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?
| Yes Office Manger for a very small company. Just started 6/1/05 |
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Were you employed previously? If yes, when and where?
| yes In seattle-got laid off 4/28/05 |
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What conditions have you been diagnosed with? When? Where?
| BiPolar 1 with rapid cycling-PSTD-Anxiety-Insomnia-Fibromyalgia. With Psychiatrist and Rumatologist in February 2000 |
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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?
| I have done alot of research online and reading books and from my Psychiatrist. I have learned how to tell when I am going Manic and what to do and when I am going into deep depression and know what to do and If I get suicidal I call my Psychiatrist or a friend. |
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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 drank alot and was very depressed alot, but when I got Manic I was happy and verry uninhibited and was out of control. During-I was afraid to go to a Psychiatrist because I didn;t want her to think I was crazy. After going to see my Psychiatrist, we tried many different meds. SSRI's cause me to go manic and have tremors. Depakote made my hair fall out. I saw her every 2 weeks at 1st. When I was stable it was only once a month. |
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Please describe how you cope with your condition(s), if at all, and the effectiveness of each strategy?
| I get into a very deep depression and I don;t want to go to work. I call in and say I have pneumonia or something that is really bad. I stay in bed for days at a time, but that only happens a few times a year. When I know I am going down, I up my anti-depressant or my mood stabilizer according to my Dr's instructions. When I am going manic, well if I am hypomanic I kind of enjoy it. But can't let it get in to mania. I have my sister and mom and a friend to talk too. |
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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 it does sometimes, I do not keep my house clean. I have a phobia of taking out my trash. I think everyone is watching me and that I have too much trash. At work soemtimes I get manic and talk real fast and do a thousand things at once, then all of a sudden I am hiding in my office with tears, because I am so sad. |
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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?
| I don't let anyone in my house because it is sooo dirty, I stay alone alot, I get anxiety attacks when I have to leave my house except to go to work. I never go out, I really don;t have any friends to hang out with. |
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How would you classify your daily interactions with people in general? (Comfortable, neutral, awkward, unpleasant) Please describe in detail.
| I have to be pleasant but I have to watch myself because I get into a mood where people just bother me, and I don't want to be bothered with them. I am good at putting on my happy face when inside I am aggitated and nervous and scared. |
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How do you envision your future?
| I wish I knew. Right now at this moment I don't envision any future except going to work, coming home, being alone, sleeping alone and then waking up and going to work again. I dread coming into my house because I can't stand the mess, but it is too overwhelming to me, I don;t know even where to start because I have too much trash and afraid to take it out. I have Osteoarthritis in left hip and can't lift my right leg up because of some torn muscle. I have to use a sstrap to pull my leg into the car and onto the bed. So I don't even want to be in the future. I still don;t know why or how people even want to live. There is nothing for me to live for except for my dog. |
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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 | | Almost always in agony | | More often distraught | | More often discouraged | | More often unsure | | More often helpless | | Often uncertain |
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My relationships help me feel I am:
| More often worthless | | More often distressed | | Almost always distant | | Almost always isolated | | More often excluded | | Often blamed | | More often criticized |
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Towards those who are emotionally close to me, I feel I am:
| Equally forgiving and resentful | | More often unreceptive | | Often rejecting | | Often discouraging | | More often distrusting | | Often misunderstanding | | Equally respectful and disrespectful |
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Universal beliefs and principles or a divine presence help me feel I am:
| Often uninspired | | More often troubled | | More often judged | | More often aimless | | More often rejected | | More often out-of-step | | Almost always adrift |
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Towards universal beliefs and principles or a divine presence I feel I am:
| Equally listening and ignoring | | More often closed | | Often demanding | | More often critical | | More often receding | | More often resisting | | More often separating |
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