Australian Doctor Australian Doctor 17th November 2017 | Page 14

Grand Rounds
Is it bipolar
disorder?
THE AUTHORS
MENTAL HEALTH
Dr Adam Bayes is
senior research fellow,
University of NSW, and
consultant psychiatrist in
Sydney, NSW.
Professor Gordon Parker
AO is Scientia Professor
of Psychiatry, University
of NSW, and formerly
executive director of the
Black Dog Institute.
A young woman presents with depression after a
relationship break-up.
S
AMANTHA is a 32-year-old beauty ther-
apist referred by her GP for diagnostic
clarification. The referral noted she was
depressed following a relationship break-
up. However, because Samantha reported “highs”
and impulsive behaviour in the past, did she have
a bipolar disorder and warrant prescription of a
mood stabiliser?
Assessment
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Samantha reported worsening mood swings over
the past six months associated with alcohol con-
sumption and illicit drug use (cocaine on week-
ends). This occurred in the context of a tumultuous
new relationship that had recently ended, after
which her mood had plummeted.
There was an absence of melancholic features of
depression (appetite o