Transcript of conference held at Jun 10, 2025 in room first_test@conference.miaiconvo.com Initial people present at 5:08:47 PM: Lillian Nguyen - Doctor Paul Hershberger Angie Castle - Patient Transcript, started at 5:08:47 PM: ________________________________________________________________________________ <5:08:47 PM> Angie Castle - Patient joined the conference <5:08:47 PM> Paul Hershberger joined the conference <5:08:47 PM> Lillian Nguyen - Doctor joined the conference <5:08:48 PM> Angie Castle - Patient: hi I'm doing okay <5:08:48 PM> Lillian Nguyen - Doctor: okay <5:09:01 PM> Lillian Nguyen - Doctor: hello Angie how are you doing today <5:09:05 PM> Lillian Nguyen - Doctor: yeah it's good to have you back saw you three months ago I saw you we had increased your dose of your antidepressants how has that been going <5:09:07 PM> Angie Castle - Patient: here <5:09:13 PM> Angie Castle - Patient: um it's been going okay I I definitely feel like the medication is helping but just not as much as I'd like <5:09:18 PM> Lillian Nguyen - Doctor: okay and what ways do you feel like it's not helping enough <5:09:26 PM> Angie Castle - Patient: yeah um I'm still struggling to sleep at night I feel like you know my mind is racing with all the worries I have from the day and <5:09:30 PM> Lillian Nguyen - Doctor: yeah <5:09:38 PM> Angie Castle - Patient: um you know it's just been kind of difficult to sleep at night and then because I'm not getting good quality sleep I feel like I'm tired at work the next day and not able to focus <5:09:50 PM> Angie Castle - Patient: um so work has been a little difficult <5:09:51 PM> Lillian Nguyen - Doctor: okay I heard a little bit that you had some life stressors coming up how are you planning on like approaching those <5:09:53 PM> Angie Castle - Patient: yeah yeah I don't know because I have a <5:10:04 PM> Lillian Nguyen - Doctor: shoes <5:10:05 PM> Lillian Nguyen - Doctor: yeah <5:10:08 PM> Angie Castle - Patient: been doing too well at work I have a job evaluation coming up and I'm worried that like my boss is going to put me on like a performance Improvement plan or something which I mean is like a Surefire way to know that you're going to get fired in the next couple months and then yeah my roommate moved out which has been really Troublesome because I just can afford rent by myself <5:10:26 PM> Lillian Nguyen - Doctor: yeah they sound like super stressful events happening <5:10:35 PM> Angie Castle - Patient: yeah <5:10:40 PM> Lillian Nguyen - Doctor: in terms of your mental health how do you feel are you feel ready to go through that <5:10:46 PM> Lillian Nguyen - Doctor: how are you dealing with that <5:10:48 PM> Angie Castle - Patient: yeah I mean it's been difficult I just feel like I'm stressed and worried all the time I don't feel like <5:10:48 PM> Lillian Nguyen - Doctor: here <5:10:55 PM> Angie Castle - Patient: I am coping with it at all you know <5:10:55 PM> Angie Castle - Patient: either <5:11:00 PM> Angie Castle - Patient: looking for a roommate or you know trying to go over my finances seeing how I could cover rent I just I absolutely can't lose my job right now <5:11:08 PM> Lillian Nguyen - Doctor: you can see that's hard I'm sorry you're going through that and we're going to try and figure out you know you're talking about some sleep issues and I know we increase your dose last time but we also gave a referral for mental health counseling have you been able to go <5:11:28 PM> Angie Castle - Patient: know I I haven't <5:11:29 PM> Lillian Nguyen - Doctor: okay um is there any reason <5:11:31 PM> Angie Castle - Patient: yeah I'm I mean I'm a little worried about the co-pay I'm not sure that my insurance is going to cover being able to go to <5:11:34 PM> Lillian Nguyen - Doctor: one <5:11:44 PM> Lillian Nguyen - Doctor: you feel like it's kind of been on the back burner <5:11:46 PM> Angie Castle - Patient: counseling and you know I'm just absolutely stressed all evening long feeling like I've either got to find another job or find a roommate and so I just haven't felt like I've had time to go <5:11:59 PM> Angie Castle - Patient: yeah I just don't feel like it's been <5:11:59 PM> Angie Castle - Patient: I just <5:12:03 PM> Lillian Nguyen - Doctor: okay <5:12:06 PM> Angie Castle - Patient: feel like it's going to solve many of my problems <5:12:09 PM> Angie Castle - Patient: yeah I mean it's it's not that I don't think it would be helpful it's just more like <5:12:10 PM> Lillian Nguyen - Doctor: in terms of like