Christy , a 40 year old married medical records employee who complains of

constant frustration, anger feeling, and some anxiety. She states that she feels very angry

along with short tempers when her children do not clean their rooms. She finds herself

going into deep depression constantly due to all the worries she has, such as losing her job

due to a verbal wrote up she received recently. Christy has a history of alcohol abuse,

and has been in and out of rehab several times. She goes on to explain that she loves her

family and work however, she has a hard time dealing with life situations. Christy often

feels like she is not good enough and tries to please everyone. She has been experiencing

these feelings for the last 2 years. Her symptoms she experiences are diminished need for

sleep, excessive talking along with racing thoughts or flight of ideas. She also has excessive

pleasurable activities, often with painful consequences.

Christy has seen several psychologist and been prescribed a low dose of xanax 1mg

to help ease the anxiety she experiences. Christy denies any history of operations or

hospitalizations. She states that she just was released from rehab for alcohol abuse.

Christy feels she needed more time in rehab to help recover. Christy states growing up

in her house was not easy. She describes her father as mentally and physically abusive

to her and her sister. Christy explains how her mother was not supportive to her feelings

or needs. She states how her mother pushed her into marriage at an early stage of her life.

Christy was able to graduate from high-school but, was married with a son. Currently

Christy works at Baylor Family Medicine as a medical records specialist. While at she

experiences frustration and agitation towards co-workers.

Christy is currently married and sexually active with her husband. She has admitted

to an affair while in rehab, where she contracted a STD, which was treated with antibiotics.

Christy is a heterosexual. Christy shows signs of bipolar disorder (manic depression).

She seems to only demonstrate moderate depression, she is able to work and conduct

everyday activities. She would be treated as an out patient. Evaluation of Christy condition

would be monitored closely to help determine if she needs medication and what type of

dosing she would need. Initiating an anti-psychotic agent along with psychosocial

intervention such as cognitive behavioral therapy, interpersonal and social rhythm therapy,

family focused therapy. Depending on Christys response to treatment, and