manic/hypomanic

[BiscayneBlvd]

a 28 y/o man has a history of a mood disorder and comes to see the psychiatrist at his wife's urging. he has decreased need for sleep and increased energy; his wife says he is irritale and acts recklessly on several occasions. which of the following is the most likely additional presenting symptom?

a depressed mood
b fear of dying
c insomnia
d racing thoughts
e recurrent thoughts and actions that relieve anxiety when carried out













i thought it was c: insominia and they said the answer is d racing thoughts. I 'm kinda confused as to kaplans thinking b/c first aid says the symptoms for manic episode is DIG FAST and I being Insomnia can nybody shed some light on thsi for me thanks

[jameslynton]

Clue following is the most likely additional presenting symptom?
The racing thoughts would go with the start of mania. Having been in clinical setting and seen these people - their minds are going so fast. They will spout off ideas so fast it will make your head spin. When I read it I thought - start of mania - clues are
1. need less sleep/have energy
2. Reckless activies
3. Irrational behavior
4. Concern all is not well by close person

Interview would disclose fast thoughts. Would be tip off to start of mania.

Clincal hint - Most Bipolar like mania and adjust meds to stay just in it. They don't see being up at night as insommina - they are just having fun. Hope this helps.

[BiscayneBlvd]

thank you so much...it makes sense and i'll never forget it :)