Archive for May, 2009

May 31, 2009

reading up on maintenance ECT…

I don’t know if digging stuff up like these make me feel any better, but here are some abstracts on maintenance/prophylactic ECT  in reputable journals.

Maintenance electroconvulsive therapy for chronic mentally ill patients: a case series, by VG Stiebel
from American Psychiatric Association,  Psychiatric Services 1995

Long-term maintenance ECT: a retrospective review of efficacy and cognitive outcome, by Russell, et al (Mayo Clinic)
from THE JOURNAL OF ECT   Vol. 19  Issue 1  Mar  2003

Impact of maintenance ECT on concentration and memory, by Datto, et al (UPenn)
from THE JOURNAL OF ECT   Vol. 17  Issue 3  Sep  2001

Continuation and maintenance ECT: An update, by Ferreira, et al
from European Psychiatry, vol. 24, supplement 9, 2009

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May 31, 2009

an incovenient test-time

It was a good thing that I had to go to work Friday night. I hadn’t showered. I slept the entire day, only to get up around lunch time to eat something. I only have three weeks left to study for the GRE, but I can barely drag myself upright to start studying. Abscond, abeyance, abjure, etc… I guess I’ve learned some “a” words.

I’m not quite sure how it is already Sunday afternoon. My house is a mess, and I still can’t get myself to take a shower today. I stare at the ceiling fan going around and around. Words escape me. Not just the GRE words, but simple, plain words. I’m so tired, and I don’t know how I got here. A few weeks ago, I woke up around 6:30a.m. and worked out and dreamt about starting back graduate school in the fall. Now, all the dreaming is done while I’m asleep, and being awake has become some sort of a nightmare. I’ve stopped working out, and the only accomplishment I’ve made is eating an entire bag of cheese puffs in one sitting. Since the ECT, I’ve had a hard time keeping track of the passing of time, and I now realize there were some things that were due by the end of May, which apparently is today. It must get done tomorrow, providing that I can get out of bed at a reasonable time . Where did all that time go? How is it that it’s already summer time? How is it that there are so many people at the condo pool just having a carefree time? I’m not angry. I’m just confused.

That ‘booster’ ECT that Dr. A and I’ve discussed seems to be now imminent. It’s really not quite like the full ECT in that you only need to wait 24 hours before going back to your normal life. Though I’ve agreed that I will go through it if I keep falling into this deep, dark pit, I hadn’t quite worked out the details, a big detail in fact. Though memory loss was not a huge factor during my own first set of treatments, nonetheless, it is still a side effect that I could have the next time I receive that ‘little spark.’ And I realized that memorization is one of the very ways to study for the GRE. If I even have one treatment, could I lose everything that I studied for in that short amount of time surrounding that little spark? It is nearly impossible to try to just study through this dark fog that’s now surrounding my head and weighing down my entire body, but what if any studying that I’ve done is swept away, all with one shock to the head? I may have been lucky with my cognition in tact these last 15 times, but they do not predict what will happen on the sixteenth.

I e-mailed my ‘Dr. Melfi’ about my concerns and in the meantime, we are upping my stimulant to see if I can just stay awake enough to get the daily chores done and feel better, maybe enough so that I don’t have to have this booster shot.

I hear laughter from the people who are out by the community pool. They sound so happy and cheerful. It’s a sunny day, and my room is yards away from that joy.  I am curled up on the couch watching the recent episodes of “In Treatment” with a GRE study book by my side. I remind myself that there will be ups and downs, as my doctor said. I know about the ups and downs, but right  now, please.  I need the ups.

May 30, 2009

a death of someone I knew

On the masthead of a publication we used to work on in college, our names were listed side-by-side. Her name was Allison Oubre. Lt. Allison Oubre.

She was one of the nicest and most pleasant people I had met through the publication. I guess we had never talked too much about our personal lives. We sometimes drank together at a friend’s dorm room, but we certainly had fun working together our entire senior year.  I didn’t know it was her lifelong dream to become a helicopter pilot until I got a call a few days ago.

A friend called to let me know that Lt. Oubre was among the six crew members killed in a Navy helicopter crash on May 19 in the Pacific Ocean near San Diego.  She was the co-pilot of this training mission. According to my friend, she had already served our country in the Middle East. Her wedding was scheduled for next month.

