Assessing and Diagnosing Patients With Mood Disorders
Training Title 2
In Test Section Index , Episode 2 (Santa Monica, CA: Symptom Media , 2016), 7 minutes
BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Why did your mom feel you should come in and talk with me today?
00:00:20MRS HOUSTON She was worried. Mom says I get moody this time of year, every year. I don't know. Maybe.
00:00:40OFF CAMERA How are you feeling, when?
00:00:45PATIENT Not great.
00:00:45OFF CAMERA What's not great?
00:00:50PATIENT Huh. Just down. I'm not doing so well.
00:01:05OFF CAMERA How's school?
00:01:05PATIENT Ok.
00:01:10OFF CAMERA Just ok?
00:01:15PATIENT Yeah. I left the program at school. I mean I did and... I'm not doing so well.
00:01:25OFF CAMERA Are the courses difficult?
00:01:30[sil.]
00:01:35PATIENT I understand everything. The teachers are getting to be a bit of a pain. The classes aren't lustrous (Sighs). I'm in this special business program, where you have to come up with a mock company. I just... I just can't seem to get it done. That, and all my other projects. I'm already late on two of them.
00:02:25OFF CAMERA Are you having difficult concentrating?
00:02:30PATIENT Yeah. I'll read the headlines in the newspaper and like, five seconds later, I can't remember what I read. And my classes, when I leave the room, I don't what we were learning about.
00:02:55OFF CAMERA Are you having any irregular sleeping or eating patterns?
00:03:05PATIENT (Sighs) I've gained ten pounds. Umm... I've slept through five of my classes this month if that answers your question.
00:03:20OFF CAMERA Have you been able to make any friends?
00:03:25PATIENT [Shrugs] Yeah. Almost immediately. The people are a lot of fun.
00:03:30OFF CAMERA What do you do with them?
00:03:35PATIENT Lately, not so much of anything.
00:03:45OFF CAMERA What happened?
00:03:50PATIENT Well, it was a blast when I arrived in August. I made friends almost immediately. We went to concerts and shows, we hung out. And we had a lot of fun.
00:04:15OFF CAMERA You don't do any of that now?
00:04:20PATIENT They kind of annoy me a little bit. I mean nothing I can't get over. They got really dull. They suddenly started playing board games... and then, things also got busy and with the weather, I don't want to go outside.
00:04:45OFF CAMERA Do you particularly dislike the cold weather?
00:04:50PATIENT It's not like I have a burning passionate hatred for the cold. I've always fretted fall and winter. I'm a summer girl. I like the beach and convertibles. And now...
00:05:10OFF CAMERA You can't do any of that.
00:05:10PATIENT No. In fact you can't do anything at all.
00:05:15OFF CAMERA Can you tell me what it is you dislike about this time of the year?
00:05:25PATIENT It's dark. And grey. And miserable. The whole city changes, it's not the same city that I loved in August. September was good. It was beautiful. Sunny, crisp days and, the leaves changing at the end of the month and then it just started getting worse and worse. Even... the snow is grey and black. I didn't know snow got like that, city snow. I thought snow was white and beautiful. But city snow isn't like that. Everything is grey. It's miserable.
00:06:30[sil.]
00:06:35SymptomMedia Visual Learning for Behavioral Health www.symptommedia.com
00:06:35END TRANSCRIPT
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Training Title 28
In Test Section Index , Episode 28 (Santa Monica, CA: Symptom Media , 2016), 6 minutes
BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Mrs. Carson? Tell me why you've come to see me today.
00:00:20MRS. CARSON I'm... [Shrugs] Wound up. Lost my temper.
00:00:25OFF CAMERA What sorts of things make you lose your temper?
00:00:25MRS. CARSON Oh... lots of things. The kids. They get on my nerves.
00:00:35OFF CAMERA When does that happen?
00:00:40MRS. CARSON Playing the television too loud. Take Shawn for instance? He spilled sugar all over the counter last night when my husband was out.
00:00:50OFF CAMERA And then what happened?
00:00:55MRS. CARSON I lost my temper. I pushed him down. Not hard... he wasn't hurt, just cried a little. Maybe...
00:01:10OFF CAMERA Maybe what?
00:01:15MRS. CARSON I was just thinking.
00:01:15OFF CAMERA What were you thinking?
00:01:20MRS. CARSON Maybe I should go away.
00:01:20OFF CAMERA Go away?
00:01:25MRS. CARSON Yeah. Like I shouldn't be here.
00:01:25OFF CAMERA Have you thought about killing yourself?
00:01:30MRS. CARSON [nods] Some.
00:01:35OFF CAMERA How would you do it?
00:01:40MRS. CARSON Driving into something. Drink a whole bunch, then drive... then make it look like an accident.
00:01:50OFF CAMERA Have you tried that? Or made plans?
00:01:50MRS. CARSON [Shakes head]. Naw. It was just a thought I had once or twice. Nothing for real. Everyone has those kinds of thoughts at some time, you know?
00:02:05OFF CAMERA I'm not so sure about that. How long have you been thinking about driving into something?
00:02:15MRS. CARSON Three months or so, I guess.
00:02:15OFF CAMERA What else was going on three months ago?
