![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 41. Go back in thread:
Posted by Alfred on January 14, 2000, at 23:29:00
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Phillip Marx on January 14, 2000, at 0:27:04
Yes, icons can be iconoclastic, especially if they are made of plastic. Some time ago I missplaced my thyme, and upon finding it not in the place I remembered placing it, I could not find the time to find the thyme, and thus the sauce was lost without reason or rhyme. Some people value clarity, but not out of charity, but this of course is a most nebulous subject. If you find yourself manic, there is no need to panic, just babble on about Babylon, or comment on commentaries of the aforementioned antic. I some times find myself partially partial to parsley, but if I could find my thyme in time I would find my thyme sublime. Variegated vagueries about somnolent soliloquies tax the facts and thus confound the information so renowned.
Posted by Phillip Marx on January 14, 2000, at 23:33:15
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Alfred on January 14, 2000, at 23:29:00
> Yes, icons can be iconoclastic, especially if they are made of plastic. Some time ago I missplaced my thyme, and upon finding it not in the place I remembered placing it, I could not find the time to find the thyme, and thus the sauce was lost without reason or rhyme. Some people value clarity, but not out of charity, but this of course is a most nebulous subject. If you find yourself manic, there is no need to panic, just babble on about Babylon, or comment on commentaries of the aforementioned antic. I some times find myself partially partial to parsley, but if I could find my thyme in time I would find my thyme sublime. Variegated vagueries about somnolent soliloquies tax the facts and thus confound the information so renowned.
Now THAT was FUN to read.
pm
Posted by Phillip Marx on January 15, 2000, at 1:06:31
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Scott L. Schofield on January 14, 2000, at 9:03:45
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.pm
> 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
>
>
> ------------------------------------------------------------
>
>
> > > In my opinion, benzodiazepines used as prescribed bear little resemblance to alcohol intoxication. There is no "buzz" or inebriation when used properly, also I think there is less impairment of judgement and other mental faculties. People unacustomed to them or who take large doses may experience some inebriation but generally fall asleep. They also are much less likely to intensify aggressiveness like alcohol can. I also think they are different from other sedatives like barbiturates, meprobamate, methaqualone etc..
> >
> > Hmmm. I “didn’t” feel any buzz, and no psychomotor inebriation. I didn’t even know or believe I “was” affected. Lots flowed, which I have severely restricted since. Lots of text flowing easily is a “good” thing to me. I am restricting discourse length (ha, dis-course, geez), not being rude. My judgement felt so unaffected that I defended it. I don’t know what alcohol drunk feels like. But I sure did suddenly learn to enjoy not having to fight rules that took more thought than I had time left for, before lights out. No one gets mad at me during the day. Only my first and last half-hour seems at risk. Good to know. Glad I found out so inexpensively. Cheap, except for the uproar. Abstract writing can attract more attention than is wanted, even from those who don’t want to give it.
> >
> > For example: http://www.dr-bob.org/babble/20000112/msgs/18893.html
> >
> > I pasted that response in full HTML with beautiful formatting (exactly matching the APA DSM-IV) and it turned into formatting babble that actually insults MY skills. No wonder other people felt insulted. I don’t think getting my HTML books back is going to help.
> >
> > pm
Posted by Sam on January 15, 2000, at 1:53:49
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Phillip Marx on January 15, 2000, at 1:06:31
Could you briefly list your troubling symptoms? I am not a psychiatrist but I might be able to help you.
Posted by Scott L. Schofield on January 15, 2000, at 7:48:37
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Phillip Marx on January 15, 2000, at 1:06:31
Was I uncivil?I thought that what I wrote would be in some way helpful.
I apologize to anyone who was offended.
- Scott
------------------------------------------------------
Scott to Phillip:
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Phillip Marx on January 14, 2000, at 0:27:04
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 to Scott
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.
------------------------------------------------------
Posted by Scott L. Schofield on January 15, 2000, at 8:08:42
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Phillip Marx on January 15, 2000, at 1:06:31
Dear Phillip,
I had a difficult time reading through your reply post. I'm one of the lucky ones for whom dementia is one of the prominent symptoms of depression. That's not to say that I didn't try. You seem to contradict yourself on numerous occasions. Perhaps my cognitive impairments prevent me from putting things together.I haven't been reading all of your posts over the past few weeks, so I don't know where you are with things.
