naked and demanding sex. The man said something about a condom and she scoffed. "We don't need one," she said, and the two had sex. Within the hour, the man was asleep, and Elizabeth lay awake with thoughts racing through her mind. She saw a small light on the side of a smoke detector. She bolted upright. "They are watching me," she whispered and hurriedly gathered up her clothes and belongings. Elizabeth got dressed in the hallway and frantically plotted her next step. She had suspected for some time that a coworker of hers had been secretly following her and spying on her, now she was sure of it. There had been plenty of evidence: her lunch had been moved from one side of the break room refrigerator to the other; she had been passed over for promotion because of the "lies" that were being told about her, her key card stopped working at work, and even though security told her that her badge had worn out, she did not believe it. Now she was being followed in Las Vegas. Elizabeth made her way to the airport. Her expansive mood and excitement had morphed into intense fear that people were watching her. She decided it was too risky to fly home and instead bought a ticket to San Francisco. It was the last time her credit card would work. Elizabeth landed very early in the morning at San Francisco International Airport and took a cab to the Haight Ashbury part of the city. She had no cash, none of her credit cards was working, and the cab driver was unhappy she could not pay the expensive fare from the airport. He called the police, and Elizabeth was taken into custody. It was apparent to the police officer that something was wrong with her. Elizabeth was making strange statements. She told him that she was important to God and that placing someone of her great stature who was also a good friend of the U.S. president-in custody was going to get the police officer in trouble. Elizabeth was placed on a "5150," or a mental health hold, and taken to the hospital. The staff there contacted Elizabeth's husband, who was relieved to hear from them since his wife had been missing for nearly a week. After spending nearly six days in a California psychiatric unit, Elizabeth returned home to face major trouble. She had been fired from her job, and she was being investigated for embezzlement. Her husband was barely speaking to her. She was remorseful about her behavior. When pressed for details about what made her act so outrageously, all Elizabeth said was, "At the time it just didn't seem like it was a bad idea." Her behavior was an incredible departure for a woman who was generally well-liked as a bookkeeper. She and her husband had been married for four years and were trying to start a family. She regarded herself as conservative and generally responsible with money. She had never before been in trouble with the law. Spring was particularly a difficult time for her. Her mood seemed to be sensitive to the seasons, and the longer days that came with spring energized her. Her mood would become elevated and expansive. She would be overly joyful and happy. She felt overconfident about her abilities, overly optimistic, and reckless. Her libido would kick into high gear, and she would have trouble noticing the negative consequences of her behavior. This spring, however, the mental state that had led her to go to Las Vegas was the worst she had ever experienced. Going months without having trouble with her moods made Elizabeth deny that she had a mental illness. She knew that medicine helped, but she often would stop taking it when she felt better. Elizabeth was excited. The 34-year-old paced around the boarding area while awaiting her flight to Las Vegas. Elizabeth was a bookkeeper for a restaurant whose owner refused to accept credit cards. They often had large amounts of cash on hand, and now a backpack full of it was slung over Elizabeth's shoulder. She had nearly $15,000 of her employer's money. She believed that with her superior statistical skills and knowledge of probability, the casinos would not stand a chance. "The Las Vegas casinos have never seen the likes of me," she said to herself. "I work on a whole different level than most people." With her boss's money, Elizabeth reasoned, she would double, if not triple the "investment." The people around Elizabeth saw that she was highly energized. When she spoke, her words came out as if she could not speak them fast enough. Her ideas came to her so quickly that she bounced from one topic to the next. She spoke with a huge smile, and while people were not put off by her high energy, some found it strange. She spent the flight telling a seatmate about her (imaginary) connections to a casino and real estate magnate in Las Vegas. Once her flight arrived, Elizabeth thought she had better "look the part" and visited some high-end shops, spending more than a third of the cash she had on a few outfits and jewelry. Then she sat down at a blackjack table and began to gamble. She made reckless bets and quickly lost thousands. Within three hours of landing in Las Vegas, Elizabeth had spent all of the cash she had with her. No matter, she thought, she would make it up. Elizabeth got several cash advances on credit cards and made even bigger bets. "Got to bet big if you want to win big," she said. Elizabeth liked the feeling of being energized. She had previously had trouble with depression. During those times she did not think very highly of herself. She had terrible fatigue and no appetite. People did not like being around her, and she cried often. Being energized was exactly the opposite. Elizabeth could go days with little sleep and was capable of working on big projects. As a teen, she once spent an entire night painting the interior of her house. "I wanted it to be a surprise for my parents. Go to sleep with white walls-wake up with pink ones!" she said. As the night in Las Vegas wore on, Elizabeth showed no signs of slowing down. She had drawn the attention of several men who were gambling alongside her. Assuming she had been taking cocaine, the men did not mind her pressured speech or some of the fantastic things she said. They especially did not mind when Elizabeth starting making frank sexual remarks. One of them convinced her to go to his hotel room. They were kissing in the elevator and if he had let her, she would have taken off her top before they reached the room. Once inside, Elizabeth was quickly