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Sam, (Adolescent) Bipolar I Disorder, Current Episode Depressed, Severe
Question: A young woman with a recent manic episode, now presents with a severe episode of depression. Her affect is severely depressed. She reports being tired and hurting all over, unable to sleep, and reports that she has given up on applying to college, feeling incapable of accomplishing any of her goals. She reports she is moody and drives people away and reports she wants to be alone. She reports that she is mean to people when she is manic, and now feels the world is "dark and cloudy." She reports two similar episodes of depression during the past year. She reports alcohol used to help her to sleep but alcohol caused headaches. She reports poor appetite with weight loss. She reports she likes when she feels manic, that she feels creative during those episodes. She reports presently having suicidal thoughts but is unwilling to fully discuss due to fear talking would lead to being committed.
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