Let us, for a moment, pretent that I am not trying to act as your adversary, but rather as a concerned friend.
I have only two questions. They each *require* a simple one word reply:
YES or NO
---------------------------------------------
Q: Are you currently manic?
Q: Have you ever been manic?
---------------------------------------------Sincerly,
Scott
Posted by Noa on January 15, 2000, at 9:42:32
In reply to Re: Phillip, posted by Scott L. Schofield on January 15, 2000, at 8:08:42
Scott, you asked for feedback. From what I read of the past few posts, I don't think you were being uncivil.
Posted by Scott L. Schofield on January 15, 2000, at 9:54:52
In reply to => Was I uncivil ? - Need feedback <=, posted by Scott L. Schofield on January 15, 2000, at 7:48:37
I just want to make certain that people don't misinterpret any of my statements in the post found below. These statements should be read within the context as being motivated by constructive rather than destructive intent. Sarcasm was not intended.
- Scott
--------------------------------------------------------
> 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.
Posted by Noa on January 15, 2000, at 10:03:42
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Scott L. Schofield on January 14, 2000, at 9:03:45
> I've been accused of being manic several times in the passed. Believe me, it was a real pain in the ass.
>
>
Scott, I am sad to read that the questions/suggestions about being manic seem like "accusations". To me, an accusation is a claim that one has DONE something WRONG. It implies some control over what is going on. In contrast, I see manic symptoms as something no one would ever ask for, nor can control. Speaking for myself, when I mentioned the idea to Phillip, it was out of concern, and certainly not at attack on him, his character, or his actions. Just some feedback.A number of years ago, after moving to a new location, and after having had a few good years, relatively depression-free, I started seeing a new therapist. I thought the issue at hand was having broken up with a boyfriend. She confronted me with the idea that I have a "lifelong" depression that needed pharmacological treatment. I had prided myself in "overcoming" my depression, and did not want to accept the idea that it was of a recurring variety. I was hurt and angry at her. I think this was in part because the idea of recurring depression raises the spectre of having to deal with it the rest of my life. All of my hope until then had been placed in the basket of thinking of my depression as something I had and am done with. Of course, I came to see that she was right.
I have had other disillusionments since then. All the hope I placed in different meds, or combos thereof, or in certain changes I made in my life. I now know that it is all so complex. What I am working on now is the idea that having a recurring form of this illness doesn't have to mean hopelessness. This isn't easy, though, because it has felt like every time I am beginning to get my life in gear, I am whalloped with another episode of bad depression. This makes it hard to let go of the constant feelings of futility and anxiety. So, my goal is to try to get and maintain control over the severe episodes. If I can get some stability back, then I might be able to start feeling some long term hopefulness.
Why am I telling you all of this? Because I think stability is the key. Trying to get control over the cycling, whether you have unipolar or bipolar, is a necessary first step. That is why people, myself included, might have confronted Phillip, or others before, to provide honest feedback that he is giving an impression of having manic symptoms. Not at all an accusation.
Posted by Scott L. Schofield on January 15, 2000, at 10:06:47
In reply to Re: => Was I uncivil ? - Need feedback <=, posted by Scott L. Schofield on January 15, 2000, at 9:54:52
> I just want to make certain that people don't misinterpret any of my statements in the post found below. These statements should be read within the context as being motivated by constructive rather than destructive intent. Sarcasm was not intended.
Oh...Just to make doubly certain, I do not believe the DSM IV to be of questionable value.
> > Using the DSM IV (questionable value) create a list...
- Scott
Posted by judy on January 15, 2000, at 10:23:10
In reply to Re: => Was I uncivil ? - Need feedback <=, posted by Scott L. Schofield on January 15, 2000, at 10:06:47
Hi, I've received a lot of enjoyment reading this thread and being diagnosed bipolar 1, rapid cycling which I think is a bunch of sh*t, Phillip you make perfect sense, i love you're style of writing, but Alfred your response is similar to what got me my label. Have a great day!
