Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes insidiously. The disease currently has a prevalence of 43/ 100 000 individuals in Malaysia. The presentation of the disease is varied resulting in delay in diagnosis and onset of complications prior to management. The disease commonly presents as joint pain and cutaneous manifestations. Neuropsychiatric presentation accounts for 24% of symptoms during onset of illness. This case report highlights that we encountered a patient who presented with neuropsychiatric manifestations, whereby the patient was managed for the psychiatric symptoms prior to the organic diagnosis being made.