You Have Come To The Right Place ~ (Sixx: AM)

Chapter One

Patient Name: MICHAEL, JAMES

DOB: 09/26/67

Date of Admission: 12/04/2016

Identifying Information:

James Michael is a forty-eight year old, divorced, Caucasian male with no children.  He is six feet, three inches tall.

Presenting Problem:

Patient is seeking help at the hospital for severe restrictive and purging behaviors.  He claims that these behaviors began in March of this year, as a way to "stabilize moods" and "get in shape" for his upcoming tour with his band, Sixx:AM.  He reports restricting food groups, focusing on "health" foods, and excessively exercising.  He reports that these behaviors worsened while touring began, and began abusing laxatives and other diet supplements a few months later.  He claims that these behaviors caused significant physical symptoms, but he refused to stop.  He reports that one night after a performance, he collapsed due to dehydration and low blood sugar, but the behaviors continued.  Patient reports that he purged for the first time during a break from touring, after forcing himself to eat pizza in front of his band-mates to prevent suspicions from being raised.  He claims that his behaviors spiraled out of control from that night, and his physical and mental state quickly deteriorated during the second leg of the tour.  He reports that his severe restriction led to "reactive" binges, which induced feelings of shame, fear, and instability.  By October, he was having binge and purge episodes up to three times a day, which caused significant medical symptoms.  Patient reports that he lost consciousness after vomiting blood during a binge and purge.  He reports that his bandmate, DJ, found him, called 9-1-1, and was admitted to the hospital for acute hypokalemia and irregular heart rhythms.  Patient reports staying at the hospital for twelve days, in which his potassium level and heart rhythms were stabilized.  He reports that he purged the same night that he got discharged, and that moment led him to seek help.  He claims that he "can't live this way any-more" and knows that "there has to be more to life than this."

Psychiatric History:

The patient reports showing symptoms of depression in his early twenties.  He claims that he attended outpatient counselling where he was treated for Major Depressive Disorder, which ended being re-diagnosed as Bipolar I Disorder in his later adult life.  Prior treatment was ineffective for that reason, and his symptoms worsened.  He reports symptoms of erratic moods, including outbursts of anger, irritability, and breakdowns where he "threw and shattered things around the room."  Patient reports of impulsive behavior, such as self-harm behaviors, use of alcohol, and careless spending.  Patient reports past and current suicidal ideation; however claims that he is safe and has no plan in place.  He reports that he ran into opposing traffic a few months ago, but claims that it was during a manic episode, and there was no intent to harm himself; although now he reports passively wishing that the car had hit him.  He reports trouble sleeping, and claims that he wakes up multiple times during the night.  He reports that the most sleep he gets per night is about four hours.  Patient reports that his bipolar symptoms frighten him at times, but he has grown accustomed to them over the years.  Patient denies any significant medical history prior to the development of eating disorder symptoms.

Alcohol/Drug History:

Patient reports first use of alcohol at age seventeen.  Patient reports that his drinking increased during his twenties, and became excessive.  Patient claims that he was using alcohol to self-medicate his Bipolar Disorder symptoms, which at the time were misdiagnosed as Major Depressive Disorder.  He reports that drinking made his symptoms worse.  He claims that drinking during a "low" made him an "ineffective" person, and led to self-destructive decision making during a "high".  Patient reports that he was forty-four years old when his alcohol usage was at its heaviest, and decided to seek help in 2013.  He claims that he has maintained his sobriety for three years, with the help of 12-step meetings and the support of his band-mates.