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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 23669
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: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Dysthymic or dysthymia? And it would help if you tell me where you got the two terms.
Customer: replied 1 year ago.
Dysthymic. It is in the psychiatrist report
Expert:  Dr. Chip replied 1 year 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 1 year ago.
I just always talk fast. Diagnosis are major depressive disorder moderate, dysthymic disorder, eating disorder nos
Expert:  Dr. Chip replied 1 year 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 1 year ago.
She doesnt think i have borderline personality
Expert:  Dr. Chip replied 1 year ago.
I didn't either
Customer: replied 1 year ago.
That makes me
Happy
Expert:  Dr. Chip replied 1 year ago.
Good. Anything else about this?
Customer: replied 1 year ago.
Nope
Expert:  Dr. Chip replied 1 year ago.
OK. I'll leave the page open if you have something new to ask about
Customer: replied 1 year ago.
Im doing really good food wise today
Expert:  Dr. Chip replied 1 year ago.
Great--keep at it
Customer: replied 1 year ago.
Ive had 100 oz of water. A banana a protein bar and now a
Ceaser salad
Expert:  Dr. Chip replied 1 year ago.
Not bad but you need some essential fats too--maybe in the salad dressing
Customer: replied 1 year ago.
Whats an essential fat
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Ill probably have brocolli and
Carrots for supper
Expert:  Dr. Chip replied 1 year ago.
That should do it
Customer: replied 1 year ago.
Ive already had 578 calories
Expert:  Dr. Chip replied 1 year ago.
You need to be on at least 1200 calories a day
Customer: replied 1 year ago.
Im trying. I really am
Expert:  Dr. Chip replied 1 year ago.
I know
Customer: replied 1 year ago.
I dont feel like any one else believes me
Expert:  Dr. Chip replied 1 year ago.
Don't listen to them
Customer: replied 1 year ago.
I talked to my gi dr he wants me to stay on the zofran
Expert:  Dr. Chip replied 1 year ago.
That's fine if he says so but I myself wouldn't keep you on it.
Customer: replied 1 year 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 1 year ago.
Bad how exactly?
Customer: replied 1 year ago.
It hurts really intense
Expert:  Dr. Chip replied 1 year ago.
Well, you've talked about the stomach pain many times--how is this any different from other times?
Customer: replied 1 year ago.
The pain is more. And it more of a gnawing pain then a firey pain
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Is it ok to take pepto? And i failed at getting in 1200 calories. I only got 824. Sorry
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Maybe tomorrow will be better
Expert:  Dr. Chip replied 1 year ago.
OK
Customer: replied 1 year 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 1 year ago.
Where exactly?
Customer: replied 1 year ago.
2ish inches below my knee cap
Expert:  Dr. Chip replied 1 year ago.
On the bone itself?
Customer: replied 1 year ago.
Im not sure maybe.
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Bone
Expert:  Dr. Chip replied 1 year 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 1 year ago.
I dont think its normal but what do i know
Expert:  Dr. Chip replied 1 year 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 1 year ago.
It coulda happened when i fell last night
Expert:  Dr. Chip replied 1 year ago.
Well I doubt you took a chunk out of the bone so it could be just a hematoma there
Customer: replied 1 year ago.
Sorry that im so bothersome
Expert:  Dr. Chip replied 1 year ago.
No problem
Customer: replied 1 year ago.
Do you think it would be ok to call my gi dr and ask him for something for pain
Expert:  Dr. Chip replied 1 year ago.
Sure
Customer: replied 1 year ago.
Do you think i need the medscor just continue to tough it out
Expert:  Dr. Chip replied 1 year ago.
Tough it out for tonight
Customer: replied 1 year 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 1 year ago.
In general, put up with it. Better on the lorazepam
Customer: replied 1 year ago.
My stool is darker than it ever hasbeen
Expert:  Dr. Chip replied 1 year ago.
Darker doesn't tell me much--what's the color and did you take any Pepto?
Customer: replied 1 year ago.
No pepto. Really really dark. Maybe the darkest brown before black. Im bad with colors
Expert:  Dr. Chip replied 1 year ago.
Unless it looks like asphalt color--black as India ink--it's just dark brown and nothing to worry about
Customer: replied 1 year ago.
Im failing at eating. Ive only had 610 calories
Expert:  Dr. Chip replied 1 year ago.
