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Phonic
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17 Jan 2012, 6:29 am

I've done a lot of "soul searching" this week and frankly I'm totally lost about my diagnoses.

I've been trying to reconcile the fact that I have both a dx of Bipolar Disorder and Attentuated Psychotic Symptoms Syndrome (you wont find it in the DSM yet) AND a dx of AS which I believe to be inaccurate.


Now here's the sucky descision I've made: I don't have bipolar disorder or APSS or ASD, I have one thing that describes all of that: Schizoaffective Disorder.

The leap from a diagnoses of a "psychotic spectrum disorder" and bipolar disorder to a diagnoses which takes both into account isn't a huge one at all, the main quibble with my therapist will be over getting rid of my AS dx in favour of a schizophrenic spectrum disorder that explains my social issues in a far more accurate way - something I intend to begin on Thursday with her,

The main reason I'm doing this is for perhaps odd reasons: schizoaffective disorder is a far more legitimate and well known illness, a dx that will benefit me far more in economic areas than the very obscure "psychotic symptoms syndrome" - a catch all term for people experiencing psychosis in a mild form, though that's debatable. being schizoaffective will for one thing make it far easier for me to get illness benefits, it also has the advantage of rolling three diagnoses that are all "somewhat accurate" into one accurate diagnoses.

it's not that bipolar doesn't accurate describe me, I just think schizoaffective gives a better picture of what I went through and what I'm currently recovering from.

But it's early days still.

My question is how I should take over a year of psychiatric care and just say "No, you had it all wrong, it's much simpler than that"? Am I being silly?

I'm open to question about the disorders mentioned here.


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RarePegs
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17 Jan 2012, 8:38 am

I would strongly suggest that Asperger's Syndrome is your primary condition and that the stress of living with the traits of Asperger's in an unaccepting society has actually caused the onset of your other mental conditions. I believe that this happens on a very widespread basis and that there would be less mental illness around if society were more accepting of everything attributable to Asperger's in the first place.



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17 Jan 2012, 9:43 am

I think a schizoaffective diagnosis would help you to get the most help. I think that's a perfectly valid reason for pursuing it (and the fact that it's more accurate). I wouldn't feel bad about trying to get a different diagnosis (well, actually I would, but that would be silly of me).

Just a question, though: why do you feel AS is not an accurate diagnosis for you?


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17 Jan 2012, 10:09 am

This is the part that concerns me.

You are very intelligent, you have mental health problems per yourself and evidently your doctors. You are getting treatment. Which sounds, where you live, your country has, I dunno what you would call it, free universal health care plan? Meaning it is free, part of social services? I am guessing here.

Ah ha, I googled it, this is correct, assuming you live in Ireland, link here:

en.wikipedia

But, try to discern between, 'oh this will get me the most coverage/ care' and 'this is really what is going on with me and this will help me the most.

Otherwise you are playing a game with your personal long term health. And acting schizophrenic to get the preferred, better coverage health care is a dangerous game, I cannot even begin to imagine the many ways this could all go sideways for you.

What is your long term game plan? Where do you want to be in the next five years? Will this diagnosis help you get there or delay you, or, worst case, you end up taking psychotropic drugs, drugs that are completely wrong for you and might give you permanent tardive dyskinesia.

This is my intuitive take on your situation and I could be completely wrong but please consider this before you proceed any further.



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17 Jan 2012, 6:45 pm

I can see that you're like me - in that you're intelligent and do your own research from which you draw your own conclusions.

I think this is a good thing, but don't get carried away. Above all, it's VITAL that you have the correct diagnosis. It doesn't matter if one diagnosis makes things easier or simpler, even in the case of gaining benefits, than a combination of three. This goes triple fold when you get into diagnosing bipolar and schizophrenic illnesses due to the hard meds you'll have to go on to keep these conditions under control. You don't want to be put on the wrong meds, but you equally don't want to not be put on the right meds (I don't know about schizophrenia, but bipolar gets worse over time if it's not properly medicated - plus I know what going on the wrong meds can do to you if you're bipolar and the result is not pretty).

