Transcript of conference held at Dec 9, 2025 in room first_test@conference.miaiconvo.com Initial people present at 2:08:59 PM: Empress James Nick - Doctor Paul Hershberger Murad Nawaz - Patient Transcript, started at 2:08:59 PM: ________________________________________________________________________________ <2:08:59 PM> Murad Nawaz - Patient joined the conference <2:08:59 PM> Nick - Doctor joined the conference <2:08:59 PM> Paul Hershberger joined the conference <2:08:59 PM> Empress James joined the conference <2:09:00 PM> Murad Nawaz - Patient: a good seeing you to Dr de Rossi <2:09:02 PM> Nick - Doctor: all right <2:09:06 PM> Nick - Doctor: moron welcome back good seeing you again <2:09:12 PM> Nick - Doctor: so we started you on that antidepressant about six months ago and we had to up the dose a little bit how do you feel like it's helping you right now <2:09:19 PM> Murad Nawaz - Patient: I mean <2:09:26 PM> Murad Nawaz - Patient: I don't really know like <2:09:29 PM> Murad Nawaz - Patient: it's still pretty tough <2:09:32 PM> Murad Nawaz - Patient: trying to get out of bed in the morning <2:09:36 PM> Murad Nawaz - Patient: you know I I typically like to play like <2:09:39 PM> Murad Nawaz - Patient: Golf and Tennis like for my free time but <2:09:43 PM> Nick - Doctor: yeah here expand on that for me <2:09:44 PM> Murad Nawaz - Patient: to like help deal with stress and I think when my dose was upped originally I <2:09:52 PM> Murad Nawaz - Patient: it was starting to play a little bit more but then this <2:09:56 PM> Murad Nawaz - Patient: guess this new job application all this stuff going on <2:10:00 PM> Murad Nawaz - Patient: I don't know I feel like I've kind of back to square one <2:10:05 PM> Murad Nawaz - Patient: like you know <2:10:11 PM> Murad Nawaz - Patient: I just still feel like that you know my energy is still super low I <2:10:17 PM> Murad Nawaz - Patient: can't <2:10:19 PM> Murad Nawaz - Patient: is the way that I want to and then you know I want to do <2:10:24 PM> Murad Nawaz - Patient: know I want to take this big next step I guess in my career but <2:10:28 PM> Murad Nawaz - Patient: and I can't <2:10:30 PM> Murad Nawaz - Patient: do the things I need to do to get there and then I start thinking I can't do this and <2:10:37 PM> Murad Nawaz - Patient: I start doing it less and less and then I feel like I'm just kind of spiraling right now <2:10:42 PM> Nick - Doctor: he kind of feel like your energy is low your your focus is low <2:10:42 PM> Nick - Doctor: and <2:10:49 PM> Nick - Doctor: and with each passing day it kind of feels like a snowballing a little bit more does that sound about right <2:10:54 PM> Murad Nawaz - Patient: yeah and I I don't know how to get out of this so I don't know what I gotta do <2:10:55 PM> Nick - Doctor: I'm really sorry <2:11:04 PM> Nick - Doctor: hearing that you say that that breaks my heart to <2:11:08 PM> Nick - Doctor: you talking like that <2:11:11 PM> Nick - Doctor: is there anything that you're looking for to right now <2:11:15 PM> Nick - Doctor: up now <2:11:19 PM> Murad Nawaz - Patient: hi I'm <2:11:21 PM> Murad Nawaz - Patient: kind of hard to say kind of just <2:11:24 PM> Murad Nawaz - Patient: I don't know what's going to help right now <2:11:27 PM> Nick - Doctor: um <2:11:27 PM> Nick - Doctor: do <2:11:30 PM> Nick - Doctor: have any social groups that you're a part of you mentioned the Golf and Tennis but do you do anything else beyond that <2:11:37 PM> Murad Nawaz - Patient: here <2:11:39 PM> Nick - Doctor: or how many friends outside the <2:11:41 PM> Murad Nawaz - Patient: um I mean yeah but <2:11:45 PM> Murad Nawaz - Patient: three <2:11:45 PM> Murad Nawaz - Patient: I guess maybe especially over the last <2:11:49 PM> Murad Nawaz - Patient: months <2:11:50 PM> Murad Nawaz - Patient: and <2:11:50 PM> Murad Nawaz - Patient: I haven't really been talking to them as much <2:11:54 PM> Murad Nawaz - Patient: and <2:11:55 PM> Murad Nawaz - Patient: I don't I again I haven't been playing those sports like I normally would be <2:12:02 PM> Murad Nawaz - Patient: what I started to work out but then like I I don't know I just been kind of <2:12:08 PM> Murad Nawaz - Patient: just laying in my bed not <2:12:08 PM> Murad Nawaz - Patient: being <2:12:11 PM> Murad Nawaz - Patient: just <2:12:11 PM> Murad Nawaz - Patient: to do that and then now I see in the mirror like I don't look the way I want to and <2:12:17 PM> Murad Nawaz - Patient: me feel worse so then I'm like I'm gonna have to do even more work to <2:12:21 PM> Murad Nawaz - Patient: get in the shape that I wanted to so <2:12:23 PM> Nick - Doctor: yeah <2:12:26 PM> Murad Nawaz - Patient: I don't know <2:12:27 PM> Nick - Doctor: I can understand that how does it feel when you work out you mentioned that you work out a little bit and those little one-offs that you do go and exercise how do you feel afterwards <2:12:29 PM> Murad Nawaz - Patient: he <2:12:41 PM> Nick - Doctor: it's a struggle <2:12:42 PM> Murad Nawaz - Patient: it was a struggle <2:12:44 PM> Murad Nawaz - Patient: like