A 40 year old man with elevated mood: March 2007

Correct Answer: Mania
Description: Ans. B: ManiaMania is characterized by extremely elevated mood, energy, unusual thought patterns and sometimes psychosis.It is most often associated with bipolar disorder, where episodes of mania may cyclically alternate with episodes of major depression.Manic symptoms include irritability, anger or rage, delusions, hypersensitivity, hypersexuality, hyper-religiosity, hyperactivity, impulsiveness, racing thoughts, talkativeness, pressure to keep talking or rapid speech, and grandiose ideas and plans, decreased need for sleep (e.g. feels rested after 3 or 4 hours of sleep).A mnemonic used to remember the symptoms of mania is DIGFAST:D = DistractibilityI = IndiscretionG = GrandiosityF = Flight of ideasA = Activity increasedS = Sleep (decreased need for)T = Talkativeness (pressured speech)Dysphoric mania is primarily manic and agitated depression is primarily depressed.Acute mania in bipolar disorder is typically treated with mood stabilizers and/or antipsychotic medication.Treatments need to be prescribed and monitored carefully to avoid harmful side-effects such as neuroleptic malignant syndrome with the antipsychotic medications.Antipsychotics and mood stabilizers help stabilize mood of those with mania or depression.They work by blocking the receptor for the neurotransmitter dopamine and allowing serotonin to still work, but in diminished capacity.Lithium is the classic mood stabilizer to prevent fuher manic and depressive episodes.More recent drug solutions include lamotrigine.
Category: Psychiatry
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