Your primary goal, first and foremost, should be to make certain your diagnosis is 100% correct.

I'm assuming you experience some hallucinations/delusions (explaining your third psychotic spectrum disorder diagnosis), but putting that aside and isolating bipolar and aspergers - which factors make you doubt the "fit" of these diagnoses?

I unfortunately don't have my DSM-IV on me, but as far as I can tell from a quick skim online, the dividing factor between bipolar and schizoaffective is how prominent and extreme the mood episodes are that you have experienced. If you have experienced manic or mixed episodes that would probably explain why the doctors had diagnosed you with bipolar as well as the more obscure psychotic spectrum disorder (perhaps you were a very clear bipolar case). Have you had a history of bipolar of people exhibiting bipolar like symptoms in your family or extended family?

Anyway, after reading this I do understand better why you would prefer the schizoaffective diagnosis. Is it necessary to have that diagnosis to get benefits? I wouldn't think so, as here the combination of AS and bipolar is more than enough. If it is necessary I would think surely the doctor could write that as an official diagnosis but continue to treat you as planned for them separately. Because although there is some overlap with meds, bipolar can be treated with milder meds than schizophrenic disorders, so maybe this is possible in your case if the psychosis isn't too bad.

Distinguishing whether or not you have Aspergers should be easier as it's on a different spectrum so there's less overlap. Personally, I am 100% confident I have both Aspergers and Bipolar.

Best way to do this, I believe, is to look back into your childhood. Once you're an adult, things can get a lot more messy and unclear (especially if you're a girl in my opinion) as in many cases you've developed various coping skills and don't present like you once did. Look at your non-mood related childhood symptoms and your symptoms today (again non-mood related).

Some things to consider:
- were you bullied as a child, and if you were, why?
- did you have problems with eye contact
- did you go on and on about things and irritate people?
- have you ever had any sort of sensory problems, in any modality (eg. I never had a problem with smell or taste, but sight and sound can occasionally be an issue. However, my especial sensory issues all come from touch. The feel of certain fabrics can make me so strongly nauseous I can dry reach, or feel like I'm about to throw up. Plus being held too long in the wrong way makes me feel like I'm suffocating and I can't breathe).
- do you find socializing exhausting and need to be by yourself to recharge? (this is irrespective of whether you enjoy it or not - cause some of us do and some don't)
- do you feel socially behind for your age, like say you're a 13 year old trapped in the body of a 21 year old and you're desperately trying to catch up but you don't understand the hidden social meanings of all this stuff going on around you? (I guess that one's more personal and less generalized but oh well, you get the idea).
- do you find it difficult to understand/pick up on vocal tone, body language, sarcasm directed towards you (you may or may not be good at being sarcastic YOURSELF).
- are you overly honest in everything you say and assume everyone else is towards you, thus making you easy to take advantage of. Are you gullible?
etc.

For more ideas, checking out the general discussion sub-forum can help.


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Angel_ryan
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19 Jan 2012, 12:09 am

I totally get where your coming from Phonic. I recently asked about getting my BP DX changed to Schizoaffective. The people working with me said essentially what RarePegs and sunshower wrote here. Even though I feel it might make things easier I have to agree that meds and treatment are a big issue. There is no questioning my autism diagnosis it's only really the BP that we can't figure out. The problem with me getting a schizoaffective DX instead would mean possibly dropping AS but then I'd have less access to a variety of treatments that my AS diagnosis provides. I do feel I highly benefit from them enough that I'm not going to pursue schizoaffective even if it suits me better in someways I can't risk closing doors I might need open in the future. Not everyone fits into a diagnosis perfectly that's what people keep saying to me anyway.


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Phonic
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23 Jan 2012, 8:41 am

RarePegs wrote:
I would strongly suggest that Asperger's Syndrome is your primary condition and that the stress of living with the traits of Asperger's in an unaccepting society has actually caused the onset of your other mental conditions.