00:02:25MRS. CARSON I was up for a promotion, didn't get it. [Shrugs]. But lots of guys didn't make it either.
00:02:35OFF CAMERA So you didn't get the promotion?
00:02:35MRS. CARSON I should have had that promotion. I would... I would have been a supervisor at the whole office. But my supervisor said others who were better, younger.
00:02:55OFF CAMERA How did that make you feel about yourself?
00:03:00MRS. CARSON Not so hot. My husband and children deserve better. Even the job I'm doing is at risk, in jeopardy.
00:03:15OFF CAMERA How so?
00:03:20MRS. CARSON I forget things. Five years of a perfect work record and my supervisor asked me is something wrong. [Shrugs]. So much for a promotion.
00:03:40OFF CAMERA Has worrying about him interfered with your sleep?
00:03:45MRS. CARSON [nods] It goes round and round in my head like... I can't get to sleep. Finally after a few hours I... I drop off.
00:04:00OFF CAMERA And what time do you wake up?
00:04:00MRS. CARSON Three, maybe four in the morning.
00:04:05OFF CAMERA Do you go back to sleep then?
00:04:05MRS. CARSON I can't go back to sleep. If I take a stiff drink or two sometimes I can, but it wears off.
00:04:20OFF CAMERA How much are you drinking?
00:04:25MRS. CARSON I try and keep it to three or four. I took my husband's sleeping pills, but they didn't work.
00:04:35OFF CAMERA Have you found anything that's helpful?
00:04:40MRS. CARSON [shakes]. No.
00:04:40OFF CAMERA Do you think things will get better?
00:04:45MRS. CARSON I don't see how. I've pretty much ruined everything.
00:04:55OFF CAMERA Mrs. Carson, from what you are describing, it sounds like you're depressed. It's often hard to know why a depression occurs when it does. We do know depression can cause all of the symptoms you have told me... the loss of sleep, the feelings of exhaustion, memory loss, irritability and worry. It makes working difficult and some people even think of committing suicide. Many factors can contribute to a chemical imbalance in the nervous system, which can cause this problem. I would also like to see you again soon to talk further about these problems. Let’s setup an appointment but if you really feel like hurting yourself, call me at any time.
00:05:30[sil.]
00:05:35 Symptom Media Visual Learning for Behavioral Health www.symptommedia.com
00:05:35 END TRANSCRIPT
Training Title 38
BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Mr. Loman I understand your sister has been in the hospital previously. Can you tell me about that and also about what... what's happening with her now?
00:00:25PATIENT You're not going to give her A C T now are you? Because if you are, we can go to Duke. That's a good hospital.
00:00:30OFF CAMERA Your sister's had A C T?
00:00:30PATIENT Yeah, she's had A C T in the past. It's a disaster. She doesn't remember anything. She puts the, the radio in the refrigerator, the cat in the microwave oven, it, it, it is a disaster.
00:00:40OFF CAMERA Can you tell us about what you'd like for us to do for her this time?
00:00:45PATIENT Confirm the psycho spiritual mode of existence. Like in the Aphrodite Adonus model. Do you read Rollo May? We read it all the time. Are you... are you a psychiatrist? Or a psychologist? Is this one of those rooms with the one way cameras.
00:01:05OFF CAMERA Uh... no, it, it is not.
00:01:05PATIENT We take precautions from the Russian infrared rays at home. Blankets all over the windows. Do you... do you take precautions? You wouldn't want to get sterile or... or have leukemia. We had two doctors the last time she was in here. It was Dr. Richard Horowitz and Dr. Stephen Hunter. Horowitz, Hunter. Horrific witch hunt. That's all this thing is is a witch hunt, right? Come on, what? I bet your going to ask her all those questions, like how a banana is similar to a typewriter.
00:01:45OFF CAMERA Has anyone ever asked you those questions?
00:01:50PATIENT God... Goodness. Yesss! We have to write these things down all the time so we can remember them when we're at home! Like how to subtract by threes or... or who we voted for for the president of the United States. Who did you vote for? I voted for Bugs Bunny. You know like, [taps fingers against his teeth]. What's up doc? [clicks teeth against each other]. For the healthcare reform.
00:02:15OFF CAMERA Uh huh. Can you tell me more about your sister's problems?
00:02:20PATIENT Love of life? You're not Devita Honeysuckle, are you? Cause if you are, I'm not going to talk to you.
00:02:30OFF CAMERA Uh, no... I'm not Devita Honeysuckle.
00:02:40[sil.]
00:02:40 END TRANSCRIPT
Training Title 8
BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Mrs. Tilman, your husband is extremely worried about you.
00:00:20MRS. TILMAN Yes, I know that.
00:00:25OFF CAMERA Does coming her bother you?
00:00:25MRS. TILMAN Yes. Yes it does. I've never been to a shrink before. I don't think I need to be here now.
00:00:35OFF CAMERA I'd like to ask you a few questions if that's ok.
00:00:40MRS. TILMAN Yeah, that should be fine.
00:00:40OFF CAMERA How have you been feeling health wise?
00:00:45MRS. TILMAN Fine. No health problems.
00:00:45OFF CAMERA Sleep?
