Eleventh Hour Moments

Dear Nicole, I'm sorry to hear how you are suf...

2011-08-18T16:46:47.507-04:00

Dear Nicole,
I'm sorry to hear how you are suffering. You mention you are anxious and possibly manic. It sounds like you don't feel in control of your emotions right now. You don't mention if you are on any other medications. There should be a covering doctor for your doctor whose not available. Please make an urgent appointment with the covering clinician so that they can look through your chart and change your medications if needed. If you are feeling unsafe, or having thoughts about hurting yourself or anyone else, please go back to the ER and tell them this information so they can help keep you safe. In the meantime, you do have control over your thoughts. The pills only help so much, you must find the strength that I know you have to help yourself control and calm your anxiety and energy. Self-soothing works! Tell yourself everything is ok. Believe that everything is ok. Tell yourself, "I'm in control of my breathing, of my thoughts, of my body." You can do this. Good luck and let us know how things are going for you.

Dear Beverly, Chronic pain can be a debilitating s...

2011-07-29T15:01:01.795-04:00

Dear Beverly,
Chronic pain can be a debilitating syndrome and often leads to depression and sometimes serious narcotic abuse. If you are not already affiliated with a pain management clinic, make an appointment with one as soon as possible. The media has been bombarding us with ads for the medication cymbalta. It's an antidepressant that supposedly also helps with pain. It's worth a try but it may not work. I am a believer in alternative medicine. Many pain management clinics offer acupuncture, reiki, massage, and meditation. Therapy will help too. These days the psychiatric world is guilty of minimizing the worth of therapy. Pills may help mood once in a while...but it's therapy that will give you long lasting coping skills and techniques to deal with your pain. You are the one who will ultimately control this pain. Persevere and accept the pain as part of who you are today. Once you accept it as part of you, you will be able to control it and manage it. Your thoughts and your mind are what will get you through this! Do not allow the pain to rule you. You are in charge! Good luck and let us know how things go for you.

Dear Heather, First, I believe you should get a se...

2011-07-04T14:12:27.429-04:00

Dear Heather,
First, I believe you should get a second opinion regarding your diagnosis. It is always helpful to hear a few different interpretations. You should also get a full medical work up if you haven't already because some times, psychiatric symptoms are related to a medical illness.
Adderall is an amphetamine. Amphetamines are associated with high abuse potential and dependence with prolonged administration. Adderall can sometimes cause people to become psychotic and that often leads to the misdiagnosis of schizophrenia. I'm not sure if that's what happened for you, but if you were on adderall, and doing well, then your doctor changed your diagnosis to schizophrenia, it may be that the adderall caused some psychotic symptoms for you.
Give the adderall another few weeks. Everyone's metabolism is different and you may just need more time to wash out the risperdal. Or, it may be that you developed a tolerance to the adderall, which is common. It may not work for you anymore and you may need to try another amphetamine.
Most importantly, please get a second opinion. Schizophrenia and ADHD are very different diagnoses and I'm wondering if the side effects of the adderall is what caused your doctor to change your diagnosis to schizophrenia. Also, consider the possibility that you can do well without medication. This is something to talk to your doctor about as well. Good luck and let us know how you are doing.

Dear Barbara, It is so very important to communica...

2011-05-26T16:57:56.849-04:00

Dear Barbara,
It is so very important to communicate this information to your husband's treaters at the rehab. Bring the note and show his clinician. You must ensure his safety and insist that they address his suicidal thoughts. Be strong and loud, do not let them discharge him until his safety is assessed by a licensed psychiatric professional. He may need to be transferred to a psychiatric unit. Here are some words to help you. Please say this to the clinicians, "I found a suicide note my husband wrote, I am very afraid that he will kill himself. He is not safe to come home. Please assess his safety and his depression. I think he needs help for his depression and suicidal thoughts. He is not safe to come home, I think he may try and hurt himself." This type of language will be a red flag to the therapist and they should evaluate your husband's depression and thoughts of hurting himself. Don't back down, insist that they do a thorough psychiatric evaluation and if they can't, insist that they transfer him to a psychiatric unit. Be strong. And advocate for your husband to get him the care he deserves and needs. Good luck and let us know how things go.
Laura NP

Yeah, addictions will get you every time.

2011-05-02T23:09:03.104-04:00

Yeah, addictions will get you every time.

Thanks SO much for the shout-out, lady! :-) We t...

2011-04-18T14:26:45.842-04:00

Thanks SO much for the shout-out, lady! :-) We think that Jane is important, and we're glad you agree!