I never stated why I do not have ASD, I don't think you've considered the possiblity that I have a very good reason to say I don't have ASD: I don't meet almost any of the criteria, and I didn't meet any of the criteria whatsoever as a child.


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Phonic
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23 Jan 2012, 8:56 am

puddingmouse wrote:
I think a schizoaffective diagnosis would help you to get the most help. I think that's a perfectly valid reason for pursuing it (and the fact that it's more accurate). I wouldn't feel bad about trying to get a different diagnosis (well, actually I would, but that would be silly of me).

Just a question, though: why do you feel AS is not an accurate diagnosis for you?


I meet no criteria, but if I met you you'd probably think I had something akin to it, but you'd be wrong and how wrong you are would be revealed by asking me "Why do you converse so oddly with people" to which a true autistic would reveal "I didn't realize" and to which I reveal "because I like messing with people" or "I felt like it".

Quote:
But, try to discern between, 'oh this will get me the most coverage/ care' and 'this is really what is going on with me and this will help me the most.

Otherwise you are playing a game with your personal long term health. And acting schizophrenic to get the preferred, better coverage health care is a dangerous game, I cannot even begin to imagine the many ways this could all go sideways for you.

What is your long term game plan? Where do you want to be in the next five years? Will this diagnosis help you get there or delay you, or, worst case, you end up taking psychotropic drugs, drugs that are completely wrong for you and might give you permanent tardive dyskinesia.

This is my intuitive take on your situation and I could be completely wrong but please consider this before you proceed any further.


I'm not malingering
This diagnoses probably isn't going to factor into my treatment much at all, that's not how my doctors behave, they don't pay close attention to ridgid dx, they just treat you on a symptom by symptom basis, even if it doesn't fit your dx


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Phonic
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23 Jan 2012, 9:27 am

sunshower wrote:
I can see that you're like me - in that you're intelligent and do your own research from which you draw your own conclusions.

I think this is a good thing, but don't get carried away. Above all, it's VITAL that you have the correct diagnosis. It doesn't matter if one diagnosis makes things easier or simpler, even in the case of gaining benefits, than a combination of three. This goes triple fold when you get into diagnosing bipolar and schizophrenic illnesses due to the hard meds you'll have to go on to keep these conditions under control. You don't want to be put on the wrong meds, but you equally don't want to not be put on the right meds (I don't know about schizophrenia, but bipolar gets worse over time if it's not properly medicated - plus I know what going on the wrong meds can do to you if you're bipolar and the result is not pretty).


Well then good news: I'm already on all the meds someone with schizoaffective would be given, anti psychotics and mood stablizers, and I've been on both for about 4 months (since my psychotic break basically).
This is why my doc says it isn't a big deal to have the right dx as long as you're being treated correctly, I disagree - I think I need clarity, when we talked about schizoaffective she said she'd keep looking into it and observing me

Your primary goal, first and foremost, should be to make certain your diagnosis is 100% correct.

Quote:
I'm assuming you experience some hallucinations/delusions (explaining your third psychotic spectrum disorder diagnosis), but putting that aside and isolating bipolar and aspergers - which factors make you doubt the "fit" of these diagnoses?


Aspergers? see my above posts, I was misdiagnosed and just went along with the dx because I didn't know enough to say otherwise, I was in such need of clarity as to what was happening to me that I latched onto AS and agreed with being diagnosed with it fully, I was wrong to, and even I knew it a little at the time.
For doubting Bipolar: well I meet all the symptoms of bipolar, it's the additional symptoms of schizophrenia that make it schizoaffective, bipolar just explains half of what's wrong with me.

Quote:
I unfortunately don't have my DSM-IV on me, but as far as I can tell from a quick skim online, the dividing factor between bipolar and schizoaffective is how prominent and extreme the mood episodes are that you have experienced. If you have experienced manic or mixed episodes that would probably explain why the doctors had diagnosed you with bipolar as well as the more obscure psychotic spectrum disorder (perhaps you were a very clear bipolar case). Have you had a history of bipolar of people exhibiting bipolar like symptoms in your family or extended family?