I keep thinking about her and her family. How relieved they must have been after her tour in the Middle East was over. How excited she must have been for her June wedding. How she still must have had that great smile I always remember about her.

We have lost a wonderful person. This world will miss Lt. Allison Oubre.

May 28, 2009

spellbound and tongue-tied

There’s actually been quite a lot going on, especially emotionally, this week. However, I just haven’t been able to put them into words in some coherent order. I’ve trying to write daily, but it’s like any motivation has been sapped out of me. My friend suggest that I just write down some stuff, and writing guides and stuff always encourage writing for the sake of writing….so, here’s some stuff.

-I really enjoy watching the spelling bee. Not just any bee, but the Scripps National Spelling Bee on ESPN and ABC primetime. And today, I spent hours just watching the competition. It’s just so interesting. Studying for a bee during fifth grade is one of the reasons why I’m a pretty good speller. However, watching this show  reminded me that while I’m a fairly good speller, I don’t know what any of the words mean, which is something I need to work on before the GRE. Apparently, GRE requires you to know a lot of words, and I know none of them.

-I have a new ThinkPad! My six-year-old ThinkPad has served me well. I kind of wanted a mac, but then I realized I didn’t really need a mac. So, I’m sticking with my trusty, nondescript-looking little PC.

-My parents left yesterday to go back to the homeland. It was a good visit, but it was nonetheless stressful. During their time here, I felt the dark mood come over me. I couldn’t figure out if it was just the stress or it was real depression. Today was my session with Dr. A, so I spoke about how I’ve been feeling for a while. If this possible depression subsists, she suggested that I go through one more ECT treatment. She asked me if I even wanted to have it scheduled for this week. I’m not hesitant about the treatment, but I resisted having it so quickly when I don’t even know if this is legitimate depression, or just the temporary dumps. She is on vacation next week. What a great time for me to be in this shape.

-I really hope I can get back to writing something of value tomorrow and be able to expand on some of the thoughts I’ve had this week. I feel deflated.

May 27, 2009

Thinking about Markers

Orginally written on Sunday.

Our family is headed back to Nashville after a day spent in Asheville, North Carolina. It’s around Sevierville now; we’re on the Dolly Parton Parkway. There are a variety of stores that we pass by. We see a gravestone-marker store. As our car drove past this shop, Mother says, “Oh, we need to go reserve one.”

It’s been almost three years since she was first diagnosed with cancer.

I knew it was somewhat of a joke from her, but the fact is that I’m sure she does think about something like this given that she’s been told of her chances of survival. This type of joke is why also I can’t escape the topic of death. I sometimes get annoyed by that type of humor. “Why not two?” I thought to myself. I’m the one that could decide any day to die instead of having to find out that I’m dying around a certain time. I’m not sure she understood that the thought of death affects me just as much as it might affect her, albeit in a much different way.

But anyway, that comment from her, and many others, just makes me sad. It means she can’t escape the thoughts of death, either. After the surgery, chemo and the news that the cancer, at least for now, is gone, what’s left perhaps is that uncertainty. And facing that feeling daily cannot be an easy task.

Some profound thoughts while on the Dolly Parton Parkway…

May 23, 2009

Washington Post: Number of US Army suicides continues to climb

Generals Find Suicide a Frustrating Enemy
As Numbers Continue to Climb, Top Officers Meet Monthly to Look for Answers

By Ann Scott Tyson and Greg Jaffe
Washington Post Staff Writers

Saturday, May 23, 2009

It was just past midnight in Afghanistan when Brig. Gen. Mark Milley appeared on the video screen in the Pentagon conference room to brief some of the Army’s top generals on a sobering development: his unit’s most recent confirmed suicide.

A 19-year-old private, working a night shift at his base, had shot himself a few weeks earlier. “There was no indication that he would harm himself, he had not been seen by the chaplain, no intimate relationships,” Milley said, running through warning signs.

In the Pentagon, Gen. Peter W. Chiarelli, the Army’s vice chief of staff, homed in on one detail. The soldier worked a job that often entailed long, solitary hours. In scouring the Army’s suicide statistics, Chiarelli had noticed a slight suicide increase among those who worked such positions. Milley said that going forward none of the 20,000 soldiers under his command would routinely work by themselves.

