Problem: Sarah is a 34-year-old single female employed as an elementary school teacher who presents to your private practice for a psychiatric evaluation. She is 5'5" and weighs 140 lbs. Her current medication is citalopram 20 mg a day, which she has taken for two years. She reports a 10-year history of episodes of feeling sad and hopeless, nothing in her life that brings her enjoyment, trouble concentrating, and trouble sleeping at night because of racing thoughts. She describes her pattern of moods as a dysthymic baseline mood with episodes of deeper depression occurring about every other month. These episodes of deeper depression are at a minimum two weeks in duration prior to her menstrual period. At this visit, Sarah is diagnosed with Bipolar II Disorder: What is your primary medication of choice? What are the dose ranges of your proposed treatment plan and target symptoms? For what situations would you consider augmenting with additional medications? If your primary medication choice is not acceptable, not covered by insurance, or contraindicated, what would be your second line choice of medication, including dose and rationale? What type of medication education and counseling would you provide to the client and family for your primary? Need Professional Help?