Diagnostic Clues
This symptom is more predictive of bipolar disorder than elevated mood.
What is decreased need for sleep?
Insomnia, irritability, and increased productivity shortly after starting an SSRI may represent this.
What is antidepressant activation?
This condition, which causes impulsivity, is chronic and lifelong rather than episodic.
What is ADHD?
Three nights of 3 hours sleep with rising productivity requires this action.
What is urgent review?
This is the most heritable mood disorder.
What is bipolar disorder?
This medication class, when used alone in bipolar disorder, may increase risk of mood destabilization.
What are antidepressants?
Mood shifts occurring over hours and triggered by relationships are more consistent with this diagnosis.
What is borderline personality disorder?
Mixed features plus suicidal ideation requires escalation within this time frame.
What is same-day?
In relapse prevention, this is usually the first biologic sign of mania.
What is reduced sleep?
If a patient becomes more agitated and sleeps less after starting sertraline, this should be concerning for ____.
What is antidepressant-induced mania?
The key feature that distinguishes bipolar II from BPD is this biologic change.
What is decreased need for sleep?
Stopping a mood stabilizer abruptly should trigger this.
What is urgent review?
If sleep drops below this number of hours for several nights with rising energy, escalation should be considered.
What is fewer than 4–5 hours?
Worsening cycling after SSRI addition may indicate this underlying vulnerability.
What is bipolar spectrum disorder?
People with this disorder have mood reactivity that's chronic and have identifiable triggers.
What is trauma-related disorder or personality disorder?
Mild insomnia without activation may be appropriate for this approach.
What is close monitoring?