Vignette 3

Has current boyfriend and close "best friend" she enjoys spending time with- watching movies, going to casinos, dancing and just "hanging out". She maintains other relationships with friends she has met in treatment and services. She shared rides with them and speaks to them on the phone. She maintains contact with friends and family through writing e-mails. The number of e-mails increases or decreases according to whether she is feeling "upbeat" or "down". She has established and developed relationships using social media and is comfortable with the use of chat rooms, Facebook and My Space as well as U-tube to "keep in contact". At times, Isabella makes plans with friends to get together but does not follow through because she becomes too depressed or anxious or is so "upbeat" that she "cannot focus enough to get ready to go out". When this happens she does not call or contact them and that may have ended the relationships.

Isabella is comfortable in social settings in the community and is aware of social cues and responds appropriately, although she states she sometimes "talks too much" and "stands to close" if she is "too upbeat". She avoids community and social contact when she is feeling "down". She is unable to tolerate being in the community when she is "nervous" and "anxious" and expresses fear that seeing a person in uniform may trigger her "soldier hallucinations". Isabella is comfortable with social networking and has used e-mail, chat rooms and Facebook in the past to develop and maintain casual relationships. Her mania, depression and anxiety get in the way of following through on responding and maintaining social contacts. Isabella has interests in music and sings and plays the piano. She enjoys "helping others" as part of her leisure time- including hair styling with nursing home residents. Her current social and leisure interactions include dancing, gambling and "hanging out".