F.A.P.A.P. is a 21 year-old white girl. Her parents are divorced since she was three, and her father lives abroad. She has serious relationship difficulties with both of them. She does not accept her appearance, and she reports that her activities are mainly studying and “losing weight”. The patient had imaginary friends during her childhood. When she was 6 years old, she was sexually abused. At the age of 9, her mother had a troubled relationship with her stepfather involving his alcohol abuse and physical aggressions. She already had homosexual intercourses when she was 10, 15 and 20, but she claims to be heterosexual. She has difficulty in making friends. She has a compulsive eating disorder and amphetamine addiction. At the age of 21, she suffered a seizure episode after cocaine abuse. She attempted suicide twice when she was 20. At the first one, she ingested 30 pills of clonazepan (2 mg), and at the second one, she ingested rat poison. She was hospitalized several times during this period due to bulimia exacerbations and others due to suicidal attempts. She fulfilled DSM- IV criteria for bipolar disorder, bulimia, substance abuse and borderline personality disorder. Her treatment included lithium 600mg/day, valproic acid 500mg/day, sertraline 100mg/day, fluoxetine 60mg/day, topiramate 100mg/day, quetiapine 100mg/day, methylphenidate 40mg/day, aripiprazole 15mg/day in monotherapy or combined. This case leads to the discussion of a spectrum of syndromes involved in the diagnosis of bipolar disorder and its comorbidities.