Posted by Mrs. G on January 15, 2000, at 10:24:39
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Scott L. Schofield on January 14, 2000, at 9:03:45
It did not look like Scott was uncivil. I don't think it was taken that way. Phillip stated in one of his posts that he is bipolar and an insomniac. Manic-depressives, of course, are bipolar. He is also very, very well-read, humorous, a good writer, and a whiz on the computer. We are all interested in this forum because of our own problems. He is no different than the rest of us who are seeking hope and understanding. Scott writes beautifully and very compassionately. No offense should be taken where none was intended.
Posted by Phillip Marx on January 15, 2000, at 10:26:23
In reply to Re: Phillip, posted by Scott L. Schofield on January 15, 2000, at 8:08:42
Phil(1): (http://www.dr-bob.org/babble/19991212/msgs/17746.html)
? I'll respond soon, point by point, to what is already written, in a separate post I have already begun composition of.Scott(1): (http://www.dr-bob.org/babble/19991212/msgs/17748.html)
I will not even begin to read beyond the first few sentences before replying.
This is not a war and I plan not to take part in one.Phil(2): (http://www.dr-bob.org/babble/20000112/msgs/18957.html)
Terms:
1. Civility the rule, not the exception, not a cold war.
War was never intended, you are the only one who wrote war. Un-civility not accused by me, just a warning only that you will be talking to no-one but yourself if the discussion leads that way.Scott(2): (http://www.dr-bob.org/babble/20000112/msgs/18921.html)
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
Scott(3) (http://www.dr-bob.org/babble/20000112/msgs/18972.html)
Dear Phillip,
I had a difficult time reading through your reply post. I'm one of the lucky ones for whom dementia is one of the prominent symptoms of depression. That's not to say that I didn't try. You seem to contradict yourself on numerous occasions. Perhaps my cognitive impairments prevent me from putting things together.
I haven't been reading all of your posts over the past few weeks, so I don't know where you are with things.
Let us, for a moment, pretent that I am not trying to act as your adversary, but rather as a concerned friend.
I have only two questions. They each *require* a simple one word reply:
YES or NO
---------------------------------------------
Q: Are you currently manic?
Q: Have you ever been manic?
---------------------------------------------
Sincerly,
ScottPhil000115 – on way to seminar, no time to deal with bait-and-switch questions, line-by-line or bottom line. Line-by-line is the bottom line.
1. What “NON-questionable value” reference are you using that is better than DSM-IV?
2. Name the numerous “seeming” contradictions.
3.Point detailed previously fails to fully qualify as mania per APA specs, what specs are you using?
4. Points to be detailed later will similarly fail to certifiably qualify, perhaps I need to know what criteria you use and how accredited are they? Enlighten me.
5. It seems to beget less protest to write on the terse side and get asked for more than to write on the lengthy side and get asked for less. Is that on purpose, how can it be so consistent?I have always conceded manic-like = almost like manic. Testing by DSM-IV, I am outside even atypical range.
pm
Posted by Scott L. Schofield on January 15, 2000, at 11:34:04
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Noa on January 15, 2000, at 10:03:42
> > I've been accused of being manic several times in the passed. Believe me, it was a real pain in the ass.
> >
> >
> Scott, I am sad to read that the questions/suggestions about being manic seem like "accusations". To me, an accusation is a claim that one has DONE something WRONG. It implies some control over what is going on. In contrast, I see manic symptoms as something no one would ever ask for, nor can control. Speaking for myself, when I mentioned the idea to Phillip, it was out of concern, and certainly not at attack on him, his character, or his actions. Just some feedback.
--------------------------------------------------
Please don't be sad.Of course I recognize, agree, and act with all of these things in mind!!
Please reread the post carefully. Pay particular attention to the intended use of the quotation marks.
I have seen mania first hand. I have been both hypomanic and psychotically manic. I have also observed others in both manic and hypomanic states. Let's just say that I may have some insight into the workings of a manic mind. I constructed my post strategically and with great care. One of the most difficult things to do is to convince someone who is in a manic state that they are indeed manic and need treatment. They feel great. They feel even better than great. In their eyes, they see themselves as being perhaps a genius and more capable of taking on any challenge that comes their way. They are, of course, displaying the illusions of grandeur that often develop in a manic state. They see any attempt to "stop" their superior and hyperfunctual state as being an attack. To try to tell them that they are manic is an "accusation". With so many people telling them that something is wrong and that they need some sort of intervention, they can often become paranoid or combative. It is imperative to them that they explain away each contention made regarding the "accusations" (symptoms) levied against them that support the "argument" that they are manic.
