The most likely diagnosis is bipolar I disorder. The patients symptoms are consistent with an episode of mixed depression and mania. Psychomotor agitation, racing thoughts, severe insomnia, anxiety, panic, and severe irritability are all symptoms suggestive of a mixed episode. Also, the patient has a high genetic risk for bipolar disorder because she has a first-degree relative with the illness. The patient is not experiencing psychotic symptoms; therefore, psychotic depression and schizophrenia are incorrect. The patient is having anxiety and panic, but because of her severe mood symptoms, a primary diagnosis of an anxiety disorder is incorrect.
- Bipolar disorder.
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