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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 25756
Experience:  Over 20 yrs of Family Practice
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What is dysthymic and pressured speech

Customer Question

What is dysthymic and pressured speech
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
Dysthymic or dysthymia? And it would help if you tell me where you got the two terms.
Customer: replied 2 years ago.
Dysthymic. It is in the psychiatrist report
Expert:  Dr. Chip replied 2 years ago.
Well, dysthymia is a term for a chronic long term depression but not as severe a depression as true depression syndrome. Pressured speech is really a bit difficult to define and is mostly in the eye of the examiner but it refers to fast talking with an inability for the interviewer to interrupt and sometimes switching subjects in the conversation frequently. If it's really intense it refers to the manic conversation of a bipolar patient in the manic phase.
Customer: replied 2 years ago.
I just always talk fast. Diagnosis are major depressive disorder moderate, dysthymic disorder, eating disorder nos
Expert:  Dr. Chip replied 2 years ago.
Well the dystymia just means long term. Sounds like the pressured speech was just a comment and not used to make a diagnosis
Customer: replied 2 years ago.
She doesnt think i have borderline personality
Expert:  Dr. Chip replied 2 years ago.
I didn't either
Customer: replied 2 years ago.
That makes me
Happy
Expert:  Dr. Chip replied 2 years ago.
Good. Anything else about this?
Customer: replied 2 years ago.
Nope
Expert:  Dr. Chip replied 2 years ago.
OK. I'll leave the page open if you have something new to ask about
Customer: replied 2 years ago.
Im doing really good food wise today
Expert:  Dr. Chip replied 2 years ago.
Great--keep at it
Customer: replied 2 years ago.
Ive had 100 oz of water. A banana a protein bar and now a
Ceaser salad
Expert:  Dr. Chip replied 2 years ago.
Not bad but you need some essential fats too--maybe in the salad dressing
Customer: replied 2 years ago.
Whats an essential fat
Expert:  Dr. Chip replied 2 years ago.
Linoleic and alpha linoleic fatty acids that the body can't make on its own--veggies like lettuce can provide some but other veggies and nuts would help.
Customer: replied 2 years ago.
Ill probably have brocolli and
Carrots for supper
Expert:  Dr. Chip replied 2 years ago.
That should do it
Customer: replied 2 years ago.
Ive already had 578 calories
Expert:  Dr. Chip replied 2 years ago.
You need to be on at least 1200 calories a day
Customer: replied 2 years ago.
Im trying. I really am
Expert:  Dr. Chip replied 2 years ago.
I know
Customer: replied 2 years ago.
I dont feel like any one else believes me
Expert:  Dr. Chip replied 2 years ago.
Don't listen to them
Customer: replied 2 years ago.
I talked to my gi dr he wants me to stay on the zofran
Expert:  Dr. Chip replied 2 years ago.
That's fine if he says so but I myself wouldn't keep you on it.
Customer: replied 2 years ago.
I know you are going to tell me there us nothing to say about this. But the pain in my stomach is bad. It has been bad all day
Expert:  Dr. Chip replied 2 years ago.
Bad how exactly?
Customer: replied 2 years ago.
It hurts really intense
Expert:  Dr. Chip replied 2 years ago.
Well, you've talked about the stomach pain many times--how is this any different from other times?
Customer: replied 2 years ago.
The pain is more. And it more of a gnawing pain then a firey pain
Expert:  Dr. Chip replied 2 years ago.
Try some Pepto if you have it but you're right--I really don't have anything new to say about it
Customer: replied 2 years ago.
Is it ok to take pepto? And i failed at getting in 1200 calories. I only got 824. Sorry
Expert:  Dr. Chip replied 2 years ago.
You gave it a good try and yes the Pepto's safe And the evening's not over yet so maybe you can have one more snack
Customer: replied 2 years ago.
Maybe tomorrow will be better
Expert:  Dr. Chip replied 2 years ago.
