Wednesday, September 26, 2007

Dave Matthews Band - Everyday

Take 4 minutes and enjoy.

Bipolar Disorder

Every once in a while I get to use the 23 years of education I obtained. Following is evidence that, indeed, I am actually a doctor.

While on internship and post-doc I found myself being confused by the requirement to "assign a diagnosis" to whomever walked through my door for help. To assign a diagnosis is indeed important as it guides treatment planning and implementation, and gives outside clinicians a brief idea of what behaviors/issues the clients are presenting with. However, I believe - much to the disappointment of some of my supervisors during those years - that in order to be a good diagnostician you need to get to know the diagnostic criteria (obvious) as well as the person/family sitting in front of you. Diagnosing from the hip went against my grain and left me feeling quite uncertain...as if I had incorrectly labeled someone. Which is important...once you give a diagnosis to someone, that diagnosis has the potential to become a label by which to identify that person and sticks with them until the end of time. This can be gravely dangerous, especially when working with children in the school system. The schools LOVE to have diagnoses, and once the teachers hear "ADHD" or "Conduct Disorder" that poor child doesn't have a chance in hell. Regardless of what we all think of the teachers who watch over our babies during the day, they are human and they have biases and sit in judgement.

Now, on the other hand, diagnoses WHEN USED CORRECTLY can be quite helpful in guiding treatment. Yet, I am often struck by colleagues and other mental health professionals who go with the diagnosis du jour without doing proper and thorough investigation. 10 years ago it was ADHD for children, and now it has become Bipolar Disorder. This is a serious illness, folks. And very complicated. Wouldn't want my kid to have it. And there are some children who do indeed exhibit symptoms associated with Bipolar Disorder, which can make their lives and their family lives hell. Here is a recent NIMH article that touches on the seriousness of diagnosing children with Bipolar Disorder.

Having said all of this:

1. If you find you or a family member needs mental health assistance, do your homework and find a clinician that looks at the behaviors and symptoms over time and in different settings (home, school, playground, work, etc.).

2. The best clinician is one that is a good fit for you, in addition to #1. This means it may take seeing and talking to 2 or 3 clinicians to find the right one. Treatment will fail if you don't like your treatment provider.

3. If you hear the diagnosis du jour, be skeptical. Do your homework. Get second and third opinions.

4. The clinician should focus on the behaviors and symptoms, not the diagnosis. If they focus on the diagnosis...RUN.

5. Treatment should be a collaboration between you and the clinician...this is important.

6. Finally, know that a diagnosis is just a label that contains in it's definition a description of the symptoms and behaviors that are included in the label. Focus on the symptoms and behaviors...your clinician will, too.

Monday, September 24, 2007

Bloggers beware...interesting

In the tiny little town of Paris, Texas there seems to be a lawsuit that should be of interest to all bloggers, and will likely make case law.

http://www.chron.com/disp/story.mpl/front/5149745.html

Back to the in-laws

My brother-in-law, his wife, his 7-year-old daughter, his 11-year-old son, and their 14-year-old niece on his wife's side were here this past weekend for a football game. I had 8 people in my house. I spent 6 hours making lasagna Saturday morning (Mr. Landlord's request...and since he is special he got the lasagna) and made a cake the night before. So, yes, I was Susie Homemaker.

I typically make it a point to know what folks like to eat before they come...I think it makes the visit more comfortable for them. My niece and nephew are very picky eaters, and their mother - an OB/GYN - has a history of being obsessed with what they eat. READ: no junk food and their snacks are Power Bars and milk. No fruit juice is allowed. And my niece has told me that McDonald's fries are the equivalent of the anti-christ. Once when they were here, I made a batch of cinnamon rolls, and their mother quickly came into my kitchen and unveiled a package of bran muffin mix which they brought from home that she was going to make for them - which I gladly turned over my kitchen for her to proceed. (These children are doomed to develop eating disorders from their mother's fear that they will turn into hefty Italians like their dad and his family.) So I felt compelled to make double sure I knew what they liked to eat. I was informed that my niece only likes elbow noodles with butter and parmesan for dinner...AND the butter had to be the I Can't Believe Its Not Butter Light spray. Sounds easy enough. Off to the store I go.

