BLOG No. TWENTY ONE

Welcome back to my blog on anxiety and depression, blog 21. We have talked of the glutamic theory and how it is a much better description of neurochemistry issues than the old monoamine theory. You will remember that this describes the balance between GABA (relaxer) and glutamate (exciter). When unbalanced, D2 dopamine rises, it causes the brain to race, rage, and react negatively.

So, I thought I would discuss a few more interesting cases with my audience, to highlight the various faces of unbalanced neurochemistry. And please remember, the studies do not highlight anyone who I would consider crazy. There are no crazy people! There are only people with unbalanced neurotransmitters.

The next case I want to discuss regards Samantha (not her true name), a young lady who takes phone orders at a well known women’s retailer. She got used to the regular kooky calls from men, pretending to order for wives or girlfriends. She would laugh as she regaled me with stories of men ordering lingerie and then adding, what would you look like in this outfit? Click. She would roll her eyes and then just roll with the punches.

But Samantha was bipolar, type one. But with medication, she excelled at her job, focusing on her orders and payments. One day when she came in to get her medicine refilled, her face didn’t radiate as it usually did. Something was amiss.

When I queried her, she told me of a male voice that was in her head. “What does the voice say?” I asked. She replied that the voice was gruff and told her that she wasn’t pretty and that she was a bad employee.

“Oh my,” I replied. She went on to say that this voice was not like the other voices.

“Other voices?” I asked. “What other voices?” I was shocked that she had never confided this info to me.

“The girls,” she replied.

“Girls?”

“Yeah, the three girls. They tell me that I am pretty and a nice person.”

“And just how long, ehem, have the girls’ voices been there?”

“They have always been there.”

“And you never mentioned this before because…”

“They are sweet. They say sweet things.” I sat back in my chair and retreated a little bit to catch my thoughts. Previously diagnosed bipolar type one, she had drifted to the right into schizoaffective disorder. That is a bipolar patient that hears voices. My D2 dopamine medication was not strong enough. I raised the dose and called her a few days later.

“The male voice is gone,” she said. “Thank you.”

“And the female voices?”

“They are still there. But I like them. Can they stay?” My cerebrum did a triple lutz.

“Yeah, as long as they are nice. But let me know if…”

“I will,” she said. And the three girls lived in her head and her employer continue to praise her for her exemplary work.

Well, I guess it’s time to say goodbye as I noticed my Chardonnay has frozen solid. Wow, Ohio weather sure can be unpredictable! Until next time this is Dr. G saying, keep the faith!