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How do you approach a patient who exhibits classic bipolar symptomatology (including cycling sleep changes, behavioral changes, and mood changes) but has never responded to any form of adequate trials of mood stabilizer treatment?
When would you consider symptoms to be potentially of other etiology? Would you ever consider a conversion or functional diagnosis?
Answer from: at Community Practice
I would question the diagnosis and look to better understand underlying anxiety, PTSD, or borderline personality disorder. I tend to see this in patient who have substantial trauma history. I look to treat the comorbid symptoms (insomnia, substance abuse, treating ADHD with an alpha 2 agonist, treat...
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