I'm standing in front of the butter case looking for this special spray and feel this sense of sadness and great irritation come over me. Then I realize...what the hell am I doing? I'm willingly buying this child, who could use a few pounds on her, LIGHT BUTTER SPRAY to put on her noodles. I'm contributing to a future of eating disorder hell for this child. And in the greater picture, I'm going overboard in making sure people are comfortable in my home in an effort to ease MY OWN ANXIETY for having people in my house. THIS IS MY HOUSE!!!!! I should not have to worry about my three dogs getting their hair on the floor so my niece and nephew won't be able to sit on the floor and play with my son. I should not have to worry that my sister-in-law is afraid of big dogs. I should not have to wash, dry, and fold FOUR sets of sheets by the time everyone is gone, much less clean the fucking kitchen....AGAIN! AND, I SHOULD NOT HAVE TO PUT ASIDE TIME FOR MY SON TO MAKE SURE THESE PEOPLE FEEL COMFORTABLE IN MY HOME! By the time they left, I had barely seen my baby boy all weekend. How suck ass is that????

Sue Doe left a comment on one of my previous posts about inlaws saying I had no boundaries. Thank you, Sue Doe, for the little dose of reality. It was a Godsend. That comment ran through my mind while standing in front of the butter, and has not since left my mind. Sometimes we psychologists need reality to slap us in the face....

Thankfulness...and humility

My back has been out for about 2.5 weeks now. Getting through the daily "stuff" takes a lot, especially with a toddler. So, while trying to take a nap I turned on the tube yesterday to get my mind off the pain. I chose CNN thinking I would see enough boring news blah blah blah that I would fall right to sleep. Boy, was I wrong.

CNN was featuring a story of the life of women in Afghanistan for the last 6 years. I was so captured by the story and images that I could not sleep nor relax. The women in this story, or in Afghanistan for that matter, would think of me as a woman of great wealth and luxury. I think of them as woman of great strength and power, though they are unable to demonstrate their strength and power in their current culture. These women continue to wear burkas, and many are found begging on the streets as they have no education or jobs. One woman featured in the story was a war widow...her husband had been killed by an American bomb. She was left to raise her two daughters. Her days consisted of begging on the streets. The cameras showed men laughing at and belittling her. Very few stopped to give her money. Other women remained in extremely abusive relationships. It was a free-for-all type of abuse....they could be abused by their mother-in-laws, husbands, brother-in-laws, or their own family. Many set themselves on fire to escape the abuse. The video, pictures, and stories are heart wrenching.

Not much has changed for these woman since the U.S. invaded Afghanistan 6 years ago, despite reports they are experiencing better treatment, living conditions, etc. since the Taliban is no longer in power. I live a life of great luxury compared to these women. I am free to make my own choices, state what is on my mind without fear, be independent, choose my relationships with significant others, obtain 23 years of education, and raise my child to be strong and independent yet compassionate toward others. Yes, I worked for it and Yes, I live in a different country. And there are no doubt social psychology issues within that culture which maintain the current state that I can't even begin to discuss here. However, I am grateful and thankful everyday for everything I have...this show and the story of these women is a fantastic reminder.

Now I'll go back to bitching about my in-laws...

Thursday, September 20, 2007

I have no idea...

So, my 82-year-old mom-in-law fell a few weeks ago and broke her collar bone, knee cap and sustained a compression fracture in her back. She has needed round the clock care since. Given she had 9 children, the girls in the family are voluteering to take care of her. This has caused serious infighting amongst the girls and has worn them out...the infighting is the most disturbing. What is the solution? I voted for getting a night nurse a few nights a week to give everyone a break. My mom-in-law refuses this saying she doesn't want a stranger in her house. Ya, okay, I understand this to some extent. HOWEVER, she has seen as of late the strain and stress this is causing amongst the siblings, so you would think she would be willing to give up a few nights of familiarity to a nurse who is better qualified to take care of her. But no...

My heart goes out to the entire family. The infighting is ridiculous...you read the emails and think that these people are younger than 10 years old, rather than in their 50s. Their focus has gone from taking care of their aging mother to who is doing the best job and who can't be trusted with the care of their mother. Some of their points may be valid, to which I again say get a fucking night nurse people...someone stand up to the plate and say "mom, we want what is best for you and right now a night nurse would be better qualified to take care of you than we are." I have said my two cents, and essentially need to back out at this point...I am only the in-law, which implies my influence is quite limited.

