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Case: Cathy Kelly is a 31-year-old computer programmer who works for a website design company. She comes to your office with reports of decreased mood, poor appetite, poor concentration, and feelings of worthlessness. She states, "I haven't gotten a good night's sleep in weeks and I've lost about 10 pounds recently." These symptoms have been present for the past 5 weeks. On further questioning she describes a period 2 years ago when she "had some trouble" around her sister's wedding. In the 4 days leading up to the wedding she was only sleeping 2 hours per night. She tells you, "I wasn't tired and had enough energy to make pastries and gifts for the wedding guests. I was up working almost all night." She recalls that "brilliant ideas for new projects" were running through her mind at that time. She continued going to work at her computer programming job during those 4 days and felt that she was very productive. When the wedding came she drank excessively and used her position as a bridesmaid to meet single friends of the groom. She took several men into a secluded bathroom and had sex with them during the wedding reception. When asked about substance abuse she reports using both cocaine and alcohol in the past to "make me feel better." She denies any cocaine use around the time of her sister's wedding however.
Question 1. What is your diagnosis of this patient? What other diagnoses could be considered?
Question 2. What symptoms does this patient have that are consistent with your diagnosis? What symptoms are NOT consistent with your diagnosis?
Question 3. What treatemnts should be considered for this patient?
Question 4. What are possible causes of this patients' diagnosis?
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