Winning!

2011-04-06T15:08:54.831-04:00

Winning!

Very good posting, Dr. Gieserman. I agree with all...

2011-03-08T13:31:19.872-05:00

Very good posting, Dr. Gieserman. I agree with all your comments. More power to Chinese marketplace, Chinese economy, and Chinese workers!

Thank you.

Xihong

I'm pushing back at Mizz Obama. I'm eatin...

2011-02-28T08:25:45.727-05:00

I'm pushing back at Mizz Obama. I'm eating cream cheese filled king cake for breakfast!

Well-said and said very well. Power To The People...

2011-02-22T09:09:23.549-05:00

Well-said and said very well.

Power To The People!

:)

Dear Angela, Benadryl does have some sedating qual...

2011-02-12T18:54:54.244-05:00

Dear Angela,
Benadryl does have some sedating qualities and doctors often use it to help people sleep and relax. But, it can sometimes be too much and people can experience some scary anticholinergic effects and even die. Too much benadryl can cause you to feel dry, look flushed or red, have blurry vision, get very hot, have an increased heart rate and increased blood pressure, and you can become disoriented, confused, and even hallucinate. There are several medications that can cause this, and benadryl is definitely one of them. Sometimes people buy benadryl over the counter and misuse it. Anticholinergic toxicity is very serious. So follow the recommendations on the box, and if you have any of the symptoms mentioned above, get to the emergency room immediately and tell the staff what medications you took. And, if your loved one is in the hospital and the doctors are ordering benadryl, ask them why and either refuse it or watch your loved one carefully.

ivy league schools are bullshit. most people never...

2010-12-27T02:49:25.334-05:00

ivy league schools are bullshit. most people never make back the money they spend going there.

Dear Angela, Seroquel, also known as quetiapine, c...

2010-12-23T09:12:36.936-05:00

Dear Angela,
Seroquel, also known as quetiapine, can cause dizziness. Dizziness is a known side effect of seroquel. It sounds like you can identify that the dizziness started when you started the medication. Some people take seroquel at bedtime and go right to sleep so they don't experience dizziness. But if you take it during the day, and you become dizzy, please sit down right away as you may have the potential to fall. Sometimes the side effect resolves on its own after you have been taking the medication for a while. If it is something you can not tolerate, you may have to change the time of day you take it or stop taking it. Tell your prescriber what's going on and the two of you can decide together what to do. If you get great benefit from the seroquel, it may be worth it to continue taking it. Good luck and let us know how things go.
Laura NP

Michelle Obama's statement is true. And if yo...

2010-12-16T03:03:59.479-05:00

Michelle Obama's statement is true. And if you're so blinded by your own party ideology to see that, well then you can pull figures you don't truly understand (do you even know how food scarcity is defined or what criteria it is measured by?)all day...it still doesn't mean you're right.

So it's okay for Arnold Schwarzenegger to travel around the country in the 1980's promoting exercise and speaking out against the health dangers of obesity, in conjunction with a Reagan administration federal program to set a standard of physical fitness? But it's not acceptable for the first lady to want to lower childhood diabetes? This is a looming healthcare cost for a life long disease that is overwhelmingly diet induced in children? Why should my health insurance have to go up for your gastric bypass surgery? Why should I have to help pay for your Lark when you can't walk around anymore on your own due to obesity?

And as for hungry kids? Yeah, I know all about it...I grew up poor and worked my way through college. I also know that the term socialism means in complex and varied forms, Obama is barely a centrist...BARELY. I bet you would have said my free school lunches were just a government handout that should be cut from spending. You really don't care about this topic, you just want to blast the President and First Lady on legislation that is actually important. There's plenty of Obama's policies that you can debate and show legitimate issues with, why manufacture them for really surface level petty reason?

Control all food? Maybe if the fat kid's parents were doing a better job controlling the excess amounts of crappy food they allow their child to consume, maybe then the government wouldn't have to get involved in epidemics like obesity.

Wake up... It's good to be angry and challenge power, but for crying out loud...be angry for reasons that matter and impact the change you want to see in the world.

I agree wholeheartedly with you YET AGAIN! Your wi...

2010-12-15T19:24:04.963-05:00

I agree wholeheartedly with you YET AGAIN! Your witticism is dead-on!

Dear Kelly, It sounds like you are doing your best...