I hope this clears things up.
Was the mission of the post successful?
Perhaps in some ways it was. Unfortunately, the ultimate goal of getting Phillip to a doctor was not. Actually,he may not need any help at all. I'm not a doctor and I don't feel like getting flamed today. If he would indeed benefit from some sort of intervention, perhaps the post has brought him one step closer.
---------------------------------------------------------
> "In contrast, I see manic symptoms as something no one would ever ask for, nor can control."This is not always true.
- Scott
Posted by Scott L. Schofield on January 15, 2000, at 11:49:02
In reply to Re: Phillip, posted by Phillip Marx on January 15, 2000, at 10:26:23
It is just my observation that you spent 543 words without answering my two simple YES/NO questions.
> I have only two questions. They each *require* a simple one word reply:YES or NO
---------------------------------------------
Q: Are you currently manic?
Q: Have you ever been manic?
---------------------------------------------Again - Sincerely
Scott
Posted by Sam on January 15, 2000, at 18:46:33
In reply to Feedback on feedback, posted by Scott L. Schofield on January 15, 2000, at 11:34:04
I have to agree with Scott. This could be mania or leading up to psychosis. This is based on my own subjective experiences. Nipping it in the bud would be a wise strategy. Without further information nothing is clear.
Posted by Scott L. Schofield on January 16, 2000, at 0:39:26
In reply to Re: Are Benzodiazepines Like Alcohol?, posted by Noa on January 15, 2000, at 10:03:42
Hi noa.
> A number of years ago, after moving to a new location, and after having had a few good years, relatively depression-free, I started seeing a new therapist. I thought the issue at hand was having broken up with a boyfriend. She confronted me with the idea that I have a "lifelong" depression that needed pharmacological treatment. I had prided myself in "overcoming" my depression, and did not want to accept the idea that it was of a recurring variety. I was hurt and angry at her. I think this was in part because the idea of recurring depression raises the spectre of having to deal with it the rest of my life. All of my hope until then had been placed in the basket of thinking of my depression as something I had and am done with. Of course, I came to see that she was right.I think I reacted in a similar way to this realization.
My initial reaction to the idea that the cause of my depression was biological, rather than psychological, was one of anger, fear, and frustration. It still is. I didn't care how f'd-up in the head I was. I figured that if I worked hard enough for long enough - with help if I needed it - I could unravel the tangles of my psyche and emerge out of depression. When I realized that the defeat of my depression was no longer in *my* hands, I was pissed. When I was confronted with the fact that treatment doesn't work for everybody, I was afraid. I am not afraid to recognize my weaknesses and I am not afraid to work. To do so much work and get nowhere was frustrating.
*I* wanted to be in control of my own destiny!
> I have had other disillusionments since then. All the hope I placed in different meds, or combos thereof, or in certain changes I made in my life. I now know that it is all so complex. What I am working on now is the idea that having a recurring form of this illness doesn't have to mean hopelessness. This isn't easy, though, because it has felt like every time I am beginning to get my life in gear, I am whalloped with another episode of bad depression. This makes it hard to let go of the constant feelings of futility and anxiety. So, my goal is to try to get and maintain control over the severe episodes. If I can get some stability back, then I might be able to start feeling some long term hopefulness.
I agree. It can be very complex. I really don't suffer disillusionments. I do suffer huge disappointments, though. Every time I begin to respond to an antidepressant - even though the duration of the response lasts for only 2 to 7 days - I am *sure* that it will last and that I will live happily ever after. I begin to make plans for my future with the confidence that I will be well and stable. Then the floor drops out beneath my feet, and I am left hanging.
> Why am I telling you all of this? Because I think stability is the key. Trying to get control over the cycling, whether you have unipolar or bipolar, is a necessary first step.
This is something that I have not appreciated enough over the years. Thanks for giving me this important insight.
> That is why people, myself included, might have confronted Phillip, or others before, to provide honest feedback that he is giving an impression of having manic symptoms. Not at all an accusation.
I hope that my follow-up posts demonstrate my good intentions. It seems that you and I may have confronted him for exactly the same reasons.
