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Currently 50% Mdd, C&p The Other Day...here's How It Went Down

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brokensoldier244th

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Doc was good, session took about an hour. Hit all the fine points and let me work off my list of notes and somewhat direct the conversation. I know that without the report yet, its difficult to say, but what are the thoughts based on this? Last C&P was almost 2 years ago. Does any of this warrant a possible increase from 50% to 70%? It looks like under the new DSM that my prior diag. of MDD actually could fall under MDD/W mixed features. Not sure if that matters now-can C&P doctors change a diagnosis that has been previously established?

Had my sit down with C&P MH the other day. Its been a year and a half since my last one-over that time ive increased meds twice (once from just counseling to meds, then a year later an increase to those), and between my wife and I compiled a list of things that are either newly evident or worse than they were when I was rated 50% for MDD.

Increases in work absences (14 in that prior year, 38 this last year in 11 months)
Actual write ups at work for client/co-worker demeanor and attitude-on 'improvement plan over next 6 months' if I don't improve Ill be terminated (IT/Support). Reduced duties, no travel, no unsupervised local client visits
-last job I had for 10 months before that, lost because of customer attitude/emotional anger outbursts (IT/Support)
-job before that and being rated at all I had for 5.5 yrs, but the last year and a half I had same issues as above and when company was sold I was not retained, same field.
Picking on nails/cuticles until bleeding-never did that before, now I do it constantly on my thumb and index fingers-noticed during exam as well.
She (wife) handles almost all the money now because my frequency of spending has increased to where we had to file 13 a year ago (just me)
weekend when she does not see me because I don't get out of bed
not showering/shaving 3 or more days a week in a row
increased withdrawal from family and friends-wife travels alone w/kids increasingly

Here is the current list of issues as discussed on Friday

- separate parts of the house

-comes home-whirlwind through common areas/LR/Kitchen-if unkept immediately starts cleaning. No asking about day, no “hi honey/hi kids, how was school”. Oldest daughter thinks he doesn’t care about anything about her. Youngest daughter scared of him when he gets angry.

-house damage-holes in wall from hitting, chairs. Broken glass stove top, requiring new stove

unkept yard/grass/trash-neighbor complaints. Vehicle maintenance not kept up, doesn’t remember oil, gas, tires. His car is a mess of wrappers/cups, etc-yet house has to be spotless?

- random yelling/throwing tantrums about little things like a small change in a plan, or something not being picked up. will be up at all hours of the night cleaning/sweeping/picking up things. Was pulling up carpet in daughters room-3 am WHILE they were sleeping in there.

-Does not go to mall, social get togethers with friends/family, opting to stay home. Has said more than once, increasing in the last few years that “if I just had an internet connection I would be happy” Will ‘zone out on internet for hours, with us in the room. Does not remember familiy dates/birthdays, phone numbers. Does not remember to take medication consistently-has internet reminders and sticky notes everywhere

-will spend literally all weekend in bed, even if I have to work

-Discussed SI for the first time, no plan, but I did relate starting the car in the garage one day to warm it up, and then falling asleep in the drivers seat with the car running, and that Ive had increasing thoughts in the last year since I have a job with benefits that life insurance isn't a bad thing-even though the better part of me knows that SI and Life insurance don't mix and it would probably be denied

-financial irregularities!!! bills not paid unless I do them, shut off notices at least once a month for something. Spends money on watches, mostly-constantly mailing watches out (selling) or buying them off internet.

-had to file BK last year to save house

-Dropped out of Masters program in compu/Sci/Security due to memory problems, late assignments/projects, missing meetings with advisor, and financial problems.

-consistency with employer-38 absences from Feb to Dec 2013. Performance Imp plan for work, have to clear any and all absences-even for PTO.

-loss of opportunity-cannot travel, inconsistent demeanor with clients, liability

-Co-workers don’t like him, don’t want to work with him, despite his knowledge of networking/products.

- Emotional inconsistency daily-on days he is 'on' he can almost be hyper, funny, over engaging. On days when he's down, he is reclusive, aloof, and surly.

-Last three jobs: Terrascan, 5+ years (2006-2011), but the last year was so inconsistent, and resulted in write ups for job performance, accuracy, customer demeanor, and eventual firing

-Xotic PC, as Service Manager (March 2011-Jan 2012) -was fired for cust demeanor, verbal clashes with boss/owner

-Stanley Healthcare (Feb 2013-Present) -has received negative writeups from customer (directly referencing him) as a negative influence. Inconsistency/accuracy with job duties-forgets online meetings, forgets client followups, cannot go to local repair/install jobs unsupervised. No promotability. Currently on 'performance improvement plan' for 6 months. If no improvement, looking at termination.

-Prior job record and BK is a liability for security clearance for work/HIPPA data/client servers. Inconsistency in relations with co-workers, and unpredictability/panic in unfamiliar situations has barred him for travel to other offices (Boston, Ottawa, Calif.)

-has used company credit card for personal purchases, groceries/gas due to his problems with spending family money-has had that card taken away.

Edited by brokensoldier244th
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Here are the notes that popped up on MyHealthVet from the questionnaire. He didn't note the fingerpicking/cuticles until bleeding, even though I was doing it at times during the interview. He also didn't note much about managing finances (said "Veteran capable of managing finances") , nor holes in walls at home, or my episodes of slamming brakes in traffic with family in car if DW tries to correct driving from the route I have in my head/appointed myself.

*shrug*

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Broken,

Sorry to say but based on this Exam, I would be surprised if the VA kept your depression at 50% and not lower it to 10-30%. Basically there isn't much bad to say on the Exam that he listed. Doc is stating that you can function in every aspect. I pray that the VA lets you keep the 50%, and not try to say that you are cured. God bless and good luck bud. Keep us posted

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Thanks for the opinion. My initial exam 2 years ago was 30% and only noted Depressed Mood as the symptom. The evidence of medication was added to it later and it was raised to 50%. The symptoms noted in this newest one has 5 more things noted that were not present before, and there are also things noted in my wife's letter of support that I noted in the exam that he did not type up. There are some things we discussed that did not make it into the notes here-perhaps there is a longer version of the questionairre? Violent outbursts at home and while driving (mentioned in exam happening weekly), Cleaning/rearranging incessantly, usually in the middle of the night when I can't sleep, picking on my fingers and feet until they bleed. All these were discussed and in some cases questioned further in our session, but did make it into the notes.

Im going to see my psych tomorrow to discuss, as well.

Edited by brokensoldier244th
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Employer filled out/faxed a 21-4192 at behest of VA, even though im still employed.

Here is what they wrote on my form before they sent it, " Lowered call volume, reduced client contact, tier 1 only calls (easy), no site visits, extended breaks" in the section labeled "If veteran is not working...." they continued "Lowered employee review, 6 month perform imrov plan enacted 1JAN". I also no longer travel for the company (since im only tier 1 calls) and have had hostility/cust perf evaluation issues where Ill score high on 'fixing' it, but very low on 'attitude, helpfulness, etc'. Reduced reliability, and 38 absenses last year also.

Ive talked about these issues with my MH person, and we've adjusted meds and we're going to start weekly counseling again, at least for awhile. My seretraline is going to be upped, and Im being put on Trazadone, also.

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