Transcript of 24th Session between Charles Balis, M.D. and Mr. Alex Rozzi, Wednesday, November 19, 1997 at 5:00 pm.

Mr. Rozzi: Hey, Doc.
Dr. Balis: Hello, Alex. I see you're feeling better this week.
Mr. Rozzi: I get some rest, but as for "feeling better"...
Dr. Balis: Well, how are you doing?
Mr. Rozzi: My legs are better than last time I saw you, but I'm still kind of freaked about Ralph I guess. He's doing so much better now than in the past few weeks, and he's looking much better, too. It's's...uh, I don't know. I mean I am so over this, you know? And that stuff you wanted me to read up on--about depression? Well, that was something in itself, I'm telling you! Do you realize how much has been written on the subject? The least you could've done was give me a title or two. That would've saved me a lot of trouble, you know?
Dr. Balis: I'm sorry you had so much trouble, Alex. What have you discovered?
Mr. Rozzi: There's a lot of stuff written about it. That it's considered a chemical imbalance in the brain, and it affects a whole lot of people in this country. I found this book called "Overcoming Depression" or something like that. It lists the symptoms of different forms of depression and the treatments. It gets into some detail about the recommended treatments, including medications. The one thing that stuck out for me was the description of a depressed or irritable mood lasting most of the day. Well, I don't usually feel sad, but irritable I definitely feel. Actually, I feel irritable most of the time lately, except last weekend with Luke, but that's another story. I feel irritable, cranky, and just feel not nice mostly. And the psychomotor agitation--that's me, too. But the other things don't fit really.
Dr. Balis: You failed to mention your insomnia. That's another frequent symptom of depression, too. Now, what other symptoms that you've read about that you don't think fit you?
Mr. Rozzi: Insomnia? Yeah, that too. But the thing that struck me most was the description for manic depression. Now I know my mom is manic, that's for sure. And I think back to my...uh, my father. I mean, never mind! You know what I mean. He was too, I think. I'm pretty certain that he was manic. And some of those symptoms fit me, too.
Dr. Balis: Which ones in particular?
Mr. Rozzi: Inflated grandiosity.
Dr. Balis: Hmm. Tell me about it.
Mr. Rozzi: But I've told you about it, maybe you just didn't catch it before. Sometimes when I climb up into the girders under that bridge, I feel like I'm high, like maybe I could fly, if I wanted to. That's somewhat grandiose, don't you think?
Dr. Balis: Hmm...okay. Tell me the other symptoms you think fit you.
Mr. Rozzi: Definitely the need for less sleep--I can go two or three days without even laying down sometimes. And sometimes, it's genuine insomnia, I think. I try going to sleep, but just toss and turn. I guess that's insomnia. Then, I'm easily distracted, and I tend to chatter on sometimes. But the biggest thing is the constant running thoughts that go on and on. Often, I feel like ideas are speeding through my mind so fast that my brain is going to explode. So many ideas that there isn't enough time to even attempt to begin to act upon them. So then, I get paralyzed by my thoughts.
Dr. Balis: You did your homework, Alex. I'm very impressed. Those are interesting symptoms that we should explore further. And I do believe that you have some of the classic symptoms of depression. Now, maybe we can talk about treatment. But before we do, I'd like to veer off onto a different but related subject. How have you been sleeping this past week?
Mr. Rozzi: I broke down and used the medication that night--the night I saw you. But I didn't need it at all after that. Wednesday night, I took it and went to bed around seven-forty-five, I think. And I slept until around eight the next morning. I didn't feel drugged, and that made me feel better. But I didn't go back to school for the rest of the week. The weird part was--and I wasn't sure if I dreamed it or not, but I think it was real--I woke up sometime that night and found Ralph asleep in the chair that sits facing my bed. It was kind of a blur but there he was, sitting in the chair with a book in his lap, sound asleep.
Dr. Balis: Did you ask him about it?