00:00:50MRS. TILMAN I can't sleep much. But that's to be expected.
00:00:50OFF CAMERA How so?
00:00:50MRS. TILMAN The baby. It cries a lot.
00:00:55OFF CAMERA And that wakes you?
00:00:55MRS. TILMAN Well I'm usually already awake.
00:01:00OFF CAMERA You have trouble sleeping?
00:01:00MRS. TILMAN Just falling asleep. Especially after the baby cries.
00:01:05OFF CAMERA What's the baby's name?
00:01:10MRS. TILMAN Jessica.
00:01:10OFF CAMERA Beautiful name. How old is she?
00:01:15MRS. TILMAN Two months.
00:01:15OFF CAMERA How has your appetite been lately?
00:01:20MRS. TILMAN I don't know. It's not big, but I want to lose weight after the pregnancy.
00:01:25OFF CAMERA You aren't comfortable with the way you look?
00:01:30MRS. TILMAN I'm terrible. Alright. I look terrible, I feel terrible. My body is bloated. I have lines on my face, bags. I look disgusting.
00:01:45OFF CAMERA What do you do to lose weight?
00:01:50MRS. TILMAN: Well, I want to run, but... I don't get out much.
00:01:55OFF CAMERA Why?
00:01:55MRS. TILMAN: Because I'm stuck at home. I have to take care of the baby, all day long. I guess I should just get used to it. This is my life now all day long, stuck at home with the kid.
00:02:10OFF CAMERA You don't have a nanny?
00:02:10MRS. TILMAN Who could afford one? Especially with having to pay for the kid.
00:02:15OFF CAMERA Have you said any of this to your husband?
00:02:20MRS. TILMAN To Rick?
00:02:20DR. GREY Uh huh.
00:02:20MRS. TILMAN No. I couldn't. He'd be so disappointed in me. How could I even tell him that I felt this way. That I wanted out. He comes home from work and... he plays with Jessica. This perfect family.
00:02:50OFF CAMERA How has your relationship been?
00:02:55MRS. TILMAN Not good.
00:02:55OFF CAMERA What's happened since Jessica was born?
00:03:00MRS. TILMAN It's not added much. I mean it is my fault. I can't stop crying. All the time. [she cries] Sometimes I don't even know who the baby is. And I yell a lot. Things just upset me. Everything and anything he does lately just upsets me.
00:03:35OFF CAMERA For instance?
00:03:40MRS. TILMAN Well... Well the other day he came home and changed her diaper but he threw the dirty diaper in the wrong trash can and he didn't tie it up in the bag the way he was supposed to.
00:03:55OFF CAMERA And that upset you?
00:03:55MRS. TILMAN Yeah. And I told him, and I was yelling so he started yelling. So yeah. That's our marriage right now.
00:04:10OFF CAMERA Have you been sexually active since Jessica was born?
00:04:10MRS. TILMAN No. Not really. I have no drive or desire. Rick keeps wanting to but I just... I push him away.
00:04:20OFF CAMERA And how is your social life?
00:04:25MRS. TILMAN Non-existent. I haven't seen my friends in forever. They came over to see the baby but that's about it. I might as well get used to it. I can't go out anymore. She's too young for a baby sitter, and even then we couldn't afford one. I had to quit my job.
00:04:55OFF CAMERA Were you forced to quit?
00:05:00MRS. TILMAN No. They gave me maternity leave, but... but I figured this is never going to end. I might as well leave now.
00:05:10OFF CAMERA Do you do anything for yourself? Something to relax, something creative?
00:05:15MRS. TILMAN No. I tried writing. I liked writing but... I don't know, I... nothing moves me.
00:05:30OFF CAMERA You can't write now?
00:05:35MRS. TILMAN I have no inspiration, and it's not fun. I know I'm going to be interrupted soon anyway. Before Jessica, I could write for hours a night. I hated anyone disturbing me. [she cries] Now I can't have twenty minutes. And you can't tell a baby to hold on with wanting her lunch. For an hour. When she's hungry, she's hungry.
00:06:05OFF CAMERA Do you regret having a child?
00:06:05MRS. TILMAN No. I... I'm just not sure. I'm not sure, okay.
00:06:20OFF CAMERA Are you happy? Does anything give you pleasure?
00:06:30MRS. TILMAN [Shakes her head] No. [she cries]. Look, please, I... I know I'm a mother now. I. [sigh] I don't know how to put this, I feel terrible. [Cries harder]. I don't want to be a bad mother. I love my daughter. But I don't know... I don't know why I say these things. It's just really difficult... and Rick, I see Rick and he has this look. It's this look, its like I know what you're thinking. It's like he's judging me. It's like he knows I'm not normal. I mean, what's wrong with me? Sometimes I can't even hold my own child, I... I, she's crying and I can't... I can't touch her. And when I give her milk it disgusts me. I don't know what to do. I don't know what's wrong with me. I don't know what's wrong with me. [She reaches for a tissue]
00:08:15OFF CAMERA Mrs. Tilman, do you have thoughts of suicide or death?
00:08:20[she shakes her head yes]
00:08:25OFF CAMERA Have you acted upon them?
