[Answered]: Jennifer is a 25-year African American female who…

Jennifer is a 25-year African American female who present for evaluation. She reports of having a history of treatment including two separate hospitalizations for suicide attempts. Last hospitalization was 2 months ago, and she was prescribed Abilify 15mg. She took medication for 3 weeks but felt “anxious” and stopped the medicine. She reports of no effect with medication and identifies being “depressed.” She reports of having “mood swings” with “highs and low.” During elevated episodes she will sleep about 1 hour and excessively clean her home. She has times of spending money excessively including buying three separate kitchenware sets from an ad she seen on social media. She reports of episodes lasting 2 days to 1 week. These episodes are followed by down times with sadness, crying spells, isolation, anhedonia, avolition, and anergia. During these episodes she has perpetual thoughts of harm including a history of plans and attempts. Her issues began at 19 years of age while attending college. She reports of issues with sadness in high school but reports of mood swings beginning her sophomore year of college and has persisted. She currently identifies being in a down episode currently with sadness, lying in bed most of the day, not showering, anorexia, and passive thoughts of suicide. She had one self-harm episode by cutting thighs with razor blade two days ago. She reports of self-harm thoughts being persistent as she believes the pain allows her to “feel.” She denies a history of psychosis. She reports of being “paranoid” when smoking marijuana, but this has not occurred since college. She denies a history of trauma or issues with anxiety. Social: Jennifer is a single female who works as a social media marketing consultant. She has struggled to be consistent with work due to issues with mood. She has a bachelor’s degree in marketing but left college twice due to mental health issues. Medication trials: Zoloft (anxiety), Risperidone (no effect), Zyprexa (mild benefit but weight gain), Abilify (anxiety). Physical: Denies current physical health issues. What medication would you choose and what is it’s mechanism of action? (include prescription, dose and titration plan). (ex Sertraline 50mg QHS – by mouth daily, take one tablet at bedtime. Increase dose in 4 weeks if no effect). What medication would you choose and what is it’s mechanism of action? (include prescription, dose and titration plan). (ex Sertraline 50mg QHS – by mouth daily, take one tablet at bedtime. Increase dose in 4 weeks if no effect).