Susan's boss told her that she was a valued member of the workforce, but that he believed some rest would do her good. Regardless of such favorable comments, Susan felt like a failure as a result. At home, things were not getting any better. Susan became increasingly depressed and succumbed to drinking as a means of handling her stress. This only resulted in an increasing sense of hopelessness and depression. Susan's boyfriend also increased his emotional attacks on her, but refused to leave when she asked him to. Eventually, Susan had to enlist the help of the police to avoid being physically abused. This resulted in their final breakup. Susan spent almost 24 hours indulging in various forms of alcohol and drug abuse before ending up on my doorstep. She told me that she was afraid of doing something "irresponsible" to herself as a result of the depression and substance abuse. A explained to Susan that I would be able to help her only if she was willing to accept such an attempt. I would write an official letter to her employer explaining that she would need a further fortnight of paid leave in order to help her through her emotional problems. During these two weeks, I would also commit Susan to our facility in order to monitor her response to medication and therapy. I decided to start Susan on a light dosage of Prozac, together with weekly sessions of individual therapy. After a month of this, and depending upon the outcome, I would start her on group therapy.

Susan was not interested in trying to mend the relationship with...

I therefore focused on helping her to heal herself. After I explained my plan, Susan told me that she was willing to be committed voluntarily for the prescribed time in order to ensure her own safety. She seemed fully aware that she was not entirely responsible for her actions, and might therefore succumb to her self-destructive urges if left to her own devices. This danger was exacerbated by the fact that she was now living alone after years of cohabitation with her former boyfriend.
After two weeks, Susan appeared to respond well to therapy. She told me that she was ready to start work again and that she was willing to continue her weekly sessions in group and individual therapy as an outpatient. She faithfully continued to attend these sessions for six months, after which we scheduled monthly sessions of group therapy and individual therapy for only every other month. While Susan intermittently confessed to feelings of inadequacy and a dangerous tendency towards overindulging in wine, she generally remained well-adjusted. She met many good friends during her therapy sessions, which helped to curb her feelings of loneliness. She had not made any new romantic acquaintances since her break-up with her former boyfriend, and expressed no interest in doing so. I continue to urge her not to neglect this area of her life, but at the same time allow her time to make her own decisions in this regard. In general, Susan continues to use Prozac in small amounts, with…