00:08:30MRS. TILMAN [she shakes her head no] No. I couldn't. I couldn't do that to Rick or Jessica. And then I feel guilty again. It's this... this endless cycle. I'm not happy and I want to get out and if I get out, then I would just... I would just... just ruin everyone and that makes me more unhappy.
00:09:05[sil.]
00:09:20SymptomMedia Visual Learning for Behavioral Health www.symptommedia.com
00:09:20 END TRANSCRIPT
Training Title 18
BEGIN TRANSCRIPT:
00:00:00[sil.] DX:
00:00:15OFF CAMERA So you're here on base now?
00:00:15PATIENT Yes, I work on base, but I live off base with my boyfriend Luke. He's a serv.
00:00:20OFF CAMERA So he's not in the military now?
00:00:25PATIENT No, he works somewhere else.
00:00:25OFF CAMERA Okay. Can you tell me about why you came in today?
00:00:30PATIENT Everyone keeps saying I have PTSD. Even Luke says I have it. He served with me, that's how we met.
00:00:40OFF CAMERA PTSD like Post Traumatic Stress Disorder?
00:00:45PATIENT Yeah. I used to be depressed when I was thirteen or fourteen.
00:00:50OFF CAMERA Were you treated for depression?
00:00:50PATIENT Yes, they gave me some kind of anti-depressants, but I stopped taking them when I was eighteen, when I decided I wanted to enlist. I didn't think they would let me enlist if I was on meds.
00:01:05OFF CAMERA And you said you were in Iraq. Did you experience, see any combat?
00:01:10PATIENT No, no combat. I helped load the soldier's body bags into the plane. I think about it a lot. It makes me sad. You know, I try to talk to Luke about it but he's away on the road most of the week. Because he's a driver now.
00:01:30OFF CAMERA How, how long have you been depressed this time?
00:01:35PATIENT Since I was eighteen. I feel like its worse when I have my period.
00:01:40OFF CAMERA And how is your sleep?
00:01:45PATIENT I don't sleep much. When I do sleep I toss and turn throughout the night.
00:01:55OFF CAMERA Uh-hm. What do you think about when your tossing and turning like that?
00:02:00PATIENT I think about Iraq. The kids over in Iraq. Who had burn scars and some of them were missing their feet and hands cause they stepped on mines.
00:02:15OFF CAMERA Mmm... that is terrible. How is your appetite doing?
00:02:25PATIENT I eat a little bit throughout the week. Sometimes I eat like three big meals and snack all day. My weight goes up and down all the time like a roller coaster.
00:02:35OFF CAMERA How about your concentration?
00:02:40PATIENT I can read one page of a magazine and I can have to read it over and over again just to try and remember it but I don't. Even when I'm watching my favorite shows I can't concentrate.
00:02:50OFF CAMERA What about crying spells?
00:02:55PATIENT All the time. An old school friend called me the other day and... I... they didn't call me back. And I couldn't stop crying. I cried all night. Sometimes I cry all day. I have no more energy to cry some days.
00:03:15OFF CAMERA Do you think you have more guilt than most people?
00:03:20PATIENT Yes. All my life. When I was in school, I feel like I disappointed my parents a lot. My sister... And my commanders, I feel like I disappoint them. And Luke, I made the soup to hot the other day. He told me not to worry about it but I just kept thinking it was all my fault. I blame myself a lot.
00:03:45OFF CAMERA What about your sex drive? How is that?
00:03:50PATIENT No sex drive. I do it when Luke presses the issue about doing stuff with sexual nature. But I don't have any emotional life behind it.
00:04:00OFF CAMERA What about other interests?
00:04:05PATIENT I have low energy and low interest all the time. I don't even like to go shopping anymore. I used to like that all the time. And I don't even play with my cat, Tigg, anymore.
00:04:20OFF CAMERA Any suicidal thoughts
00:04:20PATIENT No, I was raised strictly in a Baptist church so I would never plan to take my own life, but... I think about if I had cancer or got blown up... It wouldn't matter if I didn't live. It wouldn't matter if my life was gone.
00:04:40OFF CAMERA You said other people thought that you had PTSD do you have any flashbacks or nightmares about the terrible things you experienced in Iraq or other places?
00:04:55 PATIENT No nightmares, but I have daydreams all the time about stuff. Even when I can sleep, I don't have nightmares about Iraq. Just really about uninteresting stuff.
00:05:15OFF CAMERA If there are loud noises do you think you startle more than those people who have not been in the military?
00:05:20PATIENT Well, Luke said when he heard a loud thump, he jumped but... I didn't even notice it, like I didn't hear it.
00:05:30OFF CAMERA What about everyday anxiety or having panic attacks? Anything like that?
00:05:40PATIENT I don't like to go out and I get this really anxious feeling when people make me go out in public and socialize. I can do fine in a store, so long as no one comes up and talks to me. I feel like no one should come up and talk to me about anything. Like... Like I'm not worth it. Like I'm not good enough. I tell myself all the time I'm not good enough. And I'm not.
00:06:10 END TRANSCRIPT
Training Title 150
In Test Section Index , Episode 150 (Santa Monica, CA: Symptom Media , 2018), 2 minutes
Let me ask you about depression.
00:00:15>> I am not depressed.
