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      <p>Ms. B was reluctant to take lithium like her mother but did accept another medication,
        which seemed to provide partial relief of her symptoms; nonetheless, she remained depressed
        much of the time and still reported a tendency toward hypomania. Using the Social Rhythm
        Metric (see <xrefGrp>Table <xref ref="med-9780195309416-chapter-017-tableGroup-002">17.1</xref>
         </xrefGrp>), she and her therapist reviewed her erratic sleep schedule and
        discussed good “sleep hygiene”: slowing down in the evening, avoiding caffeine and alcohol,
        conducting only relaxing activities in the hours before bedtime, and going to bed and
        arising at the same regular hours. They discussed what work options Ms. B had to avoid
        all-nighters, which she decided she could minimize by spacing out her work assignments and
        not procrastinating.</p>
      <p><?Insert-Table ID="med-9780195309416-chapter-017-tableGroup-002"?></p>
      <p>In the meantime, the therapist noted that the patient’s depression often seemed related not
        to Ms. B’s work, which she loved, but to her relationship with her “VIP lover,” C. They
        defined this as a role dispute. Ms. B tended to take a subservient role in this relationship
        but felt neglected and misunderstood. Taking the standard role dispute approach, both
        patient and therapist explored Ms. B’s positive and negative feelings about C and their
        relationship, what she wanted from it, and how she could achieve her wishes. Except during
        hypomanic <?Page pageId="126"?>
         <milestone id="med-9780195309416-chapter-017-milestone-139" num="126" unit="page"/>moments, Ms. B was extremely passive in the relationship and had
        great difficulty either expressing her needs or setting limits with C.</p>