ChoiceHub
Sign in
A 24-year-old woman is referred because of mood swings since her late teens. Twice in two years she has had six-day spells of sleeping three hours a night, talking over people, cleaning the flat until dawn and spending money she did not have; she kept working and her flatmate called her unstoppable. She has never been admitted and has never had delusions or hallucinations. Between those spells she has had two three-month periods of being unable to get out of bed, sleeping excessively and feeling worthless. She does not drink and her urine drug screen is negative. Which one of the following best accounts for this pattern?
Shared by Mornienmiddle twist

Keep going — a set of ten like this one, one at a time.

Practise more

More from Psychiatry

See all

A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…

Pre-internship · niche

A 40-year-old man who came to Australia from Iraq as a refugee eight years ago attends a general practice with six months of broken sleep, nightmares and daily…

Clinical rotations · middle twist

A 71-year-old woman who migrated from Hong Kong 40 years ago is admitted to a psychiatric ward with a severe depressive episode. She speaks Cantonese and almost…

Pre-internship · middle twist

A metropolitan mental health service is examining why Aboriginal and Torres Strait Islander inpatients leave the ward against medical advice far more often than…

Clinical rotations · middle twist

A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…

Pre-internship · niche