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From: derek
Date: Tue Mar 16 21:29:23 MST 2004 Subject: Psychiatrist Visit

Responses
Suki: Your thoughts? (3/17/04)
derek: Thoughts (3/17/04)
MaryKay: How can I help? (3/17/04)
Boojeee: with ya, man (3/17/04)
mike: sorry (3/18/04)
stevek: psyciatrists (3/18/04)
Karen: "Name it and claim it" :-) (3/18/04)
derek: A Response (3/19/04)
stevek: serotonin (3/19/04)
derek: Volume II (3/23/04)
Karen: Painting (3/23/04)
clrclady: thoughts (3/24/04)
blancaro: thankful for you (3/25/04)
derek: Volume 3 (3/31/04)
Suki: Hypomania (4/1/04)
derek: Volume 5 I think (4/22/04)
derek: Volume 5 I Think (4/22/04)
Boojeee: still with ya, man (4/23/04)
mike: Love ya (4/24/04)
Responses (sorted by date)
mike: Love ya (4/24/04)
Boojeee: still with ya, man (4/23/04)
derek: Volume 5 I Think (4/22/04)
derek: Volume 5 I think (4/22/04)
Suki: Hypomania (4/1/04)
derek: Volume 3 (3/31/04)
blancaro: thankful for you (3/25/04)
clrclady: thoughts (3/24/04)
Karen: Painting (3/23/04)
derek: Volume II (3/23/04)
stevek: serotonin (3/19/04)
derek: A Response (3/19/04)
Karen: "Name it and claim it" :-) (3/18/04)
stevek: psyciatrists (3/18/04)
mike: sorry (3/18/04)
Boojeee: with ya, man (3/17/04)
MaryKay: How can I help? (3/17/04)
derek: Thoughts (3/17/04)
Suki: Your thoughts? (3/17/04)
Results of my Psychiatrist Visit

I saw a psychiatrist today about the manic episodes I've been having the last two weeks (panic attacks, sleepless nights, high nervous energy, etc.). Anyway, here's basically my situation as I understood it from our first meeting. I thought I may as well share me.

Diagnosis
-Social Anxiety Disorder
-General Anxiety Disorder
-Hypo-Manic Episodes
-ADD
-Also something else we will look for when my mania dies down, possibly bi-polar or obsessive-compulsive disorder. They were the ones mentioned.

Prescribed
Clonazapam
Paxil

Other Random Stuff
-He doesn't think that the manic episodes are from ADD, but believes that the ADD is helping to feed in to it nicely and perpetuate it.

-He wants me to come back next week to talk about treatment options for ADD and to discuss what else I might have.

-In two weeks he wants to get me in somewhere for psychological testing.

-I should pretty much do whatever I want for working right now. He will support me in what I decide to do, work or take time off. For sure, I should take Wednesday off for the meds. Beyond that, I can do whatever seems to help most with stress.

-Also, random point of interest, my love of coffee and of video games is based out of a coping mechanism I developed to self-medicate. They help me to focus my mind which in turn relieves tension. Kinda cool. Thank you subconsciousness!

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From: Suki
Date: Tue Mar 16 22:19:16 MST 2004 Subject: Your thoughts?

Wow, Derek. That's a whopping diagnosis. How are you feeling about it?

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From: derek
Date: Wed Mar 17 13:51:00 MST 2004 Subject: Thoughts

Good.

It's not like any of this is new to me. Now that I'm realizing what it is, I'm looking back on the rest of my life and seeing how it has played out since childhood. Most of my life has been spent flipping between manic and depressive (just never manic to this extreme during a time I actually had to deal with it). The main thing that sucks is that I hadn't done anything about it until now. I just shut myself off in my room, drank coffee, played video games, and tried to get through it. Between my mental instability and my ADD, I completely shut myself off from anyone else. Didn't let anyone walk with me. And it just became normal.

Also, even with ADD, I never really knew I was ADD through Junior High and High School. I just figured that I was an idiot, was lazy and pathetic. I ended up expelled from high school, dropped out of college, etc. Realizing I'm ADD in the last few months has changed my concept of reality and has allowed me to fight against the lies I have always believed about myself. Now with the anxiety and depressive disorders diagnosed, I can start to come to peace with some of those moments in my life that I could never explain before.

Not all roses though, I guess. Definitely is not something I really want to deal with. This manic cycle has been killing me the last two weeks. I'm hoping the meds can help to stabilize me some more. I guess I don't have too much choice in the matter though, so I'll just wander through it blindly and see what happens on the other end.

I understand Boojee's "Fellowship of the Suffering" poem more than I would really like to. It's kinda cool to be able to bring this aspect of myself and my suffering into light and into community instead of walking around in stealth mode. I don't know.