2010-11-21T11:13:39.024-05:00

Dear Kelly,
It sounds like you are doing your best to make everybody happy in this difficult family situation. But you must protect yourself first. Now that may sound selfish, but in the end it will be best for everyone involved. I suggest you don't move forward with this plan until you meet with a lawyer and this change runs its course through the court system. This way, if things breakdown between people, you will have a binding, legal, contract regarding the terms of this agreement. It sounds like you want to keep the peace and negotiate with everyone as if they are all rational adults. But the truth is, we all have moments when emotions and misperceptions take over and we can't or won't act appropriately. Please protect yourself from that and have a lawyer help you to do this the legal route. Good luck and let us know how things go.

"..A new dimension of thought"? Oh real...

2010-11-17T10:13:11.763-05:00

"..A new dimension of thought"? Oh really? 'Fraid not, miss Laura. You're drinking the same Kool-Aid as all those you've ranted about in your blogs. I'd like to think you've posted what you have in a tongue-in-cheek fashion...as a sort of come-through-the-back-door way of making people really think for themselves. But I don't (think that). Acquire some critical thinking skill and lose your illusions. Capitalism is perhaps a great concept - so is socialism - in a perfect world. But humans by definition aren't perfect. Capitalism doesn't work - nor does government regulation, nor socialism - precisely BECAUSE people act unethically and irrationally AND almost always in their own interests. The only political "vote" that truly counts is MONEY...or maybe POWER; but aren't those two essentially interchangeable terms? And "... Everyone would be accepted for who they are..."? Everything idea in your blogs is based on YOUR VERY OWN lack of acceptance of something(s) or someone (plural). Just like Arianna, you find it easy to criticize so much that goes on in the world (she makes a handsome living doing so). But in my thinking, one doesn't get kudos for criticizing an already flawed concept or position because of their own unrealistic expectations; that's like wanting praise for calling a defective part "defective". As a fellow nurse and a woman looking for true intellectual challenge from other bright women, I gotta call you out on your lack of true insights. I'll bet you can do better than what I've read today!

Dear Olivia, Trying to get clean and sober is a jo...

2010-11-16T18:52:54.525-05:00

Dear Olivia,
Trying to get clean and sober is a journey that people need to make alone for the most part. While it is helpful to have supportive people around, those people can also end up being a distraction to the work that needs to be done. It's not about you, it's about your mate taking the time he needs to work on himself. He needs to become self-reflective and really dig deep into what got him to where he is now. Many therapies in rehab emphasize the idea that the person should have minimal or no contact with the people on the outside. Alcoholism is a serious life-threatening disease. Give him his time. Wait until he completes the program and see if he calls. If he doesn't call, you need to understand that he may have come to the realization that you were possibly a trigger to his drinking and he can't see you anymore. You will need to simply accept that fact and move on. The risk of relapse is greatest right when he is discharged. As hard as this is...don't call him anymore. Wait and see if he contacts you. And remember the seriousness of his illness. He needs to save himself, no one else can do it for him.

http://www.communitycollegereview.com/articles/8

2010-11-09T02:03:46.873-05:00

http://www.communitycollegereview.com/articles/8

Dear Raja, It sounds like you are suffering with s...

2010-11-07T15:12:44.622-05:00

Dear Raja,
It sounds like you are suffering with some symptoms of both anxiety and depression. I would recommend a full medical check up to rule out any underlying medical reasons for your symptoms. After getting a medical check up, and finding that you are in good physical health, then it may be time to see a psychiatric professional. I always advise a combination of medication and therapy. If you have trouble finding a psychiatric professional, here is something that may help. It's called the "as if" exercise. It is a well-known technique that we teach our clients to help them manage their symptoms. You will simply act "as if" you are calm, happy, and composed. When you are going to enter a difficult situation, you will take a minute to stop and tell yourself that you will act as if you are calm, happy, and composed. Tell yourself, "I am calm, I am happy, I am composed." This will actually "reprogram" your brain to have a different response to situations that cause you anxiety and depression. Through your intentions (the thought that you are calm, happy, composed), and through your actions (acting as if you are calm, happy, composed), your brain will be programmed with a new response to a situation that in the past made you anxious. When you first start acting "as if," you may feel strange. But keep telling yourself, "I am completely calm and relaxed." Then act calm and relaxed. By acting as calm as you can, you are showing your brain your intentions. You can use the "as if" method for many things. You can wake up and look in the mirror and say, "I'm happy today, I feel great." Then act as if you are happy and feeling great. Don't give up. It will work. And don't forget the therapy and medications. That will help too. Good luck and let us know how things go for you.

What awesome advice. I think we often react too qu...