- Scott
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.----------------------------------------------------------------
Posted by Phillip Marx on January 16, 2000, at 23:43:02
In reply to Re: Phillip, posted by Scott L. Schofield on January 16, 2000, at 22:58:25
> 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
>
I asked him almost two weeks ago, I've no phobia against honest and skilled assessment. His response requires his consent.I'm trying to nice-up a response to your other things in ways that won't contribute to any depression. I'm not being not-nice, but short and too-to-the-point reads like retort. You can tell me how you scored me, here or by email, but....
Criteria D of the APA Criteria for Manic Episode is the only one half-applicable, first-half only thankfully, except even it pre-supposes that the moods evidenced are "causative" and not derivative:
D. The "mood" disturbance is sufficiently severe to CAUSE marked impairment in occupational functioning (duhhhh!) or in usual social activities or relationships with others,.......
I'm busy writing up a few questions for tomorrow's rounds. Most eminent deadlines usually hog my priority and attention, so I'm not dumping on you, just reserving more care. Properly responding to you will take some care, since I can't watch any instrumentation on you. I have to guess how much your acknowledged medication affected cognition levels average to. The problem with my having been the same way so long is that I both; can't remember it very well, and I've put out of my mind as much as I could of what I could remember. Repetition from multiple perspectives came in best for me then, thus I lean towards that. Trying to get through in just one post, not trying to sound manic.
I knew that half a picture's worth of words wasn't going to be enough. Everyone's learning is a pyramid of facts. I have more. I'm signed up for an Acquired Brain Injury Specialist certification class and a related Perceptual Processing: Cognitive Rehabilitation class. Most common denominator. Regardless of whether I stay up or go down again, that will help both myself and those that have helped me. Once I learn the lingo better, I'll sound like I know the lingo better.
pm
Posted by Scott L. Schofield on January 17, 2000, at 17:10:59
In reply to Re: Phillip, posted by Phillip Marx on January 16, 2000, at 23:43:02
Dear Phillip,
How are you doing?I'm O.K.
This whole thing is beginning to smell like that which I said I would take no part in. I guess I have been the culprit here in that my posts were the most instigating. This will probably be my last post regarding the fears I have that you may be headed in the direction of a manic psychosis.
> I'm trying to nice-up a response to your other things in ways that won't contribute to any depression.
Seeing my writing - that I have written at all - should give you some indication that you haven't yet contributed to my depression. Actually, producing my off-the-wall, obsessive postings may have caused quite the contrary. Please put your mind at ease. I assure you that you can never be guilty of being a trigger for me to climb a stairway to heaven. You know, it's funny that we both may have shared similar concerns.
> > It might be a good idea to begin a new thread and have Dr. Bob score it and offer some initial interpretations and suggestions.
> I asked him almost two weeks ago, I've no phobia against honest and skilled assessment. His response requires his consent.
Let me just be sure that I understand this properly. Would the following be a valid interpretation? Y/N?
"You solicited from Dr. Bob an evaluation of your current state of mental health. He subsequently corresponded with you by sending a reply to your solicitation. You now have his reply, but cannot or will not post it without his consent."
It would allay my concerns about you if you would please point me in the direction of your posts to Dr. Bob so I can stop being a pain in everybody's ass.
In any event, I am happy to hear that you have looked into the possibility that you may currently be in a manic state due to bipolar disorder. That you have been thoroughly evaluated by Dr. Bob puts my mind at ease.
I hope that I have not wasted too much of your time. I was just concerned.
Oh yeah. A few of more things...
I found your writing here to be more coherent than in previous posts. Of course, if you were manic, you may have been more focused to accomplished this. It would be a strategic attempt to...I don't know.
> I'm not being not-nice, but short and too-to-the-point reads like retort.
I tend to be very efficient with words. You can be too, if you'd like. I won't be offended.
> I knew that half a picture's worth of words wasn't going to be enough. Everyone's learning is a pyramid of facts. I have more.
I like the pyramid metaphor. Unfortunately, bipolar depression forced me to drop out of college after my sophomore year. When I was told by the clinical investigators at Columbian Presbyterian that there was nothing more they could do for me, I was compelled to plunge into the mountain of literature at the Rutgers medical school library to do it myself. The pyramid metaphor still stands (unintended pun), however, I had to start at the apex and work my way down. Fortunately, I began with a firm base built by taking courses towards a biology major.
> Everyone's learning is a pyramid of facts. I have more.
