Cynthia is a 29-year-old financial planner who is married and the mother of three children. Her husband brought her to the emergency room after having spent the past 12 days in “another cycle of depression,” marked by a quick temper, almost no sleep and tearfulness. He noted that these “dark periods” have gone on as long as he has known her but that she had experienced at least a half dozen of these episodes in the prior year. Cynthia’s husband reported that her mood typically stabilizes within a few weeks of restarting her fluoxetine. He added that he wondered whether alcohol and clonazepam worsened her symptoms, because she routinely ramped up their use when the dark periods begin.
Cynthia’s husband stated that he decided to bring her to the ER because he discovered a blog she just created that presented unethical financial planning advice to her clients. He noted she had been working on this blog around the clock. She has also avoided eating and her responsibilities regarding the children. When he confronted her, she claimed she was fine and was going to “make them as rich as the Queen of England.” …show more content…
He had been a wildly erratic, alcohol-abusing businessman who Cynthia loved very much. Her paternal grandmother had several “nervous breakdowns,” but her diagnosis and treatment history were unknown. Since college, her mood was generally “sad”. Interspersed with recurrent bouts of enhanced dysphoria, insomnia, and uncharacteristically rapid speech and hyper alertness. She had tried psychotherapy sporadically and taken a series of antidepressant medications, but her husband noted that the baseline depression persisted and that the “dark periods” were increasing in
Cynthia’s husband stated that he decided to bring her to the ER because he discovered a blog she just created that presented unethical financial planning advice to her clients. He noted she had been working on this blog around the clock. She has also avoided eating and her responsibilities regarding the children. When he confronted her, she claimed she was fine and was going to “make them as rich as the Queen of England.” …show more content…
He had been a wildly erratic, alcohol-abusing businessman who Cynthia loved very much. Her paternal grandmother had several “nervous breakdowns,” but her diagnosis and treatment history were unknown. Since college, her mood was generally “sad”. Interspersed with recurrent bouts of enhanced dysphoria, insomnia, and uncharacteristically rapid speech and hyper alertness. She had tried psychotherapy sporadically and taken a series of antidepressant medications, but her husband noted that the baseline depression persisted and that the “dark periods” were increasing in