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From: MaryKay
Date: Wed Mar 17 14:31:48 MST 2004 Subject: How can I help?

I'm praying Derek! What else do you need right now?

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From: Boojeee
Date: Wed Mar 17 16:00:55 MST 2004 Subject: with ya, man

I take clonazepam for anxiety, too. I can relate to a lot of what you're saying, having been diagnosed bipolar last year. I'm doing a lot better on meds, but it still sucks. Looking back, I too can see the mood swings going back pretty far. I pray that God will bring you a peace that will allow you to make peace with your past.
Thanks for sharing your struggles.

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From: mike
Date: Wed Mar 17 21:18:19 MST 2004 Subject: sorry

I am sorry for the diagnosis, and glad you have some awnsers. If there is anything I can do to help, let me know.

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From: stevek
Date: Thu Mar 18 12:16:53 MST 2004 Subject: psyciatrists

I applaud Derek for his openness within the community. I've been following along the path he has walked these past few week through Rod, and it's great that a diagnosis is finally on the table. Since this began, I have reflected several times on the bias we have in our society about psychiatric issues. Yesterday I went to an orthopedic doctor to get some meds to shrink some swelling in a knee. Rod has done the same lately. I have a friend who in the past week saw an internal medicine doctor for medication to shrink swelling in her broncia. Guess what - psychiatrists are nothing more than medical doctors who specialize in a different part of the anatomy than knees, lungs or whatever. Yet, we call them 'shrinks.' I used that word intentionally above to point out our bias. Nobody gives a second thought about taking medication to shrink a swollen tendon. But we recoil from medication received from a 'shrink.' Psychiatry deals with physical abnormalities which much of the time are both inherited and treatable through medication. Our brains respond to chemicals called seratonins, nor-epinephrum, gama...there are others in the village who know much more than I, so I'll just say that when our chemistry is off, the brain's uptake sites for those chemicals (which impact behavior) get screwed up and they either suck up too much of the stuff, or too little. The result is reflected behaviorally - ADD, manic, depression, anerexia, and probably most of the neuroses we each walk through the day with - fears which have no basis in reality, but are none the less real to the one who has them as a result of a chemically related imbalance. So, we develop coping mechanisms/video games, avoiding elevators, scarf and barf, you fill in the blank for your own situations. We all have them. There are also tendencies which drive us to these neuroses which do not have a chemical genesis. They're probably much a function of our past, and a present fear of facing what's inside of us. I've read some psychiatry material which takes the position that there is a perfectionist tendency in many people which brings up a fear of facing our own inadequacies in any area. What I'm leading to is that there is certainly a chemical derivation to some psychiatric issues, but there may very well also be a sprititual one. Where the mind goes, the man will follow. Whether the origin is chemical or spiritual, we act out what we first think. Why do we call a psychiatrist a 'shrink?' Maybe because we go to them so they can shrink our fears/or egos and help us to face ourselves in the way that God sees us. A perfectionist fears not only his own ability to perform at peak level in all situations, but also his own sin. Both are a sign of weakness. Praise God for 1 John 2:1 - "if anyone does sin, we have One who speaks in our defense/Jesus Christ, the righteous One." The second commandment Jesus related when asked at the end of Matthew 22 was to love our neighbor AS OURSELVES. In Luke he tells the story of the good Samaritan who eventually was identified as the neighbor. The Samaritan was the hated, ugly, to be avoided one - but he's our neighbor and we're to love him. I believe we each have a Samaritan within us/that part of us we want to hide - that we hate and don't want anyone else to see. Jesus tells us to love ourselves - even to love those parts of us that still need healing. Why? Because until we accept who we truly are - in total - God can't work the miracle of healing even the ugly parts we want to hide. Blessings on Derek for sharing the Samaritan within him. We may now each want to pray to God to help us to face those parts of us which we are trying to hide behind/as he said 'fight the lies' and to love ourselves. Jesus didn't say to fall in love with ourselves - but to love the person God loves, and is working on to perfect and become holy. It's the 'becoming' that's the hard part. Just as there's no shame in going to an orthopedic doctor, an internal medical physician or any of the other specialties, there' no shame, but only healing in going to the one who can
shrink our false impressions of who we are in Christ/fight the lies/whether through chemical or counseling means. Love your neighbor as yourself. Love yourself - God does.

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From: Karen
Date: Thu Mar 18 14:30:15 MST 2004 Subject: "Name it and claim it" :-)

Sometimes it's a relief just to have a name for something. Naming it, being able to begin to define it correctly brings back some of our power. Well, this is coming from a word-obsessed person :-)

Derek, I've been praying--and otherwise pulling--for you for the last week and a half. I was relieved to see you over at Scott's last Thursday. Please don't try to hide during this time (unless alone time is really what you need).

