Transcript of conference held at Oct 13, 2025 in room first_test@conference.miaiconvo.com Initial people present at 2:52:30 PM: Angie - Patient Nik Shilo - Doctor Transcript, started at 2:52:30 PM: ________________________________________________________________________________ <2:52:30 PM> Angie - Patient joined the conference <2:52:30 PM> Nik Shilo - Doctor joined the conference <2:52:31 PM> Angie - Patient: here <2:52:31 PM> Nik Shilo - Doctor: hi Angie thanks for coming and following up with us seeing us again I just wanted to see how you're doing on that new antidepressant medication that we've been working on <2:52:45 PM> Angie - Patient: um yeah it's been going okay um <2:52:45 PM> Nik Shilo - Doctor: you're <2:52:49 PM> Angie - Patient: definitely feel like I'm sleeping a little better <2:52:52 PM> Angie - Patient: um I was having some trouble sleeping before but I I guess I just still don't feel like I've got much <2:53:00 PM> Angie - Patient: energy much desire to do anything I still feel kind of <2:53:04 PM> Angie - Patient: low or sad a lot I guess um because I just feel like life has been really stressful lately <2:53:07 PM> Nik Shilo - Doctor: mm-hmm Angie could I'm glad you're sleeping better you know I think that's the first step with your treatment could you give me in like another example or so like where this energy low energy is impacting your life <2:53:11 PM> Angie - Patient: pregnancy <2:53:14 PM> Angie - Patient: I think in the very <2:53:18 PM> Angie - Patient: here in <2:53:20 PM> Angie - Patient: for example but um yeah so I mean at work like it's just you know it's hard to focus it's hard to get projects done <2:53:33 PM> Nik Shilo - Doctor: mm-hmm <2:53:35 PM> Angie - Patient: I work in an insurance agency and like I just find like the policies are just piling up because it's just so hard to focus <2:53:43 PM> Angie - Patient: and I'm getting kind of worried that my job evaluation that's coming up is not going to go too well <2:53:51 PM> Angie - Patient: but yeah I I just I feel like it's really starting to stress me out at work <2:53:51 PM> Nik Shilo - Doctor: how <2:53:51 PM> Nik Shilo - Doctor: yeah that those draw evaluations can certainly be stressful time of year and you know we're going to work with you the best we can to get you through this and to you know a more stable mental health picture could you tell me <2:53:57 PM> Angie - Patient: here <2:54:13 PM> Angie - Patient: you just <2:54:14 PM> Nik Shilo - Doctor: what you know or what you think about the counseling and therapy aspect of your care <2:54:21 PM> Angie - Patient: yeah I mean I just I I feel like I don't really need to talk to somebody about my problems I guess I just want to feel better you know and honestly I've been so busy you know looking for another job in case I lose this one that I don't even know that I would have time to go to therapy <2:54:40 PM> Nik Shilo - Doctor: hey <2:54:43 PM> Angie - Patient: um my <2:54:45 PM> Angie - Patient: roommate just moved out and now I'm really stressed about money and rent and I know my co-pay is going to be like you know 75 dollars a session I just don't even know how I could afford that <2:54:58 PM> Nik Shilo - Doctor: the roommate the job that the expense you know those are certainly things to consider have you heard about any of the positives that may be Associated like therapy aspect of the total Mental Health Care picture <2:55:01 PM> Angie - Patient: here <2:55:06 PM> Angie - Patient: here <2:55:16 PM> Nik Shilo - Doctor: okay <2:55:16 PM> Angie - Patient: um <2:55:16 PM> Angie - Patient: yeah <2:55:18 PM> Angie - Patient: I mean I'm sure some people say it works for them I just don't really know how sitting around talking about my problems is really going to help <2:55:27 PM> Angie - Patient: good <2:55:29 PM> Nik Shilo - Doctor: um Well Angie from The Physician perspective we've gone up on your dosing on your anti-depressant several times now and you know I'm happy to continue working with you to optimize that medication but from a medical standpoint it's also important to you know start talking about the therapy side of things the counseling side of things as an adjunct to your ongoing medication titration <2:55:32 PM> Angie - Patient: if you <2:55:41 PM> Angie - Patient: I'm like that video here <2:55:58 PM> Nik Shilo - Doctor: them and from our perspective my perspective I think it's important that we start discussing ways that <2:55:59 PM> Angie - Patient: effective <2:56:04 PM> Angie - Patient: scary person working <2:56:06 PM> Nik Shilo - Doctor: despite these barriers you start to work into some therapy or some counseling let me ask you this <2:56:14 PM> Nik Shilo - Doctor: know you have a busy week <2:56:15 PM> Angie - Patient: your presentation <2:56:16 PM> Nik Shilo - Doctor: A busy life <2:56:18 PM> Nik Shilo - Doctor: if I asked you how much time do you think you could dedicate to like a therapy or counseling everything else removed the money the <2:56:23 PM> Angie - Patient: the <2:56:27 PM> Angie - Patient: how much time a week <2:56:27 PM> Nik Shilo - Doctor: stressors <2:56:28 PM> Nik Shilo - Doctor: yeah <2:56:32 PM> Angie - Patient: yeah I mean I realized it's you know the sessions may be only an hour and there's some local providers I know of <2:56:43 PM> Nik Shilo - Doctor: here <2:56:43 PM> Angie - Patient: all things aside like yeah I mean I could dedicate the hour to it I guess I just worry about the cost associated <2:56:51 PM> Angie - Patient: here <2:56:54 PM> Nik Shilo - Doctor: once again I just kind of want to reiterate that from from our perspective we can keep keep working on the medication but getting getting some therapy getting some counseling is kind of an important part of this process if you could give me a scale like zero to ten how ready do you think you are to add this as like part of your care <2:57:09 PM> Angie - Patient: here <2:57:13 PM> Angie - Patient: or like a bit nervous <2:57:18 PM> Nik Shilo - Doctor: mm-hmm <2:57:19 PM> Angie - Patient: um I mean honestly <2:57:23 PM> Angie - Patient: like a three or a four <2:57:25 PM> Angie - Patient: here you <2:57:26 PM> Nik Shilo - Doctor: and Angie why why you not more enthusiastic about adding it as part of your kind of the Care picture it sounds like you've a lot going on in your life that's stressful potentially this could be a good a good enriching outlet for you <2:57:39 PM> Angie - Patient: right <2:57:46 PM> Angie - Patient: um yeah I just I just don't know that it's gonna work for me I feel like there's so many things going on in my life that are like situational stressors that have me feeling down that <2:57:59 PM> Angie - Patient: I don't know that a therapist is going to be able to get me another roomy or solve my financial problems or you know fix the stress that I have at work and so I think maybe that worries me a little bit that I would dedicate some time and money to those things and I don't know that any of those other things would really change <2:58:05 PM> Nik Shilo - Doctor: it <2:58:12 PM> Nik Shilo - Doctor: mmm <2:58:12 PM> Nik Shilo - Doctor: I <2:58:18 PM> Angie - Patient: for you <2:58:21 PM> Nik Shilo - Doctor: can see that point of view <2:58:23 PM> Nik Shilo - Doctor: I guess my question to you then would be you said it's about like a three or four if these situational things are truly unable to be helped by any sort of therapy or counseling why not less than three or four <2:58:36 PM> Nik Shilo - Doctor: on your Readiness to try it <2:58:37 PM> Angie - Patient: you know <2:58:37 PM> Angie - Patient: yeah I think that <2:58:39 PM> Nik Shilo - Doctor: yeah <2:58:41 PM> Angie - Patient: I mean maybe talking to someone they could help me see maybe other avenues <2:58:45 PM> Angie - Patient: or other options and it might at least make me feel a little better to get motivated to do something about those other things <2:58:55 PM> Angie - Patient: so I could see how maybe it would be helpful to talk to someone from time to time um and maybe kind of get me out of <2:58:55 PM> Angie - Patient: a <2:59:04 PM> Angie - Patient: thinking pattern <2:59:05 PM> Angie - Patient: something that we're almost <2:59:06 PM> Nik Shilo - Doctor: if we stay on the path that we're on we don't try any therapy or counseling <2:59:11 PM> Angie - Patient: here <2:59:14 PM> Angie - Patient: importantly and they <2:59:14 PM> Nik Shilo - Doctor: keyboard on the medication what positives you see potentially coming out of that <2:59:20 PM> Angie - Patient: um yeah I mean I hope that I can continue to feel better I'd like to get back to having more energy where I feel like I could you know go to the gym and work out and I'd like to just like in general be like more pleasant to be around and maybe um you know that might help the situation with my roommate moving out if I <2:59:20 PM> Angie - Patient: kind <2:59:24 PM> Nik Shilo - Doctor: I think those are all wonderful things that you know potentially could happen if we just stay on the medication side of things what negative things do you think could happen if we never explore the therapy or counseling <2:59:43 PM> Angie - Patient: of was a little more pleasant to be around I I might be able to you know make a few more friends <2:59:48 PM> Angie - Patient: he <3:00:02 PM> Nik Shilo - Doctor: oh <3:00:03 PM> Angie - Patient: um <3:00:05 PM> Angie - Patient: yeah I mean I guess things would stay the same and I guess I would continue to <3:00:05 PM> Nik Shilo - Doctor: mm-hmm <3:00:14 PM> Angie - Patient: have trouble <3:00:16 PM> Angie - Patient: know at work <3:00:17 PM> Angie - Patient: I'm like kind of continue to just like feel kind of generally crummy <3:00:21 PM> Angie - Patient: okay I'm going to jump in and stop you there <3:00:22 PM> Nik Shilo - Doctor: okay <3:00:25 PM> Nik Shilo - Doctor: yeah <3:00:26 PM> Angie - Patient: okay ________________________________________________________________________________ End of transcript at Oct 13, 2025, 3:00:33 PM