You are damned good. I can't even read my *own* mind.
> Everyone's learning is a pyramid of facts. I have more.
Facts regarding what?
> I'm signed up for an Acquired Brain Injury Specialist certification class and a related Perceptual Processing: Cognitive Rehabilitation class.
* You are getting better. You only wasted 322 words this time.
Take care,
Scott================================================================
The passage found at the bottom is a repost of my earlier submission regarding mania and some of its aspects. For the sake of emphasis, I capitalized the word EACH.Before leaving, I think it is important that it be understood that what is described here is far from being a sufficient review of the many ways that mania can manifest.
Someone please check me on this:
One presentation is called a mixed-state, where the mood state seems to have features of both mania and depression. This is far from being the energetic euphoria that represents the stereotyped mania seen in Bipolar I disorder. I imagine that it isn't a hell of a lot of fun.
My first episode of mania was labelled as "manic dysphoria" by my doctor. I don't know if this term has been used interchangeably with "mixed-state", but it too was not a hell of a lot of fun. It kind of started out as hypomania. I didn't sleep very much (perhaps 3 hours), although I wished I could. I felt "wired" and irritable. There was always something that I felt I had to do. I tried to do everything all at once. This would cause me to feel "drained" - not "fatigued", not "tired", and not "sleepy". I could never seem to recharge my batteries. I kept moving, though. I was extremely impatient with people. It would irritate the hell out of me when people could not keep up with me because they were too slow or not smart enough.
I had another manic episode that was not as dysphoric. However, I do remember having to prove, point by point (symptom by symptom) that I was not manic. I wasn't very convincing.
----------------------------------------------------------------
REPOST:I have seen mania first hand. I have been both hypomanic and psychotically manic. I have also observed others in both manic and hypomanic states. Let's just say that I may have some insight into the workings of a manic mind. I constructed my post strategically and with great care. One of the most difficult things to do is to convince someone who is in a manic state that they are indeed manic and need treatment. They feel great. They feel even better than great. In their eyes, they see themselves as being perhaps a genius and more capable of taking on any challenge that comes their way. They are, of course, displaying the illusions of grandeur that often develop in a manic state. They see any attempt to "stop" their superior and hyperfunctual state as being an attack. To try to tell them that they are manic is an "accusation". With so many people telling them that something is wrong and that they need some sort of intervention, they can often become paranoid or combative. It is imperative to them that they explain away EACH contention made regarding the "accusations" (symptoms) levied against them that support the "argument" that they are manic.
--------------------------------------------------------------
Posted by Dr. Bob on January 19, 2000, at 0:05:14
In reply to Re: Phillip, posted by Scott L. Schofield on January 17, 2000, at 17:10:59
> This will probably be my last post regarding the fears I have that you may be headed in the direction of a manic psychosis.
I think those fears have been made clear. While well-intentioned, I'm not sure that continuing to pursue them would be very productive, anyway.
> > I asked him almost two weeks ago, I've no phobia against honest and skilled assessment. His response requires his consent.
It's fine with me to post it here, but, lest people get their hopes up, I don't think it's going to settle any disagreements. :-)
Bob
Posted by judy on January 19, 2000, at 11:43:58
In reply to Re: Phillip, posted by Dr. Bob on January 19, 2000, at 0:05:14
I am so GLAD you decided to back off of Phillip, who cares what labels you deign to apply to him the man makes perfect sense and besides if he's hypomanic (which I don't think he is) that's his business and you're probably throwing fuel on an already present trait of loving to argue- which is present in you too. Anyway you remind me of all the people who "think" they're trying to help me when I DON'T need or want it and am perfectly happy to be my hyperthymic (like that label?) self. Have a great day!
Posted by Phillip Marx on January 20, 2000, at 2:13:11
In reply to Re: Phillip, posted by Phillip Marx on January 15, 2000, at 10:26:23
Time-out please.
My retirement plan is hogging my attention with 10x normal volume, 3x value swings (up^up^up^), shareholder uproars and company surprise announcements. At just what point does one need to seek help for anxxxxxxxiety?