Why can't you eat a little more?
Customer: replied 1 year 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 1 year ago.
After supper i have consumed 860 calories
Expert:  Dr. Chip replied 1 year ago.
Better but you really didn't answer why you find it so hard to eat
Customer: replied 1 year ago.
I get full. And then i feel fat
Expert:  Dr. Chip replied 1 year ago.
From just that many calories you feel fat?
Customer: replied 1 year ago.
Yes. I ate until i was full. But then i feel fat or like i overate
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Whtever you dont know
Expert:  Dr. Chip replied 1 year ago.
Yes I do and just think about what I said and don't comment anymore on it
Customer: replied 1 year ago.
Can i tell you what i ate today and you tell me where i coulda added the extra calories
Expert:  Dr. Chip replied 1 year ago.
Sure
Customer: replied 1 year 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 1 year 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 1 year 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 1 year 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 1 year 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 1 year ago.
She didn't at least give you an idea of what to eat?
Customer: replied 1 year ago.
No she didnt
Expert:  Dr. Chip replied 1 year ago.
Well, you can easily Google a good diet plan and then stick to it--not that hard.
Customer: replied 1 year 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 1 year 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 1 year 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 1 year ago.
Well, for now, if I were your doctor, I'd have you stick to the Mayo plan until it's finished
Customer: replied 1 year ago.
Im just telling you what he says. He said i can start ranitidine bid until monday then stop
Expert:  Dr. Chip replied 1 year ago.
Yes but I assume when you tell me something like that you're looking for my thoughts on it.
Customer: replied 1 year ago.
Do you think its a bad idea?
Expert:  Dr. Chip replied 1 year 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 1 year ago.
No my regular gi dr did
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Ok
Expert:  Dr. Chip replied 1 year ago.
Later
Customer: replied 1 year 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 1 year ago.
No problem
Customer: replied 1 year ago.
Do you have any big plans for today
Expert:  Dr. Chip replied 1 year ago.
None at all. You?
Customer: replied 1 year ago.
Im doing nothing
Expert:  Dr. Chip replied 1 year 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 1 year ago.
I could
Expert:  Dr. Chip replied 1 year ago.
It's usually very good
Customer: replied 1 year ago.
What can i do about being constantly tired
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Theres nothing to do today
Expert:  Dr. Chip replied 1 year ago.
You know what I meant--even if it's just taking a brisk walk.
Customer: replied 1 year ago.
I walk 2 miles every day
Expert:  Dr. Chip replied 1 year ago.
We're chatting again. Just saying getting busy and getting out of the house would help
Customer: replied 1 year ago.
Sorry
Expert:  Dr. Chip replied 1 year ago.
That's OK
Customer: replied 1 year ago.
Can i stop going to mayo?
Expert:  Dr. Chip replied 1 year ago.
You knew my answer to that before you asked. No--under NO circumstances no
Customer: replied 1 year ago.
What if they cant find out whats causing my ulcers
Expert:  Dr. Chip replied 1 year ago.
What if's are no argument at all. I'm sure they will and I think the gastrin test is crucial
Customer: replied 1 year ago.
But what if its normal then what. I stress over this whole mayo thing every day
Expert:  Dr. Chip replied 1 year ago.
Stress how?
Customer: replied 1 year 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 1 year 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 1 year 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 1 year 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 1 year ago.
Then how come its not ok for me to
Expert:  Dr. Chip replied 1 year 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 1 year ago.
One last question until wednesday. How do gi problems require meals and snacks?
Expert:  Dr. Chip replied 1 year 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 1 year ago.
Is cottage cheese a good snack
Expert:  Dr. Chip replied 1 year ago.
Yes. Now time to close the long page with a rating please.
Customer: replied 1 year ago.
Ate 1000 calories today! Have a good evening
Expert:  Dr. Chip replied 1 year ago.
Good going
Customer: replied 1 year ago.
Have to ask pulse 152
Expert:  Dr. Chip replied 1 year ago.
And you're still on the atenolol? What's the BP?
Customer: replied 1 year ago.
Yes and 102/59. I know i need to open a new page but im worried. Im sorry
Expert:  Dr. Chip replied 1 year 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 1 year ago.
I dont feel
Good
Expert:  Dr. Chip replied 1 year 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: 23669
Experience: Over 20 yrs of Family Practice
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