Posted by Scott L. Schofield on January 16, 2000, at 22:58:25
In reply to Re: Phillip, posted by Scott L. Schofield on January 15, 2000, at 11:49:02
Hi again Phillip.
I am a bit surprised, but delighted to see that you addressed each DSM criterion honestly. You have my respect. Actually, believe it or not, you always did.Your spontaneous and honest answers to each question allows that they be interpreted in a meaningful way. However, I scored the test a bit differently than you did. Unfortunately, I don't have an M.D. after my name, so any diagnosis that I were to make in your case would not be taken seriously (thank God).
It might be a good idea to begin a new thread and have Dr. Bob score it and offer some initial interpretations and suggestions. Of course, I don't know whether he would find it appropriate or not. Besides, his answers might upset you too much.
Prove me wrong. Ask him.
I dare you.
You won't because you don't have the courage to lose.
Please get well Phillip. You deserve it.
- Scott
----------------------------------------------------------------
SCOTT to PHILLIP:
Hi Phillip,I was just passing through and decided to stop in and see how you were doing.
I know that many people here have "accused" you of being manic or some such thing. That must be very irritating and frustrating, not to mention an unwarranted waste of your time and energies.
It occurred to me that there is an easy and quick way to put this thing to rest. It would certainly allow you time to pursue other urgent issues. Using the DSM IV (questionable value) create a list all of the the items used as criteria for diagnosing bipolar mania. Next to each item, quickly describe why it does not pertain to you.
I've been accused of being manic several times in the passed. Believe me, it was a real pain in the ass.
- Scott
----------------------------------------------------------------
PHILLIP'S REPLY:
Scott?
http://www.dr-bob.org/babble/19991212/msgs/17746.html
http://www.dr-bob.org/babble/19991212/msgs/17748.html
http://www.dr-bob.org/babble/19991212/msgs/17757.htmlTerms:
1. Civility the rule, not the exception, not a cold war.
2. Hypocrisy oath, you have to tolerate as much exasperation from me as I have to tolerate from you.
3. Read all statements twice before debunking them for personal reputation safety.According to COCOMO this would take far too long if shortcut hunches not taken advantage of.
Decision tree should really start on page 690.
Caffeine-related-disorders are on page 212.
Biological stress consequences=general medical condition.Precipitating event first:
Page 332 (DSM-IV Fourth edition, paperback) requires 3-4 of 7 symptoms listed under B to qualify as a manic episode thus qualifying such events for other diagnostic considerations.
1)q inflated self-esteem or grandiosity.
1)a The opposite was the course, I had to stoop to taking an extra week+ off work. Grandiose? Well, I did give the doctor the benefit of the doubt for too long.
2)q decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
2)a BIG enough need for sleep to seek doctor relief in very non-macho way, several times, NO sleep, NO relief, deep, deep exhaustion, placebo suspicions related to no perceived sense of eminent sedation relief. Very conscious that unconsciousness was going to need conscious effort, only marginal restoration after 14 days due to a very misunderstood consult.
3)q more talkative than usual or pressure to keep talking.
3)a Isolated at home, trying to make psycho-cybernetics, a year of bio-feedback, distance runners style total body relaxation and karate quiet mode maximize body rest, I couldn’t come up with any better ideas. Comments to doctor: gimme, gimme SOMETHING: thank you, bye. Probably less than 500 words all week.
4)q flight of ideas or subjective experience that thoughts are racing.
4)a Stuck on idea that I was going to miss even more work, that those darn pills aren’t working, that even the hospital wouldn’t take me in for a day for reasons they wouldn’t say, and that my engineering mental database didn’t have any better suggestions, so I was stuck. Recall thoughts are faster than initial draft thoughts, so the millionth time through that very short list of options was a lot faster than the first times. Neurons adapt that way unless there is a disorder preventing it. I must not have been too successful at impressing the doctor with how imperative the situation was getting. He didn’t get white until the last visit before I sorta went to sleep for a while. If I could have thought of anything that would have helped, I would have been willing to race to it, but there was nothing on my flight map of use.
5)q distractability (i.e., attention drawn too easily to easily drawn to unimportant or irrelevant external stimuli).
5)a attention to getting to sleep was getting to be almost manic, everything, even work (my usual highest priority) on down was put on hold.
6)q increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
6)a S/A 5a, nothing social, no work, no school, no sex, total (pre-yoga) body reduced animation.
7)q excessive activities in pleasurable activities that have a high potential for painful consequences (e.g., in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
7)a maximum minimization of activities. It wasn’t fun at all. (Well, work was a pleasurable activity with a high potential for painful stress consequences, but insomnia wasn’t one of the expected consequences, hypERsomnia was, and work was the precipitating cause, not the event, course or consequence), no buying sprees, no sex, no business investments (well, work ethic, I did call in and invest a phone call asking for more time off, I was very aware of deterioration with brink caving in)I think that’s 0 for 7 for B. That’s an automatic manic episode criteria applicability abort. The doctor was too used to me under stress. He just thought it was more of the same. I tend to neutralize emotion out of my speech for scientific discourse reasons. It was difficult for me to present to the doctor the imperative nature of the distress. I failed miserably. I should have gone in every day instead of every other day.
This means page 690 should be revisited.
Next time I’ll discuss suggestions of present mania(s), with general medical pre-condition more responsibly noted first.
I am trying to get up early enough tomorrow for a seminar, then several hours helping people consolidate themselves out of near bankruptcy, rototill garden and/or paint fence, then after dark pull up more old tile. Sunday off for God’s brain rest day, then Monday. Gotta rest and store, pool-up, reservoir all those fast think neurotransmitters (allow uptake) for some more contiguous thought at productive speed. That means I’ll start strong, but end up weak when deplete, but not likely before Monday.----------------------------------------------------------------
poster:Scott L. Schofield
thread:17465
URL: http://www.dr-bob.org/babble/20000112/msgs/19071.html