For more than two hours, Chiarelli, Army personnel chief Lt. Gen. Michael D. Rochelle and a roomful of other generals combed through the facts surrounding a dozen of the Army’s latest suicides, with commanders from Afghanistan, Iraq, the Horn of Africa and bases throughout the United States participating in a video teleconference.

Such meetings are one piece of a broader effort to arrest the Army’s rising suicide rate, which has surged to record levels in the past year. In 2008, 140 soldiers on active duty took their own lives, continuing a trend in which the number of suicides has increased more than 60 percent since 2003, surpassing the rate for the general U.S. population.

To deal with the problem, the Army has added to the ranks of mental health and substance abuse counselors. The service also required all units to cease operations for two to four hours to talk about suicide prevention in February and March.

Chiarelli’s monthly meetings are the Army’s way of sleuthing out patterns and identifying new policies to deal with the trend. In the most recent meeting, conducted last week, commanders were brutally candid about what went wrong — a mental health screener who missed signs of distress; the failure to take notice when a normally reliable infantryman with three combat tours didn’t show up for an Army school; the dangerous interactions of drugs, dispensed to help soldiers deal with combat stress, with caffeine and alcohol.

“It’s the most gut-wrenching meeting I go to,” Chiarelli said.

After the Afghanistan commander gave his briefing, it was Iraq’s turn. Maj. Gen. Daniel P. Bolger described the case of a young soldier who shot himself this year. One aberration in the case: The soldier had received a waiver so that he could take a prescription drug to treat his attention-deficit problem. The drug “when added to caffeine, could cause sleep disorders, and a lack of sleep could lead to impulsive actions,” the Iraq commander noted.

“There are a lot of those high-energy drinks being used over there,” said Chiarelli, who spent two years in Iraq. “What is that stuff that people drink in Iraq?”

“Rip It,” came the chorus around the room, referring to the energy drink that has 100 milligrams of caffeine per eight-ounce can (25 percent more than a can of Red Bull and roughly three times as much as an equivalent amount of Diet Coke). Chiarelli asked an Army doctor attending the meeting to work with his staff to create a simple chart listing the most common drugs that soldiers take for combat stress and explaining how the drugs interact with other substances. “I want it to be something an average platoon sergeant can use,” Chiarelli said.

At times Army leaders were frustrated by cases that defied simple explanation. In other instances soldiers simply fell through the cracks. One senior sergeant who had deployed multiple times to Iraq confessed to a fellow soldier that he had frequent nightmares from his first tour. He was binge-drinking. The friend took away his personal gun but never mentioned the sergeant’s struggles to commanders. A couple of days later, the sergeant didn’t show up for his slot in an Army school. Read the rest of the article

May 22, 2009

homeward bound

It’s a lovely sunny day, and our family is on the Interstate headed to upper east Tennessee, the place where I grew up. Since we are in my sister’s car, voices of Miley Cyrus, Carrie Underwood and Kelly Clarkson take turn blaring loudly as I stare out the window like a curious dog. All around are just trees, rows of wildflowers, and occasional small towns – okay, nothing exists. Well, and cows. Hard to think that much of this Japanese family’s life was spent in the cradle of this mass forestry. This “nothing” strangely feels like home as we pass by tree after tree intersperced with McDonald’s and horses. Even I can acknowledge it’s a lovely day.

For a moment, it felt like there wasn’t a reminder of anything that was really going on with our family, like about Mom’s lingering illness, or mine, for that matter. Silos and barns are now in sight. Every shade of green also appears, a Pantone paradise on a skyline pallette.

We are now driving closer to my hometown.  It does strike me, how did we end up growing up  in a place like this? In such a bucolic area, how did I become so depressed and suicidal? All around the drive seemed locked in some time capsule. It felt kind of good to be in it myself, too, but one can only be in that moment for a second. The bubble bursts quickly, and I realize, my, how time has passed and I’ve changed.

There, I now see a church with a giant “Jesus” sign draped on their building. Ah. Welcome home.

May 19, 2009

to dream, perchance to sleep

One of the most important barometers of mood  is your sleep cycle. It’s extremely important that I get at least a certain – and consistent – amount of sleep. A little change here and there isn’t a bad thing, but that meter can’t swing too far to the “too little sleep” or “too much sleep.” It often signals the beginnings of either a deeper depression or a magical mania.