Monday, September 10, 2007

Dear Lord, please send me a babysitter

Mr. Landlord and I are long overdue for some one-on-one time and adult meals and conversation. Finding a good, reliable babysitter is next to impossible. We are not asking for much, just an occasional Saturday evening out. Previously, we had a Spanish nanny/housekeeper two days a week who liked to babysit on the weekends for extra money. However, when my son started speaking she couldn't communicate with him anymore so she's out. Then we hired someone from "Grandparents Unlimited" to babysit one Saturday night who looked like an ex-meth addict...we were so nervous about her, we drove around the neighborhood and then parked at the end of the street - with the house in view - until the appropraite time interval lapsed which would allow us to go back into the house and say the movie was sold out. Our neighbors refuse to share their babysitting resources for fear that we will book their babysitter on the same night they need someone. Sooooooo....I posted an ad for a babysitter/nanny on the university job bank last week. It goes something like this:

Need babysitter/nanny for 2.5 year old boy. Must be energetic, creative, patient, caring, and engaging. (READ: You cannot sit and stare at my son while he is playing when you are babysitting.) Must also be CPR trained and English speaking, as well as classified as a sophomore or greater.

Do you think anyone will respond?

Ya, I'm calling about the house you have for rent...

{ring} ME: Hello?
CALLER: Um, ya....I was calling about the house you have for rent?
ME: Yes...How can I help you?
CALLER: Well, um...let's see...is it still available?
ME: Yes, it is. What kind of questions do you have?
CALLER: Well, how big is it?
ME: As the ad says, it is 4 bedroom/2 bath/2 car garage...about 2000 square feet.
CALLER: Um....Ummmmmm.....It's 4 bedroom?
ME: Yes, indeedeee....
CALLER: How much is the rent?
ME: As the ad says, the rent is $1600.
CALLER: Ummmm.....
ME: Like I said, it's 4/2/2, fenced in backyard with deck, hardwood and ceramic tiled floors, all new appliances, new countertops in kitchen, the owner maintains the yard, you have access to a community pool/playground/tennis courts, the elementary school is 1 mile away, grocery store is 1.5 miles away, the deposit is one month's rent and can be paid out over two months, the pet deposit is $500 - 1/2 of which is nonrefundable. There is an HOA so you will be required to abide by all HOA rules and regulations. The interior is painted in warm, neutral colors. There is a large kitchen with an island and separate breakfast area. It also comes with a washer and dryer. What else do you need to know?
CALLER: Ummm.....
ME: Let me know if you can think of anything else. Thanks for calling. {click}

and so it goes....

Friday, September 7, 2007

Madeleine McCann

This is a sickening development in this case. I am sure many people out there are screaming "I told you so," but that never accomplishes much. First of all - we, the general public, have NO IDEA what is happening and why. Mr. Landlord works on such cases...everything that is released to the media is controlled...That's right folks...those unnamed sources have a name and they know and the police know what they are telling the media. Secondly, these parents are true fuckups for leaving their children alone at night. I am amazed that they have not been brought up on child endangerment/child neglect charges at this point, but I am sure it will come - there is a reason for this as well. However, having said that - focusing on their fuckup does not make anything right for this child, or help in figuring out what happened to her.

This is the other sickening development is this story. What the hell were they thinking. That's all I can say....

I will continue to watch what happens with this, as I am sure many other people will. It is incredibly difficult not to point the finger at these parents and repress the urge to scream at them for being such neglecting, selfish, self-centered parents for leaving their children alone while they enjoy dinner...even if the condo was within eyesight. I imagine that eyesight got pretty dim once the wine hit. However, that is all we know they have done at this point...Though I can never imagine a parent would intentionally harm their own children, I've seen it happen and have treated people who do these things...Nothing surprises me anymore.

Thursday, September 6, 2007

Help for tenants...

Following are some guidelines for tenants, to ensure that they 1) will enjoy a positive relationship with their landlord, 2) get repairs performed in a timely manner and 3) get their deposit back.

