Tales of Lithium on a Friday Afternoon
an excerpt

Tales of Lithium on a Friday Afternoon

Diagnosis: Bipolar Affective Disorder, currently manic with psychotic features.

Medication: Commence Olanzapine 10mg nocte and Zolpidem 10mg nocte. To be started on Lithium after investigations.

I reviewed this pleasant 23 year old lady in my outpatient clinic today. She told me that over the past two weeks there has been a definite change in her condition, characterised by increased energy, increased appetite, increased activity, increased libido and a decreased need for sleep. Her mood has been “extremely happy to angry” but not particularly depressed anymore. She also told me that she heard the voice of her ex-husband on a few occasions over the past week and actually believed that he was standing outside, to the extent that she sellotaped the windows of her home to prevent the sound and to prevent him from coming him. On examination her psychomotor activity was clearly increased. She plans to start a “children’s play centre” and wants to be a millionaire. She also showed evidence of auditory hallucinations regarding her ex-husband’s voice. Her insight was partial and she could understand that “something is not alright now”.
My impression is that she is clearly suffering from a manic episode with psychotic features. This also confirms my earlier suspicions that Lyndsey is actually suffering from Bipolar Affective Disorder and not recurrent depression.

So here I am now, aged a tender twenty five and living my life on a rollercoaster. I don’t know what my mood will be like in the next five minutes or what the next hallucination will be but this is my tale so far.