A client is telling the nurse about his perception of his thought patterns. Which of the following statements by the client would validate the diagnosis of bipolar disorder?

  1. “Sometimes I’m ready to take on the world, but other times I’m too tired to get out of bed.”
  2. “I need to check and then recheck all the kitchen appliances several times to make sure they are off before I feel comfortable leaving my home.”
  3. “My neighbors hold sacrificial rites in their backyard.”
  4. “I keep on patrol all night so the enemy won’t invade my home and hurt me or my family.”
Number 1 is correct.
Rationale: Bipolar disorder results in dramatic changes in a person’s mood and energy. In the mania phase, people feel energized, even euphoric. When in the depressed stage, people have low energy and resist engaging with the world. The need to repeat a given behavior is consistent with obsessive-compulsive disorder. Hallucinations—believing/seeing/smelling/hearing things that do not exist—is associated with schizophrenia. Intense feelings about the need to protect oneself is associated with post-traumatic stress disorder.