Vignette 5

Isabella continues to spend money she does not have so was not able to cover her living expenses following a recent manic episode in which she gambled and drank excessively. Isabella has had many consequences for her excessive spending. She lost a house and a marriage due to her free spending. She is in debt to her family and friends and was not able to buy her son a birthday present without borrowing money. She is estranged from her brother for failure to pay a debt. Isabella had a problem with her landlord and almost lost her housing. She has developed a budget but cannot stick to it when she goes through a manic phase. When she is depressed, she feels deprived because she does not do anything and does not buy anything, so she wants to spend money after she stops feeling depressed.

Isabella has limited resources. She was able to pay off a large credit card debt by developing and maintaining a budget. She has difficulty maintaining a budget when she is "too upbeat" and spends money set aside for her basic living expenses on gambling, drinking and buying clothes for herself and friends. Recently, Isabella was not able to cover expenses for rent, electricity, copayments and medications as she spent money during a manic phase. She borrowed money to buy a birthday present for her son. Isabella is committed to limiting her spending and wants to follow a budget and avoid "bad decisions" that will impact her. She wants to begin setting aside money for Chad. She maintains a small savings jar in which she keeps change to give to others as part of her "spiritual walk".