00:00:15I mean, not hardly, no.
00:00:15>> I see that but let me ask you about other times.
00:00:20>> Okay, fine. I'll tell you what,
00:00:20 you ask, I'll answer
00:00:20that's how it will work.
00:00:25It will be like a game. Let's go.
00:00:25>> Got in the form that your parents filled out,
00:00:25they were they yesterday many times
00:00:30in the past week you appeared depressed.
00:00:30>> Yeah, yesterday I was a little bit depressed but
00:00:35it was just because I was in a bad mood.
00:00:35People get in a bad moods all the time.
00:00:35Don't you get into bad moods?
00:00:40I mean, that's in our nature.
00:00:40Animals get into bad mood.
00:00:40>> They also wrote that you started crying
00:00:40and said that you
00:00:40never wanted to participate in more school plays.
00:00:40>> Because bad moods don't make
00:00:45you want to sing obviously,
00:00:45bad moods make you want to,
00:00:50I don't know, run,
00:00:50just run and get away from everything but
00:00:50that's not now. Now is the now.
00:00:55>> They wrote that yesterday you
00:00:55had no energy [inaudible].
00:00:55>> My God, I'm sorry does it look like
00:01:00I have no energy right now?
00:01:00Because I really, I am
00:01:05as happy as a bumblebee in pollen blessed flowers.
00:01:10>> Were you happy yesterday?
00:01:10>> Yesterday was yesterday.
00:01:10Today is today.
00:01:15Maybe depends on string theory, right?
00:01:20Oh, my god. The art on this wall.
00:01:20Do you travel a lot? This is amazing.
00:01:25>> Your parents wrote that you tell them you are
00:01:25worthless for destroying everyone's lives,
00:01:25that you wanted to die.
00:01:30>> My god, why are you dragging me down
00:01:30with this ancient history?
00:01:30>> No plans, wanted to die.
00:01:30>> Ancient history buddy, come on.
00:01:35Let's just look.
00:01:35You have to live in the now.
00:01:35You can't leave in the last week.
00:01:40You can't live in the last year.
00:01:40You can't live in the last century.
00:01:40All right? Show me your smiley face.
00:01:45The future is bright.
00:01:45>> Do you agree with what your parents wrote?
00:01:45>> Look if that's what they wrote then
00:01:50that's their freedom of expression
00:01:50and I believe wholeheartedly in freedom of expression,
00:01:55I do not deny anyone any freedoms. Do you?
00:01:55This transcript was automatically generated using speech recognition technology. Because this method relies on machine learning algorithms, the quality of transcripts may vary. To request this transcript be improved with enhanced accuracy, please email transcripts@alexanderstreet.com.
Training Title 118
BEGIN TRANSCRIPT:
00:00:15 UNKNOWN You know, luck… luck… luck… luck… Luck be a lady tonight. Luck be a lady tonight. You know Frank Sinatra used to sing that. He's great. (inaudible) long day. He had like a little wife, I remember it's crazy. He's gonna… Yeah, a very small wife, who's weird. You know, whose really good now? It's Tony Bennett.
00:00:30UNKNOWN Yeah. Yeah. You told me about him.
00:00:30UNKNOWN Yeah, but got to pay attention because I mean, he's underappreciated. I mean, I… People don't, you know…
00:00:35UNKNOWN Yeah, you said…
00:00:35UNKNOWN Wait… He went down…
00:00:35UNKNOWN You said something about concerts, that you were giving concerts.
00:00:40UNKNOWN Yeah, I am. I… I did them. I just did one in New York City. I did St. Louis, I did uh… Atlantic City and I did all those little farming community, you know, that was really populated farming communities in Indiana.
00:00:50UNKNOWN Oh.
00:00:50UNKNOWN Yeah. And… and now I'm doing this some concert here at MacArthur Park. Someone have to kick out… and most people are pervert. But there's you know, the problem is, there's so many homeless people there. So it's kinda like they are getting away and I like set up…
00:01:05UNKNOWN Mm-mmm. Mm-mmm. Where did you… Mm-mmm. Where did you play in New York City?
00:01:05UNKNOWN You know I'm searching when you're talking. Oh, in New York city?
00:01:05UNKNOWN Right.
00:01:10UNKNOWN Oh, this is bad. The subway.
00:01:10UNKNOWN Subways?
00:01:10UNKNOWN Don't… don't… Seriously don't touch me. But… but really you don't understand. It was great because I get rock n' roll down there and the buses would just show up and all these people would come to see me. It was great. The door would open, it was amazing. Umm… I… I… I… I think… I transported them to like, you know, Viana, Scotland and then… then there's the… You know, Carnegie Hall in New York City where they would never…
00:01:35UNKNOWN How was it that you came to select New York City?
00:01:40UNKNOWN New York City was because of my aunt, the rich, fat rich aunt.
00:01:45UNKNOWN Mm-mmm.
00:01:45UNKNOWN That she would bring me on her trips and that, you know, I… we come along to see the relatives and family and while she, you know, she go… blabbing around, blabbing around, she go coffee-tear me, whatever like that. And I would go and I would go my concerts, I would set up and do all my concerts.
00:01:55UNKNOWN Right.
