Marcus Marcus is a 31-year-old Caucasian law student. He feels “worn out, burned out, and busted.” He has no girlfriend or boyfriend, yet he has dated in the past. Although Marcus’s studies keep him occupied, he finds himself wondering if all of his efforts are worth the coming payoff. He will be taking the bar exam soon—he is fairly sure he will pass it. Lately, Marcus has been “slipping back into some old patterns of thinking and acting.” In the past, he has battled major depressive disorder and believes that he may be becoming depressed again. Marcus quickly counts off his symptoms: sleep loss, weight loss, a sense that everything is devoid of joy or excitement, and so forth. His choice to come to counseling was precipitated by an increase in the frequency of using club drugs like ecstasy and cocaine “to have at least a little fun.” Marcus uses these now about once every 2 weeks. He notes that his last “bout” of depression happened around a time when he was using these substances frequently.
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