At first, 10mg of zolpidem tartrate did okay. Then, it turned to 15mg, 20mg, then I still couldn’t fall completely asleep. We’ve tried clonazepam this past week. For a day or so a few milligrams seemed to let me fall asleep, but by last night, I finally fell asleep after 6 mg of those cute yellow pills and a vodka/cranberry drink.  Despite all the issues with going to bed, I’ve still been waking up around 6:30am in time to watch “Morning Joe” and take a walk. But I recognize this is a problem. I e-mailed my doctor, and she called in a new prescription.

Anywhere between 50-150mg of Trazodone, a type of antidepressant that can also work as a sedative. Oh, I hope this works. With my parents being here, I need as much quality sleep as I can get so that I don’t look so exhausted in front of them.

I’m not quite sure why I’m even writing about this, so sorry for this rather negligible post. But not having enough quality sleep is making me lose any sparks of ideas in my head…

On a related note:
Science Daily: Genetic Link Found Between Sleep Disorders And Depression In Young Children

Counseling Resource: Sleep and the Treatment of Depression

May 17, 2009

The official color of mental health

Pink = breast cancer awareness
Yellow = livestrong cancer awareness
Red = Stephen Colbert wrist awareness

Every cause has a a color and a month that correlates with the respective issue, so obviously, the topic of mental health/illness would have such color and months.  Well, who knew that May is Mental Health Awareness Month. Maybe I just haven’t been following the news but I haven’t heard much about this month in the news. Accompanying this month also involves a National Anxieties Disorders Day.

Though May might be the ‘official month’ for mental health awareness, there are other times to celebrate during the year. October is Mental Illness Awareness Week, which involves a National Depression Screening Day. As for the rest of the world, there is World mental illness day is in October.

Want to start raising awareness about mental health by wearing a ribbon? The color is GREEN….unless if you look up under the ‘mental illness’ category, in which case, the alternate color is gray. Great. We can’t even agree on a color.

Ribbons, ribbon-shaped bumper stickers and charity-event shirts are found everywhere these days. But how many of us have seen a green ribbon pinned to a woman’s blouse collar, or an SUV with a green ribbon-magnet stuck next to his sport team sticker? This all may sound trivial and silly. I mean, a green ribbon could represent a whole slew of other illnesses. However, the lack of awareness on our part in these symbols indicate that we are nowhere close to bringing awareness about the topic of mental health in general. And such dearth of public recognition translates to the fact that there’s less funding for research in this field.

I found a scrap of green ribbon tonight, so I made a little loop and stuck it on my bulletin board. It may mean absolutely nothing, but when I looked at it, I thought, “I’m not just supporting the cause. I’ve survived it so I can support the cause.”

Let us learn from the other ‘ribbon’ organizations.

May 17, 2009

a simple question.

Since the ECT, I’ve become grateful for many things in my life: friendships, support, family. What I don’t know is if I can profess my gratefulness for life. Am I grateful for life? Am I grateful for having this life? Why can’t I answer this question?

May 15, 2009

plant life

My parents are coming to the United States next week. It hasn’t been too long since my mother was here, but my father hasn’t seen me since last year, when I told him about the decision to go through ECT. Planning trips, though it is just like ‘going home’ for them, is not necessarily an easy task. My mother has been having some minor health issues recently, and I could hear in her voice that she is a lot more worried that it’s enough of a problem that would make it unable for her to make this trip. I talked with her on the phone tonight after I came home from work, and she told me how she’s been recommended to eat very soft foods, like porridge. Being the American girl that I am, I tell her that she should try Smoothie King instead while she’s out here. “Oh, the blended fruits and getting to pick stuff like protein powder’s great!,” I suggest to her as I hold back tears.

I talked to her from the porch where I’ve been planting herbs for the last week or so. There’s a nice assortment growing in my planters now. One interesting surprise is my cat Simon’s love of chives in lieu of the perennial normal-cat favorite, catnip. In honor of his namesake, I planted him a “Scarborough Fair” garden. Both my parents have passed on this love of eating herbs and vegetables from your own garden, and now that I have a little patio, I try to practice their love.

There are empty pots out on the porch that are yet to be filled with anything. My mom and I have been planning for a while to browse Home Depot and other flower markets and then fill those containers while she’s here. I look at those vacant planters as I keep chatting about other mundane happenings in life. I try to speak in my normal tone while concealing that tears were beginning to stream down my cheeks.