00:01:55UNKNOWN And it would be amazing. And… and you know, I wanted to be a… I wanted to paint for the museums too. I want to paint for the galleries, you know. You're great but you can't… You know New York City is crazy. You can't do all that stuff in one trip. You know, there's no possible way I could be. You know, when I'll get back there and I'm gonna teach them because those art museums are crap.
00:02:10UNKNOWN Mm-mmm.
00:02:15UNKNOWN They are. Their art in there is just, it's old, outdated…
00:02:15UNKNOWN Mm-mmm… When you were playing music, what music were you playing?
00:02:20UNKNOWN My own.
00:02:20UNKNOWN Your own?
00:02:20UNKNOWN My own. All these symphonies just kept totally around in my brain and that impresses people.
00:02:25UNKNOWN Mm-mmm.
00:02:25UNKNOWN It impresses everyone. You know, it's beautiful, it's magic, it's beautiful. You know, beautiful dreamer… Oh, and you know, Christina Aguilera, whenever she sing that song and I wish I was beautiful. That I wish I was beautiful… She's not really…
00:02:40UNKNOWN How much of your… How much of your time do you spend to playing music?
00:02:45UNKNOWN I… Every waking hour and then more.
00:02:50UNKNOWN Mm-mmm.
00:02:50UNKNOWN So there you go.
00:02:50UNKNOWN So how was your sleep?
00:02:55UNKNOWN Sleep? What? How do you have time for sleep? Oh, my god. Do you sleep? Really, do you sleep?
00:03:00UNKNOWN Yeah.
00:03:00UNKNOWN Three hours is all I need. Three hours, it's all like freaking need. I don't need more than that. And you know, and… When I'm at Indiana, I… I… I found it really hard not to hold back but I was… I had to technically tell these fag woods people how to farm. They don't even know how to farm down there. They call themselves farmers but they don't know how to farm. I mean, the plants were upside down. They are stupid cramp…
00:03:25UNKNOWN So you're telling the farmers how to farm?
00:03:25UNKNOWN Yeah.
00:03:25UNKNOWN How did they react to that?
00:03:30UNKNOWN Embarrassed.
00:03:30UNKNOWN Mm-mmm.
00:03:30UNKNOWN Wouldn't you be embarrassed? They are supposed to be farmers, it's crazy. The lobby here is crazy because you know, I would… I… I used to watch a show in the 90s or '70s and it's like a designers challenge type of thing. And they would actually give you 20 bucks, $5, $3 and you could fix the whole room up that fast.
00:03:50UNKNOWN So you think…
00:03:50UNKNOWN You should do that. I actually wrote down… I jotted down a whole bunch of little notes that I would fix. Maybe we could fix this here…
00:03:55UNKNOWN Now I can fix my lobby… Mm-mmm.
00:03:55UNKNOWN Oh, my God, yes, it will be great. I have the notes. I have the notes. Do you want them? I mean I don't… I have them. You should look at them. Seriously you should look at them. It will be better for you.
00:04:05 END TRANSCRIPT
Training Title 43
BEGIN TRANSCRIPT:
00:00:00[sil.]
00:00:15OFF CAMERA Hello Mr. Loman. How are you doing today?
00:00:15PATIENT Um... I have a bit of a head cold, but I'm feeling pretty good.
00:00:20OFF CAMERA Are you taking your medications regularly?
00:00:25PATIENT Yeah, uh, about four times a day. Every meal and just before bed.
00:00:30OFF CAMERA Do these medications make you feel any different?
00:00:30PATIENT Yeah, um, I feel a little bit shaky. And kind of stiff. I especially noticed that when I was playing ping pong in the day room.
00:00:40OFF CAMERA Yes, those are side effects from, from these medications. They won't hurt you even though it makes you feel uncomfortable. Although you are stiff and shake some, make certain to stay on these medications. They do seem to help you with your thinking and controlling yourself. Can you tell the difference?
00:01:00PATIENT Oh yeah, the little things hardly affect me at all anymore. In fact, I uh, I was wondering if, maybe I could go home today.
00:01:15OFF CAMERA Well uh, I know you would enjoy going home. But why don't we wait a few days ok, so we can make absolutely sure we have you on the right medication and absolutely sure that this is the correct dose. Ok?
00:01:35[Patient nods his head forlornly]
00:01:40PATIENT Ok.
00:01:40OFF CAMERA Do you remember what you're thinking and, and uh, was like that first day when you came in?
00:01:45PATIENT Well, I... felt excited. I had a lot of energy. I don't think I could see very well, things seemed scary like going really fast. I... I just didn't feel like myself.
00:02:05OFF CAMERA Yeah. I understand that you did a lot of things that just were not like you. Your mother said, and these are embarrassing things, but that you pulled down your pants at the mall, and you uh, spent a lot of money and you yelled, a lot of sexual and mean comments at other, at other people. And then I observed that when you came in, your speech was very fast and very disorganized.
00:02:35PATIENT Yeah, that um... that is just not like me.
00:02:45OFF CAMERA Yeah, so, how do you feel about going home, and seeing friends, and family members, people who were seeing how you were acting.
00:03:00PATIENT Not, not very good. I, uh... don't think they would want to talk to me again. They probably think I'm a loony.