the energy level wasn't there and then like <2:12:49 PM> Murad Nawaz - Patient: I don't know in the past it would help me feel better but <2:12:54 PM> Nick - Doctor: people yeah and what about playing golf and tennis <2:12:55 PM> Murad Nawaz - Patient: oh <2:12:57 PM> Murad Nawaz - Patient: right now <2:12:59 PM> Murad Nawaz - Patient: I feel the same <2:13:02 PM> Nick - Doctor: you feel like that's helping you at all <2:13:05 PM> Nick - Doctor: you know um again I'm really sorry that you're feeling this way <2:13:13 PM> Nick - Doctor: and I I hear you when you're saying that you're looking in the mirror you're not <2:13:18 PM> Nick - Doctor: but you're not feeling like yourself you don't want to be looking a certain way and I'm sorry that you're experiencing that <2:13:27 PM> Nick - Doctor: you mad mentioned the snowball earlier the spiral earlier <2:13:33 PM> Nick - Doctor: um <2:13:35 PM> Nick - Doctor: I want to talk a little bit about that but just kind of like in the opposite direction <2:13:41 PM> Nick - Doctor: he mentioned that you feel like every day you're you're feeling like you're going a little bit down <2:13:49 PM> Nick - Doctor: the good news is <2:13:52 PM> Nick - Doctor: have the capacity to change <2:13:54 PM> Nick - Doctor: and I I believe that if you just take a little bit every day <2:14:02 PM> Nick - Doctor: rather than try to focus on making a giant jump and getting better all at once <2:14:08 PM> Nick - Doctor: you can start to make some real Improvement in gain some of them <2:14:13 PM> Nick - Doctor: um <2:14:14 PM> Nick - Doctor: over <2:14:14 PM> Nick - Doctor: have you thought about possibly going and exercising more <2:14:19 PM> Nick - Doctor: next few weeks <2:14:22 PM> Nick - Doctor: yeah and I know it sounds kind of weird for me to just be like yeah go exercise more or go do this more when you have no motivation to do so however I'm trying to build some momentum in the opposite direction <2:14:39 PM> Nick - Doctor: you've had the pendulum swing in one way for so long and I'm trying to get it to go back another way just give it a little nose so we can start building some amount of the other way <2:14:43 PM> Murad Nawaz - Patient: okay <2:14:49 PM> Nick - Doctor: um <2:14:53 PM> Nick - Doctor: my recommendation is that we continue doing the medication <2:15:01 PM> Nick - Doctor: and that we also start doing everything a little just do one thing more an extra 15 minutes an extra half hour of something that you enjoy doing every day <2:15:13 PM> Nick - Doctor: um what's something that we can that you are like really passionate about right now <2:15:18 PM> Nick - Doctor: it's okay if you don't have an answer <2:15:23 PM> Murad Nawaz - Patient: um <2:15:26 PM> Murad Nawaz - Patient: yeah <2:15:26 PM> Nick - Doctor: you mentioned your job your job application <2:15:31 PM> Nick - Doctor: yeah um you don't have to fill out the whole application like today <2:15:38 PM> Nick - Doctor: about a little bit of momentum and just do a fraction of it every day <2:15:40 PM> Murad Nawaz - Patient: yeah <2:15:42 PM> Nick - Doctor: yourself a little momentum there <2:15:45 PM> Nick - Doctor: so I would recommend at least just going outside and just going and breathing the fresh air every 15 minutes or like 15 minutes every day <2:15:55 PM> Murad Nawaz - Patient: okay <2:15:57 PM> Nick - Doctor: um the reason I say this is like once you start doing that you're going to start feeling a little bit better is my hope <2:16:05 PM> Nick - Doctor: start developing that moment between that pendulum back <2:16:07 PM> Murad Nawaz - Patient: I think I remember before all this started like <2:16:14 PM> Murad Nawaz - Patient: I haven't thought about this in a while like I used to be really big on like checklists I guess like if I even if I had like three things I had to do like even for some reason I would overthink everything so <2:16:28 PM> Murad Nawaz - Patient: if I wrote it down I remembered that <2:16:31 PM> Murad Nawaz - Patient: like when I saw only three bullet points on a piece of paper like it became less I guess overwhelming <2:16:35 PM> Nick - Doctor: mmm <2:16:37 PM> Paul Hershberger: we'll stop here <2:16:38 PM> Murad Nawaz - Patient: so I can I think maybe I can try that again <2:16:42 PM> Nick - Doctor: and maybe you have three bullet points now and you try to do them and if you can't do them all that's okay if you get through one that's still you being capable and accomplished <2:16:42 PM> Nick - Doctor: you <2:16:53 PM> Murad Nawaz - Patient: okay <2:16:56 PM> Nick - Doctor: you've performed tasks that you've wanted to get done you've reached a goal that you wanted to complete <2:17:01 PM> Nick - Doctor: so even though you didn't get all three done maybe you do that's incredible but if you just do one or two every day out of the three or out of the five again you're building that momentum back in the other direction <2:17:13 PM> Nick - Doctor: yep ________________________________________________________________________________ End of transcript at Dec 9, 2025, 2:17:17 PM