Mr. Rozzi: Yeah, but he denied it. I still think I saw him there, though, it's just that it was in a haze. He won't say so, but he is worried more about me than he is about himself--I can tell by the way he's acting. But Thursday night, I went to bed about nine-thirty and slept through until eight again. Anyway, Friday night, I went with Luke down to Carmel for the weekend, and we stayed at his father's house on the beach. Oh, man! It is so beautiful down there. And Luke drives a convertible. I insisted that we drive all the way with the top down. We ended up having the top down, and the heater on most of the way, but it was great. We got a little rained on, too, but that was fun. I slept every night and felt like it was all a dream or something. My sleep, especially in Carmel, was real deep and rejuvenating. I felt so rested when I awoke.
Dr. Balis: I'm glad. And have you been getting plenty of rest since?
Mr. Rozzi: Yeah, I guess I have. When we were down in Carmel at his dad's house, I didn't want to leave. He has a big old stone house on some bluffs on the shore, and the waves were coming up real high and crashing down real loud. That sort of lulled me to sleep. The rain helped, too. But since we came back, I've been totally on the edge again, and I hate it.
Dr. Balis: What are you on the edge about?
Mr. Rozzi: First, there's Ralph. I don't need to go back into that just now, I think you know what I mean. Then, I have this new and great guy in my life, and I'm so not ready for a relationship, but it seems to be going that way anyway. But while everything is looking so good, Monday night, I noticed this smell of smoke. It seemed to be coming from outside the kitchen, in back by the tenant's door. Ralph has this...this...uh, person who rents the little in-law unit in back by the garage. So I go to investigate, and guess what I found? That idiot was passed out on the floor, and a small fire had started in his garbage can. I had to put it out! It really pissed me off, and then it scared me, too. I'm not willing to be his personal fireman, you know? He's going to burn the whole place down or something. It really worried me. I mean what's next, you know?
Dr. Balis: What was wrong with him? What made him pass out?
Mr. Rozzi: Well, he's only the stupidest person who ever walked the planet, you know? He gets all tanked-up--totally blotto--each and every night. I told Ralph that that's not just the alcohol, it's got to be something else. But I don't want Ralph to get upset right now, he's still trying to get better and now this. The guy is so out of control. He's a damned drunk. And I think he pops pills and then washes them down with the booze. We've got to get rid of him, but Ralph just wants to make nice and keep the guy. But I don't trust him at all. There's just something not right about him, and I'm usually right about these things.
Dr. Balis: It's a good thing you were there to put out the fire. Alex, you had a lot of stressful events happen to you in the last several months, and as the result you're experiencing sleeping problems. I think it might be a good idea to take a sleeping pill or melotonin before bed--whichever works best for you--all next week. After you had a whole week of good night sleep, we could assess the state of your other symptoms. How does that sound?
Mr. Rozzi: You're the boss, I guess. It makes sense what you're saying. And so far this week, I feel a lot less stress. I attribute that to my nice weekend with Luke. We finally did it, too.
Dr. Balis: You did?
Mr. Rozzi: We did. And it was great! I loved it. Sometimes, I wonder why I waited so long, you know? He's real nice to me. And he's my age, and that's a big plus, you know? He's so good looking, and he seems to have his shit together. He knows what he wants to do with his life and stuff. But...
Dr. Balis: But what?
Mr. Rozzi: But I'm still irritable and cranky most of the time anyway. I worry about when the bottom is going to drop out from under me--I mean as far as Luke is concerned--and I still wake up with a song running on and on in my head.
Dr. Balis: Well, let's see what this next week of rest will do for you. And take your time with things, allow yourself to feel whatever it is that you're feeling, think things through. Luke seems to be a positive influence on you, too. Alex, try to see the positive things that are happening to you right now.
Mr. Rozzi: I do try to see the good stuff. There is a lot of it right now, at least where Luke is concerned. And I haven't been fighting with anyone lately either, that's got to count for something. Oh, no! I probably shouldn't have said that. I hope I didn't just jinx myself.
Dr. Balis: I'm sure you didn't. And, Alex, I'm proud of you for taking the initiative and doing the research you've done on depression. It should prove invaluable to us both.
Mr. Rozzi: Yeah, yeah. That's just because it makes your job easier, I know.
Dr. Balis: The more educated and informed you are, the better are the results of the therapy. We're out of time, Alex. I'll see you next week.
Mr. Rozzi: Yeah, later.
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