OK
Customer: replied 2 years ago.
I noticed tonight when i was putting lotion on my legs. On my left leg when i run my hand uo my leg theres a cleft tyle thing. When i rub my leg downwards there is a divot there. Thougts
Expert:  Dr. Chip replied 2 years ago.
Where exactly?
Customer: replied 2 years ago.
2ish inches below my knee cap
Expert:  Dr. Chip replied 2 years ago.
On the bone itself?
Customer: replied 2 years ago.
Im not sure maybe.
Expert:  Dr. Chip replied 2 years ago.
That's an easy question--either it's on the hard part of the shin in front or it's more to the side in the muscle
Customer: replied 2 years ago.
Bone
Expert:  Dr. Chip replied 2 years ago.
Probably just normal anatomy and nothing serious. Of course, an x-ray can easily look at the bone for anything like a cyst there
Customer: replied 2 years ago.
I dont think its normal but what do i know
Expert:  Dr. Chip replied 2 years ago.
Well if it's just cropped up that would be very unusual--actually nothing but trauma and a lot of pain could do that. So either it's normal or it's been there for quite some time
Customer: replied 2 years ago.
It coulda happened when i fell last night
Expert:  Dr. Chip replied 2 years ago.
Well I doubt you took a chunk out of the bone so it could be just a hematoma there
Customer: replied 2 years ago.
Sorry that im so bothersome
Expert:  Dr. Chip replied 2 years ago.
No problem
Customer: replied 2 years ago.
Do you think it would be ok to call my gi dr and ask him for something for pain
Expert:  Dr. Chip replied 2 years ago.
Sure
Customer: replied 2 years ago.
Do you think i need the medscor just continue to tough it out
Expert:  Dr. Chip replied 2 years ago.
Tough it out for tonight
Customer: replied 2 years ago.
Well obviously ill have to for tonight. But im talking in general; and just putting up with the pain


Also i talked to my psychiatrist today she gave me the ok to half tge dose of lorazepam but she wants me on it until my anxiety goes down
Expert:  Dr. Chip replied 2 years ago.
In general, put up with it. Better on the lorazepam
Customer: replied 2 years ago.
My stool is darker than it ever hasbeen
Expert:  Dr. Chip replied 2 years ago.
Darker doesn't tell me much--what's the color and did you take any Pepto?
Customer: replied 2 years ago.
No pepto. Really really dark. Maybe the darkest brown before black. Im bad with colors
Expert:  Dr. Chip replied 2 years ago.
Unless it looks like asphalt color--black as India ink--it's just dark brown and nothing to worry about
Customer: replied 2 years ago.
Im failing at eating. Ive only had 610 calories
Expert:  Dr. Chip replied 2 years ago.
Why can't you eat a little more?
Customer: replied 2 years ago.
I still have like 590 calories left to eat to be at minumum # XXXXX calories the dietician wants me to eat. Thats a lot left
Customer: replied 2 years ago.
After supper i have consumed 860 calories
Expert:  Dr. Chip replied 2 years ago.
Better but you really didn't answer why you find it so hard to eat
Customer: replied 2 years ago.
I get full. And then i feel fat
Expert:  Dr. Chip replied 2 years ago.
From just that many calories you feel fat?
Customer: replied 2 years ago.
Yes. I ate until i was full. But then i feel fat or like i overate
Expert:  Dr. Chip replied 2 years ago.
OK--and let's drop the topic after this. Forget about the term eating disorder or whether you have it per se. Those feelings are irrational. Not saying you're crazy or anything like it, but it means you have a distorted view of what overeating and feeling full is and you have a distorted view of what fat means. That means that you have the same mindset as a bulimic or an anorectic and if that goes too far you do get to the point of an eating disorder. So basically you do need therapy geared toward people who do have a definite diagnosis of anorexia or bulimia.
Customer: replied 2 years ago.
Whtever you dont know
Expert:  Dr. Chip replied 2 years ago.
