The day after the incidence she would be back to a stable state. Parents sent her to boarding school since they were moving around very often, after attending 1 1 different schools in 12 years. After school, she moved to different places to pursue her acting career. During this time, the patient got married for her first time and shortly after had her daughter and was divorced. She stayed at home taking care of her daughter for three years before she went back to acting. She was then married and divorced two more times that both also only lasted less than one year.
The patient was then in a severe car accident that left her out of work causing uncial problems and eventually bankruptcy. During the time she was not working from her injury, she worked on her autobiography for three years. When she would write her autobiography, she would sometimes write for 1 0 to 12 hours at a time while chain smoking, drinking excessive amounts of coffee, and barely eating or sleeping. The patient then reported getting a virus of some sort on her computer that deleted all of her work that she has done on her book.
She reported being paranoid believing that her ex- husband had connections with the government that put the virus on her imputer, and believing that he wanted to kill her. The patient began taking prescription pills and drinking when she was having these episodes. She was reported missing for four days after filing bankruptcy and selling her house. When the patient was found by the police outside in somebody yard, she had cut off her hair and pulled out her dental caps to prevent being recognized by anybody.
The patient was then transported to Olivier Medical Center, where she was diagnosed with manic depression and did not accept any treatment or the fact that she even has a disorder. The patient as then referred to this clinic. Psychosocial History: The patient was born in Yellowknife, Northwestern Territories, Canada. She has one sister and three brothers. She started loving to act by participating in school plays. After she graduated two years early, she moved to LA and started her acting career at age 21. Ms. K has been in many movies, and has always gotten attention from the media.
After having her daughter and three failed marriages, the spotlight was starting to stress her out. Being in a car accident leaving her with financial problems has left the patient at high vulnerability to depressive ND manic episodes. Mental status examination: See mental status examination checklist attached. Risk Assessment: Severe risk (see attached checklist). The patient did not have any signs of suicidal ideation or wishing to die, but she did report a previous attempted suicide when she was 14 years old over a breakup, and she recalled feeling stable and happy again the next day.
The patient has recently experienced some significant negative events such as her three short marriages all ending in divorce and a car were that kept her from acting which lead to financial issues. She reported having bet from hospital bills that lead to her selling her house and being on the streets. The patient has been displaying some impulsive and dangerous behaviors, and has admitted to chain smoking, barely eating or sleeping, and drinking when she would start feeling the mood swing so she would not feel “crazy’.
The patient has reported being very anxious and paranoid. Ms. K ha: had previous psychiatric diagnoses that she did not accept treatment for. Until she agrees to treatment, the patient is at a severe risk of suicide. Diagnosis: Bipolar I Disorder, severe (see Diagnostic Criteria Symptom List Sheet) Impression: Ms. Kiss dealing with bipolar I disorder, severe. She reported that her manic episodes have affected her sleeping and eating habits, which has caused delusions and paranoia.
Her symptoms from her manic episodes have also lead to the patient having some reckless and impulsive behaviors. She has also been drinking more during these episodes to try to escape the feeling of them. Ms. K has a few suicide risk factors (previous attempt, substance abuse, impulsive behavior). A protective factor that may reduce her risk of suicide is her daughter and her career. Plan/Agog: or Treatment: Ms. K has denied the treatment offered to her after being placed in psychiatric care.
The treatments she was offered are lithium as a mood stabilizer and psychological interventions to focus on interpersonal NC practical problems to figure out what triggers her manic episodes. She would learn new coping skills and ways of communication with people and present problems that could cause relapse. Since the patient has a severe risk level, is appropriate that she receives supervised treatment for the alcohol and drug abuse, and also that she goes to a mental health counselor for at least ix months, or until her hark risk level has decreased significantly.