My tile work needs a stall too. The batchelor balanced washing machine leaked out the bottom hose end and loosened a lot of tile. Is there a reason for such poor catastrophe prevention engineering? Most of the houses I saw on some real estate investment tours had similar or worse internal water damage. Most dishwashers only need the filter cleaned to prevent total replacement and brain damage from detergent water spots. For fun(?): why does there seem to be such an undersight of oversights? Well, my city's public secret is "expansive soil" which means micro-cracks in the foundation slab. Now that I've discovered that my house has a couple of such cracks, now wet, I'll have to delay doing a good job tile job until summer. Those cracks are going to have to be ground out and refilled with admix. Fortunately I have no floor unleveling, a big surprise since my trees were higher than the telephone poles. I'll use a masonry bit to stress relieve the crack ends and this new diamond saw blade to kerf the zig-zags. I will NOT fill my house full of concrete dust during flu and bronchitis season. Concrete dust isn’t biodegradable in the lungs at an easy to tolerate rate, especially, if it is super alkaline from my soil. I'm going to have to use that tacky, cheap and crummy adhesive square tile stuff til summer. The cheapest pattern has flowers I don't recognize since they aren't roses or carnations.
A new shopping center has opened up a mile and a half from my house and it has a brand-spanking-new Home Depot in it. Time to shop. I'm going to run out of time before I run out of projects. They sure stock a way to fix just about anything better even than it needs to be.
I've only got a week and a half til classes start and I need to at least browse the rest of the way through the books before class starts.
Well, I'll just have to indulge in some home-grown antidepressants. My Macadamia nut tree is overloaded and my across-the-street green thumb just told me how to prune it for a double-crop year. I sure hope this Macadamia AD never quits working.
pm
> Phil(1): (http://www.dr-bob.org/babble/19991212/msgs/17746.html)
> ? I'll respond soon, point by point, to what is already written, in a separate post I have already begun composition of.
>
> Scott(1): (http://www.dr-bob.org/babble/19991212/msgs/17748.html)
> I will not even begin to read beyond the first few sentences before replying.
> This is not a war and I plan not to take part in one.
>
> Phil(2): (http://www.dr-bob.org/babble/20000112/msgs/18957.html)
> Terms:
> 1. Civility the rule, not the exception, not a cold war.
> War was never intended, you are the only one who wrote war. Un-civility not accused by me, just a warning only that you will be talking to no-one but yourself if the discussion leads that way.
>
> Scott(2): (http://www.dr-bob.org/babble/20000112/msgs/18921.html)
> 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
>
> Scott(3) (http://www.dr-bob.org/babble/20000112/msgs/18972.html)
> Dear Phillip,
> I had a difficult time reading through your reply post. I'm one of the lucky ones for whom dementia is one of the prominent symptoms of depression. That's not to say that I didn't try. You seem to contradict yourself on numerous occasions. Perhaps my cognitive impairments prevent me from putting things together.
> I haven't been reading all of your posts over the past few weeks, so I don't know where you are with things.
> Let us, for a moment, pretent that I am not trying to act as your adversary, but rather as a concerned friend.
> I have only two questions. They each *require* a simple one word reply:
> YES or NO
> ---------------------------------------------
> Q: Are you currently manic?
> Q: Have you ever been manic?
> ---------------------------------------------
> Sincerly,
> Scott
>
> Phil000115 – on way to seminar, no time to deal with bait-and-switch questions, line-by-line or bottom line. Line-by-line is the bottom line.
> 1. What “NON-questionable value” reference are you using that is better than DSM-IV?
> 2. Name the numerous “seeming” contradictions.
> 3.Point detailed previously fails to fully qualify as mania per APA specs, what specs are you using?
> 4. Points to be detailed later will similarly fail to certifiably qualify, perhaps I need to know what criteria you use and how accredited are they? Enlighten me.
> 5. It seems to beget less protest to write on the terse side and get asked for more than to write on the lengthy side and get asked for less. Is that on purpose, how can it be so consistent?
>
> I have always conceded manic-like = almost like manic. Testing by DSM-IV, I am outside even atypical range.
> pm
Posted by Dreadylochs on January 20, 2000, at 18:05:16
In reply to Re: Time-out, posted by Phillip Marx on January 20, 2000, at 2:13:11
Are you on weed dude?
Posted by Ty on January 21, 2000, at 10:54:19
In reply to Re: Time-out, posted by Dreadylochs on January 20, 2000, at 18:05:16
> Are you on weed dude?
If not maybe you should start...
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