Immigration Trauma, Substance Abuse, and Suicide

Bianca is a 35-year-old, divorced Brazilian woman with a history of depression, anxiety, trauma, and substance abuse who has made several serious suicide attempts. Before three years ago, Bianca had no history of mood or anxiety symptoms. In fact, most of her recent psychiatric symptoms have occurred in the context of heavy substance use. Bianca was previously stable and gainfully employed as a legal secretary in the court system of Brazil. She functioned well until she came to the United States ten years ago looking for a better life. During the first seven years of her life as an illegal immigrant, Bianca struggled with the fear of deportation, issues of acculturation, and the lack of stable employment. Three years ago, Bianca married George, an American citizen, with the explicit purpose of obtaining legal immigration status. Despite the immigration ruse, Bianca hoped the marriage would work anyway. Before marrying,