I want to plant those flowers with my mother next week and watch those flowers grow and have our conversations later about how well they are doing. The empty pots will be waiting for her, as will I.

May 14, 2009

Good Grief

The sky was tinged with gray hues, and the sound of the leaves rustling from the wind predicted the imminent shower. It’s Thursday morning, which meant I had my weekly session with Dr. A, my Dr. Melfi. We first start the hour by checking in on how the meds are working for me and how I’ve been functioning physically.

Then, usually comes the harder part of actually having to ‘talk.’ I can’t remember exactly what she asked me that prompted me to talk about my standstill. As I started to recount my thoughts from the past week, I also stared out the window since I could see the weather changes out of her window. Minutes passed, and the gray tones turned to coal and soon the rain and a flash of lightening . Whatever gray thoughts I harbored in myself also saw this time as the chance to break open in that moment. Just as the clouds are a slow accumulation of moisture, I guess I had more emotions collected than I could hold anymore.  I spoke about as openly as I ever have  about just what it feels like to be me in this moment, at this juncture as the tears poured out of me. It felt like I cried and bawled during much of the hour.

She listened as she kept handing me one sheet of tissue paper after another. But unlike the times before when we had to deal with the tears in a more medical manner (e.g. medication), she gave me a simple answer: “This is grief. It’s the process of grieving.” I had read in books about how it is okay to revisit past traumas and reprocess those moments, but it was comforting to have her tell me that what I was doing isn’t harmful or a relapse of something terrible. It is okay to feel this way.

After each session, I always say Thank you as I head to the door. It may seem like a hollow, routine greeting, but I always mean it when I say it as I leave her office.

May 13, 2009

In the News: ECT worse than waterboarding??

Give me a f-ing break.

I came across an AP story from three days ago about a Minnesota patient who wants to refuse regular ECT. I’ve pasted the first portion of the article, written by Steve Karnowski, below:

ST. PAUL, Minn. (AP) — The court order authorizing electroshock treatments for Ray Sandford says that when he arrived at a psychiatric hospital early last year, he was “grossly psychotic” and violent toward staff and other patients.

Sandford, who has been declared legally incompetent, said he agreed to the treatments at first, but after more than 40 of them he finds it hard to remember names and other things. His bipolar disorder is under control, he says, and he should have the right to say no.

The court disagrees, but advocates of the mentally ill who call themselves the “mad pride” movement have rallied to his defense.

“This is worse than waterboarding,” said David Oaks, executive director of MindFreedom International, who led about two dozen people in a rally at the Minnesota Capitol this month to draw attention to Sandford’s case.

“Offer somebody the choice between waterboarding or forced electroshock and a lot of our people who know what it is will say waterboarding,” Oaks said.

Sandford’s caregivers persuaded a judge to order electroconvulsive therapy (ECT) plus a combination of anti-psychotic drugs.

“I just don’t like the idea of them being able to force these treatments,” said Sandford, 55, who has been in and out of mental hospitals for nearly four decades. Read the rest of the article.

I refrain from commenting on the part about mandated ECT. However, what I have an issue with is this organization MindFreedom International‘s comparison of electroconvulsive therapy to waterboarding. I know it’s an “In” thing to be talking about waterboarding, and while I’ve never been waterboarded, I do know what it is like to go through 15 treatments of ECT. And if these people would rather be waterboarded, that’s their choice. However, I can tell you from experience that there is nothing torturous about the facilitation of ECT. This medical procedure doesn’t even involve cutting open a body part. I’d like to know if this executive director’s even been waterboarded. He better be speaking from experience. Now, a repeated open-heart surgery. That would be torture. Another point: the goal of ECT (regardless of the outcome) is for the person to become better. From last I heard about waterboarding, people aren’t getting this procedure because they’re going to be better people for it.

The “Mad Pride” movement includes “groups and individuals that seek not only an end to forced treatment, but to redefine their conditions as something to be respected instead of diseases to be suppressed.” To an extent, I can understand and respect their philosophy. Though the author describe those involved in the “Mad Pride” movement as advocates for the mentally ill, what kind of advocacy is it when a group tries to take away people’s right to receive certain forms of treatment? (They are adamantly against ECT as treatment.) Also, by their wanting “respect” for their illness, they essentially want to be defined by whatever dianoses they’ve been given (and by extension, all of their behaviors condoned). There are societal rules that make certain actions undesirable to the public, but there are also a set of behaviors that are not condoned simply because others find it odd; it’s because they may actually be harmful to the individual and to to others! Though having bipolar disorder has taught me a lot of thing I would’ve otherwise never learned, no illness should have to become your sole source of pride.

