who has been successfully treated for depression with a selective serotonin reuptake inhibitor. The patient's wife is concerned, because over the past few days her husband has not slept and has been spending most of his time trading stocks online and making extravagant purchases. He has been talking about taking a trip to Spain to run with the bulls in Pamplona. She states that he is talking incessantly and seems "wired." The patient had a similar episode about a month ago that came on suddenly but resolved when the patient "crashed" and slept for several days. Which of the following is most consistent with this situation?

Question

Quizplus · Accepted Answer

The patient's symptoms are consistent with a manic episode, which is a hallmark feature of bipolar disorder. The previous episode that resolved when the patient slept for several days is also consistent with a manic episode. The symptoms of excessive spending, talking incessantly, decreased need for sleep, and grandiosity are all commonly seen in a manic episode. The other answer choices (A, B, C) are less likely given the patient's history and presentation.

Your Patient Is a 32-Year-Old Male Who Has Been Successfully