Jennifer, a 29-year-old married Caucasian physical therapist, gave birth to her first child 4 months ago. Since the third week following the birth, she has become increasingly sad and uninterested in her baby. She sought treatment at the urging of her husband, who was concerned about her deteriorating condition. During the initial interview, Jennifer revealed that she felt marriage and the baby ruined her life. The pregnancy was unplanned, and now she felt trapped in the marriage. She reported trouble sleeping with frequent nighttime awakenings. Jennifer blamed the baby for the weight she gained, even in the months after giving birth. She knew that the feelings of resentment toward her daughter were not logical, but they persisted and were often a cause of great guilt. Additionally, Jennifer's husband reported noticing that it took his wife much longer to decide on simple things like what she wanted to eat or wear that day.Jennifer also complained of low energy and was unable to exercise as usual, which further added to her frustrations.Jennifer had not been treated for a psychiatric disorder in the past, but she had a history of self-described mood swings since her early 20s. She described intermittent periods, lasting up to a week, with elevated mood, high energy, and little need for sleep. During these episodes she was sexually impulsive and prone to overspending, but not to the point that she put herself in personal or financial danger. These periods were characterized by excessive exercise, 2-hour workouts before and after work, and late-night socializing with friends. Sometimes she slept as little as 3 hours a night but felt energetic in the morning, with no impairments in functioning. Invariably, these episodes were followed by a long period of depressed mood, low energy, excess sleeping, and social isolation. Her friends noticed the changes in her mood and behavior, and one friend even wondered if she was using drugs, though Jennifer claims to have never used illicit suhctances and rarely drank alcohol.