A 49-year-old woman presents with depressive symptoms characterized by depressed mood, diminished interest, aggressive behavior and recurrent suicide attempt. Symptoms had begun four years before, involving irritability, impulsive behavior, fatigue at work and persecutory delusions. Two months before, symptoms became more intense and she was diagnosed with bipolar disorder. She was referred to a psychiatric hospital due to the persistence of symptoms after irregular use of haloperidol, risperidone and valproate. There was no previous psychiatric history.