I’m glad to see that there are people who want to fight for the rights of the mentally ill, but their rhetoric places even more unneeded agony to those who are considering ECT. There are those who will certainly die if they do not have ECT. If they want to help others like them, then, fight for this person’s right to make his own treatment decisions, not demean the treatment itself.

This argument may be a bit of a stretch, but it’s like being pro-choice. You can be pro-choice but still not like abortion. In the end, it’s the patient’s right to choose.

May 11, 2009

high school bitters

It’s hard to believe my 10-year high school reunion is coming up this summer. I don’t plan on attending, but I hope I can catch up with my small circle of friends in other ways than around a punch bowl in a large conference room. I’ve recently been keeping up with some of those friends via e-mail and so on. One of my friends, Duncan, even sent me first-season DVDs of “Mad Men” and “Pushing Daisies” while I was having ECT. Thanks to him, I’m now hooked on Mad Men.

It’s inevitable that people will ask each other what they’re up to these days. It’s been ten years, or around six years since we graduated from college.  So, what have most of my high-school friends been up to? They got their PhDs from great universities and have professorships or work at some big-time companies. Some have married and are raising children. In this gap of time, everyone’s made something of themselves. Their life situation has changed, mostly for better. To put it simply, they’ve moved on since those times in high school. I have to admit I’m more than just a bit envious. Part of me thinks I could’ve had that life, too. After all, in high school I was that kid who was involved in a bunch of stuff  – student body president, all-state band member, etc. Shouldn’t that type of energy have carried on into college?

“What have you been up to?” I can picture someone asking me that question over some finger foods and balloon-and-streamer decorations. I was voted “Most Intelligent” by the senior class back in 1999. Shouldn’t I have become something? Instead I’m an unemployed crazy person who decided to take time off to get electroconvulsive therapy. That the only thing that’s changed for me since  high school is that I’m just not in high school. The prospects of a successful life is still there, but they have not been actualized. And I’m afraid those prospects are fast diminishing. Maybe I’m just plain jealous, that people have ‘made it,’ and I’ve just watched the time float away. It’s a standstill of my own stupid making.

I think and know that people had high expectations for me. And I broke those into pieces. The thing is, I had high expectations for myself, too, and a part of the reason may be why I get upset thinking about this topic is that I know I disappointed myself the most. Much of me still want so badly to meet those expectations.

I acknowledge that I’ve been dealing with a serious illness for these last ten years, but there are plenty of people who are dealt the same hand but are really, really successful. As I have come to accept myself, I will also be honest and say that there is some bitterness left. Can’t I just get over it already?

May 11, 2009

Helped by the Stimulus package

Tim Geithner didn’t hand me this little pick-me-up to reinvigorate my state of things, but I was given a prescription for Concerta, a stimulant to combat my persistent lags in mood/motion.  It’s a methylphenidate HCI, so it’s really just an extended(controlled)-release Ritalin. So, the main use of this medication is to treat ADHD. The medication is supposed to allow me to function at a normal pace, instead of being scattered, too lethargic or constantly fatigued for no good reason.

As reported in the New Yorker article and elsewhere, people are using (or abusing) psychostimulants like Ritalin so that they can act like the energizer bunny. But for those of us who take it for legitimate reasons, this pill is just a means to be able to live a life like everyone else. I have taken this drug before, and as much as it would be great to suddenly have all the energy in the world stay up all night and finish every task ahead, it has never worked for me in that manner. From my experience, by taking Concerta, I won’t have to feel tired for simply sitting on the couch.

It’s only been a few days since I’ve been on this drug, but there is an appreciable difference already. Little by little, I find myself wanting to start and/or finish certain tasks. There’s actual motivation. More of my time during the day is really being spent more wisely than before. (Of course, this all sounds marvelous, but what I do during the day pales in comparison to what everyone else has going on). Though my emotional state is not affected, it is so nice to pick up my stride and not feel like there’s a block of cement stuck to my feet as I try to take a step.

Abuse of drugs like Concerta is a problem. But for me, this stimulant is a life-rescue package.

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