Bipolar Disorder Case Study

Scenario 1: Initial Presentation

John, 35, presents with a history of impulsivity, elevated mood, and decreased need for sleep. He has been more talkative than usual, spending large sums of money on luxury items. His behavior has become more erratic at work, and he has stopped taking his medication, leading to escalating symptoms.

Medical History: Bipolar I disorder, currently in a manic episode. Previous hospitalizations.

MAR: Lithium 1200 mg PO daily, olanzapine 5 mg PO at bedtime

Labs: Lithium level: 0.8 mEq/L, normal electrolytes

1) What is your clinical impression of John’s current condition? 2) What would be your first priority in managing his symptoms?

Correct Answer & Rationale:

Diagnosis: John is likely experiencing a manic episode of Bipolar I Disorder, as evidenced by impulsivity, elevated mood, pressured speech, and excessive spending.

Management: Stabilizing his mood with medication adjustments, especially optimizing lithium dosage, is crucial. Additionally, monitoring his safety and managing impulsive behaviors will be key.