Question: Official Dx: Bipolar 1, PTSD, SAD, Hepatitis A, Pre-Diabetic (A1c: 5.7), Hiatal Hernia (3cm), GERD, IBS, Delayed Phase Sleep Disorder
My Personal Mental Dx: Bipolar w/ Melancholic Features or “Soft Bipolar” (Proposed Bipolar IV), PTSD, SAD, Delayed Phase Sleep Disorder, GERD, IBS, No longer Pre-Diabetic, Hepatitis A
Past Dx: Mood Disorder NOS, PD NOS, Borderline Personality Disorder, MDD, Fatty Liver Disease, Multiple Ulcers, Multiple (Giardia, Protozoa, Amoeba), H. Pylori, Clostrium Difficile, Dengue, STDs, cPTSD (ICD-11), Chronis Fatigue Syndrome

Current Situation:
-     Current Symptoms
o     Anhedonia***
o     Cognitive Function on non-fasting days, fasting days improved cognition
o     Fatigue**
o     Cold Arms and Shoulders when waking up (even with pajama, no matter what)
o     Depression (especially in morning improving throughout day)
o     Memory issues (either low-dose valium or depression related)
-     Resolved Symptoms
o     Insomnia – Valdoxan
o     Early morning wake – Doxepin

Current Rx:
-     Omeprazole (40mg) – Hiatal Hernia, GERD
-     Valdoxan (50mg), Sleep Disorder & Anti-Depressent
-     Doxepin (25mg) - Sleep Maintence (Early morning wake)
-     Diazapem (2.5mg) – planned low use and taper
-     VSL-3 (450 Billion) – IBS, Anxiety
Past Rx (and things that work):
-     Alpropazam – for insomnia, works short term, benzo (on an off 2008-2015)
-     Aripipiprazole – Akithisia after 1 week (2013)
-     Buproprion – like strong coffee, partial anti-depressent response (2015)
-     Clonazapam – XXXXXXX answer to Diazapem – works similar (2015)
-     Diazapem – Used to taper off Benzos (2017)
-     Escitalopram – Did nothing (2012)
-     Fluoxetine – Together w Zyprexa, partial response, 2016
-     Gabapentin – 2015 – replace benzos, ineffective
-     Lamotrigine – Insomnia and no response (2017)
-     Lithium – Works well, 2013-2015, 2016-2019
-     Latuda – 2015, weight gain and akathisia at higher dose
-     Lorazapam – on and off for anxiety – 2012-2014
-     Mirtazapine – 2016 – too sedating, 2017-2018 – insomnia medication
-     Modafinil, - 2015 – works well to stay awake, insomnia
-     Nitrazapam – 2014 – emergency room use
-     Olanzapine – in combination with Prozac or separate, sleeps well, prediabetes issue
-     Paroxetine – 1996 use, no response
-     Quetiapine, - good for sleep, no anti-depressent response
-     Risperidone – good anti-manic response, month3+ akathisia and teeth griding (2018)
-     Sertaline – Increased anxiety and insomnia, stopped
-     Temezapam – Hospital use 2019
-     Topirimate – Good drug, makes you stupid, 2017
-     Triazolam – Insomnia 2011
-     Trazodone – Insomnia 2011-2013
-     Valdoxan – excellent response, fixes sleep phase, helps depression (2013, 2017, now)
-     Valproate – Overly sedating, possibly other drugs, couldn’t taper (2019)
-     Venlafaxine- No response, horrific withdrawal (2015)
-     Zolpidem – Adjunct to Benzo withdrawal first time (2012)
-     Ketamine – Excellent response, doctors discourage, 2016, 2018
-     Wake Therapy (insomnia due) – Due to insomnia from other medicine, often forced into wake therapy, extreme euphoria day after not sleeping
-     MRI machine – After pistol whipping, went for MRI, increased mood improvement after using machine sustained few hours
-     Ketogenic Diet – Helps significantly with depressive and manic symptoms
-     Bright Light Therapy – SAD treatment and euphoria inducing in Wake therapy
-     Fasting (like Keto) – anxiety disappears, energy reappears, able to function and feel happy when not consuming food