if we could figure out a copay to how to help you if that with a social worker would you be willing to go to mental health counseling then <5:12:20 PM> Lillian Nguyen - Doctor: here <5:12:28 PM> Lillian Nguyen - Doctor: yeah um you talked about the job evaluation coming up <5:12:29 PM> Angie Castle - Patient: I just have these other things that are more important to kind of address right now <5:12:34 PM> Angie Castle - Patient: it's next week <5:12:38 PM> Lillian Nguyen - Doctor: when is that <5:12:40 PM> Lillian Nguyen - Doctor: next week okay and then <5:12:46 PM> Lillian Nguyen - Doctor: or how you're getting ready for that if you do have to Pivot in terms of jobs have you been thinking about that <5:12:54 PM> Angie Castle - Patient: yeah I've been kind of looking around to potentially maybe find another job I don't know <5:12:55 PM> Lillian Nguyen - Doctor: yeah okay what's your job right now <5:13:00 PM> Angie Castle - Patient: um yeah I work at a insurance company and I like process you know like homeowners insurance <5:13:04 PM> Lillian Nguyen - Doctor: mm-hmm yeah I think yeah that'd be a lot <5:13:15 PM> Lillian Nguyen - Doctor: um and like sometimes these things like sleep having anxious thoughts at night you know pushing into your day and causing you to be tired at work he said it's going to affect your work sometimes you know helping to address the root issue of you know sleep like sleepless nights can help so that this doesn't happen to you again <5:13:35 PM> Angie Castle - Patient: yeah <5:13:40 PM> Angie Castle - Patient: yeah I was hoping maybe like I don't know if going up on my medication would help <5:13:42 PM> Lillian Nguyen - Doctor: okay <5:13:46 PM> Angie Castle - Patient: I don't know if there was like something I could take for sleep <5:13:48 PM> Lillian Nguyen - Doctor: mm-hmm yeah what were you looking into <5:13:49 PM> Angie Castle - Patient: I'm not sure I just thought maybe if I could sleep a little better I didn't know if like an increased dose would help me sleep take away those anxious thoughts at night or <5:14:02 PM> Lillian Nguyen - Doctor: yeah have you tried anything for it <5:14:04 PM> Angie Castle - Patient: there was something else that I could take for sleep that might help me you know perform a little better at work <5:14:10 PM> Angie Castle - Patient: oh no I have not <5:14:12 PM> Lillian Nguyen - Doctor: okay what are you thinking about at night when you're <5:14:17 PM> Lillian Nguyen - Doctor: the anxious thoughts <5:14:19 PM> Angie Castle - Patient: yeah just you know how this meeting with my boss is going to go and you know what if I get another roommate and they're not very friendly you know does that make me not even feel comfortable in my own apartment <5:14:19 PM> Lillian Nguyen - Doctor: mmm <5:14:36 PM> Lillian Nguyen - Doctor: how long have you had the issues leaving <5:14:36 PM> Angie Castle - Patient: yeah just everything like they're just seems to be a lot of change going on <5:14:40 PM> Angie Castle - Patient: um yeah for I would say maybe six or so months <5:14:44 PM> Lillian Nguyen - Doctor: okay as it always been associated with these stressors <5:14:48 PM> Angie Castle - Patient: um no not necessarily but when stressors do increase I do feel like I tend to sleep more poorly <5:14:52 PM> Lillian Nguyen - Doctor: okay <5:14:52 PM> Lillian Nguyen - Doctor: do you <5:15:01 PM> Angie Castle - Patient: um no I typically just scroll on my phone at night until I'm tired enough to fall asleep <5:15:02 PM> Lillian Nguyen - Doctor: have any coping mechanisms for that <5:15:05 PM> Lillian Nguyen - Doctor: okay yeah you know figuring out like anxiety or racing thoughts at night can help with getting better sleep we could think about taking something like trying like a melatonin or something to help you kind of get drowsy to get there <5:15:31 PM> Lillian Nguyen - Doctor: uh talking about sleep do you have any issues with waking up and then I <5:15:33 PM> Angie Castle - Patient: um yeah I I do frequently wake up and then I <5:15:36 PM> Lillian Nguyen - Doctor: okay so when you're waking up is it hard to fall back asleep again <5:15:40 PM> Angie Castle - Patient: um yeah sometimes sometimes like if I feel like I'm having a bad dream or something like it's hard to get back to sleep <5:15:47 PM> Lillian Nguyen - Doctor: okay <5:15:48 PM> Paul Hershberger: I'm going to stop you here ________________________________________________________________________________ End of transcript at Jun 10, 2025, 5:16:02 PM