1. Read the lease...in detail. Understand it. It is a legal, binding contract.
2. Abide by the lease...to the "t".
3. Report repairs in a timely manner...the longer you wait, the more damage is done. This will be legally interpreted as your neglect, not the landlords and therefore you will be responsible for the repair bill.
4. Don't attempt repairs on your own. If the repair is of poor quality, you will be responsible for the entire repair to fix what you have done and what the original problem was.
5. Clean up after your pets. Just one pee spot in the carpet can cost you your entire deposit and more.
6. If you have the carpets cleaned, they will look great initially after the cleaning. However, stains don't go away. They "wick" back up into the carpet from the pad, and the stain reappears. Just FYI...
7. The landlord has the legal right to access the property at any time...ANY TIME. It is the landlords property.
8. ANY violation of a lease can result in eviction...ANY.
9. The landlord has to abide by the property codes written and enforced by the state. The property codes protect you, so know them. (They also protect the landlord.)
10. There is typically a Tenants Council in your city or state. Call the Tenants Council, which is a government agency which provides information regarding property codes, etc. if you have questions about what is happening. They can provide you resources.
11. Landords have the ability to provide a negative report for your credit report. This will seriously hurt your chances of renting a nice place later as well as buying your own place.
12. If the property looks unkempt, it means the landlord doesn't invest time or money in the property. Don't rent it.
13. Legally in some states, landlords only have to repair items that pose a serious health risk to you. READ: Be respectful of the landlord and the property, and your more likely to get your repairs completed.
14. If you rent a property that is in HOA territory, abide by the HOA rules. HOAs will impose fines for rule violations, which you will have to pay. If you violate the rules and don't pay the fines, you will be evicted. Also, too many HOA violations can result in eviction.
15. At the beginning of the lease, ask for an inventory checklist. This checklist lets you list, item by item, room by room anything...ANYTHING...that is wrong with the property. You and your landlord will then sign off on it once it is complete. If you get a checklist and are given a timeline to return it, abide by the timeline. If you don't return the checklist in time, then you can legally be held liable for anything that is wrong with the property when you move out - even if the damage was there before you moved in. Be sure to keep a copy of the SIGNED checklist.
16. When you move out, clean the property and then schedule a walk through with the landlord. Have your inventory checklist on hand to prove what damage you caused and what damage was there when you moved in. Don't return the key until this is completed and you and your landlord agree on the final walk through.
17. If you are evicted, you are still financially responsible for the remainder of the lease term...even if the landlord immediately re-rents the property after your belongings have been removed.
18. If you break the lease, you are still financially responsible for the remainder of the lease....
19. If you do not give proper move out notice, you forfeit your deposit.
20. If you get a pet and don't tell the landlord, the landlord can remove the pet from the premises within 24 hours of discovering the pet. The cost of removing and housing the pet, defleaing the premises, cleaning the premises of all pet related damage, etc. will be your responsibility. You can also be evicted for this if there is a no pets clause in your lease.

Just some info to help folks understand their responsibility when they lease a place to live. Know the lease and know your rights...you'll have a better experience.

Wednesday, September 5, 2007

In defense of landlords

I was checking out YouTube to see what types of videos folks had made about their landlords. Landlords are getting a really bad rap. People are upset that their landlords came into their apartment/home while they weren't home, they aren't getting all of their deposit back for a variety of reasons, on and on. So, here's a video made by a landlord while he is touring one of his properties...this video is the reason landlords are so damn adamant that their property is protected. And to the girl who left the key on the counter with a note saying "send my deposit to this address," next time do a walk through with your landlord after you have cleaned the place. You'll likely get your deposit back.

http://www.youtube.com/watch?v=Ape9oF8uQAM

Medication could help with this...

The following is a true email I received. The names have been changed to protect the innocent.



Hey girls! Hope everyone is having a great week. I have totally dropped the ball on this one and I feel sooooooooooo badly-I hope that you all will jump in and bail me out. I have promised Shirley that I would throw a sip and see for everyone to meet the baby-and mostly a chance for us to shower her and make her feel special...so...I left it on the back burner and I hosted 4 other baby showers in August-now this is the last one and it is Sept and the baby has been here for weeks...ahhhh....I apologize! ...anyway-I've talked with her and the best date for her is next Thursday-Sept 6th- I know this is so soon and with no advance warning-totally my fault! I was trying to secure a location-will have it here if I have to but Joey will be gone and I hate for a babysitter to get the kids down with us here so I was trying to avoid my house....then Laverne offered but with her baby so soon, can't really do that to her-then I roped Jennifer b/c she is so close to Shirley location wise-but now Jennifer's husband has to travel and they have bday plans Thurs night...then, I got the unexpected email from Courtney-we had talked about Shirley's girls night out being the bunco replacement in Aug and I'm sorry to put one party on top of another....but I promise this will be VERY LOW KEY-just drinks, baby girl presents-nothing big at all. If someone is willing to have us over for an hour or two next Thurs, that would be awesome, if not, any suggestions on a great rest-we could have margaritas/dinner at El Arroyo b/c it is so close!?!? Okay-please email me and let me know if you can make it or ideas-totally appreciate it-I will now keep my mouth shut and stop messing up plans...Ms. Disorganized and Needs Meds



