Case 30-2016: A 63-Year-Old Woman with Bipolar Disorder, Cancer, and Worsening Depression

A 63-year-old woman with bipolar disorder and a history of cancer was admitted for electroconvulsive therapy. Chest CT revealed a new invasive breast cancer. The patient initially declined surgery and cancelled appointments. Management decisions were made. Presentation of Case Dr. Daniel J. Daunis (Psychiatry): A 63-year-old woman with bipolar disorder, worsening depression, and multiple other medical conditions, including lung cancer and breast cancer, was admitted to the inpatient psychiatry service of this hospital for electroconvulsive therapy (ECT). The patient had a long-standing history of bipolar disorder, including depressive episodes, which were characterized by low motivation, low energy, a feeling of hopelessness, agoraphobia, and suicidal ideation without suicide attempts, and brief episodes, each lasting for 2 to 3 weeks, of hypomania and mania with irritable or elevated mood, labile affect, pressured speech, and a decreased need for . . .