The bipolar came about a month before the onset of true psychotic symptoms (around august), and I was indeed a very obvious case. No one on my mothers side of the family have bipolar however I don't have any contact with my fathers side since we were never close, he's been dead for a couple of years now but I get the impression that he at least had Major Depression, so maybe I got it from my fathers side. In fact there is no major history of any mental illness on my mothers side, so thanks Dad :p

Quote:
Anyway, after reading this I do understand better why you would prefer the schizoaffective diagnosis. Is it necessary to have that diagnosis to get benefits? I wouldn't think so, as here the combination of AS and bipolar is more than enough. If it is necessary I would think surely the doctor could write that as an official diagnosis but continue to treat you as planned for them separately. Because although there is some overlap with meds, bipolar can be treated with milder meds than schizophrenic disorders, so maybe this is possible in your case if the psychosis isn't too bad.


There have been a lot of cutting back in the illness benefits in Ireland recently, AS alone certainly doesn't get you benefits, and my original attempt did mention Bipolar, but I don't think it was clear at the time - I was refused. Now my mother is helping me appeal the descision and my therapist and I are writing letters detailing psychosis, mania and co, I'm confident that I will get it this time.
I'm totally shocked that I wasn't given disability in the first place, but I don't think they realize/ed how bad things are or were for me, I'm in recovery now and I still can't leave my house alone.

Quote:
Best way to do this, I believe, is to look back into your childhood. Once you're an adult, things can get a lot more messy and unclear (especially if you're a girl in my opinion) as in many cases you've developed various coping skills and don't present like you once did. Look at your non-mood related childhood symptoms and your symptoms today (again non-mood related).


Alright, let's do these one by one.

Some things to consider:
- were you bullied as a child, and if you were, why? - Not often, if I was it was because I was intelligent and would say obviously nerdy things, and sometimes did eccentric things, but I was never ostracized.
- did you have problems with eye contact No.
- did you go on and on about things and irritate people? No more so then any child, I did yammer on but it wasn't pervasive.
- have you ever had any sort of sensory problems Yes, I am hypersensetive to sound and touch, it's one AS criteria I meet fully, and one that isn't even considered important in the DSM, though it should be.
- do you find socializing exhausting and need to be by yourself to recharge? (this is irrespective of whether you enjoy it or not - cause some of us do and some don't)
- do you feel socially behind for your age, like say you're a 13 year old trapped in the body of a 21 year old and you're desperately trying to catch up but you don't understand the hidden social meanings of all this stuff going on around you? (I guess that one's more personal and less generalized but oh well, you get the idea). No, I believe I am very socially astute, more so then most people, but people perceive me as someone socially backward, because I've made a conscious descision to be an eccentric, blunt, occasionally rude, always fascinating unique person, I have seen into their social conventions and said "no way dude"
- do you find it difficult to understand/pick up on vocal tone, body language, sarcasm directed towards you (you may or may not be good at being sarcastic YOURSELF). No
- are you overly honest in everything you say and assume everyone else is towards you, thus making you easy to take advantage of. Are you gullible? The reverse...I'm usually sort of sly and sharp, but I am honest, I'm usually the first to criticize someone that I deem to be receiving to much praise.
etc.

Thank you.


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sunshower
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23 Jan 2012, 6:19 pm

/^ Glad I could be helpful. Obviously I'm not qualified to make any diagnostic statements, but from what you said it doesn't sound like AS. Plus I've never heard of anyone with AS exhibiting no symptomology in childhood but suddenly developing symptomology in adulthood - that makes no sense as it's a developmental disorder.