00:03:10OFF CAMERA Uh, so it's going to be very important when you go home to, to stay on these medicines. So you can be back in control.
00:03:20PATIENT Yeah. I don't want to lose control again.
00:03:30OFF CAMERA Good. Good. I know taking medicines is not fun, but it's really going to be important for you to do that. Are there some other things you're doing to prepare for going home?
00:03:45PATIENT Well, I'm making some gifts for my family in the common room. Um, I'm talking to them on the phone a lot. I uh, I'm really missing being home.
00:04:05[sil.]
00:04:05 END TRANSCRIPT
__________________________________________________________________
Training Title 144
In Test Section Index , 144 (Santa Monica, CA: Symptom Media , 2018), 13 minutes
00:00:00 BEGIN TRANSCRIPT:
00:00:10[sil.]
00:00:20UNKNOWN Would you prefer I call you Miss Hartford?
00:00:25AMY I go with my middle name Amy.
00:00:25UNKNOWN Amy. Okay, Amy. What's going on?
00:00:35AMY Sorry, I… I can't. I don't… I don't like… I can't help but cry. This is just it's so embarrassing to talk about.
00:00:50UNKNOWN No need to apologize.
00:00:55AMY Everything just… It feels so overwhelming.
00:01:00UNKNOWN Uh-huh. Are you having physical pain?
00:01:00AMY Cramps, intense cramps.
00:01:05UNKNOWN Uh-huh. Do you think this pain is menstrual in nature?
00:01:10 AMY: Definitely.
00:01:10UNKNOWN Are you having other symptoms with the cramps?
00:01:15AMY Umm… hen I have my period, my breasts become very tenders. So much so that it hurts. If fabric even rests on them.
00:01:25UNKNOWN Uh-huh.
00:01:25AMY And I get bloated, I hold water. So of course, I gain weight. It's always horrible getting my period.
00:01:35UNKNOWN Do you also become lightheaded?
00:01:40AMY Oh, it's more like dizziness.
00:01:45UNKNOWN Any headaches?
00:01:45AMY Yes, with back pain that make it impossible to sit and falling apart, right? Everybody says I'm exaggerating, and they think I'm fine. But when I am, my period, I'm on my back all day cry.
00:02:05UNKNOWN Well, let's see if we can figure out what's going on. Do you also have any bouts of nausea?
00:02:10AMY No.
00:02:10UNKNOWN Food cravings.
00:02:10AMY Oh, God, yes. Not just cravings. I eat more.
00:02:15UNKNOWN Uh-huh. What do you crave and eat?
00:02:20AMY Uh… A mini cookie packs, and some kind of dried fruit nut mix thing they have at work. I always plan to only eat a small amount but then I can't stop until all of its gone. And one time I went through the entire offices supply for the week, I ate the wrapper so no one would see them and then I ran to Costco during lunch to replace them. I was petrified someone would notice.
00:02:50UNKNOWN Do you have difficulty controlling your impulses to eat?
00:02:55AMY To an embarrassing degree?
00:03:00UNKNOWN How long these symptoms been occurring with your periods?
00:03:05AMY Jeez. Since I was 10 or 11.
00:03:05UNKNOWN Okay.
00:03:10AMY Since my first period, my mother scolded me said that I was overreacting. And then my school counselor told me that I was having normal PMS and I would get used to it. But I knew it wasn't normal because none of the other girls were sick like I was. And as I became an adult it got worse. Enormously worse after I had kids. You know, I tried to power through, but I can't.
00:03:40UNKNOWN How did it worsen?
00:03:45AMY Level of pain, intensity of the pain. I'm completely zapped of energy. I feel unstable.
00:04:00UNKNOWN What do you mean unstable?
00:04:05AMY My moods jump all over the place. And if my coworkers my friends or even… even my kids say the least little thing I feel totally rejected. I cry at the drop of a hat. Or I just lay there wanting to give up. And other times I'm on edge I'm up and pacing feeling like I want to… I want to throw something or break something. Slam doors, scream at the TV.
00:04:35UNKNOWN When you're not having these difficult symptoms. Do you feel much stress in your life?
00:04:40AMY All my life is the stress. I am the single mother of two kids so I have to get them up and get them to school. And then most days I don't have enough energy. I sometimes I feel like I can't even get myself to work. So I… I call my neighbor and she drives my kids with her kids to school. Thank god she understands. But I don't know how long that'll last. And I try my best to force myself but I can't let these stupid irrational symptoms ruin another job.
00:05:15UNKNOWN Did these difficulties ruin a past previous job?
00:05:15AMY Two jobs. Yeah, I'm a paralegal so work is beyond demanding and I can't function when I'm like this. I… When I have my period I miss a day or two, maybe three. That's fine. That's totally acceptable. But the first job I lost. I heard so bad, I couldn't even get myself to pick up the phone and call in sick. I just lay there like a blob, being emotional and down. I cannot afford to lose another job.
00:05:55UNKNOWN What's it like when, as you said emotional and down?
00:06:00AMY Well, I get terribly sad and I snap at people. You know, like kids, you know yell at my coworkers. It doesn't matter yell at the walls. And I have my period. I know I'm not gonna be able to take care of my kids. So I called my ex to take them and that's how desperate I could get because we do not get along. Except on issues with the kids.
