A 40-Year-Old Woman Is Brought to the Emergency Department After

A 40-year-old woman is brought to the emergency department after her boyfriend found her sleeping on the couch with an empty bottle of alprazolam by her side.  Earlier today, he received a text message from her that said, "Goodbye, nothing matters anymore."  When he attempted to contact her by phone, she did not answer.  He drove to her apartment and found that she was difficult to arouse and was slurring her speech.  He reports that the patient was very depressed after he brought up the idea of ending their 6-year relationship a month ago.  He says, "I saw her about once a week since then, and she seemed to be getting thinner each time.  Last week, she told me she was afraid of being fired because she's been late to work 3 days in a row and is only completing about half the amount of work that she usually does."  He reports that the patient has had depression on and off throughout her life, but he has also seen her with periods lasting days to weeks when she is unusually upbeat and confident in her abilities.  He says, "She would go into the office at 6 AM, get twice as much work done by noon, and go out dancing at night until 1 AM."  On physical examination, the patient is mildly sedated and cries throughout the interview.  Vital signs are normal.  Which of the following is the most likely diagnosis?

A) Adjustment disorder with depressed mood
B) Bipolar disorder
C) Borderline personality disorder
D) Dependent personality disorder
E) Histrionic personality disorder
F) Major depressive disorder
G) Persistent depressive disorder (dysthymia)