I think you seem very clear in your head as to your correct diagnosis, and this is a good thing. I think in the end I've you've done the research often you end up being the one who was right all along, as obviously you know yourself and the inside of your head better than anyone (unless of course you are lying to yourself or incapacitated in some other way that impairs your judgment, eg. schizophrenia). With AS I actually read a whole book on it (when I was 12) and self diagnosed before being taken to a psychiatrist soon after by my parents who officially diagnosed me. At the start of this year, when I was really starting to lose it with the bipolar and I'd been desperately skimming the DSM and searching the net trying to figure out what was happening to me, my very first conclusion drawn was that I was bipolar - and even though after that i went through several different psychiatrists and had diagnoses of major depression (for the second time), anxiety, even chronically untreated ADHD (all of which were completely wrong in explaining what was happening, and dire in terms of me being prescribed the wrong meds), in the end I was, in fact, bipolar.

Some of what you said reminded me of a close friend of mine. She's definitely not AS, but she's eccentric (and I could see how some of her behaviours could be misconstrued as AS if she felt so inclined to present that way) and sees the world a little like that, plus she sort of mothers me and tries to explain dangerous people and manipulation games etc to me due to my naivety. In this sense we are almost polar opposites.

I sense from your responses you're feeling frustrated (generally speaking), are you happy with your current psychiatrist? I think it's important to be with someone who listens to you, like really listens, and values your opinion. I hope this is the case for you. Mine is really good in this area.


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23 Jan 2012, 6:31 pm

It really is starting to sound more like schizoaffective. I once dated a guy with schizo affective. I honestly thought he had AS before he told me. Getting an AS DX did feel really relieving to me. I can completely understand why you'd want a schizoaffective instead of BP. I'd change my BP to AS and schizoaffective for the same reasons but I was told the same meds are used and all that crap. Off the record I consider AS and SA my DX. I'm sticking to the BP on the record because it's a little easier to deal with. If you feel like schizoaffective is going to be more beneficial than go for it. So far personality wise I've noticed that I can hugely relate to people schizoaffective DXed than BP or AS depression wise at least. That's a huge deal for me, because I feel like less of a lonely unicorn and more like a horse in a comfortable uncrowded stable.
Image
I know this might not be right thread but I though this pic of Greyribbon goes well with my last statement


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Phonic
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24 Jan 2012, 9:42 am

Quote:
I sense from your responses you're feeling frustrated (generally speaking), are you happy with your current psychiatrist? I think it's important to be with someone who listens to you, like really listens, and values your opinion. I hope this is the case for you. Mine is really good in this area.


I suppose I'm happy with her, she never condescends to me and unlike previous psyches she actually appreciates and values how much I know about psychiatry and my conditions - but it frsutrates me how slowly she takes things, she's sdo cautious that it will probably be a couple of months before my dx changes, though everytime I meet her and nudge her in the right direction - I don't bring up schizoaffective but I do bring up me not having AS, and when I'm with her I turn on the ol' NT charm and become quite articulate, to affirm my lack of autisticness.

It's not that she doesn't value my opinions, she just doesn't consider diagnosis as important as I do because I'm already on the necessary meds (Respirdal and something akin to Lithium called Sodium Vaproate).

I am frustrated because everything is going so slow and my treatment and recovery right now consists of frsutratingly small baby steps - like me going to the local shops by myself or me reading 10 pages of a book everyday, mostly because my days tend to lack purpose and drive.

Thanks for reminding me of MLP angel, I'm behind.

What about this schizoaffective man made him seem AS?


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24 Jan 2012, 12:49 pm

Phonic wrote:
Quote:
I sense from your responses you're feeling frustrated (generally speaking), are you happy with your current psychiatrist? I think it's important to be with someone who listens to you, like really listens, and values your opinion. I hope this is the case for you. Mine is really good in this area.


I suppose I'm happy with her, she never condescends to me and unlike previous psyches she actually appreciates and values how much I know about psychiatry and my conditions - but it frsutrates me how slowly she takes things, she's sdo cautious that it will probably be a couple of months before my dx changes, though everytime I meet her and nudge her in the right direction - I don't bring up schizoaffective but I do bring up me not having AS, and when I'm with her I turn on the ol' NT charm and become quite articulate, to affirm my lack of autisticness.

