First Name
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Age Group
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Gender
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City
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State
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Zip Code
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Marital Status
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How many people share the living space with you?
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What is your highest level of formal education?
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What race/ethnicity do you belong to?
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What is the frequency of your visits to the health care provider?
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Are you presently employed? If yes, what is your occupation?
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Were you employed previously? If yes, when and where?
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What conditions have you been diagnosed with? When? Where?
| Last year in April, I was diagnosed with generalized anxiety disorder and clinical depression at the North Shore Wellness Center. |
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Have you ever been hospitalized? If yes, how many times? When was the last time that you were hospitalized?
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Please describe everything you know about your condition(s) and how you obtained such information?
| What I know about clinical depression: Symptoms include insomnia, sleeping too much, changes in appetite, irritability, loss of interest in things that used to be fun, deep sadness. These must occur for over a two week period to be considered depression. I learned about depression from my therapists and from furthur research of my own.
Anxiety disorder: Symptoms include constant worrying, irritability, inability to concentrate. I learned about anxiety disorder from my own research on the Internet and from my psychiatrist. |
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Please illustrate your life before, during, and after learning of your condition(s) and engaging in therapies, if any?
| Before I was depressed/had anxiety, I was living a full, happy life. I had lots of friends, took dance classes and studied the piano, and was generally a very normal, very happy person. Starting in November 2004, I started feeling increasingly depressed and began worrying about absolutely everything. I had trouble sleeping and my schoolwork began to fall behind drastically. I would lock myself in the bathroom and cry for hours, often for no reason. I began scratching and cutting myself to try to ease the mental pain, but it often just made things worse. Finally, my parents sent me to my pediatrician to see what I should do, and she prescribed me Ambien. The sleeping pills helped me sleep, but they also provided me with the temptation to take my own life by overdosing on them. I also saw my school social worker, who reccomended I talk to a therapist outside of school. I went to two therapists, the second of which I am currently seeing every week for talk therapy. I was then referred to a psychiatrist, who I still see bi-monthly (I saw him weekly at first) who diagnosed me with clinical depression and anxiety disorder, along with some panic issues (I had suffered from a few panic attacks). Slowly, I began feeling better with the help of Zoloft, an antidepressant that has helped me greatly, and therapy. |
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Please describe how you cope with your condition(s), if at all, and the effectiveness of each strategy?
| I cope by surrounding myself with friends and family that I care about, which is very effective, taking Zoloft, and going to therapy sessions with my psychologist. I sometimes still feel depressed or anxious, but I am slowly getting better. I also take dance six times a week and play the piano and do lots of artsy things, which is a good outlet for me. |
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Does the state of your health impede in any way your everyday activities such as work, housework, studies and so on?
| Yes. I sometimes get distracted or put things off because I feel depressed, or I am so anxious about something that I begin to shake. |
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Does the state of your health impede in any way your social activities, such as inviting others to your residence, accepting invitations, going out with friends and so on?
| Often I lie to friends and tell them that I am busy when I am really too depressed or lethargic to go out, and I have trouble calling people and inviting them to hang out because I worry that they will not like me or something will happen that will make me even more depressed. |
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How would you classify your daily interactions with people in general? (Comfortable, neutral, awkward, unpleasant) Please describe in detail.
| I tend to read too much into what people act like around me. My interactions with others can be awkward for me because, say, if the person I am talking to rolls their eyes or sounds bored, I am automatically hurt and think there is something wrong with me. I have trouble taking jokes and I get jealous very easily, which bothers some people and makes it hard to have an active conversation with me without my getting hurt. |
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How do you envision your future?
| I hope to become a ballerina, concert pianist, or public relations worker (I take dance six times a week and I still take piano) someday. Otherwise, I'm not sure what my future will hold. |
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On the whole, I am satisfied with myself.
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At times I think I am no good at all.
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I feel that I have a number of good qualities.
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I am able to do things as well as most other people.
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I feel I do not have much to be proud of.
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I certainly feel useless at times.
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I feel that I'm a person of worth, at least on an equal plane with others.
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I wish I could have more respect for myself.
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All in all, I am inclined to feel that I am a failure.
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I take a positive attitude toward myself.
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I can always manage to solve difficult problems if I try hard enough.
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If someone opposes me, I can find the ways and means to get what I want.
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I am certain that I can accomplish my goals.
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I am confident that I could deal efficiently with unexpected events.
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Thanks to my resourcefulness, I can handle unforeseen situations.
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I can solve most problems if I invest the necessary effort.
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I can remain calm when facing difficulties because I can rely on my coping abilities.
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When I am confronted with a problem, I can find several solutions.
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If I am in trouble, I can think of a good solution.
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I can handle whatever comes my way.
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With my illness experience, I feel I am:
| More often tense | | More often uncomfortable | | Often in agony | | More often distraught | | Often discouraged | | Equally confident and unsure | | Equally capable and helpless | | Almost always uncertain |
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My relationships help me feel I am:
| More often worthless | | More often distressed | | Equally close and distant | | More often isolated | | Often excluded | | Equally supported and blamed | | Often accepted |
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Towards those who are emotionally close to me, I feel I am:
| Almost always forgiving | | Almost always welcoming | | Almost always accepting | | Often discouraging | | Often distrusting | | Equally understanding and misunderstanding | | More often respectful |
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Universal beliefs and principles or a divine presence help me feel I am:
| Almost always uninspired | | Almost always troubled | | Almost always judged | | Almost always aimless | | Almost always rejected | | Almost always out-of-step | | Almost always adrift |
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Towards universal beliefs and principles or a divine presence I feel I am:
| Almost always ignoring | | Equally receptive and closed | | Equally thankful and demanding | | Equally accepting and critical | | Equally approaching and receding | | Equally willing and resisting | | Equally connecting and separating |
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