A 42-year-old patient presents to the emergency department exhibiting poor judgment, impulsivity, and an elevated mood. The patient reports they 'feel like the king of the world' and have been highly productive, requiring very little sleep over the past week. Which diagnosis best fits this patient's presentation?
The patient is showing signs of a manic episode, which is characterized by an abnormally elevated or irritable mood, grandiosity, decreased need for sleep, talkativeness, racing thoughts, distraction, increased goal-directed activity or psychomotor agitation, and excessive involvement in high-risk activities. These symptoms must persist for at least one week to meet the diagnostic criteria for a manic episode, commonly seen in bipolar disorder. It is important for the emergency nurse to recognize these signs to differentiate from other conditions and ensure appropriate treatment and referral. Major depression would present with low mood, diminished interest, and other depressive symptoms. Anxiety disorders would primarily manifest as excessive worry and related physical symptoms. Situational crisis would be linked to a triggering event, which is not necessarily suggested by the reported symptoms.
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