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From: derek
Date: Thu Mar 18 23:30:02 MST 2004 Subject: A Response

Karen, I like the duality of your "psychiatrist" post versus your "folk rock" post. I am a firm believer in postmodern thought except for times when I am not.

Steve, I like your post. I've always had that dread of psychiatrists and counselors for that very reason. Still, every now and then I'll get a "you go to COUNSELING???" in that shocked and dismayed voice from one of my students at Teen Challenge. My counselor Sheri told me going into this manic episode, "Yes, you can go through it by yourself, you've done it before, but why would you want to?" I always wanted to make it without meds, just wrestle through sheer willpower. But I finally realized I have resourses God provided. There are ADD meds that can help me focus without me having to put my shoulders to the wheel and push with all my strength. What can I do with that strength freed up?

I've been thinking a lot about what I would want from you (in third person plural sense of the word) especially in reference to Mary Kay's and Mike's post. My first response is for everyone to leave me alone and let me withdraw until I get it straightened out. Yeah, I recognize that.

On Sunday I talked with Russ. He told me not to make any decisions when I'm feeling manic. There's too much going on inside to be sure that what's coming out is truth. In that context, just listen to me and speak truth to me (gently).

I guess probably what I need is just encouragement, some "thinking about you", and "how's it going" type e-mails or whatever. No phone calls. Phones bad. It's an ADD thing. Don't worry about avoiding the subject to make me feel comfortable. I can deal with it.

Also, Prayer good.

Finally, I'm doing a little better with my meds. I went out for coffee today and wrote some poetry. Been getting better sleep (including a nap, which was weird). I am feeling a little calmer but still with a lingering dread against any stressful situation. No stomach problems or reflux the last few days. Very good. I'm hoping to go to the Friday movie thingie and see everyone there.
Hm, the Paxil commercial just came on. Slogan: "Let the world say hello to the real you." Hi.

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From: stevek
Date: Fri Mar 19 13:52:41 MST 2004 Subject: serotonin

As I understand it, the primary function of serotonin in our systems is in transmitting nerve impulses, especially to the brain. We need the stuff, and God has created several ways for us to increase it's natural production through our own behaviors and attitudes. Here are some:

let go of bitterness
love, and allow yourself to be loved
build margin into your daily life - don't overbook so you have no time left to simply reflect and decompress
get plenty of rest
laugh/enjoy the journey because you're God's epistle

There's a sermon in each one of those items - or for now at least a point on which we/I can reflect introspectively and let the Lord point to areas in which we/I can take part in our own healing. Look at them - they each involve either attitude and/or pace. Society (ours in particular) pushes the envelope in both areas - and so I suspect that to the extent we buy into it we limit our body's own healing mechanism. "Don't let the culture conform you" may well be God's way of preparing the temples we walk in so He can work effectively in a holistic sense within each of us. I'm getting way out of my league on this ramble, but it's worth tossing out for some of you who may have greater insight than me. Meditative time in prayer on each of the items listed above may be a good start.
Depression has been described as anger turned within. It makes sense that as we internalize a negative emotion, the Holy Spirit is grieved and the result is a feeling of depression. We're pretty well tied together, aren't we/body, soul, spirit.

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From: derek
Date: Tue Mar 23 15:40:37 MST 2004 Subject: Volume II

Okay, just hit my second doctors visit, we didn't get much further. . .

He still wants to get my mania and anxiety under control before we do anything else.

He doubled my dosage of Clonazepam, and increased its use to 3 times daily.

Looking at stimulants for ADD sometime in the next few weeks.

He wants me to do the art project I was working on for Saturday. (Painting is my ultimate manic phase. I end up pacing the room, cussing, my hands shake, feel insane, etc.) So, I've been very strongly avoiding it the last few weeks. He told me to take a ton of Clonazepam and tell him how it goes.

I should make another appointment for 7-10 days. By then the Paxil will have kicked in, and we can proceed futher.

Also, he's having trouble finding someone to do psych testing, but he's still working on it.

Going to work is still up to me. Do whatever I can handle.

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From: Karen
Date: Tue Mar 23 16:00:12 MST 2004 Subject: Painting

I like the sound of your MD from here.

I just prayed that you'll be able to do the painting.

I'm also praying every day this week that 200 people show up to look at it. (I hope that's OK... you know I'll be up for scrutiny, too.)