It's not that she doesn't value my opinions, she just doesn't consider diagnosis as important as I do because I'm already on the necessary meds (Respirdal and something akin to Lithium called Sodium Vaproate).

I am frustrated because everything is going so slow and my treatment and recovery right now consists of frsutratingly small baby steps - like me going to the local shops by myself or me reading 10 pages of a book everyday, mostly because my days tend to lack purpose and drive.

Thanks for reminding me of MLP angel, I'm behind.

What about this schizoaffective man made him seem AS?


Thanks I was playing around in this thread the day I posted in yours. http://www.wrongplanet.net/postt180487.html <----- Pony creator thread (^_^) I spent 2hours making awesome ponies honestly though the one I posted is the best one out of all the combinations I did. I also noticed that pinky pie has the ability to cheer me up a little. These videos are why I love ponies
http://www.youtube.com/watch?v=bQ0JahhFkts
http://www.youtube.com/watch?v=tJLL-DNu ... re=related

I can relate to the slow treatment process it's painstaking. I took a break from meds and it didn't go as well as planned. I genuinely don't want to take them. I'm more devastated by the negative symptoms and I've been really impaired in my ability to do everyday things. I haven't been eating properly or motivated to get out of bed. The only thing I'm motivated to do is go to work, but I had to cut down my hours to manage it. I'm extremely frustrated with the baby steps people who are working with me have been taking as well. I finally have an appointment a week and a half from now but I have no idea if I'm going to get anywhere with it anytime soon. I was wondering if your meds are working out ok. Do you find a mood stabilizer like Sodium Vaproate better than being on an SSRI?

My friend with schizo affective in childhood was DXed with AS eventually it was changed to childhood schizophrenia. He genuinely has grown up with schizophrenia but questions ever having AS. He said it was completely wrong. I noticed though while I was with him that he had very strong special interests he was very passionate about through out his life. He also had Learning disabilities in childhood. He did meet some of the AS criteria but his argument is that childhood schizophrenia can look like autism. When I was a kid I fit criteria seen in all three of these AS, HFA, and BP. It's even possible that my friend and I both have different forms of MCDD. The difference symptoms wise is that I have extreme negative symptoms with less extreme positive and even insight into when I'm experiencing positive. He has less severe negative and can have extreme positive where he can lose insight and even memories. Another difference is that he is extremely high functioning on his meds. You wouldn't even know he had schizophrenia. I noticed that neuroleptics actually make my autism symptoms less manageable. So I feel there's almost no point in taking them. Since positive symptoms have never been as big a deal as the depression that's coupled with it. I'm going to focus more on the negative in the hopes that the positive will have less occurrence with the negative being the focus. I noticed when I haven't been depressed for a long period of time there's way less occurrence of paranoia or bad hypomania.


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Phonic
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25 Jan 2012, 6:05 am

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I was wondering if your meds are working out ok. Do you find a mood stabilizer like Sodium Vaproate better than being on an SSRI?


I have not noticed any effects from either of them.

That's about all I have to say about it.

Here's my pony, she looks kinda like Luna. http://www.flickr.com/photos/75152896@N04/6759607119/


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25 Jan 2012, 9:45 am

Phonic wrote:
Quote:
I was wondering if your meds are working out ok. Do you find a mood stabilizer like Sodium Vaproate better than being on an SSRI?


I have not noticed any effects from either of them.

That's about all I have to say about it.

Here's my pony, she looks kinda like Luna. http://www.flickr.com/photos/75152896@N04/6759607119/


That sucks I heard it takes time, but if it ends up not doing anything good then that's a huge waste of time. People don't realize all that wasted time can cut into your life and even make it more difficult to deal.
It's already been 2 years and I still haven't managed to go to college or find the right meds. I feel way behind where I wanted to be in life.
Anyway your pony is really cute, best of luck with the DX which ever direction you plan on taking it.


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