The hypomanic tech expert

I once met a well dressed man from India whom appeared to be in good health. His chief complaint was (him) having severe panic attacks, profuse, sweating/diaphoresis and depression.

I’ve always professed to (my) medical students, “look at the patient and lift your head up from the chart”.

At the time, he looked well and was not sweating. He seemed calm and collected. This seemed odd because he told me of the distress he was experiencing. I immediately knew the diagnosis. Relative to his depression, anxiety and panic attacks… he seemed cool as a cucumber.

It became clear he was hypomanic (a stage before full-blown mania). He had manic depression and was going to lose his job, along with his wife and children. I put him on Seroquel and Lamictal. He came back in two weeks and said he felt great. He also said he felt very s*xual.

Relative to his previous state of despair, he was up up up!

This story had a “happy ending”.

His wife and children stayed but he still lost his job.

However, being a tech guy… he was hired at Google.