Yes I do and just think about what I said and don't comment anymore on it
Customer: replied 2 years ago.
Can i tell you what i ate today and you tell me where i coulda added the extra calories
Expert:  Dr. Chip replied 2 years ago.
Sure
Customer: replied 2 years ago.
For breakfast @645 i had 1/2 a protein bar and a banana for 110 calories. At 1020ish had a snack which was the other half of the protein bar for 100 calories. For lunch i went to applebees and had half a seasonal berries & spinach salad with no drrssibg for 230 caloes. At 315 i had a 100 calorie bag of popcorn. For supper i had some lunch meat for 200 calories. 4 pickles for 20 calories. And some carrots
Expert:  Dr. Chip replied 2 years ago.
Certainly the 3:15 snack didn't have to be popcorn--some fruit would have been better. And you can still add at least another 150-200 calories for a late night snack.
Customer: replied 2 years ago.
I now feel like i screwed up eating. Lije im not eatibg the right things. I am doing my best. Its hard. Im not like me coworkers who can eat/snack all day. It frustrAtes me that i have to work so hard at sonething that people do everyday
Expert:  Dr. Chip replied 2 years ago.
Didn't the dietician give you a basic plan for what to eat and when to eat it? And you weren't snacking all day and it only takes five minutes tops to snack.
Customer: replied 2 years ago.
She didnt give me a basic plan. Just told me to have 3 meals 2 snacks and to increase protein consumption.
Expert:  Dr. Chip replied 2 years ago.
She didn't at least give you an idea of what to eat?
Customer: replied 2 years ago.
No she didnt
Expert:  Dr. Chip replied 2 years ago.
Well, you can easily Google a good diet plan and then stick to it--not that hard.
Customer: replied 2 years ago.
I think you are being snide/rude. I think im doing a good job. I mean look where i was a year ago
Expert:  Dr. Chip replied 2 years ago.
I'm just trying to help here. You asked me where you could get in a few more calories and when you said you didn't think you were eating the right things I suggested how to find out what those would be. I can't help it if you get touchy when we talk about this but that touchiness indicates you have a problem with the body image/fat/overeating thinking and let's leave the subject at that.
Customer: replied 2 years ago.
Ok. I talked to my gi dr today. He says i need to be on either the nexium or ranitidine. He also said hes confused as to why they are doing a test for hpylori when ive had multiple biopsies that have tested negative
Expert:  Dr. Chip replied 2 years ago.
Well, for now, if I were your doctor, I'd have you stick to the Mayo plan until it's finished
Customer: replied 2 years ago.
Im just telling you what he says. He said i can start ranitidine bid until monday then stop
Expert:  Dr. Chip replied 2 years ago.
Yes but I assume when you tell me something like that you're looking for my thoughts on it.
Customer: replied 2 years ago.
Do you think its a bad idea?
Expert:  Dr. Chip replied 2 years ago.
Well you said something about Mayo telling you to take the ranitidine for a few days and then stopping it so it really doesn't go against that.
Customer: replied 2 years ago.
No my regular gi dr did
Expert:  Dr. Chip replied 2 years ago.
OK--I thought for sure the Mayo said stop the Nexium and keep on the ranitidine for a few days. Oh, well. I really don't see what a few days of ranitidine would do for you but I see nothing harmful about it
Customer: replied 2 years ago.
Ok
Expert:  Dr. Chip replied 2 years ago.
Later
Customer: replied 2 years ago.
I was confused last night. Yes mayo dr told me to stop them. Regular gi dr told me i coule take the ranitidine again. Sorry
Expert:  Dr. Chip replied 2 years ago.
No problem
Customer: replied 2 years ago.
Do you have any big plans for today
Expert:  Dr. Chip replied 2 years ago.
None at all. You?
Customer: replied 2 years ago.
Im doing nothing
Expert:  Dr. Chip replied 2 years ago.
