Psychiatrymiddle twist
A 54-year-old restaurateur is brought by her husband with three weeks of elevated mood, sleeping two hours a night and plans to buy a second premises. She has never seen a psychiatrist and has had no previous episode of depression. Five weeks ago a rheumatologist began high-dose oral treatment for giant cell arteritis; she also takes atorvastatin, metformin, esomeprazole and paracetamol. Her mother had bipolar disorder. She is afebrile, her thyroid is not enlarged, and there is no focal neurological deficit. Which one of the following best accounts for her presentation?