00:06:35UNKNOWN That's good.
00:06:40AMY Yeah, but I mean, he had an affair. That's the reason we divorced.
00:06:45[sil.]
00:06:50AMY Umm… So I started keeping a journal to document my feelings.
00:06:55UNKNOWN That's smart. What… what have you learned by the doing that by documenting your feelings and symptoms?
00:07:05AMY Umm… Well, I… I learned that I lose track of who I am. When I'm on my period that I become a different person. I don't know how else to describe it. When I journal it helps me to remember that when I'm like this, it… it's… it's not that bad that it will remind me that it will get that I'll get over it.
00:07:35UNKNOWN So when you're experiencing this sadness and anger, is it difficult to realize that this is going to end?
00:07:40AMY Well, it's not just sadness and anger? It's like everything in the world is different, looks and sounds and feels different. It's like there's a… there's a veil and trying to push it out of the way.
00:08:00UNKNOWN Do you feel like you lose control of your emotions?
00:08:05AMY I'm anything but in control.
00:08:10UNKNOWN Do you ever feel so out of control that you experience hallucinations, seeing or hearing things that are not there?
00:08:15AMY Oh God, no. No, that would really do mean, no.
00:08:20UNKNOWN Is there any history of mental illness in your family?
00:08:25AMY Umm… Depression on my mother's side.
00:08:30UNKNOWN Okay.
00:08:35AMY I never thought that I had depression. Because when I… when I have these feelings, I snap out of them. And then I'm fine. I mean, it's not like any depression I've ever seen. My uncle killed himself so I know what good looks like and this isn't like that.
00:08:50UNKNOWN To your symptoms that we get so bad that you think about suicide.
00:08:55AMY I get pretty far down, there no doubt about that but it's never that bad. I would never do that to my kids, no.
00:09:05UNKNOWN Have you ever seen a psychiatrist or a mental health professional?
00:09:10AMY I did after my divorce. I saw him for several years. He never diagnosed me with clinical depression. I did learn some coping mechanisms because I had anxiety issues. It just normal sadness and anger from the relationship ending but those feelings went away so I stopped seeing him.
00:09:30UNKNOWN Were you ever prescribed any psychiatric medications? anti anxiety medicines, SSRIs for depression, anything like that?
00:09:40AMY None. No.
00:09:45UNKNOWN You mentioned Do you force yourself to go to work? What else do you do to cope?
00:09:50AMY I… I take a lot of ibuprofen, I worry to take too much. I remember… don't wanna get any long term side effects. But even if I managed to get the pain to subside, I still have the problem that I can't concentrate. I read and reread depositions and court documents without absorbing any of it. Oh, I heard that some women use birth control for PMS, will that help?
00:10:25UNKNOWN There is medical evidence to support that, we'd have to get some hormonal studies. First, how often would you say these symptoms occur?
00:10:35AMY Every month, like I said with my period.
00:10:35UNKNOWN Are the symptoms that you're experiencing now are these typical during before or after your period?
00:10:45AMY They start about a week or so before builds. And then as soon as my flow starts, they subside within a day or two.
00:10:55UNKNOWN And then how will you be for the next couple of weeks?
00:11:00AMY Well, I'm fine. In fact, I'm one of the best workers in the office. I laugh at all the office jokes and there are a lot of them. And I can even manage to have fun with my kids when they're being bratty. You know, they're pretty clever, they're funny.
00:11:20UNKNOWN Mm-hmm. I noticed that even though you're suffering with the symptoms today, uh… you're able to talk about and remember hold on to the good times.
00:11:25AMY Yeah, that's… that's where journaling helps.
00:11:30UNKNOWN Really works for you. Good for you. That's great. But let me ask you about some other topics, how is your diet?
00:11:35AMY I graze. I mostly eat on the go between work and the kids. It's hard to find time to cook.
00:11:45UNKNOWN What would be a typical meal?
00:11:45AMY Oh, on the rare dire occasion, it's fast food. But typically, I try for healthier options. There's a really good chicken place near us. Most of the time, I guess I use a lot of delivery.
00:12:00UNKNOWN Such as.
00:12:05AMY Well, my kids love chicken. They love Turkey and mashed potatoes, love pasta. Oh, they're picky so that limits me but usually I can fit in a vegetable dish with each order without too many complaints from them.
00:12:20UNKNOWN Good for you, good for you, any dairy?
00:12:25AMY No, my son is lactose intolerance, so we don't buy milk but there's these cheese and cracker platters they have at work for meetings. That's typically how I get through my day. I'm embarrassed to admit that.
00:12:40UNKNOWN Any caffeine.
00:12:40AMY Oh, nonstop.
00:12:45UNKNOWN Uh-huh. Besides taking ibuprofen, what else do you do to help with your symptoms?
00:12:55AMY Umm… Basically, I sleep. I curl up on the couch and right out the storm. You know, I tried some over the counter stuff some homeopathic remedies, B6 vitamins, women health supplements but frankly, they don't seem to do anything.
00:13:20[sil.]
00:13:25 END TRANSCRIPT