What the Fuck???? First of all, Shirley emailed Ms. Disorganized and Needs Meds insisting that this not take place...not once, but four times. Some poor unsuspecting soul stepped up to the plate and bailed her out, agreeing to host this soiree at 7 pm on a Thursday night...which leads to my second point - it's on a weeknight at 7 pm, people...school has started AND do you really think Shirley and her now 7 week old baby want to be the center of attention from 7 until 9 pm at night????? Shirley is a pretty good friend of mine, though the friendship is 95% onesided (benefiting her of course), but I have totally opted out of this craziness. The above email makes me bonkers just reading it. I did my new baby duty by co-hosting a barbecue for Shirley and her family in honor of the new addition to the family, by helping out after the baby was born, and by being the ONLY friend on the block that visited the Shirley clan in the hospital after the baby was born. Shirley has all but begged for me to attend this get together, and I am firm in my stance. This is a good representation of what my neighbors are like...

Tuesday, September 4, 2007

Ugh...I just can't think of an appropriate title to this...I'm that annoyed

Mr. Landlord has a female friend/colleague...I'll call her Maria...in particular that I steer clear of...or at least try to. Maria was in his life long before me, so therefore comes with the package. I am in no way threatened by Maria and am more than sure that she will never become a "romantic" friend to Mr. Landlord. They have more of a father-daughter relationship, as her father has never been present in her life and apparently is a man of questionable character. I respect Mr. Landlord's role of father figure, and can see how it benefits Maria. However, I have NOTHING in common with Maria other than we both have an attachment...albiet different type of...to Mr. Landlord. Quite frankly, I don't like talking with her...she is annoying, and continually reminds me of how much longer she has known and how much better she knows Mr. Landlord than do I -- the latter being a delusion of hers. As a psychologist, I obviously recognize this as insecurity on her part, and knowing what I know about her, can see the role this oneupmanship serves for her and take it in stride. (She not only does this to me, but to other colleagues that they both work with...it's quite juvenile to watch and my sense is other folks feel the same way about her.) As a person, it's annoying. And even more annoying are her attempts at building a relationship with me, especially since I have no desire for said relationship. These attempts are also annoying b/c ultimately they are to serve a superficial purpose...to show me that she is very special to Mr. Landlord...not out of a genuine desire to become a friend to me. I know she has a relationship with him, and I know for her it is special...I also know it is more special for her than for Mr. Landlord.

When Mr. Landlord and I were expecting, she decided she wanted to throw a baby shower for us, which I graciously accepted. What the hell did I know? I had never had a baby before. However, this was one over the top baby shower with catered food and drink, expensive gifts, elaborate invitations, etc. etc. The theme of the baby shower was hunting, as Mr. Landlord is an avid hunter and marksman---I am NOT a hunter, so I was a bit offended that she would only consider Mr. Landlord's interests/hobbies when planning this outrageous event. Yet, I knew also that the focus of the day was the baby and the friends and family that were there to celebrate with us. Ultimately though for Maria, it was an expensive attempt to impress upon everyone in attendance her view that she is the "chosen one" in Mr. Landlord's life (trust me on this delusion of hers)...and that she was the only one that could do such a wonderful thing for him.

Does this all sound a bit selfish/self-centered? Probably...but I focus on this today b/c yesterday was my birthday and the last joyous phone call I got before retiring to bed was from Maria, wanting to wish me a happy birthday...a superficial happy birthday wish at best. And this annoyed me. I personally have not heard from her in almost a year. The conversation, after the initial "Hi! We wanted to call and wish you a happy birthday," turned to how stupid the other colleagues were in her view b/c they just don't know what she knows, they aren't as smart as her, and they don't know how close she is to Mr. Landlord so that makes them idiots, and how she is so worried that Mr. Landlord is working so much and how this could hurt his health, blah blah blah...By the time I got off the phone...30 minutes and several attempts by me to end the call later...I wanted to phone Mr. Landlord, who is out of town on business, and scream at him to intervene and tell this crazy woman to leave my happy ass alone...Obviously me as a person is reacting here...Not me as a psychologist.

I am all about developing friendships and relationships with people...However, I refuse to spend what little and precious time I have with people who engage in relationships solely with self-serving objectives and motives. Spare me your superficial bullshit...I don't have time for it and it gets really messy.