Take care :-)

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From: clrclady
Date: Wed Mar 24 13:11:20 MST 2004 Subject: thoughts

Derek-

Just read your blog, I am a little slow on the website thing. Time just seems to fade away when I try to get online. But anyway, to the point of things. I am sorry that you are having to go through this right now and my prayers have and will go out for you. Mania is crazy making and there are many things that we self medicate with. I pray specifically that you do not isolate yourself from those around you. It is easy to do as that is how I have dealt with my highs and lows for years. Medicine does help, but it comes with other hastles and problems (like crashing at 9pm sometimes when you want to stay up). I have been struggling with the right dosage and timeframe for my own medication for Bipolar for a while now and the process is long. My word of encouragement is to hold on and don't hide away. You will get through even this and there are many people who care deeply about you to help you along the way.

Cheryl

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From: blancaro
Date: Thu Mar 25 10:21:00 MST 2004 Subject: thankful for you

Deeeeeerrrrrreeeekkkkkkk, thank you for sharing your samaritan with us. Don't have many words or wisdom, only encouraging ones. In the past two years i have become familiar with 'head medication' and I can honestly say I am mostly thankfull for them. Sideeffects can be bothersome but it beats having to deal with the problem on your own. I pray for you and hope that you will soon get back to feeling like yourself again. I hope you get to finish your painting.
Blanca

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From: derek
Date: Wed Mar 31 12:22:06 MST 2004 Subject: Volume 3

Okay, third visit. . .

-Keep on keeping on with my current meds. Paxil should start kicking in soon. Probably in a week.

-He's not sure whether to treat me for depression or for bi-polar depression

-He prescribed a mood stabilizer (don't remember what it's called) and he wants me to call him tomorrow with info on how I'm feeling

-He wants me to make another apointment in a week

__________________________________________________________

I was reading up on bi-polar on the internet and symptoms of mania and depression. They had great things to say about the "mixed episode" which sounds basically like what I'm going through

Mania
feeling high, euphoric, or irritable
plus at least 4 of the following
-needing little sleep yet having great amounts of energy
-talking so fast that others cannot follow you
-having racing thoughts
-being so easily distracted that your attention shifts between many topics in just a few minutes
-having an inflated feeling of power, greatness, or importance
-doing reckless things without concern about possible bad consequences (e.g., spending too much money, inappropriate sexual activity, or making foolish business investments)

Hypomania
Hypomania is a milder form of mania that has similar but less severe symptoms and causes less impairment. During a hypomanic episode, the person may have an elevated mood, feel better than usual, and be more productive. These episodes often feel good and the quest for hypomania may even cause some individuals with bipolar disorder to stop their medication. However, hypomania can rarely be maintained indefinitely, and is often followed by an escalation to mania or a crash to depression.

Depression
In a major depressive episode, the following symptoms are present for at least 2 weeks and make it difficult for the person to function:
Feeling sad, blue, or down in the dumps or losing interest in the things one normally enjoys
plus at least 4 of the followin symptoms
-difficulty sleeping or sleeping too much
-loss of appetite or eating too much
-problems concentrating or making decisions
-feeling slowed down or feeling too agitated to sit still
-feeling worthless or guilty or having very low self-esteem

Mixed Episode
Perhaps the most disabling episodes are those that involve symptoms of both mania and depression occurring at the same time or alternating frequently during the day. Individuals are excitable or agitatated as in mania but also feel irritable and depressed.

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From: Suki
Date: Thu Apr 1 07:36:31 MST 2004 Subject: Hypomania

Too bad hypomania can't be maintained -- it sounds pretty tasty to me.

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From: derek
Date: Thu Apr 22 10:29:17 MST 2004 Subject: Volume 5 I think

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From: derek
Date: Thu Apr 22 10:37:43 MST 2004 Subject: Volume 5 I Think

Hello peoples. I just returned from another fun-filled episode with my shrink. He doubled and tripled all my meds, and he thinks I'm Bi-Polar 2. Which I guess is less severe than Bi-Polar 1. It has hypo-mania instead of full-blown mania. Next, we're going to look at Obsessive Compulsive Disorder. He gave me a form to fill out about it, and it's looking bad for the home team Way to many YES's and 1's and 2's. So, I may be OCD as well. He basically said I'm not allowed to go in to work this week until my meds are kicked in and everything's looking groovy gravy. So here I sit; I cannot do otherwise.

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From: Boojeee
Date: Fri Apr 23 10:00:44 MST 2004 Subject: still with ya, man

hang in there, derek. you're not alone in lots of ways. we love you and look forward to seeing you when you're up to it. don't stay away too long. you're in a community that can handle wherever you are.

julie

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From: mike
Date: Sat Apr 24 13:02:16 MST 2004 Subject: Love ya

I have none of the wise advice middle aged men are known for you, only the reminder you are in a community that loves you and misses you. We are there for you. Friends like this bunch is rare. We are praying for you, and look forward to seeing you when you are up to it.

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