bipolar mood disorder

A 35 years old male is brought in by his family because has been taking out various loan to start a few small business.Over the past 2 weeks,he come home at 3 a.m from work and leaves at 6 a.m. He often compares his business venture to those of bill gates. In the past he has had a few episode in which he felt hopeless and tried to commit suicide.

1) what is your provisional diagnosis
    - bipolar 1 disorder
2) list out 3 psychopathology that you see in this patient
    - decrease need of sleep
    - increase in goal directed activity
    - inflated self estemm
    DSM-IV criteria to diagnose bipolar 1 disorder
    - period of abnormal and persistently elevated,expansive,and irritable mood at least
      1 weeks, including at least 3 of this symptoms :
      - inflated self esteem and grandiosity
      - distractibility
      - talkative and pressure of speech
      - increase in goal directed activity
      - decrease need of sleep
      - excessive involvement in pleasurable activity
      - flight of idea
3) list 2 differential diagnosis for this patient
    - major depressive disorder
    - bipolar 1 disorder secondary to medication or substance use
      (somatic antidepressan,ECT,light therapy can cause manic)
4) principle of management for this patient
    - admit patient to the ward
    - pharmacotherapy
      - lithium,valproic acid, and carbamazepine(mood stabilizer)
      - a typical antipsychotic(olanzapine)
    - psychotherapy
      - supportive psychotherapy(onset of lithium is about 5-7 days)
      - family therapy(he may view differently after have psychopathology,must reduce the conflict and
        must help all family members understand each other)
      - group therapy(patient may gain insight into their own condition by listening to other)