A 34-year-old male has a 10-year psychiatric history. Chart review reveals multiple major depressive episodes during which he reports auditory hallucinations telling him he is worthless and deserves to die. Between depressive episodes, he functions well, returns to work, and has no hallucinations or delusions for months at a time. He has never experienced a manic or hypomanic episode. He currently presents in a major depressive episode with command auditory hallucinations to harm himself.