The Case of Joseph Martinez: A Medical Student with Mania

  • Shannon G. CaspersenEmail author


Lifestyles conducive to manic-like behavior, such as that of the medical student with long hours and high academic ambition, can mask and/or exacerbate mania. Early recognition and aggressive treatment, both behavioral and pharmacological, are key to management. Effect and side effect profiles of mood stabilizers need to be taken into account when choosing medications for particular patients with bipolar disorders, according to their lifestyles and life goals. Transference and countertransference with manic patients within the medical hierarchy need to be addressed in any treatment relationship, but given the sometimes aggressive and grandiose nature of mania, these issues require particular attention in the medical trainee presenting with mania.


Pressured speech Bipolar I disorder Mania Substance-induced mania Delusions of grandeur Psychotic features Mood-stabilizing medication 


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Suggested Reading

  1. Avery JD, Barnhill JW, editors. Co-occurring mental illness and substance use disorders. Arlington: American Psychiatric Publishing, Chapter 3: Depressive and bipolar disorders; 2018. p. 25–38.Google Scholar
  2. Viktorin A, Ryden E, Thase ME, et al. The risk of treatment-emergent mania with methylphenidate in bipolar disorder. Am J Psychiatry. 2017;174:341–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Weill Cornell Medical CollegeNew YorkUSA

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