Psychiatric-Mental Health Nurse Practitioner (PMHNP) Purple Book Practice Test

This question is about antidepressant-induced hypomania in someone on a bipolar spectrum course. Rapid speech and an expansive (elevated) mood after starting an antidepressant point to hypomania, not just agitation or ordinary mood. In hypomania, mood is distinctly elevated or expansive, energy and activity increase, and speech can become pressured or rapid. It often emerges after starting or increasing antidepressants in susceptible individuals and can occur within a few weeks, which fits the scenario. Activation syndrome can occur with antidepressants and includes restlessness, anxiety, irritability, and insomnia, but it typically lacks a genuinely elevated mood. A mixed state would involve concurrent depressive symptoms with manic/hypomanic features, which isn’t described here. Euthymia would be a stable mood, not the presentation given. So, the rapid speech plus expansive mood three weeks after starting an antidepressant best indicates hypomania.