A 34-year-old woman presents to the outpatient psychiatric clinic with a chief complaint of mood instability. She reports experiencing a 5-day episode last month during which she slept only 3-4 hours per night yet felt fully rested, started three new creative projects simultaneously, and was notably more talkative than her baseline. Her family members confirmed this was a distinct change from her usual demeanor. Between these episodes, which she describes as occurring two to three times per year lasting 4-7 days each, she reports stable mood and functioning at her baseline. She denies any history of impulsive self-harm, identity disturbance, or chronic feelings of emptiness. Her PHQ-9 today scores 14, indicating moderate depressive symptoms that began approximately two weeks ago. She has no significant medical history and takes no medications.