2010-11-06T19:21:30.764-04:00

What awesome advice. I think we often react too quickly in emotionally challenging times and who could blame us? However, when cooler heads prevail, dignity is more likely to be preserved if we take a moment to just think. Just take a breath, count to ten (or 1000 if necessary) and take your time with your response. I recently received a text message that I completely misunderstood and reacted inappropriately and inaccurately to. Luckily, the person I responded to was much cooler than I was and graciously accepted my apology. I suspect she knew I was quiet sincere!!!

Dear Marlene, It is a very difficult time when you...

2010-11-06T17:14:00.769-04:00

Dear Marlene,
It is a very difficult time when you find out your partner has been unfaithful. It sounds like you have made your mind up to end the relationship. I think the most important part of how you end this is that you can maintain your dignity and self-worth. Maybe something like this, "I'm so disappointed that things turned out this way, I loved you faithfully for 17 years and I see that our time together must now end. I can not stay with you after what has happened and it hurts me tremendously, but I will be moving on now. I can not stay in this relationship because you have been with someone else. I have learned a lot from you and I will always remember what we had. It was a wonderful relationship." I know how hard that may be to do. But you will feel good about yourself if you can handle it in this way. I know it will be hard, but try to be civil when separating the household items. Remember they are only things, don't fight over material things. Try to negotiate for what's most important to you and let other things go. Remember your dignity. You can do it. Good luck and let us know how things go.
LauraNP

Dear Stephanie, Most husbands are not talking to o...

2010-11-06T16:46:00.380-04:00

Dear Stephanie,
Most husbands are not talking to other women "from sun up to sun down." That's not normal behavior for a married person. You have done nothing wrong. Your husband has an obsession and he needs help to manage it. I'm wondering how it is you have accepted this behavior for 7 years. It is time to get your self-esteem back. You have been a good wife and partner to your husband. You need to find the strength in you to say to him, "I can no longer accept that you feel the need to speak with multiple women all day long. I hope that we can go to therapy together and talk about this issue because if it continues, and we can not resolve it, I'm not going to be able to stay with you. It is very disrespectful and bothers me that you spend so much of your time talking with other women." If he agrees to seek therapy with you, then he deserves the chance to fix this. If he refuses, and does not want to alter the behavior, you have to make a choice to stay and accept it, or leave. Good luck and let us know how it goes.
LauraNP

Dear Hi, Just in case the reader's don't k...

2010-11-04T11:27:57.299-04:00

Dear Hi,
Just in case the reader's don't know, a "hook up" means having casual sex with someone. Kind of like a "booty call." The premise is that there are no strings attached. The problem here is, you have major feelings for this guy. There will be emotions involved and the outcome may hurt. I think if two people can openly talk about what they both want, and they both agree on the terms, then go for it. But you have to tell him what's going on for you. You can not sit back and "see what he does." Take charge of yourself. Tell him exactly what you want and how you feel. This can be very hard for some people to do. But once you get through the process a few times, you will feel empowered and in control of every situation you are in. So maybe say something like, "We had a wonderful relationship before you moved away. We talked about you moving and the possibility of a hook up. I've noticed that you text me and IM me a few times every day. I'm wondering what your intentions are? I need to hear from you if you want to be just friends, get back together, or have occassional hook ups. Then I will have to decide how I want things to be between us. I still have strong feelings for you but we need to be on the exact same page before we engage in anything together." Give it a try. Be in control! Good luck and let us know how things go for you.
LauraNP

Dear Beverly, It's hard to determine if the me...

2010-11-02T14:05:50.092-04:00

Dear Beverly,
It's hard to determine if the medication is causing you to feel a certain way, or your bipolar illness is causing you to feel a certain way. There are always multiple factors that go into our reactions and feelings. Even how we were raised plays a role in our feelings towards particular situations. The best course of action is to get into some therapy right now and do some self-exploration. No medication will "fix" your marriage or your illness. As hard as it is, you must try, with the help of a therapist, to determine the root cause of your depression and marriage issues. It is quite possible you will be enlightened through therapy and realize it has nothing to do with medications. It sounds like you are suffering, but taking a pill won't make it all go away. You can do this, stay on your medications and engage in some intensive therapy to discover yourself. It may be the combination of therapy and medications that will free you. Bottom line...don't rely on a pill to help you. While medication can help manage some of the symptoms of your illness, it won't cure what is bothering you. Take control of your thoughts and emotions and reign them in through therapy. You will feel empowered and relieved when you recognize that the answers you've been searching for are right inside your head. Good luck and let us know how things turn out.