The patient: “Alicia,” a 39-year-old pastry chef.

Why she came to see me: The first thing Alicia said to me was, “I’m not sure if I’m in the right place, or if I should be at a psychologist’s instead.” Ten months earlier, her life had felt “calm and satisfying.” She worked as a pastry chef at a high-end restaurant and was building a cult following within her community and on social media. She was dating a wonderful man, she had no major health concerns, and she felt wholly confident with the trajectory she was on in life. In the last seven months, however, her moods had started careening out of control…

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