Well you can watch the celebration on the Capitol mall on PBS--I actually went to that about five times when I was in the DC area
Customer: replied 2 years ago.
I could
Expert:  Dr. Chip replied 2 years ago.
It's usually very good
Customer: replied 2 years ago.
What can i do about being constantly tired
Expert:  Dr. Chip replied 2 years ago.
We've talked about this before and I don't know how much of that is physical and how much of it is depression, but for now sitting at home all day today on a holiday isn't going to help that
Customer: replied 2 years ago.
Theres nothing to do today
Expert:  Dr. Chip replied 2 years ago.
You know what I meant--even if it's just taking a brisk walk.
Customer: replied 2 years ago.
I walk 2 miles every day
Expert:  Dr. Chip replied 2 years ago.
We're chatting again. Just saying getting busy and getting out of the house would help
Customer: replied 2 years ago.
Sorry
Expert:  Dr. Chip replied 2 years ago.
That's OK
Customer: replied 2 years ago.
Can i stop going to mayo?
Expert:  Dr. Chip replied 2 years ago.
You knew my answer to that before you asked. No--under NO circumstances no
Customer: replied 2 years ago.
What if they cant find out whats causing my ulcers
Expert:  Dr. Chip replied 2 years ago.
What if's are no argument at all. I'm sure they will and I think the gastrin test is crucial
Customer: replied 2 years ago.
But what if its normal then what. I stress over this whole mayo thing every day
Expert:  Dr. Chip replied 2 years ago.
Stress how?
Customer: replied 2 years ago.
I just worry about it. I worry they are not going to find anything wrong with me or that tgey will find something seriously wrong. I worry that ill get fired for taking time iff of work to go down to mayo. Im worried thst they will think everythings in my head
Expert:  Dr. Chip replied 2 years ago.
Obviously from the results of some of the tests and procedures so far it's not in your head. Whether it's serious or not remains to be seen. Let's drop this part--when you really stress about something it's time to get busy, get physical, and not just sit around worrying
Customer: replied 2 years ago.
Alright. I will talk to you wednesday when i see the mayo dr again. Just wondering. What do you eat in a typical day
Expert:  Dr. Chip replied 2 years ago.
Don't take me as a great example. I only eat one meal a day--in the evening. Usually meat, veggies, some fruit and a salad. Talk to you on Wednesday
Customer: replied 2 years ago.
Then how come its not ok for me to
Expert:  Dr. Chip replied 2 years ago.
Because you aren't me and you have GI problems that require meals and snacks. And my nightly intake is over 3,000 calories. Let's close the page.
Customer: replied 2 years ago.
One last question until wednesday. How do gi problems require meals and snacks?
Expert:  Dr. Chip replied 2 years ago.
I've already told you that. In your case, that will help to regulate your stomach acid output, keep all the proper juices and hormones flowing, and will also help to heal the gastritis and the ulcer.
Customer: replied 2 years ago.
Is cottage cheese a good snack
Expert:  Dr. Chip replied 2 years ago.
Yes. Now time to close the long page with a rating please.
Customer: replied 2 years ago.
Ate 1000 calories today! Have a good evening
Expert:  Dr. Chip replied 2 years ago.
Good going
Customer: replied 2 years ago.
Have to ask pulse 152
Expert:  Dr. Chip replied 2 years ago.
And you're still on the atenolol? What's the BP?
Customer: replied 2 years ago.
Yes and 102/59. I know i need to open a new page but im worried. Im sorry
Expert:  Dr. Chip replied 2 years ago.
Nothing really serious here with that BP. Just rest for now and I'm sure it'll slow down again. And you're right about a rating here and a new page.
Customer: replied 2 years ago.
I dont feel
Good
Expert:  Dr. Chip replied 2 years ago.
Sorry--but I have to draw the line on this page. You don't have to rate but I can't just let it go on and on. So leave it be or I'll have to opt out
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 25756
Experience: Over 20 yrs of Family Practice
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